ABSTRACT
Eukaryotic cells can initiate several distinct self-destruction mechanisms to display essential roles for the homeostasis maintenance, development, and survival of an organism. Pyroptosis, a key response mode in innate immunity, also referred to as caspase-1-dependent proinflammatory programmed necrotic cell death activated by human caspase-1/4/5, or mouse caspase-1/11, plays indispensable roles in response to cytoplasmic insults and immune defense against infectious diseases. These inflammatory caspases are employed by the host to eliminate pathogen infections such as bacteria, viruses, protozoans, and fungi. Gasdermin D requires to be cleaved and activated by these inflammatory caspases to trigger the pyroptosis process. Physiological rupture of cells results in the release of proinflammatory cytokines, the alarmins IL-1ß and IL-18, symbolizing the inflammatory potential of pyroptosis. Moreover, long noncoding RNAs play direct or indirect roles in the upstream of the pyroptosis trigger pathway. Here, we review in detail recently acquired insights into the central roles of inflammatory caspases, inflammasomes, and pyroptosis, as well as the crosstalk between pyroptosis and long noncoding RNAs in mediating infection immunity and pathogen clearance.
Subject(s)
Caspases/metabolism , Communicable Diseases/immunology , Immunity, Innate , Inflammasomes/metabolism , Pyroptosis/immunology , Signal Transduction/immunology , Alarmins/metabolism , Animals , Communicable Diseases/parasitology , Communicable Diseases/virology , Cytokines/metabolism , Host-Pathogen Interactions/immunology , Humans , Mice , Phosphate-Binding Proteins/metabolism , Pore Forming Cytotoxic Proteins/metabolism , RNA, Long Noncoding/metabolismABSTRACT
This study evaluates through modelling the possible individual and combined effect of three populational parameters of pathogens (reproduction rate; rate of novelty emergence; and propagule size) on the colonization of new host species-putatively the most fundamental process leading to the emergence of new infectious diseases. The results are analysed under the theoretical framework of the Stockholm Paradigm using IBM simulations to better understand the evolutionary dynamics of the pathogen population and the possible role of Ecological Fitting. The simulations suggest that all three parameters positively influence the success of colonization of new hosts by a novel parasite population, but contrary to the prevailing belief, the rate of novelty emergence (e.g. mutations) is the least important factor. Maximization of all parameters results in a synergetic facilitation of the colonization and emulates the expected scenario for pathogenic microorganisms. The simulations also provide theoretical support for the retention of the capacity of fast-evolving lineages to retro-colonize their previous host species/lineage by ecological fitting. Capacity is, thus, much larger than we can anticipate. Hence, the results support the empirical observations that opportunity of encounter (i.e. the breakdown in mechanisms for ecological isolation) is a fundamental determinant to the emergence of new associations-especially Emergent Infectious Diseases-and the dynamics of host exploration, as observed in SARS-CoV-2. Insights on the dynamics of Emergent Infectious Diseases derived from the simulations and from the Stockholm Paradigm are discussed.
Subject(s)
COVID-19 , Communicable Diseases , Accidents , Animals , COVID-19/epidemiology , COVID-19/veterinary , Communicable Diseases/parasitology , Communicable Diseases/veterinary , Host-Parasite Interactions , SARS-CoV-2/geneticsABSTRACT
The Eukaryotic Pathogen, Vector and Host Informatics Resource (VEuPathDB, https://veupathdb.org) represents the 2019 merger of VectorBase with the EuPathDB projects. As a Bioinformatics Resource Center funded by the National Institutes of Health, with additional support from the Welllcome Trust, VEuPathDB supports >500 organisms comprising invertebrate vectors, eukaryotic pathogens (protists and fungi) and relevant free-living or non-pathogenic species or hosts. Designed to empower researchers with access to Omics data and bioinformatic analyses, VEuPathDB projects integrate >1700 pre-analysed datasets (and associated metadata) with advanced search capabilities, visualizations, and analysis tools in a graphic interface. Diverse data types are analysed with standardized workflows including an in-house OrthoMCL algorithm for predicting orthology. Comparisons are easily made across datasets, data types and organisms in this unique data mining platform. A new site-wide search facilitates access for both experienced and novice users. Upgraded infrastructure and workflows support numerous updates to the web interface, tools, searches and strategies, and Galaxy workspace where users can privately analyse their own data. Forthcoming upgrades include cloud-ready application architecture, expanded support for the Galaxy workspace, tools for interrogating host-pathogen interactions, and improved interactions with affiliated databases (ClinEpiDB, MicrobiomeDB) and other scientific resources, and increased interoperability with the Bacterial & Viral BRC.
