1
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Du L, Deiter F, Bouzidi MS, Billaud JN, Simmons G, Dabral P, Selvarajah S, Lingappa AF, Michon M, Yu SF, Paulvannan K, Manicassamy B, Lingappa VR, Boushey H, Greenland JR, Pillai SK. A viral assembly inhibitor blocks SARS-CoV-2 replication in airway epithelial cells. Commun Biol 2024; 7:486. [PMID: 38649430 PMCID: PMC11035691 DOI: 10.1038/s42003-024-06130-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 04/01/2024] [Indexed: 04/25/2024] Open
Abstract
The ongoing evolution of SARS-CoV-2 to evade vaccines and therapeutics underlines the need for innovative therapies with high genetic barriers to resistance. Therefore, there is pronounced interest in identifying new pharmacological targets in the SARS-CoV-2 viral life cycle. The small molecule PAV-104, identified through a cell-free protein synthesis and assembly screen, was recently shown to target host protein assembly machinery in a manner specific to viral assembly. In this study, we investigate the capacity of PAV-104 to inhibit SARS-CoV-2 replication in human airway epithelial cells (AECs). We show that PAV-104 inhibits >99% of infection with diverse SARS-CoV-2 variants in immortalized AECs, and in primary human AECs cultured at the air-liquid interface (ALI) to represent the lung microenvironment in vivo. Our data demonstrate that PAV-104 inhibits SARS-CoV-2 production without affecting viral entry, mRNA transcription, or protein synthesis. PAV-104 interacts with SARS-CoV-2 nucleocapsid (N) and interferes with its oligomerization, blocking particle assembly. Transcriptomic analysis reveals that PAV-104 reverses SARS-CoV-2 induction of the type-I interferon response and the maturation of nucleoprotein signaling pathway known to support coronavirus replication. Our findings suggest that PAV-104 is a promising therapeutic candidate for COVID-19 with a mechanism of action that is distinct from existing clinical management approaches.
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Affiliation(s)
- Li Du
- Vitalant Research Institute, 360 Spear St., San Francisco, CA, 94105, USA
- University of California, San Francisco, CA, 94143, USA
| | - Fred Deiter
- University of California, San Francisco, CA, 94143, USA
- Veterans Administration Health Care System, 4150 Clement St., San Francisco, CA, 94121, USA
| | - Mohamed S Bouzidi
- Vitalant Research Institute, 360 Spear St., San Francisco, CA, 94105, USA
- University of California, San Francisco, CA, 94143, USA
| | | | - Graham Simmons
- Vitalant Research Institute, 360 Spear St., San Francisco, CA, 94105, USA
- University of California, San Francisco, CA, 94143, USA
| | - Prerna Dabral
- Vitalant Research Institute, 360 Spear St., San Francisco, CA, 94105, USA
- University of California, San Francisco, CA, 94143, USA
| | | | | | - Maya Michon
- Prosetta Biosciences Inc, 670 5th St., San Francisco, CA, 94107, USA
| | - Shao Feng Yu
- Prosetta Biosciences Inc, 670 5th St., San Francisco, CA, 94107, USA
| | - Kumar Paulvannan
- Prosetta Biosciences Inc, 670 5th St., San Francisco, CA, 94107, USA
| | | | | | - Homer Boushey
- University of California, San Francisco, CA, 94143, USA
| | - John R Greenland
- University of California, San Francisco, CA, 94143, USA
- Veterans Administration Health Care System, 4150 Clement St., San Francisco, CA, 94121, USA
| | - Satish K Pillai
- Vitalant Research Institute, 360 Spear St., San Francisco, CA, 94105, USA.
- University of California, San Francisco, CA, 94143, USA.
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2
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Bouzidi MS, Dossani ZY, Di Benedetto C, Raymond KA, Desai S, Chavez LR, Betancur P, Pillai SK. High-resolution Inference of Multiplexed Anti-HIV Gene Editing using Single-Cell Targeted DNA Sequencing. bioRxiv 2024:2024.01.24.576921. [PMID: 38328062 PMCID: PMC10849705 DOI: 10.1101/2024.01.24.576921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Gene therapy-based HIV cure strategies typically aim to excise the HIV provirus directly, or target host dependency factors (HDFs) that support viral persistence. Cure approaches will likely require simultaneous co-targeting of multiple sites within the HIV genome to prevent evolution of resistance, and/or co-targeting of multiple HDFs to fully render host cells refractory to HIV infection. Bulk cell-based methods do not enable inference of co-editing within individual viral or target cell genomes, and do not discriminate between monoallelic and biallelic gene disruption. Here, we describe a targeted single-cell DNA sequencing (scDNA-seq) platform characterizing the near full-length HIV genome and 50 established HDF genes, designed to evaluate anti-HIV gene therapy strategies. We implemented the platform to investigate the capacity of multiplexed CRISPR-Cas9 ribonucleoprotein complexes (Cas9-RNPs) to simultaneously 1) inactivate the HIV provirus, and 2) knockout the CCR5 and CXCR4 HDF (entry co-receptor) genes in microglia and primary monocyte-derived macrophages (MDMs). Our scDNA-seq pipeline revealed that antiviral gene editing is rarely observed at multiple loci (or both alleles of a locus) within an individual cell, and editing probabilities across sites are linked. Our results demonstrate that single-cell sequencing is critical to evaluate the true efficacy and therapeutic potential of HIV gene therapy.
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Affiliation(s)
- Mohamed S. Bouzidi
- Vitalant Research Institute, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Zain Y. Dossani
- Vitalant Research Institute, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | | | - Kyle A. Raymond
- Vitalant Research Institute, San Francisco, CA, USA
- Department of Virology, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
| | | | - Leonard R. Chavez
- Vitalant Research Institute, San Francisco, CA, USA
- Rewrite Therapeutics, Berkeley, CA, USA
| | - Paola Betancur
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Satish K. Pillai
- Vitalant Research Institute, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
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3
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Sperber HS, Raymond KA, Bouzidi MS, Ma T, Valdebenito S, Eugenin EA, Roan NR, Deeks SG, Winning S, Fandrey J, Schwarzer R, Pillai SK. The hypoxia-regulated ectonucleotidase CD73 is a host determinant of HIV latency. Cell Rep 2023; 42:113285. [PMID: 37910505 PMCID: PMC10838153 DOI: 10.1016/j.celrep.2023.113285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 07/04/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Deciphering the mechanisms underlying viral persistence is critical to achieving a cure for human immunodeficiency virus (HIV) infection. Here, we implement a systems approach to discover molecular signatures of HIV latently infected CD4+ T cells, identifying the immunosuppressive, adenosine-producing ectonucleotidase CD73 as a key surface marker of latent cells. Hypoxic conditioning, reflecting the lymphoid tissue microenvironment, increases the frequency of CD73+ CD4+ T cells and promotes HIV latency. Transcriptomic profiles of CD73+ CD4+ T cells favor viral quiescence, immune evasion, and cell survival. CD73+ CD4+ T cells are capable of harboring a functional HIV reservoir and reinitiating productive infection ex vivo. CD73 or adenosine receptor blockade facilitates latent HIV reactivation in vitro, mechanistically linking adenosine signaling to viral quiescence. Finally, tissue imaging of lymph nodes from HIV-infected individuals on antiretroviral therapy reveals spatial association between CD73 expression and HIV persistence in vivo. Our findings warrant development of HIV-cure strategies targeting the hypoxia-CD73-adenosine axis.
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Affiliation(s)
- Hannah S Sperber
- Vitalant Research Institute, San Francisco, CA, USA; Free University of Berlin, Institute of Biochemistry, Berlin, Germany; University of California, San Francisco, San Francisco, CA, USA; University Hospital Essen, Institute for Translational HIV Research, Essen, Germany
| | - Kyle A Raymond
- Vitalant Research Institute, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA
| | - Mohamed S Bouzidi
- Vitalant Research Institute, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA
| | - Tongcui Ma
- University of California, San Francisco, San Francisco, CA, USA; Gladstone Institutes, San Francisco, CA, USA
| | | | | | - Nadia R Roan
- University of California, San Francisco, San Francisco, CA, USA; Gladstone Institutes, San Francisco, CA, USA
| | - Steven G Deeks
- University of California, San Francisco, San Francisco, CA, USA
| | - Sandra Winning
- University of Duisburg-Essen, Institute for Physiology, Essen, Germany
| | - Joachim Fandrey
- University of Duisburg-Essen, Institute for Physiology, Essen, Germany
| | - Roland Schwarzer
- University Hospital Essen, Institute for Translational HIV Research, Essen, Germany.
| | - Satish K Pillai
- Vitalant Research Institute, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA.
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4
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Kim C, Guo A, Yassanye D, Link-Gelles R, Yates K, Duggar C, Moore L, El Kalach R, Jones-Jack N, Walker C, Gibbs Scharf L, Pillai SK, Patel A. The US Federal Retail Pharmacy Program: Optimizing COVID-19 Vaccine Delivery Through a Strategic Public-Private Partnership. Public Health Rep 2023; 138:870-877. [PMID: 37503697 PMCID: PMC10576480 DOI: 10.1177/00333549231186606] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
To help achieve the initial goal of providing universal COVID-19 vaccine access to approximately 258 million adults in 62 US jurisdictions, the federal government launched the Federal Retail Pharmacy Program (FRPP) on February 11, 2021. We describe FRPP's collaboration among the federal government, US jurisdictions, federal entity partners, and 21 national chain and independent pharmacy networks to provide large-scale access to COVID-19 vaccines, particularly in communities disproportionately affected by COVID-19 (eg, people aged ≥65 years, people from racial and ethnic minority groups). FRPP initially provided 10 000 vaccination sites for people to access COVID-19 vaccines, which was increased to >35 000 vaccination sites by May 2021 and sustained through January 31, 2022. From February 11, 2021, through January 31, 2022, FRPP vaccination sites received 293 million doses and administered 219 million doses, representing 45% of all COVID-19 immunizations provided nationwide (38% of all first doses, 72% of all booster doses). This unprecedented public-private partnership allowed the federal government to rapidly adapt and scale up an equitable vaccination program to reach adults, later expanding access to vaccine-eligible children, during the COVID-19 pandemic. As the largest federal COVID-19 vaccination program, FRPP exemplifies how public-private partnerships can expand access to immunizations during a public health emergency. Pharmacies can help meet critical national public health goals by serving as convenient access points for sustained health services. Lessons learned from this effort-including the importance of strong coordination and communication, efficient reporting systems and data quality, and increasing access to and demand for vaccine, among others-may help improve future immunization programs and support health system resiliency, emphasizing community-level access and health equity during public health emergencies.
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Affiliation(s)
- Christine Kim
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angela Guo
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Strategic Innovative Solutions, LLC, Clearwater, FL, USA
| | - Diana Yassanye
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruth Link-Gelles
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kirsten Yates
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chris Duggar
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lori Moore
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Roua El Kalach
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nkenge Jones-Jack
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chastity Walker
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynn Gibbs Scharf
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Satish K. Pillai
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anita Patel
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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5
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Du L, Bouzidi MS, Gala A, Deiter F, Billaud JN, Yeung ST, Dabral P, Jin J, Simmons G, Dossani ZY, Niki T, Ndhlovu LC, Greenland JR, Pillai SK. Human galectin-9 potently enhances SARS-CoV-2 replication and inflammation in airway epithelial cells. J Mol Cell Biol 2023; 15:mjad030. [PMID: 37127426 PMCID: PMC10668544 DOI: 10.1093/jmcb/mjad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/17/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused a global economic and health crisis. Recently, plasma levels of galectin-9 (Gal-9), a β-galactoside-binding lectin involved in immune regulation and viral immunopathogenesis, were reported to be elevated in the setting of severe COVID-19 disease. However, the impact of Gal-9 on SARS-CoV-2 infection and immunopathology remained to be elucidated. In this study, we demonstrate that Gal-9 treatment potently enhances SARS-CoV-2 replication in human airway epithelial cells (AECs), including immortalized AECs and primary AECs cultured at the air-liquid interface. Gal-9-glycan interactions promote SARS-CoV-2 attachment and entry into AECs in an angiotensin-converting enzyme 2 (ACE2)-dependent manner, enhancing the binding of the viral spike protein to ACE2. Transcriptomic analysis revealed that Gal-9 and SARS-CoV-2 infection synergistically induced the expression of key pro-inflammatory programs in AECs, including the IL-6, IL-8, IL-17, EIF2, and TNFα signaling pathways. Our findings suggest that manipulation of Gal-9 should be explored as a therapeutic strategy for SARS-CoV-2 infection.
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Affiliation(s)
- Li Du
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Mohamed S Bouzidi
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Akshay Gala
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Fred Deiter
- Department of Medicine, University of California, San Francisco, CA 94143-0410, USA
- Veterans Affairs Health Care System, San Francisco, CA 94121, USA
| | | | - Stephen T Yeung
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Prerna Dabral
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Jing Jin
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Graham Simmons
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Zain Y Dossani
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
| | - Toshiro Niki
- Department of Immunology, Kagawa University, Kagawa 760-0016, Japan
| | - Lishomwa C Ndhlovu
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - John R Greenland
- Department of Medicine, University of California, San Francisco, CA 94143-0410, USA
- Veterans Affairs Health Care System, San Francisco, CA 94121, USA
| | - Satish K Pillai
- Vitalant Research Institute, San Francisco, CA 94105, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143-0134, USA
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6
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Premeaux TA, Yeung ST, Pillai SK, Ndhlovu LC. Elevated Galectin-9 across the human brain correlates with HIV neuropathology and detrimental cognitive states. J Neurovirol 2023; 29:337-345. [PMID: 37233903 DOI: 10.1007/s13365-023-01149-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 04/16/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Abstract
HIV persistence and neuroinflammation are known to contribute to HIV-associated neuropathology. However, the multifaceted pathways driving impairment remain poorly understood. Galectin-glycan interactions have emerged as significant contributors to neuroinflammatory processes and may play a role in neuroHIV. Here, we quantified Galectin-9 (Gal-9), a pleiotropic immunomodulatory protein, in post-mortem brain tissue across multiple regions from HIV-infected and HIV-uninfected donors to determine causal associations with HIV brain injury. We demonstrate that the staining intensity, total staining area, and cell-associated frequency of Gal-9 were elevated, principally in the frontal lobe and basal ganglia. Higher frontal lobe Gal-9 levels correlated with lower pre-mortem neuropsychological performance test scores in areas of attention and motor skills. Our results suggest that Gal-9 activity across the brain plays a role in neuroHIV pathogenesis and constitutes a promising disease-modifying target.
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Affiliation(s)
- Thomas A Premeaux
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, 413 East 69th St., BRB, NY, NY, 10021, USA
| | - Stephen T Yeung
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, 413 East 69th St., BRB, NY, NY, 10021, USA
| | | | - Lishomwa C Ndhlovu
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, 413 East 69th St., BRB, NY, NY, 10021, USA.
- Feil Family Brain & Mind Research Institute, Weill Cornell Medicine, NY, New York, USA.
