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1.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(2): 23-28, jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193750

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Garantizar la seguridad y salud de los estudiantes de enfermería que realizan prácticas en el hospital ofreciéndoles vacunación hasta alcanzar el nivel inmunológico de protección necesario. METODOLOGÍA: Revisión y recogida de datos de las historias clínico-laborales de 182 estudiantes de la Escuela de Enfermería de Sacyl en Zamora (2016-2019). RESULTADOS: Todos acreditan estar vacunados según calendario oficial. Tras primera serología, el 31,6% no presenta inmunidad frente a la triple vírica, el 2,15% frente a la varicela y el 86,9% frente a la vacuna de la hepatitis B. El 7,1% resultó no respondedor frente a la vacuna de la hepatitis B tras segunda pauta vacunal completa. CONCLUSIONES: La realización de la serología en el cribado prevacunación permite revacunar a aquellos que no presentan inmunización así como detectar aquellos casos no respondedores que tendrán un manejo adecuado si ocurre un accidente con exposición a una fuente de alto riesgo


INTRODUCTION AND OBJETIVES: Ensure the safety and health of nursing students who practice in the hospital by providing them with vaccinations up to the necessary immune protection level. METHODOLOGY: Review and data collection from the clinical- workplace histories of 182 students of the Sacyl School of Nursing in Zamora (2016-2019). RESULTS: All of them certify to be vaccinated according to official calendar. After the first serology, 31.6% did not have immunity against the triple virus, 2.15% against chickenpox and 86.9% against the hepatitis B vaccine. 7.1% were not responding to the hepatitis B vaccine after the second complete vaccination. CONCLUSION: The realization of serology in the screening allows to revaccinate those who don't present immunization, as well as detect those non-responders who will have adequate management if an accident with exposure to a high-risk source occurs


Assuntos
Humanos , Estudantes de Enfermagem/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Vacinas contra Hepatite B/sangue , Varicela/sangue , Varicela/imunologia , Vacinas contra Hepatite B/imunologia , Saúde do Trabalhador/estatística & dados numéricos , Espanha
2.
Tohoku J Exp Med ; 250(3): 181-190, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32213753

RESUMO

Varicella zoster virus (VZV) causes a life-threatening infection in immunocompromised hosts. The immune response to VZV of healthy subjects has been rigorously assessed, but little is known about that of immunocompromised individuals. This study aimed to clarify the primary response to VZV infection in immunocompromised children. This prospective study enrolled six immunocompromised children (median age, 33 months; range, 20-62) receiving steroids or immunosuppressants, and 10 immunocompetent children (median age, 32 months; range, 15-81) with varicella. The immunocompromised children were three patients with acute lymphoblastic leukemia, two recipients with liver transplantation and one patient with juvenile idiopathic arthritis. Interferon-γ-producing CD69+T-cells produced by VZV stimulation (VZV-specific T-cells) were studied during the acute or convalescent phase. To further address the direct effect of immunosuppressants, we analyzed the number of VZV-specific T-cells after stimulating peripheral blood mononuclear cells obtained from healthy adults with live-attenuated VZV with or without prednisolone, cyclosporine-A, or tacrolimus. The circulating numbers of lymphocytes in the convalescent stage but not acute stage were lower in immunocompromised children compared with immunocompetent children. In the acute stage, immunocompromised patients showed lower VZV-specific CD8+T-cell counts than immunocompetent subjects. In contrast, in the convalescent phase, immunocompromised patients had lower VZV-specific CD4+T-cell counts than immunocompetent hosts. The in vitro culture of activated lymphocytes with prednisolone or immunosuppressants significantly decreased the proportion of VZV-specific CD4+T-cells. In conclusion, the decreased numbers of VZV-specific CD8+T-cells during the acute phase and VZV-specific CD4+T-cells during the convalescent phase of disease may account for severe varicella in immunocompromised children.


