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RESUMEN El artículo de revisión destaca la importancia de la planta del pie en la deambulación y su adaptación a las necesidades humanas. Se enfoca en el pie diabético (PD), definido por signos, síntomas o úlceras en el pie debido a complicaciones crónicas de la diabetes. El PD afecta a alrededor del 25% de los pacientes con diabetes mellitus (DM), con úlceras que pueden derivar en infecciones graves y riesgo de amputación. El manejo del PD es complejo y requiere un enfoque multidisciplinar. Este artículo propone un "Sistema de Evaluación y Tratamiento del Pie Diabético", aplicable en diversos entornos clínicos, que clasifica las úlceras según su profundidad e infección y ofrece guías claras para su tratamiento. Se discuten también la epidemiología de la neuropatía diabética (ND), destacando su alta prevalencia y morbilidad, y la necesidad de un diagnóstico y tratamiento adecuados. Se analiza en detalle la neuropatía de Charcot, una complicación severa del PD, incluyendo sus causas y métodos diagnósticos. Además, se enfatiza la importancia del enfoque multidisciplinar en el tratamiento de las úlceras del PD para reducir amputaciones y mejorar la calidad de vida de los pacientes. También se abordan las infecciones del PD y la antibioticoterapia, recomendando el uso de antibióticos adecuados según la gravedad de la infección y la realización de cultivos microbiológicos precisos. Finalmente, se presenta una visión global del manejo del PD, destacando la importancia de un enfoque multidisciplinar y proponiendo un sistema de evaluación y tratamiento eficaz que puede ser implementado en diversos contextos clínicos.
ABSTRACT The review article highlights the importance of the sole of the foot in ambulation and its adaptation to human needs. It focuses on diabetic foot (DF), defined by signs, symptoms, or ulcers on the foot due to chronic complications of diabetes. DF affects approximately 25 % of patients with diabetes mellitus (DM), with ulcers that can lead to severe infections and risk of amputation. Managing DF is complex and requires a multidisciplinary approach. This article proposes a "Diabetic Foot Evaluation and Treatment System," applicable in various clinical settings, which classifies ulcers according to their depth and infection and provides clear treatment guidelines. The epidemiology of diabetic neuropathy (DN) is also discussed, highlighting its high prevalence and morbidity, and the need for adequate diagnosis and treatment. The article provides a detailed analysis of Charcot neuropathy, a severe complication of DF, including its causes and diagnostic methods. Furthermore, the importance of a multidisciplinary approach in the treatment of DF ulcers is emphasized to reduce amputations and improve patients' quality of life. DF infections and antibiotic therapy are also addressed, recommending the use of appropriate antibiotics according to the severity of the infection and the performance of precise microbiological cultures. Finally, a comprehensive view of DF management is presented, highlighting the importance of a multidisciplinary approach and proposing an effective evaluation and treatment system that can be implemented in various clinical contexts.
ABSTRACT
Pederin-family polyketides today constitute a group of more than 30 molecules being produced as natural products by different microorganisms across multitude of ecological niches. They are mostly known for their extreme cytotoxic activity and the decades of long exploration as potential antitumor drugs. The difference in their potency and biological activity lies in the tailoring modifications of the core molecule. Despite the isolation of many pederin-like molecules until the date, only marine bacterium Labrenzia sp. PHM005 was reported as a cultivable producer and able to be genetically modified. Here, we study the role of tailoring enzymes from the lab gene cluster responsible for methylation and hydroxylation of labrenzin core molecule. We managed to produce a spectrum of differently tailored labrenzin analogs for the development of future drugs. This work constitutes one-step forward in understanding the biosynthesis of pederin-family polyketides and provides the tools to modify and overproduce these anticancer drugs in a-la-carte manner in Labrenzia sp. PHM005, but also in other producers in the future.
