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Koehne E, Kreidenweiss A, Adegbite BR, Manego RZ, McCall MB, Mombo-Ngoma G, Adegnika AA, Agnandji ST, Mordmüller B, Held J. Erratum to ‘In vitro activity of eravacycline, a novel synthetic halogenated tetracycline, against the malaria parasite Plasmodium falciparum’ [Journal of Global Antimicrobial Resistance 24 (2021) 93-97]. J Glob Antimicrob Resist 2022; 31:395. [DOI: 10.1016/j.jgar.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Koehne E, Kreidenweiss A, Adegbite BR, Manego RZ, McCall MBB, Mombo-Ngoma G, Adegnika AA, Agnandji ST, Mordmüller B, Held J. In vitro activity of eravacycline, a novel synthetic halogenated tetracycline, against the malaria parasite Plasmodium falciparum. J Glob Antimicrob Resist 2020; 24:93-97. [PMID: 33301999 DOI: 10.1016/j.jgar.2020.11.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/26/2020] [Accepted: 11/22/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Eravacycline is a novel synthetic halogenated tetracycline derivative with a broad antibacterial spectrum. Antibiotics, including tetracyclines, have been used for prophylaxis and, more rarely, for the treatment of malaria for several decades. The rise in drug-resistant malaria parasites renders the search for new treatment candidates urgent. We determined the in vitro potency of eravacycline against Plasmodium falciparum and investigated the apicoplast as a potential drug target. METHODS Four tetracyclines, including eravacycline, tetracycline, tigecycline, and doxycycline, and the lincosamide clindamycin, were tested in 3-day and 6-day in vitro susceptibility assays of P. falciparum laboratory strain 3D7 and/or of clinical isolates obtained from 33 P. falciparum infected individuals from Gabon in 2018. Assays with isopentenyl pyrophosphate substitution were performed to investigate whether apicoplast-encoded isoprenoid biosynthesis is inhibited by these antibiotics. RESULTS Eravacycline showed the highest activity of all tetracyclines tested in clinical isolates in the 3-day and 6-day assays. Substitution of isopentenyl pyrophosphate in vitro using the laboratory strain 3D7 reversed the activity of eravacycline and comparator antibiotics, indicating the apicoplast to be the main target organelle. CONCLUSIONS These results demonstrate the potential of novel antibiotics, and eravacycline, as candidate antimalarial therapies.
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Affiliation(s)
- Erik Koehne
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany
| | | | - Rella Zoleko Manego
- Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep of Medicine, University Medical Center Hamburg-Eppendorf, Bernhard-Nocht-Straße 74, D-20359 Hamburg, Germany
| | - Matthew B B McCall
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep of Medicine, University Medical Center Hamburg-Eppendorf, Bernhard-Nocht-Straße 74, D-20359 Hamburg, Germany
| | - Ayola Akim Adegnika
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany
| | - Sélidji Todagbé Agnandji
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany
| | - Benjamin Mordmüller
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany
| | - Jana Held
- Institute of Tropical Medicine, Eberhard Karls University Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany; Centre de Recherches Médicales de Lambaréné, B.P. 242, Lambaréné, Gabon; German Center for Infection Research, partner site Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany.