Assuntos
Varicela/imunologia , Varicela/virologia , Herpesvirus Humano 3/imunologia , Linfócitos T/imunologia , Antígenos CD/metabolismo , Antígenos de Diferenciação de Linfócitos T/metabolismo , Varicela/tratamento farmacológico , Criança , Pré-Escolar , Convalescença , Humanos , Imunocompetência , Imunossupressores/uso terapêutico , Lactente , Interferon gama/metabolismo , Lectinas Tipo C/metabolismo , Ativação Linfocitária/imunologia , Contagem de Linfócitos , Especificidade da Espécie , Doadores de Tecidos
3.
BMJ ; 368: l6987, 2020 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-31969318

RESUMO

OBJECTIVE: To assess the magnitude and duration of any hypothesised protective effect of household exposure to a child with varicella on the relative incidence of herpes zoster in adults. DESIGN: Self controlled case series. SETTING: UK general practices contributing to Clinical Practice Research Datalink. PARTICIPANTS: 9604 adults (≥18 years) with a diagnosis of herpes zoster (in primary care or hospital records) between 1997 and 2018, who during their observation period lived with a child (<18 years) with a diagnosis of varicella. MAIN OUTCOME MEASURES: Relative incidence of herpes zoster in the 20 years after exposure to a child with varicella in the household compared with baseline time (all other time, excluding the 60 days before exposure). RESULTS: 6584 of the 9604 adults with herpes zoster (68.6%) were women. Median age of exposure to a child with varicella was 38.3 years (interquartile range 32.3-48.8 years) and median observation period was 14.7 (11.1-17.7) years. 4116 adults developed zoster in the baseline period, 433 in the 60 days before exposure and 5055 in the risk period. After adjustment for age, calendar time, and season, strong evidence suggested that in the two years after household exposure to a child with varicella, adults were 33% less likely to develop zoster (incidence ratio 0.67, 95% confidence interval 0.62 to 0.73) compared with baseline time. In the 10-20 years after exposure, adults were 27% less likely to develop herpes zoster (0.73, 0.62 to 0.87) compared with baseline time. A stronger boosting effect was observed among men than among women after exposure to varicella. CONCLUSIONS: The relative incidence of zoster was lower in the periods after exposure to a household contact with varicella, with modest but long lasting protective effects observed. This study suggests that exogenous boosting provides some protection from the risk of herpes zoster, but not complete immunity, as assumed by previous cost effectiveness estimates of varicella immunisation.


Assuntos
Varicela/imunologia , Herpes Zoster/epidemiologia , Herpesvirus Humano 3/imunologia , Adulto , Estudos de Casos e Controles , Varicela/virologia , Pré-Escolar , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Seguimentos , Herpes Zoster/imunologia , Herpes Zoster/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Medição de Risco , Reino Unido/epidemiologia
4.
Transpl Infect Dis ; 22(1): e13202, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31647159

RESUMO

BACKGROUND: Solid organ transplant (SOT) recipients are a special group of patients who require comprehensive evaluation for preventable infectious diseases before transplantation. The main aim of our study was to investigate the number of heart, lung, and liver (HLL) transplant recipients who were evaluated for their immune status against measles, mumps, rubella (MMR), and varicella (VZV). As a secondary aim, we investigated whether pre-transplant infectious disease consultation (IDC) improves vaccination rates. METHODS: This study was an institution-based retrospective analysis of HLL transplant recipients born in or after 1957 and evaluated at Mayo Clinic, FL Transplant Center between January 1st, 2016 and December 31st, 2017. Data collection was obtained from electronic medical records. The vaccination rates were compared by univariate analysis based on IDC and no ID consultation (NIDC). RESULTS: One hundred and eighty-seven (77%) of a total 242 patients received an IDC pre-transplantation. Varicella IgG levels were screened in all 187 IDC candidates. Among the 187 IDC patients, mumps, measles, and rubella IgG serologies were performed in 9 (5%), 21 (11%), and 51 (27%), respectively. Among all 242 patients, vaccines given included 2 (0.8%) MMR, 10 (4.1%) varicella and 85 (35.12%) Zostavax. Univariate analysis revealed that Zostavax was given to 76 (40.6%) pre-transplant IDC patients and only in 9 (16.7%) NIDC patients (P < .001). CONCLUSIONS: Despite the relatively high IDC rate, patients' screened numbers for MMR IgG levels were low. Results pointed out the need for MMR protocol-driven serologic screening as well as for VZV and IDC prior to transplantation to increase vaccination rates.