Subject(s)
Databases, Factual , Disease Vectors/classification , Host-Pathogen Interactions/genetics , Phenotype , User-Computer Interface , Animals , Apicomplexa/classification , Apicomplexa/genetics , Apicomplexa/pathogenicity , Bacteria/classification , Bacteria/genetics , Bacteria/pathogenicity , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/pathology , Communicable Diseases/transmission , Computational Biology/methods , Data Mining/methods , Diplomonadida/classification , Diplomonadida/genetics , Diplomonadida/pathogenicity , Fungi/classification , Fungi/genetics , Fungi/pathogenicity , Humans , Insecta/classification , Insecta/genetics , Insecta/pathogenicity , Internet , Nematoda/classification , Nematoda/genetics , Nematoda/pathogenicity , Phylogeny , Virulence , WorkflowABSTRACT
Quantitative polymerase chain reaction (qPCR) of dried blood spots (DBS) for pathogen detection is a potentially convenient method for infectious disease diagnosis. This study tested 115 DBS samples paired with whole blood specimens of children and adolescent from Burkina Faso, Sudan, and Madagascar by qPCR for a wide range of pathogens, including protozoans, helminths, fungi, bacteria, and viruses. Plasmodium spp. was consistently detected from DBS but yielded a mean cycle threshold (Ct) 5.7 ± 1.6 higher than that from whole blood samples. A DBS qPCR Ct cutoff of 27 yielded 94.1% sensitivity and 95.1% specificity against the whole blood qPCR cutoff of 21 that has been previously suggested for malaria diagnosis. For other pathogens investigated, DBS testing yielded a sensitivity of only 8.5% but a specificity of 98.6% compared with whole blood qPCR. In sum, direct PCR of DBS had reasonable performance for Plasmodium but requires further investigation for the other pathogens assessed in this study.
Subject(s)
Communicable Diseases/diagnosis , Dried Blood Spot Testing/methods , Fever/etiology , Polymerase Chain Reaction/methods , Acute Disease , Adolescent , Burkina Faso , Child , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Fever/microbiology , Fever/parasitology , Humans , Madagascar , SudanABSTRACT
A substantial portion of ancient DNA research has been centred on understanding European populations' origin and evolution. A rchaeological evidence has already shown that the peopling of Europe involved an intricate pattern of demic and/or cultural diffusion since the Upper Palaeolithic, which became more evident during the Neolithic and Bronze Age periods. However, ancient DNA data has been crucial in determining if cultural changes occurred due to the movement of ideas or people. With the advent of next-generation sequencing and population-based paleogenomic research, ancient DNA studies have been directed not only at the study of continental human migrations, but also to the detailed analysis of particular archaeological sites, the processes of domestication, or the spread of disease during prehistoric times. With this vast paleogenomic effort added to a proper archaeological contextualisation of results, a deeper understanding of Europe's peopling is starting to emanate.
