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Imamura S, Oda Y, Fukumoto T, Mizuno M, Suzuki M, Washio K, Nishigori C, Fukunaga A. Solar urticaria: clinical characteristics, treatment effectiveness, long-term prognosis, and QOL status in 29 patients. Front Med (Lausanne) 2024; 11:1328765. [PMID: 38435390 PMCID: PMC10904580 DOI: 10.3389/fmed.2024.1328765] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Solar urticaria (SU), a relatively rare skin inflammatory and photosensitivity disease, is often resistant to standard urticaria treatment. Quality of life (QOL) among SU patients has not been extensively explored. This study was performed to clarify the clinical features and effectiveness of therapies (e.g., hardening therapy) for SU and to determine QOL among SU patients. Methods The authors examined the characteristics, treatments, and QOL statuses of 29 Japanese SU patients using medical records and a questionnaire approach. Results Among 29 patients, H1 antihistamine therapy (H1) was effective in 22 (75.8%) patients. H2 antihistamine therapy (H2) was effective in three of seven (42.9%) patients. Ultraviolet radiation A (UVA) hardening therapy was effective in eight of nine (88.9%) patients. Visible light (VL) hardening therapy was ineffective in three of three patients. In one patient who underwent both UVA and VL hardening therapy, only UVA hardening therapy was effective. In the questionnaire, 18 patients (90%) reported some improvement compared with disease onset (four had complete remission, six had completed treatment although mild symptoms persisted, and eight were receiving treatment with moderate symptoms), whereas two patients reported exacerbation. Patients in complete remission had a mean disease duration of 4 years, whereas patients not in remission had a mean disease duration of 8.8 years. The mean Dermatology Life Quality Index (DLQI) score for the current status was 7.4. There was a correlation between DLQI and symptom/treatment status. However, neither DLQI and action spectra nor DLQI and treatments exhibited significant differences. Discussion The questionnaire revealed current QOL status and long-term prognosis in SU patients. Compared with disease onset, most patients showed improvement when assessed for this study. Both H1 and H2 should be attempted for all SU patients. UVA hardening therapy may be an option for SU patients with an action spectrum that includes UVA.
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Affiliation(s)
- Shinya Imamura
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Dermatology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan
| | - Yoshiko Oda
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Fukumoto
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mayuko Mizuno
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mariko Suzuki
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken Washio
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chikako Nishigori
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsushi Fukunaga
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Dermatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
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Dikhit MR, Sen A. Elucidation of conserved multi-epitope vaccine against Leishmania donovani using reverse vaccinology. J Biomol Struct Dyn 2024; 42:1293-1306. [PMID: 37054523 DOI: 10.1080/07391102.2023.2201630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/29/2023] [Indexed: 04/15/2023]
Abstract
Visceral leishmaniasis (VL) is a tropical disease that causes severe public health problems in humans when untreated. As no licensed vaccine exists against VL, we aimed to formulate a potential MHC-restricted chimeric vaccine construct against this dreadful parasitic disease. Amastin-like protein derived from L. donovani is considered to be stable, immunogenic and non-allergic. A comprehensive established framework was used to explore the set of immunogenic epitopes with estimated population coverage of 96.08% worldwide. The rigorous assessment revealed 6 promiscuous T-epitopes which can plausibly be presented by more than 66 diverse HLA alleles. Further docking and simulation study of peptide receptor complexes identified a strong and stable binding interaction with better structural compactness. The predicted epitopes were combined with appropriate linkers and adjuvant molecules and their translation efficiency was evaluated in pET28+(a), an bacterial expression vector using in-silico cloning. Molecular docking followed by MD simulation study revealed a stable interaction between chimeric vaccine construct with TLRs. Immune simulation of the chimeric vaccine constructs showed an elevated Th1 immune response against both B and T epitopes. With this, the detailed computational analysis suggested that the chimeric vaccine construct can evoke a robust immune response against Leishmania donovani infection. Future studies are required to validate the role of amastin as a promising vaccine target.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Manas Ranjan Dikhit
- Department of Molecular Biology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | - Abhik Sen
- Department of Molecular Biology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, India
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Mapiye M, Ravhuhali K, de Voux A, Kufa T. Factors associated with an unsuppressed viral load among HIV-positive individuals attending STI services in South Africa, 2019. BMC Infect Dis 2024; 24:148. [PMID: 38291359 PMCID: PMC10829169 DOI: 10.1186/s12879-023-08756-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/25/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs), particularly in the absence of viral suppression, increase the risk of HIV transmission to uninfected partners. We determined factors associated with having an unsuppressed VL among HIV-positive individuals attending STI services in South Africa (SA). METHODS We analysed secondary cross-sectional data collected on HIV-positive individuals presenting with STI symptoms s at sentinel sites in Western Cape and Gauteng provinces between January-December 2019 in SA. We compared demographic characteristics of individuals on ART or not on ART, and a Poisson regression model to identify factors associated with having an unsuppressed VL (≥ 50 copies/ml) was used. RESULTS Among 93 HIV-positive individuals attending STI services with VL data, the median age was 32 years (IQR 27-37). Thirty-two (34.41%) individuals were on ART compared to 61 (65.59%) not on ART. Most of those on ART (56.25%) had an unsuppressed VL, while 86.89% of those not on ART had an unsuppressed VL. ART use was associated with a 33% lower prevalence of having unsuppressed VL. In a model adjusting for age, age at first sex and oral sex, none of the factors were significant. Among those on ART, individuals < 25 years were more likely to have an unsuppressed VL (aPRR = 1.94: 95% CI = 1.27-2.97) compared to those ≥ 25 years. CONCLUSION ART use among HIV-positive individuals was low and VL suppression among those on ART was sub-optimal. Intensified ART initiation and adherence support to HIV-positive individuals seeking STI services could improve VL suppression.
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Affiliation(s)
- Marceline Mapiye
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
- South African Field Epidemiology Training ProgrammeProgramme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
| | - Khuliso Ravhuhali
- South African Field Epidemiology Training ProgrammeProgramme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Alex de Voux
- South African Field Epidemiology Training ProgrammeProgramme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Tendesayi Kufa
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Centre for HIV/STI, National Institute for Communicable Disease (NICD), Modderfontein, Johannesburg, South Africa
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Hasan MM, Proma SB, Hossain MS, Arifuzzaman M, Islam N, Siddique MAB, Amiruzzaman. A case report on para-kala-azar dermal leishmaniasis: an unresolved mystery. BMC Infect Dis 2023; 23:885. [PMID: 38110894 PMCID: PMC10729440 DOI: 10.1186/s12879-023-08918-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/14/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Post-kala-azar dermal leishmaniasis (PKDL) is a dermatosis that occurs 2-3 years after an apparently successful treatment of visceral leishmaniasis (VL). In rare cases, PKDL occurs concurrently with VL and is characterized by fever, splenomegaly, hepatomegaly or lymphadenopathy, and poor nutritional status and is known as Para-kala-azar dermal leishmaniasis (Para-KDL). Co-association of active VL in PKDL patients is documented in Africa, but very few case reports are found in South Asia. We present a case of Para-kala-azar Dermal Leishmaniasis (Para-KDL) in a 50-year-old male patient with a history of one primary Visceral Leishmaniasis (VL) and 2 times relapse of Visceral Leishmaniasis (VL). The patient presented with fever, skin lesions, and hepatosplenomegaly. Laboratory tests revealed LD bodies in the slit skin smear and splenic biopsy. The patient was treated with two cycles of Amphotericin B with Miltefosine in between cycles for 12 weeks to obtain full recovery. CONCLUSION This case report serves as a reminder that Para-kala-azar dermal leishmaniasis can develop as a consequence of prior visceral leishmaniasis episodes, even after apparently effective therapy. Since para-kala-azar is a source of infectious spread, endemics cannot be avoided unless it is effectively recognized and treated.
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Affiliation(s)
- Md Mehedi Hasan
- Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh.
| | - Sanghita Banik Proma
- Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh.
| | - Md Saddam Hossain
- Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh
| | | | - Naylla Islam
- Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh
| | | | - Amiruzzaman
- Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh
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Ng'ambi WF, Estill J, Jahn A, Orel E, Chimpandule T, Nyirenda R, Keiser O. Factors associated with HIV viral suppression among children and adults receiving antiretroviral therapy in Malawi in 2021: Evidence from the Laboratory Management Information System. Trop Med Int Health 2022; 27:639-646. [PMID: 35622358 DOI: 10.1111/tmi.13782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the prevalence of HIV viral suppression and assess the factors associated with HIV viral suppression among persons receiving antiretroviral therapy (ART) in Malawi in 2021. METHODS Implementation study using routinely collected patient-level HIV RNA-PCR test result data extracted from the national Laboratory Management Information System (LIMS) database managed by the Department of HIV/AIDS in 2021. We calculated frequencies, proportions and odds ratios (OR) of HIV viral suppression with their associated 95% confidence intervals (95%CIs). We performed a random-effects logistic regression to determine the risk factors associated with HIV viral suppression among ART patients, controlling for the spatial autocorrelation between districts and adjusting for other variables. RESULTS We evaluated 515,797 adults and children receiving ART and having a viral load test in 2021. Of these, 92.8% had HIV viral suppression. ART patients living in urban areas had lower likelihood of HIV viral suppression than those living in rural areas (adjusted OR [aOR] = 0.95, 95%CI: 0.92-0.99, p = 0.01). There was an increasing trend in HIV viral suppression with increasing ART duration. Routine VL monitoring samples were 39% more likely to have suppressed VL values than confirmatory HIV VL monitoring samples (aOR = 1.39; 95%CI: 1.34-1.43, p < 0.001). CONCLUSION This is the first national analysis of Malawi HIV VL data from LIMS. Our findings show the need to particularly consider the urban residents, those below 20 years, males, those on ART for less than a year as well as those on specific ARV regimens in order to persistently suppress HIV VL and consequently achieve the goal of achieving HIV VL suppression by 2030.