Subject(s)
Bacteria , Polyketides , Bacteria/metabolism , Polyketides/metabolism , HydroxylationABSTRACT
The challenges associated with analyzing rare cells are dependent on a series of factors, which usually require large numbers of cells per sample for successful resolution. Among these is determining the minimum number of total events needed to be acquired as defined by the expected frequency of the target cell population. The choice of markers that identify the target population, as well as the event rate and the number of aborted events/second, will also determine the statistically significant detection of rare cell events. Sample preparation is another important but often overlooked factor in rare cell analysis, and in this study we examine Poisson theory and methods to determine the effect of sample manipulation on rare cell detection. After verifying the applicability of this theory, we have evaluated the potential impact of red cell lysis on rare cell analysis, and how cell rarity can be underestimated or overestimated based on erythrolytic sensitivity or resistance of healthy leukocytes and pathological rare cells.
Subject(s)
Erythrocytes , Leukocytes , Cell Death , Specimen Handling , Flow CytometryABSTRACT
Pederin is a potent polyketide toxin that causes severe skin lesions in humans after contact with insects of genus Paederus. Due to its potent anticancer activities, pederin family compounds have raised the interest of pharmaceutical industry. Despite the extensive studies on the cluster of biosynthetic genes responsible for the production of pederin, it has not yet been possible to isolate and cultivate its bacterial endosymbiont producer. However, the marine bacterium Labrenzia sp. PHM005 was recently reported to produce labrenzin, the closest pederin analog. By cloning a synthetic pedO gene encoding one of the three O-methyltraferase of the pederin cluster into Labrenzia sp. PHM005 we have been able to produce pederin for the first time by fermentation in the new recombinant strain.
ABSTRACT
INTRODUCTION: The objective of this study was to describe the main characteristics of migrants diagnosed with human T-lymphotropic virus (HTLV) infection within the +Redivi Spanish network. METHODS: Patients with a diagnosis of HTLV type 1 or 2 in +Redivi from October 2009 to December 2020 were included. Diagnosis was based on positive HTLV serology (enzyme-linked immunosorbent assay (ELISA)/chemiluminescent immunoassay (CLIA)) with line immunoassay (LIA)/Western blot with/without polymerase chain reaction (PCR). RESULTS: A total of 107/17 007 cases (0.6%) had a final diagnosis of HTLV infection: 83 (77.67%) HTLV-1 infections, 6 (5.6%) HTLV-2 infections and 18 (16.8%) non-specified. The majority (76, 71%) were female, median age was 42 years and median time from arrival to Spain until consultation was 10 years. The group included 100 (93.5%) immigrants and 7 (6.6%) visiting friends and relatives (VFR)-immigrants. Most patients were from South America (71, 66.4%), followed by Sub-Saharan Africa (15, 14%) and Central America-Caribbean (13, 12.1%). Around 90% of patients were asymptomatic at presentation and diagnosed as part of screening programs. Median duration of follow-up was 5 years (IQR 2-7). Regarding HTLV-associated conditions, 90 patients (84.2%) had none, 7 (6.5%) had tropical spastic paraparesis , 5 (4.7%) had other associated conditions (dermatitis, uveitis, pulmonary disease), 3 (2.8%) had other neurological symptoms and 2 (1.9%) had adult T-cell leukaemia/lymphoma. No patients with HTLV-2 had HTLV-associated conditions. Four patients (3.7%) died. Concomitant diagnoses were found in 41 (38.3%) patients, including strongyloidiasis in 15 (14%) and HIV co-infection in 4 (3.7%). In 70% of patients, screening of potential contacts was not performed/recorded. CONCLUSIONS: HTLV infections (the majority due to HTLV-1) were mainly diagnosed in asymptomatic migrants from Latin America (generally long-settled immigrants and the majority female with the consequent implications for screening/prevention). A high rate of association with strongyloidiasis was found. In the majority, screening of potential contacts was not performed, representing a missed opportunity for decreasing the under diagnosis of this infection.
