Role of interferons in the antiviral battle: from virus-host crosstalk to prophylactic and therapeutic potential in SARS-CoV-2 infection

Mammalians sense antigenic messages from infectious agents that penetrate the respiratory and digestive epithelium, as well as signals from damaged host cells through membrane and cytosolic receptors. The transduction of these signals triggers a personalized response, depending on the nature of the stimulus and the host's genetics, physiological condition, and comorbidities. Interferons (IFNs) are the primary effectors of the innate immune response, and their synthesis is activated in most cells within a few hours after pathogen invasion. IFNs are primarily synthesized in infected cells, but their anti-infective effect is extended to the neighboring cells by autocrine and paracrine action. The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in 2019 was a stark reminder of the potential threat posed by newly emerging viruses. This pandemic has also triggered an overwhelming influx of research studies aiming to unveil the mechanisms of protective versus pathogenic host immune responses induced by SARS-CoV-2. The purpose of this review is to describe the role of IFNs as vital players in the battle against SARS-CoV-2 infection. We will briefly characterize and classify IFNs, present the inductors of IFN synthesis, their sensors, and signaling pathways, and then discuss the role of IFNs in controlling the evolution of SARS-CoV-2 infection and its clinical outcome. Finally, we will present the perspectives and controversies regarding the prophylactic and therapeutic potential of IFNs in SARS-CoV-2 infection.

Role of probiotics in managing various human diseases, from oral pathology to cancer and gastrointestinal diseases

The imbalance of microbial composition and diversity in favor of pathogenic microorganisms combined with a loss of beneficial gut microbiota taxa results from factors such as age, diet, antimicrobial administration for different infections, other underlying medical conditions, etc. Probiotics are known for their capacity to improve health by stimulating the indigenous gut microbiota, enhancing host immunity resistance to infection, helping digestion, and carrying out various other functions. Concurrently, the metabolites produced by these microorganisms, termed postbiotics, which include compounds like bacteriocins, lactic acid, and hydrogen peroxide, contribute to inhibiting a wide range of pathogenic bacteria. This review presents an update on using probiotics in managing and treating various human diseases, including complications that may emerge during or after a COVID-19 infection.

Implications of oral dysbiosis and HPV infection in head and neck cancer: from molecular and cellular mechanisms to early diagnosis and therapy

Head and neck cancer (HNC) is the sixth most common type of cancer, with more than half a million new cases annually. This review focuses on the role of oral dysbiosis and HPV infection in HNCs, presenting the involved taxons, molecular effectors and pathways, as well as the HPV-associated particularities of genetic and epigenetic changes and of the tumor microenvironment occurred in different stages of tumor development. Oral dysbiosis is associated with the evolution of HNCs, through multiple mechanisms such as inflammation, genotoxins release, modulation of the innate and acquired immune response, carcinogens and anticarcinogens production, generation of oxidative stress, induction of mutations. Thus, novel microbiome-derived biomarkers and interventions could significantly contribute to achieving the desideratum of personalized management of oncologic patients, regarding both early diagnosis and treatment. The results reported by different studies are not always congruent regarding the variations in the abundance of different taxons in HNCs. However, there is a consistent reporting of a higher abundance of Gram-negative species such as Fusobacterium, Leptotrichia, Treponema, Porphyromonas gingivalis, Prevotella, Bacteroidetes, Haemophilus, Veillonella, Pseudomonas, Enterobacterales, which are probably responsible of chronic inflammation and modulation of tumor microenvironment. Candida albicans is the dominant fungi found in oral carcinoma being also associated with shorter survival rate. Specific microbial signatures (e.g., F. nucleatum, Bacteroidetes and Peptostreptococcus) have been associated with later stages and larger tumor, suggesting their potential to be used as biomarkers for tumor stratification and prognosis. On the other hand, increased abundance of Corynebacterium, Kingella, Abiotrophia is associated with a reduced risk of HNC. Microbiome could also provide biomarkers for differentiating between oropharyngeal and hypopharyngeal cancers as well as between HPV-positive and HPV-negative tumors. Ongoing clinical trials aim to validate non-invasive tests for microbiome-derived biomarkers detection in oral and throat cancers, especially within high-risk populations. Oro-pharyngeal dysbiosis could also impact the HNCs therapy and associated side-effects of radiotherapy, chemotherapy, and immunotherapy. HPV-positive tumors harbor fewer mutations, as well as different DNA methylation pattern and tumor microenvironment. Therefore, elucidation of the molecular mechanisms by which oral microbiota and HPV infection influence the HNC initiation and progression, screening for HPV infection and vaccination against HPV, adopting a good oral hygiene, and preventing oral dysbiosis are important tools for advancing in the battle with this public health global challenge.

