Application of immunomodulatory therapy in a human brucellosis patient with pancytopenia: A case report.

Brucellosis is a common zoonotic infectious disease with diverse and non-specific clinical manifestations caused by Brucella. Although Brucella can cause damage to multiple systems in the human body, hematological complications are relatively rare. We present a case of a 47-year-old male brucellosis patient with pancytopenia. In May 2018, the patient was diagnosed with brucellosis and recovered after receiving antibiotic treatment (rifampicin 600 mg/day and doxycycline 200 mg/day) for six weeks. However, after three years, the patient experienced a recurring high fever. Brucellosis relapse was confirmed based on the patient's clinical history, Rose Bengal plate agglutination test and standard tube agglutination test results. Routine blood examination revealed a decrease in the whole blood cell count, suggesting bone marrow suppression. Bone marrow aspiration and bacterial culture confirmed the diagnosis of brucellosis with pancytopenia. Antibiotic treatment failed to effectively improve the patient's condition. Therefore, a combination of immunomodulatory and antibiotic treatments was used. The antibiotic regimen included oral rifampicin 600 mg/day, intravenous doxycycline hydrochloride 200 mg/day, and subcutaneous injection of human granulocyte-stimulating factor (0.2 mg/day). Immunomodulatory therapy consisted of 20,000 mg/day intravenous human immunoglobulin (pH 4) for five days and 800 mg/day oral pidotimod liquid for 20 days. As the treatment progressed, the count gradually recovered to normal levels, and the symptoms of bone marrow suppression were alleviated. PCR testing revealed the absence of Brucella DNA in both monocyte and serum samples. Furthermore, negative standard tube agglutination test results were obtained. These findings indicate that the immunomodulatory therapy resulted in a complete clearance of Brucella. Therefore, immunomodulatory therapy could be an effective option in cases of brucellosis with pancytopenia that are unresponsive to conventional antibiotic treatment. Further research and clinical evidence are required to confirm and optimize the use of immunomodulatory therapies in patients with brucellosis.

Integrated transcriptomic and quantitative proteomic analysis identifies potential RNA sensors that respond to the Ag85A DNA vaccine.

OBJECTIVE: DNA vaccine has emerged as a promising approach with potential for Tuberculosis (TB) prevention in adults. However, the mechanism behind DNA vaccines is still largely unknown. MATERIALS AND METHODS: Utilizing the CRISPR/Cas9 technique, we engineered Ag85A mutated dendritic cells (Ag85A-M-DCs) in which the Ag85A mRNA derived from Mycobacterium tuberculosis was expressed but not the corresponding protein. Control cells (Ag85A-DCs) expressed both Ag85A mRNA and protein. To better understand the mechanism of antigen presentation following DNA vaccination, integrated transcriptomic and proteomic analysis of dendritic cells (DCs), Ag85A-DCs, and Ag85A-M-DCs were performed. RESULTS: A total of 723, 278, and 933 differentially expressed genes (DEGs), and 209, 134, and 509 differentially expressed proteins (DEPs) were identified between Ag85A-M-DCs and DCs, Ag85A-DCs and DCs, and Ag85A-M-DCs and Ag85A-DCs, respectively. Integration analysis detected 59, 15, and 64 associated DEGs/DEPs with the same expression trend between Ag85A-M-DCs and DCs, Ag85A-DCs and DCs, and Ag85A-M-DCs and Ag85A-DCs, respectively. KEGG pathway analysis showed that chemokine signaling pathway and MAPK signaling pathway were enriched in all three pairs of comparisons. The protein and protein interaction network revealed that ANXA1 was in the top 10 high-degree hub genes closely related to other genes in all three pairs of comparisons. CONCLUSION: The results indicated that Ag85A DNA vaccine might transmit immunogenicity information and induce immune responses by activating chemokine signaling pathway and MAPK signaling pathway. ANXA1 may serve as a key target molecule of the Ag85A vaccine with additional potential for TB prevention.

Dendritic cell vaccine with Ag85A enhances anti-colorectal carcinoma immunity.

Dendritic cells (DCs) are able to trigger T-cell activation and thus have been considered important for vaccine production against cancers. Vaccines containing DCs have been reported to be effective for developing immunity against cancer cells. The interactions between DCs and auxiliary agents are critical in the development of second-generation vaccines. In the present study, it was evaluated whether Ag85A-mixed DCs could enhance anti-tumor immunity in laboratory mice with colorectal carcinoma. Functional and phenotypic analyses of the effects of Ag85A-mixed DCs were conducted via flow cytometry and measurement of T-cell proliferation. In addition, interferon (IFN)-γ production was assessed. The therapeutic efficacy of DC vaccination for colorectal carcinoma treatment in mice was investigated. It was identified that Ag85A-mixed DCs exhibited strong upregulation of CD80, CD86 and major histocompatibility complex class II. Cytotoxic T-lymphocytes with CT26-primed Ag85A-DCs were indicated to induce stronger responses against CT26 tumor cells and trigger IFN-γ production. Furthermore, the Ag85A-mixed DC vaccine exerted a considerable inhibitory effect on tumor progression in mice as compared with the control group. Therefore, DCs in combination with the Ag85A gene may reinforce anti-colorectal carcinoma immunity. The current study provides a novel potential strategy for cancer treatment by enhancing immunity via Ag85A-mixed DC vaccination.