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1.
Glycoconj J ; 38(4): 447-457, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33956253

RESUMO

The capsular polysaccharide of the human pathogen Group B Streptococcus is a key virulence factor and vaccine candidate that induces protective antibodies when conjugated to carrier proteins. It consists of long polymeric chains of oligosaccharide repeating units, and each of the ten capsular serotypes described so far presents a unique chemical structure with distinct antigenic properties; therefore, broad protection against this pathogen could be achieved by a combination of ten glycoconjugates. Capsular polysaccharide biosynthesis and assembly follow a polymerase-dependent pathway that is widespread in encapsulated bacteria and is encoded by a polycistronic operon. Here we exploited the sequence similarity between the capsule operons of types V and IX to generate hybrid polysaccharides incorporating epitopes of both serotypes in a single molecule, by co-expressing their specific CpsM, O, I glycosyltransferases in a single isolate. Physicochemical and immunochemical methods confirmed that an engineered strain produced a high molecular weight chimeric polysaccharide, combining antigenic specificities of both type V and IX. By optimizing the copy number of key glycosyltransferase genes, we were able to modulate the ratio between type-specific epitopes. Finally, vaccination with chimeric glycoconjugates significantly decreased the incidence of disease in pups born from immunized mice challenged with either serotype. This study provides proof of concept for a new generation of glycoconjugate vaccines that combine the antigenic specificity of different polysaccharide variants in a single molecule, eliciting a protective immune response against multiple serotype variants.


Assuntos
Cápsulas Bacterianas/imunologia , Polissacarídeos Bacterianos/imunologia , Vacinas Estreptocócicas/imunologia , Streptococcus agalactiae/imunologia , Vacinas Combinadas/imunologia , Animais , Anticorpos Monoclonais , Proteínas de Bactérias/imunologia , Feminino , Engenharia Genética , Glicoconjugados , Humanos , Imunidade Materno-Adquirida , Camundongos
2.
J Infect Dis ; 221(6): 943-947, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-31641758

RESUMO

Recent structural studies demonstrated that the epitope recognized by a monoclonal antibody representative of the protective response against the type III group B Streptococcus polysaccharide was comprised within 2 of the repeating units that constitute the full-length native structure. In the current study, we took advantage of this discovery to design a novel vaccine based on multivalent presentation of the identified minimal epitope on a carrier protein. We show that highly glycosylated short oligosaccharide conjugates elicit functional immune responses comparable to those of the full-length native polysaccharide. The obtained results pave the way to the design of well-defined glycoconjugate vaccines based on short synthetic oligosaccharides.


Assuntos
Epitopos/química , Oligossacarídeos/química , Oligossacarídeos/metabolismo , Infecções Estreptocócicas/prevenção & controle , Vacinas Estreptocócicas/imunologia , Streptococcus agalactiae , Animais , Configuração de Carboidratos , Epitopos/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Oligossacarídeos/imunologia
3.
FASEB J ; 33(3): 4448-4457, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30566365

RESUMO

Group B Streptococcus (GBS) colonizes the human lower intestinal and genital tracts and constitutes a major threat to neonates from pregnant carrier mothers and to adults with underlying morbidity. The pathogen expresses cell-surface virulence factors that enable cell adhesion and penetration and that counteract innate and adaptive immune responses. Among these, the complement interfering protein (CIP) was recently described for its capacity to interact with the human C4b ligand and to interfere with the classical- and lectin-complement pathways. In the present study, we provide evidence that CIP can also interact with C3, C3b, and C3d. Immunoassay-based competition experiments showed that binding of CIP to C3d interferes with the interaction between C3d and the complement receptor 2/cluster of differentiation 21 (CR2/CD21) receptor on B cells. By B-cell intracellular signaling assays, CIP was confirmed to down-regulate CR2/CD21-dependent B-cell activation. The CIP domain involved in C3d binding was mapped via hydrogen deuterium exchange-mass spectrometry. The data obtained reveal a new role for this GBS polypeptide at the interface between the innate and adaptive immune responses, adding a new member to the growing list of virulence factors secreted by gram-positive pathogens that incorporate multiple immunomodulatory functions.-Giussani, S., Pietrocola, G., Donnarumma, D., Norais, N., Speziale, P., Fabbrini, M., Margarit, I. The Streptococcus agalactiae complement interfering protein combines multiple complement-inhibitory mechanisms by interacting with both C4 and C3 ligands.