The Vermiform Appendix and Its Pathologies

The vermiform appendix is a muscular cylindrical structure originating near the junction of the cecum and ileum, averaging 9 cm (5-35 cm) in size. As the most mobile viscera, it can adopt several positions, the most common being the retrocecal position. Perceived as an atavistic organ lacking physiological relevance, the vermiform appendix appears to be involved in immune function, serving in the maturation of B lymphocytes and the production of immunoglobulin A, in endocrine function, excreting amines and hormones in the 2-3 mL of mucus secreted daily, and in digestive function, by storing beneficial bacteria from where they can recolonize the colon. With a lumen of about 6 mm, the vermiform appendix has a reduced storage capacity, so any blockage of the appendix with fecoliths (fecaliths), seeds derailed from the colon, or enlarged lymph nodes prevents drainage and intraluminal accumulation of secreted mucus. Unable to relax, the appendix wall severely limits its intraluminal volume, so mucus accumulation leads to inflammation of the appendix, known generically as appendicitis. In addition, the vermiform appendix may be the site of the development of neoplastic processes, which may or may not involve mucus production, some of which can significantly affect the standard of living and ultimately lead to death. In general, mucinous tumors may have a better prognosis than non-mucinous tumors. This review takes a comprehensive path, starting by describing the anatomy and embryology of the vermiform appendix and further detailing its inflammatory pathologies, pathologies related to congenital anomalies, and appendix tumors, thus creating an up-to-date framework for better understanding, diagnosis, and treatment of these health problems.

Landscape of Genetic Mutations in Appendiceal Cancers

In appendiceal cancers, the most frequently mutated genes are (i) KRAS, which, when reactivated, restores signal transduction via the RAS-RAF-MEK-ERK signaling pathway and stimulates cell proliferation in the early stages of tumor transformation, and then angiogenesis; (ii) TP53, whose inactivation leads to the inhibition of programmed cell death; (iii) GNAS, which, when reactivated, links the cAMP pathway to the RAS-RAF-MEK-ERK signaling pathway, stimulating cell proliferation and angiogenesis; (iv) SMAD4, exhibiting typical tumor-suppressive activity, blocking the transmission of oncogenic TGFB signals via the SMAD2/SMAD3 heterodimer; and (v) BRAF, which is part of the RAS-RAF-MEK-ERK signaling pathway. Diverse mutations are reported in other genes, which are part of secondary or less critical signaling pathways for tumor progression, but which amplify the phenotypic diversity of appendiceal cancers. In this review, we will present the main genetic mutations involved in appendix tumors and their roles in cell proliferation and survival, and in tumor invasiveness, angiogenesis, and acquired resistance to anti-growth signals.

Corneal biomechanical properties in myopic and emmetropic children

OBJECTIVE

The purpose of this study was to investigate the relationship between corneal biomechanics and ocular morphology in myopic children and adolescents.

PATIENTS AND METHODS

The study included 170 right eyes, from 170 patients under the age of 18 years, who underwent a complete ophthalmologic examination, gathering the following data: spherical equivalent (SE) (under pharmacological cycloplegia), biomechanical parameters - corneal hysteresis (CH) and corneal resistance factor (CRF), structural parameters - axial length (AL) and central corneal thickness (CCT).

RESULTS

The average age of the patients was 15.26 years old (55.29% girls, 44.70% boys). Out of the 170 eyes, 111 were myopic eyes and 59 were emmetropic. Myopic eyes had a significantly lower CH (p=0.001), CRF (p=0.002) and CCT (p=0.009), and higher AL (p<0.001) than emmetropic eyes. The AL and CCT were significantly higher in myopic males, compared to myopic females (p<0.001 and 0.001). In myopes, we found statistically significant negative correlations between AL and CH (Pearson's r=-0.218), CRF (r=-0.226) and also SE (r=-0.539), and positive between SE and either CH (r=0.193) or CRF (r=0.201).

CONCLUSIONS

Corneal biomechanical properties are significantly related to myopia parameters in children.

