Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24
Filtrar
1.
Bioconjug Chem ; 34(9): 1653-1666, 2023 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-37682243

RESUMEN

Coxiella burnetii is the causative agent of Q fever, for which there is yet to be an FDA-approved vaccine. This bacterial pathogen has both extra- and intracellular stages in its life cycle, and therefore both a cell-mediated (i.e., T lymphocyte) and humoral (i.e., antibody) immune response are necessary for effective eradication of this pathogen. However, most proposed vaccines elicit strong responses to only one mechanism of adaptive immunity, and some can either cause reactogenicity or lack sufficient immunogenicity. In this work, we aim to apply a nanoparticle-based platform toward producing both antibody and T cell immune responses against C. burnetii. We investigated three approaches for conjugation of the immunodominant outer membrane protein antigen (CBU1910) to the E2 nanoparticle to obtain a consistent antigen orientation: direct genetic fusion, high affinity tris-NTA-Ni conjugation to polyhistidine-tagged CBU1910, and the SpyTag/SpyCatcher (ST/SC) system. Overall, we found that the ST/SC approach yielded nanoparticles loaded with the highest number of antigens while maintaining stability, enabling formulations that could simultaneously co-deliver the protein antigen (CBU1910) and adjuvant (CpG1826) on one nanoparticle (CBU1910-CpG-E2). Using protein microarray analyses, we found that after immunization, antigen-bound nanoparticle formulations elicited significantly higher antigen-specific IgG responses than soluble CBU1910 alone and produced more balanced IgG1/IgG2c ratios. Although T cell recall assays from these protein antigen formulations did not show significant increases in antigen-specific IFN-γ production compared to soluble CBU1910 alone, nanoparticles conjugated with a CD4 peptide epitope from CBU1910 generated elevated T cell responses in mice to both the CBU1910 peptide epitope and whole CBU1910 protein. These investigations highlight the feasibility of conjugating antigens to nanoparticles for tuning and improving both humoral- and cell-mediated adaptive immunity against C. burnetii.


Asunto(s)
Coxiella burnetii , Fiebre Q , Vacunas , Animales , Ratones , Fiebre Q/prevención & control , Antígenos Bacterianos , Anticuerpos , Epítopos
2.
Front Immunol ; 14: 1192821, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37533862

RESUMEN

Vaccines are among the most cost-effective public health measures for controlling infectious diseases. Coxiella burnetii is the etiological agent of Q fever, a disease with a wide clinical spectrum that ranges from mild symptoms, such as fever and fatigue, to more severe disease, such as pneumonia and endocarditis. The formalin-inactivated whole-cell vaccine Q-VAX® contains hundreds of antigens and confers lifelong protection in humans, but prior sensitization from infection or vaccination can result in deleterious reactogenic responses to vaccination. Consequently, there is great interest in developing non-reactogenic alternatives based on adjuvanted recombinant proteins. In this study, we aimed to develop a multivalent vaccine that conferred protection with reduced reactogenicity. We hypothesized that a multivalent vaccine consisting of multiple antigens would be more immunogenic and protective than a monovalent vaccine owing to the large number of potential protective antigens in the C. burnetii proteome. To address this, we identified immunogenic T and B cell antigens, and selected proteins were purified to evaluate with a combination adjuvant (IVAX-1), with or without C. burnetii lipopolysaccharide (LPS) in immunogenicity studies in vivo in mice and in a Hartley guinea pig intratracheal aerosol challenge model using C. burnetii strain NMI RSA 493. The data showed that multivalent vaccines are more immunogenic than monovalent vaccines and more closely emulate the protection achieved by Q-VAX. Although six antigens were the most immunogenic, we also discovered that multiplexing beyond four antigens introduces detectable reactogenicity, indicating that there is an upper limit to the number of antigens that can be safely included in a multivalent Q-fever vaccine. C. burnetii LPS also demonstrates efficacy as a vaccine antigen in conferring protection in an otherwise monovalent vaccine formulation, suggesting that its addition in multivalent vaccines, as demonstrated by a quadrivalent formulation, would improve protective responses.