Subject(s)
HIV Infections , HTLV-I Infections , Human T-lymphotropic virus 1 , Strongyloidiasis , Transients and Migrants , Adult , Female , Humans , Male , Spain/epidemiology , Strongyloidiasis/complications , HTLV-I Infections/diagnosis , HTLV-I Infections/epidemiology , HTLV-I Infections/complications , HIV Infections/complicationsABSTRACT
Gram-negative marine bacteria are an underexplored source of new chemical entities for a wide range of applications. Even though, some have shown a high antitumor activity. This chapter describes an isolation and screening protocol based on the Dilution-to-Extinction approach coupled with an antiproliferative test oriented to the discovery of new cytotoxic compounds synthesized by marine bacteria. In addition to the discovery of new bioactive secondary metabolites, this protocol provides a high-throughput isolation and screening platform for discarding no bioactive strains during the first steps of the drug discovery process.
Subject(s)
Antineoplastic Agents/metabolism , Aquatic Organisms/isolation & purification , Bacteria/isolation & purification , Bacteria/metabolism , A549 Cells , Antineoplastic Agents/pharmacology , Aquatic Organisms/metabolism , Biological Products/metabolism , Biological Products/pharmacology , Cell Line, Tumor , Drug Discovery/methods , HT29 Cells , Humans , Indicator Dilution TechniquesABSTRACT
Glutarimide-containing polyketides are known as potent antitumoral and antimetastatic agents. The associated gene clusters have only been identified in a few Streptomyces producers and Burkholderia gladioli symbiont. The new glutarimide-family polyketides, denominated sesbanimides D, E and F along with the previously known sesbanimide A and C, were isolated from two marine alphaproteobacteria Stappia indica PHM037 and Labrenzia aggregata PHM038. Structures of the isolated compounds were elucidated based on 1D and 2D homo and heteronuclear NMR analyses and ESI-MS spectrometry. All compounds exhibited strong antitumor activity in lung, breast and colorectal cancer cell lines. Subsequent whole genome sequencing and genome mining revealed the presence of the trans-AT PKS gene cluster responsible for the sesbanimide biosynthesis, described as sbn cluster. Strikingly, the modular architecture of downstream mixed type PKS/NRPS, SbnQ, revealed high similarity to PedH in pederin and Lab13 in labrenzin gene clusters, although those clusters are responsible for the production of structurally completely different molecules. The unexpected presence of SbnQ homologues in unrelated polyketide gene clusters across phylogenetically distant bacteria, raises intriguing questions about the evolutionary relationship between glutarimide-like and pederin-like pathways, as well as the functionality of their synthetic products.
Subject(s)
Polyketides , Rhodobacteraceae , Multigene Family , Polyketide Synthases/genetics , SymbiosisABSTRACT
The continued development of culturing technologies for the discovery of new molecules from marine microbes is of paramount importance for drug discovery. Coupled with this, the use of the high-throughput approach shows promise for increasing the number of Gram-negative and non-filamentous bacteria cultures that can be surveyed, since they show a lower potential of bioactivity. In this work, we propose a new strategy of high-throughput cultivation of bacteria inspired by a dilution-to-extinction (DTE) methodology for the isolation of, and screening for, new cytotoxic compound producing marine bacteria. A marine sponge tissue was directly used as inoculum and the results were compared with the data obtained through the direct plating isolation method. Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) genomic fingerprinting indicated the isolation of four bioactive strains, three of them producers of a pederin-like compound, and the fourth one able to synthesize a different compound, still unidentified, rendered by the DTE approach, in comparison with one bioactive strain identified through the plating method. Analyses based on the 16S rRNA gene data showed the existence of two different species belonging to the genus Labrenzia. The efficiency and diversity ratio in the number of isolates and compounds are discussed. In view of the results, the proposed DTE approach proved to be efficient for the isolation of new cytotoxic compounds of marine origin and pave the way for future potential applications.