Common themes in antimicrobial and anticancer drug resistance

Antimicrobial and anticancer drug resistance represent two of the main global challenges for the public health, requiring immediate practical solutions. In line with this, we need a better understanding of the origins of drug resistance in prokaryotic and eukaryotic cells and the evolutionary processes leading to the occurrence of adaptive phenotypes in response to the selective pressure of therapeutic agents. The purpose of this paper is to present some of the analogies between the antimicrobial and anticancer drug resistance. Antimicrobial and anticancer drugs share common targets and mechanisms of action as well as similar mechanisms of resistance (e.g., increased drug efflux, drug inactivation, target alteration, persister cells’ selection, protection of bacterial communities/malignant tissue by an extracellular matrix, etc.). Both individual and collective stress responses triggered by the chemotherapeutic agent involving complex intercellular communication processes, as well as with the surrounding microenvironment, will be considered. The common themes in antimicrobial and anticancer drug resistance recommend the utility of bacterial experimental models for unraveling the mechanisms that facilitate the evolution and adaptation of malignant cells to antineoplastic drugs.

Antiviral Immunity in SARS-CoV-2 Infection: From Protective to Deleterious Responses

After two previous episodes, in 2002 and 2012, when two highly pathogenic coronaviruses (SARS, MERS) with a zoonotic origin emerged in humans and caused fatal respiratory illness, we are today experiencing the COVID-19 pandemic produced by SARS-CoV-2. The main question of the year 2021 is if naturally- or artificially-acquired active immunity will be effective against the evolving SARS-CoV-2 variants. This review starts with the presentation of the two compartments of antiviral immunity-humoral and cellular, innate and adaptive-underlining how the involved cellular and molecular actors are intrinsically connected in the development of the immune response in SARS-CoV-2 infection. Then, the SARS-CoV-2 immunopathology, as well as the derived diagnosis and therapeutic approaches, will be discussed.

A 3D high resolution MRI method for the visualization of cardiac fibro-fatty infiltrations

Modifications of the myocardial architecture can cause abnormal electrical activity of the heart. Fibro-fatty infiltrations have been implicated in various cardiac pathologies associated with arrhythmias and sudden cardiac death, such as arrhythmogenic right ventricular cardiomyopathy (ARVC). Here, we report the development of an MRI protocol to observe these modifications at 9.4 T. Two fixed ex vivo human hearts, one healthy and one ARVC, were imaged with an Iterative decomposition with echo asymmetry and least-square estimations (IDEAL) and a magnetization transfer (MT) 3D sequences. The resulting fat fraction and MT ratio (MTR) were analyzed and compared to histological analysis of the three regions (“ARVC triangle”) primarily involved in ARVC structural remodeling. In the ARVC heart, high fat content was observed in the “ARVC triangle” and the superimposition of the MTR and fat fraction allowed the identification of fibrotic regions in areas without the presence of fat. The healthy heart exhibited twice less fat than the ARVC heart (31.9%, 28.7% and 1.3% of fat in the same regions, respectively). Localization of fat and fibrosis were confirmed by means of histology. This non-destructive approach allows the investigation of structural remodeling in human pathologies where fibrosis and/or fatty tissue infiltrations are expected to occur.

Difficulties in maintaining electroconvulsive treatment (ECT) in a psychiatric hospital during covid19 pandemic

Introduction

ECT is an effective care with high level of recommendation. During the COVID19, new recommendations to protect patients and caregivers combined with the increasing use of medicines and medical devices (MD) for anesthesia, caused greater difficulties of supply. Even if vital for patients, it is challenging to maintain ECT in this environment.

Objectives

The aim of this study is to resume the measures implemented in order to maintain ECT during COVID19.

Methods

Retrospective analysis of measures implemented to maintain the ECT during COVID19.

Results

As FFP2 masks were restricted to intensive care units, our hospital were not supplied. After negotiations, the regional health agency (ARS) has granted us an allocation of 100 masks to maintain ECT. Our efficient stock management of personal protective equipment as well as our transparency on these stocks with ARS and sharing with other hospitals out of stock played a role in this agreement.We had to adapt our MDs references according to breaks of many ones and new recommendations. The university hospital helping us in supplying certain missing references. Considering the difficulties in supplying drugs and MDs, and limited availability of anesthetists, we have reduced the number of ECT. Prioritization of patients with vital indications had to be achieved.

Conclusions

The prioritization of some services by the regulatory agency causes many supply difficulties for the others. It would be important to reassess the priority of ECT in such crisis because most of the time other caregivers and regulatory agencies are not aware how they are vital for patients.

