Characteristics of two zoonotic swine influenza A(H1N1) viruses isolated in Germany from diseased patients.

Interspecies transmission of influenza A viruses (IAV) from pigs to humans is a concerning event as porcine IAV represent a reservoir of potentially pandemic IAV. We conducted a comprehensive analysis of two porcine A(H1N1)v viruses isolated from human cases by evaluating their genetic, antigenic and virological characteristics. The HA genes of those human isolates belonged to clades 1C.2.1 and 1C.2.2, respectively, of the A(H1N1) Eurasian avian-like swine influenza lineage. Antigenic profiling revealed substantial cross-reactivity between the two zoonotic H1N1 viruses and human A(H1N1)pdm09 virus and some swine viruses, but did not reveal cross-reactivity to H1N2 and earlier human seasonal A(H1N1) viruses. The solid-phase direct receptor binding assay analysis of both A(H1N1)v showed a predominant binding to α2-6-sialylated glycans similar to human-adapted IAV. Investigation of the replicative potential revealed that both A(H1N1)v viruses grow in human bronchial epithelial cells to similar high titers as the human A(H1N1)pdm09 virus. Cytokine induction was studied in human alveolar epithelial cells A549 and showed that both swine viruses isolated from human cases induced higher amounts of type I and type III IFN, as well as IL6 compared to a seasonal A(H1N1) or a A(H1N1)pdm09 virus. In summary, we demonstrate a remarkable adaptation of both zoonotic viruses to propagate in human cells. Our data emphasize the needs for continuous monitoring of people and regions at increased risk of such trans-species transmissions, as well as systematic studies to quantify the frequency of these events and to identify viral molecular determinants enhancing the zoonotic potential of porcine IAV.

The role of education in cognitive functions among middle-age and older patients with untreated obstructive sleep apnea.

OBJECTIVE: The goal of the current study was to examine the interaction between educational level and obstructive sleep apnea (OSA), one of the most under diagnosed sleep disorders, on cognitive functions such as verbal fluency, psychomotor vigilance, executive functions, visuospatial ability, and attention span. MATERIAL AND METHODS: One hundred and nine participants (47 controls and 62 untreated OSA patients) participated in the study and completed the Wisconsin Card Sorting Test, WAIS-III digit span and block design, semantic and phonemic fluency tests, and a psychomotor vigilance task. Subjective sleep and health measures were assessed. RESULTS: In semantic fluency and visuospatial ability tasks, patients with higher education performed better than patients with lower education and controls with lower education. This difference in moderation effects was not observed for vigilance, phonemic fluency, attention span, or executive functions although education was a significant predictor for all cognitive tasks. CONCLUSION: Higher education may have contributed to cognitive reserve in OSA patients (but not for controls) as reflected in better semantic fluency and visuospatial ability. This benefit of higher education contributing to larger cognitive reserve in patients with OSA helped buffer the deficits for some cognitive functions but not for others. This may indicate that this buffer is not limitless because when the cognitive demand gets higher the educational buffer no longer works.