Assuntos
Proteínas de Bactérias/metabolismo , Complemento C3d/antagonistas & inibidores , Complemento C4/antagonistas & inibidores , Streptococcus agalactiae/patogenicidade , Fatores de Virulência/metabolismo , Sequência de Aminoácidos , Linfócitos B/efeitos dos fármacos , Linfócitos B/imunologia , Proteínas de Bactérias/farmacologia , Sítios de Ligação , Sinalização do Cálcio , Linhagem Celular Tumoral , Complemento C3b/antagonistas & inibidores , Complemento C3b/metabolismo , Complemento C3d/metabolismo , Ensaio de Imunoadsorção Enzimática , Humanos , Ativação Linfocitária/efeitos dos fármacos , Espectrometria de Massas , Ligação Proteica , Mapeamento de Interação de Proteínas , Receptores de Complemento 3d/metabolismo , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Streptococcus agalactiae/imunologia , Streptococcus agalactiae/metabolismo , Ressonância de Plasmônio de Superfície , Virulência , Fatores de Virulência/farmacologia
4.
Sleep Breath ; 24(2): 413-424, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31444679

RESUMO

Excessive daytime sleepiness (EDS) and fatigue are some of the most frequent symptoms in neurological diseases and could impact on quality of life by increasing the risk of accidents and generally affecting daily life activities. In this review, we will examine the variety of causes responsible for EDS in neurological diseases, including nocturnal sleep alterations, CNS pathological abnormalities with alterations in arousal and/or REM regulation systems, circadian rhythms disorders, drugs, and comorbid psychiatric or primary sleep disorders. Among neurological diseases, epilepsy, dementia, Parkinson disease, multiple sclerosis, and myotonic dystrophies represented a model for these interactions between EDS and neurological diseases. A complete diagnostic workup in neurological patients with EDS should be undertaken since EDS can worsen many different aspects such as psychiatric symptoms, cognitive deficit, and in some cases, the severity of the neurological disease per se. Moreover, quality of life and risk of accidents are dependent on EDS. An individualized approach to this symptom in neurological patients should be considered with a focus on modifiable causes such as SDB, psychiatric comorbidities, and drugs. When considering EDS and fatigue in neurological diseases, close attention to lifestyle and sleep hygiene is advisable. A critical review of ongoing pharmacological therapy should not be overlooked. Possible diagnosis and treatment of SDB should be always considered.


Assuntos
Distúrbios do Sono por Sonolência Excessiva/etiologia , Fadiga/etiologia , Doenças do Sistema Nervoso/complicações , Humanos
5.
Proc Natl Acad Sci U S A ; 114(19): 5017-5022, 2017 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-28439022

RESUMO

Despite substantial progress in the prevention of group B Streptococcus (GBS) disease with the introduction of intrapartum antibiotic prophylaxis, this pathogen remains a leading cause of neonatal infection. Capsular polysaccharide conjugate vaccines have been tested in phase I/II clinical studies, showing promise for further development. Mapping of epitopes recognized by protective antibodies is crucial for understanding the mechanism of action of vaccines and for enabling antigen design. In this study, we report the structure of the epitope recognized by a monoclonal antibody with opsonophagocytic activity and representative of the protective response against type III GBS polysaccharide. The structure and the atomic-level interactions were determined by saturation transfer difference (STD)-NMR and X-ray crystallography using oligosaccharides obtained by synthetic and depolymerization procedures. The GBS PSIII epitope is made by six sugars. Four of them derive from two adjacent repeating units of the PSIII backbone and two of them from the branched galactose-sialic acid disaccharide contained in this sequence. The sialic acid residue establishes direct binding interactions with the functional antibody. The crystal structure provides insight into the molecular basis of antibody-carbohydrate interactions and confirms that the conformational epitope is not required for antigen recognition. Understanding the structural basis of immune recognition of capsular polysaccharide epitopes can aid in the design of novel glycoconjugate vaccines.


