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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, 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A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn 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Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, Sikotra N, Simons L, Keaton N, Karounos D, Oremus R, Dye L, Myers L, Ballard D, Miers W, Sparks R, Thraikill K, Edwards K, Fowlkes J, Kinderman A, Kemp S, Morales A, Holland L, Johnson L, Paul P, Ghatak A, Phelen K, Leyland H, Henderson T, Brenner D, Law P, Oppenheimer E, Mamkin I, Moniz C, Clarson C, Lovell M, Peters A, Ruelas V, Borut D, Burt D, Jordan M, Leinbach A, Castilla S, Flores P, Ruiz M, Hanson L, Green-Blair J, Sheridan R, Wintergerst K, Pierce G, Omoruyi A, Foster M, Linton C, Kingery S, Lunsford A, Cervantes I, Parker T, Price P, Urben J, Doughty I, Haydock H, Parker V, Bergman P, Liu S, Duncum S, Rodda C, Thomas A, Ferry R, McCommon D, Cockroft J, Perelman A, Calendo R, Barrera C, Arce-Nunez E, Lloyd J, Martinez Y, De la Portilla M, Cardenas I, Garrido L, Villar M, Lorini R, Calandra E, D’Annuzio G, Perri K, Minuto N, Malloy J, Rebora C, Callegari R, Ali O, Kramer J, Auble B, Cabrera S, Donohoue P, Fiallo-Scharer R, Hessner M, Wolfgram P, Maddox K, Kansra A, Bettin N, McCuller R, Miller A, Accacha S, Corrigan J, Fiore E, Levine R, Mahoney T, Polychronakos C, Martin J, Gagne V, Starkman H, Fox M, Chin D, Melchionne F, Silverman L, Marshall I, Cerracchio L, Cruz J, Viswanathan A, Miller J, Wilson J, Chalew S, Valley S, Layburn S, Lala A, Clesi P, Genet M, Uwaifo G, Charron A, Allerton T, Milliot E, Cefalu W, Melendez-Ramirez L, Richards R, Alleyn C, Gustafson E, Lizanna M, Wahlen J, Aleiwe S, Hansen M, Wahlen H, Moore M, Levy C, Bonaccorso A, Rapaport R, Tomer Y, Chia D, Goldis M, Iazzetti L, Klein M, Levister C, Waldman L, Muller S, Wallach E, Regelmann M, Antal Z, Aranda M, Reynholds C, Leech N, Wake D, Owens C, Burns M, Wotherspoon J, Nguyen T, Murray A, Short K, Curry G, Kelsey S, Lawson J, Porter J, Stevens S, Thomson E, Winship S, Wynn L, O’Donnell R, Wiltshire E, Krebs J, Cresswell P, Faherty H, Ross C, Vinik A, Barlow P, Bourcier M, Nevoret M, Couper J, Oduah V, Beresford S, Thalagne N, Roper H, Gibbons J, Hill J, Balleaut S, Brennan C, Ellis-Gage J, Fear L, Gray T, Pilger J, Jones L, McNerney C, Pointer L, Price N, Few K, Tomlinson D, Denvir L, Drew J, Randell T, Mansell P, Roberts A, Bell S, Butler S, Hooton Y, Navarra H, Roper A, Babington G, Crate L, Cripps H, Ledlie A, Moulds C, Sadler K, Norton R, Petrova B, Silkstone O, Smith C, Ghai K, Murray M, Viswanathan V, Henegan M, Kawadry O, Olson J, Stavros T, Patterson L, Ahmad T, Flores B, Domek D, Domek S, Copeland K, George M, Less J, Davis T, Short M, Tamura R, Dwarakanathan A, O’Donnell P, Boerner B, Larson L, Phillips M, Rendell M, Larson K, Smith C, Zebrowski K, Kuechenmeister L, Wood K, Thevarayapillai M, Daniels M, Speer H, Forghani N, Quintana R, Reh C, Bhangoo A, Desrosiers P, Ireland L, Misla T, Xu P, Torres C, Wells S, Villar J, Yu M, Berry D, Cook D, Soder J, Powell A, Ng M, Morrison M, Young K, Haslam Z, Lawson M, Bradley B, Courtney J, Richardson C, Watson C, Keely E, DeCurtis D, Vaccarcello-Cruz M, Torres Z, Alies P, Sandberg K, Hsiang H, Joy B, McCormick D, Powell A, Jones H, Bell J, Hargadon S, Hudson S, Kummer M, Badias F, Sauder S, Sutton E, Gensel K, Aguirre-Castaneda R, Benavides Lopez V, Hemp D, Allen S, Stear J, Davis E, Jones T, Baker A, Roberts A, Dart J, Paramalingam N, Levitt Katz L, Chaudhary N, Murphy K, Willi S, Schwartzman B, Kapadia C, Larson D, Bassi M, McClellan D, Shaibai G, Kelley L, Villa G, Kelley C, Diamond R, Kabbani M, Dajani T, Hoekstra F, Magorno M, Beam C, Holst J, Chauhan V, Wilson N, Bononi P, Sperl M, Millward A, Eaton M, Dean L, Olshan J, Renna H, Boulware D, Milliard C, Snyder D, Beaman S, Burch K, Chester J, Ahmann A, Wollam B, DeFrang D, Fitch R, Jahnke K, Bounmananh L, Hanavan K, Klopfenstein B, Nicol L, Bergstrom R, Noland T, Brodksy J, Bacon L, Quintos J, Topor L, Bialo S, Bream S, Bancroft B, Soto A, Lagarde W, Lockemer H, Vanderploeg T, Ibrahim M, Huie M, Sanchez V, Edelen R, Marchiando R, Freeman D, Palmer J, Repas T, Wasson M, Auker P, Culbertson J, Kieffer T, Voorhees D, Borgwardt T, 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Morimoto C, Macarewich M, Norman R, Harding P, Patin K, Vargas C, Barbanica A, Yu A, Vaidyanathan P, Osborne W, Mehra R, Kaster S, Neace S, Horner J, McDonough S, Reeves G, Cordrey C, Marrs L, Miller T, Dowshen S, Doyle D, Walker S, Catte D, Dean H, Drury-Brown M, McGee PF, Hackman B, Lee M, Malkani S, Cullen K, Johnson K, Hampton P, McCarrell M, Curtis C, Paul E, Zambrano Y, Hess KO, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Veatch R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Marks J, Matheson D, Rodriguez H, Wilson D, Redondo MJ, Gomez D, Zheng X, Pena S, Pietropaolo M, Batts E, Brown T, Buckner J, Dove A, Hammond M, 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Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Sanders-Branca N, Sosenko J, Arazo L, Arce R, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Eck SP, Finney L, Fischer TA, Martin A, Muzamhindo CJ, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Ricci MJ, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Muscato MT, Viscardi M, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del Rio A, Logan A, Collier H, Rishton C, Whalley G, Ali A, Ramtoola S, Quattrin T, Mastrandea L, House A, Ecker M, Huang C, Gougeon C, Ho J, Pacuad D, Dunger D, May J, O’Brien C, Acerini C, Salgin B, Thankamony A, Williams R, Buse J, Fuller G, Duclos M, Tricome J, Brown H, Pittard D, Bowlby D, Blue A, Headley T, Bendre S, Lewis K, Sutphin K, Soloranzo C, Puskaric J, Madison H, Rincon M, Carlucci M, Shridharani R, Rusk B, Tessman E, Huffman D, Abrams H, Biederman B, Jones M, Leathers V, Brickman W, Petrie P, Zimmerman D, Howard J, Miller L, Alemzadeh R, Mihailescu D, Melgozza-Walker R, Abdulla N, Boucher-Berry C, Ize-Ludlow D, Levy R, Swenson Brousell C, Scott R, Heenan H, Lunt H, Kendall D, Willis J, Darlow B, Crimmins N, Edler D, Weis T, Schultz C, Rogers D, Latham D, Mawhorter C, Switzer C, Spencer W, Konstantnopoulus P, Broder S, Klein J, Bachrach B, Gardner M, Eichelberger D, Knight L, Szadek L, Welnick G, Thompson B, Hoffman R, Revell A, Cherko J, Carter K, Gilson E, Haines J, Arthur G, Bowen B, Zipf W, Graves P, Lozano R, Seiple D, Spicer K, Chang A, Fregosi J, Harbinson J, Paulson C, Stalters S, Wright P, Zlock D, Freeth A, Victory J, Maheshwari H, Maheshwari A, Holmstrom T, Bueno J, Arguello R, Ahern J, Noreika L, Watson V, Hourse S, Breyer P, Kissel C, Nicholson Y, Pfeifer M, Almazan S, Bajaj J, Quinn M, Funk K, McCance J, Moreno E, Veintimilla R, Wells A, Cook J, Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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Harbertson J, Jamerson M, Graf PCF, Kennemur L, House B, Michael NL, Scott P, Hale B. Population-based Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis prevalence using discarded, deidentified urine specimens previously collected for drug testing. Sex Transm Infect 2017; 94:123. [PMID: 29066630 PMCID: PMC5870458 DOI: 10.1136/sextrans-2017-053355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/18/2017] [Accepted: 09/23/2017] [Indexed: 11/21/2022] Open
