Pulmonary infections in the returning traveler.

PURPOSE OF REVIEW: The recent COVID-19 pandemic has shaped the epidemiology of other infectious diseases globally. International tourist arrivals are increasing and recovering to prepandemic levels. This review focuses on respiratory infections in travelers, highlighting the characteristics of the main imported viral, bacterial, fungal, and parasitic infections with pulmonary involvement. RECENT FINDINGS: A recent systematic review estimated a prevalence of respiratory symptoms in travelers of around 35%, increasing to nearly 65% in the context of mass gatherings. Common viral and bacterial pathogens account for the majority of respiratory infections with an identified cause; however, recent data focus on the need for surveillance of emerging infections such as MERS-CoV, henipaviruses and multidrug resistant bacteria, which may be spread through travel. Fungal and parasitic respiratory infections are less common, and acquisition is usually associated with specific risk factors or exposure in endemic areas. Special risk groups, such as immunocompromised travelers, may be particularly vulnerable, presenting with severe disease or reactivation of latent infections. SUMMARY: The next significant international epidemic could involve another new infectious agent causing respiratory disease and spreading via mobile populations. Official protocols should be adhered to, and public health interventions implemented for effective control. Continued and globally coordinated investments in research for new vaccines, therapeutic agents, disease modeling, and digital tracking strategies are essential.

Mycophenolate mofetil for the long-term treatment of HTLV-1 associated myelopathy: A case report.

Human T-cell leukemia virus type 1 (HTLV-1) can cause HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP). Current treatment options for HAM/TSP are limited. We present a woman with rapidly-progressive HAM/TSP with significant, sustained clinical improvement following initiation of mycophenolate mofetil (MMA). Peripheral blood mononuclear cells from the patient, her asymptomatic carrier husband and eight healthy controls were isolated. Frequencies of T-cell populations upon exposure to low and high MMA concentrations and differences in proliferation were analyzed using flow cytometry and a CSFE-proliferation assay. Characterization of T-cell function and proliferation showed higher levels of GranzymeB in HTLV-1+ donors. The improvement and stability of symptoms in this patient with HAM/TSP following MMA initiation requires further study as a potential treatment for HAM/TSP.

In vitro digestibility of proteins from red seaweeds: Impact of cell wall structure and processing methods.

This study aimed to assess the nutritional quality and digestibility of proteins in two red seaweed species, Gelidium corneum and Gracilaropsis longissima, through the application of in vitro gastrointestinal digestions, and evaluate the impact of two consecutive processing steps, extrusion and compression moulding, to produce food snacks. The protein content in both seaweeds was approximately 16 %, being primarily located within the cell walls. Both species exhibited similar amino acid profiles, with aspartic and glutamic acid being most abundant. However, processing impacted their amino acid profiles, leading to a significant decrease in labile amino acids like lysine. Nevertheless, essential amino acids constituted 35-36 % of the total in the native seaweeds and their processed products. Although the protein digestibility in both seaweed species was relatively low (<60 %), processing, particularly extrusion, enhanced it by approximately 10 %. Interestingly, the effect of the different processing steps on the digestibility varied between the two species. This difference was mainly attributed to compositional and structural differences. G. corneum exhibited increased digestibility with each processing step, while G. longissima reached maximum digestibility after extrusion. Notably, changes in the amino acid profiles of the processed products affected adversely the protein nutritional quality, with lysine becoming the limiting amino acid. These findings provide the basis for developing strategies to enhance protein quality in these seaweed species, thereby facilitating high-quality food production with potential applications in the food industry.

Characterization of the invasive macroalgae Rugulopteryx Okamurae for potential biomass valorisation.

This study aimed to examine the composition and properties of the invasive macroalgae R. okamurae and explore potential applications. The results showed that the seaweed biomass is mainly composed of structural carbohydrates, with alginate being the main constituent, accounting for 32 % of its total composition and with a mannuronic and guluronic acid ratio (M/G) ratio of 0.93. It also has a relatively high concentration of fucose, related to the presence of fucoidans that have important biological functions. Among the mineral contents, a high magnesium and calcium (7107 and 5504 mg/kg) concentration, and the presence of heavy metals above legislated thresholds, were notable. R. okamurae also contained a high lipid content of 17 %, mainly composed of saturated fatty acids, but with a significant fraction of n3 polyunsaturated fatty acids (18 %) resulting in a low n6/n3 ratio (0.31), that has health benefits. The protein content of R. okamurae was 12 %, with high-quality proteins, as essential amino acids (mainly leucine, phenylalanine and valine) constitute 32 % of the total amino acids. It also showed a high polyphenol content and outstanding antioxidant properties (106.88 mg TE/g). Based on these findings, R. okamurae has significant potential as a sustainable source of bioactive compounds that can add value to different sectors, including food, feed, pharmaceuticals and cosmetics.