Asunto(s)
Coxiella burnetii , Humanos , Cobayas , Animales , Ratones , Vacunas Combinadas , Lipopolisacáridos , Vacunas Bacterianas , Antígenos , Adyuvantes Inmunológicos , Aerosoles
3.
Front Immunol ; 14: 1196522, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37215096

Asunto(s)
Fiebre Q , Vacunas , Humanos
5.
Front Immunol ; 12: 754712, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34616410

RESUMEN

Q-VAX®, a whole cell, formalin-inactivated vaccine, is the only vaccine licensed for human use to protect against Coxiella burnetii, the cause of Q fever. Although this vaccine provides long-term protection, local and systemic reactogenic responses are common in previously sensitized individuals which prevents its use outside of Australia. Despite the importance of preventing these adverse reactions to develop widely accepted, novel vaccines against C. burnetii, little is understood about the underlying cellular mechanisms. This is mostly attributed to the use of a guinea pig reactogenicity model where complex cellular analysis is limited. To address this, we compared three different mouse strains develop a model of C. burnetii whole cell vaccine reactogenic responses. SKH1 and C57Bl/6, but not BALBc mice, develop local granulomatous reactions after either infection- or vaccine-induced sensitization. We evaluated local and systemic responses by measuring T cell populations from the vaccination site and spleen during elicitation using flow cytometry. Local reaction sites showed influx of IFNγ+ and IL17a+ CD4 T cells in sensitized mice compared with controls and a reduction in IL4+ CD4 T cells. Additionally, sensitized mice showed a systemic response to elicitation by an increase in IFNγ+ and IL17a+ CD4 T cells in the spleen. These results indicate that local and systemic C. burnetii reactogenic responses are consistent with a Th1 delayed-type hypersensitivity. Our experiments provide insights into the pathophysiology of C. burnetii whole cell vaccine reactogenicity and demonstrate that C57Bl/6 and SKH1 mice can provide a valuable model for evaluating the reactogenicity of novel C. burnetii vaccine candidates.


Asunto(s)
Vacunas Bacterianas/efectos adversos , Modelos Animales de Enfermedad , Hipersensibilidad Tardía/inmunología , Fiebre Q , Células TH1/inmunología , Animales , Coxiella burnetii , Femenino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Fiebre Q/prevención & control , Vacunas de Productos Inactivados/efectos adversos
6.
Rev. biol. trop ; 69(2)jun. 2021.
Artículo en Inglés | LILACS, SaludCR | ID: biblio-1387641

RESUMEN

Abstract Introduction: High Andean flamingos also known as parihuanas, are species of recurrent presence in the high Andean areas which find this area as an important resting, feeding and in some cases breeding area The species recorded here correspond to Phoenicoparrus jamesi, Phoenicoparrus andinus and Phoenicopterus chilensis, the latter being the most abundant and common. During the censuses performed during 2018 and 2019, in the high Andean lake of Salinas, Ramsar site, located within the Reserva Nacional Salinas y Aguada Blanca in Southern Peru, atypical behaviors of these birds were recorded in a sector of the lake, observing reproductive courtship and the settlement of colonies of P. chilensis. Objective: The study aimed to confirm and evaluate reproductive events of P. chilenesis (Chilean flamingo) through the use of an unmanned aerial vehicle (UAV) and image processing tools using geographic information systems. Methodology: Monitoring was conducted during 2018 and 2019 to breeding colonies of P. chilensis, we used a UAV Phantom 4 testing different flight altitudes to avoid disturbing the birds and performed records of aerial photographs and GIS post-processing with the creation of panchromatic images for the identification and counting of individuals and eggs automated, and manual verification. Results: During 2018 were identified nests and presence of six eggs, this occurred between March and June where the event was interrupted not observing chicks or juveniles during this period, for 2019 the breeding was more successful, where a higher number of eggs were counted (40-66) and with the formation of three reproductive colonies with 4 185 adult individuals, also verified the presence of chicks and juveniles that reached a maximum of 1 491 individuals. Conclusions: We confirmed two continuous reproductive events of P. chilensis in the Salinas lake, where during 2019 was the most successful incorporating several new individuals to the initial population, likewise the methodology applied in the image processing allowed differentiating between adult individuals and eggs but did not allow differentiating juveniles, however, the images directly acquired by the UAV allow distinguishing the types of individuals to perform a manual count.