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Affiliation(s)
- Wingston Felix Ng'ambi
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Andreas Jahn
- Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Erol Orel
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Rose Nyirenda
- Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
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Hagos DG, Schallig HDFH, Kiros YK, Abdulkadir M, Wolday D. Performance of rapid rk39 tests for the diagnosis of visceral leishmaniasis in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:1166. [PMID: 34789175 PMCID: PMC8600897 DOI: 10.1186/s12879-021-06826-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Visceral Leishmaniasis (VL) is a severely neglected disease affecting millions of people with high mortality if left untreated. In Ethiopia, the primary laboratory diagnosis of VL is by using an antigen from a 39-amino acid sequence repeat of a kinesin-related (rK39) of leishmania donovani complex (L. donovani), rapid diagnostic tests (RDT). Different rk39 RDT brands are available with very variable performance and studies from Ethiopia showed a very wide range of sensitivity and specificity. Therefore, a systematic review and meta-analysis were conducted to determine the pooled sensitivity and specificity of rk39 RDT in Ethiopia. Method PUBMED, EMBASE, and other sources were searched using predefined search terms to retrieve all relevant articles from 2007 to 2020. Heterogeneity was assessed by visually inspecting summary receiver operating curves (SROC), Spearman correlation coefficient (rs), Cochran Q test statistics, inconsistency square (I2) and subgroup analysis. The presence and statistical significance of publication bias were assessed by Egger's test at p < 0.05, and all the measurements showed the presence of considerable heterogeneity. Quality assessment of diagnostic accuracy studies (QUADAS-2) checklists was used to check the qualities of the study. Results A total of 664 articles were retrieved, and of this 12 articles were included in the meta-analysis. Overall pooled sensitivity and specificity of the rk39 RDT to diagnose VL in Ethiopia were 88.0% (95% CI 86.0% to 89.0%) and 84.0% (95% CI 82.0% to 86.0%), respectively. The sensitivity and specificity of the rk39 RDT commercial test kits were DiaMed: 86.9% (95% CI 84.3% to 89.1%) and 82.2% (95% CI 79.3% to 85.0%), and InBios: 80.0% (95% CI 77.0% to 82.8%) and 97.4% (95% CI 95.0% to 98.8%), respectively. Conclusion Referring to our result, rk39 RDT considered an essential rapid diagnostic test for VL diagnosis. Besides to the diagnostic accuracy, the features such as easy to perform, quick (10–20 min), cheap, equipment-free, electric and cold chain free, and result reproducibility, rk39 RDT is advisable to remains in practice as a diagnostic test at least in the remote VL endemic localities till a better test will come.
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Affiliation(s)
- Dawit Gebreegziabiher Hagos
- College of Health Sciences, School of Medicine, Department of Medical Microbiology and Immunology, Mekelle University, Mekelle, Ethiopia. .,Academic Medical Centre at the University of Amsterdam, Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Henk D F H Schallig
- Academic Medical Centre at the University of Amsterdam, Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Yazezew K Kiros
- College of Health Sciences, School of Medicine, Department of Internal Medicine, Mekelle University, Mekelle, Ethiopia
| | - Mahmud Abdulkadir
- College of Health Sciences, School of Medicine, Department of Medical Microbiology and Immunology, Mekelle University, Mekelle, Ethiopia
| | - Dawit Wolday
- College of Health Sciences, School of Medicine, Mekelle University, Mekelle, Ethiopia
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7
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Piyathilake CJ, Badiga S, Burkholder GA, Harada S, Raper JL. The accuracy of HPV genotyping in isolation and in combination with CD4 and HIV viral load for the identification of HIV-infected women at risk for developing cervical cancer. Cancer Med 2021; 10:1900-1909. [PMID: 33605553 PMCID: PMC7940247 DOI: 10.1002/cam4.3785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) genotype testing has limited utility to identify human immunodeficiency virus-infected (HIV+) women's risk for developing cervical cancer (CC) due to high positivity rate of high-risk (HR) HPVs. We investigated the accuracy of HPV testing in isolation/in combination with CD4 and HIV viral load (VL) to identify HIV+ women at risk for developing CC. METHODS Study consisted of 344 HIV+ women on combination antiretroviral therapy (cART), tested for cervical cytology/HPV using the Cobas test and had data on absolute CD4 count and VL measurements. We calculated the positive predictive value (PPV) and negative predictive value (NPV) of HPV testing, pre-, post-cART, and current CD4 and VL in isolation and in combinations to identify those with or free of higher than atypical squamous cells of unknown significance (ASCUS+) or low-grade intraepithelial lesions (LSIL+). RESULTS HPV test in combination with pre-/post-cART or current CD4 counts and VL had higher PPVs compared to HPV test alone for identifying ASCUS+ or LSIL+. PPV of HPV-CD4 combinations yielded higher PPVs compared to HPV-VL combinations. The NPVs with pre-, post-cART, or current CD4 count and VL in isolation or in combinations were comparable to that of HPV test alone. CONCLUSIONS Our results provide a more accurate tool for managing HIV+ women by combining Cobas HPV with CD4 and VL, especially those who had an undesirable pre-cART CD4 and VL status. Our results also indicate the usefulness of CD4 and VL measurements to identify those at lower risk in the absence of HPV testing.
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Affiliation(s)
- Chandrika J Piyathilake
- Department of Nutrition Sciences, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Suguna Badiga
- Department of Nutrition Sciences, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Greer A Burkholder
- Department of Medicine/Division of Infectious Diseases, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Shuko Harada
- Department of Pathology, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - James L Raper
- Department of Medicine/Division of Infectious Diseases, The University of Alabama at Birmingham (UAB), Birmingham, AL, USA
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Gelaye KA, Demissie GD, Ayele TA, Wami SD, Sisay MM, Akalu TY, Teshome DF, Wolde HF. Low Knowledge and Attitude Towards Visceral Leishmaniasis Among Migrants and Seasonal Farm Workers in Northwest Ethiopia. Res Rep Trop Med 2020; 11:159-168. [PMID: 33364871 PMCID: PMC7751707 DOI: 10.2147/rrtm.s286212] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/30/2020] [Indexed: 11/23/2022] Open
Abstract
Objective Ethiopia has the second highest burden of visceral leishmaniasis (VL) next to Sudan. North West Ethiopia alone accounts for 60% of the national burden. Migrant and seasonal farmworkers were the riskiest groups. Good knowledge and attitude on VL is a precursor for successful control of the disease. Therefore, this study was aimed to determine knowledge and attitude towards VL and its associated factors among migrants and seasonal farmworkers in West Gondar zone, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted from October to November 2018 in Metema and West Armachiho districts. Two-stage cluster sampling was used to select 950 migrant and seasonal farmworkers. A binary logistic regression model was fitted and variables having a P-value<0.05 were considered to have a significant association with the outcome variable. Odds ratio (OR) with 95% confidence interval (CI) was used as a measure of association. The goodness of fit test was assessed by Hosmer–Lemeshow test. Results Of the total participants, 33.2% (95% CI=30.2–36.2) and 30.2% (95% CI=27.4–33.2) were found to have good knowledge and favorable attitude towards VL, respectively. Factors associated with good knowledge include having health information (AOR=3.2, 95% CI=2.3–4.4), previous history of VL (AOR=6.8, 95% CI=3.7–12.8), and higher age (AOR=1.58, 95% CI=1.12–2.23). Moreover, factors associated with favorable attitude include having health information (AOR=2.8, 95% CI=2.0–3.9), previous history of VL (AOR=2.3, 95% CI=1.3–4.1), good knowledge (AOR=2.4, 95% CI=1.7–3.3), and larger number of visits to the farm area (AOR=2.5, 95% CI=1.5–4.1). Conclusion In this study, knowledge and attitude of migrants and seasonal farmworkers towards VL were low. Having health information and previous history of VL had increased the odds of both knowledge and attitude. Tailored interventions for the migrant seasonal farmworkers focusing on knowledge and attitude of VL would be supremely important.
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Affiliation(s)
- Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getu Debalkie Demissie
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Daba Wami
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Destaw Fetene Teshome
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Elnaiem DE, Khogali A, Alsharif B, Dakein O, Jibreel T, Hassan M, Edries HH, Elhadi H, Elnur B, Osman OF, Boer MD, Alvar J, Khalid NM. Understanding sand fly sampling methods: sticky traps are attraction-based and not interceptive sampling tools of Phlebotomus orientalis. Parasit Vectors 2020; 13:389. [PMID: 32736588 PMCID: PMC7393830 DOI: 10.1186/s13071-020-04249-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/20/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Sticky traps are generally viewed as interceptive sand fly sampling methods; although no previous experimental evidence has supported this assumption. In this study, we tested this assumption experimentally for Phlebotomus orientalis, the principal vector of visceral leishmaniasis in East Africa, and propose an explanation for the highly male-biased collection of sticky traps. METHODS A number of field experiments were carried out in March-June 2016-2019, in Gedarif state, eastern Sudan. In the first experiment, we compared numbers of P. orientalis caught on sticky traps made of black, red, transparent, white, yellow, green and blue A4 size papers set simultaneously at different lunar light conditions. In the second and third experiments, we compared numbers of P. orientalis captured on sticky traps placed side-by-side horizontally or vertically on the ground, or horizontally on a 15 cm height stool. We also witnessed mating behaviour of sand flies following their landing on un-sticky papers placed on the ground. RESULTS Phlebotomus orientalis showed significant attraction to white, yellow and transparent traps, with negligible numbers caught on the black and the red traps. Similarly, significantly higher numbers of P. orientalis were attracted to the horizontal traps, resulting in an 8-fold increase in sand fly trapping efficacy as compared to the vertical traps. Placing the traps on the stools resulted in significant reduction in this attraction. In contrast to the sticky traps that captured only very few females; we found that when male sand flies land on un-sticky white paper they successfully lure females and copulate with them. CONCLUSIONS We demonstrate that, for P. orientalis, sticky traps are more attractant-based than interception-based sampling tools. Further, our findings support the notion that males of this sand fly species likely utilize the bright surface of the trap papers to perform mating rituals that attract the females for copulation. However, pre-mature death in the sticky oil hampers the completion of these rituals, and thus results in failure to attract the females. These findings inform our understanding of P. orientalis behaviour and have important implications for optimization of sticky trap design for vector surveillance purposes.