Subject(s)
Bacteria , Drug Discovery , Animals , Bacteria/genetics , Phylogeny , Pyrans , RNA, Ribosomal, 16S/geneticsABSTRACT
We used metagenomics to analyze one sputum sample from a patient with symptoms of a respiratory infection that yielded negative results for all pathogens tested. We detected two viral genomes that could be assembled and showed sequence similarity to redondoviruses, a recently described group within the CRESS-DNA viruses. One hundred sputum samples were screened for the presence of these viruses using specific primers. One sample was positive for the same two viruses, and another was positive for one of them. These findings raise questions about a possible role of redondoviruses in respiratory infections in humans.
Subject(s)
DNA Viruses/classification , DNA Viruses/genetics , Genome, Viral , Metagenomics , Respiratory Tract Infections/virology , Sputum/virology , Humans , Metagenomics/methods , Phylogeny , Viral Proteins/geneticsSubject(s)
Acute Generalized Exanthematous Pustulosis , Antimalarials , Malaria, Falciparum , Malaria , Acute Generalized Exanthematous Pustulosis/diagnosis , Acute Generalized Exanthematous Pustulosis/drug therapy , Acute Generalized Exanthematous Pustulosis/etiology , Antimalarials/therapeutic use , Atovaquone/adverse effects , Drug Combinations , Humans , Malaria/drug therapy , Malaria, Falciparum/drug therapy , Proguanil/adverse effectsABSTRACT
BACKGROUND: From the first Zika virus (ZIKV) description, it has progressively widespread worldwide. We analyzed demographic, clinical, microbiologic and travel-related characteristic from returned patients from a ZIKV endemic country in a referral Tropical Medicine Unit. METHOD: A prospective cohort study performed in a Spanish referral center with the aim of determining the significant factors associated with confirmed Zika virus (ZIKV) infection. RESULTS: 817 patients, (56% women, median age 36 [IQR, Interquartile Range: 32-42]) were enrolled. Most had returned from Latin America (nâ¯=â¯486; 59.4%), travelled for tourism (nâ¯=â¯404; 49.4%) and stayed a median of 18 days (IQR: 10-30). 602 (73.6%) presented symptoms, but only 25 (4%) were finally diagnosed with confirmed ZIKV infection (including two pregnant women, without adverse fetal outcomes), 88% (n:22) presented with fever and 92% (n:23) with rash. 56% (n:14) arthralgia and/or myalgia and 28% (n:7) conjunctivitis. The presence of conjunctivitis, fever and rash were associated with an 8.9 (95% CI: 2.2-34.9), 6.4 (95% CI: 1.2-33.3) and 72.3 (95% CI: 9.2-563.5) times greater probability of confirmed ZIKV infection, respectively. CONCLUSION: Travel characteristics and clinical presentation may help clinicians to optimize requests for microbiological testing. Diagnosis of arboviriasis in travellers arriving form endemic areas remains a challenge for clinicians, but must be detected for the possible transmission outside endemic areas, where the vector is present.