Resumen Introducción: Los flamencos altoandinos también conocidos como parihuanas, son especies con presencia recurrente en las zonas altoandinas, principalmente en humedales salinos donde suelen arribar para descanso, alimentación y en algunos casos reproducción. Las especies que se registran aquí corresponden a Phoenicoparrus jamesi, Phoenicoparrus andinus y Phoenicopterus chilenesis, siendo esta última la más abundante y común. Durante los censos desarrollados en 2018 y 2019, en la laguna de Salinas, ubicada en la Reserva Nacional de Salinas y Aguada Blanca en el sur del Perú, se registraron comportamientos atípicos de estas aves en un sector del humedal, se observaron cortejos reproductivos y el asentamiento de colonias de flamencos chilenos. Objetivo: Confirmar y evaluar eventos reproductivos de Phoenicopterus chilenesis mediante la incorporación de un vehículo aéreo no tripulado (UAV) y herramientas de procesamiento de imágenes mediante sistemas de información geográfica. Metodología: Se realizaron censos aéreos durante 2018 y 2019 a colonias reproductivas del P. chilensis, utilizando un UAV Phantom 4 a diferentes alturas de vuelo para evitar la perturbación de las colonias de flamencos. Se realizaron registros de fotografías aéreas y post procesamiento SIG con la creación de imágenes pancromáticas para la identificación y conteo de individuos y huevos automatizada, así como la verificación manual. Resultados: En 2018 se identificaron nidos y la presencia de seis huevos, entre marzo y junio donde el evento fue interrumpido, no se observaron pollos o juveniles durante este periodo. En 2019 la nidificación tuvo éxito, se contabilizó un mayor número de huevos (40-66) con la formación de tres colonias reproductivas de 4 185 individuos adultos, se verificó la presencia de pollos y juveniles que alcanzaron un máximo de 1 491 individuos. Conclusiones: Se confirman dos eventos reproductivos continuos de P. chilensis en la laguna Salinas, durante el 2019 incorporando varios nuevos individuos a la población inicial. La metodología aplicada en el tratamiento de imágenes permitió diferenciar entre individuos adultos y huevos, pero no permitió diferenciar juveniles, aunque las imágenes directamente adquiridas por el UAV permiten diferenciar los tipos de individuos para realizar un conteo manual.


Asunto(s)
Animales , Aves , Dispositivos Aéreos No Tripulados , Perú , Comportamiento de Nidificación
7.
Front Immunol ; 12: 653092, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33815413

RESUMEN

Q fever is caused by the obligate intracellular bacterium, Coxiella burnetii, a designated potential agent of bioterrorism because of its route of transmission, resistance to disinfectants, and low infectious dose. The only vaccine licensed for human use is Q-VAX® (Seqirus, licensed in Australia), a formalin-inactivated whole-cell vaccine, which produces severe local and systemic reactogenic responses in previously sensitized individuals. Accordingly, the U.S. Food and Drug Administration and other regulatory bodies around the world, have been reluctant to approve Q-VAX for widespread use. To obviate these adverse reactions, we prepared recombinant protein subunit vaccine candidates containing purified CBU1910, CBU0307, CBU0545, CBU0612, CBU0891, and CBU1398 proteins and TLR triagonist adjuvants. TLR triagonist adjuvants combine different TLR agonists to enhance immune responses to vaccine antigens. We tested both the protective efficacy and reactogenicity of our vaccine candidates in Hartley guinea pigs using intratracheal infection with live C. burnetii. While all of our candidates showed varying degrees of protection during challenge, local reactogenic responses were significantly reduced for one of our vaccine candidates when compared with a formalin-inactivated whole-cell vaccine. Our findings show that subunit vaccines combined with novel TLR triagonist adjuvants can generate protective immunity to C. burnetii infection while reducing reactogenic responses.


Asunto(s)
Adyuvantes Inmunológicos/farmacología , Vacunas Bacterianas/farmacología , Coxiella burnetii/inmunología , Fiebre Q/prevención & control , Receptores Toll-Like/antagonistas & inhibidores , Adyuvantes Inmunológicos/uso terapéutico , Animales , Antígenos Bacterianos/genética , Antígenos Bacterianos/farmacología , Antígenos Bacterianos/uso terapéutico , Proteínas Bacterianas/genética , Proteínas Bacterianas/inmunología , Vacunas Bacterianas/genética , Vacunas Bacterianas/uso terapéutico , Modelos Animales de Enfermedad , Cobayas , Humanos , Inmunogenicidad Vacunal , Fiebre Q/inmunología , Fiebre Q/microbiología , Proteínas Recombinantes/genética , Proteínas Recombinantes/farmacología , Proteínas Recombinantes/uso terapéutico , Vacunas de Subunidad/genética , Vacunas de Subunidad/farmacología , Vacunas de Subunidad/uso terapéutico , Vacunas Sintéticas/genética , Vacunas Sintéticas/farmacología , Vacunas Sintéticas/uso terapéutico
8.
Cell Rep Med ; 2(12): 100461, 2021 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-35028605

RESUMEN

Q fever is caused by the intracellular bacterium Coxiella burnetii, for which there is no approved vaccine in the United States. A formalin-inactivated whole-cell vaccine (WCV) from virulent C. burnetii NMI provides single-dose long-lived protection, but concerns remain over vaccine reactogenicity. We therefore sought an alternate approach by purifying native C. burnetii antigens from the clonally derived avirulent NMII strain. A soluble bacterial extract, termed Sol II, elicits high-titer, high-avidity antibodies and induces a CD4 T cell response that confers protection in naive mice. In addition, Sol II protects against pulmonary C. burnetii challenge in three animal models without inducing hypersensitivity. An NMI-derived extract, Sol I, enhances protection further and outperforms the WCV gold standard. Collectively, these data represent a promising approach to design highly effective, non-reactogenic Q fever vaccines.