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Affiliation(s)
- Dia-Eldin Elnaiem
- Department of Natural Sciences, University of Maryland Eastern Shore, Princess Anne, MD, 21853, USA.
| | - Altayeb Khogali
- Blue Nile Health Institute for Communicable Diseases, Gezira University, Wad Medani, Sudan
| | - Bashir Alsharif
- Medical Entomology Department, Federal Ministry of Health, Khartoum, Sudan
| | - Osman Dakein
- Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, Sudan.,Kalar azar Research Centre, Faculty of Medicine and Health Sciences, University of Gedarif, Gedarif, Sudan
| | - Tayseer Jibreel
- Blue Nile Health Institute for Communicable Diseases, Gezira University, Wad Medani, Sudan
| | | | - Hassan H Edries
- Blue Nile Health Institute for Communicable Diseases, Gezira University, Wad Medani, Sudan
| | - Hanan Elhadi
- Kalar azar Research Centre, Faculty of Medicine and Health Sciences, University of Gedarif, Gedarif, Sudan
| | - Bakri Elnur
- Blue Nile Health Institute for Communicable Diseases, Gezira University, Wad Medani, Sudan
| | - Omran F Osman
- Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | | | - Jorge Alvar
- Drugs for Neglected Diseases Initiative, Geneva, Switzerland
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Wang Y, Barnhart S, Francois K, Robin E, Kalou M, Perrin G, Hall L, Koama JB, Marinho E, Balan JG, Honoré JG, Puttkammer N. Expanded access to viral load testing and use of second line regimens in Haiti: time trends from 2010-2017. BMC Infect Dis 2020; 20:283. [PMID: 32299389 PMCID: PMC7160963 DOI: 10.1186/s12879-020-04978-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/17/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Haiti initiated the scale-up of HIV viral load (VL) testing in 2015-2016, with plans to achieve 100% coverage for all patients on antiretroviral therapy (ART) for treatment of HIV/AIDS. In the absence of HIV drug susceptibility testing, VL testing is a key tool for monitoring response to ART and optimizing treatment results. This study describes trends in expanded use of VL testing, VL results, and use of second-line ART regimens, and explores the association between VL testing and second-line regimen switching in Haiti from 2010 to 2017. METHODS We conducted a retrospective cohort study with 66,042 patients drawn from 88 of Haiti's 160 national ART clinics. Longitudinal data from the iSanté electronic data system was used to analyze the trends of interest. We described patients' VL testing status in five categories based on up to two most recent VL test results: no test; suppressed; unsuppressed followed by no test; re-suppressed; and confirmed failure. Among those with confirmed failure, we described ART adherence level. Finally, we used Cox proportional hazards regression to estimate the risk of second-line regimen switching by VL testing status, after adjusting for other individual characteristics. RESULTS The number of patients who had tests done increased annually from 11 in 2010 to 18,828 in the first 9 months of 2017, while the number of second-line regimen switches rose from 21 to 279 during this same period. Compared with patients with no VL test, the hazard ratio (HR) for switching to a second-line regimen was 22.2 for patients with confirmed VL failure (95% confidence interval [CI] for HR: 18.8-26.3; p < 0.005) after adjustment for individual characteristics. Among patients with confirmed VL failure, 44.7% had strong adherence, and fewer than 20% of patients switched to a second-line regimen within 365 days of VL failure. CONCLUSIONS Haiti has significantly expanded access to VL testing since 2016. In order to promote optimal patient health outcomes, it is essential for Haiti to continue broadening access to confirmatory VL testing, to expand evidence-based initiatives to promote strong ART adherence, and to embrace timely switching for patients with confirmed ART failure despite strong ART adherence.
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Affiliation(s)
- Yu Wang
- Department of Global Health, University of Washington, Seattle, USA
| | - Scott Barnhart
- Departments of Medicine and Global Health, University of Washington, Seattle, USA
| | - Kesner Francois
- National AIDS Control Program, Haiti Ministry of Public Health and Population (PNLS/MSPP), Port-au-Prince, Haiti
| | - Ermane Robin
- National AIDS Control Program, Haiti Ministry of Public Health and Population (PNLS/MSPP), Port-au-Prince, Haiti
| | - Mireille Kalou
- Division of Global HIV and Tuberculosis Haiti, US Centers for Disease Control and Prevention, Atlanta, USA
| | - Georges Perrin
- Division of Global HIV and Tuberculosis Haiti, US Centers for Disease Control and Prevention, Atlanta, USA
| | - Lara Hall
- Division of Global HIV and Tuberculosis Haiti, US Centers for Disease Control and Prevention, Atlanta, USA
| | - Jean Baptiste Koama
- Division of Global HIV and Tuberculosis Haiti, US Centers for Disease Control and Prevention, Atlanta, USA
| | - Elisma Marinho
- Centre Haïtien pour le Renforcement du Système de Santé, Port-au-Prince, Haiti
| | - Jean Gabriel Balan
- Centre Haïtien pour le Renforcement du Système de Santé, Port-au-Prince, Haiti
| | - Jean Guy Honoré
- Centre Haïtien pour le Renforcement du Système de Santé, Port-au-Prince, Haiti
| | - Nancy Puttkammer
- Department of Global Health, University of Washington, Seattle, USA
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11
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Ling WL, Ng YL, Wipat A, Lane DP, Gan SKE. The quantification of antibody elements and receptors subunit expression using qPCR: The design of VH, VL, CH, CL, FcR subunits primers for a more holistic view of the immune system. J Immunol Methods 2019; 476:112683. [PMID: 31682797 DOI: 10.1016/j.jim.2019.112683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/20/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
The expression levels of immunoglobulin elements and their receptors are important markers for health and disease. Within the immunoglobulin locus, the constant regions and the variable region families are associated with certain pathologies, yet a holistic view of the interaction between the expressions of the multiple genes remain to be fully characterized. There is thus an important need to quantify antibody elements, their receptors and the receptor subunits in blood (PBMC cDNA) for both screening and detailed studies of such associations. Leveraging on qPCR, we designed primers for all Vκ1-6, VH1-7, Vλ1-11, nine CH isotypes, Cκ, Cκ, Cλ1 &3, FcεRI α,β, and γ subunits, all three FcγR and their subunits, and FcαR. Validating this on a volunteer PBMC cDNA, we report a qPCR primer set repertoire that can quantify the relative expression of all the above genes to the GAPDH housekeeping gene, with implications and uses in both clinical monitoring and research.
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Affiliation(s)
- Wei-Li Ling
- Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore; Newcastle Research and Innovation Institute (NewRIIS), Singapore.
| | - Yuen-Ling Ng
- Newcastle Research and Innovation Institute (NewRIIS), Singapore.
| | - Anil Wipat
- School of Computing, Newcastle University, UK.
| | - David Philip Lane
- p53 Laboratory, Agency for Science, Technology and Research (A*STAR), Singapore.
| | - Samuel Ken-En Gan
- Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore; p53 Laboratory, Agency for Science, Technology and Research (A*STAR), Singapore.
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12
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Litvak-Greenfeld D, Vaks L, Dror S, Nahary L, Benhar I. "BIClonals": Production of Bispecific Antibodies in IgG Format in Transiently Transfected Mammalian Cells. Methods Mol Biol 2019; 1904:431-454. [PMID: 30539485 DOI: 10.1007/978-1-4939-8958-4_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Bispecific antibodies (bsAbs) are antibodies with two binding sites directed at different antigens, enabling therapeutic strategies not possible with conventional monoclonal antibodies (mAbs). Since bispecific antibodies are regarded as promising therapeutic agents, many different bispecific design modalities have been evaluated. Many of these are based on antibody fragments or on inclusion of non-antibody components. For some therapeutic applications, full-size, native IgG-like bsAbs may be the optimal format.To prepare bsAbs in IgG format, two challenges should be met. One is that each heavy chain will only pair with the heavy chain of the second specificity and that heavy chain homodimerization will be prevented. The second is that each heavy chain will only pair with the light chain of its own specificity and that pairing with the light chain of the second specificity will be prevented. The first solution to the first criterion (known as knobs into holes, KIH) was presented in 1996 by Genentech and additional solutions were presented more recently. However, until recently, out of >120 published formats, only a handful of solutions for the second criterion that make it possible to produce a bispecific IgG by a single expressing cell were suggested.Here, we present a protocol for preparing bsAbs in IgG format in transfected mammalian cells. For heavy chain dimerization we use KIH while as a solution for the second challenge-correct pairing of heavy and light chains of bispecific IgGs we present our "BIClonals" technology; an engineered (artificial) disulfide bond between the antibodies' variable domains that asymmetrically replaces the natural disulfide bond between CH1 and CL.During our studies of bsAbs we found that H-L chain pairing seems to be driven by VH-VL interfacial interactions that differ between different antibodies; hence, there is no single optimal solution for effective and precise assembly of bispecific IgGs that suits every antibody sequence, making it necessary to carefully evaluate the optimal solution for each new antibody.
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Affiliation(s)
- Dana Litvak-Greenfeld
- School of Molecular Cell Biology and Biotechnology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Ramat Aviv, Israel
| | - Lilach Vaks
- School of Molecular Cell Biology and Biotechnology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Ramat Aviv, Israel
| | - Stav Dror
- School of Molecular Cell Biology and Biotechnology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Ramat Aviv, Israel
| | - Limor Nahary
- School of Molecular Cell Biology and Biotechnology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Ramat Aviv, Israel
| | - Itai Benhar
- School of Molecular Cell Biology and Biotechnology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Ramat Aviv, Israel.
