Respiratory viral infections in pediatric patients with hematopoietic stem cell transplantation / Infecciones respiratorias virales en pacientes pediátricos con trasplante de células progenitoras hematopoyéticas

Abstract Background: Viral respiratory infections in pediatric patients with hematopoietic stem cell transplantation (HSCT) significantly impact morbidity and mortality. It is necessary to determine the viral agents and their frequency of presentation to understand their impact on transplantation patients’ evolution. Methods: From January 2017 to December 2019, we conducted a cross-sectional, descriptive, and observational study of patients who underwent HSCT with a viral respiratory infection. Viral identification was performed using multiplex polymerase chain reaction for nine respiratory viruses. Descriptive statistics were performed with a report of central tendency measures and percentages. Results: Of the 54 pediatric patients who underwent HSCT, 59.2% presented an airway infection; in turn, at least one viral agent was identified in 59.3% of these patients. The most frequent viral agents were influenza (25.9%), human rhinovirus (18.5%), and respiratory syncytial virus (18.5%). Viral co-infections occurred in 36.8% of the cases. The reported complications were supplemental oxygen requirement (73.6%), support with mechanical ventilation (21%), admission to the pediatric intensive care unit (15.7%), and mortality associated with a viral respiratory infection (10.5%). Conclusions: Viral respiratory infections are frequent in pediatric patients with HSCT; influenza A/B virus was the most frequent agent. As morbidity and mortality increase due to these infections in patients with HSCT, strategies are necessary for its prevention and timely treatment after transplantation.

Resumen Introducción: Las infecciones respiratorias virales en los pacientes pediátricos con trasplante de células progenitoras hematopoyéticas (TCPH) impactan significativamente la morbilidad y la mortalidad. Para comprender su impacto en la evolución de los pacientes receptores de trasplantes es necesario conocer la frecuencia de presentación y los agentes virales. Métodos: De enero de 2017 a diciembre de 2019 se llevó a cabo un estudio transversal, descriptivo y observacional de los pacientes sometidos a TCPH que tuvieron una infección viral de vías respiratorias. La identificación de los virus se realizó por medio de la prueba de reacción en cadena de la polimerasa multiplex para nueve virus respiratorios. Se realizó estadística descriptiva con reporte de medidas de tendencia central y porcentajes. Resultados: De los 54 pacientes incluidos, el 59.2% presentaron una infección de vías respiratorias y se identificó al menos un agente viral en el 59.3% de estos casos. Los virus más frecuentes fueron influenza (25.9%), rinovirus humano (18.5%) y virus sincitial respiratorio (18.5%). En el 36.8% de los casos se detectaron coinfecciones virales. Se presentaron las siguientes complicaciones: requerimiento de oxígeno suplementario (73.6%), soporte con ventilación mecánica (21%), ingreso a la unidad de cuidados intensivos pediátricos (15.7%) y muerte asociada a infección por virus respiratorios (10.5%). Conclusiones: Las infecciones respiratorias virales en los pacientes pediátricos con TCPH son frecuentes; el virus influenza A/B es el agente más habitual. Debido a que estas infecciones se asocian con mayor morbimortalidad en los pacientes con TCPH, son estrategias necesarias para su prevención y tratamiento oportuno posterior al trasplante.

Reconstitución de células natural killer después del trasplante de células progenitoras hematopoyéticas en niños / Natural killer cell reconstitution after hematopoietic stem-cell transplantation in children

Resumen Introducción: Después de un trasplante de células progenitoras hematopoyéticas (TCPH), la reconstitución de las células natural killer (NK) es la principal barrera contra las infecciones virales. Objetivo: Determinar que el conocimiento sobre la cinética de la reconstitución de las células NK posterior al TCPH contribuye a un eficiente monitoreo del trasplante, lo que incrementa la posibilidad de éxito de este. Método: Se incluyeron 21 pacientes sometidos a TCPH, así como un grupo control de individuos clínicamente sanos. En diferentes momentos después del trasplante (intervalo de 21 a 670 días), mediante citometría de flujo se cuantificaron las células NK CD3− CD16+ CD56+ en muestras de sangre periférica. Resultados: La recuperación de las células NK ocurre entre los tres y seis meses y entre los 10 y 12 meses postrasplante; su número fue significativamente menor (en comparación con el grupo control) en el tiempo restante del monitoreo. Conclusiones: El primer periodo de recuperación de las células NK ocurre entre los tres y seis meses posteriores al trasplante. La reconstitución es transitoria y el número de células NK varía en los primeros años.