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7
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Yeung ST, Premeaux TA, Du L, Niki T, Pillai SK, Khanna KM, Ndhlovu LC. Galectin-9 protects humanized-ACE2 immunocompetent mice from SARS-CoV-2 infection. Front Immunol 2022; 13:1011185. [PMID: 36325323 PMCID: PMC9621319 DOI: 10.3389/fimmu.2022.1011185] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022] Open
Abstract
SARS-CoV-2 remains a global health crisis even with effective vaccines and the availability of FDA approved therapies. Efforts to understand the complex disease pathology and develop effective strategies to limit mortality and morbidity are needed. Recent studies reveal circulating Galectin-9 (gal-9), a soluble beta-galactoside binding lectin with immunoregulatory properties, are elevated in SARS-CoV-2 infected individuals with moderate to severe disease. Moreover, in silico studies demonstrate gal-9 can potentially competitively bind the ACE2 receptor on susceptible host cells. Here, we determined whether early introduction of exogenous gal-9 following SARS-CoV-2 infection in humanized ACE2 transgenic mice (K18-hACE2) may reduce disease severity. Mice were infected and treated with a single dose of a human recombinant form of gal-9 (rh-gal-9) and monitored for morbidity. Subgroups of mice were humanely euthanized at 2- and 5- days post infection (dpi) for viral levels by plaque assay, immune changes measures by flow cytometry, and soluble mediators by protein analysis from lung tissue and bronchoalveolar Lavage fluid (BALF). Mice treated with rh-gal-9 during acute infection had improved survival compared to PBS treated controls. At 5 dpi, rh-gal-9 treated mice had enhanced viral clearance in the BALF, but not in the lung parenchyma. Increased T and dendritic cells and decreased neutrophil frequencies in the lung at 5 dpi were observed, whereas BALF had elevated levels of type-I interferons and proinflammatory cytokines. These results suggest a role for rh-gal-9 in limiting acute COVID-19. Further studies are required to determine the optimal design of gal-9 treatment to effectively ameliorate COVID-19 disease.
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Affiliation(s)
- Stephen T. Yeung
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Thomas A. Premeaux
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Li Du
- Vitalant Research Institute, San Francisco, CA, United States
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Toshiro Niki
- Departments of Immunology and Immunopathology, Kagawa University, Kagawa, Japan
| | - Satish K. Pillai
- Vitalant Research Institute, San Francisco, CA, United States
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Kamal M. Khanna
- Department of Microbiology, New York University, New York, NY, United States
- *Correspondence: Lishomwa C. Ndhlovu, ; Kamal M. Khanna,
| | - Lishomwa C. Ndhlovu
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
- *Correspondence: Lishomwa C. Ndhlovu, ; Kamal M. Khanna,
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8
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Khanna K, Raymond W, Jin J, Charbit AR, Gitlin I, Tang M, Werts AD, Barrett EG, Cox JM, Birch SM, Martinelli R, Sperber HS, Franz S, Duff T, Hoffmann M, Healy AM, Oscarson S, Pöhlmann S, Pillai SK, Simmons G, Fahy JV. Exploring antiviral and anti-inflammatory effects of thiol drugs in COVID-19. Am J Physiol Lung Cell Mol Physiol 2022; 323:L372-L389. [PMID: 35762590 PMCID: PMC9448286 DOI: 10.1152/ajplung.00136.2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The redox status of the cysteine-rich SARS-CoV-2 spike glycoprotein (SARS-2-S) is important for the binding of SARS-2-S to angiotensin-converting enzyme 2 (ACE2), suggesting that drugs with a functional thiol group (“thiol drugs”) may cleave cystines to disrupt SARS-CoV-2 cell entry. In addition, neutrophil-induced oxidative stress is a mechanism of COVID-19 lung injury, and the antioxidant and anti-inflammatory properties of thiol drugs, especially cysteamine, may limit this injury. To first explore the antiviral effects of thiol drugs in COVID-19, we used an ACE-2 binding assay and cell entry assays utilizing reporter pseudoviruses and authentic SARS-CoV-2 viruses. We found that multiple thiol drugs inhibit SARS-2-S binding to ACE2 and virus infection. The most potent drugs were effective in the low millimolar range, and IC50 values followed the order of their cystine cleavage rates and lower thiol pKa values. To determine if thiol drugs have antiviral effects in vivo and to explore any anti-inflammatory effects of thiol drugs in COVID-19, we tested the effects of cysteamine delivered intraperitoneally to hamsters infected with SARS-CoV-2. Cysteamine did not decrease lung viral infection, but it significantly decreased lung neutrophilic inflammation and alveolar hemorrhage. We speculate that the concentration of cysteamine achieved in the lungs with intraperitoneal delivery was insufficient for antiviral effects but sufficient for anti-inflammatory effects. We conclude that thiol drugs decrease SARS-CoV-2 lung inflammation and injury, and we provide rationale for future studies to test if direct (aerosol) delivery of thiol drugs to the airways might also result in antiviral effects.
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Affiliation(s)
- Kritika Khanna
- Cardiovascular Research Institute, University of California San Francisco Medical Center, San Francisco, CA, United States
| | - Wilfred Raymond
- Cardiovascular Research Institute, University of California San Francisco Medical Center, San Francisco, CA, United States
| | - Jing Jin
- Vitalant Research Institute, San Francisco, California, United States
| | - Annabelle R Charbit
- Cardiovascular Research Institute, University of California San Francisco Medical Center, San Francisco, CA, United States
| | - Irina Gitlin
- Cardiovascular Research Institute, University of California San Francisco Medical Center, San Francisco, CA, United States
| | - Monica Tang
- Division of Pulmonary, Critical Care, Allergy and Sleep and the Department of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Adam D Werts
- Lovelace Biomedical Research Institute, Albuquerque, New Mexico, United States
| | - Edward G Barrett
- Lovelace Biomedical Research Institute, Albuquerque, New Mexico, United States
| | - Jason M Cox
- Lovelace Biomedical Research Institute, Albuquerque, New Mexico, United States
| | - Sharla M Birch
- Lovelace Biomedical Research Institute, Albuquerque, New Mexico, United States
| | - Rachel Martinelli
- Vitalant Research Institute, San Francisco, California, United States
| | - Hannah S Sperber
- Vitalant Research Institute, San Francisco, California, United States
| | - Sergej Franz
- Vitalant Research Institute, San Francisco, California, United States
| | - Thomas Duff
- Centre for Synthesis and Chemical Biology, School of Chemistry, University College Dublin, Dublin, Ireland
| | - Markus Hoffmann
- Infection Biology Unit, German Primate Center, Göttingen, Germany.,Faculty of Biology and Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Anne Marie Healy
- School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Ireland.,SSPC, The Science Foundation Ireland Research Centre for Pharmaceuticals, Trinity College Dublin, Ireland
| | - Stefan Oscarson
- Centre for Synthesis and Chemical Biology, School of Chemistry, University College Dublin, Dublin, Ireland
| | - Stefan Pöhlmann
- Infection Biology Unit, German Primate Center, Göttingen, Germany.,Faculty of Biology and Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Satish K Pillai
- Vitalant Research Institute, San Francisco, California, United States.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States
| | - Graham Simmons
- Vitalant Research Institute, San Francisco, California, United States.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States
| | - John V Fahy
- Cardiovascular Research Institute, University of California San Francisco Medical Center, San Francisco, CA, United States.,Division of Pulmonary, Critical Care, Allergy and Sleep and the Department of Medicine, University of California San Francisco, San Francisco, California, United States
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9
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Du L, Bouzidi MS, Gala A, Deiter F, Billaud JN, Yeung ST, Dabral P, Jin J, Simmons G, Dossani Z, Niki T, Ndhlovu LC, Greenland JR, Pillai SK. Human Galectin-9 Potently Enhances SARS-CoV-2 Replication and Inflammation in Airway Epithelial Cells. bioRxiv 2022:2022.03.18.484956. [PMID: 35378763 PMCID: PMC8978940 DOI: 10.1101/2022.03.18.484956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused a global economic and health crisis. Recently, plasma levels of galectin-9 (Gal-9), a β-galactoside-binding lectin involved in immune regulation and viral immunopathogenesis, were reported to be elevated in the setting of severe COVID-19 disease. However, the impact of Gal-9 on SARS-CoV-2 infection and immunopathology remained to be elucidated. Here, we demonstrate that Gal-9 treatment potently enhances SARS-CoV-2 replication in human airway epithelial cells (AECs), including primary AECs in air-liquid interface (ALI) culture. Gal-9-glycan interactions promote SARS-CoV-2 attachment and entry into AECs in an ACE2-dependent manner, enhancing the binding affinity of the viral spike protein to ACE2. Transcriptomic analysis revealed that Gal-9 and SARS-CoV-2 infection synergistically induce the expression of key pro-inflammatory programs in AECs including the IL-6, IL-8, IL-17, EIF2, and TNFα signaling pathways. Our findings suggest that manipulation of Gal-9 should be explored as a therapeutic strategy for SARS-CoV-2 infection. Importance COVID-19 continues to have a major global health and economic impact. Identifying host molecular determinants that modulate SARS-CoV-2 infectivity and pathology is a key step in discovering novel therapeutic approaches for COVID-19. Several recent studies have revealed that plasma concentrations of the human β-galactoside-binding protein galectin-9 (Gal-9) are highly elevated in COVID-19 patients. In this study, we investigated the impact of Gal-9 on SARS-CoV-2 pathogenesis ex vivo in airway epithelial cells (AECs), the critical initial targets of SARS-CoV-2 infection. Our findings reveal that Gal-9 potently enhances SARS-CoV-2 replication in AECs, interacting with glycans to enhance the binding between viral particles and entry receptors on the target cell surface. Moreover, we determined that Gal-9 accelerates and exacerbates several virus-induced pro-inflammatory programs in AECs that are established signature characteristics of COVID-19 disease and SARS-CoV-2-induced acute respiratory distress syndrome (ARDS). Our findings suggest that Gal-9 is a promising pharmacological target for COVID-19 therapies.
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10
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Yeung ST, Premeaux TA, Niki T, Pillai SK, Khanna KM, Ndhlovu LC. Galectin-9 protects humanized-ACE2 immunocompetent mice from SARS-CoV-2 Infection. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.125.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
The COVID19 pandemic caused by SARS CoV 2 remains a global health crisis even with vaccines and sparse FDA approved therapies. To limit mortality and morbidity, therapeutics are critical. Galectin 9 (gal9) is a b-galactoside binding protein, modulating cell-cell and cell-matrix interactions. It has been shown circulating gal9 levels are elevated in response to infection in patient sera with moderate to severe disease. One report gal9 unexpectedly competitively binds the ACE2 receptor on host cells, impeding viral entry. Therefore, we hypothesize early recombinant gal9 (rgal9) treatment post infection (pi) may prevent binding of the virus to prone host cells yielding a decreased severity of SARS CoV 2 related disease. To determine the potential of gal9 for treating COVID19, we infected and treated K18 hACE2 mice with a single dose of human rgal9 (rhgal9) or PBS i.p. and monitored 12 days for morbidity. Subgroups of mice were humanely euthanized at 2 and 5 dpi for viral plaque assay, flow cytometry, and protein analysis from lung tissue and BALF. We found that mice treated with rhgal9 during acute phase of infection have improved survival compared to PBS control. At 5 dpi, rhgal9 mice had enhanced viral clearance in the BALF and not in the lung parenchyma. We noted increased CD8 T cell and decreased neutrophil frequencies in the lung at 5 dpi. Finally, BALF had elevated levels of Type 1 IFN at 2 dpi and increased proinflammatory cytokines at 5 dpi. This suggests rhgal9 treatment may be therapeutic for acute COVID19, as rhgal9 with other anti-inflammatory mediator treatments cut associated harmful inflammation. Further studies are required to determine the optimal time, combination and duration of treatment pi to effectively target the gal9 pathway.
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Affiliation(s)
- Stephen T Yeung
- 1Medicine/Infectious Disease, Weill Cornell Grad. Sch. of Med. Sci
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11
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Kim C, Yee R, Bhatkoti R, Carranza D, Henderson D, Kuwabara SA, Trinidad JP, Radesky S, Cohen A, Vogt TM, Smith Z, Duggar C, Chatham-Stephens K, Ottis C, Rand K, Lim T, Jackson AF, Richardson D, Jaffe A, Lubitz R, Hayes R, Zouela A, Kotulich DL, Kelleher PN, Guo A, Pillai SK, Patel A. COVID-19 Vaccine Provider Access and Vaccination Coverage Among Children Aged 5-11 Years - United States, November 2021-January 2022. MMWR Morb Mortal Wkly Rep 2022; 71:378-383. [PMID: 35271559 PMCID: PMC8911999 DOI: 10.15585/mmwr.mm7110a4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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12
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Bhattacharyya A, Boostanpour K, Bouzidi M, Magee L, Chen TY, Wolters R, Torre P, Pillai SK, Bhattacharya M. IL10 trains macrophage profibrotic function after lung injury. Am J Physiol Lung Cell Mol Physiol 2022; 322:L495-L502. [PMID: 35107021 PMCID: PMC8917922 DOI: 10.1152/ajplung.00458.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cx3cr1+ monocyte-derived macrophages (moMacs) are recruited to tissues after injury and are known to have profibrotic effects, but the cell-cell interactions and specific pathways that regulate this polarization and function are incompletely understood. Here we investigate the role of moMac-derived Pdgfa in bleomycin-induced lung fibrosis in mice. Deletion of Pdgfa with Cx3cr1-CreERT2 decreased bleomycin-induced lung fibrosis. Among a panel of in vitro macrophage polarizing stimuli, robust induction of Pdgfa was noted with IL10 in both mouse and human moMacs. Likewise, analysis of single-cell data revealed high expression of the receptor IL10RA in moMacs from human fibrotic lungs. Studies with IL10-GFP mice revealed that IL10-expressing cells were increased after injury in mice and colocalized with moMacs. Notably, deletion of IL10ra with Csf1r-Cre: IL10ra fl/fl mice decreased both Pdgfa expression in moMacs and lung fibrosis. Taken together, these findings reveal a novel, IL10-dependent mechanism of macrophage polarization leading to fibroblast activation after injury.
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Affiliation(s)
- Aritra Bhattacharyya
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
| | - Kaveh Boostanpour
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
| | - Mohamed Bouzidi
- 3Vitalant Research Institute, San Francisco, California,4Department of Laboratory Medicine, University of California, San Francisco, California
| | - Liam Magee
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
| | - Tian Y. Chen
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
| | - Rachel Wolters
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
| | - Paola Torre
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
| | - Satish K. Pillai
- 3Vitalant Research Institute, San Francisco, California,4Department of Laboratory Medicine, University of California, San Francisco, California
| | - Mallar Bhattacharya
- 1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, California,2Sandler Asthma Basic Research Center, University of California, San Francisco, California
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13
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Yoon P, Hall J, Fuld J, Mattocks SL, Lyons BC, Bhatkoti R, Henley J, McNaghten AD, Daskalakis D, Pillai SK. Alternative Methods for Grouping Race and Ethnicity to Monitor COVID-19 Outcomes and Vaccination Coverage. MMWR Morb Mortal Wkly Rep 2021; 70:1075-1080. [PMID: 34383729 PMCID: PMC8360273 DOI: 10.15585/mmwr.mm7032a2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Population-based analyses of COVID-19 data, by race and ethnicity can identify and monitor disparities in COVID-19 outcomes and vaccination coverage. CDC recommends that information about race and ethnicity be collected to identify disparities and ensure equitable access to protective measures such as vaccines; however, this information is often missing in COVID-19 data reported to CDC. Baseline data collection requirements of the Office of Management and Budget's Standards for the Classification of Federal Data on Race and Ethnicity (Statistical Policy Directive No. 15) include two ethnicity categories and a minimum of five race categories (1). Using available COVID-19 case and vaccination data, CDC compared the current method for grouping persons by race and ethnicity, which prioritizes ethnicity (in alignment with the policy directive), with two alternative methods (methods A and B) that used race information when ethnicity information was missing. Method A assumed non-Hispanic ethnicity when ethnicity data were unknown or missing and used the same population groupings (denominators) for rate calculations as the current method (Hispanic persons for the Hispanic group and race category and non-Hispanic persons for the different racial groups). Method B grouped persons into ethnicity and race categories that are not mutually exclusive, unlike the current method and method A. Denominators for rate calculations using method B were Hispanic persons for the Hispanic group and persons of Hispanic or non-Hispanic ethnicity for the different racial groups. Compared with the current method, the alternative methods resulted in higher counts of COVID-19 cases and fully vaccinated persons across race categories (American Indian or Alaska Native [AI/AN], Asian, Black or African American [Black], Native Hawaiian or Other Pacific Islander [NH/PI], and White persons). When method B was used, the largest relative increase in cases (58.5%) was among AI/AN persons and the largest relative increase in the number of those fully vaccinated persons was among NH/PI persons (51.6%). Compared with the current method, method A resulted in higher cumulative incidence and vaccination coverage rates for the five racial groups. Method B resulted in decreasing cumulative incidence rates for two groups (AI/AN and NH/PI persons) and decreasing cumulative vaccination coverage rates for AI/AN persons. The rate ratio for having a case of COVID-19 by racial and ethnic group compared with that for White persons varied by method but was <1 for Asian persons and >1 for other groups across all three methods. The likelihood of being fully vaccinated was highest among NH/PI persons across all three methods. This analysis demonstrates that alternative methods for analyzing race and ethnicity data when data are incomplete can lead to different conclusions about disparities. These methods have limitations, however, and warrant further examination of potential bias and consultation with experts to identify additional methods for analyzing and tracking disparities when race and ethnicity data are incomplete.
