Genetic determinants of cardiometabolic risk factors in rural families in Brazil.

OBJECTIVES: The purpose of this study was to estimate the heritability of genetic and environmental correlations between cardiometabolic risk factors in extended pedigrees. METHODS: The Jequitinhonha Community Family Study Cohort (JCFSC) consists of individuals aged ≥18 years living in rural villages. Family pedigrees were constructed of the cohort. The following data were collected: demographic and socioeconomic status, lifestyle variables, anthropometrics, and lipid traits. RESULTS: The JCFSC consists of 931 individuals distributed into 69 pedigrees with 4,907 members in total. The heritabilities were 0.47 for total cholesterol (TC), 0.44 for triglycerides (TG) and 0.42 for high-density lipoprotein cholesterol (HDLc), 0.49 for metabolic syndrome, approximately 0.60 for anthropometric traits and 0.30 for blood pressure/hypertension. Significant genetic correlations (ρg ) were found mainly between TG and TC (ρg = 0.58) and hypertension and TG (ρg = 0.52). Systolic blood pressure (SBP) was correlated with TG (ρg = 0.39) and HDLc (ρg = -0.30). Diastolic blood pressures correlated with TG (ρg =0.56) and TC (ρg =0.30). Genetic correlations were also found between anthropometric traits, including: body mass index (BMI) and TG (ρg =0.34), waist circumference (WC) and TG (ρg =0.42), and WC and HDLc (ρg =-0.33). Household effects were found for HDLc (c(2) = 0.19), SBP (c(2) = 0.14) and Hypertension (c(2) = 0.14). CONCLUSIONS: To some phenotypes, including lipids, hypertension, blood pressure, and anthropometric traits, genetic contribution is important in the determination of cardiometabolic risk factors. This study provides a foundation for future studies. These will mainly focus on rare variants that could describe the genetic mechanisms influencing cardiometabolic risk. Am. J. Hum. Biol. 28:619-626, 2016. © 2016 Wiley Periodicals, Inc.

Blockade of CTLA-4 promotes the development of effector CD8+ T lymphocytes and the therapeutic effect of vaccination with an attenuated protozoan expressing NY-ESO-1.

The development of cancer immunotherapy has long been a challenge. Here, we report that prophylactic vaccination with a highly attenuated Trypanosoma cruzi strain expressing NY-ESO-1 (CL-14-NY-ESO-1) induces both effector memory and effector CD8(+) T lymphocytes that efficiently prevent tumor development. However, the therapeutic effect of such a vaccine is limited. We also demonstrate that blockade of Cytotoxic T Lymphocyte Antigen 4 (CTLA-4) during vaccination enhances the frequency of NY-ESO-1-specific effector CD8(+) T cells producing IFN-γ and promotes lymphocyte migration to the tumor infiltrate. As a result, therapy with CL-14-NY-ESO-1 together with anti-CTLA-4 is highly effective in controlling the development of an established melanoma.

Heritability of phenotypes associated with glucose homeostasis and adiposity in a rural area of Brazil.

We aimed to estimate the heritability and genetic correlation between glucose homeostasis and adiposity traits in a population in a rural community in Brazil. The Jequitinhonha Community Family Study cohort consists of subjects aged ≥18 years residing in rural areas in Brazil. The data on the following traits were assembled for 280 individuals (51.7% women): body mass index (BMI), body fat percentage, waist and mid-upper arm circumferences, triceps skinfold, conicity index, insulin, glucose, high-density lipoprotein cholesterol (HDLc), triglycerides and C-reactive protein. Extended pedigrees were constructed up to the third generation of individuals using the data management software PEDSYS. The heritability and genetic correlations were estimated using a variance component method. The age- and sex-adjusted heritability values estimated for insulin (h(2) = 52%), glucose (h(2) = 51%), HDLc (h(2) = 58%), and waist circumference (WC; h(2) = 49%) were high. Significantly adjusted genetic correlations were observed between insulin paired with each of the following phenotypes; (BMI; ρg = 0.48), WC (ρg = 0.47) and HDLc (ρg = -0.47). The homeostasis model assessment of insulin resistance (HOMA-IR) was genetically correlated with BMI (ρg = 0.53) and HDLc (ρg = -0.58). The adjusted genetic correlations between traits were consistently higher compared with the environmental correlations. In conclusion, glucose metabolism and adiposity traits are highly heritable and share common genetic effects with body adiposity traits.