Affiliation(s)
- Judith Harbertson
- US Military HIV Research Program, Walter Reed Army Institute of Research, San Diego, California, USA.,Health Sciences Business Unit, Leidos, Inc, San Diego, California, USA.,Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Matthew Jamerson
- Navy Drug Screening Laboratory, US Navy, San Diego, California, USA
| | - Paul C F Graf
- Naval Medical Center, San Diego, California, USA.,Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California, USA
| | - Lisa Kennemur
- Navy Drug Screening Laboratory, US Navy, San Diego, California, USA
| | - Brent House
- Naval Medical Center, San Diego, California, USA
| | - Nelson L Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, San Diego, California, USA
| | - Paul Scott
- US Military HIV Research Program, Walter Reed Army Institute of Research, San Diego, California, USA
| | - Brad Hale
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA.,University of California, San Diego, California, USA
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Horton KC, Dueger EL, Kandeel A, Abdallat M, El-Kholy A, Al-Awaidy S, Kohlani AH, Amer H, El-Khal AL, Said M, House B, Pimentel G, Talaat M. Viral etiology, seasonality and severity of hospitalized patients with severe acute respiratory infections in the Eastern Mediterranean Region, 2007-2014. PLoS One 2017; 12:e0180954. [PMID: 28704440 PMCID: PMC5509236 DOI: 10.1371/journal.pone.0180954] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 06/23/2017] [Indexed: 11/19/2022] Open
Abstract
Introduction Little is known about the role of viral respiratory pathogens in the etiology, seasonality or severity of severe acute respiratory infections (SARI) in the Eastern Mediterranean Region. Methods Sentinel surveillance for SARI was conducted from December 2007 through February 2014 at 20 hospitals in Egypt, Jordan, Oman, Qatar and Yemen. Nasopharyngeal and oropharyngeal swabs were collected from hospitalized patients meeting SARI case definitions and were analyzed for infection with influenza, respiratory syncytial virus (RSV), adenovirus (AdV), human metapneumovirus (hMPV) and human parainfluenza virus types 1–3 (hPIV1-3). We analyzed surveillance data to calculate positivity rates for viral respiratory pathogens, describe the seasonality of those pathogens and determine which pathogens were responsible for more severe outcomes requiring ventilation and/or intensive care and/or resulting in death. Results At least one viral respiratory pathogen was detected in 8,753/28,508 (30.7%) samples tested for at least one pathogen and 3,497/9,315 (37.5%) of samples tested for all pathogens–influenza in 3,345/28,438 (11.8%), RSV in 3,942/24,503 (16.1%), AdV in 923/9,402 (9.8%), hMPV in 617/9,384 (6.6%), hPIV1 in 159/9,402 (1.7%), hPIV2 in 85/9,402 (0.9%) and hPIV3 in 365/9,402 (3.9%). Multiple pathogens were identified in 501/9,316 (5.4%) participants tested for all pathogens. Monthly variation, indicating seasonal differences in levels of infection, was observed for all pathogens. Participants with hMPV infections and participants less than five years of age were significantly less likely than participants not infected with hMPV and those older than five years of age, respectively, to experience a severe outcome, while participants with a pre-existing chronic disease were at increased risk of a severe outcome, compared to those with no reported pre-existing chronic disease. Conclusions Viral respiratory pathogens are common among SARI patients in the Eastern Mediterranean Region. Ongoing surveillance is important to monitor changes in the etiology, seasonality and severity of pathogens of interest.
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Affiliation(s)
- Katherine C. Horton
- Global Disease Detection Center, U.S. Centers for Disease Control and Prevention, Cairo, Egypt
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt
- * E-mail:
| | - Erica L. Dueger
- Global Disease Detection Center, U.S. Centers for Disease Control and Prevention, Cairo, Egypt
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt
- Global Disease Detection Branch, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amr Kandeel
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed Abdallat
- Communicable Disease Department, Ministry of Health, Amman, Jordan
| | - Amani El-Kholy
- Clinical Pathology Department, Cairo University Hospitals, Cairo, Egypt
| | - Salah Al-Awaidy
- Communicable Disease Department, Ministry of Health, Muscat, Oman
| | | | - Hanaa Amer
- Clinical Pathology Department, Ain Shams University, Cairo, Egypt
| | | | - Mayar Said
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt
| | - Brent House
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt
| | - Guillermo Pimentel
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt
| | - Maha Talaat
- Global Disease Detection Center, U.S. Centers for Disease Control and Prevention, Cairo, Egypt
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit, No.3, Cairo, Egypt
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Kuchuloria T, Imnadze P, Mamuchishvili N, Chokheli M, Tsertsvadze T, Endeladze M, Mshvidobadze K, Gatserelia L, Makhviladze M, Kanashvili M, Mikautadze T, Nanuashvili A, Kiknavelidze K, Kokaia N, Makharadze M, Clark DV, Bautista CT, Farrell M, Fadeel MA, Maksoud MA, Pimentel G, House B, Hepburn MJ, Rivard RG. Hospital-Based Surveillance for Infectious Etiologies Among Patients with Acute Febrile Illness in Georgia, 2008-2011. Am J Trop Med Hyg 2015; 94:236-42. [PMID: 26438032 DOI: 10.4269/ajtmh.15-0400] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/20/2015] [Indexed: 11/07/2022] Open
Abstract
Information on the infectious causes of undifferentiated acute febrile illness (AFI) in Georgia is essential for effective treatment and prevention. In May 2008, a hospital-based AFI surveillance was initiated at six hospitals in Georgia. Patients aged ≥ 4 years with fever ≥ 38°C for ≥ 48 hours were eligible for surveillance. Blood culture and serologic testing were conducted for Leptospira spp., Brucella spp., West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus, Coxiella burnetii, tick-borne encephalitis virus (TBEV), hantavirus, Salmonella enterica serovar Typhi (S. Typhi), and Rickettsia typhi. Of 537 subjects enrolled, 70% were outpatients, 54% were males, and the mean age was 37 years. Patients reported having fatigue (89%), rigors (87%), sweating (83%), pain in joints (49%), and sleep disturbances (42%). Thirty-nine (7%) patients were seropositive for R. typhi, 37 (7%) for Brucella spp., 36 (7%) for TBEV, 12 (2%) for Leptospira spp., 10 (2%) for C. burnetii, and three (0.6%) for S. Typhi. None of the febrile patients tested positive for WNV antibodies. Of the patients, 73% were negative for all pathogens. Our results indicate that most of the targeted pathogens are present in Georgia, and highlight the importance of enhancing laboratory capacity for these infectious diseases.
