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Lackemeyer MG, Bohannon JK, Holbrook MR. Nipah Virus Aerosol Challenge of Three Distinct Particle Sizes in Nonhuman Primates. Methods Mol Biol 2023; 2682:175-189. [PMID: 37610582 DOI: 10.1007/978-1-0716-3283-3_13] [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: 08/24/2023]
Abstract
Aerosol and inhalational studies of high-consequence pathogens allow researchers to study the disease course and effects of biologicals transmitted through aerosol in a laboratory-controlled environment. Inhalational studies involving Nipah virus with small (1-3 μm), intermediate (6-8 μm), and large particles (10-14 μm) were explored in African green nonhuman primates to determine if the subsequent disease course more closely recapitulated what is observed in Nipah virus human disease. The aerosol procedures outlined describe the different equipment/techniques used to generate the three particle sizes and control the site of particle deposition within this animal model.
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Affiliation(s)
| | - J Kyle Bohannon
- NIAID Integrated Research Facility, Ft. Detrick, Frederick, MD, USA
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2
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Redmann RK, Kaushal D, Golden N, Threeton B, Killeen SZ, Kuehl PJ, Roy CJ. Particle Dynamics and Bioaerosol Viability of Aerosolized Bacillus Calmette-Guérin Vaccine Using Jet and Vibrating Mesh Clinical Nebulizers. J Aerosol Med Pulm Drug Deliv 2022; 35:50-56. [PMID: 34619040 PMCID: PMC8867098 DOI: 10.1089/jamp.2021.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Bacillus Calmette-Guérin (BCG) is a vaccine used to protect against tuberculosis primarily in infants to stop early infection in areas of the world where the disease is endemic. Normally administered as a percutaneous injection, BCG is a live significantly attenuated bacteria that is now being investigated for its potential within an inhalable vaccine formulation. This study investigates the feasibility and performance of two jet and two vibrating mesh nebulizers aerosolizing BCG and the resulting particle characteristics and residual viability of the bacteria postaerosolization. Methods: A jet nebulizer (Collison), outfitted either with a 3- or 6-jet head, was compared with two clinical nebulizers, the vibrating mesh Omron MicroAir and Aerogen Solo devices. Particle characteristics, including aerodynamic particle sizing, was performed on all devices within a common aerosol chamber configuration and comparable BCG innocula concentrations. Integrated aerosol samples were collected for each generator and assayed for bacterial viability using conventional microbiological technique. Results: A batch lot of BCG (Danish) was grown to titer and used in all generator assessments. Aerosol particles within the respirable range were generated from all nebulizers at four different concentrations of BCG. The jet nebulizers produced a uniformly smaller particle size than the vibrating mesh devices, although particle concentrations by mass were similar across all devices tested with the exception of the Aerogen Solo, which resulted in a low concentration of BCG aerosols. Conclusions: The resulting measured viable BCG aerosol concentration fraction produced by each device approximated one another; however, a measurable decrease of efficiency and overall viability reduction in the jet nebulizer was observed in higher BCG inoculum starting concentrations, whereas the vibrating mesh nebulizer returned a remarkably stable viable aerosol fraction irrespective of inoculum concentration.
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Affiliation(s)
- Rachel K. Redmann
- Infectious Disease Aerobiology, Division of Microbiology, Tulane National Primate Research Center, Covington, Louisiana, USA
| | - Deepak Kaushal
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Nadia Golden
- Infectious Disease Aerobiology, Division of Microbiology, Tulane National Primate Research Center, Covington, Louisiana, USA
| | - Breeanna Threeton
- Infectious Disease Aerobiology, Division of Microbiology, Tulane National Primate Research Center, Covington, Louisiana, USA
| | - Stephanie Z. Killeen
- Infectious Disease Aerobiology, Division of Microbiology, Tulane National Primate Research Center, Covington, Louisiana, USA
| | - Philip J. Kuehl
- Lovelace Biomedical Research Institute, Albuquerque, New Mexico, USA
| | - Chad J. Roy
- Infectious Disease Aerobiology, Division of Microbiology, Tulane National Primate Research Center, Covington, Louisiana, USA.,Department of Microbiology and Immunology, Tulane School of Medicine, New Orleans, Louisiana, USA.,Address correspondence to: Chad J. Roy, PhD, Infectious Disease Aerobiology, Division of Microbiology, Tulane National Primate Research Center, 18703 Three Rivers Road, Covington, LA 70433, USA
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3
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Albe JR, Ma H, Gilliland TH, McMillen CM, Gardner CL, Boyles DA, Cottle EL, Dunn MD, Lundy JD, O’Malley KJ, Salama N, Walters AW, Pandrea I, Teichert T, Klimstra WB, Reed DS, Hartman AL. Physiological and immunological changes in the brain associated with lethal eastern equine encephalitis virus in macaques. PLoS Pathog 2021; 17:e1009308. [PMID: 33534855 PMCID: PMC7886169 DOI: 10.1371/journal.ppat.1009308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/16/2021] [Accepted: 01/12/2021] [Indexed: 11/18/2022] Open
Abstract