Assuntos
Cápsulas Bacterianas/química , Epitopos/química , Oligossacarídeos/química , Polissacarídeos Bacterianos/química , Streptococcus agalactiae/química , Animais , Configuração de Carboidratos , Cristalografia por Raios X , Camundongos , Coelhos
6.
J Sleep Res ; 28(5): e12821, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30724408

RESUMO

The main condition at increased risk of dementia is considered to be mild cognitive impairment. Mild cognitive impairment has been defined as a transitional state between normal aging and dementia, of which it may represent a prodrome. The aim of our study was to evaluate whether sleep variables (both conventional and microstructural ones) in subjects with mild cognitive impairment correlate with conversion to dementia. Nineteen subjects with amnestic mild cognitive impairment (mean age 68.5 ±â€…7.0 years) and 11 cognitively intact healthy elderly individuals (mean age 69.2 ±â€…12.6 years) underwent ambulatory polysomnography for the evaluation of nocturnal sleep architecture and cyclic alternating pattern parameters. Amnestic mild cognitive impairment subjects were clinically and cognitively re-evaluated after 2 years, during routine follow-up, and further classified as amnestic mild cognitive impairment converters (that is, patients developing Alzheimer's disease, N = 11) and amnestic mild cognitive impairment non-converters. Compared with healthy elderly individuals, amnestic mild cognitive impairment showed disrupted sleep with decreased rapid eye movement sleep, cyclic alternating pattern rate and cyclic alternating pattern slow-wave-related phases (A1 index). Standard sleep architecture analysis did not show significant differences between the two subgroups of amnestic mild cognitive impairment, whereas cyclic alternating pattern analysis showed that cyclic alternating pattern rate, A1 index and A3 index are significantly reduced in converters compared with non-converters. Our data confirm that in amnestic mild cognitive impairment subjects there is a sleep impairment, particularly when considering more refined sleep parameters and that sleep variables at baseline are different among converters versus non-converters at the 2-year follow-up. Specific sleep alterations might represent potential further biomarkers for the diagnosis and prognosis of early-phase cognitive impairment.


Assuntos
Doença de Alzheimer/etiologia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/diagnóstico , Polissonografia/métodos , Idoso , Doença de Alzheimer/diagnóstico , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos
7.
BMC Microbiol ; 17(1): 148, 2017 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-28673237

RESUMO

BACKGROUND: Group B Streptococcus (GBS) is a major cause of invasive disease especially in neonates. In GBS three structurally distinct pilus polymers have been identified as important virulence factors and promising vaccine candidates. The vast majority of Group B Streptococci belonging to the hypervirulent serotype III ST-17 lineage bear pilus types 1 and 2b. The purpose of this study was to investigate the relative contribution of these two pilus types to the pathogenesis of a ST-17 strain. RESULTS: We performed in vivo and in vitro analysis of isogenic knockout mutants derived from the GBS COH1 ST-17 strain deprived of either pilus type 1 or 2b. We compared the two pilus mutants with the wild type strain in a mouse model of invasive disease, in vitro survival in macrophages, and adherence/invasion assays using human brain endothelial and lung epithelial cell lines. Significantly less of the pilus 2b mutant was recovered from the blood, lungs and brain tissue of infected mice compared to the wild-type and pilus 1 mutant strains. Further, while the pilus 2b mutant survived similarly in murine macrophages, it exhibited a lower capacity to adhere and invade human brain epithelial and lung endothelial cell lines. CONCLUSIONS: The data suggest an important role of pilus 2b in mediating GBS infection and host cell interaction of strains belonging to the hypervirulent GBS ST-17 lineage.