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14
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Hiatt J, Cavero DA, McGregor MJ, Zheng W, Budzik JM, Roth TL, Haas KM, Wu D, Rathore U, Meyer-Franke A, Bouzidi MS, Shifrut E, Lee Y, Kumar VE, Dang EV, Gordon DE, Wojcechowskyj JA, Hultquist JF, Fontaine KA, Pillai SK, Cox JS, Ernst JD, Krogan NJ, Marson A. Efficient generation of isogenic primary human myeloid cells using CRISPR-Cas9 ribonucleoproteins. Cell Rep 2021; 35:109105. [PMID: 33979618 PMCID: PMC8188731 DOI: 10.1016/j.celrep.2021.109105] [Citation(s) in RCA: 12] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 12/31/2020] [Accepted: 04/19/2021] [Indexed: 12/21/2022] Open
Abstract
Genome engineering of primary human cells with CRISPR-Cas9 has revolutionized experimental and therapeutic approaches to cell biology, but human myeloid-lineage cells have remained largely genetically intractable. We present a method for the delivery of CRISPR-Cas9 ribonucleoprotein (RNP) complexes by nucleofection directly into CD14+ human monocytes purified from peripheral blood, leading to high rates of precise gene knockout. These cells can be efficiently differentiated into monocyte-derived macrophages or dendritic cells. This process yields genetically edited cells that retain transcript and protein markers of myeloid differentiation and phagocytic function. Genetic ablation of the restriction factor SAMHD1 increased HIV-1 infection >50-fold, demonstrating the power of this system for genotype-phenotype interrogation. This fast, flexible, and scalable platform can be used for genetic studies of human myeloid cells in immune signaling, inflammation, cancer immunology, host-pathogen interactions, and beyond, and could facilitate the development of myeloid cellular therapies.
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Affiliation(s)
- Joseph Hiatt
- Medical Scientist Training Program, University of California, San Francisco, San Francisco, CA 94143, USA; Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94143, USA; J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Devin A Cavero
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Michael J McGregor
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA; Quantitative Biosciences Institute, QBI, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Weihao Zheng
- Department of Medicine, Division of Experimental Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jonathan M Budzik
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Theodore L Roth
- Medical Scientist Training Program, University of California, San Francisco, San Francisco, CA 94143, USA; Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94143, USA; J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Kelsey M Haas
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA; Quantitative Biosciences Institute, QBI, University of California, San Francisco, San Francisco, CA 94158, USA
| | - David Wu
- Medical Scientist Training Program, University of California, San Francisco, San Francisco, CA 94143, USA; Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Ujjwal Rathore
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | | | - Mohamed S Bouzidi
- Vitalant Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Eric Shifrut
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Youjin Lee
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Vigneshwari Easwar Kumar
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Eric V Dang
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - David E Gordon
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA; Quantitative Biosciences Institute, QBI, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jason A Wojcechowskyj
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA; Quantitative Biosciences Institute, QBI, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Judd F Hultquist
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA; Quantitative Biosciences Institute, QBI, University of California, San Francisco, San Francisco, CA 94158, USA; Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | | | - Satish K Pillai
- Vitalant Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jeffery S Cox
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Joel D Ernst
- Department of Medicine, Division of Experimental Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Nevan J Krogan
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA; Quantitative Biosciences Institute, QBI, University of California, San Francisco, San Francisco, CA 94158, USA.
| | - Alexander Marson
- J. David Gladstone Institutes, San Francisco, CA 94158, USA; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA; Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA; Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA; Parker Institute for Cancer Immunotherapy, San Francisco, CA 94129, USA; UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94158, USA; Chan Zuckerberg Biohub, San Francisco, CA 94158, USA.
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15
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Rutishauser RL, Deguit CDT, Hiatt J, Blaeschke F, Roth TL, Wang L, Raymond KA, Starke CE, Mudd JC, Chen W, Smullin C, Matus-Nicodemos R, Hoh R, Krone M, Hecht FM, Pilcher CD, Martin JN, Koup RA, Douek DC, Brenchley JM, Sékaly RP, Pillai SK, Marson A, Deeks SG, McCune JM, Hunt PW. TCF-1 regulates HIV-specific CD8+ T cell expansion capacity. JCI Insight 2021; 6:136648. [PMID: 33351785 PMCID: PMC7934879 DOI: 10.1172/jci.insight.136648] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 12/16/2020] [Indexed: 12/14/2022] Open
Abstract
Although many HIV cure strategies seek to expand HIV-specific CD8+ T cells to control the virus, all are likely to fail if cellular exhaustion is not prevented. A loss in stem-like memory properties (i.e., the ability to proliferate and generate secondary effector cells) is a key feature of exhaustion; little is known, however, about how these properties are regulated in human virus-specific CD8+ T cells. We found that virus-specific CD8+ T cells from humans and nonhuman primates naturally controlling HIV/SIV infection express more of the transcription factor TCF-1 than noncontrollers. HIV-specific CD8+ T cell TCF-1 expression correlated with memory marker expression and expansion capacity and declined with antigenic stimulation. CRISPR-Cas9 editing of TCF-1 in human primary T cells demonstrated a direct role in regulating expansion capacity. Collectively, these data suggest that TCF-1 contributes to the regulation of the stem-like memory property of secondary expansion capacity of HIV-specific CD8+ T cells, and they provide a rationale for exploring the enhancement of this pathway in T cell-based therapeutic strategies for HIV.
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Affiliation(s)
| | - Christian Deo T. Deguit
- Department of Medicine, UCSF, San Francisco, California, USA
- Institute of Human Genetics, University of the Philippines-National Institutes of Health, Manila, Philippines
| | - Joseph Hiatt
- Department of Microbiology and Immunology
- Medical Scientist Training Program
- Biomedical Sciences Graduate Program, and
| | - Franziska Blaeschke
- Department of Microbiology and Immunology
- Diabetes Center, UCSF, San Francisco, California, USA
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, California, USA
| | - Theodore L. Roth
- Department of Microbiology and Immunology
- Medical Scientist Training Program
- Biomedical Sciences Graduate Program, and
| | - Lynn Wang
- Department of Medicine, UCSF, San Francisco, California, USA
| | - Kyle A. Raymond
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, California, USA
| | | | - Joseph C. Mudd
- Barrier Immunity Section, Laboratory of Viral Diseases and
| | - Wenxuan Chen
- Department of Medicine, UCSF, San Francisco, California, USA
| | - Carolyn Smullin
- Department of Medicine, UCSF, San Francisco, California, USA
| | - Rodrigo Matus-Nicodemos
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Rebecca Hoh
- Department of Medicine, UCSF, San Francisco, California, USA
| | - Melissa Krone
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | | | | | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | - Richard A. Koup
- Immunology Laboratory, Vaccine Research Center, National Institute of Allergy and Infectious Diseases , NIH, Bethesda, Maryland, USA
| | - Daniel C. Douek
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | | | | | - Satish K. Pillai
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, California, USA
| | - Alexander Marson
- Department of Medicine, UCSF, San Francisco, California, USA
- Department of Microbiology and Immunology
- Diabetes Center, UCSF, San Francisco, California, USA
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
- UCSF Hellen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, California, USA
- Parker Institute for Cancer Immunotherapy, San Francisco, California, USA
| | - Steven G. Deeks
- Department of Medicine, UCSF, San Francisco, California, USA
| | | | - Peter W. Hunt
- Department of Medicine, UCSF, San Francisco, California, USA
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16
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Sperber HS, Togarrati PP, Raymond KA, Bouzidi MS, Gilfanova R, Gutierrez AG, Muench MO, Pillai SK. μ-Lat: A mouse model to evaluate human immunodeficiency virus eradication strategies. FASEB J 2020; 34:14615-14630. [PMID: 32901981 PMCID: PMC8787083 DOI: 10.1096/fj.202001612rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023]
Abstract
A critical barrier to the development of a human immunodeficiency virus (HIV) cure is the lack of a scalable animal model that enables robust evaluation of eradication approaches prior to testing in humans. We established a humanized mouse model of latent HIV infection by transplanting "J-Lat" cells, Jurkat cells harboring a latent HIV provirus encoding an enhanced green fluorescent protein (GFP) reporter, into irradiated adult NOD.Cg-Prkdcscid Il2rgtm1Wjl /SzJ (NSG) mice. J-Lat cells exhibited successful engraftment in several tissues including spleen, bone barrow, peripheral blood, and lung, in line with the diverse natural tissue tropism of HIV. Administration of tumor necrosis factor (TNF)-α, an established HIV latency reversal agent, significantly induced GFP expression in engrafted cells across tissues, reflecting viral reactivation. These data suggest that our murine latency ("μ-Lat") model enables efficient determination of how effectively viral eradication agents, including latency reversal agents, penetrate, and function in diverse anatomical sites harboring HIV in vivo.
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Affiliation(s)
- Hannah S. Sperber
- Vitalant Research Institute, San Francisco, California, United States of America
- Free University of Berlin, Institute of Biochemistry, Berlin, Germany
- University of California, San Francisco, California, United States of America
| | | | - Kyle A. Raymond
- Vitalant Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Mohamed S. Bouzidi
- Vitalant Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Renata Gilfanova
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Alan G. Gutierrez
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Marcus O. Muench
- Vitalant Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Satish K. Pillai
- Vitalant Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
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17
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Ng DL, Goldgof GM, Shy BR, Levine AG, Balcerek J, Bapat SP, Prostko J, Rodgers M, Coller K, Pearce S, Franz S, Du L, Stone M, Pillai SK, Sotomayor-Gonzalez A, Servellita V, Martin CSS, Granados A, Glasner DR, Han LM, Truong K, Akagi N, Nguyen DN, Neumann NM, Qazi D, Hsu E, Gu W, Santos YA, Custer B, Green V, Williamson P, Hills NK, Lu CM, Whitman JD, Stramer SL, Wang C, Reyes K, Hakim JMC, Sujishi K, Alazzeh F, Pham L, Thornborrow E, Oon CY, Miller S, Kurtz T, Simmons G, Hackett J, Busch MP, Chiu CY. SARS-CoV-2 seroprevalence and neutralizing activity in donor and patient blood. Nat Commun 2020; 11:4698. [PMID: 32943630 PMCID: PMC7499171 DOI: 10.1038/s41467-020-18468-8] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/18/2020] [Indexed: 01/08/2023] Open
Abstract
Given the limited availability of serological testing to date, the seroprevalence of SARS-CoV-2-specific antibodies in different populations has remained unclear. Here, we report very low SARS-CoV-2 seroprevalence in two San Francisco Bay Area populations. Seroreactivity was 0.26% in 387 hospitalized patients admitted for non-respiratory indications and 0.1% in 1,000 blood donors in early April 2020. We additionally describe the longitudinal dynamics of immunoglobulin-G (IgG), immunoglobulin-M (IgM), and in vitro neutralizing antibody titers in COVID-19 patients. The median time to seroconversion ranged from 10.3-11.0 days for these 3 assays. Neutralizing antibodies rose in tandem with immunoglobulin titers following symptom onset, and positive percent agreement between detection of IgG and neutralizing titers was >93%. These findings emphasize the importance of using highly accurate tests for surveillance studies in low-prevalence populations, and provide evidence that seroreactivity using SARS-CoV-2 anti-nucleocapsid protein IgG and anti-spike IgM assays are generally predictive of in vitro neutralizing capacity.
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Affiliation(s)
- Dianna L Ng
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Brian R Shy
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew G Levine
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Balcerek
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sagar P Bapat
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Mary Rodgers
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Kelly Coller
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sandra Pearce
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sergej Franz
- Vitalant Research Institute, San Francisco, CA, USA
| | - Li Du
- Vitalant Research Institute, San Francisco, CA, USA
| | - Mars Stone
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | | | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Claudia Sanchez San Martin
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Andrea Granados
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Dustin R Glasner
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Lucy M Han
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Kent Truong
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Naomi Akagi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - David N Nguyen
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
| | - Neil M Neumann
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Qazi
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Elaine Hsu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Yale A Santos
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA
| | | | | | - Nancy K Hills
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Chuanyi M Lu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Laboratory Medicine Service, San Francisco VA Health Care System, San Francisco, CA, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Candace Wang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kevin Reyes
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Jill M C Hakim
- Department of Medicine at ZSFG, The Division of HIV, ID & Global Medicine, San Francisco, CA, USA
| | - Kirk Sujishi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Fariba Alazzeh
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lori Pham
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Edward Thornborrow
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ching-Ying Oon
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Theodore Kurtz
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Graham Simmons
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - John Hackett
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Michael P Busch
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA.
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA.
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18
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Burke RM, Balter S, Barnes E, Barry V, Bartlett K, Beer KD, Benowitz I, Biggs HM, Bruce H, Bryant-Genevier J, Cates J, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu VT, Clark S, Cody SH, Cohen M, Conners EE, Dasari V, Dawson P, DeSalvo T, Donahue M, Dratch A, Duca L, Duchin J, Dyal JW, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Freeman-Ponder B, Fry AM, Gant J, Gautom R, Ghinai I, Gounder P, Grigg CT, Gunzenhauser J, Hall AJ, Han GS, Haupt T, Holshue M, Hunter J, Ibrahim MB, Jacobs MW, Jarashow MC, Joshi K, Kamali T, Kawakami V, Kim M, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Lang M, Layden J, Leidman E, Lindquist S, Lindstrom S, Link-Gelles R, Marlow M, Mattison CP, McClung N, McPherson TD, Mello L, Midgley CM, Novosad S, Patel MT, Pettrone K, Pillai SK, Pray IW, Reese HE, Rhodes H, Robinson S, Rolfes M, Routh J, Rubin R, Rudman SL, Russell D, Scott S, Shetty V, Smith-Jeffcoat SE, Soda EA, Spitters C, Stierman B, Sunenshine R, Terashita D, Traub E, Vahey GM, Verani JR, Wallace M, Westercamp M, Wortham J, Xie A, Yousaf A, Zahn M. Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States. PLoS One 2020; 15:e0238342. [PMID: 32877446 DOI: 10.1101/2020.04.27.20081901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/19/2020] [Accepted: 08/15/2020] [Indexed: 05/24/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19.