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Fernandes JF, Held J, Dorn M, Lalremruata A, Schaumburg F, Alabi A, Agbanrin MD, Kokou C, Ben Adande A, Esen M, Eibach D, Adegnika AA, Agnandji ST, Lell B, Eckerle I, Henrichfreise B, Hogan B, May J, Kremsner PG, Grobusch MP, Mordmüller B. Causes of fever in Gabonese children: a cross-sectional hospital-based study. Sci Rep 2020; 10:2080. [PMID: 32034188 PMCID: PMC7005879 DOI: 10.1038/s41598-020-58204-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
The causes of infections in pediatric populations differ between age groups and settings, particularly in the tropics. Such differences in epidemiology may lead to misdiagnosis and ineffective empirical treatment. Here, we investigated the current spectrum of pathogens causing febrile diseases leading to pediatric hospitalization in Lambaréné, Gabon. From August 2015 to March 2016, we conducted a prospective, cross-sectional, hospital-based study in a provincial hospital. Patients were children ≤ 15 years with fever ≥ 38 °C and required hospitalization. A total of 600 febrile patients were enrolled. Malaria was the main diagnosis found in 52% (311/600) patients. Blood cultures revealed septicemia in 3% (17/593), among them four cases of typhoid fever. The other causes of fever were heterogeneously distributed between both bacteria and viruses. Severe infections identified by Lambaréné Organ Dysfunction Score (LODS) were also most often caused by malaria, but children with danger signs did not have more coinfections than others. In 6% (35/600) of patients, no pathogen was isolated. In Gabon, malaria is still the major cause of fever in children, followed by a bacterial and viral disease. Guidelines for both diagnosis and management should be tailored to the spectrum of pathogens and resources available locally.
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Affiliation(s)
- José Francisco Fernandes
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jana Held
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon. .,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany. .,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany.
| | - Magdalena Dorn
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon
| | - Albert Lalremruata
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, 48149, Münster, Germany
| | - Abraham Alabi
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon
| | - Maradona Daouda Agbanrin
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon
| | - Cosme Kokou
- Albert Schweitzer Hospital, Lambaréné, BP: 118, Lambaréné, Gabon
| | - Abel Ben Adande
- Albert Schweitzer Hospital, Lambaréné, BP: 118, Lambaréné, Gabon
| | - Meral Esen
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Daniel Eibach
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74 D-, 20359, Hamburg, Germany.,German Center for Infection Research (DZIF), partner site Hamburg, Hamburg, Germany
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Sélidji Todagbé Agnandji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Isabella Eckerle
- Institute of Virology, University of Bonn Medical Centre, 53127, Bonn, Germany
| | - Beate Henrichfreise
- Pharmaceutical Microbiology, University Hospital Bonn, University Bonn, 53115, Bonn, Germany
| | - Benedikt Hogan
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74 D-, 20359, Hamburg, Germany.,German Center for Infection Research (DZIF), partner site Hamburg, Hamburg, Germany
| | - Jürgen May
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74 D-, 20359, Hamburg, Germany.,German Center for Infection Research (DZIF), partner site Hamburg, Hamburg, Germany
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon. .,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany. .,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. .,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Benjamin Mordmüller
- Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, B.P: 242, Lambaréné, Gabon.,Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
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Maloupazoa Siawaya AC, Kuissi Kamgaing E, Minto'o Rogombe S, Obiang T, Moungoyi Massala E, Magossou Mbadinga MJV, Leboueny M, Mvoundza Ndjindji O, Mveang-Nzoghe A, Ondo JP, Mintsa Ndong A, N Essone P, Agnandji ST, Kaba M, Ategbo S, Djoba Siawaya JF. HIV-exposed uninfected compared with unexposed infants show the presence of leucocytes, lower lactoferrin levels and antimicrobial-resistant micro-organisms in the stool. Paediatr Int Child Health 2019; 39:249-258. [PMID: 30762489 DOI: 10.1080/20469047.2019.1577063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: HIV-exposed uninfected (HEU)-infants have been shown to be particularly vulnerable to infections. In this population, disturbance of the gut micro-environment might increase their susceptibility to enteric diseases and even favour the translocation of bacteria in the bloodstream. Methods: The gastro-intestinal micro-environment was explored in 22 HEU infants and 16 HIV-unexposed (HU) infants aged 6-24 weeks. Faecal leucocytes, firmicutes (gram-positive bacteria) and gracilicutes (gram-negative bacteria) were assessed by cytology. Faecal lactoferrin and sIgA were measured by ELISA. The spectrum of micro-organisms in infants' stool was analysed by culturing. Results: HEU infants were 14 times more likely to have leucocytes in their stool than HU infants (p < 0.005). The lactoferrin level was significantly lower in HEU infants than in HU infants (p = 0.02). Potentially pathogenic bacteria such as Escherichia coli were more prevalent in HEU than in HU infants (64% vs 23.5%). Also, E. coli strains resistant to key antibiotics including co-trimoxazole, β-lactam (cephalosporins included) and tetraclines were observed in some HEU infants. Conclusion: HEU infants are more likely to present an inflamed digestive tract as highlighted by the presence of leucocytes. In addition, there is a real risk of colonisation of HEU infants' microbiota by resistant micro-organisms.