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Affiliation(s)
- Tinatin Kuchuloria
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Paata Imnadze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Nana Mamuchishvili
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Maiko Chokheli
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Tengiz Tsertsvadze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Marina Endeladze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Ketevan Mshvidobadze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Lana Gatserelia
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Manana Makhviladze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Marine Kanashvili
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Teona Mikautadze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Alexander Nanuashvili
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Khatuni Kiknavelidze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Nora Kokaia
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Manana Makharadze
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Danielle V Clark
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Christian T Bautista
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Margaret Farrell
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Moustafa Abdel Fadeel
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Mohamed Abdel Maksoud
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Guillermo Pimentel
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Brent House
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Matthew J Hepburn
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Robert G Rivard
- Javakhishvili Tbilisi State University, Tbilisi, Georgia; United States Army Medical Research Unit-Georgia, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; V. Bochorishvili Sepsis Center, Tbilisi, Georgia; Sachkhere Hospital, Sachkhere, Georgia; S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, United States Naval Medical Research Unit No. 3, Cairo, Egypt; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
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Harbertson J, Scott P, Graf P, Kennemur L, Jamerson M, House B, Balansay-Ames M, Myers CA, Brice G, Hale B. 1583Randomized, Active-duty U.S. Military Population-based NAAT Screening for Asymptomatic Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis Infection using De-identified Urine Samples Received by the Navy Drug Screening Laboratory, San Diego. Open Forum Infect Dis 2014. [PMCID: PMC5781598 DOI: 10.1093/ofid/ofu052.1129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Judith Harbertson
- Naval Health Research Center, San Diego, CA
- U.S. Military HIV Research Program, Bethesda, MD
| | - Paul Scott
- U.S. Military HIV Research Program, Bethesda, MD
| | - Paul Graf
- Laboratory, Naval Medical Center San Diego, San Diego, CA
| | | | | | - Brent House
- Laboratory, Naval Medical Center San Diego, San Diego, CA
| | | | | | - Gary Brice
- Naval Health Research Center, San Diego, CA
| | - Braden Hale
- Department of Defense HIV/AIDS Prevention Program, San Diego, CA
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Kavanaugh M, Johnson M, Graf P, Campbell W, Russell M, Betterton L, Ayoade R, Pugliese C, Hall N, House B, Chen K, Maves R. 1675A Novel Murine Pneumonia and Bacteremia Model for Carbapenem-Resistant Klebsiella pneumoniae Infection. Open Forum Infect Dis 2014. [PMCID: PMC5782140 DOI: 10.1093/ofid/ofu052.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
| | | | - Paul Graf
- Laboratory, Naval Medical Center San Diego, San Diego, CA
| | - Wesley Campbell
- Infectious Diseases, Naval Medical Center San Diego, San Diego, CA
| | - Matthew Russell
- Internal Medicine, Naval Medical Center San Diego, San Diego, CA
| | | | - Ramon Ayoade
- Vivarium, Naval Medical Center San Diego, San Diego, CA
| | - Cara Pugliese
- Special Operations Command, Camp Pendleton Marine Corps Base, Camp Pendleton, CA
| | - Natalie Hall
- Pharmacy, Naval Medical Center San Diego, San Diego, CA
| | - Brent House
- Laboratory, Naval Medical Center San Diego, San Diego, CA
| | - Kejian Chen
- CID, Naval Medical Center San Diego, San Diego, CA
| | - Ryan Maves
- Internal Medicine, Naval Medical Center San Diego, San Diego, CA
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8
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Akhvlediani T, Bautista CT, Shakarishvili R, Tsertsvadze T, Imnadze P, Tatishvili N, Davitashvili T, Samkharadze T, Chlikadze R, Dvali N, Dzigua L, Karchava M, Gatserelia L, Macharashvili N, Kvirkvelia N, Habashy EE, Farrell M, Rowlinson E, Sejvar J, Hepburn M, Pimentel G, Dueger E, House B, Rivard R. Etiologic agents of central nervous system infections among febrile hospitalized patients in the country of Georgia. PLoS One 2014; 9:e111393. [PMID: 25369023 PMCID: PMC4219716 DOI: 10.1371/journal.pone.0111393] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/24/2014] [Indexed: 11/29/2022] Open
Abstract
Objectives There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. Methods Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF) was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV) types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV), Streptococcus pneumoniae, HiB and Neisseria meningitidis. Results Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26), VZV (n = 4), and HSV-1 (n = 2). No patient was positive for mumps or HSV-2. Conclusions Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia.
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Affiliation(s)
- Tamar Akhvlediani
- I. Javakhishvili Tbilisi State University, Department of Neurology and Neurosurgery, Tbilisi, Georgia
- US Army Medical Research Unit-Georgia (USAMRU-G), Tbilisi, Georgia
- * E-mail:
| | - Christian T. Bautista
- Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Roman Shakarishvili
- P. Sarajishvili Institute of Clinical Neurology and Neurosurgery, Tbilisi, Georgia
| | - Tengiz Tsertsvadze
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Paata Imnadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Nana Tatishvili
- Neurology Department of the Iashvili Children's Hospital, Tbilisi, Georgia
| | - Tamar Davitashvili
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Tamar Samkharadze
- Neurology Department of the Iashvili Children's Hospital, Tbilisi, Georgia
| | - Rusudan Chlikadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Natia Dvali
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Lela Dzigua
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Mariam Karchava
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Lana Gatserelia
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Nino Macharashvili
- Scientific Research Center of Infectious Pathology, AIDS, and Clinical Immunology, Tbilisi, Georgia
| | - Nana Kvirkvelia
- P. Sarajishvili Institute of Clinical Neurology and Neurosurgery, Tbilisi, Georgia
| | - Engy Emil Habashy
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - Margaret Farrell
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - Emily Rowlinson
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - James Sejvar
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Hepburn
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
| | - Guillermo Pimentel
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - Erica Dueger
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Brent House
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - Robert Rivard
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
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Rahman BA, Wasfy MO, Maksoud MA, Hanna N, Dueger E, House B. Multi-drug resistance and reduced susceptibility to ciprofloxacin among Salmonella enterica serovar Typhi isolates from the Middle East and Central Asia. New Microbes New Infect 2014; 2:88-92. [PMID: 25356352 PMCID: PMC4184576 DOI: 10.1002/nmi2.46] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 03/16/2014] [Accepted: 04/18/2014] [Indexed: 12/03/2022] Open
Abstract
Typhoid fever is common in developing countries, with an estimated 120 million infections and 700 000 annual deaths, worldwide. Fluoroquinolones have been the treatment of choice for infection with multidrug-resistant (MDR) Salmonella enterica serovar Typhi (S. Typhi). However, alarming reports of fluoroquinolone-resistance and failure of typhoid fever treatment have recently been published. To determine the proportion of S. Typhi isolates with reduced susceptibility to ciprofloxacin (RSC) from six countries in the Middle East and Central Asia, 968 S. Typhi isolates collected between 2002 and 2007 from Egypt, Uzbekistan, Pakistan, Qatar, Jordan and Iraq were tested for antibiotic susceptibility to five antibiotics using the disc-diffusion method. MDR was defined as resistance to amicillin, chloramphenicol and trimethoprim-sulfamethoxazole. The E-test was employed to determine the MIC of ciprofloxacin only. Nalidixic acid resistance was evaluated as a marker for RSC. Interpretations were made according to CLSI guidelines. MDR strains were considerably more prevalent in Iraq (83%) and Pakistan (52%) compared with the other countries studied (13–52%). Nearly all isolates were susceptible (99.7%) to ceftriaxone. RSC was detected in a total of 218 isolates (22%), mostly from Iraq (54/59, 92%), Uzbekistan (98/123, 80%), Qatar (23/43, 54%) and Pakistan (31/65, 47%). Many of these (21%) were also MDR. Use of nalidixic acid resistance as an indicator for RSC was 99% sensitive and 98% specific. This study reinforces the need for routine antimicrobial susceptibility surveillance of enteric fever isolates and close review of current therapeutic policies in the region.