Asunto(s)
Antígenos Bacterianos/inmunología , Coxiella burnetii/inmunología , Hipersensibilidad/inmunología , Inmunidad , Fiebre Q/inmunología , Fiebre Q/prevención & control , Aerosoles , Animales , Afinidad de Anticuerpos , Variación Antigénica , Vacunas Bacterianas/inmunología , Linfocitos T CD4-Positivos/inmunología , Modelos Animales de Enfermedad , Femenino , Cobayas , Inmunización , Lipopolisacáridos , Pulmón/microbiología , Pulmón/patología , Macaca mulatta , Masculino , Ratones Endogámicos C57BL , Fiebre Q/microbiología , Solubilidad
9.
Pediatr Blood Cancer ; 67(11): e28665, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32827342

RESUMEN

Recent clinical trials have moved iodine-131 (I-131) metaiodobenzylguanidine (MIBG) therapy into frontline management of high-risk neuroblastoma. With this expansion, it is reasonable to anticipate the need for intensive care level resuscitations. Radiation exposure remains the greatest risk to health care professionals managing these patients. We combined shock simulation scenario data with actual radiation dosimetry data to create a care model allowing for aggressive, prolonged in situ resuscitation of a critically ill pediatric patient after I-131 MIBG administration. This model will maintain a critical care provider's radiation level below 10% of the annual occupational dose limit (5 mSv, 500 mrem) per patient managed.


Asunto(s)
3-Yodobencilguanidina/efectos adversos , Enfermedad Crítica/terapia , Radioisótopos de Yodo/efectos adversos , Modelos Estadísticos , Neuroblastoma/radioterapia , Atención Dirigida al Paciente/normas , Exposición a la Radiación/normas , 3-Yodobencilguanidina/administración & dosificación , Niño , Cuidados Críticos/normas , Enfermedad Crítica/epidemiología , Femenino , Humanos , Infusiones Intravenosas , Radioisótopos de Yodo/administración & dosificación , Michigan/epidemiología , Pronóstico , Radiofármacos/administración & dosificación , Radiofármacos/efectos adversos , Dosificación Radioterapéutica
10.
Infect Immun ; 88(10)2020 09 18.
Artículo en Inglés | MEDLINE | ID: mdl-32690632

RESUMEN

Reproductive failure is the hallmark of brucellosis in animals. An uncommon but important complication in pregnant women who become acutely infected with Brucella melitensis is spontaneous pregnancy loss or vertical transmission to the fetus. Unfortunately, the mechanism behind reproductive failure is still obscure, partially due to the lack of a proper study model. Recently, it was demonstrated that intratracheal (IT) inoculation of nonpregnant guinea pigs would replicate features of clinical disease in humans. To determine if IT inoculation would induce reproductive disease, guinea pigs were infected at mid-gestation and monitored daily for fever and abortions. Fever developed between day 14 to 18 postinoculation, and by 3 weeks postinoculation, 75% of pregnant guinea pigs experienced stillbirths or spontaneous abortions mimicking natural disease. Next, to investigate the guinea pig as a model for evaluating vaccine efficacy during pregnancy, nonpregnant guinea pigs were vaccinated with S19, 16MΔvjbR + Quil-A, or 100 µl PBS + Quil-A (as control). Guinea pigs were bred and vaccinated guinea pigs were challenged at mid-gestation with B. melitensis IT inoculation and monitored for fever and abortions. Vaccination with both vaccines prevented fever and protected against abortion. Together, this study indicates that pregnant guinea pigs are an appropriate animal model to study reproductive disease and offer an improved model to evaluate the ability of vaccine candidates to protect against a serious manifestation of disease.


