After-action review of rabies and anthrax outbreaks multisectoral response in Tanzania, challenges and lessons

After-action review uses experiences gained from past events to adopt best practices, thereby improving future interventions. In December 2016 and late 2018, the government of Tanzania with support from partners responded to anthrax and rabies outbreaks in Arusha and Morogoro regions respectively. The One Health Coordination Desk (OHCD) of the Prime Minister's Office (PMO) later coordinated after-action reviews to review the multi-sectoral preparedness and response to the outbreaks. To establish and describe actions undertaken by the multi-sectoral investigation and response teams during planning and deployment, execution of field activities, and outbreak investigation and response, system best practices and deficiencies. These were cross-sectional surveys. Semi-structured, open and closed-ended questionnaire and focus group discussions were administered to collect information from responders at the national and subnational levels. It was found that the surveillance and response systems were weak at community level, lack of enforcement of public health laws including vaccination of livestock and domestic animals and joint preparedness efforts were generally undermined by differential disease surveillance capacities among sectors. Lack of resources in particular funds for supplies, transport and deployment of response teams contributed to many shortfalls. The findings underpin the importance of after-action reviews in identifying critical areas for improvement in multi-sectoral prevention and control of disease outbreaks. Main sectors under the coordination of the OHCD should include after action reviews in their plans and budget it as a tool to continuously assess and improve multi-sectoral preparedness and response to public health emergencies.

Immune function of zhenqi fuzheng capsule on volleyball players after high intensity training / Função imunitária da cápsula zhenqi fuzheng em jogadores de voleibol após treinamento de alta intensidade / Efecto de la cápsula zhenqi fuzheng sobre la función inmune de los jugadores de voleibol después del entrenamiento de alta intensidad

ABSTRACT At present, many studies have proved that proper exercise can promote the immune function of human body to a certain extent, but athletes need a lot of high-intensity sports training, and their immune function declines instead of improving. In order to control the decline of immune function of athletes after high-intensity training, this study propose the Zhenqi Fuzheng capsule to achieve this goal. Through experimental comparison, the parameters such as white blood cell content, immunoglobulin number, T lymphocyte, human hemoglobin content and exercise exhaustion time were detected after high-intensity training. The results showed that compared with the control group taking Zhenqi Fuzheng, the weight of those who had taken qifuzhengs capsule did not change, and the content of white blood cells, immunoglobulin, hemoglobin content and exercise time increased to a certain extent. The results showed that Zhenqi Fuzheng could inhibit the decrease of body immune function after high-intensity exercise, then accelerate the recovery of human immune function. This study is expected to enhance the immunity of sports athletes, and reduce athletes' pain after high-intensity training.

RESUMO Atualmente, muitos estudos prova que exercícios adequados podem promover a função imunológica do corpo humano em certa medida, mas os atletas precisam de muito treinamento esportivo de alta intensidade, e sua função imunológica diminui em vez de melhorar. A fim de controlar o declínio da função imunológica dos atletas após treinamento de alta intensidade, este estudo propôs a administração da cápsula Zhenqi Fuzheng para alcançar esse objetivo. Através de comparação experimental, foram detectados parâmetros como o teor de glóbulos brancos, imunoglobulina, linfócitos T, hemoglobina humana e tempo de exaustão do exercício após treinamento de alta intensidade. Os resultados mostraram que, em comparação com o grupo controle que tomou a cápsula Zhenqi Fuzheng, o peso daqueles que tinham tomado a cápsula de qifuzheng não se alterou, e o teor de glóbulos brancos, imunoglobulina, hemoglobina e o tempo de exercício aumentaram em certa medida. Os resultados mostraram que a cápsula Zhenqi Fuzheng poderia inibir a diminuição da função imunológica corporal após exercícios de alta intensidade, e acelerar a recuperação da função imunológica humana. Espera-se que este estudo possa aumentar a imunidade dos atletas e reduzir a dor dos atletas após treinamento alta intensidade para fornecer uma certa referência.