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Affiliation(s)
- B A Rahman
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 PSC 452 Box 5000, Cairo, FPO AE 09835-9998, Egypt
| | - M O Wasfy
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 PSC 452 Box 5000, Cairo, FPO AE 09835-9998, Egypt
| | - M A Maksoud
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 PSC 452 Box 5000, Cairo, FPO AE 09835-9998, Egypt
| | - N Hanna
- Central Public Health Laboratories Cairo, Egypt
| | - E Dueger
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 PSC 452 Box 5000, Cairo, FPO AE 09835-9998, Egypt ; Centers for Disease Control and Prevention Atlanta, GA, 30333, USA
| | - B House
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 PSC 452 Box 5000, Cairo, FPO AE 09835-9998, Egypt
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10
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Kuchuloria T, Imnadze P, Chokheli M, Tsertsvadze T, Endeladze M, Mshvidobadze K, Clark DV, Bautista CT, Abdel Fadeel M, Pimentel G, House B, Hepburn MJ, Wölfel S, Wölfel R, Rivard RG. Viral hemorrhagic fever cases in the country of Georgia: Acute Febrile Illness Surveillance Study results. Am J Trop Med Hyg 2014; 91:246-8. [PMID: 24891463 DOI: 10.4269/ajtmh.13-0460] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Minimal information is available on the incidence of Crimean-Congo hemorrhagic fever (CCHF) virus and hantavirus infections in Georgia. From 2008 to 2011, 537 patients with fever ≥ 38°C for ≥ 48 hours without a diagnosis were enrolled into a sentinel surveillance study to investigate the incidence of nine pathogens, including CCHF virus and hantavirus. Of 14 patients with a hemorrhagic fever syndrome, 3 patients tested positive for CCHF virus immunoglobulin M (IgM) antibodies. Two of the patients enrolled in the study had acute renal failure. These 2 of 537 enrolled patients were the only patients in the study positive for hantavirus IgM antibodies. These results suggest that CCHF virus and hantavirus are contributing causes of acute febrile syndromes of infectious origin in Georgia. These findings support introduction of critical diagnostic approaches and confirm the need for additional surveillance in Georgia.
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Affiliation(s)
- Tinatin Kuchuloria
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Paata Imnadze
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Maiko Chokheli
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Tengiz Tsertsvadze
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Marina Endeladze
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Ketevan Mshvidobadze
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Danielle V Clark
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Christian T Bautista
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Moustafa Abdel Fadeel
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Guillermo Pimentel
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Brent House
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Matthew J Hepburn
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Silke Wölfel
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Roman Wölfel
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Robert G Rivard
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia; National Center for Disease Control and Public Health, Tbilisi, Georgia; Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Walter Reed Army Institute of Research, Silver Spring, Maryland; Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt; US Army Medical Command; Bundeswehr Institute of Microbiology, Munich, Germany; US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
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11
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Akhvlediani T, Rowlinson E, Bautista C, Farrell M, Kuchuloria T, Tsertsvadze T, Shakarishvili R, Tatishvili N, Kvirkvelia N, Dvali N, Karchava M, Tsintsadze T, Kandashvili L, Chlikadze R, Imnadze P, Hepburn M, Pimentel G, House B, Dueger E, Rivard R. Etiologic agents of central nervous system infections in Georgia. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Newire EA, Ahmed SF, House B, Valiente E, Pimentel G. Detection of new SHV-12, SHV-5 and SHV-2a variants of extended spectrum beta-lactamase in Klebsiella pneumoniae in Egypt. Ann Clin Microbiol Antimicrob 2013; 12:16. [PMID: 23866018 PMCID: PMC3723734 DOI: 10.1186/1476-0711-12-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 06/30/2013] [Indexed: 11/10/2022] Open
Abstract
Background Klebsiella pneumoniae outbreaks possessing extended-spectrum β-lactamase- (ESBL) mediated resistance to third-generation cephalosporins have increased significantly in hospital and community settings worldwide. The study objective was to characterize prevalent genetic determinants of TEM, SHV and CTX-M types ESBL activity in K. pneumoniae isolates from Egypt. Methods Sixty five ESBL-producing K. pneumoniae strains, isolated from nosocomial and community-acquired infections from 10 Egyptian University hospitals (2000–2003), were confirmed with double disc-synergy method and E-test. blaTEM, blaSHV and blaCTX-m genes were identified by PCR and DNA sequencing. Pulsed-field gel electrophoresis (PFGE) was conducted for genotyping. Results All isolates displayed ceftazidime and cefotaxime resistance. blaTEM and blaSHV genes were detected in 98% of the isolates’ genomes, while 11% carried blaCTX-m. DNA sequencing revealed plasmid-borne SHV-12,-5,-2a (17%), CTX-m-15 (11%), and TEM-1 (10%) prevalence. Among SHV-12 (n=8), one isolate displayed 100% blaSHV-12 amino acid identity, while others had various point mutations: T17G (Leu to Arg, position 6 of the enzyme: n=2); A8T and A10G (Tyr and Ile to Phe and Val, positions 3 and 4, respectively: n=4), and; A703G (Lys to Glu 235: n=1). SHV-5 and SHV-2a variants were identified in three isolates: T17G (n=1); A703G and G705A (Ser and Lys to Gly and Glu: n=1); multiple mutations at A8T, A10G, T17G, A703G and G705A (n=1). Remarkably, 57% of community-acquired isolates carried CTX-m-15. PFGE demonstrated four distinct genetic clusters, grouping strains of different genetic backgrounds. Conclusions This is the first study demonstrating the occurrence of SHV-12, SHV-5 and SHV-2a variants in Egypt, indicating the spread of class A ESBL in K. pneumoniae through different mechanisms.
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Affiliation(s)
- Enas A Newire
- Global Disease Detection and Response Program, U,S, Naval Medical Research Unit No, 3 (NAMRU-3), Abbassia, Cairo, Egypt.