Breakthrough SARS-CoV-2 infections among patients with cancer following two and three doses of COVID-19 mRNA vaccines: a retrospective observational study from the COVID-19 and Cancer Consortium.

Background: Breakthrough SARS-CoV-2 infections following vaccination against COVID-19 are of international concern. Patients with cancer have been observed to have worse outcomes associated with COVID-19 during the pandemic. We sought to evaluate the clinical characteristics and outcomes of patients with cancer who developed breakthrough SARS-CoV-2 infections after 2 or 3 doses of mRNA vaccines. Methods: We evaluated the clinical characteristics of patients with cancer who developed breakthrough infections using data from the multi-institutional COVID-19 and Cancer Consortium (CCC19; NCT04354701). Analysis was restricted to patients with laboratory-confirmed SARS-CoV-2 diagnosed in 2021 or 2022, to allow for a contemporary unvaccinated control population; potential differences were evaluated using a multivariable logistic regression model after inverse probability of treatment weighting to adjust for potential baseline confounding variables. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported. The primary endpoint was 30-day mortality, with key secondary endpoints of hospitalization and ICU and/or mechanical ventilation (ICU/MV). Findings: The analysis included 2486 patients, of which 564 and 385 had received 2 or 3 doses of an mRNA vaccine prior to infection, respectively. Hematologic malignancies and recent receipt of systemic anti-neoplastic therapy were more frequent among vaccinated patients. Vaccination was associated with improved outcomes: in the primary analysis, 2 doses (aOR: 0.62, 95% CI: 0.44-0.88) and 3 doses (aOR: 0.20, 95% CI: 0.11-0.36) were associated with decreased 30-day mortality. There were similar findings for the key secondary endpoints of ICU/MV (aOR: 0.60, 95% CI: 0.45-0.82 and 0.37, 95% CI: 0.24-0.58) and hospitalization (aOR: 0.60, 95% CI: 0.48-0.75 and 0.35, 95% CI: 0.26-0.46) for 2 and 3 doses, respectively. Importantly, Black patients had higher rates of hospitalization (aOR: 1.47, 95% CI: 1.12-1.92), and Hispanic patients presented with higher rates of ICU/MV (aOR: 1.61, 95% CI: 1.06-2.44). Interpretation: Vaccination against COVID-19, especially with additional doses, is a fundamental strategy in the prevention of adverse outcomes including death, among patients with cancer. Funding: This study was partly supported by grants from the National Cancer Institute grant number P30 CA068485 to C-YH, YS, SM, JLW; T32-CA236621 and P30-CA046592 to C.R.F; CTSA 2UL1TR001425-05A1 to TMW-D; ACS/FHI Real-World Data Impact Award, P50 MD017341-01, R21 CA242044-01A1, Susan G. Komen Leadership Grant Hunt to MKA. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH).

Molecular detection of Chlamydia trachomatis and HPV infections in cervical samples with normal and abnormal cytopathological findings.

It has been suggested that Chlamydia trachomatis (CT) and human papillomaviruses (HPV) co-infection could contribute to development of intraepithelial lesions. In this study, HPV and CT-DNA were investigated in 250 cervicovaginal samples of patients from Minas Gerais, Brazil. The cytological analysis revealed that 70% of samples (175) were negative, 5.2% (13) presented atypical squamous or glandular cells of undetermined significance (ASCUS/AGUS), 12.4% (31) presented low-grade squamous intraepithelial lesion (LSIL), 10.8% (27) high-grade squamous intraepithelial lesion (HSIL), and 1.6% (4) invasive carcinoma. HPV-DNA and HPV/CT co-infection was observed in 40% (100/250) and in 5.2% (13/250) of samples, respectively. Among the positive cytological samples, HPV-DNA was detected in 73.3% and CT-DNA in 9.33% and in 13%, if only the HPV positive samples were considered. The highest co-infection rate (15.4%) was observed among ASCUS/AGUS samples. Although a significant association was found for HPV infection and the precursor lesions of cervical cancer, it was not possible to establish a significant association between these lesions and CT or HPV/CT co-infection.

