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1.
Heliyon ; 10(1): e23246, 2024 Jan 15.
Article in English | MEDLINE | ID: mdl-38163241

ABSTRACT

Background: During the peak of Coronavirus disease (COVID-19) pandemic in Thailand when the emergence of delta variant reduced the efficacy of inactivated vaccine, Thailand had abundance of inactivated vaccine but mRNA vaccine was not available and the supply of adenoviral-vectored vaccine was limited. The heterologous vaccination using CoronaVac and ChAdOx1-nCoV-19 vaccines was applied. We aim to compare the immunogenicity of immune response of primary vaccination with homologous ChAdOx1 nCoV-19 and heterologous vaccination with CoronaVac and ChAdOx1 nCoV-19. Methods: A total of 430 adults, scheduled to receive ChAdOx1-nCoV-19 as their second dose of primary COVID-19 vaccination, were enrolled. Participants were classified into two groups based on the first dose vaccine as CoronaVac (heterologous group) or ChAdOx1 nCoV-19 (homologous group). The primary outcome was antibodies to the SARS-CoV-2 spike protein receptor binding domain (anti-RBD) titres at 28 days after the second dose of vaccination. Secondary outcomes were anti-RBD titres at 90 days, surrogate viral neutralizing test (sVNT) at 28 and 90 days, and adverse events. Findings: In 358 participants with correct vaccine interval, the anti-RBD geometric mean titre ratio for the heterologous versus homologous group was 0.55 (95%CI; 0.44-0.067); p < 0.001 at day 28, and 0.80 (95%CI; 0.65-1.00); P = 0.05 at day 90. Median sVNT neutralizing activity was not significantly different in the heterologous versus homologous group at 28 days (93.5 vs 92.7 %); p = 0.13, but significantly higher in the heterologous group at day 90 (82.9 vs 76.4 %); p = 0.01. Interpretation: The homologous vaccination resulted in higher anti-RBD titres at 28 days after vaccination, but titres in the homologous group showed more rapid decline at 90 days. In the sVNT assay, median neutralization was similar at 28 days, but was longer-lasting and higher in the heterologous group at 90 days. Funding: This research received funding from the Royal College of Physicians of Thailand special grant 2021 for research initiative during COVID-19 pandemic.

2.
Int J Infect Dis ; 129: 19-31, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36682680

ABSTRACT

OBJECTIVES: The study aimed to compare the immunogenicity and safety of fractional (half) third doses of heterologous COVID-19 vaccines (AZD1222 or BNT162b2) to full doses after the two-dose CoronaVac and when boosting after three different extended intervals. METHODS: At 60-<90, 90-<120, or 120-180 days intervals after the two-dose CoronaVac, participants were randomized to full-dose or half-dose AZD1222 or BNT162b2, followed up at day 28, 60, and 90. Vaccination-induced immune responses to Ancestral, Delta, and Omicron BA.1 strains were evaluated by antispike, pseudovirus, and microneutralization and T cell assays. Descriptive statistics and noninferiority cut-offs were reported as geometric mean concentration or titer and concentration or titer ratios comparing baseline to day 28 and day 90 and different intervals. RESULTS: No safety concerns were detected. All assays and intervals showed noninferior immunogenicity between full doses and half doses. However, full-dose vaccines and/or longer 120-180-day intervals substantially improved the immunogenicity (measured by antispike or measured by pseudotyped virus neutralizing titers 50; P <0.001). Seroconversion rates were over 90% against the SARS-CoV-2 strains by all assays. Immunogenicity waned more quickly with half doses than full doses but remained high against the Ancestral or Delta strains. Against Omicron, the day 28 immunogenicity increased with longer intervals than shorter intervals for full-dose vaccines. CONCLUSION: Immune responses after day 28 when boosting at longer intervals after the two-dose CoronaVac was optimal. Half doses met the noninferiority criteria compared with the full dose by all the immune assays assessed.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , COVID-19 Vaccines/adverse effects , ChAdOx1 nCoV-19 , BNT162 Vaccine , COVID-19/prevention & control , SARS-CoV-2 , RNA, Messenger , mRNA Vaccines , Antibodies, Viral , Antibodies, Neutralizing
3.
Vaccines (Basel) ; 10(12)2022 Dec 12.
Article in English | MEDLINE | ID: mdl-36560535