Assuntos
Fímbrias Bacterianas/genética , Fímbrias Bacterianas/metabolismo , Meningites Bacterianas/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/patogenicidade , Animais , Aderência Bacteriana , Encéfalo/citologia , Encéfalo/microbiologia , Linhagem Celular , Modelos Animais de Doenças , Células Epiteliais/citologia , Células Epiteliais/microbiologia , Humanos , Pulmão/citologia , Pulmão/microbiologia , Macrófagos/citologia , Macrófagos/microbiologia , Camundongos , Mutação , Streptococcus agalactiae/genética , Fatores de Virulência/genética , Fatores de Virulência/metabolismo
8.
Psychol Health Med ; 22(8): 896-901, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28102087

RESUMO

In the field of sleep disorders, the quality of couple relationship is arousing increasing attention, given its implications for quality of life and treatment adherence. The aim of the present study was to evaluate relationship quality in a sample of treated or untreated patients with Obstructive Sleep Apnoea Syndrome. Eighty-seven patients were recruited in a hospital-based Centre for Sleep Medicine. Subjects were administered the Dyadic Adjustment Scale (DAS) to evaluate relationship quality, and the Epworth Sleepiness Scale (ESS). Apnoea-hypopnoea indexes (AHI) were collected through nocturnal polysomnography or home testing with a portable monitoring device. Although the DAS average scores were similar to local normative values, relationship quality was significantly lower in the untreated patients when compared with the ones treated. The ESS scores showed a negative correlation with many DAS scores, whereas no significant correlation emerged for AHI. Such data suggest a significant impact of perceived sleep apnoea symptoms on marital satisfaction, even though in the absence of striking differences between the whole sample and the general population.


Assuntos
Casamento , Qualidade de Vida/psicologia , Apneia Obstrutiva do Sono/psicologia , Adulto , Idoso , Pressão Positiva Contínua nas Vias Aéreas/psicologia , Distúrbios do Sono por Sonolência Excessiva/psicologia , Distúrbios do Sono por Sonolência Excessiva/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Psicometria/estatística & dados numéricos , Apneia Obstrutiva do Sono/terapia , Inquéritos e Questionários
9.
Clin Infect Dis ; 63(6): 746-753, 2016 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-27402816

RESUMO

BACKGROUND: Group B Streptococcus (GBS) is a major cause of neonatal sepsis and meningitis. A vaccine targeting pregnant women could protect infants through placentally transferred antibodies. The association between GBS maternal antibody concentrations and the risk of neonatal infection has been investigated in US and African populations. Here we studied naturally acquired immunoglobulin G (IgG) responses to GBS capsular polysaccharides (CPS) and pilus proteins in European pregnant women. METHODS: Maternal sera were prospectively collected in 8 EU countries from 473 GBS non-colonized and 984 colonized pregnant women who delivered healthy neonates and from 153 mothers of infants with GBS disease. GBS strains from these colonized women and infected infants were obtained in parallel and their capsular and pilus types were identified by serological and molecular methods. Maternal serum concentrations of IgG anti- Ia, -Ib, -III and -V polysaccharides and anti-BP-1, -AP1-2a and -BP-2b pilus proteins were determined by enzyme-linked immunosorbent assay. Antibody functional activity was quantified by Opsonophagocytic Killing Assay. RESULTS: Antibody levels against CPS and pilus proteins were significantly higher in GBS colonized women delivering healthy babies than in mothers of neonates with GBS disease or non-colonized women. Moreover, maternal anti-capsular IgG concentrations showed a significant correlation with functional titers measured by Opsonophagocytic Killing Assay. CONCLUSIONS: Maternal anti-capsular IgG concentrations above 1 µg/mL mediated GBS killing in vitro and were predicted to respectively reduce by 81% (95% confidence interval, 40%-100%) and 78% (45%-100%) the risk of GBS Ia and III early-onset disease in Europe.


Assuntos
Anticorpos Antibacterianos/sangue , Fímbrias Bacterianas/imunologia , Imunidade Materno-Adquirida , Polissacarídeos Bacterianos/imunologia , Infecções Estreptocócicas/imunologia , Streptococcus agalactiae/imunologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Imunoglobulina G/sangue , Gravidez , Estudos Prospectivos , Infecções Estreptocócicas/epidemiologia
10.
Emerg Infect Dis ; 22(11): 1877-1883, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27767008