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Wang X, Momeni A, Eid I, Li L, Brackett F, Davis-Smith B, Wieczorek R, Pincus MR. Major Discrepancies of HCV Viral Loads Determined by Real Time Polymerase Chain Reaction Caused by Use of Collection Tubes that Differ Only with the Presence or Absence of Serum Separator. Ann Clin Lab Sci 2018; 48:286-295. [PMID: 29970430] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND For viral load (VL) analysis of hepatitis C virus (HCV) by Real Time PCR, approved collection tubes were lavender top (LTT) and plasma processing (PPT) tubes, that differ in that PPTs include plasma separator. Using a Real Time PCR method, we investigated how the results correlated for the two tube types. METHODS The plasma fractions of blood samples from each of 202 patients were collected in LTT and PPT tubes at the same time and were assayed for HCV VL by the Abbott m2000 Real Time PCR System; the results were analyzed statistically. RESULTS VLs for 103 samples for both tubes were negative. Positive results were obtained for another 79 tube pairs, including six with VLs for LTTs but values below linearity for the corresponding PPTs. For the 73 samples for which quantitative results were obtained for both tube types, VLs were statistically higher in LTTs (means 1,817,821.8 in LTTs and 1,083,669.1 in PPTs, p=0.006, alpha=0.05) using the paired t-test and confirmed by the Chi Square and McNemars tests. CONCLUSIONS VLs in LTTs are significantly higher and more sensitive than in PPTs, suggesting the necessity of standardization of collection tubes for HCV VLs.
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Affiliation(s)
- XiaoHong Wang
- Veterans Affairs New York Harbor Healthcare System - Manhattan Campus, USA
| | - Amir Momeni
- Department of Pathology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Issa Eid
- Veterans Affairs New York Harbor Healthcare System - Manhattan Campus, USA
| | - Liuzhe Li
- Veterans Affairs New York Harbor Healthcare System - Manhattan Campus, USA
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - Francina Brackett
- Veterans Affairs New York Harbor Healthcare System - Manhattan Campus, USA
| | - Brenda Davis-Smith
- Veterans Affairs New York Harbor Healthcare System - Manhattan Campus, USA
| | - Rosemary Wieczorek
- Veterans Affairs New York Harbor Healthcare System - Manhattan Campus, USA
| | - Matthew R Pincus
- Department of Pathology, New York University School of Medicine, New York, NY, USA
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Akram H, Dayal V, Mahlknecht P, Georgiev D, Hyam J, Foltynie T, Limousin P, De Vita E, Jahanshahi M, Ashburner J, Behrens T, Hariz M, Zrinzo L. Connectivity derived thalamic segmentation in deep brain stimulation for tremor. Neuroimage Clin 2018; 18:130-142. [PMID: 29387530 PMCID: PMC5790021 DOI: 10.1016/j.nicl.2018.01.008] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 12/23/2017] [Accepted: 01/13/2018] [Indexed: 02/02/2023]
Abstract
The ventral intermediate nucleus (VIM) of the thalamus is an established surgical target for stereotactic ablation and deep brain stimulation (DBS) in the treatment of tremor in Parkinson's disease (PD) and essential tremor (ET). It is centrally placed on a cerebello-thalamo-cortical network connecting the primary motor cortex, to the dentate nucleus of the contralateral cerebellum through the dentato-rubro-thalamic tract (DRT). The VIM is not readily visible on conventional MR imaging, so identifying the surgical target traditionally involved indirect targeting that relies on atlas-defined coordinates. Unfortunately, this approach does not fully account for individual variability and requires surgery to be performed with the patient awake to allow for intraoperative targeting confirmation. The aim of this study is to identify the VIM and the DRT using probabilistic tractography in patients that will undergo thalamic DBS for tremor. Four male patients with tremor dominant PD and five patients (three female) with ET underwent high angular resolution diffusion imaging (HARDI) (128 diffusion directions, 1.5 mm isotropic voxels and b value = 1500) preoperatively. Patients received VIM-DBS using an MR image guided and MR image verified approach with indirect targeting. Postoperatively, using parallel Graphical Processing Unit (GPU) processing, thalamic areas with the highest diffusion connectivity to the primary motor area (M1), supplementary motor area (SMA), primary sensory area (S1) and contralateral dentate nucleus were identified. Additionally, volume of tissue activation (VTA) corresponding to active DBS contacts were modelled. Response to treatment was defined as 40% reduction in the total Fahn-Tolosa-Martin Tremor Rating Score (FTMTRS) with DBS-ON, one year from surgery. Three out of nine patients had a suboptimal, long-term response to treatment. The segmented thalamic areas corresponded well to anatomically known counterparts in the ventrolateral (VL) and ventroposterior (VP) thalamus. The dentate-thalamic area, lay within the M1-thalamic area in a ventral and lateral location. Streamlines corresponding to the DRT connected M1 to the contralateral dentate nucleus via the dentate-thalamic area, clearly crossing the midline in the mesencephalon. Good response was seen when the active contact VTA was in the thalamic area with highest connectivity to the contralateral dentate nucleus. Non-responders had active contact VTAs outside the dentate-thalamic area. We conclude that probabilistic tractography techniques can be used to segment the VL and VP thalamus based on cortical and cerebellar connectivity. The thalamic area, best representing the VIM, is connected to the contralateral dentate cerebellar nucleus. Connectivity based segmentation of the VIM can be achieved in individual patients in a clinically feasible timescale, using HARDI and high performance computing with parallel GPU processing. This same technique can map out the DRT tract with clear mesencephalic crossing.
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Key Words
- AC, anterior commissure
- BEDPOSTX, Bayesian estimation of diffusion parameters obtained using sampling techniques X
- BET, brain extraction tool
- CI, confidence interval
- CON, connectivity
- Connectivity
- DBS
- DBS, deep brain stimulation
- DF, degrees of freedom
- DICOM, digital imaging and communications in medicine
- DRT
- DWI
- DWI, diffusion weighted imaging
- Deep brain stimulation
- Dentate nucleus
- Dentato-rubro-thalamic tract
- Diffusion weighted imaging
- EV, explanatory variable
- FLIRT, FMRIB's linear image registration tool
- FMRIB, Oxford centre for functional MRI of the brain
- FNIRT, FMRIB's non-linear image registration tool
- FSL, FMRIB's software library
- FoV, field of view
- GLM, general linear model
- HARDI, high angular resolution diffusion imaging
- HFS, high frequency stimulation
- IPG, implantable pulse generator
- LC, Levodopa challenge
- LEDD, l-DOPA equivalent daily dose
- M1, primary motor cortex
- MMS, mini-mental score
- MNI, Montreal neurological institute
- MPRAGE, magnetization-prepared rapid gradient-echo
- MPTP, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
- NHNN, National Hospital for Neurology and Neurosurgery
- NIfTI, neuroimaging informatics technology initiative
- PC, posterior commissure
- PD
- PFC, prefrontal cortex
- PMC, premotor cortex
- Parkinson's disease
- S1, primary sensory cortex
- SAR, specific absorption rate
- SD, standard deviation
- SE, standard error
- SMA, supplementary motor area
- SNR, signal-to-noise ratio
- SSEPI, single-shot echo planar imaging
- STN, subthalamic nucleus
- TFCE, threshold-free cluster enhancement
- TMS, transcranial magnetic stimulation
- Tremor
- UPDRS, unified Parkinson's disease rating scale
- VBM, voxel based morphometry
- VIM
- VL
- VL, ventral lateral
- VP, ventral posterior
- VTA, volume of tissue activated
- Ventrointermedialis
- Ventrolateral nucleus
- cZI, caudal zona incerta
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Affiliation(s)
- Harith Akram
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
| | - Viswas Dayal
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Philipp Mahlknecht
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Dejan Georgiev
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Jonathan Hyam
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Thomas Foltynie
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Patricia Limousin
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Enrico De Vita
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, UK
| | - Marjan Jahanshahi
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - John Ashburner
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Tim Behrens
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Centre for Functional MRI of the Brain (FMRIB), John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Marwan Hariz
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
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Verma S, Singh R, Sharma V, Bumb RA, Negi NS, Ramesh V, Salotra P. Development of a rapid loop-mediated isothermal amplification assay for diagnosis and assessment of cure of Leishmania infection. BMC Infect Dis 2017; 17:223. [PMID: 28335752 PMCID: PMC5363003 DOI: 10.1186/s12879-017-2318-8] [Citation(s) in RCA: 39] [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] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 03/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Leishmaniasis is a spectrum of diseases with great relevance to public health. Conventional diagnostic methods are time consuming, needing trained personnel. A robust, rapid and cost effective diagnostic test is warranted for on-time diagnosis and field application. Methods We have developed a loop mediated isothermal amplification (LAMP) assay with primers (n = 6) based on Leishmania donovani kDNA for detection of Leishmania infection, using a closed tube to prevent cross-contamination. The assay was used to detect Leishmania infection in biological samples obtained from patients of visceral leishmaniasis (VL), post kala-azar dermal leishmaniasis (PKDL) and cutaneous leishmaniasis (CL). Results The assay was positive for L. donovani, L. tropica and L. major parasites, with the highest sensitivity towards L. donovani (1 fg DNA). The high sensitivity of the assay for detection of L. donovani was reflected in its ability to detect parasite DNA within 30 min of amplification time with a threshold detection limit of ≥25 copies per reaction. The assay detected parasite in 64 of 66 VL blood samples (sensitivity, 96.9%; 95% CI: 89.6-99.2%), 15 of 15 VL bone marrow aspirate samples (sensitivity, 100%; 95% CI:79.6-100%), 65 of 67 PKDL tissue biopsy samples (sensitivity, 97%; 95% CI:89.7-99.2%). The assay was evaluated in a few cases of CL wherein it was found positive in 8 of 10 tissue biopsies (sensitivity, 80%; 95% CI: 49-94.3%). The assay was negative in all control blood (n = 76) and tissue biopsy (n = 24) samples (specificity, 100%; 95% CI: 96.3-100%). Further, the assay was evaluated for its utility in assessment of cure in treated VL and PKDL patients. The assay detected parasite DNA in 2 of 20VL blood samples and 2 of 21 PKDL tissue samples. Out of 4 cases that were positive for parasite DNA at post treatment stage, 2 patients (1VL and 1 PKDL) returned with relapse. Conclusions The study demonstrated a Leishmania genus specific closed tube LAMP assay for reliable and rapid molecular diagnosis of VL and PKDL with potential for application in assessment of cure.