ABSTRACT

Background: Heterologous prime-boost vaccination potentially augments the immune response against SARS-CoV-2 in liver transplant (LT) recipients. We investigated immunogenicity induced by different primary prime-boost vaccination protocols and the subsequent response to the booster vaccine among LT recipients. Methods: LT recipients, who received primary immunisation with ChAdOx1/ChAdOx1 or ChAdOx1/BNT162b2, were administered the third dose of mRNA-1273 three months following the primary vaccination. Blood samples were collected before and after primary vaccination and post-booster. The levels of receptor binding domain antibody (anti-RBD) and neutralising antibody (sVNT) and spike-specific T-cell responses were assessed. Results: Among the 89 LT recipients, patients receiving ChAdOx1/BNT162b2 had significantly higher anti-RBD titres, sVNT, and cellular response after primary vaccination than those receiving ChAdOx1/ChAdOx1 (p < 0.05). The antibody response decreased 12 weeks after the primary vaccination. After the booster, humoral and cellular responses significantly improved, with comparable seroconversion rates between the heterologous and homologous groups. Positive sVNT against the wild type occurred in >90% of LT patients, with only 12.3% positive against the Omicron variant. Conclusions: ChAdOx1/BNT162b2 evoked a significantly higher immunological response than ChAdOx1/ChAdOx1 in LT recipients. The booster strategy substantially induced robust immunity against wild type in most patients but was less effective against the Omicron strain.

4.
Vaccines (Basel) ; 10(10)2022 Oct 09.
Article in English | MEDLINE | ID: mdl-36298550

ABSTRACT

Kidney transplant recipients (KTRs) have a suboptimal immune response to COVID-19 vaccination due to the effects of immunosuppression, mostly mycophenolic acid (MPA). This study investigated the benefits of switching from the standard immunosuppressive regimen (tacrolimus (TAC), MPA, and prednisolone) to a regimen of mammalian target of rapamycin inhibitor (mTORi), TAC and prednisolone two weeks pre- and two weeks post-BNT162b2 booster vaccination. A single-center, opened-label pilot study was conducted in KTRs, who received two doses of ChAdOx-1 and a single dose of BNT162b2. The participants were randomly assigned to continue the standard regimen (control group, n = 14) or switched to a sirolimus (an mTORi), TAC, and prednisolone (switching group, n = 14) regimen two weeks before and two weeks after receiving a booster dose of BNT162b2. The anti-SARS-CoV-2 S antibody level after vaccination in the switching group was significantly greater than the control group (4051.0 [IQR 3142.0-6466.0] BAU/mL vs. 2081.0 [IQR 1077.0-3960.0] BAU/mL, respectively; p = 0.01). One participant who was initially seronegative in the control group remained seronegative after the booster dose. These findings suggest humoral immune response benefits of switching the standard immunosuppressive regimen to the regimen of mTORi, TAC, and prednisolone in KTRs during vaccination.

5.
Transplant Direct ; 8(11): e1393, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36312516

ABSTRACT

Two doses of coronavirus disease 2019 vaccination provide suboptimal immune response in transplant patients. Mycophenolic acid (MPA) is one of the most important factors that blunts the immune response. We studied the immune response to the extended primary series of 2 doses of AZD1222 and a single dose of BNT162b2 in kidney transplant patients who were on the standard immunosuppressive regimen compared to those on the MPA-sparing regimen. Methods: The kidney transplant recipients who were enrolled into the study were divided into 2 groups based on their immunosuppressive regimen. Those on the standard immunosuppressive regimen received tacrolimus (TAC), MPA, and prednisolone (standard group). The patients in the MPA-sparing group received mammalian target of rapamycin inhibitors (mTORi) with low dose TAC plus prednisolone (MPA-sparing group). The vaccination consisted of 2 doses of AZD1222 and a single dose of BNT162b2. Results: A total of 115 patients completed the study. There were 76 (66.08%) patients in the standard group and 39 (33.91%) patients in the MPA-sparing group. The overall median anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) S antibody level at 4 wk after vaccine completion was 676.64 (interquartile range = 6.02-3644.03) BAU/mL with an 80% seroconversion rate. The MPA-sparing group achieved higher anti-SARS-CoV-2 S antibody level compared to the standard group (3060.69 and 113.91 BAU/mL, P < 0.001). The seroconversion rate of MPA-sparing and standard groups were 97.4% and 71.1%, respectively (P < 0.001). The anti-HLA antibodies did not significantly increase after vaccination. Conclusions: The extended primary series of 2 doses of AZD1222 and a single dose of BNT162b2 provided significant humoral immune response. The MPA-sparing regimen with mTORi and low dose TAC had a higher ant-SARS-CoV-2 S antibody level and seroconversion rate compared to the participants in the standard regimen.