RESUMO

Immunization of nonpregnant adults could help prevent invasive group B Streptococcus (GBS) infections, but adult immune responses have not been investigated. We defined capsular polysaccharide (CPS) and pilus island (PI) surface antigen distribution and expression and immune responses to GBS infection in nonpregnant adults. Prospective surveillance from 7 hospitals in Houston, Texas, USA, identified 102 adults with GBS bacteremia; 43% had skin/soft tissue infection, 16% bacteremia without focus, and 12% osteomyelitis. CPS-specific IgG was determined by ELISA and pilus-specific IgG by multiplex immunoassay. CPS types were Ia (24.5%), Ib (12.7%), II (9.8%), III (16.7%), IV (13.7%), and V (12.7%); 9.8% were nontypeable by serologic methods. Pili, expressed by 89%, were most often PI-2a. CPS and pilus-specific IgG increased during convalescence among patients with strains expressing CPS or PI. All GBS expressed CPS or PI; 79% expressed both. Increased antibodies to CPS and PI during recovery suggests that GBS bacteremia in adults is potentially vaccine preventable.


Assuntos
Infecções Estreptocócicas/imunologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Especificidade de Anticorpos/imunologia , Bacteriemia , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Polissacarídeos Bacterianos/imunologia , Sorotipagem , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae/classificação , Streptococcus agalactiae/genética , Streptococcus agalactiae/isolamento & purificação
11.
Psychol Health Med ; 21(3): 309-16, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26222934

RESUMO

The aims of the present study are to evaluate the impact of insomnia on psychological well-being and to examine the associations of insomnia and psychological well-being with anxiety and depression. Forty-one patients attending our hospital-based Centre for sleep medicine were administered scales for the evaluation of insomnia (ISI), anxiety (STAI-Y), depression (BDI-II) and psychological well-being (PWB). The scores were compared to those of a control group of 68 subjects attending the hospital for routine examinations or as accompanying persons. Significant differences between patients and controls were detected for anxiety and depression, as well as for psychological well-being. Even if subclinical on average, anxiety and depression symptoms were significantly related to poor psychological well-being, whereas insomnia per se was not. These findings suggest that patients with insomnia report a relevant impact on their psychological well-being, and that such an impact seems to be strongly associated with concomitant subthreshold symptoms of anxiety and depression. The implications for diagnosis and treatment are discussed.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Bioconjug Chem ; 26(8): 1839-49, 2015 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-26230938

RESUMO

We have recently described a method for tyrosine-ligation of complex glycans that was proven efficient for the site selective coupling of GBS capsular polysaccharides (PSs). Herein, we explored the effect of conjugation of type V polysaccharide onto predetermined lysine or tyrosine residues of the GBS67 pilus protein with the dual role of T-cell carrier for the PS and antigen. For the preparation of a conjugate at predetermined lysine residues of the protein, we investigated a two-step procedure based on microbial Transglutaminase (mTGase) catalyzed insertion of a tag bearing an azide for following copper-free strain-promoted azide-alkyne [3 + 2] cycloaddition (SPAAC) with the polysaccharide. Two glycoconjugates were obtained by tyrosine-ligation through the known SPAAC and a novel thiol-maleimide addition based approach. Controls were prepared by random conjugation of PSV to GBS67 and CRM197, a carrier protein present in many commercial vaccines. Immunological evaluation in mice showed that all the site-directed constructs were able to induce good levels of anti-polysaccharide and anti-protein antibodies inducing osponophagocytic killing of strains expressing individually PSV or GBS67. GBS67 randomly conjugated to PSV showed carrier properties similar to CRM197. Among the tested site-directed conjugates, tyrosine-directed ligation and thiol-malemide addition was elected as the best combination to ensure production of anti-polysaccharide and anti-protein functional antibodies (in vitro opsonophagocytic killing titers) comparable to the controls made by random conjugation, while avoiding anti-linker antibodies. Our findings demonstrate that (i) mTGase based conjugation at lysine residues is an alternative approach for the synthesis of large capsular polysaccharide-protein conjugates; (ii) GBS67 can be used with the dual role of antigen and carrier for PSV; and (iii) thiol-maleimide addition in combination with tyrosine-ligation ensures the production of anti-polysaccharide and anti-protein functional antibodies while maintaining low levels of anti-linker antibodies. Site-specific conjugation methods aid in defining conjugation site and chemistry in carbohydrate-protein conjugates.