Asunto(s)
Vacuna contra la Brucelosis/administración & dosificación , Brucella melitensis/inmunología , Brucelosis/prevención & control , Modelos Animales de Enfermedad , Complicaciones Infecciosas del Embarazo/prevención & control , Animales , Anticuerpos Antibacterianos/sangre , Brucella melitensis/patogenicidad , Brucelosis/microbiología , Brucelosis/patología , Femenino , Cobayas , Humanos , Glándulas Mamarias Animales/microbiología , Glándulas Mamarias Animales/patología , Placenta/microbiología , Placenta/patología , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Complicaciones Infecciosas del Embarazo/patología , Vacunación
11.
J Infect Dis ; 220(4): 624-634, 2019 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-30938819

RESUMEN

BACKGROUND: Protective immunity against Coxiella burnetii infection is conferred by vaccination with virulent (PI-WCV), but not avirulent (PII-WCV) whole-cell inactivated bacterium. The only well-characterized antigenic difference between virulent and avirulent C. burnetii is they have smooth and rough lipopolysaccharide (LPS), respectively. METHODS: Mice were vaccinated with PI-WCV and PII-WCV. Humoral and cellular responses were evaluated using protein chip microarrays and ELISpots, respectively. Dendritic cell (DC) maturation after stimulation with PI-WVC and PII-WVC was evaluated using flow cytometry. Vaccine-challenge studies were performed to validate the importance of the receptor CCR7. RESULTS: Other than specific antibody response to PI-LPS, similar antibody profiles were observed but IgG titers were significantly higher after vaccination with PI-WCV. Furthermore, higher frequency of antigen-specific CD4+ T cells was detected in mice immunized with PI-WCV. PI-WCV-stimulated DCs displayed significantly higher levels of CCR7 and migratory ability to secondary lymphoid organs. Challenge-protection studies in wild-type and CCR7-deficient mice confirmed that CCR7 is critical for PI-WCV-induced cellular immunity. CONCLUSIONS: PI-WVC stimulates protective immunity to C. burnetii in mice through stimulation of migratory behavior in DCs for protective cellular immunity. Additionally, the humoral immune response to LPS is an important component of protective immunity.


Asunto(s)
Anticuerpos Antibacterianos/inmunología , Antígenos Bacterianos/inmunología , Vacunas Bacterianas/inmunología , Coxiella burnetii/inmunología , Inmunidad Celular , Fiebre Q/inmunología , Receptores de Quimiocina/inmunología , Animales , Formación de Anticuerpos , Células Dendríticas/inmunología , Femenino , Humanos , Lipopolisacáridos/inmunología , Ratones , Fiebre Q/microbiología , Fiebre Q/prevención & control , Vacunación
12.
Clin Vaccine Immunol ; 24(11)2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28903988

RESUMEN

Burkholderia pseudomallei is a Gram-negative, facultative intracellular pathogen that causes the disease melioidosis in humans and other mammals. Respiratory infection with B. pseudomallei leads to a fulminant and often fatal disease. It has previously been shown that glycoconjugate vaccines can provide significant protection against lethal challenge; however, the limited number of known Burkholderia antigens has slowed progress toward vaccine development. The objective of this study was to identify novel antigens and evaluate their protective capacity when incorporated into a nanoglycoconjugate vaccine platform. First, an in silico approach to identify antigens with strong predicted immunogenicity was developed. Protein candidates were screened and ranked according to predicted subcellular localization, transmembrane domains, adhesive properties, and ability to interact with major histocompatibility complex (MHC) class I and class II. From these in silico predictions, we identified seven "high priority" proteins that demonstrated seroreactivity with anti-B. pseudomallei murine sera and convalescent human melioidosis sera, providing validation of our methods. Two novel proteins, together with Hcp1, were linked to lipopolysaccharide (LPS) and incorporated with the surface of a gold nanoparticle (AuNP). Animals receiving AuNP glycoconjugate vaccines generated high protein- and polysaccharide-specific antibody titers. Importantly, immunized animals receiving the AuNP-FlgL-LPS alone or as a combination demonstrated up to 100% survival and reduced lung colonization following a lethal challenge with B. pseudomallei Together, this study provides a rational approach to vaccine design that can be adapted for other complex pathogens and provides a rationale for further preclinical testing of AuNP glycoconjugate in animal models of infection.


Asunto(s)
Vacunas Bacterianas/inmunología , Burkholderia pseudomallei/inmunología , Glicoconjugados/inmunología , Nanopartículas del Metal/administración & dosificación , Animales , Anticuerpos Antibacterianos/inmunología , Antígenos Bacterianos/inmunología , Femenino , Oro/inmunología , Humanos , Lipopolisacáridos/inmunología , Melioidosis/inmunología , Melioidosis/prevención & control , Ratones , Ratones Endogámicos C57BL , Modelos Animales , Vacunología/métodos
13.
Pediatr Blood Cancer ; 64(11)2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28436582