National environmental quality assessment and monitoring of atmospheric heavy metal pollution - A moss bag approach

As airborne pollution is recognised as the single largest environmental health hazard in Europe, the necessity to develop effective systems for monitoring and reducing the level of air pollutants, becomes imperative. The paper describes a tested and implemented long-term biomonitoring system for airborne heavy metals at a national scale. Moss bags (Hylocomium splendens) were exposed in 142 monitoring stations designated in Romania, and the content of Pb, Cd, Ni and As was quantified using inductively coupled plasma mass spectrometry. The results revealed that the accumulation of heavy metals exceeded the established thresholds, marking high pollution levels in 8.8% of samples for As, in 5.63% samples for Cd, in 3.17% samples for Pb, and in 0.35% samples for Ni. The maximum heavy metal concentration was 113.77 mg kg^-1 dry weight for Pb, 44.93 mg kg^-1 dry weight for Ni, 14.68 mg kg^-1 dry weight for As, and 3.88 mg kg^-1 dry weight for Cd, with several overlaps for at least two metals, thus marking pollution hotspots. In order to process, summarise and communicate the obtained data, a software named BioMonRo has been developed as the core part of a complex monitoring and warning-informative system. The software is able to generate heavy metal pollution maps and specific reports, depicting the levels and patterns of distribution, which can be automatically sent to a number of interested recipients. The results show that the developed national system is functional, cost-effective, and could be successfully used for long-term monitoring of airborne heavy metals.

Chemical composition and seasonal changes in the fatty acid profile of Uruguayan “Colonia” Cheeses

The basic chemical composition and the fatty acid (FA) profile of Uruguayan Colonia cheese, consumed in the Mercosur region, were determined. 24 cheeses from different dairy farms: 10 elaborated in autumn and 14 in spring, were analyzed. Those cheeses are made from cow´s milk, whose diet was composed of 50% pasture system, 25% concentrate, and 25% silage reserves. The cheese making and ripening time were similar. Seasonal differences emerged in the profiles of saturated FA (SFA), unsaturated FA (UFA) and polyunsaturated FA (PUFA). The seasonal comparation of polyunsaturated FA (PUFA) as well as the CLA isomer such as C18:2 t10c12 showed significant differences (p < 0.05). CLA isomer such as C18:2 c9t11, showed no differences (p > 0.05). The atherogenesis index (AI) = 2.21 and thrombogenicity (IT) = 2.84, were calculated and discussed.

The Impact of Thyroid Autoimmunity on the Clinical and Diabetes Parameters of Patients with Latent Autoimmune Diabetes in Adults

AIM

We evaluated the clinical and diabetes parameters of latent autoimmune diabetes in adults (LADA) patients according to the presence of thyroid autoimmunity (TA).

MATERIALS AND METHODS

Patients with LADA (diabetes onset after 30 years of age, no need for insulin treatment for at least 6 months after diabetes onset, positive for glutamic acid decarboxylase antibodies (GADA)) were evaluated for the presence of thyroid peroxidase antibodies (TPOAb) and were subjected to clinical and laboratory evaluations of the glycated hemoglobin and basal C peptide levels. The patients were stratified into either group A (with TA) or group B (without TA).

RESULTS

We evaluated 104 (57 female and 47 male) patients with LADA. The mean age at diabetes onset was 44±10 years. The prevalence of TA among the LADA patients was 28.8% (30 patients; 23 female and 7 male). In groups A and B, the mean age at diabetes onset was 41.47±10.15 and 45.07±10 years (p=0.03), the basal C peptide level was 0.69±0.16 and 1.9±1.3 ng/ml (p<0.0001), the glycated hemoglobin level was 9.8±2.2 and 9.1±2.2 (p=0.04), and the time to insulin treatment was 3.2±2.1 years and 4.98±2.2 years (p=0.038), respectively. The use of a basal bolus insulin regimen was more frequent in group A than in group B (56.7% and 35.1%, respectively; p=0.03).

CONCLUSION

TA identifies a particular phenotype of LADA displaying a higher GADA titer, lower basal C peptide levels and poorer glycemic control.

