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Tumbo AM, Schindler T, Dangy JP, Orlova-Fink N, Bieri JR, Mpina M, Milando FA, Juma O, Hamad A, Nyakarungu E, Chemba M, Mtoro A, Ramadhan K, Olotu A, Makweba D, Mgaya S, Stuart K, Perreau M, Stapleton JT, Jongo S, Hoffman SL, Tanner M, Abdulla S, Daubenberger C. Role of human Pegivirus infections in whole Plasmodium falciparum sporozoite vaccination and controlled human malaria infection in African volunteers. Virol J 2021; 18:28. [PMID: 33499880 PMCID: PMC7837505 DOI: 10.1186/s12985-021-01500-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/20/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Diverse vaccination outcomes and protection levels among different populations pose a serious challenge to the development of an effective malaria vaccine. Co-infections are among many factors associated with immune dysfunction and sub-optimal vaccination outcomes. Chronic, asymptomatic viral infections can contribute to the modulation of vaccine efficacy through various mechanisms. Human Pegivirus-1 (HPgV-1) persists in immune cells thereby potentially modulating immune responses. We investigated whether Pegivirus infection influences vaccine-induced responses and protection in African volunteers undergoing whole P. falciparum sporozoites-based malaria vaccination and controlled human malaria infections (CHMI). METHODS HPgV-1 prevalence was quantified by RT-qPCR in plasma samples of 96 individuals before, post vaccination with PfSPZ Vaccine and after CHMI in cohorts from Tanzania and Equatorial Guinea. The impact of HPgV-1 infection was evaluated on (1) systemic cytokine and chemokine levels measured by Luminex, (2) PfCSP-specific antibody titers quantified by ELISA, (3) asexual blood-stage parasitemia pre-patent periods and parasite multiplication rates, (4) HPgV-1 RNA levels upon asexual blood-stage parasitemia induced by CHMI. RESULTS The prevalence of HPgV-1 was 29.2% (28/96) and sequence analysis of the 5' UTR and E2 regions revealed the predominance of genotypes 1, 2 and 5. HPgV-1 infection was associated with elevated systemic levels of IL-2 and IL-17A. Comparable vaccine-induced anti-PfCSP antibody titers, asexual blood-stage multiplication rates and pre-patent periods were observed in HPgV-1 positive and negative individuals. However, a tendency for higher protection levels was detected in the HPgV-1 positive group (62.5%) compared to the negative one (51.6%) following CHMI. HPgV-1 viremia levels were not significantly altered after CHMI. CONCLUSIONS HPgV-1 infection did not alter PfSPZ Vaccine elicited levels of PfCSP-specific antibody responses and parasite multiplication rates. Ongoing HPgV-1 infection appears to improve to some degree protection against CHMI in PfSPZ-vaccinated individuals. This is likely through modulation of immune system activation and systemic cytokines as higher levels of IL-2 and IL17A were observed in HPgV-1 infected individuals. CHMI is safe and well tolerated in HPgV-1 infected individuals. Identification of cell types and mechanisms of both silent and productive infection in individuals will help to unravel the biology of this widely present but largely under-researched virus.