6.
Int J STD AIDS ; 33(5): 492-498, 2022 04.
Article in English | MEDLINE | ID: mdl-35257618

ABSTRACT

Introduction: Adolescents and young adults (AYA) have limited access to HIV screening tests despite the risk of acquiring HIV infection. This study aims to understand AYA preferences and their ability to perform HIV self-tests (HIVST).Methods: A cross-sectional study looked at AYA preferences when offered a choice between blood-based (INSTI®) and oral fluid-based (OraQuick®) HIVST. Adolescents and young adult participants between 18 and 24 years-old who report inconsistent condom use or had a history of sexually transmitted diseases were enrolled. Participants were offered a choice between blood-based and/or oral fluid-based HIVSTs with explanations of the differences between two types. Then, written and short video instructions according to the chosen type were given before participants performed a test. The study seeks to understand test preference, ability to perform and interpret test results.Results: From March to April 2021, 87 AYA were enrolled with a median age of 20 years (interquartile range (IQR) 18-22). Of the participants, 54 (62.1%) were men who have sex with men (MSM), 25 (28.7%) were cisgender men or women and 8 (9.2%) were transgender women (TGW). There were 37 (42.5%) first-time HIV testers and 32 (36.8%) HIV PrEP users. There were 57 participants (65.6%, 95% CI 54.6%-75.4%) that preferred blood-based HIVSTs. Reasons for preferring blood-based testing were the rapid results (77.2%) and higher accuracy (66.7%). The ability to perform and interpret HIVST results were 89.5% and 98% among INSTI users and 93.3% and 100.0% among OraQuick® users. None was HIV-positive. Moreover, 13.8% of the participants initiated same-day pre-exposure prophylaxis (PrEP).Conclusions: Thai AYA preferred blood-based over oral fluid-based HIVSTs. Most AYAs were able to perform the HIVSTs and interpret results. Supervision and post-test counselling of HIVSTs should be implemented to ensure AYA gain benefits from HIVSTs.


Subject(s)
HIV Infections , Sexual and Gender Minorities , Adolescent , Adult , Cross-Sectional Studies , Female , HIV Infections/diagnosis , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Mass Screening , Self-Testing , Thailand , Young Adult
7.
Curr Microbiol ; 79(1): 23, 2021 Dec 14.
Article in English | MEDLINE | ID: mdl-34905091

ABSTRACT

Enhanced HSV-1 production is found in activated T-lymphocytes, but the mechanism is still unknown. In this paper, the HSV-1 entry step in CD3+CD4-CD8-Jurkat T lymphocytes was investigated. Observation under electron microscopy revealed the level of filopodia formation on the surface of activated Jurkat cells was significantly higher than that of non-activated Jurkat cells especially after adding HSV-1 for 15 min. A significant increase of actin protein was demonstrated in HSV-1 infected, activated Jurkat cells compared to HSV-1 infected, non-activated Jurkat cells. After the cells were treated with 2.5 and 5 µg/mL cytochalasin D, an inhibitor of actin polymerization that causes depolymerization of actin's filamentous form, the actin protein was decreased significantly, resulting in an absence of filopodia formation. In summary, this is the first study revealing that HSV-1 induced filopodia formation through actin polymerization in activated T cells similar to epithelial, mucosal and neuronal cells. This phenomenon supported the virus entry resulting to increased yield of HSV-1 production.


Subject(s)
Actins , Herpesvirus 1, Human , Pseudopodia , T-Lymphocytes/virology , Virus Internalization , Herpesvirus 1, Human/physiology , Humans , Polymerization
8.
J Virus Erad ; 6(3): 100005, 2020 Sep.
Article in English | MEDLINE | ID: mdl-33251023

ABSTRACT

BACKGROUND: Complete recovery of the CD4 T cell count is uncommon among chronically HIV-infected individuals with very low pre-treatment CD4 count. We studied the prevalence of chronically immune recovery and its associated factors including immune characteristics chronic HIV-infected Thais. METHODS: Treatment-naïve participants (n â€‹= â€‹375) from the HIV-NAT 006 cohort with a pre-treatment CD4 T cell count after initiating antiretroviral therapy (ART) and having achieved a suppressed viremia (HIV-RNA level â€‹< â€‹400 copies/mL) were retrospectively followed at the Thai Red Cross AIDS Research Centre, Bangkok, Thailand. Suboptimal immune recovery (SIR) was defined as having a CD4+ T cell count <200 â€‹cells/mm3 for 3 years after ART initiation. A case-control sub-study matched for age, sex and pre-ART CD4 T cell count was conducted to compare immunological characteristics between SIR (n â€‹= â€‹17) and non-SIR (n â€‹= â€‹24) participants. Immunological biomarkers such as interleukin-7 (IL-7) and soluble CD14 (sCD14) and other covariates including cytomegalovirus (CMV) DNA level, baseline hemoglobin level, hepatitis B and C co-infections, and T cell subsets associated with immune activation and exhaustion were evaluated. RESULTS: Among 375 participants with pre-ART CD4 T cell counts < 200 â€‹cells/mm3, the prevalence of SIR was 39.7%, 19.7% and 7.7% at years 1, 2 and 3 after starting ART, respectively. In a multivariate analysis, a pre-ART CD4 T cell count ≤100 â€‹cells/mm3 (adjusted odds ratio [aOR] 9.45, 95% CI 2.92-30.61, p â€‹< â€‹0.001), older age (aOR 1.07, 95% CI 1.01-1.13, p â€‹= â€‹0.029) and baseline HIV-RNA level (aOR 0.36, 95% CI 0.21-0.59, p â€‹< â€‹0.001) were independently associated with SIR at year 3 after ART initiation. In the matched case-control sub-study (cases â€‹= â€‹17, controls â€‹= â€‹24), there was a higher prevalence of hepatitis C co-infection (18.8% vs. 0%, p â€‹= â€‹0.05), lower sCD14 levels (mean, 6.23 vs. 6.27 log10 â€‹pg/mL, p â€‹= â€‹0.04), lower CD8 T cell counts (mean, 514 vs. 876, p â€‹= â€‹0.0003), lower CD4/CD8 T cell ratio (mean, 0.27 vs. 0.41, p â€‹= â€‹0.01) and higher expression of PD1 on CD8+ T cells (74.2% vs. 65.1%, p â€‹= â€‹0.02) observed in SIR participants compared to their non-SIR counterparts at year 3 after ART initiation. CONCLUSIONS: Nearly 10% of the study participants who had achieved virological suppression failed to recover a CD4 T cell count > 200 cells/mm3 after 3 years of ART which was with a very low pre-ART CD4 T cell count and older age. The long-term clinical outcomes of SIR participants need to be further explored.