RESUMEN Actualmente, muchos estudios prueban que ejercicios adecuados pueden promover la función inmunológica del cuerpo humano en cierta medida, pero los atletas precisan mucho entrenamiento deportivo de alta intensidad, y su función inmunológica disminuye en vez de mejorar. A fin de controlar la declinación de la función inmunológica de los atletas después del entrenamiento de alta intensidad, este estudio propuso la administración de la cápsula Zhenqi Fuzheng para alcanzar ese objetivo. Por medio de comparación experimental, fueron detectados parámetros como el tenor de glóbulos blancos, inmunoglobulina, linfocitos T, hemoglobina humana y tiempo de agotamiento del ejercicio después de entrenamiento de alta intensidad. Los resultados mostraron que, en comparación con el grupo control que tomó la cápsula Zhenqi Fuzheng, el peso de aquellos que habían tomado la cápsula de qifuzheng no se alteró, y el tenor de glóbulos blancos, inmunoglobulina, hemoglobina y el tiempo de ejercicio aumentaron en cierta medida. Los resultados mostraron que la cápsula Zhenqi Fuzheng podría inhibir la disminución de la función inmunológica corporal después de ejercicios de alta intensidad, y acelerar la recuperación de la función inmunológica humana. Se espera que este estudio pueda aumentar la inmunidad de los atletas y reducir el dolor después de entrenamiento de alta intensidad para proveer una cierta referencia.

Modeling the Long-term Antibody Response and Duration of Immune Protection Induced by an Inactivated, Preservative-free Hepatitis A Vaccine (Healive) in Children / 生物医学与环境科学（英文）

Objective@#Long-term seroprotection the hepatitis A vaccine is essential for the prevention of disease from the hepatitis A virus (HAV). Due to documented difficulties during decade-long follow-ups after receiving vaccines, statistical-modeling approaches have been applied to predict the duration of immune protection.@*Methods@#Based on five-year follow-up data from a randomized positive-controlled trial among Chinese children (1-8 years old) following a 0, 6 months vaccination schedule, a power-law model accounting for the kinetics of B-cell turnover, as well as a modified power-law model considering a memory-B-cell subpopulation, were fitted to predict the long-term immune responses induced by HAV vaccination (Healive or Havrix). Anti-HAV levels of each individual and seroconversion rates up to 30 years after vaccination were predicted.@*Results@#A total of 375 participants who completed the two-dose vaccination were included in the analysis. Both models predicted that, over a life-long period, participants vaccinated with Healive would have close but slightly higher antibody titers than those of participants vaccinated with Havrix. Additionally, consistent with previous studies, more than 90% of participants were predicted to maintain seroconversion for at least 30 years. Moreover, the modified power-law model predicted that the antibody titers would reach a plateau level after nearly 15 years post-vaccination.@*Conclusions@#Based on the results of our modeling, Healive may adequately induce long-term immune responses following a 0, 6 months vaccination schedule in children induction of memory B cells to provide stable and durable immune protection.

Efeito da exposição à hidroquinona na resposta imune adaptativa induzida pela vacina contra a influenza / Effects of hydroquinone exposure on the adaptive immune response induced by the influenza vaccine

A gripe é causada pelo vírus Influenza e é um problema de saúde pública mundial, que pode levar a problemas sérios em idosos e crianças. O Brasil implantou a vacinação anual contra influenza a partir de 1999, como ação preventiva contra a doença. A vacina é produzida pelo Instituto Butantan e contém três cepas diferentes do vírus Influenza fragmentado para induzir resposta imune adaptativa, com produção de anticorpos específicos e neutralizantes. A literatura tem mostrado que a exposição à xenobióticos com potencial imunossupressor pode comprometer a eficácia de imunizações ativas, como a imunização contra a gripe. Nosso grupo de pesquisa tem mostrado que a exposição à hidroquinona (HQ), um composto tóxico presente em altas concentrações na fumaça do cigarro, prejudica a resposta imune inata e adquirida. Assim, este trabalho avaliou o efeito da exposição à HQ sobre a resposta imune à vacinação contra influenza. Camundongos machos da linhagem C57BL/6 foram diariamente expostos à HQ (2500 ppm) ou PBS, por 1 hora, por nebulização, por um período de 8 semanas. Durante este período, foram imunizados nas semanas 6 e 8 do início das exposições, pela injeção i.m. de 100µL da vacina. Os parâmetros tóxicos e imunológicos foram avaliados 7, 35 e 70 dias após a segunda dose da vacina. A exposição à HQ não alterou o peso corpóreo dos animais e nem causou alterações morfológicas no pulmão, fígado e rins (histologia por H&E); reduziu a frequência de hemácias (11%), hematócrito (14%), hemoglobina (14%) e volume celular (4%); causou estresse oxidativo no baço (citometria de fluxo); aumentou a área dos folículos de células B no baço e linfonodomegalia (histologia por H&E). Em conjunto, os dados aqui obtidos mostram que a exposição à HQ afetou mecanismos envolvidos na gênese da imunidade ativa contra influenza. Assim, os dados deste trabalho mostram mecanismos tóxicos ainda não descritos para a HQ, e ressalta a HQ como um poluente ambiental que deve ser considerado nas avaliações de risco