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Affiliation(s)
- Sandeep Verma
- National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029, India
| | - Ruchi Singh
- National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029, India
| | - Vanila Sharma
- National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029, India
| | - Ram Avtar Bumb
- Department of Skin, STD and Leprosy, S. P. Medical College, Bikaner, India
| | | | - V Ramesh
- Department of Dermatology, Safdarjung Hospital, New Delhi, India
| | - Poonam Salotra
- National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029, India.
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Amit A, Dikhit MR, Mahantesh V, Chaudhary R, Singh AK, Singh A, Singh SK, Das VNR, Pandey K, Ali V, Narayan S, Sahoo GC, Das P, Bimal S. Immunomodulation mediated through Leishmania donovani protein disulfide isomerase by eliciting CD8+ T-cell in cured visceral leishmaniasis subjects and identification of its possible HLA class-1 restricted T-cell epitopes. J Biomol Struct Dyn 2016; 35:128-140. [PMID: 26727289 DOI: 10.1080/07391102.2015.1134349] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Protein disulphide isomerase (PDI) is one of the key enzymes essential for the survival of Leishmania donovani in the host. Our study suggested that PDI is associated with the generation of Th1-type of cellular responses in treated Visceral leishmaniasis (VL) subjects. The stimulation of Peripheral blood mononuclear cells (PBMCs) with recombinant Protein Disulphide Isomerase upregulated the reactive oxygen species generation, Nitric oxide release, IL12 and IFN-γ production indicating its pivotal role in protective immune response. Further, a pre-stimulation of PBMCs with Protein disulphide isomerase induced a strong IFN-γ response through CD8+ T cells in treated VL subjects. These findings also supported through the evidence that this antigen was processed and presented by major histocompatibility complex class I (MHC-1) dependent pathway and had an immunoprophylactic potential which can induce CD8+ T cell protective immune response in MHC class I dependent manner against VL. To find out the possible epitopes that might be responsible for CD8+ T cell specific IFN-γ response, computational approach was adopted. Six novel promiscuous epitopes were predicted to be highly immunogenic and can be presented by 32 different HLA allele to CD8+ T cells. Further investigation will explore more about their immunological relevance and usefulness as vaccine candidates.
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Affiliation(s)
- Ajay Amit
- a Division of Immunology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Manas R Dikhit
- a Division of Immunology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India.,b Department of Bioinformatics , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Vijay Mahantesh
- a Division of Immunology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India.,c Department of Biotechnology , National Institutes of Pharmaceutical Education and Research , Hajipur 844102 , India
| | - Rajesh Chaudhary
- a Division of Immunology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Ashish Kumar Singh
- a Division of Immunology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India.,d Dept. of Pathology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Ashu Singh
- c Department of Biotechnology , National Institutes of Pharmaceutical Education and Research , Hajipur 844102 , India
| | - Shubhankar Kumar Singh
- h Dept. of Microbiology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - V N R Das
- e Dept. of Clinical Medicine , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Krishna Pandey
- e Dept. of Clinical Medicine , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Vahab Ali
- f Dept. of Molecular Biochemistry , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Shyam Narayan
- h Dept. of Microbiology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Ganesh C Sahoo
- b Department of Bioinformatics , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Pradeep Das
- g Dept. of Molecular Biology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
| | - Sanjiva Bimal
- a Division of Immunology , Rajendra Memorial Research Institute of Medical Sciences , Patna 800007 , India
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Kim DY, To R, Kandalaft H, Ding W, van Faassen H, Luo Y, Schrag JD, St-Amant N, Hefford M, Hirama T, Kelly JF, MacKenzie R, Tanha J. Antibody light chain variable domains and their biophysically improved versions for human immunotherapy. MAbs 2014; 6:219-35. [PMID: 24423624 PMCID: PMC3929445 DOI: 10.4161/mabs.26844] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 01/03/2023] Open
Abstract
We set out to gain deeper insight into the potential of antibody light chain variable domains (VLs) as immunotherapeutics. To this end, we generated a naïve human VL phage display library and, by using a method previously shown to select for non-aggregating antibody heavy chain variable domains (VHs), we isolated a diversity of VL domains by panning the library against B cell super-antigen protein L. Eight domains representing different germline origins were shown to be non-aggregating at concentrations as high as 450 µM, indicating VL repertoires are a rich source of non-aggregating domains. In addition, the VLs demonstrated high expression yields in E. coli, protein L binding and high reversibility of thermal unfolding. A side-by-side comparison with a set of non-aggregating human VHs revealed that the VLs had similar overall profiles with respect to melting temperature (Tm), reversibility of thermal unfolding and resistance to gastrointestinal proteases. Successful engineering of a non-canonical disulfide linkage in the core of VLs did not compromise the non-aggregation state or protein L binding properties. Furthermore, the introduced disulfide bond significantly increased their Tms, by 5.5–17.5 °C, and pepsin resistance, although it somewhat reduced expression yields and subtly changed the structure of VLs. Human VLs and engineered versions may make suitable therapeutics due to their desirable biophysical features. The disulfide linkage-engineered VLs may be the preferred therapeutic format because of their higher stability, especially for oral therapy applications that necessitate high resistance to the stomach’s acidic pH and pepsin.
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Affiliation(s)
- Dae Young Kim
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Rebecca To
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Hiba Kandalaft
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Wen Ding
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Henk van Faassen
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Yan Luo
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Joseph D Schrag
- Human Health Therapeutics; National Research Council Canada; Montréal, QC Canada
| | - Nadereh St-Amant
- Centre for Vaccine Evaluation; Biologics and Genetic Therapies Directorate;, Health Canada; Ottawa, ON Canada
| | - Mary Hefford
- Centre for Vaccine Evaluation; Biologics and Genetic Therapies Directorate;, Health Canada; Ottawa, ON Canada
| | - Tomoko Hirama
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - John F Kelly
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada
| | - Roger MacKenzie
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada; School of Environmental Sciences; Ontario Agricultural College; University of Guelph; Guelph, ON Canada
| | - Jamshid Tanha
- Human Health Therapeutics; National Research Council Canada; Ottawa, ON Canada; School of Environmental Sciences; Ontario Agricultural College; University of Guelph; Guelph, ON Canada; Department of Biochemistry, Microbiology, and Immunology; University of Ottawa; Ottawa, ON Canada
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18
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Geng SB, Cheung JK, Narasimhan C, Shameem M, Tessier PM. Improving monoclonal antibody selection and engineering using measurements of colloidal protein interactions. J Pharm Sci 2014; 103:3356-3363. [PMID: 25209466 DOI: 10.1002/jps.24130] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/30/2014] [Accepted: 07/29/2014] [Indexed: 12/14/2022]
Abstract
A limitation of using mAbs as therapeutic molecules is their propensity to associate with themselves and/or with other molecules via nonaffinity (colloidal) interactions. This can lead to a variety of problems ranging from low solubility and high viscosity to off-target binding and fast antibody clearance. Measuring such colloidal interactions is challenging given that they are weak and potentially involve diverse target molecules. Nevertheless, assessing these weak interactions-especially during early antibody discovery and lead candidate optimization-is critical to preventing problems that can arise later in the development process. Here we review advances in developing and implementing sensitive methods for measuring antibody colloidal interactions as well as using these measurements for guiding antibody selection and engineering. These systematic efforts to minimize nonaffinity interactions are expected to yield more effective and stable mAbs for diverse therapeutic applications. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 103:3356-3363, 2014.
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Affiliation(s)
- Steven B Geng
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical & Biological Engineering, Rensselaer Polytechnic Institute, Troy, New York 12180
| | - Jason K Cheung
- Sterile Product and Analytical Development, Merck Research Laboratories, Kenilworth, New Jersey 07033
| | - Chakravarthy Narasimhan
- Sterile Product and Analytical Development, Merck Research Laboratories, Kenilworth, New Jersey 07033
| | - Mohammed Shameem
- Sterile Product and Analytical Development, Merck Research Laboratories, Kenilworth, New Jersey 07033
| | - Peter M Tessier
- Center for Biotechnology & Interdisciplinary Studies, Isermann Department of Chemical & Biological Engineering, Rensselaer Polytechnic Institute, Troy, New York 12180.
