Response to Monoclonal Antibodies in Asthma: Definitions, Potential Reasons for Failure, and Therapeutic Options for Suboptimal Response.

Real-life data reveal that more than half of severe asthma patients treated with monoclonal antibodies (mAbs) do not achieve a complete response. Response to mAbs must be assessed holistically, considering all the clinically meaningful therapeutic goals, not only reduction of exacerbations and oral corticosteroids. There are 2 different ways of measuring the response to mAbs. One, qualitative, classifies patients according to the degree of disease control they have achieved, without explaining how much a given patient improves relative to the baseline (pre-mAb) clinical situation; the other, quantitative, scores the changes occurring after treatment. Both methods are complementary and essential to making clinical decisions on whether to continue treatment. The various potential causes of suboptimal response to mAbs include incorrect identification of the specific T2 pathways, comorbidities that reduce the room for improvement, insufficient dose, autoimmune phenomena, infections, change in the initial inflammatory endotype, and adverse events. Once a suboptimal response has been confirmed, a well-structured and multifaceted assessment of the potential causes of failure should be performed, with emphasis on the resulting inflammatory process of the airway after mAb therapy and the presence of chronic or recurrent infection. This investigation should guide the decision on the best therapeutic approach. The present review aims to help clinicians gain insights into how to measure response to mAbs and proceed in cases of suboptimal response.

Male-specific Y-linked transgene markers to enhance biologically-based control of the Mexican fruit fly, Anastrepha ludens (Diptera: Tephritidae).

BACKGROUND: Reliable marking systems are critical to the prospective field release of transgenic insect strains. This is to unambiguously distinguish released insects from wild insects in the field that are collected in field traps, and tissue-specific markers, such as those that are sperm-specific, have particular uses such as identifying wild females that have mated with released males. For tephritid fruit flies such as the Mexican fruit fly, Anastrepha ludens, polyubiquitin-regulated fluorescent protein body markers allow transgenic fly identification, and fluorescent protein genes regulated by the spermatocyte-specific ß2-tubulin promoter effectively mark sperm. For sterile male release programs, both marking systems can be made male-specific by linkage to the Y chromosome. RESULTS: An A. ludens wild type strain was genetically transformed with a piggyBac vector, pBXL{PUbnlsEGFP, Asß2tub-DsRed.T3}, having the polyubiquitin-regulated EGFP body marker, and the ß2-tubulin-regulated DsRed.T3 sperm-specific marker. Autosomal insertion lines effectively expressed both markers, but a single Y-linked insertion (YEGFP strain) expressed only PUbnlsEGFP. This insertion was remobilized by transposase helper injection, which resulted in three new autosomal insertion lines that expressed both markers. This indicated that the original Y-linked Asß2tub-DsRed.T3 marker was functional, but specifically suppressed on the Y chromosome. The PUbnlsEGFP marker remained effective however, and the YEGFP strain was used to create a sexing strain by translocating the wild type allele of the black pupae (bp+) gene onto the Y, which was then introduced into the bp- mutant strain. This allows the mechanical separation of mutant female black pupae from male brown pupae, that can be identified as adults by EGFP fluorescence. CONCLUSIONS: A Y-linked insertion of the pBXL{PUbnlsEGFP, Asß2tub-DsRed.T3} transformation vector in A. ludens resulted in male-specific expression of the EGFP fluorescent protein marker, and was integrated into a black pupae translocation sexing strain (T(YEGFP/bp+), allowing the identification of male adults when used in sterile male release programs for population control. A unique observation was that expression of the Asß2tub-DsRed.T3 sperm-specific marker, which was functional in autosomal insertions, was specifically suppressed in the Y-linked insertion. This may relate to the Y chromosomal regulation of male-specific germ-line genes in Drosophila.

Coronavirus pandemic: An opportunity to study the anthropogenic impact on micro-climate conditions and CaCO3 crystal morphology in the Nerja Cave (SE Spain).

Following the declaration of the COVID-19 pandemic, the Spanish Government restricted non-essential movements of all citizens and closed all public spaces, such as the Nerja Cave, until May 31, 2020. This particular condition of the closure of the cave provided a unique opportunity to study the micro-climate conditions and carbonate precipitation in this tourist cave without the presence of visitors. Our results show the significant effect of visitors on the air isotopic signature of the cave and on the genesis of the extensive dissolution features affecting the carbonate crystals formed in the tourist sector of the cave, alerting us to the possible corrosion of the speleothems located there. The movement of visitors within the cave also favours the mobilisation of aerial fungi and bacterial spores and their subsequent sedimentation simultaneously with the abiotic precipitation of carbonates from the drip water. The traces of these biotic elements could be the origin of the micro-perforations previously described in the carbonate crystals formed in the tourist galleries of the cave, but they are subsequently enlarged due to abiotic dissolution of the carbonates through these weaker zones.

Dark matter axion search using a Josephson Traveling wave parametric amplifier.

