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Shukla R, Soni J, Kumar A, Pandey R. Uncovering the diversity of pathogenic invaders: insights into protozoa, fungi, and worm infections. Front Microbiol 2024; 15:1374438. [PMID: 38596382 PMCID: PMC11003270 DOI: 10.3389/fmicb.2024.1374438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/13/2024] [Indexed: 04/11/2024] Open
Abstract
Post COVID-19, there has been renewed interest in understanding the pathogens challenging the human health and evaluate our preparedness towards dealing with health challenges in future. In this endeavour, it is not only the bacteria and the viruses, but a greater community of pathogens. Such pathogenic microorganisms, include protozoa, fungi and worms, which establish a distinct variety of disease-causing agents with the capability to impact the host's well-being as well as the equity of ecosystem. This review summarises the peculiar characteristics and pathogenic mechanisms utilized by these disease-causing organisms. It features their role in causing infection in the concerned host and emphasizes the need for further research. Understanding the layers of pathogenesis encompassing the concerned infectious microbes will help expand targeted inferences with relation to the cause of the infection. This would strengthen and augment benefit to the host's health along with the maintenance of ecosystem network, exhibiting host-pathogen interaction cycle. This would be key to discover the layers underlying differential disease severities in response to similar/same pathogen infection.
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Affiliation(s)
- Richa Shukla
- Division of Immunology and Infectious Disease Biology, INGEN-HOPE (INtegrative GENomics of HOst-PathogEn) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India
| | - Jyoti Soni
- Division of Immunology and Infectious Disease Biology, INGEN-HOPE (INtegrative GENomics of HOst-PathogEn) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Ashish Kumar
- Division of Immunology and Infectious Disease Biology, INGEN-HOPE (INtegrative GENomics of HOst-PathogEn) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India
| | - Rajesh Pandey
- Division of Immunology and Infectious Disease Biology, INGEN-HOPE (INtegrative GENomics of HOst-PathogEn) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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Satti Z, Khurshid A, Mohammed R, Jose R, Olayode A. Plasmodium vivax Presenting With Septic Shock and Disseminated Intravascular Coagulation (DIC): A Case Report. Cureus 2023; 15:e40042. [PMID: 37425547 PMCID: PMC10324627 DOI: 10.7759/cureus.40042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Malaria has various causative agents that can have a spectrum of disease manifestations, some potentially fatal. Various species have been established as etiologies of malaria, though our understanding of the severity of various species is changing. We present a unique case of Plasmodium vivax malaria that resulted in severe disease, a magnitude rarely seen in previous literature. Our patient was a 35-year-old healthy woman who presented to the emergency department with abdominal pain, nausea, vomiting, and fever. Further workup revealed severe thrombocytopenia with prolonged prothrombin (PT) and partial thromboplastin time (PTT). An initial thick smear failed to detect any Plasmodium species, but a thin smear revealed P. vivax. The patient's hospital stay was complicated by septic shock requiring intensive care unit (ICU) admission. This unique case represents P. vivax as the causative agent of severe malaria even in healthy, immunocompetent patients.
