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2.
Hum Vaccin Immunother ; 13(10): 2307-2315, 2017 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-28700264

RESUMO

Pneumococcal diseases are associated with a significant clinical and economic burden. The 7-valent pneumococcal conjugate vaccine (PCV-7) has been used for the immunization of newborns against invasive pneumococcal diseases (IPD) in Italy while now, the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) and the 13-valent pneumococcal conjugate vaccine (PCV-13) are available. The aim of this analysis was to compare the estimated health benefits, cost and cost-effectiveness of immunization strategies vs. non-vaccination in Italy using the concept of overall vaccine effectiveness. A published Markov model was adapted using local data wherever available to compare the impact of neonatal pneumococcal vaccination on epidemiological and economic burden of invasive and non-invasive pneumococcal diseases, within a cohort of newborns from the Italian National Health Service (NHS) perspective. A 18-year and a 5-year time horizon were considered for the base-case and scenario analysis, respectively. PHiD-CV and PCV-13 are associated with the most important reduction of the clinical burden, with a potential marginal advantage of PHiD-CV over PCV-13. Compared with no vaccination, PHiD-CV is found on the higher limit of the usually indicated willingness to pay range (30,000 - 50,000€/quality-adjusted life year [QALY] gained), while the incremental cost-effectiveness ratio (ICER) for PCV-13 is slightly above. Compared with PCV-13, PHiD-CV would provide better health outcomes and reduce costs even at parity price, solely due to its differential effect on the incidence of NTHi acute otitis media (AOM). The analysis on a shorter time horizon confirms the direction of the base-case.


Assuntos
Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/economia , Infecções Comunitárias Adquiridas/economia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/prevenção & controle , Efeitos Psicossociais da Doença , Análise Custo-Benefício , Feminino , Humanos , Lactente , Masculino , Cadeias de Markov , Infecções Pneumocócicas/complicações , Infecções Pneumocócicas/economia , Infecções Pneumocócicas/imunologia , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/imunologia , Anos de Vida Ajustados por Qualidade de Vida , Streptococcus pneumoniae/imunologia , Vacinação/economia , Potência de Vacina , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/economia , Vacinas Conjugadas/imunologia
4.
Trends Microbiol ; 21(6): 261-4, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23731493

RESUMO

While the pharmaceutical industry is facing highly challenging times, the academic drug discovery sector has the potential to contribute meaningfully to the discovery of novel drug targets and to the development of new mode-of-action therapeutics against a range of diseases, including rare and neglected diseases.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Descoberta de Drogas , Indústria Farmacêutica/organização & administração , Parcerias Público-Privadas , Universidades/organização & administração , Pesquisa Biomédica , Humanos
5.
J Anat ; 209(6): 817-27, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17118068

RESUMO

Parafibromin is a protein encoded by the HRPT2 oncosuppressor gene, whose mutation causes the hyperparathyroidism-jaw tumour syndrome, characterized by the occurrence of parathyroid adenoma or carcinoma, fibro-osseous jaw tumours, and renal neoplastic and non-neoplastic abnormalities. Non-morphological techniques, such as Northern and Western blotting and reverse transcriptase-PCR, indicate that parafibromin is ubiquitously expressed, but extensive immunohistochemical studies have not been performed. To increase our knowledge of the distribution and patterns of expression of parafibromin, we examined its expression and location in many different mouse and human organs by immunohistochemistry. There were no substantial differences in parafibromin expression between mouse and human. We found widespread expression of parafibromin, except in connective tissue, smooth muscle, endothelium and some other types of epithelia (colonic, urinary, tubaric, uterine, thyroid). Heterogeneity of positivity intensity and subcellular location (nuclear, nucleocytoplasmic, cytoplasmic) was found between tissues and cell types, suggesting differential functional involvement of parafibromin. Moreover, higher parafibromin expression was found in cell types, such as hepatocytes, cells of the base of gastric glands, renal cortex tubules and the pars intermedia of the hypophysis, which are characterized by different proliferative capacity, thus indicating that the cellular function of parafibromin may not be reduced only to its anti-proliferative effect.


Assuntos
Células/química , Proteínas Supressoras de Tumor/análise , Adulto , Idoso , Animais , Núcleo Celular/química , Citoplasma/química , Feminino , Fibroma/genética , Fibroma/metabolismo , Mucosa Gástrica/química , Hepatócitos/química , Humanos , Hiperparatireoidismo/genética , Hiperparatireoidismo/metabolismo , Imuno-Histoquímica , Neoplasias Maxilomandibulares/genética , Neoplasias Maxilomandibulares/metabolismo , Túbulos Renais/química , Masculino , Camundongos , Pessoa de Meia-Idade , Mutação , Hipófise/química , Especificidade da Espécie , Síndrome , Proteínas Supressoras de Tumor/genética
6.
J Med Virol ; 74(1): 78-84, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15258972

RESUMO

After bone marrow (BM) or solid-organ (SO) transplantation viremic Cytomegalovirus (CMV) infection is observed frequently. Quantitative assay of CMV in blood helps the management of this clinical condition. In the present report, 83 samples from 39 solid organ recipients, three CMV assays were compared simultaneously for the first time: the Nuclisens CMV pp67 assay (nucleic acid sequence-based amplification, NASBA), an "in-house" quantitative real-time PCR assay (TaqMan) for CMV DNA, and pp65 antigenemia. The relation between CMV DNA and pp65 antigenemia, the quantitative assays, was evaluated on a larger group including 251 blood samples from 118 solid organ recipients. Real-time PCR provided the best results; > or =130 CMV DNA copies/2 x 10(5) peripheral blood leukocytes (PBLs) predicted > or =1 pp65 antigen positive (Ag+) cell/2 x 10(5) PBLs. By taking pp65 antigenemia as the "gold standard," the sensitivity of CMV DNA quantitation and of the pp67 RNA assay were 0.95 and 0.20, respectively, while the corresponding specificity values were 0.50 and 0.93. When real-time PCR was considered as the "gold standard," the sensitivity and specificity of the pp65 antigenemia were 0.65 and 0.91, respectively. Among the three tests examined, the sensitivity of the pp67 RNA assay was the lowest. On the other hand, the pp67 RNA assay was highly specific and effective in pinpointing high viremia patients. The present report, by providing predictive values for all three diagnostic profiles, DNA load, antigenemia, and pp67RNA, is a contribution for validation of real-time PCR as a new standard for quantitative assessment of CMV viremia in clinical settings.


Assuntos
Infecções por Citomegalovirus/virologia , Citomegalovirus/fisiologia , Transplante de Órgãos , Reação em Cadeia da Polimerase , RNA Mensageiro/sangue , Carga Viral , Antígenos Virais/sangue , Citomegalovirus/imunologia , Infecções por Citomegalovirus/diagnóstico , DNA Viral/sangue , Humanos , Leucócitos/virologia , Fosfoproteínas/sangue , Fosfoproteínas/genética , Valor Preditivo dos Testes , RNA Viral/sangue , Sensibilidade e Especificidade , Proteínas da Matriz Viral/sangue , Proteínas da Matriz Viral/genética
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