Analysis of the source term formation in a severe accident initiated by end fitting failure in CANDU type reactors

CANDU type reactors have some peculiarities in initiation and progression of severe accidents. In the present paper one of the specificities – the End Fitting Failure accident – is analysed from the point of view of source term formation. The accident is initiated by a failure of the re-fueling machine. Fuel bundles are ejected in the re-fuelling machine room and fuel elements suffer a significant fragmentation by mechanical impact and by the rapid increase of the temperature. A direct transfer of the fission products occurs directly to the containment. The source term in the containment and also the source term to the environment is calculated supposing an open venting communication to the external atmosphere. The simulation is performed by using the ASTEC code in coupled calculation CPA-IODE-ISODOPE-DOSE option. The evolution of the distributions for the most important released fission products is presented for different regions and for different hosts. The most important factors of influence on the source term formation are identified and discussed.

Chemistry aspects of the source term formation for a severe accident in a CANDU type reactor

The progression of a severe accident in a CANDU type reactor is slow because the core is surrounded by a large quantity of heavy and light water which acts as a heat sink to remove the decay heat. Therefore, the source term formation is a complex and long process involving fission products transport and releasing in the fuel matrix, thermal hydraulics of the transport fluid in the primary heat system and containment, deposition and transport of fission products, chemistry including the interaction with the dousing system, structural materials and paints, etc. The source term is strongly dependent on initial conditions and accident type. The paper presents chemistry aspects for a severe accident in a CANDU type reactor, in terms of the retention in the primary heat system. After releasing from the fuel elements, the fission products suffer a multitude of phenomena before they are partly transferred into the containment region. The most important species involved in the deposition were identified. At the same time, the influence of the break position in the transfer fractions from the primary heat system to the containment was investigated.

Uncertainty analysis for fission products transport in CANDU primary heat transport during a severe accident

The work realized under the Severe Accident Research Network of excellence (SARNET) project has shown that the SOPHAEROS module, part of Accident Source Term Evaluation Code (ASTEC) can be fully used to simulate the fission products transport and deposition phenomena in the CANDU Primary Heat Transport (PHT) system. This paper presents an uncertainty analysis for the fission products transport in the CANDU PHT system during a severe accident to obtain the domains of the output parameters, for this study masses of Caesium, Strontium and Iodine deposited in the PHT system and its nodes, taking into account the associated input parameters uncertainties. Five uncertain parameters, the starting time for the releasing process, the duration of the releasing process, the releasing fractions for Cs, Sr and I have been chosen. To generate aleatory values for the uncertain parameters, a method and software have been developed and Monte Carlo simulations to determine uncertainties propagation through the SOPHAEROS module has been carried out.

SU-E-T-499: Validation of the Varian Generic Phase Space Files for Monte Carlo Calculations of Dose Distributions for the TrueBeam Linac Head

PURPOSE

To validate the generic phase space files for Varian TrueBeam linac head simulations.

METHODS

The generic phase space files include the simulation results of 6MV, 10MV, 6MV FFF, and 10MV FFF (flattening-filter free) operating modes of TrueBeam for patient-independent linac head components. Using the generic phase space files as the radiation sources, the BEAMnrc Monte Carlo codes are used to simulate the patient-dependent parts of the TrueBeam linac and the resulting phase space files are generated at a plane just before entering a water phantom for 4 different field sizes (5×5, 10×10, 20×20, and 40×40 cm² ). Dose distributions are calculated by DOSXYZnrc in the water phantom of size 50×50×40 cm³ . The percentage-depth-dose (PDD) curves and lateral dose profiles at three different depths (dmax, 10cm, 20cm) are obtained. Comprehensive comparisons have been made for a total of 64 dose profiles (including PDDs) between the Monte Carlo calculations and the measured data. The gamma index analysis is performed for all the comparisons.

RESULTS

The matching of the calculated dose distributions to the measured ones is analyzed by the gamma index method with a criterion of 2% dose tolerance and 2 mm distance-to-agreement. Of the 64 comparisons, the minimum gamma index passing rate is at least 92%, after taking into account the statistical nature of the Monte Carlo calculated dose values. Despite the existence of latent variance of phase space files, the phantom dose calculation uncertainty can be less than 1% for field sizes as small as 5×5 cm² . The computing time saved by using phase space files could be a factor of 5-10.

CONCLUSIONS

The Varian generic phase space files are accurate and efficient radiation sources for Monte Carlo calculations of radiation dose distributions for TrueBeam linac head. This work was supported in part by Varian Medical Systems and the NIH (1R01 CA104205 and 1R21 CA153587).