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Affiliation(s)
- Zain Satti
- School of Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Abaan Khurshid
- School of Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Rahed Mohammed
- Critical Care Medicine, Mount Sinai Queens Hospital, Queens, USA
| | - Rejath Jose
- Internal Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Adewale Olayode
- Critical Care Medicine, Mount Sinai Queens Hospital, Queens, USA
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Hasabo EA, Khalid RI, Mustafa GE, Taha RE, Abdalla RS, Mohammed RA, Haroun MS, Adil R, Khalil RA, Mansour RM, Mohamed RK, Awadalla H. Treatment-seeking behaviour, awareness and preventive practice toward malaria in Abu Ushar, Gezira state, Sudan: a household survey experience from a rural area. Malar J 2022; 21:182. [PMID: 35690814 PMCID: PMC9188226 DOI: 10.1186/s12936-022-04207-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022] Open
Abstract
Background Usage of mosquito bed nets and the practice of other prevention methods are essential for the prevention of malaria in endemic areas. Proper community knowledge about malaria and prompt treatment-seeking behaviour for early diagnosis and treatment are crucial for eliminating the disease. This study aimed to assess the awareness, treatment-seeking behaviour, and prevention practices towards malaria in Abu Ushar, Gezira State, Sudan. Methods A community-based, cross-sectional study was conducted in March 2021, including 310 households in Abu Ushar, Aljazeera, Sudan. Data were collected through face-to-face interviews with head of the household using an interviewer-administered questionnaire. Data were entered and analysed using R software. Results A total of 310 households were enrolled in this study. Sixty per cent had children under the age of 5 years. The majority of these households (94.8%) had a history of malaria in the past 12 months. Overall, awareness of malaria was good; 197 (63.5%) households had bed nets in their houses; 75.8% of total households identified fever with shivering as a symptom of malaria. Regarding treatment-seeking behaviour, 77.9% seek treatment from the nearby primary health centre, and 60% seek treatment within the first day. Only 45.3% stated that everyone in the household sleeps under bed nets. Conclusion High awareness about malaria and preventive measures was found among participants in households. Most households had previous infections with malaria. Therefore, an interventional programme should be established in this area to reduce this high rate of malaria.
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Affiliation(s)
| | - Rawan I Khalid
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Ruaa E Taha
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Riham S Abdalla
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Mazin S Haroun
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Rawaa Adil
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Riham A Khalil
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Rawaa M Mansour
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Reham K Mohamed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Heitham Awadalla
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Folliero V, Zannella C, Chianese A, Stelitano D, Ambrosino A, De Filippis A, Galdiero M, Franci G, Galdiero M. Application of Dendrimers for Treating Parasitic Diseases. Pharmaceutics 2021; 13:343. [PMID: 33808016 PMCID: PMC7998910 DOI: 10.3390/pharmaceutics13030343] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 01/02/2023] Open
Abstract
Despite advances in medical knowledge, parasitic diseases remain a significant global health burden and their pharmacological treatment is often hampered by drug toxicity. Therefore, drug delivery systems may provide useful advantages when used in combination with conventional therapeutic compounds. Dendrimers are three-dimensional polymeric structures, characterized by a central core, branches and terminal functional groups. These nanostructures are known for their defined structure, great water solubility, biocompatibility and high encapsulation ability against a wide range of molecules. Furthermore, the high ratio between terminal groups and molecular volume render them a hopeful vector for drug delivery. These nanostructures offer several advantages compared to conventional drugs for the treatment of parasitic infection. Dendrimers deliver drugs to target sites with reduced dosage, solving side effects that occur with accepted marketed drugs. In recent years, extensive progress has been made towards the use of dendrimers for therapeutic, prophylactic and diagnostic purposes for the management of parasitic infections. The present review highlights the potential of several dendrimers in the management of parasitic diseases.