RESUMEN

PURPOSE: Prognosis for relapsed/refractory high-risk neuroblastoma (HR-NBL) remains poor. Bortezomib, a proteasome inhibitor, has shown preclinical activity against NBL as a single agent and in combination with cytotoxic chemotherapy including irinotecan. PATIENTS AND METHODS: Eighteen HR-NBL patients with primary refractory (n = 8) or relapsed (n = 10) disease were enrolled in a Phase I study using modified Time To Event Continual Reassessment Method. Bortezomib (1.2 mg/m2 /day) was administered on days 1, 4, 8, and 11 intravenously (IV) and irinotecan was given IV on days 1-5 (35, 40, or 45 mg/m2 /day, on dose levels [DL] 1-3, respectively). The maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and response rate were examined. RESULTS: Eighteen NBL patients were evaluable for toxicity; 17 were evaluable for response assessment. A total of 142 courses were delivered (mean 8.2, median 2, range 1-48), with two patients receiving more than 40 courses of therapy. Two DLTs were reported, including a grade 4 thrombocytopenia (DL2) and a grade 3 irritability (DL3). MTD was estimated as DL3. Two of 17 (12%) evaluable patients showed objective responses (ORs) lasting more than 40 courses, including 1 partial remission and 1 complete remission. Four patients (23%) had prolonged stable disease (SD) lasting six or more courses, with a total of 35% study patients demonstrating clinical benefit in the form of prolonged OR or SD. CONCLUSION: The combination of bortezomib and irinotecan was well tolerated by patients with relapsed/refractory NBL with favorable toxicity profile. It also showed modest but promising clinical activity and merits further testing in Phase II studies.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Resistencia a Antineoplásicos/efectos de los fármacos , Recurrencia Local de Neoplasia/tratamiento farmacológico , Neuroblastoma/tratamiento farmacológico , Terapia Recuperativa , Adolescente , Adulto , Bortezomib/administración & dosificación , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Niño , Preescolar , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Lactante , Irinotecán , Masculino , Dosis Máxima Tolerada , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Neuroblastoma/patología , Pronóstico , Tasa de Supervivencia , Adulto Joven
14.
J Infect Dis ; 215(10): 1580-1589, 2017 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-27703037

RESUMEN

Coxiella burnetii is a gram-negative bacterium that causes acute and chronic Q fever. Because of the severe adverse effect of whole-cell vaccination, identification of immunodominant antigens of C. burnetii has become a major focus of Q fever vaccine development. We hypothesized that secreted C. burnetii type IV secretion system (T4SS) effectors may represent a major class of CD8+ T-cell antigens, owing to their cytosolic localization. Twenty-nine peptides were identified that elicited robust CD8+ T-cell interferon γ (IFN-γ) recall responses from mice infected with C. burnetii. Interestingly, 22 of 29 epitopes were derived from 17 T4SS-related proteins, none of which were identified as immunodominant antigens by using previous antibody-guided approaches. These epitopes were expressed in an attenuated Listeria monocytogenes vaccine strain. Immunization with recombinant L. monocytogenes vaccines induced a robust CD8+ T-cell response and conferred measurable protection against C. burnetii infection in mice. These data suggested that T4SS effectors represent an important class of C. burnetii antigens that can induce CD8+ T-cell responses. We also showed that attenuated L. monocytogenes vaccine vectors are an efficient antigen-delivery platform that can be used to induce robust protective CD8+ T-cell immune responses against C. burnetii infection.


Asunto(s)
Presentación de Antígeno/inmunología , Vacunas Bacterianas/inmunología , Linfocitos T CD8-positivos/inmunología , Coxiella burnetii/inmunología , Epítopos de Linfocito T/inmunología , Vacunas Atenuadas/inmunología , Animales , Anticuerpos Antibacterianos/inmunología , Antígenos Bacterianos/inmunología , Proteínas Bacterianas/química , Proteínas Bacterianas/inmunología , Vacunas Bacterianas/química , Coxiella burnetii/química , Epítopos de Linfocito T/química , Femenino , Ensayos de Liberación de Interferón gamma , Listeria monocytogenes/inmunología , Ratones , Ratones Endogámicos C57BL , Fragmentos de Péptidos/química , Fragmentos de Péptidos/inmunología , Fiebre Q/inmunología , Fiebre Q/microbiología , Sistemas de Secreción Tipo IV/química , Sistemas de Secreción Tipo IV/inmunología , Vacunas Atenuadas/química
15.
Semin Ophthalmol ; 31(4): 415-25, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27142085