10.
AIDS ; 33(9): 1421-1429, 2019 07 15.
Article in English | MEDLINE | ID: mdl-30932962

ABSTRACT

OBJECTIVES: CD8 T cells recognize human leukocyte antigen-peptide complex through the T-cell receptor. Although amino acid variation in T-cell receptor variable chains often affects antigen specificity, dimorphism in the beta chain constant region (TRBC1 and TRBC2) is not thought to affect T-cell function. A recent study suggested that adoptive transfer of TRBC1-specific chimeric antigen-receptor-T cells provided an option for T-cell leukemia therapy that preserved T-cell immunity in the TRBC2 subset. This raises an important question as to whether TRBC1T cells are qualitatively different from TRBC2T cells. DESIGN: Cross-sectional study. METHODS: Sixty-six antiretroviral therapy-naive HIV-infected individuals, including 19 viraemic controllers and 47 noncontrollers, were enrolled. Peripheral blood mononuclear cells were isolated for T-cell functional assays, tetramer analyses, TRBC1 staining and immunophenotyping. RESULTS: Viraemic controllers had a higher proportion of circulating TRBC1T cells than noncontrollers, raising the possibility that TRBC1T cells might be associated with HIV control. TRBC1T cells also showed more functional T-cell responses against both HIV and cytomegalovirus (P < 0.01). The immunophenotypes of TRBC1-bearing T cells were skewed towards naive and central memory phenotypes, whereas the majority of TRBC2-expressing T cells were terminally differentiated. Inverse correlations were observed between %TRBC1T cells and HIV plasma viral load, which was most pronounced for CD8 T cells (r = -0.7096, P = 0.00002357). CONCLUSION: These data suggest that TRBC1T-cell responses are of better quality than their TRBC2 counterparts, which should be considered in immunotherapeutic strategies for HIV infection. Conversely, depletion of TRBC1T cells as part of the treatment of TRBC1 T-cell malignancies may lead to compromised T-cell response quality.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , Genes, T-Cell Receptor beta , Genetic Variation , HIV Infections/immunology , Receptors, Antigen, T-Cell, alpha-beta/genetics , T-Lymphocyte Subsets/immunology , Adult , Cross-Sectional Studies , Cytomegalovirus/immunology , Cytomegalovirus Infections/immunology , Female , HIV/immunology , Humans , Male , Middle Aged , Young Adult
11.
Radiol Oncol ; 52(2): 195-203, 2018 Jun.
Article in English | MEDLINE | ID: mdl-30018524

ABSTRACT

BACKGROUND: Plasma EBV DNA concentrations at the time of diagnosis (pre-EBV) and post treatment (post-EBV) have significant value for predicting the clinical outcome of nasopharyngeal cancer (NPC) patients. However, the prognostic value of the EBV concentration during radiation therapy (mid-EBV) has not been vigorously studied. PATIENTS AND METHODS: This was a post hoc analysis of 105 detectable pre-EBV NPC patients from a phase II/III study comparing sequential (SEQ) versus simultaneous integrated boost (SIB) intensity-modulated radiation therapy (IMRT). Plasma EBV DNA concentrations were measured by PCR before commencement of IMRT, at the 5th week of radiation therapy and 3 months after the completion of IMRT. The objective was to identify the prognostic value of mid-EBV to predict overall survival (OS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). RESULTS: A median pre-EBV was 6880 copies/ml. Mid-EBV and post-EBV were detectable in 14.3% and 6.7% of the patients, respectively. The median follow-up time was 45.3 months. The 3-year OS, PFS and DMFS rates were 86.0% vs. 66.7% (p = 0.043), 81.5% vs. 52.5% (p = 0.006), 86.1% vs. 76.6% (p = 0.150), respectively, for those with undetectable mid-EBV vs. persistently detectable mid-EBV. However, in the multivariate analysis, only persistently detectable post-EBV was significantly associated with a worse OS (hazard ratio (HR) = 6.881, 95% confident interval (CI) 1.699-27.867, p = 0.007), PFS (HR = 5.117, 95% CI 1.562-16.768, p = 0.007) and DMFS (HR = 129.071, 95%CI 19.031-875.364, p < 0.001). CONCLUSIONS: Detectable post-EBV was the most powerful adverse prognostic factor for OS, PFS and DMFS; however, detectable mid-EBV was associated with worse OS, PFS especially Local-PFS (LPFS) and may facilitate adaptive treatment during the radiation treatment period.