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Affiliation(s)
- Rachel M Burke
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sharon Balter
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Emily Barnes
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vaughn Barry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Karri Bartlett
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Karlyn D Beer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Isaac Benowitz
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Holly M Biggs
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hollianne Bruce
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Jonathan Bryant-Genevier
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jordan Cates
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kevin Chatham-Stephens
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nora Chea
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Howard Chiou
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Demian Christiansen
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Victoria T Chu
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shauna Clark
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle-King County, Seattle, Washington, United States of America
| | - Sara H Cody
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Max Cohen
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erin E Conners
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vishal Dasari
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patrick Dawson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Traci DeSalvo
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Matthew Donahue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alissa Dratch
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
| | - Lindsey Duca
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Duchin
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle-King County, Seattle, Washington, United States of America
| | - Jonathan W Dyal
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Leora R Feldstein
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Marty Fenstersheib
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Marc Fischer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Fisher
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Chelsea Foo
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Brandi Freeman-Ponder
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alicia M Fry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jessica Gant
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Romesh Gautom
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Isaac Ghinai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Prabhu Gounder
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Cheri T Grigg
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Gunzenhauser
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Aron J Hall
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - George S Han
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Thomas Haupt
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Michelle Holshue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Jennifer Hunter
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mireille B Ibrahim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Max W Jacobs
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - M Claire Jarashow
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Kiran Joshi
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Talar Kamali
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vance Kawakami
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle-King County, Seattle, Washington, United States of America
| | - Moon Kim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Hannah L Kirking
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amanda Kita-Yarbro
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Rachel Klos
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Miwako Kobayashi
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Kocharian
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Misty Lang
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Jennifer Layden
- The COVID-19 Close Contact Investigation Team, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Eva Leidman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Scott Lindquist
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Stephen Lindstrom
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ruth Link-Gelles
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mariel Marlow
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire P Mattison
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
| | - Nancy McClung
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tristan D McPherson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Lynn Mello
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Claire M Midgley
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shannon Novosad
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan T Patel
- The COVID-19 Close Contact Investigation Team, United States of America
- Illinois Department of Public Health, Chicago, Illinois, United States of America
| | - Kristen Pettrone
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Satish K Pillai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ian W Pray
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Heather E Reese
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heather Rhodes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wyoming Department of Health, Cheyenne, Wyoming, United States of America
| | - Susan Robinson
- The COVID-19 Close Contact Investigation Team, United States of America
- Arizona Department of Health Services, Phoenix, Arizona, United States of America
| | - Melissa Rolfes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Janell Routh
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rachel Rubin
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Sarah L Rudman
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Denny Russell
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Sarah Scott
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Varun Shetty
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah E Smith-Jeffcoat
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A Soda
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher Spitters
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Bryan Stierman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Sunenshine
- The COVID-19 Close Contact Investigation Team, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Dawn Terashita
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Elizabeth Traub
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Grace M Vahey
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer R Verani
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan Wallace
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Westercamp
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jonathan Wortham
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amy Xie
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Yousaf
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Zahn
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
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19
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Burke RM, Balter S, Barnes E, Barry V, Bartlett K, Beer KD, Benowitz I, Biggs HM, Bruce H, Bryant-Genevier J, Cates J, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu VT, Clark S, Cody SH, Cohen M, Conners EE, Dasari V, Dawson P, DeSalvo T, Donahue M, Dratch A, Duca L, Duchin J, Dyal JW, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Freeman-Ponder B, Fry AM, Gant J, Gautom R, Ghinai I, Gounder P, Grigg CT, Gunzenhauser J, Hall AJ, Han GS, Haupt T, Holshue M, Hunter J, Ibrahim MB, Jacobs MW, Jarashow MC, Joshi K, Kamali T, Kawakami V, Kim M, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Lang M, Layden J, Leidman E, Lindquist S, Lindstrom S, Link-Gelles R, Marlow M, Mattison CP, McClung N, McPherson TD, Mello L, Midgley CM, Novosad S, Patel MT, Pettrone K, Pillai SK, Pray IW, Reese HE, Rhodes H, Robinson S, Rolfes M, Routh J, Rubin R, Rudman SL, Russell D, Scott S, Shetty V, Smith-Jeffcoat SE, Soda EA, Spitters C, Stierman B, Sunenshine R, Terashita D, Traub E, Vahey GM, Verani JR, Wallace M, Westercamp M, Wortham J, Xie A, Yousaf A, Zahn M. Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States. PLoS One 2020; 15:e0238342. [PMID: 32877446 PMCID: PMC7467265 DOI: 10.1371/journal.pone.0238342] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 05/19/2020] [Accepted: 08/15/2020] [Indexed: 12/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19.
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Affiliation(s)
- Rachel M. Burke
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sharon Balter
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Emily Barnes
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vaughn Barry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Karri Bartlett
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Karlyn D. Beer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Isaac Benowitz
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Holly M. Biggs
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hollianne Bruce
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Jonathan Bryant-Genevier
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jordan Cates
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kevin Chatham-Stephens
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nora Chea
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Howard Chiou
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Demian Christiansen
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Victoria T. Chu
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shauna Clark
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle–King County, Seattle, Washington, United States of America
| | - Sara H. Cody
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Max Cohen
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erin E. Conners
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vishal Dasari
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patrick Dawson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Traci DeSalvo
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Matthew Donahue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alissa Dratch
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
| | - Lindsey Duca
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Duchin
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle–King County, Seattle, Washington, United States of America
| | - Jonathan W. Dyal
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Leora R. Feldstein
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Marty Fenstersheib
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Marc Fischer
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Fisher
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Chelsea Foo
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Brandi Freeman-Ponder
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alicia M. Fry
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jessica Gant
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Romesh Gautom
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Isaac Ghinai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Prabhu Gounder
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Cheri T. Grigg
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey Gunzenhauser
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Aron J. Hall
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - George S. Han
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Thomas Haupt
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Michelle Holshue
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Jennifer Hunter
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mireille B. Ibrahim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Max W. Jacobs
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - M. Claire Jarashow
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Kiran Joshi
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Talar Kamali
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Vance Kawakami
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Seattle–King County, Seattle, Washington, United States of America
| | - Moon Kim
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Hannah L. Kirking
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amanda Kita-Yarbro
- The COVID-19 Close Contact Investigation Team, United States of America
- Public Health Madison & Dane County, Madison, Wisconsin, United States of America
| | - Rachel Klos
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Miwako Kobayashi
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Kocharian
- The COVID-19 Close Contact Investigation Team, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Misty Lang
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Jennifer Layden
- The COVID-19 Close Contact Investigation Team, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Eva Leidman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Scott Lindquist
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Stephen Lindstrom
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ruth Link-Gelles
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mariel Marlow
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire P. Mattison
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
| | - Nancy McClung
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tristan D. McPherson
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Chicago Department of Public Health, Chicago, Illinois, United States of America
| | - Lynn Mello
- The COVID-19 Close Contact Investigation Team, United States of America
- San Benito County Public Health Services, Hollister, California, United States of America
| | - Claire M. Midgley
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shannon Novosad
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan T. Patel
- The COVID-19 Close Contact Investigation Team, United States of America
- Illinois Department of Public Health, Chicago, Illinois, United States of America
| | - Kristen Pettrone
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Satish K. Pillai
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ian W. Pray
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Heather E. Reese
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heather Rhodes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Wyoming Department of Health, Cheyenne, Wyoming, United States of America
| | - Susan Robinson
- The COVID-19 Close Contact Investigation Team, United States of America
- Arizona Department of Health Services, Phoenix, Arizona, United States of America
| | - Melissa Rolfes
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Janell Routh
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rachel Rubin
- The COVID-19 Close Contact Investigation Team, United States of America
- Cook County Department of Public Health, Oak Forest, Illinois, United States of America
| | - Sarah L. Rudman
- The COVID-19 Close Contact Investigation Team, United States of America
- County of Santa Clara, Public Health Department, San Jose, California, United States of America
| | - Denny Russell
- The COVID-19 Close Contact Investigation Team, United States of America
- Washington State Public Health Laboratories, Shoreline, Washington, United States of America
| | - Sarah Scott
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Varun Shetty
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah E. Smith-Jeffcoat
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A. Soda
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher Spitters
- The COVID-19 Close Contact Investigation Team, United States of America
- Snohomish Health District, Everett, Washington, United States of America
| | - Bryan Stierman
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca Sunenshine
- The COVID-19 Close Contact Investigation Team, United States of America
- Maricopa County Department of Public Health, Phoenix, Arizona, United States of America
| | - Dawn Terashita
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Elizabeth Traub
- The COVID-19 Close Contact Investigation Team, United States of America
- Los Angeles County Department of Public Health, Los Angeles, California, United States of America
| | - Grace M. Vahey
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer R. Verani
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Megan Wallace
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Westercamp
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jonathan Wortham
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amy Xie
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Yousaf
- The COVID-19 Close Contact Investigation Team, United States of America
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthew Zahn
- The COVID-19 Close Contact Investigation Team, United States of America
- Orange County Healthcare Agency, Santa Ana, California, United States of America
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20
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Marques de Menezes EG, Jang K, George AF, Nyegaard M, Neidleman J, Inglis HC, Danesh A, Deng X, Afshari A, Kim YH, Billaud JN, Marson K, Pilcher CD, Pillai SK, Norris PJ, Roan NR. Seminal Plasma-Derived Extracellular-Vesicle Fractions from HIV-Infected Men Exhibit Unique MicroRNA Signatures and Induce a Proinflammatory Response in Cells Isolated from the Female Reproductive Tract. J Virol 2020; 94:e00525-20. [PMID: 32434889 PMCID: PMC7394899 DOI: 10.1128/jvi.00525-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/15/2020] [Indexed: 11/20/2022] Open
Abstract
The continuing spread of HIV/AIDS is predominantly fueled by sexual exposure to HIV-contaminated semen. Seminal plasma (SP), the liquid portion of semen, harbors a variety of factors that may favor HIV transmission by facilitating viral entry into host cells, eliciting the production of proinflammatory cytokines, and enhancing the translocation of HIV across the genital epithelium. One important and abundant class of factors in SP is extracellular vesicles (EVs), which, in general, are important intercellular signal transducers. Although numerous studies have characterized blood plasma-derived EVs from both uninfected and HIV-infected individuals, little is known about the properties of EVs from the semen of HIV-infected individuals. We report here that fractionated SP enriched for EVs from HIV-infected men induces potent transcriptional responses in epithelial and stromal cells that interface with the luminal contents of the female reproductive tract. Semen EV fractions from acutely infected individuals induced a more proinflammatory signature than those from uninfected individuals. This was not associated with any observable differences in the surface phenotypes of the vesicles. However, microRNA (miRNA) expression profiling analysis revealed that EV fractions from infected individuals exhibit a broader and more diverse profile than those from uninfected individuals. Taken together, our data suggest that SP EVs from HIV-infected individuals exhibit unique miRNA signatures and exert potent proinflammatory transcriptional changes in cells of the female reproductive tract, which may facilitate HIV transmission.IMPORTANCE Seminal plasma (SP), the major vehicle for HIV, can modulate HIV transmission risk through a variety of mechanisms. Extracellular vesicles (EVs) are extremely abundant in semen, and because they play a key role in intercellular communication pathways and immune regulation, they may impact the likelihood of HIV transmission. However, little is known about the properties and signaling effects of SP-derived EVs in the context of HIV transmission. Here, we conduct a phenotypic, transcriptomic, and functional characterization of SP and SP-derived EVs from uninfected and HIV-infected men. We find that both SP and its associated EVs elicit potent proinflammatory transcriptional responses in cells that line the genital tract. EVs from HIV-infected men exhibit a more diverse repertoire of miRNAs than EVs from uninfected men. Our findings suggest that EVs from the semen of HIV-infected men may significantly impact the likelihood of HIV transmission through multiple mechanisms.
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Affiliation(s)
- Erika G Marques de Menezes
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Karen Jang
- Gladstone Institute of Virology and Immunology, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, California, USA
| | - Ashley F George
- Gladstone Institute of Virology and Immunology, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, California, USA
| | - Mette Nyegaard
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Jason Neidleman
- Gladstone Institute of Virology and Immunology, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, California, USA
| | | | - Ali Danesh
- Vitalant Research Institute, San Francisco, California, USA
| | - Xutao Deng
- Vitalant Research Institute, San Francisco, California, USA
| | | | - Young H Kim
- Agilent Technologies, Inc., Santa Clara, California, USA
| | | | - Kara Marson
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Christopher D Pilcher
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Satish K Pillai
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Philip J Norris
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
- Department of Medicine, University of California, San Francisco, California, USA
| | - Nadia R Roan
- Gladstone Institute of Virology and Immunology, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, California, USA
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21
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Kujawski SA, Wong KK, Collins JP, Epstein L, Killerby ME, Midgley CM, Abedi GR, Ahmed NS, Almendares O, Alvarez FN, Anderson KN, Balter S, Barry V, Bartlett K, Beer K, Ben-Aderet MA, Benowitz I, Biggs H, Binder AM, Black SR, Bonin B, Brown CM, Bruce H, Bryant-Genevier J, Budd A, Buell D, Bystritsky R, Cates J, Charles EM, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu V, Cody S, Cohen M, Conners E, Curns A, Dasari V, Dawson P, DeSalvo T, Diaz G, Donahue M, Donovan S, Duca LM, Erickson K, Esona MD, Evans S, Falk J, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Fricchione MJ, Friedman O, Fry AM, Galang RR, Garcia MM, Gerber SI, Gerrard G, Ghinai I, Gounder P, Grein J, Grigg C, Gunzenhauser JD, Gutkin GI, Haddix M, Hall AJ, Han G, Harcourt J, Harriman K, Haupt T, Haynes A, Holshue M, Hoover C, Hunter JC, Jacobs MW, Jarashow C, Jhung MA, Joshi K, Kamali T, Kamili S, Kim L, Kim M, King J, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Komatsu KK, Koppaka R, Layden JE, Li Y, Lindquist S, Lindstrom S, Link-Gelles R, Lively J, Livingston M, Lo K, Lo J, Lu X, Lynch B, Madoff L, Malapati L, Marks G, Marlow M, Mathisen GE, McClung N, McGovern O, McPherson TD, Mehta M, Meier A, Mello L, Moon SS, Morgan M, Moro RN, Murray J, Murthy R, Novosad S, Oliver SE, O'Shea J, Pacilli M, Paden CR, Pallansch MA, Patel M, Patel S, Pedraza I, Pillai SK, Pindyck T, Pray I, Queen K, Quick N, Reese H, Rha B, Rhodes H, Robinson S, Robinson P, Rolfes M, Routh J, Rubin R, Rudman SL, Sakthivel SK, Scott S, Shepherd C, Shetty V, Smith EA, Smith S, Stierman B, Stoecker W, Sunenshine R, Sy-Santos R, Tamin A, Tao Y, Terashita D, Thornburg NJ, Tong S, Traub E, Tural A, Uehara A, Uyeki TM, Vahey G, Verani JR, Villarino E, Wallace M, Wang L, Watson JT, Westercamp M, Whitaker B, Wilkerson S, Woodruff RC, Wortham JM, Wu T, Xie A, Yousaf A, Zahn M, Zhang J. Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Nat Med 2020; 26:861-868. [PMID: 32327757 DOI: 10.1101/2020.03.09.20032896] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/06/2020] [Indexed: 05/28/2023]
Abstract
Data on the detailed clinical progression of COVID-19 in conjunction with epidemiological and virological characteristics are limited. In this case series, we describe the first 12 US patients confirmed to have COVID-19 from 20 January to 5 February 2020, including 4 patients described previously1-3. Respiratory, stool, serum and urine specimens were submitted for SARS-CoV-2 real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing, viral culture and whole genome sequencing. Median age was 53 years (range: 21-68); 8 patients were male. Common symptoms at illness onset were cough (n = 8) and fever (n = 7). Patients had mild to moderately severe illness; seven were hospitalized and demonstrated clinical or laboratory signs of worsening during the second week of illness. No patients required mechanical ventilation and all recovered. All had SARS-CoV-2 RNA detected in respiratory specimens, typically for 2-3 weeks after illness onset. Lowest real-time PCR with reverse transcription cycle threshold values in the upper respiratory tract were often detected in the first week and SARS-CoV-2 was cultured from early respiratory specimens. These data provide insight into the natural history of SARS-CoV-2. Although infectiousness is unclear, highest viral RNA levels were identified in the first week of illness. Clinicians should anticipate that some patients may worsen in the second week of illness.