Abstract Introduction: After hematopoietic stem cell transplantation (HSCT), natural killer (NK) cells reconstitution is the main barrier against viral infections. Objective: To determine that the knowledge on the kinetics of NK cell reconstitution after HSCT contributes to transplant efficient monitoring, which increases the possibility of its success. Method: Twenty-one patients undergoing HSCT were included, as well as a control group of clinically healthy individuals. At different time points after transplantation (range of 21 to 670 days), CD3- CD16+ CD56+ NK cells were quantified by flow cytometry in peripheral blood samples. Results: NK cell recovery occurs at three to six months and 10 to 12 months post-transplantation; their number was significantly lower (in comparison with the control group) in the rest of the monitoring time. Conclusions: The first period of NK cell recovery occurs between three and six months after transplantation. Reconstitution is transient and the number of NK cells varies in the first years.

Determinación y cuantificación de subpoblaciones de linfocitos T y células natural killer en sangre periférica de individuos sanos por citometría de flujo / Detection and quantification of T-cell subpopulations and NK cells in peripheral blood from healthy individuals

Resumen Introducción: La determinación de las diferentes subpoblaciones de los linfocitos T en las diversas patologías y el monitoreo postratamiento ayuda a que el médico tome decisiones terapéuticas teniendo como referencia la cinética de los linfocitos T localizados en sangre periférica. Métodos: Se realizó la estandarización de un perfil de moléculas de superficie para la caracterización de subpoblaciones de linfocitos T: naïve, activados y de memoria, así como las células natural killer o asesinas naturales (CD3− CD56+) en sangre periférica de individuos clínicamente sanos. Resultados: Se identificaron las subpoblaciones de linfocitos: naïve (CD3+, CD4+ o CD8+, CD45RA+, CD62L+, CCR7+), activados (CD3+, CD4+ o CD8+, CD45RA+ o CD45RO+, CD69+ y/o CRTAM+), efectores (CD3+, CD4+ o CD8+, CD45RA+, CD62L−, CCR7−), de memoria central (CD3+, CD4+ o CD8+, CD45RO+, CD62L+, CCR7+) y de memoria efectora (CD3+, CD4+ o CD8+, CD45RO+, CD62L−, CCR7−) en las poblaciones de linfocitos T CD4+ y CD8+. Se integraron los datos obtenidos con estadística descriptiva (valores mínimos, valores máximos, media, mediana). Conclusiones: Este panel será de gran utilidad para monitorear pacientes en quienes se requiera valorar el estado inmunológico desde el punto de vista celular. Particularmente, puede apoyar en el seguimiento de los pacientes en los que se requiera evaluar la reconstitución inmunológica (componente celular de estirpe T).

Abstract Background: The knowledge of the participation of different subpopulations of T lymphocytes in various pathologies helps to make therapeutic decisions, having as reference the presence of the different subpopulations of the T lymphocytes associated with the disease. Methods: A profile standardization of surface molecules for the characterization of subpopulations of T cells was conducted: naïve, activated and memory, as well as natural killer (CD3− CD56+) cells in peripheral blood of clinically healthy individuals. Results: Naïve (CD3+, CD4+ or CD8+, CD45RA+, CD62L+, CCR7+), activated (CD3+, CD4+ or CD8+, CD45RA+ or CD45RO+, CD69+ and/or CRTAM+), effectors (CD3+, CD4+ o CD8+, CD45RA+, CD62L−, CCR7−), central memory (CD3+, CD4+ o CD8+, CD45RO+, CD62L+, CCR7+), memory effectors (CD3+, CD4+ or CD8+, CD62RO+, CD62L−, CCR7−) subpopulations were analyzed by flow cytometry. Descriptive statistics parameters were calculated (minimum values, maximum values, mean values, median). Conclusions: This panel can be very useful for monitoring patients in whom the immunological status from a cellular perspective is needed. Particularly, it can support the follow-up of patients who require an immunological reconstitution (T-cell component) evaluation.

Primary dengue virus infections induce differential cytokine production in Mexican patients

Severe dengue pathogenesis is not fully understood, but high levels of proinflammatory cytokines have been associated with dengue disease severity. In this study, the cytokine levels in 171 sera from Mexican patients with primary dengue fever (DF) and dengue haemorrhagic fever (DHF) from dengue virus (DENV) 1 (n = 116) or 2 (n = 55) were compared. DF and DHF were defined according to the patient’s clinical condition, the primary infections as indicated by IgG enzymatic immunoassay negative results, and the infecting serotype as assessed by real-time reverse transcription-polymerase chain reaction. Samples were analysed for circulating levels of interleukin (IL)-12p70, interferon (IFN)-γ, tumour necrosis factor (TNF)-α, IL-6, and IL-8 using a commercial cytometric bead array. Significantly higher IFN-γ levels were found in patients with DHF than those with DF. However, significantly higher IL-12p70, TNF-α, and IL-6 levels were associated with DHF only in patients who were infected with DENV2 but not with DENV1. Moreover, patients with DF who were infected with DENV1 showed higher levels of IL-12p70, TNF-α, and IL-6 than patients with DHF early after-fever onset. The IL-8 levels were similar in all cases regardless of the clinical condition or infection serotype. These results suggest that the association between high proinflammatory cytokine levels and dengue disease severity does not always stand, and it once again highlights the complex nature of DHF pathogenesis.

