Distinct Adverse Reactions to mRNA, Inactivated Virus, and Adenovirus Vector COVID-19 Vaccines: Insights from a Cohort Study on Atopic and Non-Atopic Subjects in Brazil.

The emergence of COVID-19 caused by SARS-CoV-2 prompted an unprecedented global response to develop vaccines at an accelerated pace. Messenger RNA (mRNA) and adenovirus vector vaccines emerged as the frontrunners in global immunization efforts, significantly reducing hospitalization, severity, and mortality, supplemented by inactivated virus-based vaccines in developing countries. However, concerns regarding adverse effects, including allergic reactions, have been raised. This study aimed to investigate the adverse effects following COVID-19 vaccination, particularly in atopic and non-atopic individuals. A cohort of 305 volunteers receiving BNT162, ChAdOx1, or CoronaVac vaccines were assessed based on a Skin Prick Test (SPT), specific IgE levels, and clinical history of asthma and rhinitis. Adverse effects were self-reported and scored across the different vaccination shots. The results indicated a notable presence of mild adverse effects following the first and third doses, regardless of vaccine type. ChAdOx1 recipients experienced more adverse effects compared to those receiving BNT162 and CoronaVac, including headaches, muscle pain, fever, chills, nausea, and flu-like symptoms. Atopic individuals receiving ChAdOx1 reported more adverse effects, such as muscle pain, fever, and chills, compared to non-atopic individuals. Conversely, headaches were more frequently reported in non-atopic individuals receiving BNT162 compared to atopic individuals. No anaphylaxis or allergic reactions were reported, indicating valuable evidence supporting the safety of COVID-19 vaccination in individuals with respiratory allergies. This study highlights the importance of understanding vaccine-related adverse effects, particularly in vulnerable populations, to inform vaccination strategies and address safety concerns in global immunization campaigns.

Leptospira interrogans insoluble fraction as a potential antigen source for lateral flow immunochromatography.

BACKGROUND: Leptospirosis is an emerging zoonosis that affects humans and animals. Immunochromatography rapid test is widely used for early diagnosis of leptospirosis, but with low sensitivity and specificity. OBJECTIVES: To evaluate Leptospira interrogans insoluble fraction as a potential antigen source for lateral flow immunochromatography. METHODS: Insoluble fraction derived from the crude bacterial extract was obtained by serial centrifugation. The polypeptide profile was determined using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Immune reactivity of this fraction was assessed by Western Blotting and lateral flow immunochromatography (LFI). It was tested 160 microagglutination test (MAT)-positive sera from patients in the acute phase, 100 MAT-negative sera from patients with acute febrile illness, and 45 patients with other infectious diseases. FINDINGS: There was a predominance of low molecular mass-polypeptide bands, ranging from 2 to 37 kDa. The antibody reactivity of theses polypeptides was found to range from 13-50%, especially between 10 and 38 kDa. Among MAT-positive sera of patients with leptospirosis in the acute phase, 97% were also positive in LFI, indicating high sensitivity. Among MAT-negative sera, all were negative in LFI, indicating high specificity. Only 2% of cross-reactivity was detected. CONCLUSION: The insoluble fraction can be a valuable antigen source for development of point-of-care diagnosis test for leptospirosis.

Leptospira interrogans insoluble fraction as a potential antigen source for lateral flow immunochromatography

BACKGROUND Leptospirosis is an emerging zoonosis that affects humans and animals. Immunochromatography rapid test is widely used for early diagnosis of leptospirosis, but with low sensitivity and specificity. OBJECTIVES To evaluate Leptospira interrogans insoluble fraction as a potential antigen source for lateral flow immunochromatography. METHODS Insoluble fraction derived from the crude bacterial extract was obtained by serial centrifugation. The polypeptide profile was determined using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Immune reactivity of this fraction was assessed by Western Blotting and lateral flow immunochromatography (LFI). It was tested 160 microagglutination test (MAT)-positive sera from patients in the acute phase, 100 MAT-negative sera from patients with acute febrile illness, and 45 patients with other infectious diseases. FINDINGS There was a predominance of low molecular mass-polypeptide bands, ranging from 2 to 37 kDa. The antibody reactivity of theses polypeptides was found to range from 13-50%, especially between 10 and 38 kDa. Among MAT-positive sera of patients with leptospirosis in the acute phase, 97% were also positive in LFI, indicating high sensitivity. Among MAT-negative sera, all were negative in LFI, indicating high specificity. Only 2% of cross-reactivity was detected. CONCLUSION The insoluble fraction can be a valuable antigen source for development of point-of-care diagnosis test for leptospirosis.