Assuntos
Anticorpos Antivirais/sangue , Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/etiologia , Transplante de Órgãos , Encaminhamento e Consulta , Testes Sorológicos , Adulto , Varicela/etiologia , Varicela/imunologia , Varicela/prevenção & controle , Doenças Transmissíveis/imunologia , Humanos , Sarampo/etiologia , Sarampo/imunologia , Sarampo/prevenção & controle , Caxumba/etiologia , Caxumba/imunologia , Caxumba/prevenção & controle , Estudos Retrospectivos , Rubéola (Sarampo Alemão)/etiologia , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacinação
5.
Indian J Med Microbiol ; 37(1): 24-28, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31424006

RESUMO

Introduction: Varicella outbreaks are known to occur in developing nations as vaccine coverage is still low. Material and Methods: In the present study, an institutional outbreak from Chandigarh, India, is reported wherein the utility of non-invasive samples such as saliva and urine was studied for the molecular diagnosis of varicella by conventional polymerase chain reaction (PCR), real-time PCR and real-time loop-mediated isothermal amplification (real-time LAMP). Results: The results of the present study showed that saliva and urine samples can be used for outbreak investigation of varicella compared to varicella-zoster virus DNA in vesicular swab samples with reasonable sensitivity. Conclusion: Thus, molecular techniques may be useful in the early identification of the outbreak and timely isolation, and the treatment of cases can further prevent its spread.


Assuntos
Varicela/diagnóstico , Varicela/epidemiologia , Técnicas de Diagnóstico Molecular/métodos , Saliva/virologia , Urina/virologia , Adolescente , Anticorpos Antivirais/sangue , Varicela/imunologia , Criança , Bem-Estar da Criança , DNA Viral/análise , Surtos de Doenças/estatística & dados numéricos , Feminino , Instalações de Saúde , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/imunologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Índia/epidemiologia , Masculino , Técnicas de Amplificação de Ácido Nucleico/métodos , Reação em Cadeia da Polimerase
6.
PLoS One ; 14(8): e0221084, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31408478

RESUMO

INTRODUCTION: Infection with varicella zoster virus (VZV) in pregnancy may lead to serious outcomes both for the mother and the newborn. Targeted screening and vaccination of non-immune women during reproductive age could prevent varicella infection in pregnancy. Currently, no universal varicella screening of pregnant women is implemented in Norway, but serological testing in pregnancy is recommended in particular situations. We examined seroprevalence of VZV in a national pregnancy cohort in order to help assess a need for VZV screening of women during reproductive age. METHODS: We determined the susceptibility to VZV and the reliability of self-reported history of VZV infection in the Norwegian obstetric population by using a random sample of 1,184 pregnant women from the Norwegian Mother and Child Cohort study (MoBa). The MoBa study included approximately 95,200 pregnant women in Norway between 1998 and 2009. Blood samples taken at gestational week 17-18 were analysed using a commercial enzyme immunoassay for specific IgG antibodies to Varicella-Zoster virus. Second sample taken at birth was tested if the first sample result was negative or equivocal. RESULTS: Of the 1,184 pregnant women, 98.6% (n = 1,167) were seropositive, 0.83% (n = 10) remained seronegative, and four women (0.34%) seroconverted during their pregnancy. No significant associations were found between serological status and women's age at birth, gestational age, women's country of birth and year of child's birth. One woman reported prior history of varicella, whereas 143 (12.1%) women reported a household exposure to childhood diseases with fever and rash, of which 25 reported exposure to varicella, of which all were seropositive. CONCLUSIONS: The findings support antenatal screening recommendations in Norway advising testing for VZV in pregnant women with unknown immunity to VZV. Further studies are however needed to better identify target groups for screening and vaccination.


Assuntos
Anticorpos Antivirais/imunologia , Varicela/imunologia , Herpesvirus Humano 3/imunologia , Imunoglobulina G/imunologia , Complicações Infecciosas na Gravidez/imunologia , Sistema de Registros , Adulto , Varicela/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Noruega/epidemiologia , Gravidez , Estudos Soroepidemiológicos , Adulto Jovem
7.
PLoS One ; 14(7): e0217749, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31269033