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Affiliation(s)
- A C Maloupazoa Siawaya
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori , Libreville , Gabon
| | - E Kuissi Kamgaing
- Département de Pédiatrie, Université des Sciences de la Santé , Libreville , Gabon
| | - S Minto'o Rogombe
- Département de Pédiatrie, Université des Sciences de la Santé , Libreville , Gabon
| | - T Obiang
- Département de Pédiatrie, Université des Sciences de la Santé , Libreville , Gabon
| | - E Moungoyi Massala
- Département de Chimie, Faculté des Sciences, Université des Sciences et Techniques de Masuku , Franceville , Gabon
| | - M J V Magossou Mbadinga
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori , Libreville , Gabon
| | - M Leboueny
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori , Libreville , Gabon
| | - O Mvoundza Ndjindji
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori , Libreville , Gabon
| | - A Mveang-Nzoghe
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori , Libreville , Gabon
| | - J P Ondo
- Département de Chimie, Faculté des Sciences, Université des Sciences et Techniques de Masuku , Franceville , Gabon
| | - A Mintsa Ndong
- Laboratoire National de Santé Publique, Unité de Virologie , Libreville , Gabon
| | - P N Essone
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Centre de Recherches Médicales de Lambaréné , Lambaréné , Gabon.,Institut für Tropenmedizin, Universitätsklinikum Tübingen , Tübingen , Germany
| | - S T Agnandji
- Centre de Recherches Médicales de Lambaréné , Lambaréné , Gabon.,Institut für Tropenmedizin, Universitätsklinikum Tübingen , Tübingen , Germany
| | - M Kaba
- Division of Medical Microbiology, University of Cape Town , Cape Town , South Africa
| | - S Ategbo
- Département de Pédiatrie, Université des Sciences de la Santé , Libreville , Gabon
| | - J F Djoba Siawaya
- Laboratoire National de Santé Publique, Unités de Recherche et de Diagnostics Spécialisés , Libreville , Gabon.,Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori , Libreville , Gabon
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5
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Manego RZ, Mombo-Ngoma G, Witte M, Held J, Gmeiner M, Gebru T, Tazemda B, Mischlinger J, Groger M, Lell B, Adegnika AA, Agnandji ST, Kremsner PG, Mordmüller B, Ramharter M, Matsiegui PB. Demography, maternal health and the epidemiology of malaria and other major infectious diseases in the rural department Tsamba-Magotsi, Ngounie Province, in central African Gabon. BMC Public Health 2017; 17:130. [PMID: 28129759 PMCID: PMC5273856 DOI: 10.1186/s12889-017-4045-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 01/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa is undergoing an epidemiological transition from a predominance of infectious diseases to non-communicable and lifestyle related conditions. However, the pace of this transition and the pattern of disease epidemiology are uneven between affluent urban and rural poor populations. To address this question for a remote rural region located in the central African rainforest region of Gabon, this study was conducted to assess reasons for health care attendance and to characterize the epidemiology of malaria and other major infectious diseases for the department of Tsamba Magotsi. METHODS Major causes for health care attendance were collected from local hospital records. Cross sectional population based surveys were performed for the assessment of local malaria epidemiology. Pregnant women attending antenatal care services were surveyed as a sentinel population for the characterization of chronic viral and parasitic infections in the community. RESULTS Infectious diseases were responsible for 71% (7469) of a total of 10,580 consultations at the formal health care sector in 2010. Overall, malaria - defined by clinical syndrome - remained the most frequent cause for health care attendance. A cross sectional malaria survey in 840 asymptomatic individuals residing in Tsamba Magotsi resulted in a Plasmodium spp. infection prevalence of 37%. The infection rate in 2-10 year old asymptomatic children - a standard measure for malaria endemicity - was 46% (100 of 217) with P. falciparum as predominant species (79%). Infection with other plasmodial species (P. ovale and