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Haddad NS, Nozick S, Ohanian S, Smith R, Elias S, Auwaerter PG, Lee FEH, Daiss JL. Circulating antibody-secreting cells are a biomarker for early diagnosis in patients with Lyme disease. PLoS One 2023; 18:e0293203. [PMID: 37922270 PMCID: PMC10624293 DOI: 10.1371/journal.pone.0293203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/07/2023] [Indexed: 11/05/2023] Open
Abstract
BACKGROUND Diagnostic immunoassays for Lyme disease have several limitations including: 1) not all patients seroconvert; 2) seroconversion occurs later than symptom onset; and 3) serum antibody levels remain elevated long after resolution of the infection. INTRODUCTION MENSA (Medium Enriched for Newly Synthesized Antibodies) is a novel diagnostic fluid that contains antibodies produced in vitro by circulating antibody-secreting cells (ASC). It enables measurement of the active humoral immune response. METHODS In this observational, case-control study, we developed the MicroB-plex Anti-C6/Anti-pepC10 Immunoassay to measure antibodies specific for the Borrelia burgdorferi peptide antigens C6 and pepC10 and validated it using a CDC serum sample collection. Then we examined serum and MENSA samples from 36 uninfected Control subjects and 12 Newly Diagnosed Lyme Disease Patients. RESULTS Among the CDC samples, antibodies against C6 and/or pepC10 were detected in all seropositive Lyme patients (8/8), but not in sera from seronegative patients or healthy controls (0/24). Serum antibodies against C6 and pepC10 were detected in one of 36 uninfected control subjects (1/36); none were detected in the corresponding MENSA samples (0/36). In samples from newly diagnosed patients, serum antibodies identified 8/12 patients; MENSA antibodies also detected 8/12 patients. The two measures agreed on six positive individuals and differed on four others. In combination, the serum and MENSA tests identified 10/12 early Lyme patients. Typically, serum antibodies persisted 80 days or longer while MENSA antibodies declined to baseline within 40 days of successful treatment. DISCUSSION MENSA-based immunoassays present a promising complement to serum immunoassays for diagnosis and tracking therapeutic success in Lyme infections.
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Affiliation(s)
| | - Sophia Nozick
- MicroB-plex, Inc., Atlanta, GA, United States of America
| | - Shant Ohanian
- MicroB-plex, Inc., Atlanta, GA, United States of America
| | - Robert Smith
- Division of Infectious Diseases, Maine Medical Center, MaineHealth Institute for Research, Portland, ME, United States of America
| | - Susan Elias
- Division of Infectious Diseases, Maine Medical Center, MaineHealth Institute for Research, Portland, ME, United States of America
| | - Paul G. Auwaerter
- Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, The Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - F. Eun-Hyung Lee
- MicroB-plex, Inc., Atlanta, GA, United States of America
- Division of Pulmonary, Allergy & Immunology, Emory University, Atlanta, GA, United States of America
| | - John L. Daiss
- MicroB-plex, Inc., Atlanta, GA, United States of America
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Naz F, Petri WA. Host Immunity and Immunization Strategies for Clostridioides difficile Infection. Clin Microbiol Rev 2023; 36:e0015722. [PMID: 37162338 PMCID: PMC10283484 DOI: 10.1128/cmr.00157-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Clostridioides difficile infection (CDI) represents a significant challenge to public health. C. difficile-associated mortality and morbidity have led the U.S. CDC to designate it as an urgent threat. Moreover, recurrence or relapses can occur in up to a third of CDI patients, due in part to antibiotics being the primary treatment for CDI and the major cause of the disease. In this review, we summarize the current knowledge of innate immune responses, adaptive immune responses, and the link between innate and adaptive immune responses of the host against CDI. The other major determinants of CDI, such as C. difficile toxins, the host microbiota, and related treatments, are also described. Finally, we discuss the known therapeutic approaches and the current status of immunization strategies for CDI, which might help to bridge the knowledge gap in the generation of therapy against CDI.