RESUMO

INTRODUCTION: Despite vaccination, there were more than 100,000 annual cases of varicella in the United States in 2013-2014. Individuals at highest risk of developing severe or complicated varicella include immunocompromised people, preterm infants, and pregnant women. Varicella zoster immune globulin (human) (VARIZIG) is recommended by the CDC for postexposure prophylaxis to prevent or attenuate varicella-zoster virus infection in high-risk individuals. Contemporary information on administration of VARIZIG is limited. METHODS: This open-label, expanded-access program provided VARIZIG to physician-identified, high-risk participants exposed to varicella. Participants included immunocompromised children/adults, infants (preterm, newborns whose mothers had varicella onset within 5 days before or 2 days after delivery, and those aged <1 year), and pregnant women. VARIZIG (125 IU/10 kg [up to 625 IU]) was administered intramuscularly, ideally within 96 hours, but up to 10 days, postexposure. Incidence of varicella rash and severity (>100 pox, pneumonia, or encephalitis) were assessed up to 42 days after administration. RESULTS: The varicella outcome population (n = 507) included 263 immunocompromised participants (32 adults, 231 children), 137 pregnant women, 105 infants, and 2 healthy adults with no history of varicella. Varicella incidence was 4.5% in immunocompromised participants, 7.3% in pregnant women, and 11.5% in infants. The incidence of varicella was similar when comparing VARIZIG administration ≤ 96 hours vs > 96 hours (up to 10 days) postexposure in the entire population (6.2% vs. 9.4%, respectively), and also in each subgroup. Of 34 participants with varicella, 5 developed > 100 pox and 1 developed pneumonia and encephalitis. There were no product-related deaths and only 1 serious adverse event (serum sickness) considered probably related to VARIZIG. CONCLUSION: Postexposure administration of VARIZIG was associated with low rates of varicella in high-risk participants, regardless of when administered within 10 days postexposure. VARIZIG was well-tolerated and safe in high-risk participants.


Assuntos
Varicela/imunologia , Varicela/prevenção & controle , Soros Imunes/administração & dosagem , Hospedeiro Imunocomprometido , Recém-Nascido Prematuro , Feminino , Humanos , Soros Imunes/efeitos adversos , Lactente , Recém-Nascido , Masculino , Gravidez
8.
BMC Infect Dis ; 19(1): 356, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035950

RESUMO

BACKGROUND: Varicella during pregnancy can lead to serious maternal and fetal consequences. Although an effective vaccine is available it is not incorporated in to the routine vaccination programs in most of the Asian countries. Objectives of the study were to determine the susceptibility to varicella and factors associated with immunity, among a group of pregnant women attending to a tertiary care hospital in Sri Lanka. METHODS: A hospital based descriptive cross sectional study was carried out at De Soyza maternity Hospital, Colombo. A sample of 385 pregnant women was selected. Data were collected through an interviewer administered questionnaire; presence of varicella IgG in blood was assessed by a validated commercial ELISA (Enzyme Linked Immunosorbant Assay. RESULTS: The sample had a mean age of 28.5 years and majority was educated beyond General Certificate of Education (GCE) Ordinary Level. We found that 34% of study population was susceptible for the infection. A past history of varicella had a 89.5% positive predictive value and 53.1% negative predictive value for varicella immunity. Varicella sero-positivity was only associated with a lower educational level and number of childhood household members more than four. There was no association of sero-positivity with age. CONCLUSION: This study demonstrates that a significant proportion of pregnant women of the study population are varicella-susceptible. Pre-pregnancy screening and preventive strategies including vaccination should be evaluated. History of past varicella infection could be a useful screening tool to exclude patients for vaccination.


Assuntos
Varicela/diagnóstico , Herpesvirus Humano 3/imunologia , Adolescente , Adulto , Varicela/epidemiologia , Varicela/imunologia , Varicela/virologia , Estudos Transversais , Suscetibilidade a Doenças , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Gestantes , Cuidado Pré-Natal , Prevalência , Sri Lanka/epidemiologia , Centros de Atenção Terciária , Adulto Jovem
9.
Sci Immunol ; 4(35)2019 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-31076527