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19
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Coilly A, Roche B, Dumortier J, Leroy V, Botta-Fridlund D, Radenne S, Pageaux GP, Si-Ahmed SN, Guillaud O, Antonini TM, Haïm-Boukobza S, Roque-Afonso AM, Samuel D, Duclos-Vallée JC. Safety and efficacy of protease inhibitors to treat hepatitis C after liver transplantation: a multicenter experience. J Hepatol 2014; 60:78-86. [PMID: 23994384 DOI: 10.1016/j.jhep.2013.08.018] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 07/16/2013] [Accepted: 08/15/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Protease inhibitors (PI) with peginterferon/ribavirin have significantly improved SVR rates in HCV G1 patients. Their use to treat HCV recurrence after liver transplantation (LT) is a challenge. METHODS This cohort study included 37 liver transplant recipients (male, 92%, age 57 ± 11 years), treated with boceprevir (n=18) or telaprevir (n=19). The indication for therapy was HCV recurrence (fibrosis stage ≥F2 (n=31, 83%) or fibrosing cholestatic hepatitis (n=6, 16%). RESULTS Eighteen patients were treatment-naive, five were relapsers and fourteen were non-responders to dual therapy after LT. Twenty-two patients received cyclosporine and fifteen tacrolimus. After 12 weeks of PI therapy, a complete virological response was obtained in 89% of patients treated with boceprevir, and 58% with telaprevir (p=0.06). The end of treatment virological response rate was 72% (13/18) in the boceprevir group and 40% (4/10) in the telaprevir group (p=0.125). A sustained virological response 12 weeks after treatment discontinuation was observed in 20% (1/5) and 71% (5/7) of patients in the telaprevir and boceprevir groups, respectively (p=0.24). Treatment was discontinued in sixteen patients (treatment failures (n=11), adverse events (n=5)). Infections occurred in ten patients (27%), with three fatal outcomes (8%). The most common adverse effect was anemia (n=34, 92%), treated with erythropoietin and/or a ribavirin dose reduction; thirteen patients (35%) received red blood cell transfusions. The cyclosporine dose was reduced by 1.8 ± 1.1-fold and 3.4 ± 1.0-fold with boceprevir and telaprevir, respectively. The tacrolimus dose was reduced by 5.2 ± 1.5-fold with boceprevir and 23.8±18.2-fold with telaprevir. CONCLUSIONS Our results suggest that triple therapy is effective in LT recipients, particularly those experiencing a severe recurrence. The occurrence of anemia and drug-drug interactions, and the risk of infections require close monitoring.
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20
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Doerner A, Rhiel L, Zielonka S, Kolmar H. Therapeutic antibody engineering by high efficiency cell screening. FEBS Lett 2013; 588:278-87. [PMID: 24291259 DOI: 10.1016/j.febslet.2013.11.025] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [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: 10/10/2013] [Revised: 11/17/2013] [Accepted: 11/18/2013] [Indexed: 12/11/2022]
Abstract
In recent years, several cell-based screening technologies for the isolation of antibodies with prescribed properties emerged. They rely on the multi-copy display of antibodies or antibody fragments on a cell surface in functional form followed by high through put screening and isolation of cell clones that carry an antibody variant with the desired affinity, specificity, and stability. Particularly yeast surface display in combination with high-throughput fluorescence-activated cell sorting has proven successful in the last fifteen years as a very powerful technology that has some advantages over classical generation of monoclonals using the hybridoma technology or bacteriophage-based antibody display and screening. Cell-based screening harbours the benefit of single-cell online and real-time analysis and characterisation of individual library candidates. Moreover, when using eukaryotic expression hosts, intrinsic quality control machineries for proper protein folding and stability exist that allow for co-selection of high-level expression and stability simultaneously to the binding functionality. Recently, promising technologies emerged that directly rely on antibody display on higher eukaryotic cell lines using lentiviral transfection or direct screening on B-cells. The combination of immunisation, B-cell screening and next generation sequencing may open new avenues for the isolation of therapeutic antibodies with prescribed physicochemical and functional characteristics.
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Affiliation(s)
- Achim Doerner
- Protein Engineering and Antibody Technologies, Merck Serono, Merck KGaA, Frankfurter Straße 250, D-64293 Darmstadt, Germany
| | - Laura Rhiel
- Protein Engineering and Antibody Technologies, Merck Serono, Merck KGaA, Frankfurter Straße 250, D-64293 Darmstadt, Germany
| | - Stefan Zielonka
- Institute for Organic Chemistry and Biochemistry, Technische Universität Darmstadt, Alarich-Weiss-Strasse 4, D-64287 Darmstadt, Germany
| | - Harald Kolmar
- Institute for Organic Chemistry and Biochemistry, Technische Universität Darmstadt, Alarich-Weiss-Strasse 4, D-64287 Darmstadt, Germany.
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21
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Lavocat F, Dény P, Pichoud C, Al Hawajri N, Kitrinos K, Borroto-Esoda K, Zoulim F. Similar evolution of hepatitis B virus quasispecies in patients with incomplete adefovir response receiving tenofovir/emtricitabine combination or tenofovir monotherapy. J Hepatol 2013; 59:684-95. [PMID: 23742912 DOI: 10.1016/j.jhep.2013.05.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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: 10/09/2012] [Revised: 04/19/2013] [Accepted: 05/21/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Adefovir (ADV) resistance mutations induce low-level cross-resistance to tenofovir in vitro. Our aim was to compare viral kinetics, nucleos(t)ide analog resistance mutations, and quasispecies (QS) evolution during therapy with tenofovir disoproxil fumarate (TDF) or emtricitabine + TDF (FTC/TDF) in selected patients with incomplete ADV responses. METHODS Patients with chronic hepatitis B and incomplete response to ADV were randomized in a double-blind trial of TDF vs. FTC/TDF. Extensive analysis of QS evolution was performed in 17 patients through 48 weeks of treatment. RESULTS At week 24, 48% of patients (9/17) achieved HBV DNA undetectability (<69 IU/ml) with no difference between treatment groups. ADV and/or LAM resistance mutations were detected in all 17 patients at baseline and in 5/6 analyzable patients at week 48. A total of 1224 reverse transcriptase clones were analyzed. Clonal analysis revealed no significant difference at baseline in QS complexity or diversity between treatment groups. There was a trend in both treatment groups for an increase in QS complexity at week 12, followed by a decrease in complexity and diversity by week 48. Analysis of individual patients showed no consistent selection/accumulation of specific viral resistance patterns during treatment, but at week 48, mutations at rtA181 persisted in 4 patients. CONCLUSIONS TDF or FTC/TDF demonstrated strong viral suppression in patients with an incomplete response to ADV and no significant selective pressure on pre-existing ADV or LAM resistant strains. TDF monotherapy and FTC/TDF combination therapy had a comparable impact on QS evolution.
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Affiliation(s)
- Fabien Lavocat
- Inserm, U1052, UMR CNRS 5268, Centre de Recherche en Cancérologie de Lyon, F-69003 Lyon, France
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22
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Ciriello J, Caverson MM, Li Z. Effects of hypocretin and norepinephrine interaction in bed nucleus of the stria terminalis on arterial pressure. Neuroscience 2013; 255:278-91. [PMID: 24070630 DOI: 10.1016/j.neuroscience.2013.09.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/16/2013] [Accepted: 09/16/2013] [Indexed: 11/20/2022]
Abstract
Forebrain neuronal circuits containing hypocretin-1 (hcrt-1) and norepinephrine (NE) are important components of central arousal-related processes. Recently, these two systems have been shown to have an overlapping distribution within the bed nucleus of the stria terminalis (BST), a limbic structure activated by stressful challenges, and which functions to adjust arterial pressure (AP) and heart rate (HR) to the stressor. However, whether hcrt-1 and NE interact in BST to alter cardiovascular function is unknown. Experiments were done in urethane-α-chloralose anesthetized, paralyzed, and artificially ventilated male Wistar rats to investigate the effect of hcrt-1 and NE on the cardiovascular responses elicited by l-glutamate (Glu) stimulation of BST neurons. Microinjections of hcrt-1, NE or tyramine into BST attenuated the decrease in AP and HR to Glu stimulation of BST. Additionally, combined injections of hcrt-1 with NE or tyramine did not elicit a greater attenuation than either compound alone. Furthermore, injections into BST of the α2-adrenergic receptor (α2-AR) antagonist yohimbine, but not the α1-AR antagonist 2-{[β-(4-hydroxyphenyl)ethyl]aminomethyl}-1-tetralone hydrochloride, blocked both the hcrt-1 and NE-induced inhibition of the BST cardiovascular depressors responses. Finally, injections into BST of the GABAA receptor antagonist bicuculline, but not the GABAB receptor antagonist phaclofen, blocked the hcrt-1 and NE attenuation of the BST Glu-induced depressor and bradycardia responses. These data suggest that hcrt-1 effects in BST are mediated by NE neurons, and hcrt-1 likely acts to facilitate the synaptic release of NE. NE neurons, acting through α2-AR may activate Gabaergic neurons in BST, which in turn through the activation of GABAA receptors inhibit a BST sympathoinhibitory pathway. Taken together, these data suggest that hcrt-1 pathways to BST through their interaction with NE and Gabaergic neurons may function in the coordination of cardiovascular responses associated with different behavioral states.
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23
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Zhang H, Zhao B, Han X, Wang Z, Liu B, Lu C, Zhang M, Liu J, Chen O, Hu Q, Jiang F, Shang H. Associations of HLA class I antigen specificities and haplotypes with disease progression in HIV-1-infected Hans in Northern China. Hum Immunol 2013; 74:1636-42. [PMID: 24012585 DOI: 10.1016/j.humimm.2013.08.287] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/17/2013] [Accepted: 08/10/2013] [Indexed: 12/11/2022]
Abstract
The human leukocyte antigen (HLA) allele frequencies, which differ among various ethnic populations, may result in population-specific effects on HIV-1 disease progression. No large-scale study has yet been conducted on the Chinese population. In this study, HLA class I antigen specificities were determined in a cohort including 105 long-term non-progressors (LTNPs) and 321 typical progressors (TPs), who were recruited from HIV-1-infected Northern Han Chinese, to determine the associations between certain HLA types and HIV-1 disease progression. The frequencies of HLA class I specificities and haplotypes among the two groups were compared using binary logistic stepwise regression. Results showed that HLA-A(∗)30-B(∗)13-C(∗)06 (OR = 0.387, P = 0.019) and B(∗)67 (OR = 0.134, P = 0.005) were associated with a long-term non-progressing condition, and C(∗)01 (OR = 2.539, P = 0.050) was overrepresented in TPs after adjusting for non-genetic factors (sex, age, the location of patients, HIV subtype and the route of infection). The influence of HLA homozygosity on HIV disease progression was also analyzed. However, homozygosity at HLA-A, HLA-B or HLA-C conferred no observable disadvantage in our study population (P = 0.730, 0.246 and 0.445, respectively). These findings suggest that the host's genetics make important contributions to HIV viral control and may help to develop peptide-based vaccines for this population.