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13
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Otsyula N, Angov E, Bergmann-Leitner E, Koech M, Khan F, Bennett J, Otieno L, Cummings J, Andagalu B, Tosh D, Waitumbi J, Richie N, Shi M, Miller L, Otieno W, Otieno GA, Ware L, House B, Godeaux O, Dubois MC, Ogutu B, Ballou WR, Soisson L, Diggs C, Cohen J, Polhemus M, Heppner DG, Ockenhouse CF, Spring MD. Results from tandem Phase 1 studies evaluating the safety, reactogenicity and immunogenicity of the vaccine candidate antigen Plasmodium falciparum FVO merozoite surface protein-1 (MSP1(42)) administered intramuscularly with adjuvant system AS01. Malar J 2013; 12:29. [PMID: 23342996 PMCID: PMC3582548 DOI: 10.1186/1475-2875-12-29] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/14/2013] [Indexed: 01/06/2023] Open
Abstract
Background The development of an asexual blood stage vaccine against Plasmodium falciparum malaria based on the major merozoite surface protein-1 (MSP1) antigen is founded on the protective efficacy observed in preclinical studies and induction of invasion and growth inhibitory antibody responses. The 42 kDa C-terminus of MSP1 has been developed as the recombinant protein vaccine antigen, and the 3D7 allotype, formulated with the Adjuvant System AS02A, has been evaluated extensively in human clinical trials. In preclinical rabbit studies, the FVO allele of MSP142 has been shown to have improved immunogenicity over the 3D7 allele, in terms of antibody titres as well as growth inhibitory activity of antibodies against both the heterologous 3D7 and homologous FVO parasites. Methods Two Phase 1 clinical studies were conducted to examine the safety, reactogenicity and immunogenicity of the FVO allele of MSP142 in the adjuvant system AS01 administered intramuscularly at 0-, 1-, and 2-months: one in the USA and, after evaluation of safety data results, one in Western Kenya. The US study was an open-label, dose escalation study of 10 and 50 μg doses of MSP142 in 26 adults, while the Kenya study, evaluating 30 volunteers, was a double-blind, randomized study of only the 50 μg dose with a rabies vaccine comparator. Results In these studies it was demonstrated that this vaccine formulation has an acceptable safety profile and is immunogenic in malaria-naïve and malaria-experienced populations. High titres of anti-MSP1 antibodies were induced in both study populations, although there was a limited number of volunteers whose serum demonstrated significant inhibition of blood-stage parasites as measured by growth inhibition assay. In the US volunteers, the antibodies generated exhibited better cross-reactivity to heterologous MSP1 alleles than a MSP1-based vaccine (3D7 allele) previously tested at both study sites. Conclusions Given that the primary effector mechanism for blood stage vaccine targets is humoral, the antibody responses demonstrated to this vaccine candidate, both quantitative (total antibody titres) and qualitative (functional antibodies inhibiting parasite growth) warrant further consideration of its application in endemic settings. Trial registrations Clinical Trials NCT00666380
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Affiliation(s)
- Nekoye Otsyula
- Walter Reed Project, Kenya Medical Research Institute, Kisumu, Kenya
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14
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Hafez S, Saied T, Hasan E, Elnawasany M, Ahmad E, Lloyd L, El-Shobary W, House B, Talaat M. Incidence and modifiable risk factors of surveillance of surgical site infections in Egypt: a prospective study. Am J Infect Control 2012; 40:426-30. [PMID: 21943830 DOI: 10.1016/j.ajic.2011.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 07/04/2011] [Accepted: 07/05/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Surgical site infections (SSIs) contribute significantly to patient morbidity and mortality and exhaust health care system resources. The main objectives of the study were to describe the incidence rates of SSIs among patients undergoing urologic or cardiothoracic surgeries, the associated risk factors, and the common causative etiologies found at Alexandria University Hospital in Egypt. METHODS A prospective active surveillance study for patients undergoing urologic and cardiothoracic surgeries was implemented from July 2009 to December 2010. Patients were inspected daily for developing SSIs and with a 30-day postoperative follow-up. Wound swabs were obtained from patients who had clinical signs suggestive of infection. Swabs were cultured for bacterial identification and tested for antimicrobial sensitivity. Standard Centers for Disease Control and Prevention National Health Safety Network case definitions were used. RESULTS SSIs occurred in 187 (17%) of patients with complete follow-up (n = 1,062), of which 106 (57%) occurred in-hospital and 81 (43%) occurred after discharge. Higher SSI rates were observed in cardiothoracic surgeries (23.3%), compared with urologic surgeries (9%) (P < .001). A stepwise logistic model identified an increased risk of SSI for those who underwent cardiothoracic surgeries (odds ratio [OR], 4.7; 95% confidence interval [CI], 2.2-11.1), those aged >45 years (OR, 2.32; 95% CI, 1.35-4.01), increased duration of hospital stay before (OR, 1.03; 95% CI, 1.01-1.05) and after (OR, 1.07; 95% CI, 1.04-1.09) surgery, antibiotics ≤24 hours before surgery (OR, 2.54; 95% CI, 1.63-3.94), and dirty wounds (OR, 4.09; 95% CI, 1.60-10.43). CONCLUSIONS Measures to reduce the high rates of SSI need to be instituted through a multidisciplinary effort including infection control education and specific SSI prevention activities at Alexandria University Hospital.
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Sedegah M, Tamminga C, McGrath S, House B, Ganeshan H, Lejano J, Abot E, Banania GJ, Sayo R, Farooq F, Belmonte M, Manohar N, Richie NO, Wood C, Long CA, Regis D, Williams FT, Shi M, Chuang I, Spring M, Epstein JE, Mendoza-Silveiras J, Limbach K, Patterson NB, Bruder JT, Doolan DL, King CR, Soisson L, Diggs C, Carucci D, Dutta S, Hollingdale MR, Ockenhouse CF, Richie TL. Adenovirus 5-vectored P. falciparum vaccine expressing CSP and AMA1. Part A: safety and immunogenicity in seronegative adults. PLoS One 2011; 6:e24586. [PMID: 22003383 PMCID: PMC3189181 DOI: 10.1371/journal.pone.0024586] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 08/15/2011] [Indexed: 11/24/2022] Open
Abstract
Background Models of immunity to malaria indicate the importance of CD8+ T cell responses for targeting intrahepatic stages and antibodies for targeting sporozoite and blood stages. We designed a multistage adenovirus 5 (Ad5)-vectored Plasmodium falciparum malaria vaccine, aiming to induce both types of responses in humans, that was tested for safety and immunogenicity in a Phase 1 dose escalation trial in Ad5-seronegative volunteers. Methodology/Principal Findings The NMRC-M3V-Ad-PfCA vaccine combines two adenovectors encoding circumsporozoite protein (CSP) and apical membrane antigen-1 (AMA1). Group 1 (n = 6) healthy volunteers received one intramuscular injection of 2×10∧10 particle units (1×10∧10 each construct) and Group 2 (n = 6) a five-fold higher dose. Transient, mild to moderate adverse events were more pronounced with the higher dose. ELISpot responses to CSP and AMA1 peaked at 1 month, were higher in the low dose (geomean CSP = 422, AMA1 = 862 spot forming cells/million) than in the high dose (CSP = 154, p = 0.049, AMA1 = 423, p = 0.045) group and were still positive at 12 months in a number of volunteers. ELISpot depletion assays identified dependence on CD4+ or on both CD4+ and CD8+ T cells, with few responses dependent only on CD8+ T cells. Intracellular cytokine staining detected stronger CD8+ than CD4+ T cell IFN-γ responses (CSP p = 0.0001, AMA1 p = 0.003), but similar frequencies of multifunctional CD4+ and CD8+ T cells secreting two or more of IFN-γ, TNF-α or IL-2. Median fluorescence intensities were 7–10 fold higher in triple than single secreting cells. Antibody responses were low but trended higher in the high dose group and did not inhibit growth of cultured P. falciparum blood stage parasites. Significance As found in other trials, adenovectored vaccines appeared safe and well-tolerated at doses up to 1×10∧11 particle units. This is the first demonstration in humans of a malaria vaccine eliciting strong CD8+ T cell IFN-γ responses. Trial Registration ClinicalTrials.govNCT00392015
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Affiliation(s)
- Martha Sedegah
- U.S. Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, Maryland, United States of America.
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Tamminga C, Sedegah M, Regis D, Chuang I, Epstein JE, Spring M, Mendoza-Silveiras J, McGrath S, Maiolatesi S, Reyes S, Steinbeiss V, Fedders C, Smith K, House B, Ganeshan H, Lejano J, Abot E, Banania GJ, Sayo R, Farooq F, Belmonte M, Murphy J, Komisar J, Williams J, Shi M, Brambilla D, Manohar N, Richie NO, Wood C, Limbach K, Patterson NB, Bruder JT, Doolan DL, King CR, Diggs C, Soisson L, Carucci D, Levine G, Dutta S, Hollingdale MR, Ockenhouse CF, Richie TL. Adenovirus-5-vectored P. falciparum vaccine expressing CSP and AMA1. Part B: safety, immunogenicity and protective efficacy of the CSP component. PLoS One 2011; 6:e25868. [PMID: 22003411 PMCID: PMC3189219 DOI: 10.1371/journal.pone.0025868] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 09/12/2011] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND A protective malaria vaccine will likely need to elicit both cell-mediated and antibody responses. As adenovirus vaccine vectors induce both these responses in humans, a Phase 1/2a clinical trial was conducted to evaluate the efficacy of an adenovirus serotype 5-vectored malaria vaccine against sporozoite challenge. METHODOLOGY/PRINCIPAL FINDINGS NMRC-MV-Ad-PfC is an adenovirus vector encoding the Plasmodium falciparum 3D7 circumsporozoite protein (CSP). It is one component of a two-component vaccine NMRC-M3V-Ad-PfCA consisting of one adenovector encoding CSP and one encoding apical membrane antigen-1 (AMA1) that was evaluated for safety and immunogenicity in an earlier study (see companion paper, Sedegah et al). Fourteen Ad5 seropositive or negative adults received two doses of NMRC-MV-Ad-PfC sixteen weeks apart, at 1 x 1010 particle units per dose. The vaccine was safe and well tolerated. All volunteers developed positive ELISpot responses by 28 days after the first immunization (geometric mean 272 spot forming cells/million[sfc/m]) that declined during the following 16 weeks and increased after the second dose to levels that in most cases were less than the initial peak (geometric mean 119 sfc/m). CD8+ predominated over CD4+ responses, as in the first clinical trial. Antibody responses were poor and like ELISpot responses increased after the second immunization but did not exceed the initial peak. Pre-existing neutralizing antibodies (NAb) to Ad5 did not affect the immunogenicity of the first dose, but the fold increase in NAb induced by the first dose was significantly associated with poorer antibody responses after the second dose, while ELISpot responses remained unaffected. When challenged by the bite of P. falciparum-infected mosquitoes, two of 11 volunteers showed a delay in the time to patency compared to infectivity controls, but no volunteers were sterilely protected. SIGNIFICANCE The NMRC-MV-Ad-PfC vaccine expressing CSP was safe and well tolerated given as two doses, but did not provide sterile protection. TRIAL REGISTRATION ClinicalTrials.gov NCT00392015.