RESUMO

Adaptive immune responses are defined as antigen sensitization-dependent and antigen-specific responses leading to establishment of long-lived immunological memory. Although natural killer (NK) cells have traditionally been considered cells of the innate immune system, mounting evidence in mice and nonhuman primates warrants reconsideration of the existing paradigm that B and T cells are the sole mediators of adaptive immunity. However, it is currently unknown whether human NK cells can exhibit adaptive immune responses. We therefore tested whether human NK cells mediate adaptive immunity to virally encoded antigens using humanized mice and human volunteers. We found that human NK cells displayed vaccination-dependent, antigen-specific recall responses in vitro, when isolated from livers of humanized mice previously vaccinated with HIV-encoded envelope protein. Furthermore, we discovered that large numbers of cytotoxic NK cells with a tissue-resident phenotype were recruited to sites of varicella-zoster virus (VZV) skin test antigen challenge in VZV-experienced human volunteers. These NK-mediated recall responses in humans occurred decades after initial VZV exposure, demonstrating that NK memory in humans is long-lived. Our data demonstrate that human NK cells exhibit adaptive immune responses upon vaccination or infection. The existence of human memory NK cells may allow for the development of vaccination-based approaches capable of establishing potent NK-mediated memory functions contributing to host protection.


Assuntos
Imunidade Adaptativa/imunologia , Antígenos Virais/imunologia , Memória Imunológica/imunologia , Células Matadoras Naturais/imunologia , Adulto , Idoso , Animais , Varicela/imunologia , Varicela/virologia , Feminino , Antígenos HIV/imunologia , Herpesvirus Humano 3/imunologia , Humanos , Fígado/citologia , Fígado/imunologia , Camundongos , Pessoa de Meia-Idade , Fenótipo , Pele/citologia , Pele/imunologia , Baço/citologia , Baço/imunologia , Vacinação , Proteínas do Envelope Viral/imunologia , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-30686830

RESUMO

Background: Chickenpox infection acquired during pregnancy is a serious condition. There may be congenital malformations and neonatal varicella syndrome with significant morbidity and mortality. Egypt has no routine varicella-zoster vaccination program. Objective: To assess the immune status against varicella-zoster virus (VZV) antibodies among a group of pregnant women and to study the relationship between VZV seroprevalence and some sociodemographic characteristics. Subjects and methods: A descriptive cross-sectional study was conducted on a group of pregnant women (n = 333) attending antenatal care (ANC) clinic at Fayoum University Hospital. Serologic testing for VZV was performed using ELISA through the years 2016-2017. Results: VZV seroprevalence was detected in 294 (88.3%) of the 333 recruited pregnant women. Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17-0.70)), also having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17-0.70)). Conclusions: Despite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries. We recommend targeted vaccination for women in the reproductive age especially young and primipara. Trial registration: Ethical Committee Registration number R67 session 42: date 12/11/2017(retrospectively registered).


Assuntos
Anticorpos Antivirais/sangue , Varicela/epidemiologia , Varicela/imunologia , Herpesvirus Humano 3/imunologia , Herpesvirus Humano 3/isolamento & purificação , Gestantes , Cuidado Pré-Natal/métodos , Adulto , Fatores Etários , Estudos Transversais , Egito/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
12.
J Infect Dis ; 219(3): 391-399, 2019 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-30184182

RESUMO

Background: This national, sentinel prospective study aimed to identify children with severe hospitalized varicella, despite availability of universal 1-dose vaccination since 2005, and determine associations between virus genotypes and disease severity. Methods: Children with varicella or zoster from 5 Paediatric Active Enhanced Disease Surveillance hospitals were enrolled. Lesions were swabbed for genotyping. Associations with disease severity were analyzed using multiple regression. Results: From 2007 to 2015, 327 children with confirmed varicella (n = 238) or zoster (n = 89) were enrolled. Two hundred three (62%) were immunocompetent children; including 5 of 8 children who required intensive care unit management. Eighteen percent (36 of 203) of immunocompetent children had been previously vaccinated. Vaccinated children aged >18 months were less likely to have severe disease (9%; 5 of 56) than unvaccinated children (21%; 21 of 100; P = .05). Three of 126 children who had virus genotyping (2 immunocompromised) had varicella (n = 2) or zoster (n = 2) due to the Oka/vaccine strain. European origin clades predominated and were independently associated with more severe disease (odds ratio = 3.2; 95% confidence interval, 1.1- 9.5; P = .04). Conclusions: Severe hospitalized varicella still occurs with a 1-dose varicella program, although predominantly in unvaccinated children. Most 1-dose vaccine recipients were protected against severe disease. Viral genotyping in complex hospitalized cases is important to assist in monitoring disease due to Oka-vaccine strain.