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Affiliation(s)
- Hui Zhang
- Key Laboratory of AIDS Immunology of the Ministry of Health, Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
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24
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Beaumier CM, Gillespie PM, Hotez PJ, Bottazzi ME. New vaccines for neglected parasitic diseases and dengue. Transl Res 2013; 162:144-55. [PMID: 23578479 DOI: 10.1016/j.trsl.2013.03.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [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: 11/20/2012] [Revised: 03/15/2013] [Accepted: 03/16/2013] [Indexed: 01/13/2023]
Abstract
Neglected tropical diseases (NTDs) are a significant source of morbidity and socioeconomic burden among the world's poor. Virtually all of the 2.4 billion people who live on less than $2 per d, more than a third of the world's population, are at risk for these debilitating NTDs. Although chemotherapeutic measures exist for many of these pathogens, they are not sustainable countermeasures on their own because of rates of reinfection, risk of drug resistance, and inconsistent maintenance of drug treatment programs. Preventative and therapeutic NTD vaccines are needed as long-term solutions. Because there is no market in the for-profit sector of vaccine development for these pathogens, much of the effort to develop vaccines is driven by nonprofit entities, mostly through product development partnerships. This review describes the progress of vaccines under development for many of the NTDs, with a specific focus on those about to enter or that are currently in human clinical trials. Specifically, we report on the progress on dengue, hookworm, leishmaniasis, schistosomiasis, Chagas disease, and onchocerciasis vaccines. These products will be some of the first with specific objectives to aid the world's poorest populations.
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Affiliation(s)
- Coreen M Beaumier
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston 77030, Tex., USA
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25
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Abzug MJ, Song LY, Levin MJ, Nachman SA, Borkowsky W, Pelton SI; International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1024 and P1061s Protocol Teams. Antibody persistence and immunologic memory after sequential pneumococcal conjugate and polysaccharide vaccination in HIV-infected children on highly active antiretroviral therapy. Vaccine 2013; 31:4782-90. [PMID: 23954381 DOI: 10.1016/j.vaccine.2013.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 07/02/2013] [Accepted: 08/01/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND The capacity of pneumococcal vaccination to confer memory in HIV-infected children is critical for durable protection. METHODS HIV-infected children 2-<19 years administered two doses of pneumococcal conjugate vaccine (PCV7) and one dose of polysaccharide vaccine (PPV) on HAART were randomized 4-5 years later to receive a PCV7 or PPV booster. Total and high avidity antibodies to serotypes 1 (PPV) and 6B and 14 (PCV7 and PPV) were determined by ELISA. Memory was defined as persistence of ≥ 0.5 mcg/mL of serotype-specific antibody on day 0 or change from <0.5 mcg/mL to ≥ 0.5 mcg/mL between day 0 and week 1, or, ≥ 4-fold antibody rise between day 0 and week 1. RESULTS Prior to boosting, 4-5 years after the previous PCV7-PCV7-PPV series, geometric mean concentrations (GMCs) were 0.46 mcg/mL (serotype 1), 1.31 mcg/mL (serotype 6B), and 1.47 mcg/mL (serotype 14), with concentrations ≥ 0.5 mcg/mL in 41% (serotype 1) to 82% (serotypes 6B and 14). Memory based on antibody concentration ≥ 0.5 mcg/mL before or 1 week after boosting with PCV7 or PPV was demonstrated in 42-61% for serotype 1 and 87-94% for serotypes 6B and 14, with lower rates based on day 0 to week 1 ≥ 4-fold antibody rise (serotype 1, 3-13%; serotype 6B, 13-31%; serotype 14, 29-53%). Antibody concentrations post-boosting were greater following PCV7 than PPV for serotypes 6B and 14. Ratios of highly avid to total antibody pre- and post-boosting were 0.5-0.8. Predictors of memory included higher CD4% (nadir before HAART and at P1024 and P1061s entry), CD19% (at P1024 and P1061s entry), and antibody response after the PCV7-PCV7-PPV primary series and lower viral load (at P1024 and P1061s entry) and age. CONCLUSIONS Protective antibody concentrations, high avidity, and booster responses to PCV7 or PPV indicative of memory were present 4-5 years after PCV7-PCV7-PPV in HIV-infected children on HAART.
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Scholl EA, Dudek FE, Ekstrand JJ. Neuronal degeneration is observed in multiple regions outside the hippocampus after lithium pilocarpine-induced status epilepticus in the immature rat. Neuroscience 2013; 252:45-59. [PMID: 23896573 DOI: 10.1016/j.neuroscience.2013.07.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 07/17/2013] [Accepted: 07/18/2013] [Indexed: 01/25/2023]
Abstract
Although hippocampal sclerosis is frequently identified as a possible epileptic focus in patients with temporal lobe epilepsy, neuronal loss has also been observed in additional structures, including areas outside the temporal lobe. The claim from several researchers using animal models of acquired epilepsy that the immature brain can develop epilepsy without evidence of hippocampal neuronal death raises the possibility that neuronal death in some of these other regions may also be important for epileptogenesis. The present study used the lithium pilocarpine model of acquired epilepsy in immature animals to assess which structures outside the hippocampus are injured acutely after status epilepticus. Sprague-Dawley rat pups were implanted with surface EEG electrodes, and status epilepticus was induced at 20 days of age with lithium pilocarpine. After 72 h, brain tissue from 12 animals was examined with Fluoro-Jade B, a histochemical marker for degenerating neurons. All animals that had confirmed status epilepticus demonstrated Fluoro-Jade B staining in areas outside the hippocampus. The most prominent staining was seen in the thalamus (mediodorsal, paratenial, reuniens, and ventral lateral geniculate nuclei), amygdala (ventral lateral, posteromedial, and basomedial nuclei), ventral premammillary nuclei of hypothalamus, and paralimbic cortices (perirhinal, entorhinal, and piriform) as well as parasubiculum and dorsal endopiriform nuclei. These results demonstrate that lithium pilocarpine-induced status epilepticus in the immature rat brain consistently results in neuronal injury in several distinct areas outside of the hippocampus. Many of these regions are similar to areas damaged in patients with temporal lobe epilepsy, thus suggesting a possible role in epileptogenesis.
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Key Words
- AA
- ACH
- ACo
- AD
- AHC
- AI
- AM
- AO
- APir
- AStr
- AV
- Acb
- AcbSh
- BAOT
- BLA
- BLP
- BLV
- BMA
- BMP
- BSTIA
- BSTM
- CA
- CL
- CM
- CPu
- CeL
- CeM
- Cg1-3
- DEn
- DG
- DI
- DLG
- DP
- EEG
- Ent
- Fluoro-jade B
- Fr1-3
- GABA
- GI
- GP
- HC
- Hil
- I
- IL
- LDDM
- LDVL
- LHb
- LM
- LO
- LOT
- LPLR
- LPMR
- LSD
- LSI
- LSV
- LaD
- LaV
- MD
- MGD
- MGM
- MGP
- MGV
- MHb
- MO
- MS
- MTu
- MeA
- MePD
- MePV
- NAc
- Oc2L
- P
- PC
- PF
- PLCo
- PMCo
- PMD
- PMV
- PRh
- PT
- PVA
- PVP
- PaS
- Par1
- Pir
- Po
- PrS
- RSA
- RSG
- Re
- Rh
- Rt
- S
- SG
- SI
- SNR
- STh
- TLE
- Te1,3
- VL
- VLG
- VLO
- VM
- VP
- VPL
- VPM
- VTR
- ZI
- accumbens
- accumbens shell
- agranular insular cortex
- amygdalopiriform transition area
- amygdalostriatal transition area
- anterior amygdaloid area
- anterior cingulate
- anterior cortical nucleus
- anterior hypothalamic area
- anterior hypothalamic area, central
- anterior olfactory nucleus
- anterodorsal nucleus
- anteromedial
- anteroventral nucleus
- basolateral nucleus, anterior
- basolateral nucleus, posterior
- basolateral nucleus, ventral
- basomedial nucleus, anterior
- basomedial nucleus, posterior
- bed nucleus accessory olfactory tract
- bed nucleus stria terminalis, intraamygdaloid division
- bed stria terminalis nuclei
- caudate putamen
- central nucleus, lateral
- central nucleus, medial
- centrolateral nucleus
- centromedial nucleus
- cornu ammonis
- dentate gyrus
- dorsal endopiriform nucleus
- dorsal peduncular
- dorsolateral geniculate nucleus
- dysgranular insular cortex
- electroencephalogram
- entorhinal cortex
- frontal cortex
- globus pallidus
- granular insular cortex
- hilus
- hippocampus
- immature brain
- infralimbic
- intercalated masses
- lateral habenula
- lateral mammillary
- lateral nucleus, dorsal
- lateral nucleus, ventral
- lateral orbital cortex
- lateral septal, dorsal
- lateral septal, intermediate
- lateral septal, ventral
- laterodorsal nucleus, dorsomedial
- laterodorsal nucleus, ventrolateral
- lateroposterior nucleus, lateral rostral
- lateroposterior nucleus, medial rostral
- lithium pilocarpine
- medial geniculate nucleus, dorsal
- medial geniculate nucleus, medial
- medial geniculate nucleus, ventral
- medial globus pallidus
- medial habenula
- medial nucleus, anterior
- medial nucleus, posterodorsal
- medial nucleus, posteroventral
- medial orbital cortex
- medial septal
- medial tuberal
- mediodorsal nucleus
- nucleus accumbens
- nucleus lateral olfactory tract
- occipital cortex
- paracentral
- parafasicular
- parasubiculum
- paratenial
- paraventricular nucleus, anterior
- paraventricular nucleus, posterior
- parietal cortex
- perirhinal cortex
- piriform cortex
- post-natal day
- posterior nucleus
- posterolateral cortical nucleus
- posteromedial cortical nucleus
- premammillary nucleus, dorsal
- premammillary nucleus, ventral
- presubiculum
- reticular nucleus
- retrosplenial agranular cortex
- retrosplenial granular cortex
- reuniens nucleus
- rhomboid nucleus
- status epilepticus
- subiculum
- substantia innominate
- substantia nigra pars reticulate
- subthalamic nucleus
- suprageniculate nucleus
- temporal cortex
- temporal lobe epilepsy
- vRe
- ventral pallidum
- ventral posterolateral nucleus
- ventral posteromedial nucleus
- ventral reuniens nucleus
- ventral tegmental area
- ventrolateral geniculate nucleus
- ventrolateral nucleus
- ventrolateral orbital cortex
- ventromedial nucleus
- zona incerta
- γ-aminobutyric acid
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Affiliation(s)
- E A Scholl
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, United States
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Pham TT, Loiseau PM, Barratt G. Strategies for the design of orally bioavailable antileishmanial treatments. Int J Pharm 2013; 454:539-52. [PMID: 23871737 DOI: 10.1016/j.ijpharm.2013.07.035] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 12/21/2022]
Abstract
Leishmaniasis is one of the six major tropical diseases targeted by the World Health Organization. The most serious, life-threatening form is visceral leishmaniasis (VL). No vaccine is yet available for human use and chemotherapy is the main mean of dealing with this disease. This review focuses on the development of drug delivery systems (DDS) for treatment of leishmaniasis. After an overview of the significance of leishmaniasis in 2013, current chemotherapy and its limitations are considered, leading to possible strategies to improve the treatment of VL: new drugs, combinations of existing drugs and DDS, particularly for oral administration. Nanostructured biomaterials such as lipid-based or polymeric nanoparticles have unique physicochemical properties, ultra-small and controllable size, large surface area to mass ratio and the possibility of surface modification which can be used to advantage for the oral administration of antileishmanial drugs. They can improve the rate of dissolution of poorly water-soluble drugs, increase intestinal residence time by bioadhesion and, especially when lipid additives are used, influence the route and efficiency of absorption. These recent advances in this very active field should lead to better management of this serious disease.