The flu is a health problem worldwide which is caused by the Influenza virus and may result in severe illness in infants and the elderly. The annually vaccination against influenza was implemented in Brazil in 1999 as a preventive measure. The vaccine is produced by Butantan Institute and contains three different strains of the inactivated Influenza virus which induce the adaptive immune response along with production of specific and neutralizing antibodies. The literature has shown that exposure to immunosuppressive xenobiotics may compromise the efficacy of active immunizations, such as influenza. Our research group has shown that exposure to hydroquinone (HQ), a toxic constituent of cigarette smoke, impairs both innate and adaptive immune response. Thus, the aim of this work was to evaluate the effects of HQ on the immune response induced by the influenza vaccine. Male C57BL/6 mice were daily exposed to HQ (2500 ppm) or PBS by nebulization, for 1 hour, for 8 weeks. During the exposure period, the animals were vaccinated on weeks 6 and 8 with 100µL of the vaccine. Toxicologic and immunological parameters were assessed 7, 35 and 70 days after boost administration. HQ exposure did not alter body weight and did not cause morphological alterations in the lungs, liver and kidneys (H&E staining); reduced the frequency of erythrocytes (11%), hematocrit (14%), hemoglobin (14%) and cellular volume (4%) and caused oxidative stress on the spleen (Flow Cytometry); increased the area of B cell follicles in the spleen and increased the size of draining lymph nodes (H&E staining). Altogether, these data show that HQ exposure affected mechanisms involved in the genesis of the adaptive immune response. Thus, the data presented in this work show toxic mechanisms of HQ that have not yet been described, and it also points out HQ as an environmental pollutant which should be considered on risk assessments

Prevalência de imunidade à hepatite B entre profissionais de enfermagem atuantes em hemodiálise / Prevalencia de inmunidad a la hepatitis B entre enfermería profesional activa en la hemodiálisis / Prevalence of immunity to hepatitis B among professional nursing active in hemodialysis

Objective: to evaluate the prevalence of immunity to hepatitis B among nurses active on hemodialysis. Methods: Cross-sectional study was conducted with 63 professionals from a hemodialysis private service and 29 public service ones that answered a questionnaire containing information on demographics, labor, adoption of biosecurity measures in hemodialysis and related to vaccination, immunity and occupational exposure and non-occupational at Hepatitis B vírus. Results: Among the professionals from the private service, the prevalence of immunity to hepatitis B was 93.7% and among the professionals in the public service, the prevalence was 86.2%; in both services were not found statistically significant differences when characteristics related to demographics, laboral and occupational and non-occupational exposure to hepatitis B were considered. Conclusion: Possibly these high prevalences were due to complete immunization schedule against hepatitis B found in over 80% of study participants.

Objetivo: avaliar a prevalência de imunidade à hepatite B entre profissionais de enfermagem atuantes em hemodiálise. Métodos: Estudo seccional desenvolvido com 63 profissionais de um serviço privado de hemodiálise e 29 de um serviço público que responderam um questionário contendo informações demográficas, trabalhistas, sobre adoção de medidas de biossegurança em hemodiálise e relativas à vacinação, imunidade e exposição ocupacional e não ocupacional ao vírus da hepatite B. Resultados: Entre os profissionais do serviço privado, a prevalência de imunidade à hepatite B foi de 93,7% e, entre os profissionais do serviço público, a prevalência foi de 86,2%; em ambos serviços diferenças estatisticamente significativas não foram encontradas quando características demográficas, trabalhistas e de exposição ocupacional e não ocupacional ao vírus da hepatite B foram consideradas. Conclusão: Possivelmente essas elevadas prevalências se deviam ao esquema vacinal completo contra a hepatite B encontrado em mais de 80% dos profissionais de enfermagem participantes do estudo.