Subject(s)
Communicable Diseases/epidemiology , DNA, Ancient/analysis , Domestication , Genome, Human , Human Migration , Archaeology , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/virology , Europe , Genomics , HumansABSTRACT
BACKGROUND: Dirofilariosis is a vector-borne parasitosis caused by filarial nematodes of the genus Dirofilaria. In humans, who represent accidental hosts, dirofilariosis is mostly caused by Dirofilaria repens and Dirofilaria immitis. In Austria, the first reported case occurred in 1978. Since then, several (case) reports have been published. METHODS: A systematic and retrospective review of collected published cases and new, unpublished confirmed cases of human dirofilariosis occurring in Austria was performed. A nematode was extracted from the eyelid of a previously unreported case and subsequently characterized histologically and using molecular biology techniques. RESULTS: Data on a total of 39 cases of human dirofilariosis in Austria occurring between 1978 and 2020 are summarized. Over the past four decades the incidence has markedly increased, in particular after 1998. Of the 39 patients, men and women were equally affected, and the mean age was 47.1 years. The area most frequently affected was the head (38.5% of cases). Confined ocular involvement was observed in 23.1% of cases, and nematodes were isolated from the neck/trunk, extremities and the genito-inguinal area in 25.6, 15.4 and 15.4% of patients, respectively. Microfilariae were detected in two cases. Of the 39 patients, only 73.9% tested positive for anti-filarial antibodies and 56.3% for eosinophilia, despite successful isolation of a nematode; consequently, these measures did not represent reliable markers for dirofilariosis. Most patients had a travel history to countries endemic for Dirofilaria species. One patient who had not traveled abroad represented the only autochthonous case recorded to date. Dirofilaria repens was the predominant species, identified in 89.7% of cases. In the newly reported case of subcutaneous dirofilariosis, a live non-gravid Dirofilaria repens adult female of 12 cm length was isolated from the eyelid of the patient, and a video of the extraction is provided. CONCLUSIONS: The incidence of human dirofilariosis cases has increased strikingly over the last four decades in Austria. More cases can be expected in the foreseeable future due to changes in human behavior and (travel) activities as well as climate changes and the associated alterations in the availability of the natural reservoir, the vectors and the intrinsic characteristics of the parasite.
Subject(s)
Dirofilariasis , Animals , Austria/epidemiology , Communicable Diseases/parasitology , Communicable Diseases/transmission , Dirofilaria immitis/isolation & purification , Dirofilaria repens/isolation & purification , Dirofilariasis/parasitology , Dirofilariasis/transmission , Disease Reservoirs/parasitology , Eyelids/parasitology , Female , Humans , Incidence , Male , Microfilariae/isolation & purification , Retrospective Studies , Vector Borne Diseases/parasitology , Vector Borne Diseases/transmissionABSTRACT
Despite tremendous recent interest, the application of deep learning in microbiology has still not reached its full potential. To tackle the challenges faced by human-operated microscopy, deep-learning-based methods have been proposed for microscopic image analysis of a wide range of microorganisms, including viruses, bacteria, fungi, and parasites. We believe that deep-learning technology-based systems will be on the front line of monitoring and investigation of microorganisms.
Subject(s)
Communicable Diseases/diagnostic imaging , Deep Learning , Image Processing, Computer-Assisted/methods , Microscopy/methods , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/virology , Humans , Microscopy/instrumentationABSTRACT
Despite being nearly 10 months into the COVID-19 (coronavirus disease 2019) pandemic, the definitive animal host for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the causal agent of COVID-19, remains unknown. Unfortunately, similar problems exist for other betacoronaviruses, and no vouchered specimens exist to corroborate host species identification for most of these pathogens. This most basic information is critical to the full understanding and mitigation of emerging zoonotic diseases. To overcome this hurdle, we recommend that host-pathogen researchers adopt vouchering practices and collaborate with natural history collections to permanently archive microbiological samples and host specimens. Vouchered specimens and associated samples provide both repeatability and extension to host-pathogen studies, and using them mobilizes a large workforce (i.e., biodiversity scientists) to assist in pandemic preparedness. We review several well-known examples that successfully integrate host-pathogen research with natural history collections (e.g., yellow fever, hantaviruses, helminths). However, vouchering remains an underutilized practice in such studies. Using an online survey, we assessed vouchering practices used by microbiologists (e.g., bacteriologists, parasitologists, virologists) in host-pathogen research. A much greater number of respondents permanently archive microbiological samples than archive host specimens, and less than half of respondents voucher host specimens from which microbiological samples were lethally collected. To foster collaborations between microbiologists and natural history collections, we provide recommendations for integrating vouchering techniques and archiving of microbiological samples into host-pathogen studies. This integrative approach exemplifies the premise underlying One Health initiatives, providing critical infrastructure for addressing related issues ranging from public health to global climate change and the biodiversity crisis.