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22
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Chu VT, Freeman-Ponder B, Lindquist S, Spitters C, Kawakami V, Dyal JW, Clark S, Bruce H, Duchin JS, DeBolt C, Podczervinski S, D'Angeli M, Pettrone K, Zacks R, Vahey G, Holshue ML, Lang M, Burke RM, Rolfes MA, Marlow M, Midgley CM, Lu X, Lindstrom S, Hall AJ, Fry AM, Thornburg NJ, Gerber SI, Pillai SK, Biggs HM. Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA. Emerg Infect Dis 2020; 26:1671-1678. [PMID: 32470316 PMCID: PMC7392438 DOI: 10.3201/eid2608.201423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe the contact investigation for an early confirmed case of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the United States. Contacts of the case-patient were identified, actively monitored for symptoms, interviewed for a detailed exposure history, and tested for SARS-CoV-2 infection by real-time reverse transcription PCR (rRT-PCR) and ELISA. Fifty contacts were identified and 38 (76%) were interviewed, of whom 11 (29%) reported unprotected face-to-face interaction with the case-patient. Thirty-seven (74%) had respiratory specimens tested by rRT-PCR, and all tested negative. Twenty-three (46%) had ELISA performed on serum samples collected ≈6 weeks after exposure, and none had detectable antibodies to SARS-CoV-2. Among contacts who were tested, no secondary transmission was identified in this investigation, despite unprotected close interactions with the infectious case-patient.
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23
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Ng DL, Goldgof GM, Shy BR, Levine AG, Balcerek J, Bapat SP, Prostko J, Rodgers M, Coller K, Pearce S, Franz S, Du L, Stone M, Pillai SK, Sotomayor-Gonzalez A, Servellita V, Martin CSS, Granados A, Glasner DR, Han LM, Truong K, Akagi N, Nguyen DN, Neumann NM, Qazi D, Hsu E, Gu W, Santos YA, Custer B, Green V, Williamson P, Hills NK, Lu CM, Whitman JD, Stramer S, Wang C, Reyes K, Hakim JM, Sujishi K, Alazzeh F, Pham L, Oon CY, Miller S, Kurtz T, Hackett J, Simmons G, Busch MP, Chiu CY. SARS-CoV-2 seroprevalence and neutralizing activity in donor and patient blood from the San Francisco Bay Area. medRxiv 2020:2020.05.19.20107482. [PMID: 32511477 PMCID: PMC7273245 DOI: 10.1101/2020.05.19.20107482] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We report very low SARS-CoV-2 seroprevalence in two San Francisco Bay Area populations. Seropositivity was 0.26% in 387 hospitalized patients admitted for non-respiratory indications and 0.1% in 1,000 blood donors. We additionally describe the longitudinal dynamics of immunoglobulin-G, immunoglobulin-M, and in vitro neutralizing antibody titers in COVID-19 patients. Neutralizing antibodies rise in tandem with immunoglobulin levels following symptom onset, exhibiting median time to seroconversion within one day of each other, and there is >93% positive percent agreement between detection of immunoglobulin-G and neutralizing titers.
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Affiliation(s)
- Dianna L. Ng
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M. Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Brian R. Shy
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew G. Levine
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Balcerek
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sagar P. Bapat
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Mary Rodgers
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Kelly Coller
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sandy Pearce
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sergej Franz
- Vitalant Research Institute, San Francisco, CA, USA
| | - Li Du
- Vitalant Research Institute, San Francisco, CA, USA
| | - Mars Stone
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | | | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Claudia Sanchez San Martin
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Andrea Granados
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Dustin R. Glasner
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Lucy M. Han
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Kent Truong
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Naomi Akagi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - David N. Nguyen
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
| | - Neil M. Neumann
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Qazi
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Elaine Hsu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Yale A. Santos
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA
| | | | | | - Nancy K. Hills
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Chuanyi M. Lu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Lab Medicine Service, San Francisco VA Healthcare System
| | - Jeffrey D. Whitman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Candace Wang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kevin Reyes
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Jill M.C. Hakim
- Department of Medicine at ZSFG, the Division of HIV, ID & Global Medicine
| | - Kirk Sujishi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Fariba Alazzeh
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lori Pham
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ching-Ying Oon
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Theodore Kurtz
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John Hackett
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Graham Simmons
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Michael P. Busch
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Charles Y. Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
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24
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Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A, Diaz G, Cohn A, Fox L, Patel A, Gerber SI, Kim L, Tong S, Lu X, Lindstrom S, Pallansch MA, Weldon WC, Biggs HM, Uyeki TM, Pillai SK. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020. [PMID: 32004427 DOI: 10.1056/nejmoa2001191/suppl_file/nejmoa2001191_disclosures.pdf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/08/2023]
Abstract
An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
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Affiliation(s)
- Michelle L Holshue
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Chas DeBolt
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Scott Lindquist
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Kathy H Lofy
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - John Wiesman
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Hollianne Bruce
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Christopher Spitters
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Keith Ericson
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Sara Wilkerson
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Ahmet Tural
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - George Diaz
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Amanda Cohn
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - LeAnne Fox
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Anita Patel
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Susan I Gerber
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Lindsay Kim
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Suxiang Tong
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Xiaoyan Lu
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Steve Lindstrom
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Mark A Pallansch
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - William C Weldon
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Holly M Biggs
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Timothy M Uyeki
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Satish K Pillai
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
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Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A, Diaz G, Cohn A, Fox L, Patel A, Gerber SI, Kim L, Tong S, Lu X, Lindstrom S, Pallansch MA, Weldon WC, Biggs HM, Uyeki TM, Pillai SK. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020; 382:929-936. [PMID: 32004427 PMCID: PMC7092802 DOI: 10.1056/nejmoa2001191] [Citation(s) in RCA: 3707] [Impact Index Per Article: 926.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
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Affiliation(s)
- Michelle L Holshue
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Chas DeBolt
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Scott Lindquist
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Kathy H Lofy
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - John Wiesman
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Hollianne Bruce
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Christopher Spitters
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Keith Ericson
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Sara Wilkerson
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Ahmet Tural
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - George Diaz
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Amanda Cohn
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - LeAnne Fox
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Anita Patel
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Susan I Gerber
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Lindsay Kim
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Suxiang Tong
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Xiaoyan Lu
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Steve Lindstrom
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Mark A Pallansch
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - William C Weldon
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Holly M Biggs
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Timothy M Uyeki
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
| | - Satish K Pillai
- From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) - all in Washington
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Nakiire L, Mwanja H, Pillai SK, Gasanani J, Ntungire D, Nsabiyumva S, Mafigiri R, Muneza N, Ward SE, Daffe Z, Ahabwe PB, Kyazze S, Ojwang J, Homsy J, Mclntyre E, Lamorde M, Walwema R, Makumbi I, Muruta A, Merrill RD. Population Movement Patterns Among the Democratic Republic of the Congo, Rwanda, and Uganda During an Outbreak of Ebola Virus Disease: Results from Community Engagement in Two Districts - Uganda, March 2019. MMWR Morb Mortal Wkly Rep 2020; 69:10-13. [PMID: 31917781 PMCID: PMC6973344 DOI: 10.15585/mmwr.mm6901a3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Fleck-Derderian S, Shankar M, Rao AK, Chatham-Stephens K, Adjei S, Sobel J, Meltzer MI, Meaney-Delman D, Pillai SK. The Epidemiology of Foodborne Botulism Outbreaks: A Systematic Review. Clin Infect Dis 2019; 66:S73-S81. [PMID: 29293934 DOI: 10.1093/cid/cix846] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background We performed a systematic review of foodborne botulism outbreaks to describe their clinical aspects and descriptive epidemiology in order to inform public health response strategies. Methods We searched seven databases for reports of foodborne botulism outbreaks published in English from database inception to May 2015. We summarized descriptive characteristics and analyzed differences in exposure and toxin types by geographic region. We performed logistic regression to assess correlations between exposure source, implicated food, and outbreak size. Results There were 197 outbreaks reported between 1920 and 2014. The median number of cases per outbreak was 3 (range 2-97). The majority of reported outbreaks (109; 55%) occurred in the United States. Toxin types A, B, E, and F were identified as the causative agent in 34%, 16%, 17%, and 1% of outbreaks, respectively. The median duration between exposure and symptom onset was approximately 1 day. The mean percentage of cases requiring mechanical ventilation per outbreak was 34%. Seventy percent of all outbreaks and 77% of small outbreaks (≤11 cases) originated from point source exposures, while commercial foods were significantly (odds ratio, 6.9; 95% confidence interval, 2.2-21.1) associated with large outbreaks (≥12 cases). Conclusions Toxin type A accounted for half of outbreaks, and these outbreaks had a higher proportion of patient ventilatory failure. Most outbreaks were due to point source exposures, while outbreaks due to commercial food were larger. For effective responses to foodborne botulism outbreaks, these findings demonstrate the need for timely outbreak investigation and hospital surge capacity.
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Affiliation(s)
- Shannon Fleck-Derderian
- Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.,Oak Ridge Institute for Science and Education, CDC Fellowship Program, Tennessee
| | - Manjunath Shankar
- Scientific Programs Services Branch, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Agam K Rao
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kevin Chatham-Stephens
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stacey Adjei
- Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeremy Sobel
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Martin I Meltzer
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dana Meaney-Delman
- Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Satish K Pillai
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Patel A, Lee L, Pillai SK, Valderrama AL, Delaney LJ, Radonovich L. Approach to Prioritizing Respiratory Protection When Demand Exceeds Supplies During an Influenza Pandemic: A Call to Action. Health Secur 2019; 17:152-155. [PMID: 31009256 DOI: 10.1089/hs.2019.0027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Anita Patel
- Anita Patel, PharmD, MS, is Senior Advisor, Medical Care and Countermeasures Lead, Influenza Coordination Unit; and Leslie Lee, MPH, is a Public Health Advisor, General Dynamics Information Technology, contracted to the Influenza Coordination Unit; both in the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish K. Pillai, MD, MPH, is Deputy Director, Division of Preparedness and Emerging Infectious Disease; and Amy L. Valderrama, PhD, RN, is a Nurse Epidemiologist, Division of Healthcare Quality Promotion; both in the National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, GA. Lisa J. Delaney, MS, is Associate Director for Emergency Preparedness and Response, National Institute for Occupational Safety and Health (NIOSH), CDC, Atlanta, GA. Lewis Radonovich, MD, is Chief of Research, National Personal Protective Technology Laboratory, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no conflicts of interest
| | - Leslie Lee
- Anita Patel, PharmD, MS, is Senior Advisor, Medical Care and Countermeasures Lead, Influenza Coordination Unit; and Leslie Lee, MPH, is a Public Health Advisor, General Dynamics Information Technology, contracted to the Influenza Coordination Unit; both in the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish K. Pillai, MD, MPH, is Deputy Director, Division of Preparedness and Emerging Infectious Disease; and Amy L. Valderrama, PhD, RN, is a Nurse Epidemiologist, Division of Healthcare Quality Promotion; both in the National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, GA. Lisa J. Delaney, MS, is Associate Director for Emergency Preparedness and Response, National Institute for Occupational Safety and Health (NIOSH), CDC, Atlanta, GA. Lewis Radonovich, MD, is Chief of Research, National Personal Protective Technology Laboratory, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no conflicts of interest
| | - Satish K Pillai
- Anita Patel, PharmD, MS, is Senior Advisor, Medical Care and Countermeasures Lead, Influenza Coordination Unit; and Leslie Lee, MPH, is a Public Health Advisor, General Dynamics Information Technology, contracted to the Influenza Coordination Unit; both in the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish K. Pillai, MD, MPH, is Deputy Director, Division of Preparedness and Emerging Infectious Disease; and Amy L. Valderrama, PhD, RN, is a Nurse Epidemiologist, Division of Healthcare Quality Promotion; both in the National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, GA. Lisa J. Delaney, MS, is Associate Director for Emergency Preparedness and Response, National Institute for Occupational Safety and Health (NIOSH), CDC, Atlanta, GA. Lewis Radonovich, MD, is Chief of Research, National Personal Protective Technology Laboratory, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no conflicts of interest
| | - Amy L Valderrama
- Anita Patel, PharmD, MS, is Senior Advisor, Medical Care and Countermeasures Lead, Influenza Coordination Unit; and Leslie Lee, MPH, is a Public Health Advisor, General Dynamics Information Technology, contracted to the Influenza Coordination Unit; both in the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish K. Pillai, MD, MPH, is Deputy Director, Division of Preparedness and Emerging Infectious Disease; and Amy L. Valderrama, PhD, RN, is a Nurse Epidemiologist, Division of Healthcare Quality Promotion; both in the National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, GA. Lisa J. Delaney, MS, is Associate Director for Emergency Preparedness and Response, National Institute for Occupational Safety and Health (NIOSH), CDC, Atlanta, GA. Lewis Radonovich, MD, is Chief of Research, National Personal Protective Technology Laboratory, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no conflicts of interest
| | - Lisa J Delaney
- Anita Patel, PharmD, MS, is Senior Advisor, Medical Care and Countermeasures Lead, Influenza Coordination Unit; and Leslie Lee, MPH, is a Public Health Advisor, General Dynamics Information Technology, contracted to the Influenza Coordination Unit; both in the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish K. Pillai, MD, MPH, is Deputy Director, Division of Preparedness and Emerging Infectious Disease; and Amy L. Valderrama, PhD, RN, is a Nurse Epidemiologist, Division of Healthcare Quality Promotion; both in the National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, GA. Lisa J. Delaney, MS, is Associate Director for Emergency Preparedness and Response, National Institute for Occupational Safety and Health (NIOSH), CDC, Atlanta, GA. Lewis Radonovich, MD, is Chief of Research, National Personal Protective Technology Laboratory, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no conflicts of interest
| | - Lewis Radonovich
- Anita Patel, PharmD, MS, is Senior Advisor, Medical Care and Countermeasures Lead, Influenza Coordination Unit; and Leslie Lee, MPH, is a Public Health Advisor, General Dynamics Information Technology, contracted to the Influenza Coordination Unit; both in the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Satish K. Pillai, MD, MPH, is Deputy Director, Division of Preparedness and Emerging Infectious Disease; and Amy L. Valderrama, PhD, RN, is a Nurse Epidemiologist, Division of Healthcare Quality Promotion; both in the National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, GA. Lisa J. Delaney, MS, is Associate Director for Emergency Preparedness and Response, National Institute for Occupational Safety and Health (NIOSH), CDC, Atlanta, GA. Lewis Radonovich, MD, is Chief of Research, National Personal Protective Technology Laboratory, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors have no conflicts of interest
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Hardy MC, Stinnett RC, Kines KJ, Rivera-Nazario DM, Lowe DE, Mercante AM, Gonzalez Jimenez N, Cuevas Ruiz RI, Rivera Arbolay HI, Gonzalez Peña RL, Toro M, Trujillo AA, Pappas CL, Llewellyn AC, Candal F, Burgos Garay M, Gomez GA, Concepcion Acevedo J, Ansbro M, Moura H, Shaw MW, Muehlenbachs A, Romanoff LC, Sunshine BJ, Rose DA, Patel A, Shapiro CN, Luna-Pinto SC, Pillai SK, O'Neill E. Lessons from the reestablishment of Public Health Laboratory activities in Puerto Rico after Hurricane Maria. Nat Commun 2019; 10:2720. [PMID: 31221973 PMCID: PMC6586791 DOI: 10.1038/s41467-019-10776-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/02/2018] [Accepted: 05/31/2019] [Indexed: 12/02/2022] Open
Abstract
Public Health Laboratories (PHLs) in Puerto Rico did not escape the devastation caused by Hurricane Maria. We implemented a quality management system (QMS) approach to systematically reestablish laboratory testing, after evaluating structural and functional damage. PHLs were inoperable immediately after the storm. Our QMS-based approach began in October 2017, ended in May 2018, and resulted in the reestablishment of 92% of baseline laboratory testing capacity. Here, we share lessons learned from the historic recovery of the largest United States’ jurisdiction to lose its PHL capacity, and provide broadly applicable tools for other jurisdictions to enhance preparedness for public health emergencies. Hurricane Maria hit Puerto Rico in 2017 and resulted in a complete loss of activity of the Public Health Laboratories. Here, the authors discuss the approach taken and tools developed to re-establish activity in these laboratories using a quality management system and the lessons learned in this process.