We describe the first implementation of a Josephson Traveling Wave Parametric Amplifier (JTWPA) in an axion dark matter search. The operation of the JTWPA for a period of about two weeks achieved sensitivity to axion-like particle dark matter with axion-photon couplings above 10-13 Ge V-1 over a narrow range of axion masses centered around 19.84 µeV by tuning the resonant frequency of the cavity over the frequency range of 4796.7-4799.5 MHz. The JTWPA was operated in the insert of the axion dark matter experiment as part of an independent receiver chain that was attached to a 0.56-l cavity. The ability of the JTWPA to deliver high gain over a wide (3 GHz) bandwidth has engendered interest from those aiming to perform broadband axion searches, a longstanding goal in this field.

Development of transgenic strains for the biological control of the Mexican fruit fly, Anastrepha ludens.

The Mexican fruit fly, Anastrepha ludens, is a highly significant agricultural pest species that has been genetically transformed with a piggyBac-based transposon vector system using independent vector and transposase helper plasmids. Minimum estimated germ-line transformation frequencies were approximately 13-21% per fertile G(0) individual, similar to previously reported frequencies using single vector-helper plasmids. Two vector constructs were tested with potential importance to transgenic strain development for mexfly biological control. The first allows post-integration stabilization of a transposon-vector by deletion of a terminal sequence necessary for mobilization. The complete pB[L1-EGFP-L2-DsRed-R1] vector was integrated into the Chiapas wild type strain with subsequent deletion of the L2-DsRed-R1 sub-vector carrying the piggyBac 3' terminal sequence. Quality control tests for three of the stabilization vector lines (previous to stabilization) assessed viability at all life stages, fertility, adult flight ability, and adult male sexual competitiveness. All three transgenic lines were less fit compared to the wild strain by approximately 5-10% in most tests, however, there was no significant difference in sexual competitiveness which is the major prerequisite for optimal strain release. The second vector, pB[XL-EGFP, Asß2-tub-DsRed.T3], has the DsRed.T3 fluorescent protein reporter gene regulated by the A. suspensa Asß2-tubulin promoter, that resulted in testis and sperm-specific DsRed fluorescence in transgenic male mexflies. Fluorescent sperm bundles were unambiguously observed in the spermathecae of non-transgenic females mated to transgenic males. One transgenic line apparently had a male-specific Y-chromosome insertion, having potential use for sexing by fluorescent-embryo sorting. All transgenic lines expressed easily detectable and stable fluorescence in adults allowing their identification after trapping in the field.

Confinement resonances in photoionization of Xe@C60+.

Experimental evidence is presented for confinement resonances associated with photoabsorption by a Xe atom in a C60 cage. The giant 4d resonance in photoionization of Xe is predicted to be redistributed into four components due to multipath interference of photoelectron waves reflected by the cage. The measurements were made in the photon energy range 60-150 eV by merging a beam of synchrotron radiation with a mass/charge selected Xe@C60+ ion beam. The phenomenon was observed in the Xe@C(58)(3+) product ion channel. [corrected]

Clusters formation and fragmentation of nitromethane at 266 nm.

We carry out experiments on the fragmentation of nitromethane by multiphoton absorption at the wavelength 266 nm. This was conducted in a reflectron (Jordan), modified in the laboratory. Due to the large number of fragments, special care has been taken into the calibration of the system, in the simultaneity between the laser pulse and the sample, and the associated electronics to ensure that produced fragment spectra arise from the interaction laser-sample. We emphasize the next aspects of the method:•Simple design for introducing a gas sample at laser interaction region to facilitate the cluster formation•Astonishing number of fragments produced by multiphoton absorption.

Tobramycin inhalation powder (TOBI Podhaler) for the treatment of lung infection in patients with cystic fibrosis.

Cystic fibrosis (CF) is an autosomal recessive inherited disease secondary to a defect in the CF transmembrane conductance regulator gene (CFTR). Mortality in CF is associated with impairment of lung function in which bacterial infection plays a fundamental role. The microorganism Pseudomonas aeruginosa (P. aeruginosa) is a marker of poor prognosis. Tobramycin was the first parenteral antibiotic to be used as inhaled medication in CF. Owing to its beneficial effects; it was subsequently used in designed inhaled formulations. The first formulation was the inhalation solution, which improved lung function, lowered hospitalization rates, and reduced the courses of intravenous antibiotic. However, the high associated costs and time necessary to administer the medication negatively affected quality of life. The recent development of tobramycin inhalation powder has optimized treatment. The dry powder inhaler is a simple device that reduces administration time and improves adherence. As there is no risk of bacterial contamination, disinfection is unnecessary.

Molecular epidemiology of severe respiratory disease by human rhinoviruses and enteroviruses at a tertiary paediatric hospital in Barcelona, Spain.

In order to describe the molecular epidemiology of human rhinovirus (HRV) and enterovirus (EV) infection in severely ill children, we studied all episodes of bronchospasm/bronchopneumonia in 6-month-old to 18-year-old patients from January 2010 to May 2012 who required mechanical ventilation. HRV/EVs were detected in 55 (57.3%) of 96 patients, of which 50 (91%) were HRV (HRV-A, 16; HRV-B, 1; HRV-C, 18) and 5 (9%) were EVs (EV-D68, 3). No significant differences in epidemiologic and clinical characteristics were found between different types. In six of the 13 patients who required invasive mechanical ventilation, HRV was the only pathogen detected.