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Affiliation(s)
- Anneth-Mwasi Tumbo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Tobias Schindler
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jean-Pierre Dangy
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nina Orlova-Fink
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jose Raso Bieri
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Maximillian Mpina
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Florence A Milando
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Omar Juma
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ali Hamad
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Elizabeth Nyakarungu
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Mwajuma Chemba
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Ali Mtoro
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Kamaka Ramadhan
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Ally Olotu
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Damas Makweba
- Dar-Es-Salaam Institute of Technology, Dar-Es-Salaam, Tanzania
- Tanzania Education and Research Networks, Dar-Es-Salaam, Tanzania
- Tanzania Commission for Science and Technology, Dar-Es-Salaam, Tanzania
| | - Stephen Mgaya
- Tanzania Education and Research Networks, Dar-Es-Salaam, Tanzania
- Tanzania Commission for Science and Technology, Dar-Es-Salaam, Tanzania
| | - Kenneth Stuart
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, 307 Westlake Avenue, N. Suite 500, Seattle, WA, 98109, USA
| | | | - Jack T Stapleton
- Iowa City Veterans Administration and the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Said Jongo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | | | - Marcel Tanner
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Salim Abdulla
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Claudia Daubenberger
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
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Fink G, Orlova-Fink N, Schindler T, Grisi S, Ferrer APS, Daubenberger C, Brentani A. Inactivated trivalent influenza vaccination is associated with lower mortality among patients with COVID-19 in Brazil. BMJ Evid Based Med 2020; 26:bmjebm-2020-111549. [PMID: 33310766 PMCID: PMC7735072 DOI: 10.1136/bmjebm-2020-111549] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To estimate associations between trivalent influenza vaccination and COVID-19 mortality as well as severe clinical outcomes among hospitalised patients. DESIGN Retrospective observational study. SETTING This study was conducted among hospitalised patients with COVID-19 in Brazil. PARTICIPANTS We analysed all hospitalised patients with COVID-19 with available vaccination information captured in Brazil's national electronic respiratory infection data system between 1 January 2020 and 23 June 2020. MAIN OUTCOME MEASURES The primary outcomes were age-specific mortality rates of hospitalised patients with COVID-19 with and without recent inactivated trivalent influenza vaccination. RESULTS A total of 53 752 clinically confirmed COVID-19 cases were analysed. Controlling for health facility of treatment, comorbidities as well as an extensive range of sociodemographic factors, patients who received a recent influenza vaccine experienced on average 7% lower odds of needing intensive care treatment (95% CI 0.87 to 0.98), 17% lower odds of requiring invasive respiratory support (95% CI 0.77 to 0.88) and 16% lower odds of death (95% CI 0.78 to 0.90). Protective effects were larger when the vaccine was administered after onset of symptoms as well as among younger patients. CONCLUSION Patients with COVID-19 with recent inactivated influenza vaccination experience significantly better health outcomes than non-vaccinated patients in Brazil. Beneficial off-target effects of influenza vaccination through trained innate immune responses seem plausible and need to be further explored. Large-scale promotion of influenza vaccines seems advisable, especially in populations at high risk for severe COVID-19 disease progression.
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Affiliation(s)
- Günther Fink
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
| | - Nina Orlova-Fink
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
| | - Tobias Schindler
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
| | - Sandra Grisi
- Department of Pediatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Ana Paula S Ferrer
- Department of Pediatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Claudia Daubenberger
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
| | - Alexandra Brentani
- Department of Pediatrics, University of São Paulo Medical School, São Paulo, Brazil
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3
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Mkindi CG, Marandu EA, Masawa N, Bani F, Nyuri A, Byakuzana T, Klimkait T, Ding S, Pantaleo G, Battegay M, Orlova-Fink N, Weisser-Rohacek M, Daubenberger C. Safety and tolerance of lymph node biopsies from chronic HIV-1 volunteers in rural Tanzania. BMC Res Notes 2019; 12:561. [PMID: 31492170 PMCID: PMC6729032 DOI: 10.1186/s13104-019-4600-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/03/2019] [Indexed: 11/29/2022] Open
Abstract
Objective HIV-1 rapidly establishes a persistent infection that can be contained under life-long antiretroviral therapy (ART) but not cured. One major viral reservoir is the peripheral lymph node (LN) follicles. Studying the impact of novel HIV-1 treatment and vaccination approaches on cells residing in germinal centers is essential for rapid progress towards HIV-1 prevention and cure. Results We enrolled 9 asymptomatic adult volunteers with a newly diagnosed HIV-1 infection and CD4 T cell counts ≥ 350/ml. The patients underwent venous blood collection and inguinal lymph node excision surgery in parallel. Mononuclear cells were extracted from blood and tissues simultaneously. Participants were followed up regularly for 2 weeks until complete healing of the surgical wounds. All participants completed the lymph node excision surgery without clinical complications. Among the 9 volunteers, one elite controller was identified. The number of mononuclear cells recovered from lymph nodes ranged from 68 to 206 million and correlated positively with lymph node size. This is the first study to show that lymph node biopsy is a safe procedure and can be undertaken with local experts in rural settings. It provides a foundation for detailed immune response investigations during future clinical trials.