Assuntos
Vacina contra Varicela/administração & dosagem , Varicela/imunologia , Varicela/prevenção & controle , Genótipo , Herpesvirus Humano 3/genética , Programas de Imunização , Índice de Gravidade de Doença , Austrália/epidemiologia , Varicela/epidemiologia , Varicela/virologia , Vacina contra Varicela/imunologia , Criança , Criança Hospitalizada , Pré-Escolar , Feminino , Herpes Zoster/epidemiologia , Herpes Zoster/imunologia , Herpes Zoster/prevenção & controle , Humanos , Hospedeiro Imunocomprometido , Lactente , Masculino , Estudos Prospectivos , Vacinação
13.
Expert Rev Vaccines ; 17(11): 1021-1035, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30354696

RESUMO

INTRODUCTION: The exogenous boosting (EB) hypothesis posits that cell-mediated immunity is boosted for individuals reexposed to varicella-zoster virus (VZV). Historically, mathematical models of the impact of universal childhood varicella vaccination (UVV) have used limited data to capture EB and often conclude that UVV will temporarily increase herpes zoster (HZ) incidence. AREAS COVERED: We updated a 2013 systematic literature review of 40 studies to summarize new evidence from observational or modeling studies related to EB and its parameterization. We abstracted data on observational study designs and mathematical model structures, EB frameworks, and HZ-related parameter values. EXPERT COMMENTARY: This review identified an additional 41 studies: 22 observational and 19 modeling studies. Observational analyses generally reported pre-UVV increases in HZ incidence, making it difficult to attribute post-UVV increases to UVV versus other causes. Modeling studies considered a range of EB frameworks, from no boosting to full permanent immunity. Mathematical modeling efforts are needed in countries with long-standing vaccination programs to capture the dynamics of VZV transmission and temporal changes that may affect HZ incidence. Use of real-world pre-/postvaccination data on varicella and HZ incidence to validate model predictions may improve approaches to EB parameterization and understanding of the effects of varicella vaccination programs.


Assuntos
Vacina contra Varicela/administração & dosagem , Varicela/prevenção & controle , Herpesvirus Humano 3/imunologia , Varicela/imunologia , Vacina contra Varicela/imunologia , Herpes Zoster/epidemiologia , Herpes Zoster/imunologia , Humanos , Imunidade Celular/imunologia , Programas de Imunização/organização & administração , Modelos Teóricos , Vacinação/métodos
15.
Trends Mol Med ; 24(10): 904-915, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30115567

RESUMO

In most individuals, varicella zoster virus (VZV) causes varicella upon primary infection and zoster during reactivation. However, in a subset of individuals, VZV may cause severe disease, including encephalitis. Host genetics is believed to be the main determinant of exacerbated disease manifestations. Recent studies have demonstrated that defects in the DNA sensor RNA polymerase III (POL III) confer selective increased susceptibility to VZV infection, thus providing fundamental new insight into VZV immunity. Here we describe the roles of POL III in housekeeping and immune surveillance during VZV infection. We present the latest knowledge on the role of POL III in VZV infection and discuss outstanding questions related to the role of POL III in VZV immunity, and how this insight can be translated into clinical medicine.


Assuntos
Varicela/genética , Encefalite por Varicela Zoster/genética , Herpes Zoster/genética , Interações Hospedeiro-Patógeno , RNA Polimerase III/genética , Ativação Viral , Adulto , Varicela/imunologia , Varicela/patologia , Varicela/virologia , Proteína DEAD-box 58/genética , Proteína DEAD-box 58/imunologia , DNA Viral/genética , DNA Viral/imunologia , Encefalite por Varicela Zoster/imunologia , Encefalite por Varicela Zoster/patologia , Encefalite por Varicela Zoster/virologia , Regulação da Expressão Gênica , Predisposição Genética para Doença , Herpes Zoster/imunologia , Herpes Zoster/patologia , Herpes Zoster/virologia , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/imunologia , Humanos , Imunidade Inata , Vigilância Imunológica , Interferons/genética , Interferons/imunologia , Subunidades Proteicas/genética , Subunidades Proteicas/imunologia , RNA Polimerase III/imunologia
16.
Autoimmunity ; 51(4): 147-151, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29996671