Experimental infections of pregnant sows with ovine Chlamydia psittaci strains.

Four sows were experimentally inoculated at 42 days pregnancy, with the BS isolate of Chlamydia psittaci from aborted ewes. Their body temperature and health were monitored until 30 days after farrowing. The sows seroconverted but their reproductive performance was not impaired. Chlamydiae were identified in the afterbirths from two sows with normal litters using stained smears, "Clearview" and "IDEIA" ELISA antigen detection tests. The presence of inclusion bodies was detected in sections of the infected fetal membranes after staining with haematoxylin and eosin, methylene blue and Streptavidin-Biotin using an anti-Chlamydia monoclonal antibody.

N+ charge transfer and N+2 dissociation in N2 at swarm energies.

This paper reports a drift-tube-mass-spectrometer measurement of the relative abundances of N+ and N+2 in pure nitrogen, over a ratio of electric field to gas density, E/N, from 800 to 7200 Td [1 townsend (Td)=10(-17) V cm(2)]. A proposed charge transfer dissociation scheme between the above two ions and N2 allowed us to obtain spatial rate coefficients for charge transfer and dissociation over the E/N range 800-2800 Td. Using previously measured cross sections for the above processes, and assuming a Maxwellian distribution of ion velocities, we calculated the reaction coefficients, which were found to be in good agreement with our measured values. In particular, the present results support the trend toward fairly high charge transfer cross section values for N+ energies above 10 eV. In the overlap range between 2.4 and 7.2 kTd, our concentration ratio [N(+)/N(+)(2)] is about five times smaller than that measured previously from a diffuse Townsend discharge in which electron impact is involved in addition to N+2 collisional dissociation with N2, but has the same trend. Thus it seems that, besides N+2 dissociation by electron impact, collisional dissociation becomes important at elevated values of E/N. In connection with previous discharge work in nitrogen, the present study may help explain the enhanced cathode yields observed.

Major bacterial infections following liver transplantation: a prospective study.

The incidence and characteristics of major bacterial infections were studied prospectively in 50 consecutive adult patients who underwent liver transplantation (LT). All patients received the same protocol of immunosuppression, bowel decontamination, antibiotics prophylaxis, and follow-up. Thirty-two patients (64%) had at least one episode of major bacterial infection. One death was directly related to a bacterial infection, accounting for 13% of postoperative mortality. The most critical period for infection was the first 2 months after surgery, when 69% of the infections occurred. The most frequent clinical presentations were bacteremia, pneumonia and abdominal abscesses. Eighty percent of the bacteremias had an identifiable source, the most frequent being intravascular catheters. Gram-positive microorganisms (69%) predominated over gram-negative rods (26%) and anaerobes (5%). The use of selective bowel decontamination (SBD) with norfloxacin may explain this predominance. Major bacterial infections are an important source of morbidity and mortality after LT. Efforts to prevent these infections and to determine their source and specific treatment, will improve the management and the outcome of these patients in the future.

[Individual treatment of smoking addiction. Results using 2 and 4 mg nicotine gum]. / Tratamiento individualizado del tabaquismo. Resultados con chicles de 2 y 4 mg de nicotina.

We present the results of an open follow-up study aimed at analyzing the efficacy of combining psychological counseling with prescription of 2 and 4 mg nicotine gum to treat smokers. Two groups of smokers wer studied. Group A contained 124 subjects (74 men, 50 women) with a mean age of 37.4 (15.3) yr who were smokers of 15.3 (8.7) cigarettes/day. In this group physical addiction to nicotine was low, assessed as 1.7 (1.3) on the Fagerström test. Group B consisted of 107 subjects (61 men, 46 women) with a mean age of 38.9 (14.6) who were smokers of 26.9 (9.3) cigarettes/day and whose level of physical addiction to nicotine was moderate-to-high, assessed as 6.1 (2.4) on the Fagerström test. Standard deviations are shown between parentheses. Both groups were given minimal psychological counseling; additionally, patients were prescribed one piece of nicotine gum very 90 to 120 minutes during waking hours (2 mg in group A and 4 mg in group B). The dose was gradually reduced after the sixth to the eight week. The subjects were seen eight times over the first year (first day of consultation and during the first, second, fourth, eight and twelfth weeks after quitting, and again after six and twelve months). After twelve weeks of follow-up, sixty-one subjects (49%) in group A and 50 (47%) in group B were still abstinent. These proportions fell to 56 (45%) and 46 (43%), respectively, after one year of follow-up. Eighty-one percent of group A patients who were successful after three months of follow-up, and 87% of the successful group B patients, had used the nicotine gum as prescribed. Oropharyngeal, dental, and temporo-mandibular joint symptoms, hiccoughins, flatulence and heartburn were the most frequent side effects (ranging from 3% to 18%). Side effects were always slight and were not detected after the eighth week of treatment. In conclusion, combined therapy (minimal psychological counseling plus use of 2 or 4 mg nicotine gum depending on the level of physical addiction) yields a success rate between 43% and 45% still abstaining after one year of follow-up. Side effects are few and mild.