Subject(s)
Travel-Related Illness , Zika Virus Infection/diagnosis , Adult , Asia , Female , Humans , Latin America , Male , Middle Aged , Pregnancy , Prospective Studies , Referral and Consultation , Spain/epidemiology , Spain/ethnology , Travel , Young Adult , Zika Virus/isolation & purification , Zika Virus Infection/epidemiologyABSTRACT
The complete genome of the strain Labrenzia sp. PHM005, a free-living producer of a pederin analog 18-O-demethyl pederin, hereinafter labrenzin, has been sequenced. This strain contains two replicons comprising a circular chromosome of 6,167,349 bp and a circular plasmid (named p1BIR) of 19,450 bp. A putative gene cluster responsible for the synthesis of labrenzin (lab cluster) has been identified showing that it encodes a trans-AT mixed type PKS/NRPS biosynthetic pathway that is responsible for the synthesis of pederin and possibly an onnamide analog. The putative boundaries of the lab gene cluster were determined by genetic comparisons with other related strains, suggesting that the cluster consists of a 79-kb region comprising 3 genes encoding multidomain hybrid polyketide synthase/non-ribosomal peptide synthetase (PKS/NRPS) proteins (PKS4, PKS/NRPS13, and PKS/NRPS15), and 16 auxiliary enzymes. Transcriptomic analyses suggest that all the genes of the cluster are expressed in our culture conditions (i.e., in minimal medium in the absence of any specific inducer) at detectable levels. We have developed genetic tools to facilitate the manipulation of this strain and the functional characterization of the cluster genes. We have created a site-directed mutant unable to produce pederin, demonstrating experimentally for the first time the role of the cluster in the synthesis of pederin. This work paves the way to unravel the clues of the biosynthesis of pederin family compounds and opens the door to modify and overproduce these anticancer drugs for industrial and pharmaceutical purposes.
ABSTRACT
A global census of marine microbial life has been underway over the past several decades. During this period, there have been scientific breakthroughs in estimating microbial diversity and understanding microbial functioning and ecology. It is estimated that the ocean, covering 71% of the earth's surface with its estimated volume of about 2 × 1018 m3 and an average depth of 3800 m, hosts the largest population of microbes on Earth. More than 2 million eukaryotic and prokaryotic species are thought to thrive both in the ocean and on its surface. Prokaryotic cell abundances can reach densities of up to 1012 cells per millilitre, exceeding eukaryotic densities of around 106 cells per millilitre of seawater. Besides their large numbers and abundance, marine microbial assemblages and their organic catalysts (enzymes) have a largely underestimated value for their use in the development of industrial products and processes. In this perspective article, we identified critical gaps in knowledge and technology to fast-track this development. We provided a general overview of the presumptive microbial assemblages in oceans, and an estimation of what is known and the enzymes that have been currently retrieved. We also discussed recent advances made in this area by the collaborative European Horizon 2020 project 'INMARE'.
Subject(s)
Aquatic Organisms/enzymology , Oceans and Seas , Water Microbiology , Bacteria/enzymology , BiodiversityABSTRACT
Jomthonic acids (JAs) are a group of natural products (NPs) with adipogenic activity. Structurally, JAs are formed by a modified ß-methylphenylalanine residue, whose biosynthesis involves a methyltransferase that in Streptomyces hygroscopicus has been identified as MppJ. Up to date, three JA members (Aâ»C) and a few other natural products containing ß-methylphenylalanine have been discovered from soil-derived microorganisms. Herein, we report the identification of a gene (jomM) coding for a putative methyltransferase highly identical to MppJ in the chromosome of the marine actinobacteria Streptomyces caniferus GUA-06-05-006A. In its 5' region, jomM clusters with two polyketide synthases (PKS) (jomP1, jomP2), a nonribosomal peptide synthetase (NRPS) (jomN) and a thioesterase gene (jomT), possibly conforming a single transcriptional unit. Insertion of a strong constitutive promoter upstream of jomP1 led to the detection of JA A, along with at least two novel JA family members (D and E). Independent inactivation of jomP1, jomN and jomM abolished production of JA A, JA D and JA E, indicating the involvement of these genes in JA biosynthesis. Heterologous expression of the JA biosynthesis cluster in Streptomyces coelicolor M1152 and in Streptomyces albus J1074 led to the production of JA A, B, C and F. We propose a pathway for JAs biosynthesis based on the findings here described.
