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Giri S, Chhabra P, Kulkarni R, Reju S, Sabapathy SK, Selvarajan S, Varghese T, Kalaivanan M, Dorairaj P, Kalrao V, Mankar S, Sangamnerkar M, Purushothaman GKC, Srikanth P, Kang G, Vinjé J. Hospital-based norovirus surveillance in children <5 years of age from 2017 to 2019 in India. J Med Virol 2024; 96:e29384. [PMID: 38235830 PMCID: PMC10875411 DOI: 10.1002/jmv.29384] [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: 09/06/2023] [Revised: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 01/19/2024]
Abstract
After the introduction of the rotavirus vaccine into the Universal Immunization Program in India in 2016, relatively few studies have assessed the prevalence and epidemiological patterns of acute gastroenteritis (AGE) among hospitalized children ≤5 years of age. We used a uniform protocol to recruit children with AGE as well as standardized testing and typing protocols. Stool specimens from children with AGE younger than 5 years of age admitted to six hospitals in three cities in India were collected from January 2017 through December 2019. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-qPCR) followed by typing positive specimens by conventional RT-PCR and Sanger sequencing. Norovirus was detected in 322 (14.8%) of 2182 specimens with the highest rate in 2018 (17.6%, 146/829), followed by 2019 (14.4%, 122/849) and 2017 (10.7%, 54/504). Rotavirus vaccine status was known for 91.6% of the children of which 70.4% were vaccinated and 29.6% not. Norovirus positivity in rotavirus-vaccinated children was 16.3% and 12% in unvaccinated children. GII.4 Sydney[P16] (39.3%), GII.4 Sydney[P31] (18.7%), GII.2[P16] (10%), GI.3[P13] (6.8%), GII.3[P16] (5.9%), and GII.13[P16] (5%) accounted for 85.8% (188/219) of the typed strains. Our data highlight the importance of norovirus in Indian children hospitalized with AGE.
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Affiliation(s)
- Sidhartha Giri
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ruta Kulkarni
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth, Pune, India
| | - Sudhabharathi Reju
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Satheesh Kumar Sabapathy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology (NIE), Chennai, India
| | - Sribal Selvarajan
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Tintu Varghese
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | - Vijay Kalrao
- Bharati Hospital, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
| | | | | | | | - Padma Srikanth
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Chhabra P, Tully DC, Mans J, Niendorf S, Barclay L, Cannon JL, Montmayeur AM, Pan CY, Page N, Williams R, Tutill H, Roy S, Celma C, Beard S, Mallory ML, Manouana GP, Velavan TP, Adegnika AA, Kremsner PG, Lindesmith LC, Hué S, Baric RS, Breuer J, Vinjé J. Emergence of Novel Norovirus GII.4 Variant. Emerg Infect Dis 2024; 30:163-167. [PMID: 38063078 PMCID: PMC10756382 DOI: 10.3201/eid3001.231003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 12/22/2023] Open
Abstract
We detected a novel GII.4 variant with an amino acid insertion at the start of epitope A in viral protein 1 of noroviruses from the United States, Gabon, South Africa, and the United Kingdom collected during 2017-2022. Early identification of GII.4 variants is crucial for assessing pandemic potential and informing vaccine development.