Excreción fecal de Salmonella Albany, su aislamiento en la ración alimenticia y repercusión en el estado de salud de un ocelote (Leopardus pardalis) en cautiverio / Fecal excretion of Salmonella Albany, its isolation in the diet and health repercussion on an ocelot (Leopardus pardalis) in captivity

Salmonella enterica serotypes are 99% responsible for salmonellosis in human and animals, especially Salmonella enterica serovar Albany that has been identified in chicken carcass representing a risk for human and animal health. Salmonella enterica serovar Albany was isolated from the feces of a male ocelot (Leopardus pardalis), at the zoo in Culiacan, Sinaloa, Mexico, and from raw chicken (feline's diet). The pulsed-field gel electrophoresis pattern (PFGE) generated by Xba I enzyme was identical in both isolates, indicating that the source of infection was the raw chicken. Five months after having isolated the bacteria from the feces, a post mortem study was carried out on the feline. Macroscopically, severe hemorrhagic enterocolitis and renal fibrosis was observed and microscopically, there was evidence of severe mononuclear lymphocytic infiltration in the ileum, as well as necrosis of intestinal villi and crypts, besides severe multifocal interstitial nephritis and fibrosis in both kidneys. The invA gene was amplified from intestinal samples confirming an infection by Salmonella. The microbiologic, molecular and histopathology diagnoses suggest that death of the feline was caused by ingestion of raw chicken contaminated with Salmonella enterica serovar Albany. This clinical case highlights the importance of persistent fecal Salmonella shedding animals and describes the molecular epidemiological relationships of isolates from feces and food, which allowed to find the primary source of infection.

Los serotipos de Salmonella especie enterica son los responsables del 99% de las salmonelosis en humanos y animales, en particular, Salmonella enterica serovariedad Albany se ha identificado en canales de pollo, por lo que representa un riesgo para la salud humana y animal. Se aisló Salmonella enterica serovariedad Albany a partir de heces de un ocelote macho (Leopardus pardalis), cautivo en el zoológico de Culiacán, Sinaloa, México, y de pollo crudo (alimento del felino). El patrón por electroforesis en campo pulsado (PFGE) con la enzima Xba I fue idéntico en ambos aislados, lo que indica que la fuente de infección fue el pollo crudo. Cinco meses después de haber aislado las bacterias de las heces, se realizó estudio post mortem del felino anteriormente mencionado, y se observó macroscópicamente: enterocolitis hemorrágica severa y fibrosis renal; y microscópicamente: necrosis de vellosidades y de criptas e infiltrado mononuclear linfocitario severo en íleon, además nefritis intersticial severa multifocal y fibrosis en riñón. A partir de muestras intestinales se amplificó el gen invA que confirma la infección por Salmonella. Los diagnósticos microbiológico, molecular e histopatológico sugieren que la muerte del felino se debió a la infección causada por la ingesta de pollo crudo contaminado con Salmonella enterica serovariedad Albany. Este caso clínico confirma la importancia que tienen los animales que excretan Salmonella vía fecal y describe la relación epidemiológica-molecular de los aislamientos obtenidos de heces y alimento, lo que permitió esclarecer la fuente primaria de infección.

Detection of a factor released by L5178Y lymphoblasts that inhibits mouse Macrophage-Activation induced by lipopolysaccharides

Background. Several factors inhibit cellular immune response by deactivating macrophages, but very few, such as those described here, prevent macrophage activation. Methods. Ascites liquid from 12-day-old BALB/c mice bearing 5178Y lymphoma tumors was collected, and cell-free ascites liquid (CFAL) was separated from lymphoblasts. The supernatant (SI) was obtained from the homogenized and centrifuged lymphoblasts Then, macrophage cultures contaning 0.2 X 10 a the sixth cells from lymphoma-bearing or hearthly mice were added to 10 µL of CFAL or S1, plus 5 µg of lipopolysaccharides (LPS)/mL, 40 U interferon-ç or a blend of both. Macrophages were incubated with CFAL or S1 prior to or after adding the activators to investigate whether any of the previously mentioned lymphoma fraction inhibited macrophage activation or whether they deactivated them. The effect of CFAL or S1 was estimated as the diminution of the amount of nitric ixide released by the experimental macrophage cultures with respect to controls (activated macrophages treated with none of the lymphoma fractions). Results. LPS, IFN-ç, and the LPS/ç blend activated macrophages from both lymphomabearing and healthy mice. None of the lymphoma fractions deactivated macrophages. CFAL, but not S1, inhibited the macrophage activation, i.e., the percentage of inhibition of nitric oxide releasing 76.7 percent in macrophages from healthy and lymphomabearing mice, respectively. In addition, CFAL was unable to inhibit macrophage-activation effect of IFN-ç or the LPS/IFN-ç blend. Conclusions. Mouse L5178Y Lymphoma releases a factor that in vitro inhibits the macrophage activation induced by LPS, but not by IFN-ç controls