Caracterização da resposta imune induzida por protocolos de vacinação dose e reforço usando diferentes vetores virais (adenovirus e MVA) expressando o gene A2 de Leishmania donovani / Characterization of the immune response induced by vaccination protocols dose and reinforcement using different viral vectors (adenovirus and MVA) expressing the Leishmania donovani A2 gene

As Leishmanioses são consideradas pela Organização Mundial de Saúde comouma das seis doenças tropicais mais importantes. A ausência de uma forma eficaz decontrole e contenção da doença justifica o desenvolvimento de uma vacina mais eficaz.Por sua vez, o antígeno A2, exclusivamente expresso nas formas amastigotas deLeishmania tem sido considerado um excelente alvo no desenvolvimento deformulações vacinais em fase experimental. Esse trabalho visou à caracterização daresposta imune induzida por diferentes protocolos de vacinação dose e reforço usando,além do MVA-A2, o Adenovírus-A2, AdA2. O MVA é um vírus atenuado, derivado doVírus Vaccínia Ankara, não replicativo em células de mamíferos. Assim, foramavaliadas as respostas celular, por ensaios de ELISPOT e citotoxicidade in vivo,mediante estimulação dos esplenócitos com peptídeos correspondentes aos epítopospara células TCD4+ e TCD8+ na proteína A2 e a resposta humoral, por ELISA. Apenasos animais vacinados com AdA2 + MVAA2 apresentaram níveis elevados de célulasprodutoras de IFNg e níveis de baixos IL-10 e IL-4, sob estimulação com ambos ospeptídeos, nos ensaios de ELISPOT. Da mesma forma, alta porcentagem de lise foiobservada apenas nesse grupo de animais, indicando que esse esquema vacinal foicapaz de induzir a resposta de células T CD8+ e TCD4+. A resposta imune induzidanesse grupo, considerada do tipo Th1, tem sido relacionada à proteção contra ainfecção desafio por diferentes espécies de Leishmania. Nos testes de ELISA, não foiidentificada produção de anticorpos contra o Antígeno Solúvel de Leishmania, SLA, daforma promastigota, em quaisquer grupos vacinais, o que os diferenciou dos animaisinfectados, nos quais a produção foi observada. Isso é importante no diagnóstico doscães domésticos, uma vez que a vacina atual não possibilita essa diferenciação. Nosoutros grupos vacinados, a resposta imune celular será investigada contra a formaíntegra da proteína A2 e SLA da forma amastigota

Caracterização da resposta imune induzida por protocolos de vacinação dose e reforço usando diferentes vetores virais (adenovirus e MVA) expressando o gene A2 de Leishmania donovani

As Leishmanioses são consideradas pela Organização Mundial de Saúde comouma das seis doenças tropicais mais importantes. A ausência de uma forma eficaz decontrole e contenção da doença justifica o desenvolvimento de uma vacina mais eficaz.Por sua vez, o antígeno A2, exclusivamente expresso nas formas amastigotas deLeishmania tem sido considerado um excelente alvo no desenvolvimento deformulações vacinais em fase experimental. Esse trabalho visou à caracterização daresposta imune induzida por diferentes protocolos de vacinação dose e reforço usando,além do MVA-A2, o Adenovírus-A2, AdA2. O MVA é um vírus atenuado, derivado doVírus Vaccínia Ankara, não replicativo em células de mamíferos. Assim, foramavaliadas as respostas celular, por ensaios de ELISPOT e citotoxicidade in vivo,mediante estimulação dos esplenócitos com peptídeos correspondentes aos epítopospara células TCD4+ e TCD8+ na proteína A2 e a resposta humoral, por ELISA. Apenasos animais vacinados com AdA2 + MVAA2 apresentaram níveis elevados de célulasprodutoras de IFNg e níveis de baixos IL-10 e IL-4, sob estimulação com ambos ospeptídeos, nos ensaios de ELISPOT. Da mesma forma, alta porcentagem de lise foiobservada apenas nesse grupo de animais, indicando que esse esquema vacinal foicapaz de induzir a resposta de células T CD8+ e TCD4+. A resposta imune induzidanesse grupo, considerada do tipo Th1, tem sido relacionada à proteção contra ainfecção desafio por diferentes espécies de Leishmania. Nos testes de ELISA, não foiidentificada produção de anticorpos contra o Antígeno Solúvel de Leishmania, SLA, daforma promastigota, em quaisquer grupos vacinais, o que os diferenciou dos animaisinfectados, nos quais a produção foi observada. Isso é importante no diagnóstico doscães domésticos, uma vez que a vacina atual não possibilita essa diferenciação. Nosoutros grupos vacinados, a resposta imune celular será investigada contra a formaíntegra da proteína A2 e SLA da forma amastigota