12.
Jpn J Clin Oncol ; 48(5): 467-475, 2018 May 01.
Article in English | MEDLINE | ID: mdl-29522203

ABSTRACT

OBJECTIVE: Plasma Epstein-Barr virus (EBV) DNA concentration at the time of diagnosis (pre-EBV) can be used to stratify risk for nasopharyngeal cancer (NPC) patients. However, pre-EBV cut-off values vary among studies. METHODS: This was a post hoc analysis of 208 NPC patients from a phase II/III study comparing sequential (SEQ) vs. simultaneous integrated boost (SIB) intensity modulated radiation therapy. The objective was to identify the optimal pre-EBV cut-off value to predict overall survival (OS), progression free survival (PFS) and distant metastatic free survival (DMFS) rates. RESULTS: The pre-EBV and post-treatment EBV DNA (post-EBV) were detectable in 59.1% and 3.8% of the patients, respectively. A new pre-EBV cut-off value of 2300 copies/ml was identified by the receiver operating characteristics analysis. This cut-off value showed 82% sensitivity, 59% specificity and 31.7% positive and 93.5% negative predictive values in predicting OS. The 3-year OS, PFS and DMFS were 95.6 vs. 73.8%, 89.8 vs. 55.3% and 93 vs. 70.1% for pre-EBV < vs. ≥2300 copies/ml, respectively. Older age group (≥45 years), high pre-EBV and detectable post-EBV concentration were independent predictors for OS, PFS and DMFS in a multivariate analysis. When the stage grouping and pre-EBV value were combined, a subgroup of patients with stage II-III and pre-EBV values <2300 copies/ml. had the best survival outcomes, while the worst survival subgroup was the patients with stage III-IVb with pre-EBV values ≥2300 copies/ml. CONCLUSIONS: Pre-EBV cut-off of 2300 copies/ml is an optimal value predicting OS, PFS and DMFS.


Subject(s)
Epstein-Barr Virus Infections/therapy , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated/methods , Disease-Free Survival , Female , Humans , Male , Middle Aged , Nasopharyngeal Neoplasms/pathology , Prognosis , Prospective Studies
13.
Sci Transl Med ; 9(377)2017 02 15.
Article in English | MEDLINE | ID: mdl-28202771

ABSTRACT

CD8+ T cells play a critical role in controlling HIV viremia and could be important in reducing HIV-infected cells in approaches to eradicate HIV. The simian immunodeficiency virus model provided the proof of concept for a CD8+ T cell-mediated reservoir clearance but showed conflicting evidence on the role of these cells to eliminate HIV-infected cells. In humans, HIV-specific CD8+ T cell responses have not been associated with a reduction of the HIV-infected cell pool in vivo. We studied HIV-specific CD8+ T cells in the RV254 cohort of individuals initiating ART in the earliest stages of acute HIV infection (AHI). We showed that the HIV-specific CD8+ T cells generated as early as AHI stages 1 and 2 before peak viremia are delayed in expanding and acquiring effector functions but are endowed with higher memory potential. In contrast, the fully differentiated HIV-specific CD8+ T cells at peak viremia in AHI stage 3 were more prone to apoptosis but were associated with a steeper viral load decrease after ART initiation. Their capacity to persist in vivo after ART initiation correlated with a lower HIV DNA reservoir. These findings demonstrate that HIV-specific CD8+ T cell magnitude and differentiation are delayed in the earliest stages of infection. These results also demonstrate that potent HIV-specific CD8+ T cells contribute to the reduction of the pool of HIV-producing cells and the HIV reservoir seeding in vivo and provide the rationale to design interventions aiming at inducing these potent responses to cure HIV infection.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , Cell Differentiation , Disease Reservoirs/virology , HIV Infections/immunology , HIV Infections/virology , Viremia/immunology , Acute Disease , Adult , Antiretroviral Therapy, Highly Active , Cell Proliferation , Cytokines/metabolism , Female , HIV Infections/drug therapy , HIV Infections/pathology , Humans , Male , Survival Analysis , Viral Load , Viremia/virology
14.
J Radiat Res ; 58(4): 509-516, 2017 Jul 01.
Article in English | MEDLINE | ID: mdl-28204596