Objetivo: evaluar la prevalencia de inmunidad a la hepatitis B entre los profesionales de enfermería que trabajan en hemodiálisis. Métodos: Estudio transversal con 63 profesionales de servicio privado y 29 de servicio público que respondieron un cuestionario que contiene información demográfica, laboral, sobre la adopción de medidas de bioseguridad en hemodiálises, relacionados con la vacunación, la inmunidad, la exposición ocupacional y no ocupacional al virus de la hepatitis B. Resultados: Entre los profesionales del servicio privado, la prevalencia de la inmunidad a la hepatitis B fue 93,7% y entre los profesionales del público, la prevalencia fue de 86,2%; en ambos no se encontraron diferencias estadísticamente significativas cuando se consideraron los datos demográficos, laboral, exposición ocupacional y no ocupacional a la hepatitis B. Conclusión: Posiblemente estas elevadas prevalencias se debieron a el completo esquema de vacunación contra la hepatitis B que se encontró en más del 80% de los participantes del estudio.

Progress towards a comprehensive approach to maternal and neonatal immunization in the Americas / Progreso hacia un método integral de inmunización materna y neonatal en la Región de las Américas / Avanços rumo a um enfoque amplo de imunização materna e neonatal nas Américas

ABSTRACT Maternal and neonatal immunization (MNI) is a core component of the new immunization model in the Americas, which transitioned from immunization of children to that of the entire family. Immunization during pregnancy protects the mother and the fetus by providing the neonate with maternal antibodies against disease. It has the potential to impact early childhood morbidity and mortality, and thus MNI has gained visibility and priority on the global health agenda. The Region of the Americas is a leader in MNI, as seen by its elimination of congenital rubella syndrome in 2015 and the progress made toward neonatal tetanus elimination. In the Americas, 31 countries currently target pregnant women for influenza vaccination; and 21 countries—over 90% of the Region's birth cohort—have nationwide newborn hepatitis B vaccination. This paper describes the status of MNI in the Americas and identifies gaps in the evidence, obstacles to optimal implementation, and opportunities for future improvements. Catalysts for MNI in the Region have been political commitment, endorsement by scientific societies, an established "culture of vaccination," widespread access to antenatal care, and con-text-specific communications; however, universal and equitable access for pregnant women and their newborns continues to be a formidable challenge, and additional vaccine safety and effectiveness evidence is needed. Continued efforts to integrate MNI with maternal and child health services will be critical to furthering the MNI platform as well.

RESUMEN La inmunización materna y neonatal es un componente central del nuevo modelo de inmunización en la Región de las Américas, que pasó de la inmunización infantil a la de toda la familia. La inmunización durante el embarazo protege a la madre y el feto dando al recién nacido los anticuerpos maternos contra las enfermedades. Tiene el potencial de repercutir en la morbilidad y la mortalidad en la primera infancia, por lo que la inmunización materna y neonatal ha adquirido visibilidad y prioridad en la agenda mundial de salud. La Región de las Américas ocupa una posición de liderazgo en materia de inmunización materna y neonatal, como lo demuestra la eliminación del síndrome de rubéola congénita en el 2015 y los avances logrados para la eliminación del tétanos neonatal. Actualmente en 31 países de la Región se da prioridad a las embarazadas para que reciban vacunación antigripal y en 21 países —más de 90% de la cohorte de nacimiento de la Región— se incluye la vacunación de los recién nacidos contra la hepatitis B a nivel nacional. En este documento se describe la situación de la inmunización materna y neonatal en la Región de las Américas y se señalan las lagunas en la evidencia, los obstáculos a la implementación óptima y las oportunidades para las mejoras futuras. Los catalizadores de la inmunización materna y neonatal en la Región han sido el compromiso político, el aval de las sociedades científicas, una "cultura de vacunación" establecida, el acceso generalizado a la atención prenatal y las comunicaciones específicas para cada contexto; sin embargo, el acceso universal y equitativo de las embarazadas y los recién nacidos sigue siendo un reto enorme y se necesitan más datos científicos sobre la seguridad y efectividad de las vacunas. La continuación de los esfuerzos para integrar la inmunización materna y neonatal en los servicios de salud maternoinfantil será fundamental para promover también la plataforma a favor de esta inmunización.