Subject(s)
Biomedical Research/standards , Communicable Diseases/pathology , Natural History/standards , Zoonoses/pathology , Animals , Biodiversity , Biomedical Research/trends , COVID-19/pathology , COVID-19/virology , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/virology , Host-Pathogen Interactions , Humans , Museums/standards , SARS-CoV-2/classification , SARS-CoV-2/physiology , Specimen Handling , Zoonoses/microbiology , Zoonoses/parasitology , Zoonoses/virologyABSTRACT
Toxoplasmosis is a zoonosis of reproductive nature that is transmitted to humans mainly by ingestion of undercooked meat or drinking oocyte-contaminated water. The slaughter of small ruminants in clandestine slaughterhouses and the presence of companion animals in these locations may be epidemiologically important for the dissemination of the disease. The objective of the present study was to determine toxoplasmosis prevalence by researching anti- Toxoplasma gondii antibodies in meat sheep herds from farms in Teresina microregion, Piauí, Brazil. A total of 450 blood samples were collected from sheep of both sexes, belonging to 28 herds from the 14 municipalities that comprise the microregion. The samples were analyzed by the enzyme-linked immunosorbent assay (ELISA), and the presence of anti-T. gondii antibodies was observed in 62% (279/450) of the animals in all the municipalities and on at least one farm in each municipality. The high occurrence of positive animals is an indication of reproductive problems in these herds, characterizing a problem for both sheep rearing and public health.
Subject(s)
Humans , Animals , Sheep , Zoonoses , Toxoplasmosis , Communicable Diseases/parasitology , Ruminants , Enzyme-Linked Immunosorbent Assay , Cross-Sectional Studies , Abattoirs , Food Safety , Animals, DomesticABSTRACT
Vaccines save millions of lives from infectious diseases caused by viruses and bacteria. As the world awaits safe and effective COVID-19 vaccines, we celebrate the progresses made and highlight challenges ahead in vaccines and the science behind them.
Subject(s)
Communicable Disease Control , Communicable Diseases/immunology , Vaccines/immunology , Adjuvants, Immunologic/administration & dosage , COVID-19 , COVID-19 Vaccines , Clinical Trials as Topic , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/virology , Coronavirus Infections/etiology , Coronavirus Infections/immunology , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Drug Utilization , Humans , Immunity, Herd , Pandemics/prevention & control , Patient Acceptance of Health Care , Pneumonia, Viral/immunology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/virology , Vaccination , Vaccines/administration & dosage , Viral Vaccines/chemistry , Viral Vaccines/immunologyABSTRACT
Mosquito-transmitted diseases, including malaria and dengue, are a major threat to human health around the globe, affecting millions each year. A diverse array of next-generation tools has been designed to eliminate mosquito populations or to replace them with mosquitoes that are less capable of transmitting key pathogens. Many of these new approaches have been built on recent advances in CRISPR/Cas9-based genome editing. These initiatives have driven the development of pathogen-resistant lines, new genetics-based sexing methods, and new methods of driving desirable genetic traits into mosquito populations. Many other emerging tools involve microorganisms, including two strategies involving Wolbachia that are achieving great success in the field. At the same time, other mosquito-associated bacteria, fungi, and even viruses represent untapped sources of new mosquitocidal or antipathogen compounds. Although there are still hurdles to be overcome, the prospect that such approaches will reduce the impact of these diseases is highly encouraging.
Subject(s)
Biological Control Agents , Communicable Disease Control , Communicable Diseases/parasitology , Communicable Diseases/virology , Culicidae/genetics , Mosquito Control/methods , Animals , Communicable Diseases/transmission , Culicidae/parasitology , Culicidae/physiology , Culicidae/virology , Humans , Infertility , Malaria , Wolbachia/geneticsABSTRACT
In recent years, scientists studying the molecular mechanisms of inflammation have discovered an amazing phenomenon - the inflammasome - a component of the innate immune system that can regulate the functional activity of effector cells during inflammation. At present, it is known that inflammasomes are multimolecular complexes (cytosolic multiprotein oligomers of the innate immune system) that contain many copies of receptors recognizing the molecular structures of cell-damaging factors and pathogenic agents. Inflammasomes are mainly formed in myeloid cells, and their main function is participation in the cleavage of the pro-IL-1ß and pro-IL-18 cytokines into their biologically active forms (IL-1ß, IL-18). Each type of microorganism influences particular inflammasome activation, and long-term exposure of the organism to viruses, bacteria, yeasts or parasites, among others, can induce uncontrolled inflammation and autoinflammatory diseases. Therefore, this review aims to present the most current scientific data on the molecular interplay between inflammasomes and particular microorganisms. Knowledge about the mechanisms responsible for the interaction between the host and certain types of microorganisms could contribute to the individuation of innovative strategies for the treatment of uncontrolled inflammation targeting a specific type of inflammasome activated by a specific type of pathogen.