RESUMEN

OBJECTIVE: This review demonstrates the gender and racial disparities among patients who have committed ocular autoenucleation. DESIGN: Peer-reviewed articles were identified and reviewed on the basis of a literature search in PubMed/MEDLINE and Ovid/EMBASE databases from all available literature to date. RESULTS: We identified 60 cases of autoenucleation published in contemporary literature with nine attempted cases. The ratio of men to women who have committed autoenucleation is 8:1. Only 28 cases of autoenucleation included confirmed reports of racial makeup. 17 out of 28 cases were White, eight out of 28 cases were Hispanic or Asian, and only three cases were Black. White patients account for 61% of the cases, while Black patients make up 11% and other races constitute 28%. The common underlying psychiatric motivations among autoenucleation patients include biblical interpretations, religious delusions, and paranoia of the eye. The most common associated psychiatric disorders among patients with autoenucleation include schizophrenia, major depressive disorder, and bipolar disorder. CONCLUSION: Autoenucleation largely occurs amongst male patients with active psychiatric disorders. Our findings challenge previously published reviews where the incidence of autoenucleation is reported as equal for the two sexes. A higher incidence among the White population is also suggested. This is the first time gender and racial disparity have been demonstrated with respect to autoenucleation.


Asunto(s)
Enucleación del Ojo/estadística & datos numéricos , Disparidades en el Estado de Salud , Grupos Raciales , Automutilación/epidemiología , Distribución por Sexo , Enucleación del Ojo/psicología , Femenino , Humanos , Masculino , Automutilación/psicología
16.
Semin Ophthalmol ; 31(4): 400-4, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27101105

RESUMEN

INTRODUCTION: The etiology, frequency, manifestation, and treatment of uveitis and uveitic glaucoma are commonly influenced by race. MATERIALS AND METHODS: This study aims to review the effect of race on the diagnosis and treatment of patients with common diseases of uveitis that may develop into glaucoma. RESULTS: Race affects the presentation and prevalence of uveitis. Sarcoidosis, for example, is more common in Blacks than in Whites in the United States. Furthermore, Blacks more commonly have anterior segment involvement, while Whites more commonly have posterior segment involvement. In addition, treatments-such as steroid implants and trabeculectomy-in the setting of uveitis and uveitic glaucoma may have higher risk of failure in Black patients. DISCUSSION: Over the last half-century, we have increased our understanding of the role of race in uveitis and uveitic glaucoma. Major gaps remain and further study is needed.


Asunto(s)
Glaucoma/diagnóstico , Glaucoma/terapia , Disparidades en Atención de Salud/estadística & datos numéricos , Grupos Raciales/etnología , Uveítis/diagnóstico , Uveítis/terapia , Glaucoma/etnología , Humanos , Uveítis/etnología
17.
Semin Ophthalmol ; 31(4): 325-36, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27101252

RESUMEN

INTRODUCTION: The etiology, frequency, manifestation, and treatment of dry eye syndrome are commonly influenced by sex and gender. MATERIALS AND METHODS: This study aims to review the differences in epidemiology, pathophysiology, and associated diseases between the sexes. The terms men and male and women and female are used interchangeably throughout the review to refer to biological sex. RESULTS: There are numerous objective and subjective markers of dry eye syndrome but not one diagnostic criterion. There are numerous associated conditions with dry eye syndrome varying from autoimmune to allergic. Large epidemiologic studies reviewed suggest that there does indeed exist a difference between dry eye symptoms between men and women, with women having dry eye signs and reporting dry eye symptoms more often than men. The increased prevalence in women could be correlated to an increased association with certain systemic diseases, specifically autoimmune diseases, and to hormonal variations. Several studies found equivocal data about prevalence of dry eye symptoms between men and women. DISCUSSION: Interpreting studies that investigate epidemiology, pathogenesis, and treatment of dry-eye conditions is complicated by the lack of universally adapted diagnostic criteria and standardized, specific diagnostic tests, and inter-study variability in the definition of dry eye syndrome.


Asunto(s)
Síndromes de Ojo Seco , Disparidades en el Estado de Salud , Síndromes de Ojo Seco/diagnóstico , Síndromes de Ojo Seco/epidemiología , Síndromes de Ojo Seco/fisiopatología , Femenino , Humanos , Masculino , Prevalencia , Factores Sexuales
18.
Nanomedicine ; 11(2): 447-56, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25194998

RESUMEN

Burkholderia mallei are Gram-negative bacteria, responsible for the disease glanders. B. mallei has recently been classified as a Tier 1 agent owing to the fact that this bacterial species can be weaponised for aerosol release, has a high mortality rate and demonstrates multi-drug resistance. Furthermore, there is no licensed vaccine available against this pathogen. Lipopolysaccharide (LPS) has previously been identified as playing an important role in generating host protection against Burkholderia infection. In this study, we present gold nanoparticles (AuNPs) functionalised with a glycoconjugate vaccine against glanders. AuNPs were covalently coupled with one of three different protein carriers (TetHc, Hcp1 and FliC) followed by conjugation to LPS purified from a non-virulent clonal relative, B. thailandensis. Glycoconjugated LPS generated significantly higher antibody titres compared with LPS alone. Further, they improved protection against a lethal inhalation challenge of B. mallei in the murine model of infection. FROM THE CLINICAL EDITOR: Burkholderia mallei is associated with multi-drug resistance, high mortality and potentials for weaponization through aerosol inhalation. The authors of this study present gold nanoparticles (AuNPs) functionalized with a glycoconjugate vaccine against this Gram negative bacterium demonstrating promising results in a murine model even with the aerosolized form of B. Mallei.