P. malariae) presented most commonly as coinfections (23.2%). Prevalence of HIV, HBV, and syphilis were 6.2, 7.3, and 2.5%, respectively, in cross-sectional assessments of antenatal care visits of pregnant women. Urogenital schistosomiasis and the filarial pathogens Loa loa and Mansonella perstans are highly prevalent chronic parasitic infections affecting the local population. CONCLUSIONS Despite major improvements in the accessibility of Tsamba Magotsi over the past decade the epidemiological transition does not appear to have majorly changed on the spectrum of diseases in this rural Gabonese population. The high prevalence of Plasmodium infection indicates a high burden of malaria related morbidity. Infectious diseases remain one of the most important health issues and further research activities in the field of tropical medicine and infectious diseases could help improve health care for the local population.
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Affiliation(s)
- R Zoleko Manego
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - G Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Département de Parasitologie-Mycologie, Université des Sciences de La Santé, Libreville, Gabon
| | - M Witte
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - J Held
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - M Gmeiner
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - T Gebru
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - B Tazemda
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon
| | - J Mischlinger
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - M Groger
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - B Lell
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - A A Adegnika
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - S T Agnandji
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - P G Kremsner
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany
| | - B Mordmüller
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Deutsches Zentrum für Infektionsforschung (DZIF), Standort, Tübingen, Germany
| | - M Ramharter
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon. .,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany. .,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
| | - P B Matsiegui
- Centre de Recherches Médicales de Lambaréné , Lambaréné, Gabon.,Institut für Tropenmedizin, University of Tübingen, 72074, Tübingen, Germany.,Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon
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6
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Moekotte AL, Huson MAM, van der Ende AJ, Agnandji ST, Huizenga E, Goorhuis A, Grobusch MP. Monoclonal antibodies for the treatment of Ebola virus disease. Expert Opin Investig Drugs 2016; 25:1325-1335. [PMID: 27676206 DOI: 10.1080/13543784.2016.1240785] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 12/22/2022]
Abstract
INTRODUCTION To date, the management of patients with suspected or confirmed Ebolavirus disease (EVD) depends on quarantine, symptomatic management and supportive care, as there are no approved vaccines or treatments available for human use. However, accelerated by the recent large outbreak in West Africa, significant progress has been made towards vaccine development but also towards specific treatment with convalescent plasma and monoclonal antibodies. Areas covered: We describe recent developments in monoclonal antibody treatment for EVD, encompassing mAb114 and the MB-003, ZMAb, ZMapp™ and MIL-77E cocktails. Expert opinion: Preventive measures, are, and will remain essential to curb EVD outbreaks; even more so with vaccine development progressing. However, research for treatment options must not be neglected. Small-scale animal and individual human case studies show that monoclonal antibodies (mAbs) can be effective for EVD treatment; thus justifying exploration in clinical trials. Potential limitations are that high doses may be needed to yield clinical efficacy; epitope mutations might reduce efficacy; and constant evolution of (outbreak-specific) mAb mixtures might be required. Interim advice based on the clinical experience to date is that treatment of patients with mAbs is sensible, provided those could be made available in the necessary amounts in time.