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Marzetti E, Calvani R, Cesari M, Buford TW, Lorenzi M, Behnke BJ, Leeuwenburgh C. Mitochondrial dysfunction and sarcopenia of aging: from signaling pathways to clinical trials. Int J Biochem Cell Biol 2013; 45:2288-301. [PMID: 23845738 DOI: 10.1016/j.biocel.2013.06.024] [Citation(s) in RCA: 355] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 06/20/2013] [Accepted: 06/26/2013] [Indexed: 12/12/2022]
Abstract
Sarcopenia, the age-related loss of muscle mass and function, imposes a dramatic burden on individuals and society. The development of preventive and therapeutic strategies against sarcopenia is therefore perceived as an urgent need by health professionals and has instigated intensive research on the pathophysiology of this syndrome. The pathogenesis of sarcopenia is multifaceted and encompasses lifestyle habits, systemic factors (e.g., chronic inflammation and hormonal alterations), local environment perturbations (e.g., vascular dysfunction), and intramuscular specific processes. In this scenario, derangements in skeletal myocyte mitochondrial function are recognized as major factors contributing to the age-dependent muscle degeneration. In this review, we summarize prominent findings and controversial issues on the contribution of specific mitochondrial processes - including oxidative stress, quality control mechanisms and apoptotic signaling - on the development of sarcopenia. Extramuscular alterations accompanying the aging process with a potential impact on myocyte mitochondrial function are also discussed. We conclude with presenting methodological and safety considerations for the design of clinical trials targeting mitochondrial dysfunction to treat sarcopenia. Special emphasis is placed on the importance of monitoring the effects of an intervention on muscle mitochondrial function and identifying the optimal target population for the trial. This article is part of a Directed Issue entitled: Molecular basis of muscle wasting.
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Affiliation(s)
- Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome 00168, Italy.
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Morin N, Morissette M, Grégoire L, Gomez-Mancilla B, Gasparini F, Di Paolo T. Chronic treatment with MPEP, an mGlu5 receptor antagonist, normalizes basal ganglia glutamate neurotransmission in L-DOPA-treated parkinsonian monkeys. Neuropharmacology 2013; 73:216-31. [PMID: 23756168 DOI: 10.1016/j.neuropharm.2013.05.028] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 05/17/2013] [Accepted: 05/18/2013] [Indexed: 10/26/2022]
Abstract
Metabotropic glutamate 5 (mGlu5) receptor antagonists reduce L-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesias (LID) in Parkinson's disease (PD). The aim of this study was to investigate the long-term effect of the prototypal mGlu5 receptor antagonist 2-methyl-6-(phenylethynyl)pyridine (MPEP) on glutamate receptors known to be involved in the development of LID in the de novo chronic treatment of monkeys lesioned with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). MPTP monkeys were treated for one month with L-DOPA and developed dyskinesias while those treated with L-DOPA and MPEP (10 mg/kg) developed significantly less. Normal control and saline-treated MPTP monkeys were also included. All MPTP monkeys were extensively and similarly denervated. The basal ganglia [(3)H]ABP688 specific binding (mGlu5 receptors) was elevated in L-DOPA-treated MPTP monkeys compared to controls but not in those treated with L-DOPA and MPEP; dyskinesia scores of these monkeys correlated positively with their [(3)H]ABP688 specific binding. Striatal density (B(max)) of [(3)H]ABP688 specific binding increased in L-DOPA-treated MPTP monkeys compared to other groups and affinity (Kd) remained unchanged. Striatal mGlu5 receptor mRNA remained unchanged following treatments. Elevated basal ganglia specific binding of [(3)H]Ro 25-6981 (NMDA NR1/NR2B receptors), [(3)H]Ro 48-8587 (AMPA receptors) but not [(3)H]CGP-39653 (NMDA NR1/NR2A receptors) was observed only in L-DOPA-treated MPTP monkeys; dyskinesias scores correlated with binding. By contrast, basal ganglia [(3)H]LY341495 specific binding (mGlu2/3 receptors) decreased in L-DOPA-treated MPTP monkeys compared to controls, saline and L-DOPA + MPEP treated MPTP monkeys; dyskinesias scores correlated negatively with this binding. Hence, chronic MPEP treatment reduces the development of LID and is associated with a normalization of glutamate neurotransmission.
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Affiliation(s)
- Nicolas Morin
- Neuroscience Research Unit, Laval University Medical Center (CHUQ), Quebec, QC, Canada
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Levy R, Ahluwalia K, Bohmann DJ, Giang HM, Schwimmer LJ, Issafras H, Reddy NB, Chan C, Horwitz AH, Takeuchi T. Enhancement of antibody fragment secretion into the Escherichia coli periplasm by co-expression with the peptidyl prolyl isomerase, FkpA, in the cytoplasm. J Immunol Methods 2013; 394:10-21. [PMID: 23624043 DOI: 10.1016/j.jim.2013.04.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 04/08/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
Improper protein folding or aggregation can frequently be responsible for low expression and poor functional activity of antibody fragments secreted into the Escherichia coli periplasm. Expression issues also can affect selection of antibody candidates from phage libraries, since antibody fragments displayed on phage also are secreted into the E. coli periplasm. To improve secretion of properly folded antibody fragments into the periplasm, we have developed a novel approach that involves co-expressing the antibody fragments with the peptidyl prolyl cis-trans isomerase, FkpA, lacking its signal sequence (cytFkpA) which consequently is expressed in the E. coli cytosol. Cytoplasmic expression of cytFkpA improved secretion of functional Fab fragments into the periplasm, exceeding even the benefits from co-expressing Fab fragments with native, FkpA localized in the periplasm. In addition, panning and subsequent screening of large Fab and scFv naïve phage libraries in the presence of cytFkpA significantly increased the number of unique clones selected, as well as their functional expression levels and diversity.
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Affiliation(s)
- Raphael Levy
- Preclinical Research and Development, XOMA Corp., Berkeley, CA 94710, USA.
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Thanongsaksrikul J, Chaicumpa W. Botulinum neurotoxins and botulism: a novel therapeutic approach. Toxins (Basel) 2011; 3:469-88. [PMID: 22069720 PMCID: PMC3202833 DOI: 10.3390/toxins3050469] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 04/22/2011] [Accepted: 04/28/2011] [Indexed: 01/01/2023] Open
Abstract
Specific treatment is not available for human botulism. Current remedial mainstay is the passive administration of polyclonal antibody to botulinum neurotoxin (BoNT) derived from heterologous species (immunized animal or mouse hybridoma) together with supportive and symptomatic management. The antibody works extracellularly, probably by blocking the binding of receptor binding (R) domain to the neuronal receptors; thus inhibiting cellular entry of the holo-BoNT. The antibody cannot neutralize the intracellular toxin. Moreover, a conventional antibody with relatively large molecular size (150 kDa) is not accessible to the enzymatic groove and, thus, cannot directly inhibit the BoNT zinc metalloprotease activity. Recently, a 15-20 kDa single domain antibody (V(H)H) that binds specifically to light chain of BoNT serotype A was produced from a humanized-camel VH/V(H)H phage display library. The V(H)H has high sequence homology (>80%) to the human VH and could block the enzymatic activity of the BoNT. Molecular docking revealed not only the interface binding between the V(H)H and the toxin but also an insertion of the V(H)H CDR3 into the toxin enzymatic pocket. It is envisaged that, by molecular linking the V(H)H to a cell penetrating peptide (CPP), the CPP-V(H)H fusion protein would be able to traverse the hydrophobic cell membrane into the cytoplasm and inhibit the intracellular BoNT. This presents a novel and safe immunotherapeutic strategy for botulism by using a cell penetrating, humanized-single domain antibody that inhibits the BoNT by means of a direct blockade of the groove of the menace enzyme.
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Affiliation(s)
- Jeeraphong Thanongsaksrikul
- Laboratory for Research and Technology Development, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok-noi, Bangkok 10700, Thailand.
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