Assuntos
Proteínas de Bactérias/imunologia , Vacinas Bacterianas/farmacologia , Glicoconjugados/farmacologia , Polissacarídeos/imunologia , Infecções Estreptocócicas/prevenção & controle , Streptococcus/imunologia , Vacinas Conjugadas/farmacologia , Sequência de Aminoácidos , Animais , Proteínas de Bactérias/química , Vacinas Bacterianas/imunologia , Sequência de Carboidratos , Ensaio de Imunoadsorção Enzimática , Feminino , Glicoconjugados/imunologia , Imunização , Camundongos , Dados de Sequência Molecular , Polissacarídeos/química , Infecções Estreptocócicas/imunologia , Tirosina/química , Tirosina/imunologia , Vacinas Conjugadas/imunologia
13.
Pharm Stat ; 14(3): 189-97, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25689055

RESUMO

Opsonophagocytic killing assays (OPKA) are routinely used for the quantification of bactericidal antibodies in blood serum samples. Quantification of the OPKA readout, the titer, provides the basis for the statistical analysis of vaccine clinical trials having functional immune response endpoints. Traditional OPKA titers are defined as the maximum serum dilution yielding a predefined bacterial killing threshold value, and they are estimated by fitting a dose-response model to the dilution-killing curve. This paper illustrates a novel definition of titer, the threshold-free titer, which preserves biological interpretability while not depending on any killing threshold or on a postulated shape of the dose-response curve. These titers are shown to be more precise than the traditional threshold-based titers when using simulated and experimental group B streptococcus OPKA experimental data. Also, titer linearity is shown to be not measurable when using threshold-based titers, whereas it becomes measurable using threshold-free titers. The biological interpretability and operational characteristics demonstrated here indicate that threshold-free titers are an appropriate tool for the routine analysis of OPKA data.


Assuntos
Anticorpos Antibacterianos/sangue , Bioensaio , Estatística como Assunto , Streptococcus agalactiae/imunologia , Vacinas Bacterianas/uso terapêutico , Bioensaio/métodos , Ensaios Clínicos como Assunto , Humanos , Modelos Estatísticos
14.
Arch Ital Biol ; 153(2-3): 204-13, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26742674

RESUMO

Menopause in the female life cycle is a special period due to important hormonal, physical and psychological changes. Sleep disruption represents a common complaint for midlife and menopausal women, related to primary sleep disorders, including insomnia, sleep disordered breathing, restless legs syndrome (RLS), mood and anxiety disorder, other medical illness, hormonal-related vasomotor symptoms, and aging per se. Aims of our study were to evaluate the prevalence of sleep disorders in a sample of pre and post menopausal women, and to investigate the relationship between sleep and other medical disorders, and life habits. Among workers in the six participant centers, we enrolled 334 women, aged between 40 and 60 years, that completed a questionnaire that included screening on menarche, menstrual cycle, fertility, parity, menopause, life habits, personal medical and sleep history and related treatment, and self-administered scales for sleep quality (PSQI), excessive daytime sleepiness [Epworth Sleepiness Scale (ESS)], mood disorder [Beck Depression Inventory (BDI)], Berlin Questionnaire for sleep disordered breathing (SDB), IRLS diagnostic interview and Rating Scale. Menopausal and perimenopausal women showed an increased prevalence of poor sleep, high risk of SDB, and mood disorder; menopausal women also reported increased RLS severity. Mood disorder had a significant impact on night sleep measures and excessive daytime sleepiness, as well as on RLS severity, and had a greater prevalence in hypertensive women. Sleep disturbances are frequent in menopausal women. Their aetiology is unclear, but probably multifactorial, and many factors contribute to the sleep disruption. Our data suggest the importance of correctly investigate and address sleep problems associated with menopause, through sleep history, and a sleep study could be obtained if clinically warranted. Pharmacological and behavioural treatment strategies should then be aimed at improving sleep and life quality in perimenopausal and menopausal women.