ABSTRACT

Epstein-Barr virus (EBV) DNA has been recognized as a promising tumor marker for nasopharyngeal carcinoma (NPC). This study aims to demonstrate the prevalence of plasma EBV DNA and its temporal correlation with treatment outcomes in the modern era. A total of 204 patients with Stage I-IVB NPC treated with intensity-modulated radiotherapy (IMRT) were enrolled. Quantitative plasma EBV DNA measurement was performed before treatment (pre-IMRT), on the fifth week of radiation (mid-IMRT), at 3 months after radiation (post-IMRT), then every 6 months until disease relapse. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Plasma EBV DNA was detected in 110 patients (53.9%), with a median pre-IMRT EBV DNA level of 8005 copies/ml. Significant correlation was noted between pre-IMRT EBV DNA level and disease stage, but not between pre-IMRT EBV DNA level and World Health Organization classification. With a median follow-up time of 35.1 months, the 3-year PFS and OS rates were higher in the group with undetectable pre-IMRT EBV DNA level compared with in the group in which it was detectable. When classified according to disease stage and pre-IMRT EBV DNA, patients with early disease and detectable pre-IMRT EBV DNA experienced poorer survival than those with locally advanced disease and undetectable pre-IMRT EBV DNA. According to the dynamic changes in EBV DNA level between pre-IMRT and mid/post IMRT, survival was significantly higher in patients who achieved an undetectable level following treatment. On multivariate analysis, post-IMRT EBV DNA level was the strongest predictor of all treatment outcomes (P < 0.001). Our study demonstrated the clinical significance of the plasma EBV DNA level at specific time points, as well as of the dynamic changes in the EBV DNA level. Disappearance of plasma EBV DNA after treatment was associated with better survival.


Subject(s)
Carcinoma/blood , DNA, Viral/blood , Herpesvirus 4, Human/genetics , Nasopharyngeal Neoplasms/blood , Adolescent , Adult , Child , Demography , Disease-Free Survival , Female , Humans , Male , Middle Aged , Multivariate Analysis , Nasopharyngeal Carcinoma , Prognosis , Treatment Outcome , Young Adult
15.
PLoS One ; 10(3): e0118871, 2015.
Article in English | MEDLINE | ID: mdl-25764310

ABSTRACT

In this cross-sectional study we evaluated T-cell responses using several assays to determine immune correlates of HIV control that distinguish untreated viraemic controllers (VC) from noncontrollers (NC) with similar CD4 counts. Samples were taken from 65 ART-naïve chronically HIV-infected VC and NC from Thailand with matching CD4 counts in the normal range (>450 cells/µl). We determined HIVp24-specific T-cell responses using standard Interferon-gamma (IFNγ) ELISpot assays, and compared the functional quality of HIVp24-specific CD8+ T-cell responses using polychromatic flow cytometry. Finally, in vitro HIV suppression assays were performed to evaluate directly the activity of CD8+ T cells in HIV control. Autologous CD4+ T cells were infected with primary patient-derived HIV isolates and the HIV suppressive activity of CD8+ T cells was determined after co-culture, measuring production of HIVp24 Ag by ELISA. The HIVp24-specific T-cell responses of VC and NC could not completely be differentiated through measurement of IFNγ-producing cells using ELISpot assays, nor by the absolute cell numbers of polyfunctional HIVp24-specific CD8+ T cells. However, in vitro HIV suppression assays showed clear differences between VC and NC. HIV suppressive activity, mediated by either ex vivo unstimulated CD8+ T cells or HIVp24-specific T-cell lines, was significantly greater using cells from VC than NC cells. Additionally, we were able to demonstrate a significant correlation between the level of HIV suppressive activity mediated by ex vivo unstimulated CD8+ T cells and plasma viral load (pVL) (Spearman r = -0.7345, p = 0.0003). This study provides evidence that in vitro HIV suppression assays are the most informative in the functional evaluation of CD8+ T-cell responses and can distinguish between VC and NC.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , HIV Core Protein p24/immunology , HIV Infections/immunology , HIV Infections/virology , Viremia/immunology , Viremia/virology , Adult , CD4 Lymphocyte Count , Cells, Cultured , Cross-Sectional Studies , Female , HIV-1/immunology , Humans , Male , Middle Aged , Thailand , Young Adult
16.
Indian J Exp Biol ; 51(8): 597-605, 2013 Aug.
Article in English | MEDLINE | ID: mdl-24228383

ABSTRACT

The cytotoxic function of polyclonal expanded gamma/delta T cells against pamidronate-treated cervical cancer cells in vitro and in vivo were determined. The gamma/delta T cells were isolated and purified from PBMCs by using miniMACS and were later treated with 10 microM pamidronate. The expansion of gamma/delta T cells was 15 times more than the non-stimulated cells. Among the expanded gamma/delta T cells, 47% were Vgamma9/Vdelta2 T cells with a purity of 87%. Analyzing the cytotoxic function of gamma/delta T cells against 3 cervical cancer cells in vitro by LDH cytotoxicity test revealed that the killing efficacy increased if the cervical cancer cells (HeLa, SiHa and CaSki) were pretreated with pamidronate. The presence of CD107 on gamma/delta T cells indicated the degranulation of perforin and granzyme pathway is one of the mechanisms used by the gamma/delta T cells to kill cancer cells. The killing ability of gamma/delta T cells against cancer cells in vivo was preliminary assessed by using mouse baring HeLa cells. The results demonstrated that gamma/delta T cells induce apoptosis in tumor cells. Our study supports the usefulness of gamma/delta T cells in future development of immunotherapy for cervical cancer.