RESUMO A imunização materna e neonatal é peça fundamental do novo modelo de imunização nas Américas, com a transição da vacinação de crianças à vacinação de toda a família. A vacinação da gestante protege a mãe e o feto ao proporcionar ao recém-nascido anticorpos maternos contra doenças. A imunização materna e neonatal possivelmente repercute na primeira infância reduzindo a morbidade e a mortalidade e, portanto, ganhou visibilidade sendo considerada prioritária na agenda global de saúde. A Região das Américas é líder em imunização materna e neonatal, tendo alcançado a eliminação da síndrome da rubéola congênita em 2015 e avançado para a eliminação do tétano neonatal. Existem atualmente programas de vacinação contra influenza para gestantes em 31 países e programas nacionais de vacinação contra hepatite B para recém-nascidos em 21 países (com uma cobertura superior a 90% da coorte de nascidos vivos na Região). Este artigo apresenta um panorama da imunização materna e neonatal nas Américas, destaca as lacunas nas evidências científicas e os obstáculos à implementação ideal dos programas de vacinação e aponta oportunidades futuras para melhorias. Entre os fatores responsáveis pelo incentivo à imunização materna e neonatal na Região estão o compromisso político, o endosso das sociedades científicas, uma "cultura de vacinação" estabelecida, o amplo acesso à assistência pré-natal e a comunicação contextualizada. Porém, o acesso universal e equitativo das gestantes e seus recém--nascidos à vacinação é ainda um grande desafio e se fazem necessárias mais evidências sobre a segurança e a efetividade das vacinas. Além disso, é imprescindível o empenho contínuo para integrar a imunização materna e neonatal aos serviços de saúde materno-infantil e seguir promovendo a plataforma de imunização materna e neonatal.

Anti-tumor Immune Response after Cryoablation in Renal Cell Carcinoma Murine Model

PURPOSE: Cryoablation has been used successfully for the local treatment of renal cell carcinoma. Besides local destruction, Cryoablation has an immunogenic nature. In this study, we evaluated the anti-tumor immune response induced by cryoablation in renal cell carcinoma murine model. MATERIALS AND METHODS: Renal cell carcinoma was produced in BALB/c mice by the subcutaneous inoculation of Renca cells in the thigh. After 7 days, the tumors were removed using liquid nitrogen in cryoablation group and bipolar electrocoagulation in electrocautery group. For twelve days after re-inoculation of Renca cells at contralateral thigh, tumor volumes were measured daily to assess the effect against the growth of tumor. The immunocyte levels (T4, T8, B and NK cell) were determined to evaluate immune activity by FACS (Fluorescence activated cell sorter) analysis. The effect of cryoablation to induce apoptosis of tumor was evaluated by TUNEL (Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end-labeling) assay. RESULTS: The tumor volume of cryoablation group was significantly smaller than that of electrocautery group and control (p<0.05). Comparing with control, T cell level was significantly increased after cryoablation (p<0.05), but no group had a significant difference in the levels of B cell and NK cell by FACS analysis. The apoptosis index % of cryoablation group was significantly increased than that of control group (p<0.05) by TUNEL. CONCLUSIONS: Cryoablation could result in the inhibition of re-inoculated tumor growth and induce T cell mediated immune response. The active immune response may be attributed to the apoptosis of tumor after cryoablation.

Inmunosenescencia: efectos de la edad sobre el sistema inmune / Immunosenescence: effects of aging process on immune system

El proceso de envejecimiento provoca cambios en el sistema inmune que afectan su funcionamiento y desarrollo. Estos cambios pueden manifestarse desde la linfopoyesis hasta la respuesta que orquesta el sistema inmune frente a determinada enfermedad o agente infeccioso. Ambas ramas de la inmunidad, innata y adaptativa, se afectan en este proceso, lo que genera un impacto negativo en la respuesta inmune de los ancianos y los predispone a padecer enfermedades infecciosas, cáncer, autoinmunidad y a desarrollar respuestas pobres tras la administración de vacunas...