Why Physical Activity Should Be Considered in Clinical Trials for COVID-19 Vaccines: A Focus on Risk Groups.

Since the World Health Organization declared the global COVID-19 state of emergency in early 2020, several vaccine candidates have emerged to control SARS-CoV-2, and some of them have been approved and implemented in vaccination campaigns worldwide. Although clinical trials for these vaccines have been carried out using highly controlled methods with accurate immunological tests, clinical questionnaires did not include questions concerning the physical activity profile among volunteers. It has been well established that physical activity plays a pivotal role in the immune response after vaccination, led by the activation of cytokines, antibodies, and cells. This concept should have been considered when evaluating the efficacy of COVID-19 vaccine candidates, particularly in elderly and obese people. Here, we discuss data from the literature providing strong evidence regarding the importance of analyzing physical activity parameters to improve the accuracy of clinical trials on assessing the efficacy of vaccine candidates.

Physical activity learning by medical students: the current picture in Brazil / Aprendizagem sobre atividade física por estudantes de Medicina: a situação hoje no Brasil

Abstract: Introduction: Physical activity is essential for preventing and treating many diseases. Although physicians are the most influential health professionals in advising their patients on the benefits of physical activity, most medical degree programs in Brazil do not seem to include physical activity topics in their curricula. Objective: This study aimed to investigate physical activity topics on active medical curricula in Brazil. Method: The research was conducted separately in April 2015 and February 2019 using a governmental resource, the e-MEC system, and search in internet databases. Data were split into categories according to the type of enrollment (mandatory or optional) of the courses that have subjects or thematic modules with topics on physical activity, type of activities (theoretical, practical, or theoretical-practical), and emphasis on the content (health, performance, or health and performance). Results: Of the 223 medical curricula compiled in 2015 and 286 in 2019, respectively, only 24 (10.8%) and 19 (6.7%) had at least one subject or thematic module concerning physical activity with emphasis on health. Conclusion: In Brazil, the number of undergraduate medical curricula covering physical activity topics is still small and suffered a reduction between 2015 and 2019, which should warn medical education institutions about the need to include physical activity longitudinally distributed contents, with theoretical and - if possible - practical approaches, and emphasis on health promotion and treatment of diseases, in mandatory curricular units.

Resumo: Introdução: A atividade física é essencial para prevenir e tratar muitas doenças. Embora os médicos sejam os profissionais de saúde que mais influenciam a orientação de seus pacientes sobre os benefícios da atividade física, a maioria dos programas de graduação em Medicina no Brasil parece não incluir tópicos sobre atividade física em seus currículos. Objetivo: Este estudo teve como objetivo investigar a presença de tópicos sobre atividade física nos currículos médicos ativos no Brasil. Método: A pesquisa foi realizada separadamente em abril de 2015 e fevereiro de 2019, utilizando um recurso governamental, o sistema e-MEC, e pesquisa em bancos de dados da internet. Os dados foram divididos em categorias, de acordo com a condição de matrícula (obrigatória ou opcional) dos cursos com disciplinas ou módulos temáticos contendo tópicos sobre atividade física, tipo de atividades (teóricas, práticas ou teórico-práticas) e ênfase no conteúdo (saúde, desempenho ou saúde e desempenho). Resultado: Dos 223 currículos médicos compilados em 2015 e 286 em 2019, respectivamente, apenas 24 (10,8%) e 19 (6,7%) apresentaram pelo menos uma disciplina ou módulo temático contendo tópico sobre atividade física com ênfase em saúde. Conclusão: No Brasil, o número de currículos de graduação em Medicina contemplando tópicos de atividade física ainda é pequeno e sofreu uma redução entre 2015 e 2019, o que deve servir de alerta para as instituições de ensino médico quanto à necessidade de inclusão de conteúdos longitudinalmente distribuídos sobre atividade física, com abordagens teórica e, se possível, prática, e com ênfase na promoção da saúde e no tratamento de doenças, em unidades curriculares obrigatórias.