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Affiliation(s)
- A L Moekotte
- a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - M A M Huson
- a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - A J van der Ende
- b Lion Heart Medical Center , Yele , Sierra Leone.,c Lion Heart Medical Research Unit , Yele , Sierra Leone
| | - S T Agnandji
- d Centre de Recherches Médicales en Lambaréné (CERMEL) , Lambaréné , Gabon.,e Institute of Tropical Medicine , University of Tübingen , Tübingen , Germany
| | - E Huizenga
- b Lion Heart Medical Center , Yele , Sierra Leone.,c Lion Heart Medical Research Unit , Yele , Sierra Leone
| | - A Goorhuis
- a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.,c Lion Heart Medical Research Unit , Yele , Sierra Leone
| | - M P Grobusch
- a Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.,c Lion Heart Medical Research Unit , Yele , Sierra Leone.,d Centre de Recherches Médicales en Lambaréné (CERMEL) , Lambaréné , Gabon.,e Institute of Tropical Medicine , University of Tübingen , Tübingen , Germany
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Neafsey DE, Juraska M, Bedford T, Benkeser D, Valim C, Griggs A, Lievens M, Abdulla S, Adjei S, Agbenyega T, Agnandji ST, Aide P, Anderson S, Ansong D, Aponte JJ, Asante KP, Bejon P, Birkett AJ, Bruls M, Connolly KM, D'Alessandro U, Dobaño C, Gesase S, Greenwood B, Grimsby J, Tinto H, Hamel MJ, Hoffman I, Kamthunzi P, Kariuki S, Kremsner PG, Leach A, Lell B, Lennon NJ, Lusingu J, Marsh K, Martinson F, Molel JT, Moss EL, Njuguna P, Ockenhouse CF, Ogutu BR, Otieno W, Otieno L, Otieno K, Owusu-Agyei S, Park DJ, Pellé K, Robbins D, Russ C, Ryan EM, Sacarlal J, Sogoloff B, Sorgho H, Tanner M, Theander T, Valea I, Volkman SK, Yu Q, Lapierre D, Birren BW, Gilbert PB, Wirth DF. Genetic Diversity and Protective Efficacy of the RTS,S/AS01 Malaria Vaccine. N Engl J Med 2015; 373:2025-2037. [PMID: 26488565 PMCID: PMC4762279 DOI: 10.1056/nejmoa1505819] [Citation(s) in RCA: 264] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The RTS,S/AS01 vaccine targets the circumsporozoite protein of Plasmodium falciparum and has partial protective efficacy against clinical and severe malaria disease in infants and children. We investigated whether the vaccine efficacy was specific to certain parasite genotypes at the circumsporozoite protein locus. METHODS We used polymerase chain reaction-based next-generation sequencing of DNA extracted from samples from 4985 participants to survey circumsporozoite protein polymorphisms. We evaluated the effect that polymorphic positions and haplotypic regions within the circumsporozoite protein had on vaccine efficacy against first episodes of clinical malaria within 1 year after vaccination. RESULTS In the per-protocol group of 4577 RTS,S/AS01-vaccinated participants and 2335 control-vaccinated participants who were 5 to 17 months of age, the 1-year cumulative vaccine efficacy was 50.3% (95% confidence interval [CI], 34.6 to 62.3) against clinical malaria in which parasites matched the vaccine in the entire circumsporozoite protein C-terminal (139 infections), as compared with 33.4% (95% CI, 29.3 to 37.2) against mismatched malaria (1951 infections) (P=0.04 for differential vaccine efficacy). The vaccine efficacy based on the hazard ratio was 62.7% (95% CI, 51.6 to 71.3) against matched infections versus 54.2% (95% CI, 49.9 to 58.1) against mismatched infections (P=0.06). In the group of infants 6 to 12 weeks of age, there was no evidence of differential allele-specific vaccine efficacy. CONCLUSIONS These results suggest that among children 5 to 17 months of age, the RTS,S vaccine has greater activity against malaria parasites with the matched circumsporozoite protein allele than against mismatched malaria. The overall vaccine efficacy in this age category will depend on the proportion of matched alleles in the local parasite population; in this trial, less than 10% of parasites had matched alleles. (Funded by the National Institutes of Health and others.).
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