Asunto(s)
Vacunas Bacterianas/administración & dosificación , Burkholderia mallei/efectos de los fármacos , Muermo/tratamiento farmacológico , Nanopartículas del Metal/administración & dosificación , Administración por Inhalación , Animales , Vacunas Bacterianas/química , Burkholderia mallei/patogenicidad , Modelos Animales de Enfermedad , Muermo/inmunología , Muermo/microbiología , Glicoconjugados/administración & dosificación , Glicoconjugados/química , Oro/química , Humanos , Lipopolisacáridos/administración & dosificación , Lipopolisacáridos/inmunología , Nanopartículas del Metal/química , Ratones
19.
Vaccine ; 33(5): 686-92, 2015 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-25533326

RESUMEN

The Gram-negative Burkholderia mallei is a zoonotic pathogen and the causative agent of glanders disease. Because the bacteria maintain the potential to be used as a biothreat agent, vaccine strategies are required for human glanders prophylaxis. A rhesus macaque (Macaca mulatta) model of pneumonic (inhalational) glanders was established and the protective properties of a nanoparticle glycoconjugate vaccine composed of Burkholderia thailandensis LPS conjugated to FliC was evaluated. An aerosol challenge dose of ∼1×10(4) CFU B. mallei produced mortality in 50% of naïve animals (n=2/4), 2-3 days post-exposure. Although survival benefit was not observed by vaccination with a glycoconjugate glanders vaccine (p=0.42), serum LPS-specific IgG titers were significantly higher on day 80 in 3 vaccinated animals who survived compared with 3 vaccinated animals who died. Furthermore, B. mallei was isolated from multiple organs of both non-vaccinated survivors, but not from any organs of 3 vaccinated survivors at 30 days post-challenge. Taken together, this is the first time a candidate vaccine has been evaluated in a non-human primate aerosol model of glanders and represents the initial step for consideration in pre-clinical studies.


Asunto(s)
Vacunas Bacterianas/inmunología , Burkholderia mallei/inmunología , Muermo/prevención & control , Oro/administración & dosificación , Nanopartículas/administración & dosificación , Animales , Anticuerpos Antibacterianos/sangre , Antígenos Bacterianos/administración & dosificación , Antígenos Bacterianos/inmunología , Vacunas Bacterianas/administración & dosificación , Modelos Animales de Enfermedad , Glicoconjugados/administración & dosificación , Glicoconjugados/inmunología , Lipopolisacáridos/administración & dosificación , Lipopolisacáridos/inmunología , Macaca mulatta , Análisis de Supervivencia , Vacunas Conjugadas/administración & dosificación , Vacunas Conjugadas/inmunología
20.
Artículo en Inglés | MEDLINE | ID: mdl-23532930

RESUMEN

Vaccination has had a major impact on the control of infectious diseases. However, there are still many infectious diseases for which the development of an effective vaccine has been elusive. In many cases the failure to devise vaccines is a consequence of the inability of vaccine candidates to evoke appropriate immune responses. This is especially true where cellular immunity is required for protective immunity and this problem is compounded by the move toward devising sub-unit vaccines. Over the past decade nanoscale size (<1000 nm) materials such as virus-like particles, liposomes, ISCOMs, polymeric, and non-degradable nanospheres have received attention as potential delivery vehicles for vaccine antigens which can both stabilize vaccine antigens and act as adjuvants. Importantly, some of these nanoparticles (NPs) are able to enter antigen-presenting cells by different pathways, thereby modulating the immune response to the antigen. This may be critical for the induction of protective Th1-type immune responses to intracellular pathogens. Their properties also make them suitable for the delivery of antigens at mucosal surfaces and for intradermal administration. In this review we compare the utilities of different NP systems for the delivery of sub-unit vaccines and evaluate the potential of these delivery systems for the development of new vaccines against a range of pathogens.


Asunto(s)
Portadores de Fármacos/administración & dosificación , Nanopartículas/administración & dosificación , Vacunas de Subunidad/administración & dosificación , Células Presentadoras de Antígenos/inmunología , Portadores de Fármacos/farmacocinética , Inmunidad Celular , Células TH1/inmunología , Vacunas de Subunidad/farmacocinética
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...