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Affiliation(s)
- Cindy Tamminga
- U.S. Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, Maryland, United States of America.
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17
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Thera MA, Doumbo OK, Coulibaly D, Laurens MB, Ouattara A, Kone AK, Guindo AB, Traore K, Traore I, Kouriba B, Diallo DA, Diarra I, Daou M, Dolo A, Tolo Y, Sissoko MS, Niangaly A, Sissoko M, Takala-Harrison S, Lyke KE, Wu Y, Blackwelder WC, Godeaux O, Vekemans J, Dubois MC, Ballou WR, Cohen J, Thompson D, Dube T, Soisson L, Diggs CL, House B, Lanar DE, Dutta S, Heppner DG, Plowe CV. A field trial to assess a blood-stage malaria vaccine. N Engl J Med 2011; 365:1004-13. [PMID: 21916638 PMCID: PMC3242358 DOI: 10.1056/nejmoa1008115] [Citation(s) in RCA: 275] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Blood-stage malaria vaccines are intended to prevent clinical disease. The malaria vaccine FMP2.1/AS02(A), a recombinant protein based on apical membrane antigen 1 (AMA1) from the 3D7 strain of Plasmodium falciparum, has previously been shown to have immunogenicity and acceptable safety in Malian adults and children. METHODS In a double-blind, randomized trial, we immunized 400 Malian children with either the malaria vaccine or a control (rabies) vaccine and followed them for 6 months. The primary end point was clinical malaria, defined as fever and at least 2500 parasites per cubic millimeter of blood. A secondary end point was clinical malaria caused by parasites with the AMA1 DNA sequence found in the vaccine strain. RESULTS The cumulative incidence of the primary end point was 48.4% in the malaria-vaccine group and 54.4% in the control group; efficacy against the primary end point was 17.4% (hazard ratio for the primary end point, 0.83; 95% confidence interval [CI], 0.63 to 1.09; P=0.18). Efficacy against the first and subsequent episodes of clinical malaria, as defined on the basis of various parasite-density thresholds, was approximately 20%. Efficacy against clinical malaria caused by parasites with AMA1 corresponding to that of the vaccine strain was 64.3% (hazard ratio, 0.36; 95% CI, 0.08 to 0.86; P=0.03). Local reactions and fever after vaccination were more frequent with the malaria vaccine. CONCLUSIONS On the basis of the primary end point, the malaria vaccine did not provide significant protection against clinical malaria, but on the basis of secondary results, it may have strain-specific efficacy. If this finding is confirmed, AMA1 might be useful in a multicomponent malaria vaccine. (Funded by the National Institute of Allergy and Infectious Diseases and others; ClinicalTrials.gov number, NCT00460525.).
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Affiliation(s)
- Mahamadou A Thera
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
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18
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Thera MA, Doumbo OK, Coulibaly D, Laurens MB, Kone AK, Guindo AB, Traore K, Sissoko M, Diallo DA, Diarra I, Kouriba B, Daou M, Dolo A, Baby M, Sissoko MS, Sagara I, Niangaly A, Traore I, Olotu A, Godeaux O, Leach A, Dubois MC, Ballou WR, Cohen J, Thompson D, Dube T, Soisson L, Diggs CL, Takala SL, Lyke KE, House B, Lanar DE, Dutta S, Heppner DG, Plowe CV. Safety and immunogenicity of an AMA1 malaria vaccine in Malian children: results of a phase 1 randomized controlled trial. PLoS One 2010; 5:e9041. [PMID: 20140214 PMCID: PMC2816207 DOI: 10.1371/journal.pone.0009041] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 01/07/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The objective was to evaluate the safety and immunogenicity of the AMA1-based malaria vaccine FMP2.1/AS02(A) in children exposed to seasonal falciparum malaria. METHODOLOGY/PRINCIPAL FINDINGS A Phase 1 double blind randomized controlled dose escalation trial was conducted in Bandiagara, Mali, West Africa, a rural town with intense seasonal transmission of Plasmodium falciparum malaria. The malaria vaccine FMP2.1/AS02(A) is a recombinant protein (FMP2.1) based on apical membrane antigen 1 (AMA1) from the 3D7 clone of P. falciparum, formulated in the Adjuvant System AS02(A). The comparator vaccine was a cell-culture rabies virus vaccine (RabAvert). One hundred healthy Malian children aged 1-6 years were recruited into 3 cohorts and randomized to receive either 10 microg FMP2.1 in 0.1 mL AS02(A), or 25 microg FMP2.1 in 0.25 mL AS02(A), or 50 microg FMP2.1 50 microg in 0.5 mL AS02(A), or rabies vaccine. Three doses of vaccine were given at 0, 1 and 2 months, and children were followed for 1 year. Solicited symptoms were assessed for 7 days and unsolicited symptoms for 30 days after each vaccination. Serious adverse events were assessed throughout the study. Transient local pain and swelling were common and more frequent in all malaria vaccine dosage groups than in the comparator group, but were acceptable to parents of participants. Levels of anti-AMA1 antibodies measured by ELISA increased significantly (at least 100-fold compared to baseline) in all 3 malaria vaccine groups, and remained high during the year of follow up. CONCLUSION/SIGNIFICANCE The FMP2.1/AS02(A) vaccine had a good safety profile, was well-tolerated, and induced high and sustained antibody levels in malaria-exposed children. This malaria vaccine is being evaluated in a Phase 2 efficacy trial in children at this site. TRIAL REGISTRATION ClinicalTrials.gov NCT00358332 [NCT00358332].