Aerosol exposure to eastern equine encephalitis virus (EEEV) can trigger a lethal viral encephalitis in cynomolgus macaques which resembles severe human disease. Biomarkers indicative of central nervous system (CNS) infection by the virus and lethal outcome of disease would be useful in evaluating potential medical countermeasures, especially for therapeutic compounds. To meet requirements of the Animal Rule, a better understanding of the pathophysiology of EEEV-mediated disease in cynomolgus macaques is needed. In this study, macaques given a lethal dose of clone-derived EEEV strain V105 developed a fever between 2-3 days post infection (dpi) and succumbed to the disease by 6 dpi. At the peak of the febrile phase, there was a significant increase in the delta electroencephalography (EEG) power band associated with deep sleep as well as a sharp rise in intracranial pressure (ICP). Viremia peaked early after infection and was largely absent by the onset of fever. Granulocytosis and elevated plasma levels of IP-10 were found early after infection. At necropsy, there was a one hundred- to one thousand-fold increase in expression of traumatic brain injury genes (LIF, MMP-9) as well as inflammatory cytokines and chemokines (IFN-γ, IP-10, MCP-1, IL-8, IL-6) in the brain tissues. Phenotypic analysis of leukocytes entering the brain identified cells as primarily lymphoid (T, B, NK cells) with lower levels of infiltrating macrophages and activated microglia. Massive amounts of infectious virus were found in the brains of lethally-infected macaques. While no infectious virus was found in surviving macaques, quantitative PCR did find evidence of viral genomes in the brains of several survivors. These data are consistent with an overwhelming viral infection in the CNS coupled with a tremendous inflammatory response to the infection that may contribute to the disease outcome. Physiological monitoring of EEG and ICP represent novel methods for assessing efficacy of vaccines or therapeutics in the cynomolgus macaque model of EEEV encephalitis.
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Affiliation(s)
- Joseph R. Albe
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Henry Ma
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Theron H. Gilliland
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Cynthia M. McMillen
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Christina L. Gardner
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Devin A. Boyles
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Emily L. Cottle
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Matthew D. Dunn
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jeneveve D. Lundy
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Katherine J. O’Malley
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Noah Salama
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Aaron W. Walters
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Ivona Pandrea
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Tobias Teichert
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - William B. Klimstra
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail: (WBK); (DSR); (ALH)
| | - Douglas S. Reed
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail: (WBK); (DSR); (ALH)
| | - Amy L. Hartman
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail: (WBK); (DSR); (ALH)
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4
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KS, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerg Infect Dis 2020. [PMID: 32568661 DOI: 10.3201/eid2609.201806)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
We aerosolized severe acute respiratory syndrome coronavirus 2 and determined that its dynamic aerosol efficiency surpassed those of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome. Although we performed experiment only once across several laboratories, our findings suggest retained infectivity and virion integrity for up to 16 hours in respirable-sized aerosols.
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5
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KS, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerg Infect Dis 2020. [PMID: 32568661 DOI: 10.1101/2020.04.13.20063784v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
We aerosolized severe acute respiratory syndrome coronavirus 2 and determined that its dynamic aerosol efficiency surpassed those of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome. Although we performed experiment only once across several laboratories, our findings suggest retained infectivity and virion integrity for up to 16 hours in respirable-sized aerosols.
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6
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Bulski K. Bioaerosols at plants processing materials of plant origin-a review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:27507-27514. [PMID: 32415447 PMCID: PMC7334269 DOI: 10.1007/s11356-020-09121-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/29/2020] [Indexed: 05/03/2023]
Abstract
Due to the dynamic development of industry, related to the processing of plant materials and a subsequent significant increase in the number of employees working in this kind of industry, the indoor air quality is of great importance for the human health. The premises of plants processing plant materials are a specific environment, related to exposure to biological agents. The major sources of microbial contamination of premises are employees' activities and the operation of devices used in the production process, quality of plant materials, technological processes, construction materials, ventilation (air-conditioning) systems, and outdoor air. Biological agents (primarily bacteria and fungi) transported in the air can cause numerous adverse health outcomes in exposed workers.
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Affiliation(s)
- Karol Bulski
- Department of Microbiology and Biomonitoring, University of Agriculture in Krakow, Krakow, Poland.
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7
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KS, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerg Infect Dis 2020; 26. [PMID: 32568661 PMCID: PMC7454081 DOI: 10.3201/eid2609.201806] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
We aerosolized severe acute respiratory syndrome coronavirus 2 and determined that its dynamic aerosol efficiency surpassed those of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome. Although we performed experiment only once across several laboratories, our findings suggest retained infectivity and virion integrity for up to 16 hours in respirable-sized aerosols.