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Affiliation(s)
- Margaret C Hardy
- Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Division of Foodborne and Waterborne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Office of the Chief Regulatory Scientist, Australian Pesticides and Veterinary Medicines Authority, Armidale, New South Wales, 2350, Australia
| | - Rita C Stinnett
- Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Kristine J Kines
- Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Danisha M Rivera-Nazario
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - David E Lowe
- Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Alexandra M Mercante
- Division of Foodborne and Waterborne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Nathalie Gonzalez Jimenez
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Rosa I Cuevas Ruiz
- Public Health Laboratories, Puerto Rico Department of Health, San Juan, PR, 00936, USA
| | | | | | - Mayra Toro
- Public Health Laboratories, Puerto Rico Department of Health, San Juan, PR, 00936, USA
| | - Alma A Trujillo
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Claudia L Pappas
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Anna C Llewellyn
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Francisco Candal
- Office of Technology and Innovation, Office of Science, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - María Burgos Garay
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Gerardo A Gomez
- Division of Foodborne and Waterborne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jeniffer Concepcion Acevedo
- Division of Foodborne and Waterborne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Marisela Ansbro
- Division of Select Agents and Toxins, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Hercules Moura
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Michael W Shaw
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Atis Muehlenbachs
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Lovisa C Romanoff
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Brittany J Sunshine
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Dale A Rose
- Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, 30329, USA.,Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Anita Patel
- Influenza Coordination Unit, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Craig N Shapiro
- Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, 30329, USA
| | - S Carolina Luna-Pinto
- Office of the Director, Center for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Satish K Pillai
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Eduardo O'Neill
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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Li Z, Wu J, Chavez L, Hoh R, Deeks SG, Pillai SK, Zhou Q. Reiterative Enrichment and Authentication of CRISPRi Targets (REACT) identifies the proteasome as a key contributor to HIV-1 latency. PLoS Pathog 2019; 15:e1007498. [PMID: 30645648 PMCID: PMC6333332 DOI: 10.1371/journal.ppat.1007498] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 09/27/2018] [Accepted: 12/03/2018] [Indexed: 02/06/2023] Open
Abstract
The establishment of HIV-1 latency gives rise to persistent chronic infection that requires life-long treatment. To reverse latency for viral eradiation, the HIV-1 Tat protein and its associated ELL2-containing Super Elongation Complexes (ELL2-SECs) are essential to activate HIV-1 transcription. Despite efforts to identify effective latency-reversing agents (LRA), avenues for exposing latent HIV-1 remain inadequate, prompting the need to identify novel LRA targets. Here, by conducting a CRISPR interference-based screen to reiteratively enrich loss-of-function genotypes that increase HIV-1 transcription in latently infected CD4+ T cells, we have discovered a key role of the proteasome in maintaining viral latency. Downregulating or inhibiting the proteasome promotes Tat-transactivation in cell line models. Furthermore, the FDA-approved proteasome inhibitors bortezomib and carfilzomib strongly synergize with existing LRAs to reactivate HIV-1 in CD4+ T cells from antiretroviral therapy-suppressed individuals without inducing cell activation or proliferation. Mechanistically, downregulating/inhibiting the proteasome elevates the levels of ELL2 and ELL2-SECs to enable Tat-transactivation, indicating the proteasome-ELL2 axis as a key regulator of HIV-1 latency and promising target for therapeutic intervention. To cure chronic HIV-1 infection requires reversal of HIV-1 latency from latently infected CD4+ T cells. A key step in HIV latency reversal is the recruitment of Super Elongation Complexes (SECs) that contain ELL2 by an HIV-encoded protein, Tat, to activate proviral transcription. To identify novel drug targets, we conducted a CRISPRi-based screen to enrich the sgRNAs that increase HIV transcription in latently infected CD4+ T cells. Three of the six most prominent hits in our screen are proteasome subunits. We further proved that antagonizing the proteasome promotes Tat-induced HIV-1 transcription in cell line-based latency models. Furthermore, we found that two FDA-approved proteasome inhibitors strongly synergize with existing LRAs ex vivo without inducing cell activation or proliferation. We further found that antagonizing the proteasome elevates the levels of ELL2 and ELL2-containing SECs in the cells, thus enabling Tat-transactivation. These results indicate that the proteasome-ELL2 axis is a key regulator of HIV-1 latency could potentially be targeted for therapeutic interventions.
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Affiliation(s)
- Zichong Li
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
| | - Jun Wu
- School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Leonard Chavez
- Vitalant Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Rebecca Hoh
- University of California, San Francisco, California, United States of America
| | - Steven G. Deeks
- University of California, San Francisco, California, United States of America
| | - Satish K. Pillai
- Vitalant Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Qiang Zhou
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
- * E-mail:
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31
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Premeaux TA, D'Antoni ML, Abdel-Mohsen M, Pillai SK, Kallianpur KJ, Nakamoto BK, Agsalda-Garcia M, Shiramizu B, Shikuma CM, Gisslén M, Price RW, Valcour V, Ndhlovu LC. Elevated cerebrospinal fluid Galectin-9 is associated with central nervous system immune activation and poor cognitive performance in older HIV-infected individuals. J Neurovirol 2018; 25:150-161. [PMID: 30478799 DOI: 10.1007/s13365-018-0696-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 01/25/2023]
Abstract
We previously reported that galectin-9 (Gal-9), a soluble lectin with immunomodulatory properties, is elevated in plasma during HIV infection and induces HIV transcription. The link between Gal-9 and compromised neuronal function is becoming increasingly evident; however, the association with neuroHIV remains unknown. We measured Gal-9 levels by ELISA in cerebrospinal fluid (CSF) and plasma of 70 HIV-infected (HIV+) adults stratified by age (older > 40 years and younger < 40 years) either ART suppressed or with detectable CSF HIV RNA, including a subgroup with cognitive assessments, and 18 HIV uninfected (HIV-) controls. Gal-9 tissue expression was compared in necropsy brain specimens from HIV- and HIV+ donors using gene datasets and immunohistochemistry. Among older HIV+ adults, CSF Gal-9 was elevated in the ART suppressed and CSF viremic groups compared to controls, whereas in the younger group, Gal-9 levels were elevated only in the CSF viremic group (p < 0.05). CSF Gal-9 positively correlated with age in all groups (p < 0.05). CSF Gal-9 tracked with CSF HIV RNA irrespective of age (β = 0.33; p < 0.05). Higher CSF Gal-9 in the older viremic HIV+ group correlated with worse neuropsychological test performance scores independently of age and CSF HIV RNA (p < 0.05). Furthermore, CSF Gal-9 directly correlated with myeloid activation (CSF-soluble CD163 and neopterin) in both HIV+ older groups (p < 0.05). Among HIV+ necropsy specimens, Gal-9 expression was increased in select brain regions compared to controls (p < 0.05). Gal-9 may serve as a novel neuroimmuno-modulatory protein that is involved in driving cognitive deficits in those aging with HIV and may be valuable in tracking cognitive abnormalities.
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Affiliation(s)
- Thomas A Premeaux
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 325, Honolulu, HI, 96813, USA
| | - Michelle L D'Antoni
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 325, Honolulu, HI, 96813, USA.,Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA
| | | | - Satish K Pillai
- Blood Systems Research Institute, 270 Masonic Ave, San Francisco, CA, 94118, USA
| | - Kalpana J Kallianpur
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 325, Honolulu, HI, 96813, USA.,Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA
| | - Beau K Nakamoto
- Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA.,Straub Medical Center, 888 S King St, Honolulu, HI, 96813, USA
| | - Melissa Agsalda-Garcia
- Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA
| | - Bruce Shiramizu
- Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA
| | - Cecilia M Shikuma
- Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA
| | - Magnus Gisslén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden
| | - Richard W Price
- Department of Neurology, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA
| | - Lishomwa C Ndhlovu
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 325, Honolulu, HI, 96813, USA. .,Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St BSB 225, Honolulu, HI, 96813, USA.
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32
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Narra R, Sobel J, Piper C, Gould D, Bhadelia N, Dott M, Fiore A, Fischer WA, Frawley MJ, Griffin PM, Hamilton D, Mahon B, Pillai SK, Veltus EF, Tauxe R, Jhung M. CDC Safety Training Course for Ebola Virus Disease Healthcare Workers. Emerg Infect Dis 2018; 23. [PMID: 29154748 PMCID: PMC5711301 DOI: 10.3201/eid2313.170549] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Response to sudden epidemic infectious disease emergencies can demand intensive and specialized training, as demonstrated in 2014 when Ebola virus disease (EVD) rapidly spread throughout West Africa. The medical community quickly became overwhelmed because of limited staff, supplies, and Ebola treatment units (ETUs). Because a mechanism to rapidly increase trained healthcare workers was needed, the US Centers for Disease Control and Prevention developed and implemented an introductory EVD safety training course to prepare US healthcare workers to work in West Africa ETUs. The goal was to teach principles and practices of safely providing patient care and was delivered through lectures, small-group breakout sessions, and practical exercises. During September 2014-March 2015, a total of 570 participants were trained during 16 course sessions. This course quickly increased the number of clinicians who could provide care in West Africa ETUs, showing the feasibility of rapidly developing and implementing training in response to a public health emergency.
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33
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Danesh A, Inglis HC, Abdel-Mohsen M, Deng X, Adelman A, Schechtman KB, Heitman JW, Vilardi R, Shah A, Keating SM, Cohen MJ, Jacobs ES, Pillai SK, Lacroix J, Spinella PC, Norris PJ. Granulocyte-Derived Extracellular Vesicles Activate Monocytes and Are Associated With Mortality in Intensive Care Unit Patients. Front Immunol 2018; 9:956. [PMID: 29867942 PMCID: PMC5951932 DOI: 10.3389/fimmu.2018.00956] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 04/17/2018] [Indexed: 11/13/2022] Open
Abstract
To understand how extracellular vesicle (EV) subtypes differentially activate monocytes, a series of in vitro studies were performed. We found that plasma-EVs biased monocytes toward an M1 profile. Culturing monocytes with granulocyte-, monocyte-, and endothelial-EVs induced several pro-inflammatory cytokines. By contrast, platelet-EVs induced TGF-β and GM-CSF, and red blood cell (RBC)-EVs did not activate monocytes in vitro. The scavenger receptor CD36 was important for binding of RBC-EVs to monocytes, while blockade of CD36, CD163, CD206, TLR1, TLR2, and TLR4 did not affect binding of plasma-EVs to monocytes in vitro. To identify mortality risk factors, multiple soluble factors and EV subtypes were measured in patients' plasma at intensive care unit admission. Of 43 coagulation factors and cytokines measured, two were significantly associated with mortality, tissue plasminogen activator and cystatin C. Of 14 cellular markers quantified on EVs, 4 were early predictors of mortality, including the granulocyte marker CD66b. In conclusion, granulocyte-EVs have potent pro-inflammatory effects on monocytes in vitro. Furthermore, correlation of early granulocyte-EV levels with mortality in critically ill patients provides a potential target for intervention in management of the pro-inflammatory cascade associated with critical illness.
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Affiliation(s)
- Ali Danesh
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Heather C Inglis
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Mohamed Abdel-Mohsen
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Xutao Deng
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Avril Adelman
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Kenneth B Schechtman
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.,Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - John W Heitman
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Ryan Vilardi
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Avani Shah
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Sheila M Keating
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mitchell J Cohen
- Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Evan S Jacobs
- Blood Systems Research Institute, San Francisco, CA, United States
| | - Satish K Pillai
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jacques Lacroix
- Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montreal, QC, Canada
| | - Philip C Spinella
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Philip J Norris
- Blood Systems Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States.,Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Battivelli E, Dahabieh MS, Abdel-Mohsen M, Svensson JP, Tojal Da Silva I, Cohn LB, Gramatica A, Deeks S, Greene WC, Pillai SK, Verdin E. Distinct chromatin functional states correlate with HIV latency reactivation in infected primary CD4 + T cells. eLife 2018; 7:e34655. [PMID: 29714165 PMCID: PMC5973828 DOI: 10.7554/elife.34655] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/18/2018] [Indexed: 12/21/2022] Open
Abstract
Human immunodeficiency virus (HIV) infection is currently incurable, due to the persistence of latently infected cells. The 'shock and kill' approach to a cure proposes to eliminate this reservoir via transcriptional activation of latent proviruses, enabling direct or indirect killing of infected cells. Currently available latency-reversing agents (LRAs) have however proven ineffective. To understand why, we used a novel HIV reporter strain in primary CD4+ T cells and determined which latently infected cells are reactivatable by current candidate LRAs. Remarkably, none of these agents reactivated more than 5% of cells carrying a latent provirus. Sequencing analysis of reactivatable vs. non-reactivatable populations revealed that the integration sites were distinguishable in terms of chromatin functional states. Our findings challenge the feasibility of 'shock and kill', and suggest the need to explore other strategies to control the latent HIV reservoir.