Characterization and internalization of small extracellular vesicles released by human primary macrophages derived from circulating monocytes.

Extracellular vesicles (EVs) are small membrane-limited structures derived from outward budding of the plasma membrane or endosomal system that participate in cellular communication processes through the transport of bioactive molecules to recipient cells. To date, there are no published methodological works showing step-by-step the isolation, characterization and internalization of small EVs secreted by human primary macrophages derived from circulating monocytes (MDM-derived sEVs). Thus, here we aimed to provide an alternative protocol based on differential ultracentrifugation (dUC) to describe small EVs (sEVs) from these cells. Monocyte-derived macrophages were cultured in EV-free medium during 24, 48 or 72 h and, then, EVs were isolated from culture supernatants by (dUC). Macrophages secreted a large amount of sEVs in the first 24 h, with size ranging from 40-150 nm, peaking at 105 nm, as evaluated by nanoparticle tracking analysis and scanning electron microscopy. The markers Alix, CD63 and CD81 were detected by immunoblotting in EV samples, and the co-localization of CD63 and CD81 after sucrose density gradient ultracentrifugation (S-DGUC) indicated the presence of sEVs from late endosomal origin. Confocal fluorescence revealed that the sEVs were internalized by primary macrophages after three hours of co-culture. The methodology here applied aims to contribute for enhancing reproducibility between the limited number of available protocols for the isolation and characterization of MDM-derived sEVs, thus providing basic knowledge in the area of EV methods that can be useful for those investigators working with sEVs released by human primary macrophages derived from circulating monocytes.

IgE, IgG1, and IgG4 Reactivity to Dermatophagoides pteronyssinus Glycosylated Extract in Allergic Patients.

BACKGROUND: House dust mites are important allergen sources and some of these allergenic proteins may contain carbohydrate moieties, which are able to be isolated using lectins, as Concanavalin A (ConA). This study aimed to investigate allergenicity (IgE) and antigenicity (IgG1 and IgG4) of ConA-unbound and ConA-bound Dermatophagoides pteronyssinus (Dpt) crude extracts using sera of mite-allergic patients as well as inhibition capacity of antibody binding. MATERIAL AND METHODS: We obtained mannose-enriched and mannose-depleted fractions from Dpt by ConA affinity chromatography. Both ConA-bound and ConA-unbound fractions were evaluated by ELISA and Western Blotting for specific IgE, IgG1, and IgG4 reactivity with sera obtained from 95 mite-allergic patients (DP+) and 92 nonallergic (NA) subjects. Inhibition ELISA was used to assess cross-reactivity between Dpt extract and its fractions. RESULTS: Among the DP+ patients, no difference was found between ConA-unbound and ConA-bound fractions regarding the levels of specific IgE, IgG1, and IgG4. Nonallergic subjects had the same levels of specific IgG1 to both ConA-unbound and ConA-bound fractions, although for specific IgG4, values were higher for ConA-bound. A positive correlation was found among specific IgE, IgG1, and IgG4 levels when Dpt was compared to ConA-unbound and ConA-bound fractions. Recognition of crude Dpt by IgE, IgG1, and IgG4 was highly inhibited by ConA-unbound and ConA-bound fractions. Western Blotting revealed a broad spectrum of bands ranging from 14 to 116 kDa recognized by specific IgE and IgG4. However, IgG1 reached higher frequency values on high molecular weight polypeptides. CONCLUSION: ConA-unbound and ConA-bound fractions derived from D. pteronyssinus crude extract revealed important components involved in the IgE recognition in allergic patients as well as IgG1 and/or IgG4 in allergic and healthy subjects.