Subject(s)
Apoptosis/drug effects , Cytotoxicity, Immunologic/drug effects , Diphosphonates/pharmacology , Receptors, Antigen, T-Cell, gamma-delta/metabolism , T-Lymphocytes/drug effects , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/pathology , Animals , Antineoplastic Agents/pharmacology , Cytokines/metabolism , Enzyme-Linked Immunosorbent Assay , Female , Humans , Leukocytes, Mononuclear/drug effects , Lymphocyte Activation , Mice , Mice, Inbred BALB C , Mice, Nude , Pamidronate , T-Lymphocytes/immunology , T-Lymphocytes/metabolism , Tumor Cells, Cultured , Uterine Cervical Neoplasms/immunology
17.
AIDS ; 27(1): 17-27, 2013 Jan 02.
Article in English | MEDLINE | ID: mdl-23079801

ABSTRACT

OBJECTIVES: Analysis of immune response in HIV controllers, a unique group of infected individuals who are able to control HIV naturally, has provided us a chance to investigate the roles of host immune responses in HIV control. DESIGN: In this study, the functional quality of HIV Gag p24-specific CD8 T-cell responses was assessed in two groups of clinically distinct, HLA-B*27, HLA-B*57/58-matched individuals, viremic controllers [plasma HIV load (pVL) ≤ 2000 copies/ml) and noncontrollers (pVL >2000 copies/ml) to determine its impacts on natural HIV clinical outcome. METHODS: An ex-vivo interferon (IFN)-γ ELISpot assay was used to screen for each individual's HIV Gag p24-specific T-cell responses. Intracellular cytokine staining assay was used to determine their functional quality (as number of cytokine being produced). RESULTS: We found that, in contrast to previous studies, all Thai volunteers with HLA-B*5801 were uniformly noncontrollers. Viremic controllers were observed with a significantly larger number of high functional quality p24-specific CD8 T cells than noncontrollers (P < 0.05). This superior quality of responses was observed at both total p24 and epitope-specific level. Moreover, the absolute number of high functional quality Gag p24-specific CD8 T cells was significantly in a negative correlation with pVL (r = -0.6984, P = 0.0006) and also in a positive correlation with CD4 T-cell count (r = 0.5648, P = 0.0095). CONCLUSION: We concluded that an adequate number of high functional quality Gag p24-specific CD8 T cells is strongly associated with a natural HIV controller status.


Subject(s)
HIV Core Protein p24/immunology , HIV Infections/immunology , HIV-1/immunology , Host-Pathogen Interactions/immunology , Immunity, Mucosal/immunology , gag Gene Products, Human Immunodeficiency Virus/metabolism , Adult , CD8-Positive T-Lymphocytes/immunology , Female , HIV Infections/genetics , HIV-1/physiology , HLA-B Antigens/metabolism , HLA-B27 Antigen/metabolism , Host-Pathogen Interactions/genetics , Humans , Immunity, Mucosal/genetics , Male , Middle Aged , Viral Load
18.
ScientificWorldJournal ; 2012: 102843, 2012.
Article in English | MEDLINE | ID: mdl-22973164

ABSTRACT

Herpes simplex virus (HSV) can cause generalized infection in human immunodeficiency virus- (HIV-) infected patients leading to death. This study investigated HSV-1 replication in PBMCs from 25 HIV-infected individuals and 15 healthy donors and the effects of HSV-1 superinfection on HIV-1 production. Herpes viral entry mediator (HVEM) receptor on T lymphocytes was also evaluated. Our results confirmed that the number of activated (CD3+ and CD38+) T lymphocytes in HIV-infected individuals (46.51 ± 17.54%) was significantly higher than in healthy donors (27.54 ± 14.12%, P value = 0.001) without any significant differences in HVEM expression. Even though the percentages of HSV-1 infected T lymphocytes between HIV-infected individuals (79.25 ± 14.63%) and healthy donors (80.76 ± 7.13%) were not different (P value = 0.922), yet HSV-1 production in HIV-infected individuals (47.34 ± 11.14 × 10³ PFU/ml) was significantly greater than that of healthy donors (34.17 ± 8.48 × 10³ PFU/ml, P value = 0.001). Moreover, HSV-1 virions were released extracellularly rather than being associated with the cells, and superinfection of HSV-1 at a multiplicity of infection (MOI) of 5 significantly decreased HIV production (P value < 0.001).


