Pan-Enterovirus Characterization Reveals Cryptic Circulation of Clinically Relevant Subtypes in Arizona Wastewater

Background

Most seasonally circulating enteroviruses result in asymptomatic or mildly symptomatic infections. In rare cases, however, infection with some subtypes can result in paralysis or death. Of the 300 subtypes known, only poliovirus is reportable, limiting our understanding of the distribution of other enteroviruses that can cause clinical disease.

Objective

The overarching objectives of this study were to: 1) describe the distribution of enteroviruses in Arizona during the late summer and fall of 2022, the time of year when they are thought to be most abundant, and 2) demonstrate the utility of viral pan-assay approaches for semi-agnostic discovery that can be followed up by more targeted assays and phylogenomics.

Methods

This study utilizes pooled nasal samples collected from school-aged children and long-term care facility residents, and wastewater from multiple locations in Arizona during July-October of 2022. We used PCR to amplify and sequence a region common to all enteroviruses, followed by species-level bioinformatic characterization using the QIIME 2 platform. For Enterovirus-D68 (EV-D68), detection was carried out using RT-qPCR, followed by confirmation using near-complete whole EV-D68 genome sequencing using a newly designed tiled amplicon approach.

Results

In the late summer and early fall of 2022, multiple enterovirus species were identified in Arizona wastewater, with Coxsackievirus A6, EV-D68, and Coxsackievirus A19 composing 86% of the characterized reads sequenced. While EV-D68 was not identified in pooled human nasal samples, and the only reported acute flaccid myelitis case in Arizona did not test positive for the virus, an in-depth analysis of EV-D68 in wastewater revealed that the virus was circulating from August through mid-October. A phylogenetic analysis on this relatively limited dataset revealed just a few importations into the state, with a single clade indicating local circulation.

Significance

This study further supports the utility of wastewater-based epidemiology to identify potential public health threats. Our further investigations into EV-D68 shows how these data might help inform healthcare diagnoses for children presenting with concerning neurological symptoms.

Insulin resistance and need for a lifestyle change to eliminate it

The AIM of our work is to point out the relationship between insulin resistance and metabolic compensation of diabetes mellitus, as well as to explore the possibilities of improving these parameters by non-drug measures. The rising incidence of insulin resistance associated with many comorbidities, especially due to the increase in obesity and unhealthy lifestyles, is a serious medical problem today. It is therefore necessary to be able to recognize and evaluate the presence of insulin resistance, prevent its occurrence, and ensure its elimination in high-risk individuals. In our study, we evaluated 106 patients with diabetes mellitus based on glycated hemoglobin parameters, ratio of triacylglycerols to high-density lipoproteins, and body mass index before and after adjustment of dietary and regime measures. Statistical analysis of our data showed a positive correlation between the assessed parameters of insulin resistance and metabolic compensation of diabetes with a Pearson correlation coefficient of 0.3156, and a decrease in glycated hemoglobin and insulin resistance after adjustment of dietary and regimen measures in 73.58 % of patients. Based on the above results, it is shown that non-drug measures are able to significantly improve the parameters of metabolic compensation of diabetes mellitus as well as those of insulin resistance (Tab. 4, Fig. 1, Ref. 18) Keywords: insulin resistance, TAG/HDL ratio, diabetes mellitus.

In vitro effect of essential oils and isolated mono- and sesquiterpenes on Leishmania major and Trypanosoma brucei

The effect of different essential oils as well as of isolated mono- and sesquiterpenes on the viability of bloodstream forms of Trypanosoma brucei, promastigotes of Leishmania major and human HL-60 cells was evaluated using the Almar Blue assay. Of the 12 essential oils and 8 terpenes investigated, only three essential oils, Melissa officinalis (balmmint) oil, Thymus vulgaris (thyme) oil, and Melaleuca alternifolia (tea tree) oil were about 50-fold and 80-fold more toxic to bloodstream forms of T. brucei than to HL-60 cells, respectively. Terpinen-4-ol, the main compound of the Australian tea tree oil, was even 1000-fold more toxic to trypanosomes than to the human cells. On the other hand, none of the essential oils and terpenes tested were more toxic to promastigotes of L. major than to HL-60 cells.

A simple colorimetric method to screen drug cytotoxicity against Leishmania using the dye Alamar Blue

A quantitative colorimetric assay using the oxidation-reduction indicator Alamar Blue was developed to measure cytotoxicity of compounds against the protozoan parasite Leishmania. Absorbance increased linearly with the plating density of promastigotes of L. major MRHO/IR/76 vaccine strain up to at least 2.5 x 10(6) cells/ml when parasites were incubated for 72 h in the presence of 10% Alamar Blue. The 50% effective dose values of common drugs (amphotericin B, pentostam and paromomycin) obtained by this assay were in the same range as previously determined by other methods. The Alamar Blue assay permits a simple, reproducible and reliable method for screening antileishmanial drugs.