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Affiliation(s)
- Mahamadou A. Thera
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Ogobara K. Doumbo
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Drissa Coulibaly
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Matthew B. Laurens
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Abdoulaye K. Kone
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Ando B. Guindo
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Karim Traore
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Mady Sissoko
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Dapa A. Diallo
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Issa Diarra
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Bourema Kouriba
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Modibo Daou
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Amagana Dolo
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Mounirou Baby
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | | | - Issaka Sagara
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Amadou Niangaly
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Idrissa Traore
- Malaria Research and Training Center, University of Bamako, Bamako, Mali
| | - Ally Olotu
- GlaxoSmithKline Biologicals, Rixensart, Belgium
| | | | | | | | | | - Joe Cohen
- GlaxoSmithKline Biologicals, Rixensart, Belgium
| | - Darby Thompson
- EMMES Corporation, Rockville, Maryland, United States of America
| | - Tina Dube
- EMMES Corporation, Rockville, Maryland, United States of America
| | - Lorraine Soisson
- Malaria Vaccine Development Program, U.S. Agency for International Development, Washington, D.C., United States of America
| | - Carter L. Diggs
- Malaria Vaccine Development Program, U.S. Agency for International Development, Washington, D.C., United States of America
| | - Shannon L. Takala
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Kirsten E. Lyke
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Brent House
- Division of Malaria Vaccine Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - David E. Lanar
- Division of Malaria Vaccine Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Sheetij Dutta
- Division of Malaria Vaccine Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - D. Gray Heppner
- Division of Malaria Vaccine Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Christopher V. Plowe
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
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19
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Pichyangkul S, Tongtawe P, Kum-Arb U, Yongvanitchit K, Gettayacamin M, Hollingdale MR, Limsalakpetch A, Stewart VA, Lanar DE, Dutta S, Angov E, Ware LA, Bergmann-Leitner ES, House B, Voss G, Dubois MC, Cohen JD, Fukuda MM, Heppner DG, Miller RS. Evaluation of the safety and immunogenicity of Plasmodium falciparum apical membrane antigen 1, merozoite surface protein 1 or RTS,S vaccines with adjuvant system AS02A administered alone or concurrently in rhesus monkeys. Vaccine 2009; 28:452-62. [PMID: 19857448 DOI: 10.1016/j.vaccine.2009.10.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 09/29/2009] [Accepted: 10/07/2009] [Indexed: 11/15/2022]
Abstract
In an effort to broaden the immune response induced by the RTS,S/AS02(A),vaccine, we have evaluated the immunogenicity of the RTS,S antigen when combined with MSP1(42) and with AMA1, antigens derived from the asexual blood stage. The objectives of this study were (i) to determine whether MSP1(42) and AMA1 vaccines formulated with the AS02(A) Adjuvant System were safe and immunogenic in the rhesus monkey model; (ii) to investigate whether MSP1(42) or AMA1 induced immune interference to each other, or to RTS,S, when added singly or in combinations at a single injection site; (iii) in the event of immune interference, to determine if this could be reduced when antigens were administered at separate sites. We found that MSP1(42) and AMA1 were safe and immunogenic, eliciting antibodies, and Th1 and Th2 responses using IFN-gamma and IL-5 as markers. When malaria antigens were delivered together in one formulation, MSP1(42) and RTS,S reduced AMA1-specific antibody responses as measured by ELISA however, only MSP1(42) lowered parasite growth inhibitory activity of anti-AMA1 antibodies as measured by in vitro growth inhibition assay. Unlike RTS,S, MSP1(42) significantly reduced AMA1 IFN-gamma and IL-5 responses. MSP1(42) suppression of AMA1 IFN-gamma responses was not seen in animals receiving RTS,S+AMA1+MSP1(42) suggesting that RTS,S restored IFN-gamma responses. Conversely, AMA1 had no effect on MSP1(42) antibody and IFN-gamma and IL-5 responses. Neither AMA1 alone or combined with MSP1(42) affected RTS,S antibody or IFN-gamma and IL-5 responses. Immune interference by MSP1(42) on AMA1 antibody responses was also evident when AMA1, MSP1(42) and RTS,S were administered concurrently at separate sites. These results suggest that immune interference may be complex and should be considered for the design of multi-antigen, multi-stage vaccines against malaria.
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Affiliation(s)
- S Pichyangkul
- Department of Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
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20
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Plassmeyer ML, Reiter K, Shimp RL, Kotova S, Smith PD, Hurt DE, House B, Zou X, Zhang Y, Hickman M, Uchime O, Herrera R, Nguyen V, Glen J, Lebowitz J, Jin AJ, Miller LH, MacDonald NJ, Wu Y, Narum DL. Structure of the Plasmodium falciparum circumsporozoite protein, a leading malaria vaccine candidate. J Biol Chem 2009; 284:26951-63. [PMID: 19633296 PMCID: PMC2785382 DOI: 10.1074/jbc.m109.013706] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 07/17/2009] [Indexed: 11/06/2022] Open
Abstract
The Plasmodium falciparum circumsporozoite protein (CSP) is critical for sporozoite function and invasion of hepatocytes. Given its critical nature, a phase III human CSP malaria vaccine trial is ongoing. The CSP is composed of three regions as follows: an N terminus that binds heparin sulfate proteoglycans, a four amino acid repeat region (NANP), and a C terminus that contains a thrombospondin-like type I repeat (TSR) domain. Despite the importance of CSP, little is known about its structure. Therefore, recombinant forms of CSP were produced by expression in both Escherichia coli (Ec) and then refolded (EcCSP) or in the methylotrophic yeast Pichia pastoris (PpCSP) for structural analyses. To analyze the TSR domain of recombinant CSP, conformation-dependent monoclonal antibodies that recognized unfixed P. falciparum sporozoites and inhibited sporozoite invasion of HepG2 cells in vitro were identified. These monoclonal antibodies recognized all recombinant CSPs, indicating the recombinant CSPs contain a properly folded TSR domain structure. Characterization of both EcCSP and PpCSP by dynamic light scattering and velocity sedimentation demonstrated that both forms of CSP appeared as highly extended proteins (R(h) 4.2 and 4.58 nm, respectively). Furthermore, high resolution atomic force microscopy revealed flexible, rod-like structures with a ribbon-like appearance. Using this information, we modeled the NANP repeat and TSR domain of CSP. Consistent with the biochemical and biophysical results, the repeat region formed a rod-like structure about 21-25 nm in length and 1.5 nm in width. Thus native CSP appears as a glycosylphosphatidylinositol-anchored, flexible rod-like protein on the sporozoite surface.
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Affiliation(s)
- Matthew L. Plassmeyer
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Karine Reiter
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Richard L. Shimp
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Svetlana Kotova
- Laboratory of Bioengineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892
| | - Paul D. Smith
- Laboratory of Bioengineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892
| | - Darrell E. Hurt
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, NIAID, National Institutes of Health, Bethesda, Maryland 20892, and
| | - Brent House
- United States Navy, Naval Medical Research Center, Silver Spring, Maryland 20910
| | - Xiaoyan Zou
- United States Navy, Naval Medical Research Center, Silver Spring, Maryland 20910
| | - Yanling Zhang
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Merrit Hickman
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Onyinyechukwu Uchime
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Raul Herrera
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Vu Nguyen
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Jacqueline Glen
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Jacob Lebowitz
- Laboratory of Bioengineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892
| | - Albert J. Jin
- Laboratory of Bioengineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892
| | - Louis H. Miller
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Nicholas J. MacDonald
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - Yimin Wu
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
| | - David L. Narum
- From the Malaria Vaccine Development Branch, NIAID, National Institutes of Health, Rockville, Maryland 20852
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21
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Sachs JD, Baillie JEM, Sutherland WJ, Armsworth PR, Ash N, Beddington J, Blackburn TM, Collen B, Gardiner B, Gaston KJ, Godfray HCJ, Green RE, Harvey PH, House B, Knapp S, Kumpel NF, Macdonald DW, Mace GM, Mallet J, Matthews A, May RM, Petchey O, Purvis A, Roe D, Safi K, Turner K, Walpole M, Watson R, Jones KE. Biodiversity Conservation and the Millennium Development Goals. Science 2009; 325:1502-3. [DOI: 10.1126/science.1175035] [Citation(s) in RCA: 188] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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22
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House B, Kus JV, Prayitno N, Mair R, Que L, Chingcuanco F, Gannon V, Cvitkovitch DG, Barnett Foster D. Acid-stress-induced changes in enterohaemorrhagic Escherichia coli O157 : H7 virulence. Microbiology (Reading) 2009; 155:2907-2918. [DOI: 10.1099/mic.0.025171-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Enterohaemorrhagic Escherichia coli (EHEC) O157 : H7 is naturally exposed to a wide variety of stresses including gastric acid shock, and yet little is known about how this stress influences virulence. This study investigated the impact of acid stress on several critical virulence properties including survival, host adhesion, Shiga toxin production, motility and induction of host-cell apoptosis. Several acid-stress protocols with relevance for gastric passage as well as external environmental exposure were included. Acute acid stress at pH 3 preceded by acid adaptation at pH 5 significantly enhanced the adhesion of surviving organisms to epithelial cells and bacterial induction of host-cell apoptosis. Motility was also significantly increased after acute acid stress. Interestingly, neither secreted nor periplasmic levels of Shiga toxin were affected by acid shock. Pretreatment of bacteria with erythromycin eliminated the acid-induced adhesion enhancement, suggesting that de novo protein synthesis was required for the enhanced adhesion of acid-shocked organisms. DNA microarray was used to analyse the transcriptome of an EHEC O157 : H7 strain exposed to three different acid-stress treatments. Expression profiles of acid-stressed EHEC revealed significant changes in virulence factors associated with adhesion, motility and type III secretion. These results document profound changes in the virulence properties of EHEC O157 : H7 after acid stress, provide a comprehensive genetic analysis to substantiate these changes and suggest strategies that this pathogen may use during gastric passage and colonization in the human gastrointestinal tract.