Subject(s)
Bacteria/immunology , Communicable Diseases/immunology , Immunity, Innate , Inflammasomes/immunology , Inflammation/immunology , Parasites/immunology , Viruses/immunology , Yeasts/immunology , Animals , Bacteria/pathogenicity , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/virology , Cytokines/metabolism , Host-Pathogen Interactions , Humans , Inflammasomes/metabolism , Inflammation/microbiology , Inflammation/parasitology , Inflammation/virology , Inflammation Mediators/metabolism , Parasites/pathogenicity , Signal Transduction , Viruses/pathogenicity , Yeasts/pathogenicityABSTRACT
Global health and food security constantly face the challenge of emerging human and plant diseases caused by bacteria, viruses, fungi, and other pathogens. Disease outbreaks such as SARS, MERS, Swine Flu, Ebola, and COVID-19 (on-going) have caused suffering, death, and economic losses worldwide. To prevent the spread of disease and protect human populations, rapid point-of-care (POC) molecular diagnosis of human and plant diseases play an increasingly crucial role. Nucleic acid-based molecular diagnosis reveals valuable information at the genomic level about the identity of the disease-causing pathogens and their pathogenesis, which help researchers, healthcare professionals, and patients to detect the presence of pathogens, track the spread of disease, and guide treatment more efficiently. A typical nucleic acid-based diagnostic test consists of three major steps: nucleic acid extraction, amplification, and amplicon detection. Among these steps, nucleic acid extraction is the first step of sample preparation, which remains one of the main challenges when converting laboratory molecular assays into POC tests. Sample preparation from human and plant specimens is a time-consuming and multi-step process, which requires well-equipped laboratories and skilled lab personnel. To perform rapid molecular diagnosis in resource-limited settings, simpler and instrument-free nucleic acid extraction techniques are required to improve the speed of field detection with minimal human intervention. This review summarizes the recent advances in POC nucleic acid extraction technologies. In particular, this review focuses on novel devices or methods that have demonstrated applicability and robustness for the isolation of high-quality nucleic acid from complex raw samples, such as human blood, saliva, sputum, nasal swabs, urine, and plant tissues. The integration of these rapid nucleic acid preparation methods with miniaturized assay and sensor technologies would pave the road for the "sample-in-result-out" diagnosis of human and plant diseases, especially in remote or resource-limited settings.
Subject(s)
Communicable Diseases/diagnosis , Lab-On-A-Chip Devices , Nucleic Acids/isolation & purification , Plant Diseases , Point-of-Care Systems , Betacoronavirus/isolation & purification , COVID-19 , Chemical Fractionation/instrumentation , Chemical Fractionation/methods , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Communicable Diseases/virology , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Equipment Design , Humans , Nucleic Acid Amplification Techniques/instrumentation , Nucleic Acid Amplification Techniques/methods , Nucleic Acids/blood , Nucleic Acids/urine , Pandemics , Plant Diseases/microbiology , Plant Diseases/parasitology , Plant Diseases/virology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , SARS-CoV-2ABSTRACT
Antibody phage display is regarded as a critical tool for the development of monoclonal antibodies for infectious diseases. The different classes of antibody libraries are classified based on the source of repertoire used to generate the libraries. Immune antibody libraries are generated from disease infected host or immunization against an infectious agent. Antibodies derived from immune libraries are distinct from those derived from naïve libraries as the host's in vivo immune mechanisms shape the antibody repertoire to yield high affinity antibodies. As the immune system is constantly evolving in accordance to the health state of an individual, immune libraries can offer more than just infection-specific antibodies but also antibodies derived from the memory B-cells much like naïve libraries. The combinatorial nature of the gene cloning process would give rise to a combination of natural and un-natural antibody gene pairings in the immune library. These factors have a profound impact on the coverage of immune antibody libraries to target both disease-specific and non-disease specific antigens. This review looks at the diverse nature of antibody responses for immune library generation and discusses the extended potential of a disease-specified immune library in the context of phage display.