Chagas Disease in Europe.

Chagas disease is currently present in many non-endemic countries and remains a neglected tropical disease globally. A review of the literature identified significant gaps and scarcity of updated information from European countries, with most studies reporting data from Spain and Italy. The index of underdiagnosis may be as high as 70%, affecting mainly females of child-bearing age. Standardized screening of fertile, non-pregnant, women from endemic countries and subsequent treatment is considered an essential strategy to control transmission and prevent new cases, yet no uniform legislation for screening risk groups exists. There is heterogeneity in Europe in terms of preventive strategies to avoid transfusion-related transmission of Chagas disease, not necessarily in line with the European directives, with some countries conducting systematic screening for T. cruzi infection in blood donors, whilst others rely on pre-transfusion questionnaires. The growing burden of the infection in resource-rich areas may provide an opportunity for progress in certain aspects of control and prevention. Options for improving screening strategies, management and linkage to care are reviewed.

Occurrence of SARS-CoV-2 viremia is associated with genetic variants of genes related to COVID-19 pathogenesis.

Introduction: SARS-CoV-2 viral load has been related to COVID-19 severity. The main aim of this study was to evaluate the relationship between SARS-CoV-2 viremia and SNPs in genes previously studied by our group as predictors of COVID-19 severity. Materials and methods: Retrospective observational study including 340 patients hospitalized for COVID-19 in the University Hospital La Princesa between March 2020 and December 2021, with at least one viremia determination. Positive viremia was considered when viral load was above the quantifiable threshold (20 copies/ml). A total of 38 SNPs were genotyped. To study their association with viremia a multivariate logistic regression was performed. Results: The mean age of the studied population was 64.5 years (SD 16.6), 60.9% patients were male and 79.4% white non-Hispanic. Only 126 patients (37.1%) had at least one positive viremia. After adjustment by confounders, the presence of the minor alleles of rs2071746 (HMOX1; T/T genotype OR 9.9 p < 0.0001), rs78958998 (probably associated with SERPING1 expression; A/T genotype OR 2.3, p = 0.04 and T/T genotype OR 12.9, p < 0.0001), and rs713400 (eQTL for TMPRSS2; C/T + T/T genotype OR 1.86, p = 0.10) were associated with higher risk of viremia, whereas the minor alleles of rs11052877 (CD69; A/G genotype OR 0.5, p = 0.04 and G/G genotype OR 0.3, p = 0.01), rs2660 (OAS1; A/G genotype OR 0.6, p = 0.08), rs896 (VIPR1; T/T genotype OR 0.4, p = 0.02) and rs33980500 (TRAF3IP2; C/T + T/T genotype OR 0.3, p = 0.01) were associated with lower risk of viremia. Conclusion: Genetic variants in HMOX1 (rs2071746), SERPING1 (rs78958998), TMPRSS2 (rs713400), CD69 (rs11052877), TRAF3IP2 (rs33980500), OAS1 (rs2660) and VIPR1 (rs896) could explain heterogeneity in SARS-CoV-2 viremia in our population.

Aminobisphosphonates reactivate the latent reservoir in people living with HIV-1.

