Reverse vaccinology approach to identify novel and immunogenic targets against Porphyromonas gingivalis: An in silico study.

Porphyromonas gingivalis is a primary causative agent of chronic periodontitis. Moreover, it leads to several systemic diseases, including rheumatoid arthritis, cardiovascular, neurodegenerative, and Alzheimer's diseases. It seems that the development of a vaccine against this bacterium is necessary. Thus, this study decided to identify novel immunogenic targets and developed multiple epitope-based vaccines against P. gingivalis. For this purpose, the pan/core-proteome of this bacterium was studied, and the suitable vaccine targets were selected based on different properties, including exposed localization of proteins, antigenicity, non-allergenicity, non-similarity to host proteome, stability, B-cell epitopes and MHC II binding sites, sequence conservation, molecular docking, and immune simulation. Through the quartile scoring method, 12 proteins with ≥ 20 scores were considered as suitable immunogenic targets. The results of the protein domain and functional class search showed that most of the immunogenic proteins were involved in the transport and metabolism of inorganic ions and lipids. In addition, two unknown function proteins, including WP_004584259.1 and WP_099780539.1 were detected as immunogenic targets. Three constructions carrying multi-epitopes were generated including Naked, LCL, and as chimeric structures. Among them, FliC chimeric protein had the strongest affinity to the human TLR2, 4, and 6, while the LCL platform represented the highest level of immune stimulation response. The obtained results from this study revealed new insights into prophylactic routes against P. gingivalis by introducing novel immunogenic targets. However, further investigations, including site-directed mutation and immunoassay are needed to confirm the pathogenic role and protectivity of these novel proteins.

Molecular detection of Bordetella holmesii in two infants with pertussis-like syndrome: the first report from Iran.

BACKGROUND AND OBJECTIVES: Bordetella holmesii is associated with a pertussis-like respiratory syndrome in healthy individuals and also a rare cause of septicaemia, endocarditis, pneumonia, and septic arthritis, mostly in immunocompromised patients. Culture technique and real-time PCR are 2 methods used to detect Bordetella spp. MATERIALS AND METHODS: In this study, 435 nasopharyngeal specimens of patients with suspected whooping cough were checked for the presence of B. holmesii using 2 methods of culture technique and real-time PCR. RESULTS: In this study, we detected hIS1001 and IS481 of B. holmesii in 2 infants suspected of having pertussis-like syndrome. CONCLUSION: Our observations demonstrate that accurate diagnosis is needed to discriminate between B. holmesii and B. pertussis infections among pertussis cases; otherwise, it could lead to misestimating pertussis rate and vaccine efficacy.

Correlation of arterial blood gas measurements with venous blood gas values in mechanically ventilated patients.

BACKGROUND: Arterial blood gas (ABG) analysis is useful in evaluation of the clinical condition of critically ill patients; however, arterial puncture or insertion of an arterial catheter may cause many complications. The aim of this study was to determine whether venous blood gas (VBG) values can be used as an alternative to arterial blood gas measurements in patients under mechanical ventilation. MATERIALS AND METHODS: This study was carried out on patients admitted to the Intensive Care Unit of Kashan Beheshti Hospital. Blood for VBG analysis was obtained from the cubital vein, while for ABG analysis blood was taken simultaneously from the radial artery. ABG and VBG samples were obtained simultaneously, and indexes of pH, PCO2, HCO3, base excess (BE), PO2 and O2 saturation level were analyzed. RESULTS: A total of 102 pair of simultaneous venous and arterial blood samples were obtained from 102 patients (mean age 58.4±21.5 years). Seventy (69%) were males. The mean difference between arterial and venous values was 0.04 for pH, 5.6 mm/Hg for PCO2, -0.32 mmol/l for HCO3, -1.03 mmol/l for BE, 53.6 mm/Hg for PO2, and 23.5% for O2 saturation. The Pearson correlation coefficients between arterial and venous values for pH, PCO2, HCO3, BE, PO2 and O2 saturation were 0.874, 0.835, 0.768, 0.810, 0.287, and 0.310, respectively. Linear regression equations for the estimation of pH, PCO2, HCO3, BE, PO2 and O2 saturation were as follows: arterial pH=1.927+0.745×venous pH [r=0.801, p<0.001]; PCO2=6.470+0.706×venous PCO2 [r=0.835, p<0.001]; arterial HCO3=7.455+0.681×venous HCO3 [r=0.768, p<0.001]; arterial BE=-0.952+0.736×venous BE [r=0.810, p<0.001]; arterial PO2=70.374+0.620×venous PO2 [r=0.287, p=0.003]; arterial venous saturation= 89.753+0.082×venous O2 saturation [r=0.317, p=0.001]. CONCLUSION: Venous blood gases, especially pH, Base excess, and PCO2 levels have relatively good correlation with ABG values. Because this correlation is not close, VBG cannot substitute ABG in mechanically ventilated patients.

Prognostic value of B-type natriuretic peptide for assessment of left ventricular function in patients with chronic kidney disease.

INTRODUCTION: Since the level of B-type natriuretic peptide (BNP) increases in heart failure, elevated plasma BNP concentration is used as a predictor in the diagnosis and management of heart failure. Due to the diminished renal clearance of BNP, its level is above normal in kidney failure. This study evaluated the BNP prognostic value for assessing ventricular function in patients with chronic kidney disease. MATERIALS AND METHODS: All the participants were diagnosed with chronic kidney disease. Echocardiography was employed to assess ejection fraction. Body mass index, serum creatinine, and BNP were measured for all the patients. Prognostic value of BNP was assessed for ventricular function measured by ejection fraction. RESULTS: Forty-four patients, including 34 men and 10 women, participated in the study. Level of BNP had a significant correlation with body mass index, ejection fraction, age, and gender. The sensitivity and specificity of BNP levels of 150 pg/mL and 705 pg/mL were 93.3% and 28.6% and 50.0% and 85.7%, respectively, for the diagnosis of ventricular dysfunction in the patients with chronic kidney disease. CONCLUSIONS: These findings suggest that a level of BNP of 705 pg/mL is a rather acceptable predictive factor for heart failure in patients with chronic kidney disease. The participants' height and weight, which were associated with BNP as body mass index, contributed to this level.

Comparison of oral folic acid and folinic acid on blood homocysteine level of patients on hemodialysis.

INTRODUCTION. Hyperhomocysteinemia is common in patients with chronic kidney disease. There is a direct relationship between cardiovascular mortality and increase of blood homocysteine. Folic acid is used as common treatment in such patients. Folinic acid, a shortened form of folic acid, is not affected by inhibitors of dihydrofolate reductase enzyme such as methoterxate. This study was performed to evaluate the effect of oral folinic acid on the blood homocysteine level of hemodialysis patients, in comparison with folic acid. MATERIALS AND METHODS. This clinical trial was performed on 60 hemodialysis patients. The participants were divided into 2 groups to receive either 15 mg of oral folic acid or 15 mg of oral folinic acid, daily. Blood homocysteine levels were measured before dialysis and after the study period. RESULTS. Folic acid and folinic acid decreased the blood homocysteine levels by 33.0% and 28.7%, respectively (P < .001). However, only 3 patients (6.5%) enjoyed a normalized homocysteine level. CONCLUSIONS. Our study showed that both folic and folinic acid decreased the blood homocysteine level and no meaningful difference was observed between them; therefore, we suggest they can be used interchangeably.