RESUMO

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system causing axonal injury, neuronal loss, and atrophy of the central nervous system leading to permanent neurological and clinical disability. Presence of mutations in M9 domain of HNRNPA1 and detection of autoantibodies against this domain in HNRNPA1 qualifies it as a strong candidate for causing MS. These two aspects indicate the presence of a facilitator in associating them. Varicella zoster virus (VZV), known to cause chicken pox infection in humans, is a significant contender in sensitizing the infected people towards MS. Reactivation of latent herpes viruses by other infectious agents and cross-recognition of common viral antigens with antigens found in the myelin sheath induces molecular mimicry or superantigens. Mutations in HNRNPA1 cause mislocalization to the cytoplasm, and co-localize with stress granules (SG) causing cellular apoptosis, this creates the first step toward MS pathogenesis. Mutant HNRNPA1 accumulates in SG allowing the cells to display peptides of HNRNPA1 on surfaces of major histocompatibility complex (MHC) I triggering a cascade of immune reactions. Since glycoprotein E (gE) of VZV shares >62% amino acids sequence similarity with Prion-like domain (PrLD) of HNRNPA1, signifying the reason behind autoantibodies against M9 and PrLD of HNRNPA1. This review attempts to delineate the interactions of VZV, gE of VZV, with M9 domain and PrLD of HNRNPA1 in a step-by-step process. This supports the tripartite model that an environmental trigger in genetically susceptible individuals causes an autoimmune response to self-CNS antigens that result in the pathology observed in the brain and spinal cord of MS patients.


Assuntos
Sistema Nervoso Central/imunologia , Varicela/imunologia , Varicela/virologia , Herpesvirus Humano 3/imunologia , Ribonucleoproteína Nuclear Heterogênea A1/imunologia , Esclerose Múltipla , Mutação , Proteínas do Envelope Viral/imunologia , Animais , Antígenos Virais/imunologia , Apoptose/genética , Apoptose/imunologia , Autoanticorpos/genética , Autoanticorpos/imunologia , Axônios/imunologia , Axônios/patologia , Sistema Nervoso Central/patologia , Sistema Nervoso Central/virologia , Varicela/patologia , Herpesvirus Humano 3/patogenicidade , Ribonucleoproteína Nuclear Heterogênea A1/genética , Antígenos de Histocompatibilidade Classe I/imunologia , Humanos , Modelos Imunológicos , Mimetismo Molecular/genética , Mimetismo Molecular/imunologia , Esclerose Múltipla/genética , Esclerose Múltipla/imunologia , Esclerose Múltipla/patologia , Esclerose Múltipla/virologia , Bainha de Mielina/imunologia , Bainha de Mielina/patologia , Bainha de Mielina/virologia , Domínios Proteicos , Superantígenos/genética , Superantígenos/imunologia
17.
Hum Vaccin Immunother ; 14(10): 2464-2471, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30019992

RESUMO

Objective To delineate seroepidemiology of VZV in children aged 1-14 years in Hangzhou, to evaluate immunological response of VarV via 2 dose regimen immunization of VarV, for improving immunization strategy of VarV. Methods From 2014-2016, a multi-stage stratified random sampling method was employed to select participants included via physical examination for children in the Community Health Centre in Hangzhou. Results were compared among 11 various age groups: 1-,2-,3-,4-,5-,6-,7-,8-,9-,10-,11-14 years. Demographic data and vaccination history of all subjects derived from Zhejiang Information System for Immunization Program. Then, the second dose of the VarV was conducted on children aged 4-6 years who had immunization history of one dose of VarV. ELISA was used to detect VZV IgG in serum samples. Results 895 subjects with available information were included. The rate of VZV IgG seropositivity was 65.59% and the geometric mean concentration (GMC) for VZV IgG was 5.14 ± 1.89 mIU/ml. The GMC in urban subjects were higher than rural ones. Both the rate of VZV IgG seropositivity and the GMC in children aged 4-6 years groups were statistically lower than participants younger than 4 years and aged 7-14 years (1-,2-,3-,7-,8-,9-,10-,11-14 years). 627 subjects had immunization history of VarV. Both the rate of VZV IgG seropositivity and the GMC in subjects had immunization history of VarV was higher than who had no immunization history.90 subjects were included after the 2nd dose immunization of VarV. Both the rate of VZV IgG seropositivity and the GMC were significantly increased after the immunization of the 2nd dose of VarV. Conclusions The GMC for VZV IgG in children aged 4-6 years were lower than participants groups (1-,2-,3-,7-,8-,9-,10-,11-14 years).2 doses regimen immunization of VarV are effective for increasing both the rate of VZV IgG seropositivity and the GMC in these subjects.