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Affiliation(s)
- Farha Naz
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - William A. Petri
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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Tian H, Cui J, Ye C, Zhao J, Yang B, Xu Y, Ji S, Wang L, Lv X, Ma C, Zhou S, Li N, Wang X, Qin H, Chen Q. Depletion of butyrate-producing microbes of the Firmicutes predicts nonresponse to FMT therapy in patients with recurrent Clostridium difficile infection. Gut Microbes 2023; 15:2236362. [PMID: 37469017 PMCID: PMC10361143 DOI: 10.1080/19490976.2023.2236362] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
Approximately 10% of individuals diagnosed with Clostridium difficile infection (CDI) show the resistance to fecal microbiota transplantation (FMT), with the underlying mechanisms remaining elusive. Deciphering the intricate microbiome profile within this particular subset of FMT-refractory patients via clinical FMT investigations assumes paramount importance, as it holds the key to designing targeted therapeutic interventions tailored for CDI, particularly recurrent CDI (rCDI). A cohort of twenty-three patients afflicted with rCDI, exhibiting congruent clinical baselines, was meticulously selected for FMT. Rigorous screening of thousands of healthy individuals identified ten FMT donors who met stringent health standards, while a total of 171 stool samples were collected to serve as healthy controls. To assess the influence of microbiome dynamics on FMT efficacy, fecal samples were collected from four donors over a continuous period of twenty-five weeks. After FMT treatment, seven individuals exhibited an inadequate response to FMT. These non-remission patients displayed a significant reduction in α-diversity indexes. Meanwhile, prior to FMT, the abundance of key butyrate-producing Firmicutes bacteria, including Christensenellaceae_R_7_group, Ruminococcaceae_unclassified, Coprococcus_2, Fusicatenibacter, Oscillospira, and Roseburia, were depleted in non-remission patients. Moreover, Burkholderiales_unclassified, Coprococcus_2, and Oscillospira failed to colonize non-remission patients both pre- and post-treatment. Conversely, patients with a favorable FMT response exhibited a higher relative abundance of Veillonella prior to treatment, whereas its depletion was commonly observed in non-remission individuals. Genera interactions in lower effectiveness FMT donors were more similar to those in non-remission patients, and Burkholderiales_unclassified, Coprococcus_2, and Oscillospira were frequently depleted in these lower effectiveness donors. Older patients were not conducive to the colonization of Veillonella, consistent with their poor prognosis after FMT. FMT non-remission rCDI patients exhibited distinct characteristics that hindered the colonization of beneficial butyrate-producing Firmicutes microbes. These findings hold promise in advancing the precision of FMT therapy for rCDI patients.
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Affiliation(s)
- Hongliang Tian
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Jiaqu Cui
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Chen Ye
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Jiangman Zhao
- Department of Bioinformatics, Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Bo Yang
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Yue Xu
- Department of Bioinformatics, Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Shushen Ji
- Department of Bioinformatics, Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Le Wang
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Xiaoqiong Lv
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Chunlian Ma
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Shailan Zhou
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Ning Li
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
| | - Xinjun Wang
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
- Research Institute of Intestinal Diseases, Tongji University School of Medicine, Shanghai, China
| | - Huanlong Qin
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
- Research Institute of Intestinal Diseases, Tongji University School of Medicine, Shanghai, China
| | - Qiyi Chen
- Intestinal Microenvironment Treatment Center of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Clinical Research Center for Digestive Diseases, Tongji University, Shanghai, China
- Shanghai Institution of Gut Microbiota Research and Engineering Development, Tenth People’s Hospital of Tongji University, Shanghai, China
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Woodruff MC, Nguyen DC, Faliti CE, Saini AS, Lee FEH, Sanz I. Response under pressure: deploying emerging technologies to understand B-cell-mediated immunity in COVID-19. Nat Methods 2022; 19:387-391. [PMID: 35396475 DOI: 10.1038/s41592-022-01450-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Matthew C Woodruff
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA.,Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA
| | - Doan C Nguyen
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Caterina E Faliti
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA.,Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA
| | - Ankur Singh Saini
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA.,Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA
| | - F Eun-Hyung Lee
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, GA, USA
| | - Ignacio Sanz
- Department of Medicine, Division of Rheumatology, Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA. .,Emory Autoimmunity Center of Excellence, Emory University, Atlanta, GA, USA.
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