RESUMO
Background: Recurrent vulvovaginal candidiasis (RVVC) is a problematic form of mucosal Candida infection, characterized by repeated episodes per year. Candida albicans is the most common cause of RVVC. Currently, there are no immunotherapeutic treatments for RVVC. Methods: This exploratory randomized, double-blind, placebo-controlled trial evaluated an immunotherapeutic vaccine (NDV-3A) containing a recombinant C. albicans adhesin/invasin protein for prevention of RVVC. Results: The study in 188 women with RVVC (n = 178 evaluable) showed that 1 intramuscular dose of NDV-3A was safe and generated rapid and robust B- and T-cell immune responses. Post hoc exploratory analyses revealed a statistically significant increase in the percentage of symptom-free patients at 12 months after vaccination (42% vaccinated vs 22% placebo; P = .03) and a doubling in median time to first symptomatic episode (210 days vaccinated vs 105 days placebo) for the subset of patients aged <40 years (n = 137). The analysis of evaluable patients, which combined patients aged <40 years (77%) and ≥40 years (23%), trended toward a positive impact of NDV-3A versus placebo (P = .099). Conclusions: In this unprecedented study of the effectiveness of a fungal vaccine in humans, NDV-3A administered to women with RVVC was safe and highly immunogenic and reduced the frequency of symptomatic episodes of vulvovaginal candidiasis for up to 12 months in women aged <40 years. These results support further development of NDV-3A vaccine and provide guidance for meaningful clinical endpoints for immunotherapeutic management of RVVC. Clinical Trials Registration: NCT01926028.
Assuntos
Candidíase Vulvovaginal/terapia , Proteínas Fúngicas/uso terapêutico , Vacinas Fúngicas/uso terapêutico , Imunoterapia , Adolescente , Adulto , Linfócitos B/imunologia , Candida albicans/efeitos dos fármacos , Candidíase Vulvovaginal/imunologia , Método Duplo-Cego , Feminino , Vacinas Fúngicas/efeitos adversos , Humanos , Imunogenicidade da Vacina , Injeções Intramusculares , Pessoa de Meia-Idade , Recidiva , Linfócitos T/imunologia , Adulto JovemRESUMO
We systematically investigated the role of surface modification of nanoparticles catalyst in alkyne hydrogenation reactions and proposed the general explanation of effect of surface ligands on the selectivity and activity of Pt and Co/Pt nanoparticles (NPs) using experimental and computational approaches. We show that the proper balance between adsorption energetics of alkenes at the surface of NPs as compared to that of capping ligands defines the selectivity of the nanocatalyst for alkene in alkyne hydrogenation reaction. We report that addition of primary alkylamines to Pt and CoPt(3) NPs can drastically increase selectivity for alkene from 0 to more than 90% with ~99.9% conversion. Increasing the primary alkylamine coverage on the NP surface leads to the decrease in the binding energy of octenes and eventual competition between octene and primary alkylamines for adsorption sites. At sufficiently high coverage of catalysts with primary alkylamine, the alkylamines win, which prevents further hydrogenation of alkenes into alkanes. Primary amines with different lengths of carbon chains have similar adsorption energies at the surface of catalysts and, consequently, the same effect on selectivity. When the adsorption energy of capping ligands at the catalytic surface is lower than adsorption energy of alkenes, the ligands do not affect the selectivity of hydrogenation of alkyne to alkene. On the other hand, capping ligands with adsorption energies at the catalytic surface higher than that of alkyne reduce its activity resulting in low conversion of alkynes.
RESUMO
BACKGROUND: Military trainees are at increased risk for Staphylococcus aureus colonization and infection. Disease prevention strategies are needed, but a S. aureus vaccine does not currently exist. METHODS: We enrolled US Army Infantry trainees (Fort Benning, GA) in a phase 2, randomized, double-blind, placebo-controlled trial of NDV-3A, a vaccine containing a recombinant adhesin/invasion protein of Candida albicans that has structural similarity to the S. aureus protein clumping factor A. Study participants received one intramuscular dose of NDV-3A or placebo (adjuvant alone) within 72 h of arrival on base. Longitudinal nasal and oral (throat) swabs were collected throughout the 14-week Infantry training cycle. Safety, immunogenicity, and efficacy of NDV-3A against S. aureus nasal / oral acquisition were the endpoints. RESULTS: The NDV-3A candidate had minimal reactogenicity and elicited robust antigen-specific B- and T-cell responses. During the 56-day post-vaccination period, there was no difference in the incidence of S. aureus nasal acquisition between those who were randomized to receive NDV-3A vs. placebo (25.6% vs. 29.1%; vaccine efficacy [VE]: 12.1%; p = 0.31). In time-to-event analysis, there was no difference between study groups with respect to the S. aureus colonization-free interval (VE: 13%; p = 0.29). Similarly, the efficacy of NDV-3A against S. aureus oral acquisition was poor (VE: 2.4%; p = 0.52). CONCLUSIONS: A single dose of NDV-3A did not prevent nasal nor oral acquisition of S. aureus in a population of military trainees at high risk for colonization.