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Affiliation(s)
| | | | - Janet Mans
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Sandra Niendorf
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Leslie Barclay
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Jennifer L. Cannon
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Anna M. Montmayeur
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Chao-Yang Pan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Nicola Page
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Rachel Williams
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Helena Tutill
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Sunando Roy
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Cristina Celma
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Stuart Beard
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Michael L. Mallory
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Gédéon Prince Manouana
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Thirumalaisamy P. Velavan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Ayola Akim Adegnika
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Peter G. Kremsner
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Lisa C. Lindesmith
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Stéphane Hué
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Ralph S. Baric
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Judith Breuer
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Chhabra, L. Barclay, J.L. Cannon, A.M. Montmayeur, J. Vinjé)
- London School of Hygiene & Tropical Medicine, London, UK (D.C. Tully, S. Hué)
- University of Pretoria, Pretoria, South Africa (J. Mans, N. Page)
- Robert Koch Institut, Berlin, Germany (S. Niendorf)
- California Department of Public Health, Richmond, California, USA (C.-Y. Pan)
- National Institute for Communicable Diseases, Sandringham, South Africa (N. Page)
- UCL Great Ormond Street Institute of Child Health, London (R. Williams, H. Tutill, S. Roy, J. Breuer)
- UK Health Security Agency, London (C. Celma, S. Beard)
- University of North Carolina, Chapel Hill, North Carolina, USA (M.L. Mallory, L.C. Lindesmith, R.S. Baric)
- Universitätsklinikum Tübingen, Tübingen, Germany (G.P. Manouana, T.P. Velavan, A.A. Adegnika)
- Centre de Recherches Médicales de Lambaréné, Lambarene, Gabon (G.P. Manouana, A.A. Adegnika, P.G. Kremsner)
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam (T.P. Velavan)
- Duy Tan University, Da Nang, Vietnam (T.P. Velavan)
- German Center for Infection Research, Tübingen (A.A. Adegnika)
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3
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Cates J, Baker JM, Almendares O, Balachandran N, McKeever ER, Kambhampati AK, Cubenas C, Vinjé J, Cannon JL, Chhabra P, Freeman B, Reagan-Steiner S, Bhatnagar J, Gastañaduy PA, Kirking HL, Sugerman D, Parashar UD, Tate JE. Paediatric acute hepatitis of unknown aetiology: a national surveillance investigation in the USA during 2021 and 2022. Lancet Child Adolesc Health 2023; 7:773-785. [PMID: 37774732 PMCID: PMC11088931 DOI: 10.1016/s2352-4642(23)00192-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Adenovirus is a known cause of hepatitis in immunocompromised children, but not in immunocompetent children. In April, 2022, following multiple reports of hepatitis of unknown aetiology and adenovirus viraemia in immunocompetent children in the USA and UK, the US Centers for Disease Control and Prevention (CDC) and jurisdictional health departments initiated national surveillance of paediatric acute hepatitis of unknown aetiology. We aimed to describe the clinical and epidemiological characteristics of children identified with hepatitis of unknown aetiology between Oct 1, 2021, and Sept 30, 2022, in the USA and to compare characteristics of those who tested positive for adenovirus with those who tested negative. METHODS In this national surveillance investigation in the USA, children were identified for investigation if they were younger than 10 years with elevated liver transaminases (>500 U/L) who had an unknown cause for their hepatitis and onset on or after Oct 1, 2021. We reviewed medical chart abstractions, which included data on demographics, underlying health conditions, signs and symptoms of illness, laboratory results, vaccination history, radiological and liver pathology findings, diagnoses and treatment received, and outcomes. Caregiver interviews were done to obtain information on symptoms and health-care utilisation for the hepatitis illness, medical history, illness in close contacts or at school or daycare, diet, travel, and other potential exposures. Blood, stool, respiratory, and tissue specimens were evaluated according to clinician discretion and available specimens were submitted to CDC for additional laboratory testing or pathology evaluation. FINDINGS Surveillance identified 377 patients from 45 US jurisdictions with hepatitis of unknown aetiology with onset from Oct 1, 2021, to Sept 30, 2022. The median age of patients was 2·8 years (IQR 1·2-5·0) and 192 (51%) were male, 184 (49%) were female, and one patient had sex unknown. Only 22 (6%) patients had a notable predisposing underlying condition. 347 patients (92%) were admitted to hospital, 21 (6%) subsequently received a liver transplant, and nine (2%) died. Among the 318 patients without notable underlying conditions, 275 were tested for adenovirus. Of these 116 (42%) had at least one positive specimen, and species F type 41 was the most frequent type identified (19 [73%] of 26 typed specimens were HAdV-41). Proportions of patients who had acute liver failure, received a liver transplant, and died were similar between those who tested positive for adenovirus compared with those who tested negative. Adenovirus species F was detected by polymerase chain reaction in nine pathology liver evaluations, but not by immunohistochemistry in seven of the nine with adequate liver tissue available. Interviews with caregivers yielded no common exposures. INTERPRETATION Adenovirus, alone or in combination with other factors, might play a potential role in acute hepatitis among immunocompetent children identified in this investigation, but the pathophysiologic mechanism of liver injury is unclear. To inform both prevention and intervention measures, more research is warranted to determine if and how adenovirus might contribute to hepatitis risk and the potential roles of other pathogens and host factors. FUNDING None.