The aging process produces functional and developmental changes in the immune system. Those changes may appear from lymphopoiesis up to the final response of the immune system facing a certain disease. Both branches of immunity, innate and adaptive, are affected by the aging process; hence these changes can have a negative impact on the immune response of elderly patients and increase their susceptibility to infectious diseases, cancer and decreased vaccine efficacy...

Kinetics of rabies antibodies as a strategy for canine active immunization

Background Rabies, a zoonosis found throughout the globe, is caused by a virus of theLyssavirus genus. The disease is transmitted to humans through the inoculation of the virus present in the saliva of infected mammals. Since its prognosis is usually fatal for humans, nationwide public campaigns to vaccinate dogs and cats against rabies aim to break the epidemiological link between the virus and its reservoirs in Brazil.Findings During 12 months we evaluated the active immunity of dogs first vaccinated (booster shot at 30 days after first vaccination) against rabies using the Fuenzalida-Palácios modified vaccine in the urban area of Botucatu city, São Pauto state, Brazil. Of the analyzed dogs, 54.7% maintained protective titers (≥0.5 IU/mL) for 360 days after the first vaccination whereas 51.5% during all the study period.Conclusions The present results suggest a new vaccination schedule for dogs that have never been vaccinated. In addition to the first dose of vaccine, two others are recommended: the second at 30 days after the first and the third dose at 180 days after the first for the maintenance of protective titers during 12 months.(AU)

Analysis of protective effect of using chickenpox live attenuated vaccine among 4-17 years old children in Minhang district, Shanghai / 中华预防医学杂志

<p><b>OBJECTIVES</b>To survey on the vaccination of varicella live attenuated vaccine among 4-17 children in Minhang District, and analyze the protective effect against varicella.</p><p><b>METHODS</b>We collected outbreak chickenpox cases reported from infectious disease report system and surveillance units in Minhang district from 1st May in 2012 to 30th Apr in 2013. The 1: 3 matched case-control study was conducted to questionnaire the legal guardian of the cases and control group, and calculate the protective effect and effective term of protection. The survey included vaccination, chickenpox exposure history, previous history of varicella illness, suffering from the symptoms of chickenpox, the vaccinations brand, etc. The criteria of accepted case were those healthy students who were in the same class with those chickenpox cases. The accepted matched controlling data were those children who were from the same class with outbreak chickenpox cases without varicelliform eruption, similar live condition, the closest house, the same gender, the closest age. This study investigated 390 cases of patients and the control group included 1 170 cases. Chi-square test was used to compare the vaccination of cases and controls, as well as the incidence of chickenpox vaccination different brands VarV, Mantel-Haenzel chi-square test was applied to compare the protective effect of the two groups.</p><p><b>RESULTS</b>VarV overall vaccination rate was 68.3% (1 065/1 560), among them, the case group coverage was 45.1% (176/390), significantly lower than the control group (76.0% (889/1 170)) (χ² = 128.55, P < 0.01). The coverage in children of 4-10 years old group was 88.4% (375/424), significantly higher than the 11-17 years old group (60.7% (690/1 136)) (χ² = 109.40, P < 0.01). The overall protective effect of VarV was 78.10% (71.82%-82.98%).Vaccinated group incidence ratio was 16.5% (176/1 065), significantly lower than the unvaccinated group (43.2% (214/495)) (χ² = 128.55, P < 0.01). The chickenpox risk of the children who were vaccinated was lower than those who were not, and the OR (95%CI) was 0.22(0.17-0.28) . Proportion of the fever and the typical symptoms of varicella zoster were 26.1% (46/176), 8.0% (14/176) in the children vaccinated VarV, significantly lower than children without VarV vaccination history (54.7% (117/214) , 18.2% (39/214) ) (χ² values were 32.33 and 8.67, respectively. P values both <0.01). The varicella incidence was 17.4% (139/797) in children vaccinated domestic VarV, and it was 13.8% (37/268) in the group of imported VarV (χ² = 1.92, P = 0.184) . The average duration of effective protection period for domestic and imported VarV was (6.2 ± 2.7), (6.3 ± 3.4) years (F = 2.24, P = 0.136).</p><p><b>CONCLUSIONS</b>The risk of varicella incidence and the proportion of fever or typical varicella zoster were lower in the one dose of VarV vaccinated; Effective protective effect was consistent in the children with domestic or imported VarV vaccination.</p>