Assuntos
Anticorpos Antivirais/sangue , Vacina contra Varicela/administração & dosagem , Vacina contra Varicela/imunologia , Varicela/epidemiologia , Varicela/imunologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , China/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Lactente , Masculino , Estudos Soroepidemiológicos
18.
J Dermatol Sci ; 92(1): 89-96, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30041832

RESUMO

BACKGROUND: Effects of universal varicella vaccination on the herpes zoster (HZ) incidence have not been elucidated. Universal varicella vaccination was introduced in Japan in October 2014. OBJECTIVE: We investigated the effects of universal varicella vaccination on HZ epidemiology. METHODS: Patients with HZ have been monitored by the Miyazaki Dermatologist Society since 1997, and the effects of universal vaccination on the HZ incidences have been analyzed to determine which generation is most affected. RESULTS: The number of HZ patients increased 1.54 times, and the gradual increase in the HZ incidence was observed in not only patients >60 years, but also other generations during the period from 1997 to 2017. The number of varicella patients was gradually reduced from 2010 to 2017 before introduction of universal varicella vaccination, and the HZ incidence in yearly change significantly increased from 2014 to 2016 in the total population associated with the significant decrease in varicella incidence. The HZ incidence significantly increased for individuals aged 20 to 49 years from 2014 to 2015 and most for individuals age 20-29 years (odds ratio [OR], 1.270; 95% confidence interval [CI], 1.071-1.505, P<0.001). We identified the child-rearing generation of age 20 to 49 years (OR, 1.270; 95% CI, 1.071-1.505, P<0.001) as the generation most influenced by universal varicella vaccination, when the HZ incidence increased gradually by approximately 2% per year. CONCLUSIONS: Universal vaccination increased the HZ incidence in the child-rearing generation among the generations, possibly by reduced chance of boosting their immunity by exposure to varicella.


Assuntos
Vacina contra Varicela/administração & dosagem , Varicela/prevenção & controle , Herpes Zoster/epidemiologia , Vacinação , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Varicela/epidemiologia , Varicela/imunologia , Varicela/virologia , Criança , Educação Infantil , Pré-Escolar , Feminino , Herpes Zoster/imunologia , Herpes Zoster/virologia , Humanos , Incidência , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
19.
Infection ; 46(5): 693-699, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29766472

RESUMO

Data from 215 pregnant women exposed to varicella and 276 with varicella observed at the Tuscany Reference Center for Infectious Diseases in Pregnancy, Florence, Italy, in the period 1997-2016 were retrospectively collected. The risk of developing varicella was lower in exposed women who received varicella zoster immunoglobulin compared with those who did not receive it [42% (21 of 50) vs 72% (13 of 18); p = 0.0263]. Typical congenital varicella syndrome was observed in 1.56% of fetuses/neonates born from pregnant women with varicella.


Assuntos
Varicela/epidemiologia , Herpesvirus Humano 3/imunologia , Soros Imunes/administração & dosagem , Resultado da Gravidez/epidemiologia , Adolescente , Adulto , Varicela/imunologia , Feminino , Humanos , Recém-Nascido , Itália/epidemiologia , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Risco , Adulto Jovem
20.
Sports Health ; 10(5): 406-411, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29792776

RESUMO

BACKGROUND: Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. HYPOTHESIS: There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. STUDY DESIGN: Cross-sectional cohort study. LEVEL OF EVIDENCE: Level 4. METHODS: A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). RESULTS: A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). CONCLUSION: One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. CLINICAL RELEVANCE: These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.


Assuntos
Beisebol/fisiologia , Basquetebol/fisiologia , Varicela/imunologia , Imunidade Ativa , Sarampo/imunologia , Caxumba/imunologia , Rubéola (Sarampo Alemão)/imunologia , Adulto , Varicela/prevenção & controle , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , Sarampo/prevenção & controle , Caxumba/prevenção & controle , Projetos Piloto , Prevalência , Rubéola (Sarampo Alemão)/prevenção & controle , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
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