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Affiliation(s)
- Jordan Cates
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Julia M Baker
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Olivia Almendares
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Neha Balachandran
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Cherokee Nation Assurance, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin R McKeever
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anita K Kambhampati
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caelin Cubenas
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer L Cannon
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; CDC Foundation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brandi Freeman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah Reagan-Steiner
- National Center for Immunization and Respiratory Diseases; Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julu Bhatnagar
- National Center for Immunization and Respiratory Diseases; Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul A Gastañaduy
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hannah L Kirking
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David Sugerman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Umesh D Parashar
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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4
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Brown TW, Park GW, Wittry B, Barclay L, Person M, Relja B, Daly S, Chhabra P, Kincaid E, Johnson J, Ahmad A, Herzegh O, Vinjé J, Murphy J. SARS-CoV-2 surface contamination in metro-Atlanta grocery stores. PLoS One 2023; 18:e0291747. [PMID: 37725625 PMCID: PMC10508621 DOI: 10.1371/journal.pone.0291747] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
While the COVID-19 pandemic has had a detrimental impact on many businesses worldwide, essential businesses, such as grocery stores, continued to operate despite potential disease transmission. Although the principal mode by which people are infected with SARS-CoV-2, the virus that causes COVID-19, is through exposure to respiratory droplets and very small particles carrying infectious virus, contaminated surfaces might play a role in transmission. We collected swab samples from frequently touched surfaces, including grocery carts, touchscreen monitors, credit card keypads, pharmacy counters, self-service food utensils, and refrigerator and freezer handles, in two metro-Atlanta grocery stores over the course of two sampling events in March 2021. Of the 260 swab samples collected, 6 (2.3%) samples were positive for SARS-CoV-2 RNA by reverse transcriptase quantitative polymerase chain reaction. Positive samples were collected from pharmacy (12.0% [3/25] samples), refrigerator/freezer aisles (2.5% [1/39] samples), and self-service food court (5.0% [2/40] samples) areas. Table/counter edge and underside surfaces represented 33% (2/6) of positive samples. These data suggest that risk of exposure to SARS-CoV-2 from frequently touched surfaces in grocery store settings is likely low; however, more frequent cleaning of surfaces in pharmacy and self-service food courts might be warranted.