Subject(s)
Antibodies/immunology , Biomedical Research , Biomedical Technology , Communicable Diseases/immunology , Host-Pathogen Interactions/immunology , Animals , Antibodies, Monoclonal/immunology , Biomedical Research/methods , Biomedical Technology/methods , Cell Surface Display Techniques , Communicable Diseases/parasitology , Communicable Diseases/virology , Humans , Immunoglobulin Isotypes/immunology , Peptide Library , Sensitivity and Specificity , Single-Domain Antibodies/immunologySubject(s)
Animals, Domestic/parasitology , Apicomplexa , Coccidiosis/veterinary , Animals , Coccidiosis/diagnosis , Coccidiosis/pathology , Coccidiosis/transmission , Communicable Diseases/parasitology , Communicable Diseases/pathology , Communicable Diseases/transmission , Communicable Diseases/veterinary , Congresses as Topic , Cryptosporidium parvum , Neospora , Sarcocystidae , Theileria parva , Toxoplasma , ZoonosesABSTRACT
Amebiasis caused by Entamoeba histolytica is nowadays a serious public health problem worldwide, especially in developing countries. Annually, up to 100,000 deaths occur across the world. Due to the resistance that pathogenic protozoa exhibit against commercial antiprotozoal drugs, a growing emphasis has been placed on plants used in traditional medicine to discover new antiparasitics. Previously, we reported the in vitro antiamoebic activity of a methanolic extract of Lippia graveolens Kunth (Mexican oregano). In this study, we outline the isolation and structure elucidation of antiamoebic compounds occurring in this plant. The subsequent work-up of this methanol extract by bioguided isolation using several chromatographic techniques yielded the flavonoids pinocembrin (1), sakuranetin (2), cirsimaritin (3), and naringenin (4). Structural elucidation of the isolated compounds was achieved by spectroscopic/spectrometric analyses and comparing literature data. These compounds revealed significant antiprotozoal activity against E. histolytica trophozoites using in vitro tests, showing a 50% inhibitory concentration (IC50) ranging from 28 to 154 µg/mL. Amebicide activity of sakuranetin and cirsimaritin is reported for the first time in this study. These research data may help to corroborate the use of this plant in traditional Mexican medicine for the treatment of dyspepsia.
Subject(s)
Antiprotozoal Agents/chemistry , Antiprotozoal Agents/pharmacology , Entamoeba histolytica/drug effects , Flavonoids/chemistry , Flavonoids/pharmacology , Lippia/chemistry , Communicable Diseases/parasitology , Flavanones/chemistry , Flavanones/pharmacology , Flavones/chemistry , Flavones/pharmacologyABSTRACT
The annual meeting "Signal Transduction-Receptors, Mediators and Genes" of the Signal Transduction Society (STS) is an interdisciplinary conference open to all scientists sharing the common interest in elucidating the signalling pathways underlying the physiological or pathological processes in health and disease of humans, animals, plants, fungi, prokaryotes and protists. The 23rd meeting on signal transduction was held from 4-6 November 2019 in Weimar, Germany, and focused on "Trends in Cancer and Infection". As usual, keynote presentations by invited scientists introduced the respective workshops and were followed by speakers chosen from the submitted abstracts. Ample time had been reserved for discussion of the presented data during the workshops. In this report, we provide a concise summary of the various workshops and further aspects of the scientific program.
Subject(s)
Communicable Diseases/immunology , Neoplasms/immunology , Neoplasms/metabolism , Signal Transduction , Animals , Communicable Diseases/metabolism , Communicable Diseases/microbiology , Communicable Diseases/parasitology , Germany , Humans , Neoplasms/genetics , Signal Transduction/immunologyABSTRACT
TRIAL REGISTRATION: clinicaltrials.gov (NCT02342860).