Antiretroviral therapy (ART) is not curative due to the existence of cellular reservoirs of latent HIV-1 that persist during therapy. Current research efforts to cure HIV-1 infection include "shock and kill" strategies to disrupt latency using small molecules or latency-reversing agents (LRAs) to induce expression of HIV-1 enabling cytotoxic immune cells to eliminate infected cells. The modest success of current LRAs urges the field to identify novel drugs with increased clinical efficacy. Aminobisphosphonates (N-BPs) that include pamidronate, zoledronate, or alendronate, are the first-line treatment of bone-related diseases including osteoporosis and bone malignancies. Here, we show the use of N-BPs as a novel class of LRA: we found in ex vivo assays using primary cells from ART-suppressed people living with HIV-1 that N-BPs induce HIV-1 from latency to levels that are comparable to the T cell activator phytohemagglutinin (PHA). RNA sequencing and mechanistic data suggested that reactivation may occur through activation of the activator protein 1 signaling pathway. Stored samples from a prior clinical trial aimed at analyzing the effect of alendronate on bone mineral density, provided further evidence of alendronate-mediated latency reversal and activation of immune effector cells. Decay of the reservoir measured by IPDA was however not detected. Our results demonstrate the novel use of N-BPs to reverse HIV-1 latency while inducing immune effector functions. This preliminary evidence merits further investigation in a controlled clinical setting possibly in combination with therapeutic vaccination.

Updates on Malaria Epidemiology and Prevention Strategies.

Purpose of Review: The objective of this review was to provide an update on recent malaria epidemiology, both globally and in non-endemic areas, to identify the current distribution and repercussions of genetically diverse Plasmodium species and summarize recently implemented intervention and prevention tools. Recent Findings: Notable changes in malaria epidemiology have occurred in recent years, with an increase in the number of total cases and deaths globally during 2020-2021, in part attributed to the COVID-19 pandemic. The emergence of artemisinin-resistant species in new areas and the expanding distribution of parasites harbouring deletions of the pfhrp2/3 genes have been concerning. New strategies to curb the burden of this infection, such as vaccination, have been implemented in certain endemic areas and their performance is currently being evaluated. Summary: Inadequate control of malaria in endemic regions may have an effect on imported malaria and measures to prevent re-establishment of transmission in malaria-free areas are essential. Enhanced surveillance and investigation of Plasmodium spp. genetic variations will contribute to the successful diagnosis and treatment of malaria in future. Novel strategies for an integrated One Health approach to malaria control should also be strengthened.

Nanostructural changes in Polysaccharide-Casein Gel-Like structures upon in vitro gastrointestinal digestion.

This work reports on the nanostructural changes taking place during the in vitro gastrointestinal digestion of polysaccharide-casein gel-like structures through the use of small angle X-ray scattering (SAXS). The results indicated that during the gastric phase, the hydrolysis of casein led to a swelling of the micellar structure, yielding peptide clusters. The presence of sulphated polysaccharides such as agar and κ-carrageenan was seen to limit the hydrolysis of casein during the gastric phase, hence decreasing the size of the formed clusters. After the intestinal phase, the produced peptidic fragments appeared to interact with the bile salts present in the digestion medium, yielding a mixture of bile salt lamellae/micelles and vesicular structures. However, in the presence of polysaccharides, which can interact with bile salts, the formation of vesicular structures was limited. Interestingly, the inclusion of casein within hybrid gel-like structures led to the formation of strong polysaccharide-protein interactions, especially in the case of κ-carrageenan. As a result, in some of the formulations, polysaccharide-peptide complexes were released towards the liquid medium, which formed larger vesicular structures. This was related to the greater protective effect of these particular gel-like structures. Furthermore, κ-carrageenan hindered the formation of bile salt lamellae/micelles. These results are of high relevance to understand the intestinal transport mechanism of the digestion products from protein-based ingredients and will allow a rational design of novel products with optimum nutritional and functional properties.

Polysaccharide-based structured lipid carriers for the delivery of curcumin: An in vitro digestion study.

The present work aimed at studying the in vitro digestion fate of κ-carrageenan (KC) or agar (AG) emulsion gels (EG), and KC oil-filled aerogels (OAG) in terms of their structural changes, lipolysis kinetics and curcumin bioaccessibility. On the one hand, both EG and aerogels showed large (70-200 µm) and heterogeneous particles after gastric conditions, indicating the release of bulk oil and gelled material. Nonetheless, this material release in the stomach phase was lower in the case of EG-AG and OAG-KC compared to EG-KC. After small intestinal conditions, EG and oil-filled aerogels presented a wide range of particle sizes probably due to the presence of undigested lipid material, gelled structures, as well as lipid digestion products. For the most part, adding curcumin to the structures' lipid phase did not cause of the structural modifications that occurred at the different in vitro digestion phases. On the other hand, the lipolysis kinetics was different depending on the type of structure. Amongst emulsion-gels, those formulated with κ-carrageenan presented a slower and lower lipolysis kinetics compared to those formulated with agar, which could be attributed to their higher initial hardness. Overall, the addition of curcumin in the lipid phase decreased the lipolysis in all the structures, which evidenced its interference in the lipid digestion process. The curcumin bioaccessibility reached high values (≈ 100 %) for all the studied structures, presenting a high solubility in intestinal fluids. This work unravels the implications of microstructural changes of emulsion-gels and oil-filled aerogels during digestion and their impact on their digestibility and subsequent functionality.