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8
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KC, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Comparative dynamic aerosol efficiencies of three emergent coronaviruses and the unusual persistence of SARS-CoV-2 in aerosol suspensions. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 32511433 DOI: 10.1101/2020.04.13.20063784] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The emergent coronavirus, designated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a zoonotic pathogen that has demonstrated remarkable transmissibility in the human population and is the etiological agent of a current global pandemic called COVID-191. We measured the dynamic (short-term) aerosol efficiencies of SARS-CoV-2 and compared the efficiencies with two other emerging coronaviruses, SARS-CoV (emerged in 2002) and Middle Eastern respiratory syndrome CoV (MERS-CoV; emerged starting in 2012). We also quantified the long-term persistence of SARS-CoV-2 and its ability to maintain infectivity when suspended in aerosols for up to 16 hours.
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Affiliation(s)
- A C Fears
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
| | - W B Klimstra
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
| | - P Duprex
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
| | - A Hartman
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA.,Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA.,World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX.,U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD.,National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - S C Weaver
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - K C Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - D Mirchandani
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - J A Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - P V Aguilar
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - D Fernández
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - A Nalca
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - A Totura
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - D Dyer
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - B Kearney
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - M Lackemeyer
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - J K Bohannon
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - R Johnson
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - R F Garry
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
| | - D S Reed
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
| | - C J Roy
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
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9
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Pathogenesis of Rift Valley Fever Virus Aerosol Infection in STAT2 Knockout Hamsters. Viruses 2018; 10:v10110651. [PMID: 30463176 PMCID: PMC6265887 DOI: 10.3390/v10110651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/08/2018] [Accepted: 11/16/2018] [Indexed: 01/29/2023] Open
Abstract
Rift Valley fever virus (RVFV) is an emerging pathogen capable of causing severe disease in livestock and humans and can be transmitted by multiple routes including aerosol exposure. Several animal models have been developed to gain insight into the pathogenesis associated with aerosolized RVFV infection, but work with these models is restricted to high containment biosafety level (BSL) laboratories limiting their use for antiviral and vaccine development studies. Here, we report on a new RVFV inhalation infection model in STAT2 KO hamsters exposed to aerosolized MP-12 vaccine virus by nose-only inhalation that enables a more accurate delivery and measurement of exposure dose. RVFV was detected in hepatic and other tissues 4⁻5 days after challenge, consistent with virus-induced lesions in the liver, spleen and lung. Furthermore, assessment of blood chemistry and hematological parameters revealed alterations in several liver disease markers and white blood cell parameters. Our results indicate that STAT2 KO hamsters develop a disease course that shares features of disease observed in human cases and in other animal models of RVFV aerosol exposure, supporting the use of this BSL-2 infection model for countermeasure development efforts.
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Blais-Lecours P, Perrott P, Duchaine C. Non-culturable bioaerosols in indoor settings: Impact on health and molecular approaches for detection. ATMOSPHERIC ENVIRONMENT (OXFORD, ENGLAND : 1994) 2015; 110:45-53. [PMID: 32288547 PMCID: PMC7108366 DOI: 10.1016/j.atmosenv.2015.03.039] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 03/09/2015] [Accepted: 03/19/2015] [Indexed: 05/21/2023]
Abstract
Despite their significant impact on respiratory health, bioaerosols in indoor settings remain understudied and misunderstood. Culture techniques, predominantly used for bioaerosol characterisation in the past, allow for the recovery of only a small fraction of the real airborne microbial burden in indoor settings, given the inability of several microorganisms to grow on agar plates. However, with the development of new tools to detect non-culturable environmental microorganisms, the study of bioaerosols has advanced significantly. Most importantly, these techniques have revealed a more complex bioaerosol burden that also includes non-culturable microorganisms, such as archaea and viruses. Nevertheless, air quality specialists and consultants remain reluctant to adopt these new research-developed techniques, given that there are relatively few studies found in the literature, making it difficult to find a point of comparison. Furthermore, it is unclear as to how this new non-culturable data can be used to assess the impact of bioaerosol exposure on human health. This article reviews the literature that describes the non-culturable fraction of bioaerosols, focussing on bacteria, archaea and viruses, and examines its impact on bioaerosol-related diseases. It also outlines available molecular tools for the detection and quantification of these microorganisms and states various research needs in this field.
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Affiliation(s)
- Pascale Blais-Lecours
- Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC, Canada
| | - Phillipa Perrott
- Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC, Canada
| | - Caroline Duchaine
- Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC, Canada
- Département de biochimie, de microbiologie et de bioinformatique, Faculté des sciences et de génie, Université Laval, Québec, QC, Canada
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