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Affiliation(s)
- Catherine Gerald Mkindi
- Department of Medical Parasitology and Infection Biology, Clinical Immunology, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Ifakara Health Institute, Bagamoyo, Tanzania
| | | | | | - Farida Bani
- Ifakara Health Institute, Bagamoyo, Tanzania
| | - Amina Nyuri
- Ifakara Health Institute, Bagamoyo, Tanzania
| | | | | | - Song Ding
- EuroVacc Foundation, Amsterdam, The Netherlands
| | - Giuseppe Pantaleo
- Service of Immunology and Allergy, Lausanne University Hospital, Lausanne, Switzerland.,Swiss Vaccine Research Institute, Lausanne, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Nina Orlova-Fink
- Department of Medical Parasitology and Infection Biology, Clinical Immunology, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland.,Ifakara Health Institute, Bagamoyo, Tanzania
| | - Maja Weisser-Rohacek
- Department of Medical Parasitology and Infection Biology, Clinical Immunology, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland.,Ifakara Health Institute, Bagamoyo, Tanzania.,Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Claudia Daubenberger
- Department of Medical Parasitology and Infection Biology, Clinical Immunology, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland. .,Ifakara Health Institute, Bagamoyo, Tanzania.
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Lee GQ, Orlova-Fink N, Einkauf K, Chowdhury FZ, Sun X, Harrington S, Kuo HH, Hua S, Chen HR, Ouyang Z, Reddy K, Dong K, Ndung'u T, Walker BD, Rosenberg ES, Yu XG, Lichterfeld M. Clonal expansion of genome-intact HIV-1 in functionally polarized Th1 CD4+ T cells. J Clin Invest 2017. [PMID: 28628034 DOI: 10.1172/jci93289] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
HIV-1 causes a chronic, incurable disease due to its persistence in CD4+ T cells that contain replication-competent provirus, but exhibit little or no active viral gene expression and effectively resist combination antiretroviral therapy (cART). These latently infected T cells represent an extremely small proportion of all circulating CD4+ T cells but possess a remarkable long-term stability and typically persist throughout life, for reasons that are not fully understood. Here we performed massive single-genome, near-full-length next-generation sequencing of HIV-1 DNA derived from unfractionated peripheral blood mononuclear cells, ex vivo-isolated CD4+ T cells, and subsets of functionally polarized memory CD4+ T cells. This approach identified multiple sets of independent, near-full-length proviral sequences from cART-treated individuals that were completely identical, consistent with clonal expansion of CD4+ T cells harboring intact HIV-1. Intact, near-full-genome HIV-1 DNA sequences that were derived from such clonally expanded CD4+ T cells constituted 62% of all analyzed genome-intact sequences in memory CD4 T cells, were preferentially observed in Th1-polarized cells, were longitudinally detected over a duration of up to 5 years, and were fully replication- and infection-competent. Together, these data suggest that clonal proliferation of Th1-polarized CD4+ T cells encoding for intact HIV-1 represents a driving force for stabilizing the pool of latently infected CD4+ T cells.
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Affiliation(s)
- Guinevere Q Lee
- Infectious Disease Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Nina Orlova-Fink
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Kevin Einkauf
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | | | - Xiaoming Sun
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Sean Harrington
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Hsiao-Hsuan Kuo
- Infectious Disease Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Stephane Hua
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Hsiao-Rong Chen
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Zhengyu Ouyang
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Kavidha Reddy
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, and
| | - Krista Dong
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, and
| | - Thumbi Ndung'u
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA.,HIV Pathogenesis Programme, Doris Duke Medical Research Institute, and.,KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.,Max Planck Institute for Infection Biology, Berlin, Germany
| | - Bruce D Walker
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA.,Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
| | - Eric S Rosenberg
- Infectious Disease Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Xu G Yu
- Infectious Disease Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Mathias Lichterfeld
- Infectious Disease Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
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