Assuntos
Menopausa , Transtornos do Sono-Vigília/epidemiologia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade
15.
Epilepsy Behav ; 29(2): 344-8, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24011397

RESUMO

The aims of our study were to evaluate excessive daytime sleepiness in a group of de novo untreated people with epilepsy using a comprehensive and standardized approach, including subjective evaluation and neurophysiological and performance tests, and to compare these results with those obtained in a control group. Forty-seven patients with epilepsy (17 affected by primary generalized epilepsy and 30 by partial epilepsy), with a new epilepsy diagnosis and never treated, and 44 controls underwent Multiple Sleep Latency Test (preceded by nocturnal polysomnography), simple/complex visual reaction times, and Epworth Sleepiness Scale evaluation. Newly diagnosed and drug-free patients with epilepsy did not differ from controls in any of the tests performed to evaluate daytime sleepiness. In clinical practice, daytime sleepiness is a well-known and frequent complaint of patients with epilepsy, but different mechanisms and causes, such as associated psychiatric or sleep disorders, nocturnal seizures, sleep fragmentation, and antiepileptic drugs, must be taken into account. Excessive daytime sleepiness should not be considered an unavoidable consequence of epilepsy. Thus, a complete diagnostic work-up in patients with epilepsy and sleepiness should be undertaken whenever possible.


Assuntos
Epilepsia/complicações , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia , Adulto , Eletrofisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Polissonografia , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Estudos Retrospectivos , Sono/fisiologia , Estatísticas não Paramétricas , Adulto Jovem
16.
Mult Scler Relat Disord ; 79: 104946, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37639779

RESUMO

BACKGROUND: Restless Legs Syndrome is a sleep-related sensorimotor disorder with a higher prevalence in Multiple Sclerosis (MS) patients than in the general population. Our aim was to determine the prevalence of RLS in a group of relapsing-remittent multiple sclerosis (RRMS) patients, and to investigate whether RLS is associated with MS-related disability, sleep quality, mood disorders and fatigue. METHODS: In this retrospective, mono-centric, observational study, 92 RRMS patients were recruited (median age 46.5 years, 68.5% female patients). Data on MS clinical and radiological variables were collected. Patients underwent a subjective evaluation with standardized questionnaires on sleep fatigue and mood, which were evaluated by an expert neurologists specialized in sleep disorders about the occurrence of RLS. RESULTS: Prevalence of RLS in our sample was of 47.8%. Patients with RLS had a significantly higher rate of worse sleep quality and fatigue, compared to non RLS subjects (respectively 56.8% vs. 35.4%, p=0.04 and 54.4% vs 22.7%, p=0.002). Univariate analysis showed that RLS was significantly more frequent in fatigued patients (66.7% vs 38.5% RLS- patients, p=0.009). Multivariate analysis showed that fatigue correlated with MS-related disability (OR 1.556, p=0.011), poor sleep quality (OR 1.192, p 0.036), and mood disorders (OR 1.096, p 0.046). RLS appears to independently increase the risk of fatigue of 50%, without reaching clear statistical significance (OR 1.572, p 0,0079). CONCLUSION: Our study confirms the high prevalence of RLS in patients with multiple sclerosis and highlights the potential impact of RLS on fatigue and its strict interaction with sleep quality.


Assuntos
Esclerose Múltipla , Síndrome das Pernas Inquietas , Transtornos do Sono-Vigília , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Esclerose Múltipla/complicações , Esclerose Múltipla/epidemiologia , Síndrome das Pernas Inquietas/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Fadiga/etiologia , Fadiga/complicações , Inquéritos e Questionários , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/complicações , Prevalência
17.
NPJ Vaccines ; 8(1): 152, 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37803013

RESUMO

A maternal vaccine to protect neonates against Group B Streptococcus invasive infection is an unmet medical need. Such a vaccine should ideally be offered during the third trimester of pregnancy and induce strong immune responses after a single dose to maximize the time for placental transfer of protective antibodies. A key target antigen is the capsular polysaccharide, an anti-phagocytic virulence factor that elicits protective antibodies when conjugated to carrier proteins. The most prevalent polysaccharide serotypes conjugated to tetanus or diphtheria toxoids have been tested in humans as monovalent and multivalent formulations, showing excellent safety profiles and immunogenicity. However, responses were suboptimal in unprimed individuals after a single shot, the ideal schedule for vaccination during the third trimester of pregnancy. In the present study, we obtained and optimized self-assembling virus-like particles conjugated to Group B Streptococcus capsular polysaccharides. The resulting glyco-nanoparticles elicited strong immune responses in mice already after one immunization, providing pre-clinical proof of concept for a single-dose vaccine.