Autologous Immunoglobulin Therapy in Patients With Severe Recalcitrant Atopic Dermatitis: A Preliminary Report

The management of severe recalcitrant atopic dermatitis (AD) is a challenging issue for clinicians and patients. We hypothesized that repeated intramuscular injections of autologous immunoglobulin (autologous immunoglobulin therapy: AIGT) might induce clinical improvements in patients with AD by stimulation of the active immune response to antigen-binding-site of pathogenic antibodies. We tried AIGT in 3 adult patients with severe recalcitrant AD whose clinical conditions could not be effectively controlled by medical treatments (including oral cyclosporine) for more than 2 years. Autologous immunoglobulin was purified from the autologous plasma by affinity chromatography using Protein A. The patients were treated by an intramuscular injection of 50 mg of autologous immunoglobulin twice a week for 4 weeks. A clinical severity score of AD (SCORAD value) showed a decrease greater than 30% at 8 weeks after the initiation of AIGT compared with the baseline before the initiation of AIGT in all 3 patients with severe recalcitrant AD. No significant side effects from treatment were observed. Further studies with larger numbers of patients are required to evaluate the clinical usefulness of AIGT for AD.

Bovine response to lipoarabinomannan vaccination and challenge with Mycobacterium paratuberculosis

This study aimed to evaluate the immune response in bovines following immunization with a mycobaterial Lipoarabinomannan extract (LAMe) and the effect of Map challenge. LAMe vaccine induced specific antibody levels that diminished after the challenge and affected Map excretion at least for 100 days thereafter.

Interventional effect of vitamin A supplementation on re-vaccination to hepatitis B virus among rural infants and young children in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>The objective of this study was to observe the interventional effect of cod liver oil supplementation on re-vaccination to hepatitis B virus (HBV) among infants and young children.</p><p><b>METHODS</b>All 7-36 months old infants and young children, who had been vaccinated with obligatory HBV vaccines routinely by the national technical and administrative procedures for HBV vaccination on children of China, were convened among villages in Linyi, Shandong province, from October 2008 to March 2009. After detection of serum anti-HBV, one hundred children with lower serum anti-HBV were picked out for the randomized, double blinded, placebo controlled vitamin A supplementation study. The children in the intervention group (50 subjects) took 0.5 g condensed cod liver oil (containing 25 000 IU vitamin A and 2500 IU vitamin D(2)) every 15 days for six times. The children in the control group (50 subjects) were given corn oil with same volume. All children were re-vaccinated at the 30th and the 60th day of the experiment. The serum samples were collected from each child at the 90th day of the experiment. Retinol concentration in serum samples was analyzed with HPLC method before and after the intervention. The levels of serum anti-HBs were detected by the electro-chemi-luminescence immunoassay (ECLIA).</p><p><b>RESULTS</b>Total 74 children finished the supplemental experiment and blood collection, 37 subjects in each group, respectively. After intervention, the serum retinol level in the experimental and control group were (404.1 ± 123.1) and (240.8 ± 92.8) µg/L (t = 6.441, P < 0.01), respectively. The serum anti-HBs levels in the experimental and control group were (2737.2 ± 2492.6) and (1199.7 ± 2141.6) U/L (t = 2.846, P < 0.01), respectively. The rate of weak or no-answer case in experimental and control groups was 0.00% (0/37) and 10.81% (4/37) (χ(2) = 4.229, P = 0.040), respectively.</p><p><b>CONCLUSION</b>The results showed that vitamin A supplementation might enhance the re-vaccination reaction against HB vaccine in infants and young children.</p>