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Affiliation(s)
- Veronica Folliero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Annalisa Chianese
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Debora Stelitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Annalisa Ambrosino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Anna De Filippis
- Department of Pharmacy, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
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Oboh MA, Ndiaye T, Diongue K, Ndiaye YD, Sy M, Deme AB, Diallo MA, Yade MS, Volkman SK, Badiane AS, Amambua-Ngwa A, Ndiaye D. Allelic diversity of MSP1 and MSP2 repeat loci correlate with levels of malaria endemicity in Senegal and Nigerian populations. Malar J 2021; 20:38. [PMID: 33436004 PMCID: PMC7805152 DOI: 10.1186/s12936-020-03563-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Characterizing the genetic diversity of malaria parasite populations in different endemic settings (from low to high) could be helpful in determining the effectiveness of malaria interventions. This study compared Plasmodium falciparum parasite population diversity from two sites with low (pre-elimination) and high transmission in Senegal and Nigeria, respectively. METHODS Parasite genomic DNA was extracted from 187 dried blood spot collected from confirmed uncomplicated P. falciparum malaria infected patients in Senegal (94) and Nigeria (93). Allelic polymorphism at merozoite surface protein 1 (msp1) and merozoite surface protein- 2 (msp2) genes were assessed by nested PCR. RESULTS The most frequent msp1 and msp2 allelic families are the K1 and IC3D7 allelotypes in both Senegal and Nigeria. Multiplicity of infection (MOI) of greater that 1 and thus complex infections was common in both study sites in Senegal (Thies:1.51/2.53; Kedougou:2.2/2.0 for msp1/2) than in Nigeria (Gbagada: 1.39/1.96; Oredo: 1.35/1.75]). The heterozygosity of msp1 gene was higher in P. falciparum isolates from Senegal (Thies: 0.62; Kedougou: 0.53) than isolates from Nigeria (Gbagada: 0.55; Oredo: 0.50). In Senegal, K1 alleles was associated with heavy than with moderate parasite density. Meanwhile, equal proportions of K1 were observed in both heavy and moderate infection types in Nigeria. The IC3D7 subtype allele of the msp2 family was the most frequent in heavily parasitaemic individuals from both countries than in the moderately infected participants. CONCLUSION The unexpectedly low genetic diversity of infections high endemic Nigerian setting compared to the low endemic settings in Senegal is suggestive of possible epidemic outbreak in Nigeria.
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Affiliation(s)
- Mary A Oboh
- Medical Research Council Unit, the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
| | - Tolla Ndiaye
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal.
| | - Khadim Diongue
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Yaye D Ndiaye
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Mouhamad Sy
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Awa B Deme
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Mamadou A Diallo
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Mamadou S Yade
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Sarah K Volkman
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA
| | - Aida S Badiane
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Alfred Amambua-Ngwa
- Medical Research Council Unit, the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Daouda Ndiaye
- Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA
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Lai JY, Lim TS. Infectious disease antibodies for biomedical applications: A mini review of immune antibody phage library repertoire. Int J Biol Macromol 2020; 163:640-648. [PMID: 32650013 PMCID: PMC7340592 DOI: 10.1016/j.ijbiomac.2020.06.268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 12/18/2022]
Abstract
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.
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Affiliation(s)
- Jing Yi Lai
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Theam Soon Lim
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Penang, Malaysia; Analytical Biochemistry Research Centre, Universiti Sains Malaysia, 11800 Penang, Malaysia.
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Modeling antimalarial and antihuman African trypanosomiasis compounds: a ligand- and structure-based approaches. Mol Divers 2019; 24:1107-1124. [PMID: 31760561 DOI: 10.1007/s11030-019-10015-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/06/2019] [Indexed: 02/07/2023]
Abstract
This study examines the interaction of 137 antimalarial and antihuman African trypanosomiasis compounds [bis(2-aminoimidazolines), bisguanidinediphenyls and polyamines] on three different in vitro assays (Trypanosoma brucei rhodesiense (T.b.r.), Plasmodium falciparum (P.f.) and cytotoxicity-L6 cells). ΔTm values, wherever available, were also examined for the considered ligands. Eight DNA-ligand complexes and one DNA structure without ligand were selected from protein data bank (PDB) based on the structural similarity. Geometry optimization of all the considered ligands was carried out at the B3LYP/6-31G(d) level of theory. The AutoDock4 tool was utilized for the docking of these molecules at the minor groove of nine selected DNA crystal structures. We observed DT20, DA6, DT8 and DT19 residues generally interact with most of the considered ligands. Molecular dynamics simulations, molecular mechanics-generalized born surface area and molecular mechanics-Poisson Boltzmann surface area calculations indicate that the docked poses are generally stable and docked ligands do not show much deviation in the minor groove of DNA until 10 ns simulation. Efficient and statistically significant quantitative structure-activity relationship models for T.b.r., P.f., C-L6 and ΔTm values were developed. All the generated models are internally and externally validated. We predicted a few ligands with significant IC50 values against P.f. based on the developed models. These results may help to design new and potent antimalarial and antihuman African trypanosomal compounds.