18.
JACS Au ; 2(7): 1724-1735, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35911445

RESUMO

Group B Streptococcus (GBS) is a Gram-positive bacterium and the most common cause of neonatal blood and brain infections. At least 10 different serotypes exist, that are characterized by their different capsular polysaccharides. The Group B carbohydrate (GBC) is shared by all serotypes and therefore attractive be used in a glycoconjugate vaccine. The GBC is a highly complex multiantennary structure, composed of rhamnose rich oligosaccharides interspaced with glucitol phosphates. We here report the development of a convergent approach to assemble a pentamer, octamer, and tridecamer fragment of the termini of the antennae. Phosphoramidite chemistry was used to fuse the pentamer and octamer fragments to deliver the 13-mer GBC oligosaccharide. Nuclear magnetic resonance spectroscopy of the generated fragments confirmed the structures of the naturally occurring polysaccharide. The fragments were used to generate model glycoconjugate vaccine by coupling with CRM197. Immunization of mice delivered sera that was shown to be capable of recognizing different GBS strains. The antibodies raised using the 13-mer conjugate were shown to recognize the bacteria best and the serum raised against this GBC fragment-mediated opsonophagocytic killing best, but in a capsule dependent manner. Overall, the GBC 13-mer was identified to be a highly promising antigen for incorporation into future (multicomponent) anti-GBS vaccines.

20.
mSphere ; 4(4)2019 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391276

RESUMO

Group B Streptococcus (GBS) infections constitute a major cause of invasive disease during the first three months of life and an unmet medical need that could be addressed by maternal vaccination. The GBS capsular polysaccharides (CPSs) have shown promise as vaccine targets in clinical studies. A highly specific serological assay to quantify maternal and neonatal anti-CPS antibody levels will be instrumental for GBS vaccine licensure. Here, we describe the development and comparison of two novel multiplex immunoassays (MIAs) based on the Luminex technology for the quantification of IgG antibodies recognizing the five most frequent GBS capsular variants (Ia, Ib, II, III, and V) out of the ten types identified. The first assay is based on the use of biotinylated CPSs coupled to streptavidin-derivatized magnetic microspheres (Biotin-CPS MIA), while the second is a sandwich assay with plain CPSs coupled to magnetic microspheres coated with polysaccharide-specific mouse monoclonal antibodies (Sandwich MIA). Both assays showed good specificity, linearity, and precision, although the Biotin-CPS MIA presented higher sensitivity and lower complexity than the Sandwich MIA. A panel of human sera representing a wide range of anti-CPS IgG concentrations was tested in parallel by the two assays, which resulted in comparable titers. Our data support the preservation of antigenic epitopes in the biotinylated polysaccharides and the suitability of the Biotin-CPS MIA for the precise determination of GBS anti-CPS IgG concentrations in human sera.IMPORTANCE Group B streptococcal infections can cause death in neonates up to 3 months of age. Intrapartum antibiotic prophylaxis in GBS-colonized mothers has limited early infections but has no impact after the first week of life. The development of a maternal vaccine to address this unmet medical need has been identified as a priority by the World Health Organization, and the GBS CPSs are considered the best antigen targets. However, to date there are no accepted standardized assays to measure immune responses to the investigational vaccines and for establishment of serocorrelates of protection. Here, we describe the performance of two microsphere-based pentaplex immunoassays for the determination of antibodies recognizing the five most frequent GBS serotypes. Our data confirm that an assay based on biotinylated polysaccharides coupled to streptavidin microspheres would be suitable for the intended purpose.


Assuntos
Anticorpos Antibacterianos/sangue , Imunoensaio/métodos , Imunoglobulina G/sangue , Polissacarídeos Bacterianos/imunologia , Streptococcus agalactiae/imunologia , Biotina , Humanos , Microesferas , Estreptavidina
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