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Affiliation(s)
- Emilie Battivelli
- Gladstone Institute of Virology and ImmunologyGladstone InstitutesSan FranciscoUnited States
- Department of MedicineUniversity of California San FranciscoSan FranciscoUnited States
- Buck Institute for Research on AgingNovatoUnited States
| | - Matthew S Dahabieh
- Gladstone Institute of Virology and ImmunologyGladstone InstitutesSan FranciscoUnited States
- Department of MedicineUniversity of California San FranciscoSan FranciscoUnited States
| | - Mohamed Abdel-Mohsen
- University of California San FranciscoSan FranciscoUnited States
- Blood Systems Research InstituteSan FranciscoUnited States
- The Wistar InstitutePhiladelphiaUnited States
| | - J Peter Svensson
- Department of Biosciences and NutritionKarolinska InstitutetSolnaSweden
| | - Israel Tojal Da Silva
- Laboratory of Molecular ImmunologyThe Rockefeller UniversityNew YorkUnited States
- Laboratory of Computational Biology and BioinformaticsInternational Research CenterSao PauloBrazil
| | - Lillian B Cohn
- Laboratory of Molecular ImmunologyThe Rockefeller UniversityNew YorkUnited States
| | - Andrea Gramatica
- Gladstone Institute of Virology and ImmunologyGladstone InstitutesSan FranciscoUnited States
- Department of MedicineUniversity of California San FranciscoSan FranciscoUnited States
- Department of Cellular and Molecular PharmacologyUniversity of California San FranciscoSan FranciscoUnited States
| | - Steven Deeks
- Department of MedicineUniversity of California San FranciscoSan FranciscoUnited States
| | - Warner C Greene
- Gladstone Institute of Virology and ImmunologyGladstone InstitutesSan FranciscoUnited States
- Department of MedicineUniversity of California San FranciscoSan FranciscoUnited States
- Department of Cellular and Molecular PharmacologyUniversity of California San FranciscoSan FranciscoUnited States
| | - Satish K Pillai
- University of California San FranciscoSan FranciscoUnited States
- Blood Systems Research InstituteSan FranciscoUnited States
| | - Eric Verdin
- Gladstone Institute of Virology and ImmunologyGladstone InstitutesSan FranciscoUnited States
- Department of MedicineUniversity of California San FranciscoSan FranciscoUnited States
- Buck Institute for Research on AgingNovatoUnited States
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35
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Lavery AM, Patel A, Boehmer TK, Lee L, Bhavsar T, Thomas J, Hall L, Beavers S, Murray M, Pillai SK. Notes from the Field: Pharmacy Needs After a Natural Disaster - Puerto Rico, September-October 2017. MMWR Morb Mortal Wkly Rep 2018; 67:402-403. [PMID: 29621203 PMCID: PMC5889241 DOI: 10.15585/mmwr.mm6713a4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Concepción-Acevedo J, Patel A, Luna-Pinto C, Peña RG, Cuevas Ruiz RI, Arbolay HR, Toro M, Deseda C, De Jesus VR, Ribot E, Gonzalez JQ, Rao G, De Leon Salazar A, Ansbro M, White BB, Hardy MC, Georgi JC, Stinnett R, Mercante AM, Lowe D, Martin H, Starks A, Metchock B, Johnston S, Dalton T, Joglar O, Stafford C, Youngblood M, Klein K, Lindstrom S, Berman L, Galloway R, Schafer IJ, Walke H, Stoddard R, Connelly R, McCaffery E, Rowlinson MC, Soroka S, Tranquillo DT, Gaynor A, Mangal C, Wroblewski K, Muehlenbachs A, Salerno RM, Lozier M, Sunshine B, Shapiro C, Rose D, Funk R, Pillai SK, O’Neill E. Initial Public Health Laboratory Response After Hurricane Maria - Puerto Rico, 2017. MMWR Morb Mortal Wkly Rep 2018; 67:333-336. [PMID: 29565842 PMCID: PMC5868205 DOI: 10.15585/mmwr.mm6711a5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vibholm L, Schleimann MH, Højen JF, Benfield T, Offersen R, Rasmussen K, Olesen R, Dige A, Agnholt J, Grau J, Buzon M, Wittig B, Lichterfeld M, Petersen AM, Deng X, Abdel-Mohsen M, Pillai SK, Rutsaert S, Trypsteen W, De Spiegelaere W, Vandekerchove L, Østergaard L, Rasmussen TA, Denton PW, Tolstrup M, Søgaard OS. Short-Course Toll-Like Receptor 9 Agonist Treatment Impacts Innate Immunity and Plasma Viremia in Individuals With Human Immunodeficiency Virus Infection. Clin Infect Dis 2018; 64:1686-1695. [PMID: 28329286 DOI: 10.1093/cid/cix201] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 03/03/2017] [Indexed: 12/22/2022] Open
Abstract
Background. Treatment with latency reversing agents (LRAs) enhances human immunodeficiency virus type 1 (HIV-1) transcription in vivo but leads to only modest reductions in the size of the reservoir, possibly due to insufficient immune-mediated elimination of infected cells. We hypothesized that a single drug molecule-a novel Toll-like receptor 9 (TLR9) agonist, MGN1703-could function as an enhancer of innate immunity and an LRA in vivo. Methods. We conducted a single-arm, open-label study in which 15 virologically suppressed HIV-1-infected individuals on antiretroviral therapy received 60 mg MGN1703 subcutaneously twice weekly for 4 weeks. We characterized plasmacytoid dendritic cell, natural killer (NK), and T-cell activation using flow cytometry on baseline and after 4 weeks of treatment. HIV-1 transcription was quantified by measuring plasma HIV-1 RNA during MGN1703 administration. Results. In accordance with the cell type-specific expression of TLR9, MGN1703 treatment led to pronounced activation of plasmacytoid dendritic cells and substantial increases in plasma interferon-α2 levels (P < .0001). Consistently, transcription of interferon-stimulated genes (eg, OAS1, ISG15, Mx1; each P < .0001) were upregulated in CD4+ T cells as demonstrated by RNA sequencing. Further, proportions of activated cytotoxic NK cells and CD8+ T cells increased significantly during MGN1703 dosing, suggesting an enhancement of cellular immune responses. In 6 of 15 participants, plasma HIV-1 RNA increased from <20 copies/mL to >1500 copies/mL (range, 21-1571 copies/mL) during treatment. Conclusions. TLR9 agonist treatment in HIV infection has a dual potential by increasing HIV-1 transcription and enhancing cytotoxic NK cell activation, both of which are key outcomes in HIV-1 eradication therapy. Clinical Trials Registration. NCT02443935.
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Affiliation(s)
- Line Vibholm
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | - Mariane H Schleimann
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | - Jesper F Højen
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | - Thomas Benfield
- Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, and
| | - Rasmus Offersen
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | | | - Rikke Olesen
- Department of Infectious Diseases, Aarhus University Hospital
| | - Anders Dige
- Institute of Clinical Medicine, Aarhus University.,Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Jørgen Agnholt
- Institute of Clinical Medicine, Aarhus University.,Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Judith Grau
- Hebron Institute of Research, Department of Infectious Diseases, Barcelona, Spain
| | - Maria Buzon
- Hebron Institute of Research, Department of Infectious Diseases, Barcelona, Spain
| | - Burghardt Wittig
- Foundation Institute Molecular Biology and Bioinformatics, Freie Universitaet, Berlin, Germany
| | - Mathias Lichterfeld
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Boston; Departments of
| | - Andreas Munk Petersen
- Gastroenterology and.,Microbiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Xutao Deng
- Blood Systems Research Institute, San Francisco, California, and.,University of California, San Francisco
| | - Mohamed Abdel-Mohsen
- Blood Systems Research Institute, San Francisco, California, and.,University of California, San Francisco.,The Wistar Institute, Philadelphia, Pennsylvania; and Departments of
| | - Satish K Pillai
- Blood Systems Research Institute, San Francisco, California, and.,University of California, San Francisco
| | | | | | - Ward De Spiegelaere
- Internal Medicine; and.,Morphology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | | | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | | | - Paul W Denton
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | - Martin Tolstrup
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
| | - Ole S Søgaard
- Department of Infectious Diseases, Aarhus University Hospital.,Institute of Clinical Medicine, Aarhus University
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Bangirana P, Ruel TD, Boivin MJ, Pillai SK, Giron LB, Sikorskii A, Banik A, Achan J. Absence of neurocognitive disadvantage associated with paediatric HIV subtype A infection in children on antiretroviral therapy. J Int AIDS Soc 2018; 20. [PMID: 29052340 PMCID: PMC5810341 DOI: 10.1002/jia2.25015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 04/11/2017] [Accepted: 09/28/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction Infection with HIV subtype A has been associated with poorer neurocognitive outcomes compared to HIV subtype D in Ugandan children not eligible for antiretroviral therapy (ART). In this study, we sought to determine whether subtype‐specific differences are also observed among children receiving ART. Materials and Methods Children were recruited from a clinical trial in which they were randomized to receive either lopinavir (LPV)‐ or non‐nucleoside reverse transcriptase inhibitor (NNRTI)‐ based ART (NCT00978068). Age at initiation of ART ranged from six months to six years. HIV subtype was determined by PCR amplification and population sequencing of the pol region derived from peripheral blood mononuclear cell DNA, followed by application of the REGA and Recombinant Identification Programme algorithms. General cognition was assessed using the Kaufman Assessment Battery for Children (Second Edition), attention using the Test of Variables of Attention, and motor skills using the Bruininks‐Oseretsky Test of Motor Proficiency (Second Edition). Home environment was assessed using the Home Observation for the Measurement of the Environment (HOME). Age‐adjusted test z‐scores were entered into a regression model that adjusted for sex, socio‐economic status score, HOME score, years of schooling, and ART treatment type. Results One hundred and five children were tested; median (interquartile range) age was 7.05 years (6.30 to 8.44), CD4 count was 867.7 cells/mm3 (416.0 to 1203.5), and duration on ART was 4.03 years (3.55 to 4.23). Seventy‐eight children had HIV subtype A and 27 had subtype D; the groups had comparable home and socio‐economic status, except that there were more males among children infected with subtype A than D (64.7% vs. 35.3%, p = 0.02). There were no differences between the subtypes in general cognition (estimated mean difference: 0.20; 95% CI: −0.11 to 0.50); p = 0.21), attention (−0.18, 95% CI: −0.60 to 0.24, p = 0.41) and motor skills (1.60, 95% CI: −0.84 to 4.04, p = 0.20). Conclusions Our results imply that ART may diminish the neurocognitive disadvantage seen in treatment‐naïve HIV‐infected children with subtype A.
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Affiliation(s)
- Paul Bangirana
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Theodore D Ruel
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Michael J Boivin
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - Satish K Pillai
- Blood Systems Research Institute, San Francisco, CA, USA.,Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | | | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA.,Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | - Asish Banik
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | - Jane Achan
- Disease Control and Elimination Theme, Medical Research Council Unit, Banjul, The Gambia
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Keating SM, Pilcher CD, Jain V, Lebedeva M, Hampton D, Abdel-Mohsen M, Deng X, Murphy G, Welte A, Facente SN, Hecht F, Deeks SG, Pillai SK, Busch MP. HIV Antibody Level as a Marker of HIV Persistence and Low-Level Viral Replication. J Infect Dis 2017; 216:72-81. [PMID: 28498985 DOI: 10.1093/infdis/jix225] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) antibodies are generated and maintained by ongoing systemic expression of HIV antigen. We investigated whether HIV antibody responses as measured by high-throughput quantitative and qualitative assays could be used to indirectly measure persistent HIV replication in individuals receiving antiretroviral therapy (ART). Methods HIV antibody responses were measured over time in the presence or absence of suppressive ART and were compared to the HIV reservoir size and expression of antiviral restriction factors. Results Among untreated individuals, including both elite controllers (ie, persons with a viral load of ≤40 copies/mL) and noncontrollers, antibody parameters were stable over time and correlated with the individual viral load. Viral suppression with ART led to a progressive decline in antibody responses after treatment induction that persisted for 5-7 years. Higher levels of HIV antibodies during suppressive therapy were associated with later initiation of ART after infection, with higher DNA and cell-associated RNA levels, and with lower expression of multiple anti-HIV host restriction factors. Discussion These findings suggest that declining antibody levels during ART reflect lower levels of antigen production and/or viral replication in the persistent HIV reservoir. Results of relatively inexpensive and quantitative HIV antibody assays may be useful indirect markers that enable efficient monitoring of the viral reservoir and suppression during functional-cure interventions.
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Affiliation(s)
- Sheila M Keating
- Blood Systems Research Institute.,Department of Laboratory Medicine
| | | | - Vivek Jain
- Department of Medicine, University of California, San Francisco, California
| | | | | | | | | | - Gary Murphy
- Public Health England, London, United Kingdom
| | - Alex Welte
- South African Department of Science and Technology, National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch, South Africa
| | - Shelley N Facente
- Department of Medicine, University of California, San Francisco, California
| | - Frederick Hecht
- Department of Medicine, University of California, San Francisco, California
| | - Steven G Deeks
- Department of Medicine, University of California, San Francisco, California
| | - Satish K Pillai
- Blood Systems Research Institute.,Department of Laboratory Medicine
| | - Michael P Busch
- Blood Systems Research Institute.,Department of Laboratory Medicine
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40
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Henrich TJ, Deeks SG, Pillai SK. Measuring the Size of the Latent Human Immunodeficiency Virus Reservoir: The Present and Future of Evaluating Eradication Strategies. J Infect Dis 2017; 215:S134-S141. [PMID: 28520968 DOI: 10.1093/infdis/jiw648] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
One of the major barriers to the successful design and implementation of human immunodeficiency virus (HIV) curative strategies is the limited ability to sensitively, specifically, and precisely quantify and characterize the whole-body burden of replication-competent HIV in individuals on effective antiretroviral therapy. Here, we review the development and validation of assays that directly and indirectly measure the size and distribution of the reservoir in blood and tissues. We also discuss the role that treatment interruptions will have in validating these assays and ultimately as a "proof of cure."
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Affiliation(s)
| | | | - Satish K Pillai
- Blood Systems Research Institute and Department of Laboratory Medicine, University of California, San Francisco
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41
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Togarrati PP, Sasaki RT, Abdel-Mohsen M, Dinglasan N, Deng X, Desai S, Emmerson E, Yee E, Ryan WR, da Silva MCP, Knox SM, Pillai SK, Muench MO. Identification and characterization of a rich population of CD34 + mesenchymal stem/stromal cells in human parotid, sublingual and submandibular glands. Sci Rep 2017; 7:3484. [PMID: 28615711 PMCID: PMC5471181 DOI: 10.1038/s41598-017-03681-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 05/03/2017] [Indexed: 02/07/2023] Open
Abstract
Mesenchymal stem/stromal cells (MSCs) play crucial roles in maintaining tissue homeostasis during physiological turnovers and injuries. Very little is known about the phenotype, distribution and molecular nature of MSCs in freshly isolated human salivary glands (SGs) as most reports have focused on the analysis of cultured MSCs. Our results demonstrate that the cell adhesion molecule CD34 was widely expressed by the MSCs of human major SGs, namely parotid (PAG), sublingual (SLG) and submandibular (SMG) glands. Further, gene expression analysis of CD34+ cells derived from fetal SMGs showed significant upregulation of genes involved in cellular adhesion, proliferation, branching, extracellular matrix remodeling and organ development. Moreover, CD34+ SMG cells exhibited elevated expression of genes encoding extracellular matrix, basement membrane proteins, and members of ERK, FGF and PDGF signaling pathways, which play key roles in glandular development, branching and homeostasis. In vitro CD34+ cell derived SG-MSCs revealed multilineage differentiation potential. Intraglandular transplantation of cultured MSCs in immunodeficient mice led to their engraftment in the injected and uninjected contralateral and ipsilateral glands. Engrafted cells could be localized to the stroma surrounding acini and ducts. In summary, our data show that CD34+ derived SG-MSCs could be a promising cell source for adoptive cell-based SG therapies, and bioengineering of artificial SGs.