Subject(s)
Amino Acids/biosynthesis , Streptomyces/metabolism , Amino Acids/chemistry , Biological Products , Computational Biology , Gene Expression Regulation, Bacterial , Molecular Structure , Multigene Family , Phenylalanine/analogs & derivativesABSTRACT
The polyketide pederin family are cytotoxic compounds isolated from insects, lichen, and marine sponges. During the past decade, different uncultivable bacteria symbionts have been proposed as the real producers of these compounds, such as those found in insects, lichen, and marine sponges, and their trans-AT polyketide synthase gene clusters have been identified. Herein we report the isolation and biological activities of a new analogue of the pederin family, compound 1, from the culture of a marine heterotrophic alphaproteobacterium, Labrenzia sp. PHM005. This is the first report of the production of a pederin-type compound by a free-living marine bacteria that could be cultured in the laboratory.
Subject(s)
Pyrans/metabolism , Alphaproteobacteria , Animals , Bacteria/metabolism , Coleoptera/metabolism , Lichens , Marine Biology , Molecular Structure , Multigene Family , Polyketide Synthases/metabolism , Porifera/microbiology , Pyrans/chemistry , Sequence Analysis, DNA , SymbiosisABSTRACT
BACKGROUND: Antitumor compounds PM100117 and PM100118 are glycosylated polyketides derived from the marine actinobacteria Streptomyces caniferus GUA-06-05-006A. The organization and characterization of the PM100117/18 biosynthesis gene cluster has been recently reported. RESULTS: Based on the preceding information and new genetic engineering data, we have outlined the pathway by which PM100117/18 are glycosylated. Furthermore, these genetic engineering experiments have allowed the generation of novel PM100117/18 analogues. Deletion of putative glycosyltranferase genes and additional genes presumably involved in late biosynthesis steps of the three 2,6-dideoxysugars appended to the PM100117/18 polyketide skeleton, resulted in the generation of a series of intermediates and novel derivatives. CONCLUSIONS: Isolation and identification of the novel compounds constitutes an important contribution to our knowledge on PM100117/18 glycosylation, and set the basis for further characterization of specific enzymatic reactions, additional genetic engineering and combinatorial biosynthesis approaches.
Subject(s)
Antineoplastic Agents/metabolism , Genetic Engineering/methods , Macrolides/metabolism , A549 Cells , Antineoplastic Agents/pharmacology , Cell Line, Tumor , Drug Screening Assays, Antitumor , Gene Deletion , Glycosylation , Glycosyltransferases/genetics , Glycosyltransferases/metabolism , HT29 Cells , Humans , Macrolides/pharmacology , Streptomyces/genetics , Streptomyces/metabolismABSTRACT
Babesiosis is an emerging zoonosis now found in several areas of the world. Using PCR and indirect immunofluorescence assay, we have diagnosed the first case of human babesiosis caused by Babesia microti in Spain. Diagnosis was delayed because of the nonspecific clinical symptoms that occurred in an immunocompetent patient.
Subject(s)
Babesia microti , Babesiosis/epidemiology , Babesiosis/microbiology , Adult , Animals , Anti-Bacterial Agents/therapeutic use , Babesiosis/drug therapy , Humans , Male , Spain/epidemiology , ZoonosesABSTRACT
BACKGROUND: PM100117 and PM100118 are glycosylated polyketides with remarkable antitumor activity, which derive from the marine symbiotic actinobacteria Streptomyces caniferus GUA-06-05-006A. Structurally, PM100117 and PM100118 are composed of a macrocyclic lactone, three deoxysugar units and a naphthoquinone (NQ) chromophore that shows a clear structural similarity to menaquinone. RESULTS: Whole-genome sequencing of S. caniferus GUA-06-05-006A has enabled the identification of PM100117 and PM100118 biosynthesis gene cluster, which has been characterized on the basis of bioinformatics and genetic engineering data. The product of four genes shows high identity to proteins involved in the biosynthesis of menaquinone via futalosine. Deletion of one of these genes led to a decay in PM100117 and PM100118 production, and to the accumulation of several derivatives lacking NQ. Likewise, five additional genes have been genetically characterized to be involved in the biosynthesis of this moiety. Moreover, the generation of a mutant in a gene coding for a putative cytochrome P450 has led to the production of PM100117 and PM100118 structural analogues showing an enhanced in vitro cytotoxic activity relative to the parental products. CONCLUSIONS: Although a number of compounds structurally related to PM100117 and PM100118 has been discovered, this is, to our knowledge, the first insight reported into their biosynthesis. The structural resemblance of the NQ moiety to menaquinone, and the presence in the cluster of four putative menaquinone biosynthetic genes, suggests a connection between the biosynthesis pathways of both compounds. The availability of the PM100117 and PM100118 biosynthetic gene cluster will surely pave a way to the combinatorial engineering of more derivatives.