Pathogenesis of Gastric MALT Lymphoma

Mucosa-associated lymphoid tissue (MALT) lymphoma is a heterogeneous form of a B-cell non-Hodgkin's lymphoma with extranodal location. In the view of molecular biology, there are two types of MALT lymphoma: translocation-negative MALT lymphoma and translocation-positive MALT lymphoma. The pathogenesis of translocation-negative MALT lymphoma is driven by an active immune response to Helicobacter pylori infection. Thismost probably underscores the tumor cell survival and proliferation, and thus determines their response to Helicobacter pylorieradication. The oncogenic products of t(1;14) (p22;q32)/CL10-IGH, t(14;18)(q32;21)/IGH-MALT1 and t(11;18)(q21;q21)/API2-MALT1, found in translocation-positive MALT lymphoma, are all potent activators of the NF-kappaB activation pathway. They activate the canonical NF-kappaB activation pathway, and also potentially trigger directly and /r indirectly activation of the non-canonical NF-kappaB pathway. Inactivation of the global NF-kappaB inhibitor A20 also impacts upon multiple signaling pathways leading to NF-kappaB activation and thus potentially exacerbates the effect of stimulation of surface receptors. This review discusses the recent advances in the molecular pathogenesis of MALT lymphoma, and explores how the above genetic abnormalities cooperate with immunological stimulation in the development of lymphoma.

Determination of antibody levels to hepatitis B surface antigen [HBsAb] in Shahrekord Hajar hospital staffs, 2007-8

Hepatitis B virus [HBV] is one of the main causes of hepatitis and can lead to hepatic cirrhosis. Health services staffs are at high risk to this disease and are recommended to be vaccinated against HBV virus. The purpose of this study was to determine antibody levels against hepatitis B surface antigen [HBsAb] in Shahrekord Hajar hospital staffs. In this cross sectional study, 275 people from the Hajar hospital personnel were evaluated for their levels of HBsAb. The level of HBsAb was measured by Eliza test. Data were statistically analyzed From 257 people, 21 persons [8.2%] were not immune, 91 people [35.4%] were partially immune and 145 persons [56.4%] were completely immune. 56.4 percent of those personnel who had received their last vaccination within previous 5 years were immune [P < 0.05]. Our study showed that the level of HBsAb in health services personnel in Hajar hospital was good enough to protect them from hepatitis. In addition, maximum acquired immunity time is five years

Pathogenicity variations of susceptibility and resistance to leishmania major MRHO/IR/75/ER strain in BALB/c and C57BL/6 mice

To compare the pathogenicity differences in two susceptible Balb/c and resistant C57b1/6 mice infected with Leishmania major MRHO/IR/75/ER as a prevalent strain of zoonotic cutaneous leishmaniasis in Iran. Mice were assigned into four groups as control and infected BALB/c and C57BL/6 mice. Experimental leishmaniasis was initiated by [s. c] injection of the 2x10[6] L. major promastigotes into the basal tail of infected groups. The development of lesions was determined weekly by measuring the two diameters. After 10 weeks, all mice were killed humanly, target tissues including lymph node, spleen and liver from each mouse were removed, weighted, and their impression smears were prepared. Proliferation of amastigotes inside macrophages, pathogenicity signs in two susceptible, resistant hosts was varied, and these variations were depended on mice strain. Host immunity may modify clinical signs and could affect the proliferation of amastigotes inside macrophages, the size of lesions, the survival rates, the degree of hepatomegaly and splenomegaly and the percentage of amastigotes in lesion, liver, spleen, lymph node and brain smears

Enhancing active immunity against hepatitis B virus by HBV vaccine immunization in patients with HBV-related end-stage liver diseases treated with liver transplantation / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To study the active immunity response of liver transplant patients for HBV-related diseases after hepatitis B virus (HBV) vaccine immunization and to investigate the factors that influence the effectiveness of the vaccination in order to find measures to increase its success.</p><p><b>METHODS</b>Thirteen patients who had liver transplants because of HBV-related end-stage liver diseases received hepatitis B virus immunoglobulin and lamivudine for an average of 38 months (range 27-77 months). They received double intramuscular doses (40 microg) of a recombinant vaccine at months 0, 1, 2 and 6. The anti-HBs titers were tested regularly at months 1, 2, 3, 6 and 7.</p><p><b>RESULTS</b>Seven of the 13 patients (53.8%) developed higher serum titers of anti-HBs compared with their titers prior to the vaccinations, 2 patients of the 13 (15.4%) developed an increase by 100 U/L and in 4 patients (30.8%) their base levels were doubled. Those responding patients were followed-up for another 8 months after the fourth vaccination, and only 1 patient among them had a decrease of the anti-HBs titers below the level prior to the vaccination.</p><p><b>CONCLUSION</b>Hepatitis B vaccine immunization can be used to enhance the active immunity against HBV in patients who had liver transplants for HBV-related diseases.</p>