Subject(s)
HIV-1/pathogenicity , Herpesvirus 1, Human/pathogenicity , Leukocytes, Mononuclear/virology , Superinfection/virology , Adult , Animals , Case-Control Studies , Chlorocebus aethiops , Coinfection/virology , Female , HIV Infections/virology , HIV-1/physiology , Herpes Simplex/virology , Herpesvirus 1, Human/physiology , Humans , Male , Middle Aged , RNA, Viral/analysis , Receptors, Tumor Necrosis Factor, Member 14/analysis , T-Lymphocytes/virology , Vero Cells , Viral Load , Virus Replication , Young Adult
19.
PLoS One ; 6(8): e23603, 2011.
Article in English | MEDLINE | ID: mdl-21887282

ABSTRACT

BACKGROUND: CD8+ T cell responses play an important role in the control of HIV-1. The extensive sequence diversity of HIV-1 represents a critical hurdle to developing an effective HIV-1 vaccine, and it is likely that regional-specific vaccine strains will be required to overcome the diversity of the different HIV-1 clades distributed world-wide. Unfortunately, little is known about the CD8+ T cell responses against CRF01_AE, which is responsible for the majority of infections in Southeast Asia. METHODOLOGY/PRINCIPAL FINDINGS: To identify dominant CD8+ T cell responses recognized in HIV-1 clade CRF01_AE infected subjects we drew upon data from an immunological screen of 100 HIV-1 clade CRF01_AE infected subjects using IFN-gamma ELISpot to characterize a novel immunodominant CD8+ T cell response in HIV-1 Gag restricted by HLA-Cw*0102 (p24, (277)YSPVSILDI(285), YI9). Over 75% of Cw*0102+ve subjects targeted this epitope, representing the strongest response in more than a third of these individuals. This novel CD8 epitope was located in a highly conserved region of HIV-1 Gag known to contain immunodominant CD8 epitopes, which are restricted by HLA-B*57 and -B*27 in clade B infection. Nonetheless, viral escape in this epitope was frequently observed in Cw*0102+ve subjects, suggestive of strong selection pressure being exerted by this common CD8+ T cell response. CONCLUSIONS/SIGNIFICANCE: As HLA-Cw*0102 is frequently expressed in the Thai population (allelic frequency of 16.8%), this immunodominant Cw*0102-restricted Gag epitope may represent an attractive candidate for vaccines specific to CRF01_AE and may help facilitate further studies of immunopathogenesis in this understudied HIV-1 clade.


Subject(s)
Alleles , CD8-Positive T-Lymphocytes/immunology , Conserved Sequence/genetics , HIV Infections/immunology , HLA-C Antigens/genetics , Immunodominant Epitopes/immunology , gag Gene Products, Human Immunodeficiency Virus/immunology , Adult , Amino Acid Sequence , Female , HIV Infections/genetics , HIV-1 , Humans , Immunodominant Epitopes/chemistry , Male , Molecular Sequence Data , Mutation/genetics , Thailand , gag Gene Products, Human Immunodeficiency Virus/chemistry
20.
Indian J Exp Biol ; 47(5): 327-32, 2009 May.
Article in English | MEDLINE | ID: mdl-19579796

ABSTRACT

Human papillomavirus (HPV) plays important role in developing several types of cancer especially cervical cancer. In order to understand the viral pathogenesis, the animal model of HPV infection is very necessary. This communication reports establishment of an animal model carrying implanted HeLa cells, a human cervical cancer cell line via dorsal skinfold window chambers. Nude mice were divided into 4 groups; each group contained different amount of HeLa cells, 2.5 x 10(5), 5 x 10(5), and 1 x 10(6) cells, and cell free medium (control), respectively. The results showed that even using the low number of HeLa cells (2.5 x l0(5)), the tumor microvasculature was developed at 2 weeks after implantation with the enlarged tumor margin which then progressed to tumor mass in the following week. The existing tumor was confirmed to be HeLa-cell type by PCR, in situ hybridization, and HPV genotyping. By using linear regression analysis, it indicated that means of tumor size from each group significantly increased in relation to number of HeLa cells used (R2 = 0.98, y = 0.1171x + 4.35). This mouse model will be useful for the further HPV studies particularly anti-cancer drugs efficacy.


Subject(s)
Neoplasms, Experimental/virology , Papillomaviridae/pathogenicity , Skin/virology , Animals , Disease Models, Animal , Female , HeLa Cells , Humans , In Situ Hybridization , Mice , Mice, Inbred BALB C , Mice, Nude , Neoplasms, Experimental/pathology , Papillomaviridae/genetics , Papillomaviridae/isolation & purification , Polymerase Chain Reaction
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