Deep characterization of human γδ T cell subsets defines shared and lineage-specific traits.

Under non-pathological conditions, human γδ T cells represent a small fraction of CD3+ T cells in peripheral blood (1-10%). They constitute a unique subset of T lymphocytes that recognize stress ligands or non-peptide antigens through MHC-independent presentation. Major human γδ T cell subsets, Vδ1 and Vδ2, expand in response to microbial infection or malignancy, but possess distinct tissue localization, antigen recognition, and effector responses. We hypothesized that differences at the gene, phenotypic, and functional level would provide evidence that γδ T cell subpopulations belong to distinct lineages. Comparisons between each subset and the identification of the molecular determinants that underpin their differences has been hampered by experimental challenges in obtaining sufficient numbers of purified cells. By utilizing a stringent FACS-based isolation method, we compared highly purified human Vδ1 and Vδ2 cells in terms of phenotype, gene expression profile, and functional responses. We found distinct genetic and phenotypic signatures that define functional differences in γδ T cell populations. Differences in TCR components, repertoire, and responses to calcium-dependent pathways suggest that Vδ1 and Vδ2 T cells are different lineages. These findings will facilitate further investigation into the ligand specificity and unique role of Vδ1 and Vδ2 cells in early immune responses.

Tissue-specific chromatin-binding patterns of Caenorhabditis elegans heterochromatin proteins HPL-1 and HPL-2 reveal differential roles in the regulation of gene expression.

Heterochromatin is characterized by an enrichment of repetitive elements and low gene density and is often maintained in a repressed state across cell division and differentiation. The silencing is mainly regulated by repressive histone marks such as H3K9 and H3K27 methylated forms and the heterochromatin protein 1 (HP1) family. Here, we analyzed in a tissue-specific manner the binding profile of the two HP1 homologs in Caenorhabditis elegans, HPL-1 and HPL-2, at the L4 developmental stage. We identified the genome-wide binding profile of intestinal and hypodermal HPL-2 and intestinal HPL-1 and compared them with heterochromatin marks and other features. HPL-2 associated preferentially to the distal arms of autosomes and correlated positively with the methylated forms of H3K9 and H3K27. HPL-1 was also enriched in regions containing H3K9me3 and H3K27me3 but exhibited a more even distribution between autosome arms and centers. HPL-2 showed a differential tissue-specific enrichment for repetitive elements conversely with HPL-1, which exhibited a poor association. Finally, we found a significant intersection of genomic regions bound by the BLMP-1/PRDM1 transcription factor and intestinal HPL-1, suggesting a corepressive role during cell differentiation. Our study uncovers both shared and singular properties of conserved HP1 proteins, providing information about genomic binding preferences in relation to their role as heterochromatic markers.

Anti-Steatotic Effects of Chlorella vulgaris, Nannochloropsis gaditana and Gracilaria vermiculophylla Algae Extracts in AML-12 Hepatocytes.

Non-alcoholic fatty liver disease (NAFLD) is considered the most common chronic liver alteration whose prevalence is increasing in Western countries. Microalgae and macroalgae have attracted great interest due to the high content in bioactive compounds with beneficial effects on health. The aim of the present study is to assess the potential interest of extracts rich in proteins obtained from the microalgae Chlorella vulgaris and Nannochloropsis gaditana and the macroalga Gracilaria vermiculophylla in the prevention of lipid accumulation in AML-12 hepatocytes. Toxicity was not observed at any of the tested doses. Both microalgae and the macroalga were effective in preventing triglyceride accumulation, with Nannochloropsis gaditana being the most effective one. Although the three algae extracts were able to increase different catabolic pathways involved in triglyceride metabolism, the mechanisms underlying the anti-steatotic effect were different in each algae extract. In conclusion, the present study demonstrates that Chlorella vulgaris, Nannochloropsis gaditana and Gracilaria vermiculophylla extracts are able to partially prevent the accumulation of triglycerides induced by palmitic acid in cultured hepatocytes, a model used to mimic the steatosis induced in liver by dietary patterns rich in saturated fat.