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Talapko J, Škrlec I, Alebić T, Jukić M, Včev A. Malaria: The Past and the Present. Microorganisms 2019; 7:microorganisms7060179. [PMID: 31234443 PMCID: PMC6617065 DOI: 10.3390/microorganisms7060179] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/28/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023] Open
Abstract
Malaria is a severe disease caused by parasites of the genus Plasmodium, which is transmitted to humans by a bite of an infected female mosquito of the species Anopheles. Malaria remains the leading cause of mortality around the world, and early diagnosis and fast-acting treatment prevent unwanted outcomes. It is the most common disease in Africa and some countries of Asia, while in the developed world malaria occurs as imported from endemic areas. The sweet sagewort plant was used as early as the second century BC to treat malaria fever in China. Much later, quinine started being used as an antimalaria drug. A global battle against malaria started in 1955, and Croatia declared 1964 to be the year of eradication of malaria. The World Health Organization carries out a malaria control program on a global scale, focusing on local strengthening of primary health care, early diagnosis of the disease, timely treatment, and disease prevention. Globally, the burden of malaria is lower than ten years ago. However, in the last few years, there has been an increase in the number of malaria cases around the world. It is moving towards targets established by the WHO, but that progress has slowed down.
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Affiliation(s)
- Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, HR-31000 Osijek, Croatia.
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, HR-31000 Osijek, Croatia.
| | - Tamara Alebić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, HR-31000 Osijek, Croatia.
| | - Melita Jukić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, HR-31000 Osijek, Croatia.
- General Hospital Vukovar, Županijska 35, HR-32000 Vukovar, Croatia.
| | - Aleksandar Včev
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, HR-31000 Osijek, Croatia.
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, HR-31000 Osijek, Croatia.
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Schmidt M, Geilenkeuser WJ, Sireis W, Seifried E, Hourfar K. Emerging Pathogens - How Safe is Blood? Transfus Med Hemother 2014; 41:10-7. [PMID: 24659943 PMCID: PMC3949612 DOI: 10.1159/000358017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 12/16/2013] [Indexed: 12/17/2022] Open
Abstract
During the last few decades, blood safety efforts were mainly focused on preventing viral infections. However, humanity's increased mobility and improved migration pathways necessitate a global perspective regarding other transfusion-transmitted pathogens. This review focuses on the general infection risk of blood components for malaria, dengue virus, Trypanosoma cruzi (Chagas disease) and Babesia spp. Approximately 250 million people become infected by Plasmodium spp. per year. Dengue virus affects more than 50 million people annually in more than 100 countries; clinically, it can cause serious diseases, such as dengue haemorrhagic fever and dengue shock syndrome. Chagas disease, which is caused by Trypanosoma cruzi, mainly occurs in South America and infects approximately 10 million people annually. Babesia spp. is a parasitic infection that infects red blood cells; although many infections are asymptomatic, severe clinical disease has been reported, especially in the elderly. Screening assays are available for all considered pathogens but make screening strategies more complex and more expensive. A general pathogen inactivation for all blood components (whole blood) promises to be a long-term, sustainable solution for both known and unknown pathogens. Transfusion medicine therefore eagerly awaits such a system.
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Affiliation(s)
- Michael Schmidt
- Reference Institute for Bioanalytics, Bonn, Goethe University, Frankfurt/M., Germany
| | | | - Walid Sireis
- German Red Cross, Baden-Wuerttemberg – Hessen, Institute of Transfusion Medicine and Immuno-hemotherapy, Goethe University, Frankfurt/M., Germany
| | - Erhard Seifried
- German Red Cross, Baden-Wuerttemberg – Hessen, Institute of Transfusion Medicine and Immuno-hemotherapy, Goethe University, Frankfurt/M., Germany
| | - Kai Hourfar
- German Red Cross, Baden-Wuerttemberg – Hessen, Institute of Transfusion Medicine and Immuno-hemotherapy, Goethe University, Frankfurt/M., Germany
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