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Affiliation(s)
| | - Robson T Sasaki
- Department of Morphology and Genetics - Discipline of Descriptive and Topographic Anatomy, Federal University of São Paulo, Brazil, CEP, USA
| | - Mohamed Abdel-Mohsen
- Blood Systems Research Institute, San Francisco, CA, USA.,Department of Medicine, University of California San Francisco, San Francisco, California, USA.,The Wistar Institute, Philadelphia, PA, USA
| | | | - Xutao Deng
- Blood Systems Research Institute, San Francisco, CA, USA
| | - Shivani Desai
- Blood Systems Research Institute, San Francisco, CA, USA
| | - Elaine Emmerson
- Department of Cell and Tissue Biology, University of California, San Francisco, CA, USA
| | - Elizabeth Yee
- Blood Systems Research Institute, San Francisco, CA, USA
| | - William R Ryan
- Division of Head and Neck Oncologic/Endocrine/Salivary Surgery, Department of Otolaryngology, University of California San Francisco, San Francisco, CA, USA
| | - Marcelo C P da Silva
- Department of Morphology and Genetics - Discipline of Descriptive and Topographic Anatomy, Federal University of São Paulo, Brazil, CEP, USA
| | - Sarah M Knox
- Department of Cell and Tissue Biology, University of California, San Francisco, CA, USA
| | - Satish K Pillai
- Blood Systems Research Institute, San Francisco, CA, USA.,Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Marcus O Muench
- Blood Systems Research Institute, San Francisco, CA, USA. .,Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
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42
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Pillai SK, Deeks SG. Signature of the Sleeper Cell: A Biomarker of HIV Latency Revealed. Trends Immunol 2017; 38:457-458. [PMID: 28511815 DOI: 10.1016/j.it.2017.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022]
Abstract
HIV establishes a reservoir in latently infected T cells, and this reservoir has long hampered curative approaches. A recent study by Descours et al. identifies CD32a as a marker of latently infected T cells, potentially opening the way to the development of strategies that directly target this critical HIV reservoir.
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Affiliation(s)
- Satish K Pillai
- Blood Systems Research Institute and Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
| | - Steven G Deeks
- Positive Health Program, University of California, San Francisco, CA, USA
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43
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Oussayef NL, Pillai SK, Honein MA, Ben Beard C, Bell B, Boyle CA, Eisen LM, Kohl K, Kuehnert MJ, Lathrop E, Martin SW, Martin R, McAllister JC, McClune EP, Mead P, Meaney-Delman D, Petersen B, Petersen LR, Polen KND, Powers AM, Redd SC, Sejvar JJ, Sharp T, Villanueva J, Jamieson DJ. Zika Virus -10 Public Health Achievements in 2016 and Future Priorities. MMWR Morb Mortal Wkly Rep 2017; 65:1482-1488. [PMID: 28056005 DOI: 10.15585/mmwr.mm6552e1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The introduction of Zika virus into the Region of the Americas (Americas) and the subsequent increase in cases of congenital microcephaly resulted in activation of CDC's Emergency Operations Center on January 22, 2016, to ensure a coordinated response and timely dissemination of information, and led the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. During the past year, public health agencies and researchers worldwide have collaborated to protect pregnant women, inform clinicians and the public, and advance knowledge about Zika virus (Figure 1). This report summarizes 10 important contributions toward addressing the threat posed by Zika virus in 2016. To protect pregnant women and their fetuses and infants from the effects of Zika virus infection during pregnancy, public health activities must focus on preventing mosquito-borne transmission through vector control and personal protective practices, preventing sexual transmission by advising abstention from sex or consistent and correct use of condoms, and preventing unintended pregnancies by reducing barriers to access to highly effective reversible contraception.
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44
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Nyenswah TG, Kateh F, Bawo L, Massaquoi M, Gbanyan M, Fallah M, Nagbe TK, Karsor KK, Wesseh CS, Sieh S, Gasasira A, Graaff P, Hensley L, Rosling H, Lo T, Pillai SK, Gupta N, Montgomery JM, Ransom RL, Williams D, Laney AS, Lindblade KA, Slutsker L, Telfer JL, Christie A, Mahoney F, De Cock KM. Ebola and Its Control in Liberia, 2014-2015. Emerg Infect Dis 2016; 22:169-77. [PMID: 26811980 PMCID: PMC4734504 DOI: 10.3201/eid2202.151456] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Several factors explain the successful response to the outbreak in this country. The severe epidemic of Ebola virus disease in Liberia started in March 2014. On May 9, 2015, the World Health Organization declared Liberia free of Ebola, 42 days after safe burial of the last known case-patient. However, another 6 cases occurred during June–July; on September 3, 2015, the country was again declared free of Ebola. Liberia had by then reported 10,672 cases of Ebola and 4,808 deaths, 37.0% and 42.6%, respectively, of the 28,103 cases and 11,290 deaths reported from the 3 countries that were heavily affected at that time. Essential components of the response included government leadership and sense of urgency, coordinated international assistance, sound technical work, flexibility guided by epidemiologic data, transparency and effective communication, and efforts by communities themselves. Priorities after the epidemic include surveillance in case of resurgence, restoration of health services, infection control in healthcare settings, and strengthening of basic public health systems.
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Petersen EE, Meaney-Delman D, Neblett-Fanfair R, Havers F, Oduyebo T, Hills SL, Rabe IB, Lambert A, Abercrombie J, Martin SW, Gould CV, Oussayef N, Polen KND, Kuehnert MJ, Pillai SK, Petersen LR, Honein MA, Jamieson DJ, Brooks JT. Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Persons with Possible Zika Virus Exposure - United States, September 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1077-1081. [PMID: 27711033 DOI: 10.15585/mmwr.mm6539e1] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
CDC has updated its interim guidance for persons with possible Zika virus exposure who are planning to conceive (1) and interim guidance to prevent transmission of Zika virus through sexual contact (2), now combined into a single document. Guidance for care for pregnant women with possible Zika virus exposure was previously published (3). Possible Zika virus exposure is defined as travel to or residence in an area of active Zika virus transmission (http://www.cdc.gov/zika/geo/index.html), or sex* without a condom† with a partner who traveled to or lived in an area of active transmission. Based on new though limited data, CDC now recommends that all men with possible Zika virus exposure who are considering attempting conception with their partner, regardless of symptom status,§ wait to conceive until at least 6 months after symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). Recommendations for women planning to conceive remain unchanged: women with possible Zika virus exposure are recommended to wait to conceive until at least 8 weeks after symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). Couples with possible Zika virus exposure, who are not pregnant and do not plan to become pregnant, who want to minimize their risk for sexual transmission of Zika virus should use a condom or abstain from sex for the same periods for men and women described above. Women of reproductive age who have had or anticipate future Zika virus exposure who do not want to become pregnant should use the most effective contraceptive method that can be used correctly and consistently. These recommendations will be further updated when additional data become available.
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Lindblade KA, Nyenswah T, Keita S, Diallo B, Kateh F, Amoah A, Nagbe TK, Raghunathan P, Neatherlin JC, Kinzer M, Pillai SK, Attfield KR, Hajjeh R, Dweh E, Painter J, Barradas DT, Williams SG, Blackley DJ, Kirking HL, Patel MR, Dea M, Massoudi MS, Barskey AE, Zarecki SLM, Fomba M, Grube S, Belcher L, Broyles LN, Maxwell TN, Hagan JE, Yeoman K, Westercamp M, Mott J, Mahoney F, Slutsker L, DeCock KM, Marston B, Dahl B. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014-2015. Emerg Infect Dis 2016; 22:1653-5. [PMID: 27268508 PMCID: PMC4994349 DOI: 10.3201/eid2209.160416] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.
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Lindblade KA, Nyenswah T, Keita S, Diallo B, Kateh F, Amoah A, Nagbe TK, Raghunathan P, Neatherlin JC, Kinzer M, Pillai SK, Attfield KR, Hajjeh R, Dweh E, Painter J, Barradas DT, Williams SG, Blackley DJ, Kirking HL, Patel MR, Dea M, Massoudi MS, Barskey AE, Zarecki SLM, Fomba M, Grube S, Belcher L, Broyles LN, Maxwell TN, Hagan JE, Yeoman K, Westercamp M, Mott J, Mahoney F, Slutsker L, DeCock KM, Marston B, Dahl B. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015. Emerg Infect Dis 2016. [DOI: 10.3201/eid2209.16.0416] [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: 11/19/2022] Open
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Huang E, Pillai SK, Bower WA, Hendricks KA, Guarnizo JT, Hoyle JD, Gorman SE, Boyer AE, Quinn CP, Meaney-Delman D. Antitoxin Treatment of Inhalation Anthrax: A Systematic Review. Health Secur 2016; 13:365-77. [PMID: 26690378 DOI: 10.1089/hs.2015.0032] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Concern about use of anthrax as a bioweapon prompted development of novel anthrax antitoxins for treatment. Clinical guidelines for the treatment of anthrax recommend antitoxin therapy in combination with intravenous antimicrobials; however, a large-scale or mass anthrax incident may exceed antitoxin availability and create a need for judicious antitoxin use. We conducted a systematic review of antitoxin treatment of inhalation anthrax in humans and experimental animals to inform antitoxin recommendations during a large-scale or mass anthrax incident. A comprehensive search of 11 databases and the FDA website was conducted to identify relevant animal studies and human reports: 28 animal studies and 3 human cases were identified. Antitoxin monotherapy at or shortly after symptom onset demonstrates increased survival compared to no treatment in animals. With early treatment, survival did not differ between antimicrobial monotherapy and antimicrobial-antitoxin therapy in nonhuman primates and rabbits. With delayed treatment, antitoxin-antimicrobial treatment increased rabbit survival. Among human cases, addition of antitoxin to combination antimicrobial treatment was associated with survival in 2 of the 3 cases treated. Despite the paucity of human data, limited animal data suggest that adjunctive antitoxin therapy may improve survival. Delayed treatment studies suggest improved survival with combined antitoxin-antimicrobial therapy, although a survival difference compared with antimicrobial therapy alone was not demonstrated statistically. In a mass anthrax incident with limited antitoxin supplies, antitoxin treatment of individuals who have not demonstrated a clinical benefit from antimicrobials, or those who present with more severe illness, may be warranted. Additional pathophysiology studies are needed, and a point-of-care assay correlating toxin levels with clinical status may provide important information to guide antitoxin use during a large-scale anthrax incident.
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Oduyebo T, Igbinosa I, Petersen EE, Polen KND, Pillai SK, Ailes EC, Villanueva JM, Newsome K, Fischer M, Gupta PM, Powers AM, Lampe M, Hills S, Arnold KE, Rose LE, Shapiro-Mendoza CK, Beard CB, Muñoz JL, Rao CY, Meaney-Delman D, Jamieson DJ, Honein MA. Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016. MMWR Morb Mortal Wkly Rep 2016; 65:739-44. [PMID: 27467820 DOI: 10.15585/mmwr.mm6529e1] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. To increase the proportion of pregnant women with Zika virus infection who receive a definitive diagnosis, CDC recommends expanding real-time reverse transcription-polymerase chain reaction (rRT-PCR) testing. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(†) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(§) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). Symptomatic pregnant women who are evaluated <2 weeks after symptom onset should receive serum and urine Zika virus rRT-PCR testing. Symptomatic pregnant women who are evaluated 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. For asymptomatic pregnant women who live in areas without active Zika virus transmission and who are evaluated <2 weeks after last possible exposure, rRT-PCR testing should be performed. If the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. Asymptomatic pregnant women with ongoing risk for exposure to Zika virus should receive Zika virus IgM antibody testing as part of routine obstetric care during the first and second trimesters; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.
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Abdel-Mohsen M, Chavez L, Tandon R, Chew GM, Deng X, Danesh A, Keating S, Lanteri M, Samuels ML, Hoh R, Sacha JB, Norris PJ, Niki T, Shikuma CM, Hirashima M, Deeks SG, Ndhlovu LC, Pillai SK. Human Galectin-9 Is a Potent Mediator of HIV Transcription and Reactivation. PLoS Pathog 2016; 12:e1005677. [PMID: 27253379 PMCID: PMC4890776 DOI: 10.1371/journal.ppat.1005677] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [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: 01/07/2016] [Accepted: 05/12/2016] [Indexed: 02/06/2023] Open
Abstract
Identifying host immune determinants governing HIV transcription, latency and infectivity in vivo is critical to developing an HIV cure. Based on our recent finding that the host factor p21 regulates HIV transcription during antiretroviral therapy (ART), and published data demonstrating that the human carbohydrate-binding immunomodulatory protein galectin-9 regulates p21, we hypothesized that galectin-9 modulates HIV transcription. We report that the administration of a recombinant, stable form of galectin-9 (rGal-9) potently reverses HIV latency in vitro in the J-Lat HIV latency model. Furthermore, rGal-9 reverses HIV latency ex vivo in primary CD4+ T cells from HIV-infected, ART-suppressed individuals (p = 0.002), more potently than vorinostat (p = 0.02). rGal-9 co-administration with the latency reversal agent "JQ1", a bromodomain inhibitor, exhibits synergistic activity (p<0.05). rGal-9 signals through N-linked oligosaccharides and O-linked hexasaccharides on the T cell surface, modulating the gene expression levels of key transcription initiation, promoter proximal-pausing, and chromatin remodeling factors that regulate HIV latency. Beyond latent viral reactivation, rGal-9 induces robust expression of the host antiviral deaminase APOBEC3G in vitro and ex vivo (FDR<0.006) and significantly reduces infectivity of progeny virus, decreasing the probability that the HIV reservoir will be replenished when latency is reversed therapeutically. Lastly, endogenous levels of soluble galectin-9 in the plasma of 72 HIV-infected ART-suppressed individuals were associated with levels of HIV RNA in CD4+ T cells (p<0.02) and with the quantity and binding avidity of circulating anti-HIV antibodies (p<0.009), suggesting a role of galectin-9 in regulating HIV transcription and viral production in vivo during therapy. Our data suggest that galectin-9 and the host glycosylation machinery should be explored as foundations for novel HIV cure strategies.
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Affiliation(s)
- Mohamed Abdel-Mohsen
- Blood Systems Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Leonard Chavez
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Ravi Tandon
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Glen M. Chew
- Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States of America
| | - Xutao Deng
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Ali Danesh
- Blood Systems Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Sheila Keating
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Marion Lanteri
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Michael L. Samuels
- RainDance Technologies, Inc., Billerica, Massachusetts, United States of America
| | - Rebecca Hoh
- University of California, San Francisco, California, United States of America
| | - Jonah B. Sacha
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Oregon National Primate Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Philip J. Norris
- Blood Systems Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
| | - Toshiro Niki
- GalPharma Co., Ltd., Takamatsu-shi, Kagawa, Japan
- Department of Immunology and Immunopathology, Kagawa University, Kagawa, Japan
| | - Cecilia M. Shikuma
- Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States of America
| | - Mitsuomi Hirashima
- GalPharma Co., Ltd., Takamatsu-shi, Kagawa, Japan
- Department of Immunology and Immunopathology, Kagawa University, Kagawa, Japan
| | - Steven G. Deeks
- University of California, San Francisco, California, United States of America
| | - Lishomwa C. Ndhlovu
- Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States of America
| | - Satish K. Pillai
- Blood Systems Research Institute, San Francisco, California, United States of America
- University of California, San Francisco, California, United States of America
- * E-mail:
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