Structural and functional properties of alginate obtained by means of high hydrostatic pressure-assisted extraction.

The effects of the high hydrostatic pressure (HPP) pre-treatment on the alginate extraction were seen to greatly depend on the recalcitrant nature of two algae species. Alginates were deeply characterized in terms of composition, structure (HPAEC-PAD, FTIR, NMR, SEC-MALS), functional and technological properties. The pre-treatment significantly increased the alginate yield in the less recalcitrant A. nodosum (AHP) also favoring the extraction of sulphated fucoidan/fucan structures and polyphenols. Although the molecular weight was significantly lower in AHP samples, neither the M/G ratio nor the M and G sequences were modified. In contrast, a lower increase in alginate extraction yield was observed for the more recalcitrant S. latissima after the HPP pre-treatment (SHP), but it significantly affected the M/G values of the resulting extract. The gelling properties of the alginate extracts were also explored by external gelation in CaCl2 solutions. The mechanical strength and nanostructure of the hydrogel beads prepared were determined using compression tests, synchrotron small angle X-ray scattering (SAXS), and cryo-scanning electron microscopy (Cryo-SEM). Interestingly, the application of HPP significantly improved the gel strength of SHP, in agreement with the lower M/G values and the stiffer rod-like conformation obtained for these samples.

Characterizing the physical and mental health profile of children, adolescents and adults with autism spectrum disorder in Spain.

Introduction: Autistic men and women are more likely to experience health issues than the general population, although the available epidemiological studies addressing co-occurrence conditions are limited. This is the first Spanish epidemiologic study addressing the health profile and poor-health exacerbating factors in individuals of all ages with autism spectrum disorder (ASD). Methods: We analyzed 2,629 registries extracted from Autism Spain's sociodemographic registry (November 2017-May 2020). A descriptive health data analysis was conducted to assess the prevalence of other conditions associated to ASD in the Spanish population. Nervous system disorders (12.9%), mental health diagnoses (17.8%), and other comorbidities (25.4%) were reported. Men-to-women ratio was 4:1. Results: Women, elder individuals and those with intellectual disability (ID) were at an increased risk of health comorbidities and psychopharmacological exposure. Women were also more prone to severe intellectual and functional impairment. Nearly all individuals had difficulties in their adaptative functioning, especially those with ID (50% of the population). Almost half of the sample received psychopharmacological treatments starting from infancy and early childhood, mostly antipsychotics and anticonvulsants. Discussion: This study represents an important first approach to the health status of autistic people in Spain and can contribute to the development of public policies and innovative health strategies.

Aminobisphosphonates reactivate the latent reservoir in people living with HIV-1.

Antiretroviral therapy (ART) is not curative due to the existence of cellular reservoirs of latent HIV-1 that persist during therapy. Current research efforts to cure HIV-1 infection include "shock and kill" strategies to disrupt latency using small molecules or latency-reversing agents (LRAs) to induce expression of HIV-1 enabling cytotoxic immune cells to eliminate infected cells. The modest success of current LRAs urges the field to identify novel drugs with increased clinical efficacy. Aminobisphosphonates (N-BPs) that include pamidronate, zoledronate, or alendronate, are the first-line treatment of bone-related diseases including osteoporosis and bone malignancies. Here, we show the use of N-BPs as a novel class of LRA: we found in ex vivo assays using primary cells from ART-suppressed people living with HIV-1 that N-BPs induce HIV-1 from latency to levels that are comparable to the T cell activator phytohemagglutinin (PHA). RNA sequencing and mechanistic data suggested that reactivation may occur through activation of the activator protein 1 signaling pathway. Stored samples from a prior clinical trial aimed at analyzing the effect of alendronate on bone mineral density, provided further evidence of alendronate-mediated latency reversal and activation of immune effector cells. Decay of the reservoir measured by IPDA was however not detected. Our results demonstrate the novel use of N-BPs to reverse HIV-1 latency while inducing immune effector functions. This preliminary evidence merits further investigation in a controlled clinical setting possibly in combination with therapeutic vaccination.