Subject(s)
Actinobacteria/genetics , Antineoplastic Agents/pharmacology , Biosynthetic Pathways/genetics , Genetic Engineering/methods , Macrolides/pharmacology , Multigene Family/genetics , Seawater/microbiology , Actinobacteria/drug effects , Antineoplastic Agents/chemistry , Biological Transport/drug effects , Biosynthetic Pathways/drug effects , Carbohydrates/biosynthesis , Carbohydrates/chemistry , Computational Biology , Computer Simulation , Cytochrome P-450 Enzyme System/genetics , Cytochrome P-450 Enzyme System/metabolism , Genome, Bacterial , Macrolides/chemistry , Naphthoquinones/chemistry , Naphthoquinones/metabolism , Sequence Analysis, DNAABSTRACT
BACKGROUND: The current outbreak of Ebola Virus Disease in West Africa is caused by a new variant of Ebola virus (EBOV) named Makona 2014, whose sequence differs 3% from isolates from Central Africa such as Mayinga 1976 EBOV. The specificity and kinetics of the neutralizing antibody response induced by the circulating Makona EBOV has not been thoroughly studied. METHODS: We have used a lentiviral EBOV-glycoprotein (GP)-pseudotyped infection assay to measure Makona-GP and Mayinga-GP specific neutralizing activity of plasma from three convalescent Ebola Virus Disease patients from the current EBOV outbreak at 2, 3, 4 and 9 months post-infection. Total anti-EBOV GP IgG was measured by a commercial ELISA assay. FINDINGS: In convalescent Ebola Virus Disease patients, Makona-GP-specific neutralizing titers increased from 2 months (mean IC50 1/59), 3 months (IC50 1/212), 4 months (IC50 1/239) and up to 9 months (IC50 1/268) post-infection. Neutralizing activity of plasma from the three convalescent Ebola Virus Disease patients was more vigorous against the current Makona-GP pseudotyped EBOV variant than against Mayinga-GP pseudotyped EBOV and this difference was observed at each time point tested: Mayinga vs Makona mean IC50 fold=4.92 at 2 months post-infection, 2.89 fold at 3 months post-infection, 2.23 at 4 months post-infection and 2.98 at 9 months post-infection (all differences p<0.01). Total level of IgG against EBOV-GP did not evolve significantly during the follow up. DISCUSSION: In convalescent Ebola Virus Disease patients, EBOV-GP specific neutralizing activity increases over time, at least up to 9 months post-infection, which suggests that active affinity maturation of antibodies takes place long after clinical recovery. EBOV-GP specific neutralizing response is significantly higher against Makona EBOV circulating in West Africa than against the variants included in the currently approved vaccines. Correlates of protection for EBOV vaccines have not been completely established and the relevance of a lower neutralizing activity in convalescent plasma from the current outbreak against one of the EBOV-GPs contained in the vaccines in terms of its potential efficacy does not necessarily preclude its efficacy. However, this observation highlights the concern regarding the natural diversity of EBOV and its subsequent challenge for diagnosis, therapy and vaccine design. EBOV-GP neutralizing activity varies considerably over time in convalescent Ebola Virus Disease patients. Titering of convalescent blood products would be desirable to standardize and evaluate their potential therapeutic value.