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Affiliation(s)
- B. House
- Department of Chemistry and Biology, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - J. V. Kus
- Department of Chemistry and Biology, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - N. Prayitno
- Department of Chemistry and Biology, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - R. Mair
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - L. Que
- Department of Chemistry and Biology, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - F. Chingcuanco
- Department of Chemistry and Biology, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - V. Gannon
- Public Health Agency of Canada, Lethbridge, Alberta, Canada
| | | | - D. Barnett Foster
- Department of Chemistry and Biology, Ryerson University, Toronto, ON M5B 2K3, Canada
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23
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Elting JJ, Mikhail WE, Zicat BA, Hubbell JC, Lane LE, House B. Preliminary report of impaction grafting for exchange femoral arthroplasty. Clin Orthop Relat Res 1995:159-67. [PMID: 7554625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Gie and Ling have described a method for femoral component revision using compressed morselized cancellous allograft and a cemented collarless polished taper stem. The authors report their early experience with this technique. Of the first 67 patients who had femoral exchange by impaction grafting, 60 were alive 2 to 5 years after hip revision; 2 hips failed because of late sepsis, and 5 patients were decreased. In 56 individuals available for review, the Harris Hip Score average was 90 points, with > 80% reporting no pain. On radiograph, 48% of the stems showed an average of 2.8 mm of subsidence in the polymethylmethacrylate mantle, but only 7% of the cement graft composites had subsided in the cortical tube. Lucent lines were rare, and in 93% of revised femurs the radiographs showed evidence of graft incorporation and bone remodeling. There were 6 reoperations in the group: 3 for late fracture of the femoral shaft and 3 for cup exchange (2 chronically dislocating, 1 loose). No evidence for femoral component loosening was found in this group. Further study is necessary, but these preliminary findings give rise to cautious optimism that this is a reliable method for femoral revision, reconstruction, and reconstitution.
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Affiliation(s)
- J J Elting
- Otsego Orthopaedics, PC, Oneonta, New York 13820, USA
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24
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Mills EW, Comerford JW, Hollender R, Harpster HW, House B, Henning WR. Meat composition and palatability of Holstein and beef steers as influenced by forage type and protein source. J Anim Sci 1992; 70:2446-51. [PMID: 1506306 DOI: 10.2527/1992.7082446x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This experiment determined meat composition and palatability changes resulting from feeding Holstein (HOL) and crossbred beef (XB) steers diets containing corn silage (CS) or alfalfa haylage (AH) (forage type) and soybean meal (SM) or fish meal (FM) (protein source). Fifty-nine steers (30 HOL and 29 XB) were randomly assigned to diet combinations for a 2 x 2 x 2 (breed x forage x protein) factorial arrangement. Steers were fed to a fat-constant end point (fat depth over the longissimus muscle measured by ultrasound: 1.0 cm XB, .6 cm HOL). Proximate and fatty acid analysis and sensory evaluation were conducted on a rib eye roast and steaks, respectively, removed from the left side of each carcass at ribs 9 to 12. Proximate analysis of the longissimus muscle showed no significant difference (P greater than .05) in moisture, protein, or fat content due to breed, forage, or protein treatment. Forage type had no significant effect (P greater than .05) on amount of individual fatty acids found in longissimus muscle. However, total polyunsaturated fatty acids were higher (P greater than .05) for AH than for CS-fed animals. Longissimus muscle from steers fed FM had higher palmitoleic and lower stearic acid contents (both P less than .05) than longissimus muscle from animals fed SM. Muscle from HOL had higher palmitoleic and lower stearic acid contents than that from XB steers (both P less than .05). There was no significant interaction (P greater than .05) of breed with either diet treatment for individual fatty acid contents.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E W Mills
- Department of Dairy and Animal Science, Pennsylvania State University, University Park 16802
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25
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Abstract
A prospective, randomized, double-masked study compared topical 1% ALO 2145, an alpha 2-agonist, with placebo in therapy for immediate postoperative intraocular pressure (IOP) rise after argon laser trabeculoplasty. Seventy-three eyes (73 patients) underwent 360 degrees of treatment utilizing 80 spots of 800 to 1000 mW of power. Intraocular pressure rise was measured hourly for the first three hours after operation, at one week, and at one month. Eyes treated with ALO 2145 had both significantly lower mean IOPs and greater IOP decreases from baseline than placebo-treated eyes during the first three hours after operation. No eyes treated with ALO 2145 and six eyes (18%) treated with placebo experienced an IOP rise of 10 mm Hg or greater. Twenty eyes (59%) in the placebo group and eight eyes (21%) treated with ALO 2145 had an IOP elevation. No change was detected in the mean heart rate. ALO 2145 appears to be effective in eliminating large, acute IOP elevations after argon laser trabeculoplasty.
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Abstract
The authors investigated the retinal toxicity of the antiviral agent ganciclovir after its addition to vitrectomy infusion fluid in rabbit eyes. Intravitreal infusion of the drug in concentrations up to 30 micrograms/ml produced no electroretinographic or histologic changes suggestive of retinal toxicity. Ganciclovir in vitrectomy infusion fluid has potential therapeutic benefit in viral retinitis (particularly in cytomegalovirus retinitis) associated with vitreous traction or rhegmatogenous retinal detachment. Based on the median inhibitory doses of ganciclovir against various herpes group viruses and the results of this study, a concentration of 30 micrograms/ml or less of the drug is recommended for vitrectomy infusion solution.
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Abstract
The authors have developed a CW YAG laser for transpupillary coagulation. The effects of CW YAG coagulation on the retina, retinal vessels, and fovea were compared with those produced by the krypton red and argon green lasers. To produce threshold coagulative lesions in monkeys and rabbits, we needed five to ten times more energy with the CW YAG than with the krypton red or argon green lasers. Nerve fiber damage was observed only when coagulating retinal vessels with the argon green laser. At the parameters used, none of the lasers damaged the sensory retina of the fovea. The CW YAG may be used as a new mode of laser coagulation in the treatment of retinal diseases.
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Leeds NH, Peyman GA, House B. Moxalactam (Moxam) in the treatment of experimental staphylococcal endophthalmitis. Ophthalmic Surg 1982; 13:653-6. [PMID: 6215601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We investigated the intraocular penetration, retinal toxicity, clearance from the vitreous, and antibacterial activity of moxalactam (Moxam), a new third-generation cephalosporin with activity against aerobic and anaerobic gram positive organisms and many gram negative organisms. Seventy-four albino rabbits were used. Subconjunctival injection yielded therapeutic aqueous and vitreous levels for all hours studied. Intraocular penetration following single dose intravenous and intramuscular administration was poor. Two mg injected into the vitreous produced rare focal retinal toxicity. Eleven of the 11 eyes receiving intravitreal injections of 2 mg moxalactam eight hours after inoculation with S. aureus were sterile and free of morphologic changes. Moxalactam appears to be a potent broad spectrum antibiotic with a low degree of toxicity to rabbit retinal tissue.
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Hanna GS, House B, Salisbury LH. WAIS performance of Alaskan native university freshmen. J Genet Psychol 1968; 112:57-61. [PMID: 5651356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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