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Affiliation(s)
- Travis W. Brown
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Geun W. Park
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Beth Wittry
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Leslie Barclay
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Margaret Person
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Boris Relja
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Scott Daly
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Preeti Chhabra
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erin Kincaid
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jona Johnson
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ausaf Ahmad
- Division of Scientific Resources, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Owen Herzegh
- Division of Scientific Resources, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunological and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer Murphy
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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5
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Rabin J, Zhao Y, Mostafa E, Al-Suqi M, Fleischmann E, Conaway MR, Mann BJ, Chhabra P, Brayman KL, Krupnick A, Linden J, Lau CL. Regadenoson for the treatment of COVID-19: A five case clinical series and mouse studies. PLoS One 2023; 18:e0288920. [PMID: 37566593 PMCID: PMC10420352 DOI: 10.1371/journal.pone.0288920] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/04/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Adenosine inhibits the activation of most immune cells and platelets. Selective adenosine A2A receptor (A2AR) agonists such as regadenoson (RA) reduce inflammation in most tissues, including lungs injured by hypoxia, ischemia, transplantation, or sickle cell anemia, principally by suppressing the activation of invariant natural killer T (iNKT) cells. The anti-inflammatory effects of RA are magnified in injured tissues due to induction in immune cells of A2ARs and ecto-enzymes CD39 and CD73 that convert ATP to adenosine in the extracellular space. Here we describe the results of a five patient study designed to evaluate RA safety and to seek evidence of reduced cytokine storm in hospitalized COVID-19 patients. METHODS AND FINDINGS Five COVID-19 patients requiring supplemental oxygen but not intubation (WHO stages 4-5) were infused IV with a loading RA dose of 5 μg/kg/h for 0.5 h followed by a maintenance dose of 1.44 μg/kg/h for 6 hours, Vital signs and arterial oxygen saturation were recorded, and blood samples were collected before, during and after RA infusion for analysis of CRP, D-dimer, circulating iNKT cell activation state and plasma levels of 13 proinflammatory cytokines. RA was devoid of serious side effects, and within 24 hours from the start of infusion was associated with increased oxygen saturation (93.8 ± 0.58 vs 96.6 ± 1.08%, P<0.05), decreased D-dimer (754 ± 17 vs 518 ± 98 ng/ml, P<0.05), and a trend toward decreased CRP (3.80 ± 1.40 vs 1.98 ± 0.74 mg/dL, P = 0.075). Circulating iNKT cells, but not conventional T cells, were highly activated in COVID-19 patients (65% vs 5% CD69+). RA infusion for 30 minutes reduced iNKT cell activation by 50% (P<0.01). RA infusion for 30 minutes did not influence plasma cytokines, but infusion for 4.5 or 24 hours reduced levels of 11 of 13 proinflammatory cytokines. In separate mouse studies, subcutaneous RA infusion from Alzet minipumps at 1.44 μg/kg/h increased 10-day survival of SARS-CoV-2-infected K18-hACE2 mice from 10 to 40% (P<0.001). CONCLUSIONS Infused RA is safe and produces rapid anti-inflammatory effects mediated by A2A adenosine receptors on iNKT cells and possibly in part by A2ARs on other immune cells and platelets. We speculate that iNKT cells are activated by release of injury-induced glycolipid antigens and/or alarmins such as IL-33 derived from virally infected type II epithelial cells which in turn activate iNKT cells and secondarily other immune cells. Adenosine released from hypoxic tissues, or RA infused as an anti-inflammatory agent decrease proinflammatory cytokines and may be useful for treating cytokine storm in patients with Covid-19 or other inflammatory lung diseases or trauma.
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Affiliation(s)
- Joseph Rabin
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
| | - Yunge Zhao
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
| | - Ezzat Mostafa
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
| | - Manal Al-Suqi
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
| | - Emily Fleischmann
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
| | - Mark R. Conaway
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Barbara J. Mann
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Preeti Chhabra
- Department of Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Kenneth L. Brayman
- Department of Surgery, University of Virginia, Charlottesville, Virginia, United States of America
| | - Alexander Krupnick
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
| | - Joel Linden
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Christine L. Lau
- Department of Surgery, Division of Thoracic, University of Maryland, Baltimore, Maryland, United States of America
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6
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Mann BJ, Chhabra P, Ma M, Brovero SG, Hannan RT, Sturek JM, Jones MK, Linden J, Brayman KL. Improved survival of SARS COV-2-infected K18- hACE2 mice treated with adenosine A 2AR agonist. Heliyon 2023; 9:e19226. [PMID: 37664715 PMCID: PMC10469936 DOI: 10.1016/j.heliyon.2023.e19226] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 05/31/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
A life-threatening manifestation of Covid-19 infection is a cytokine storm that requires hospitalization and supplemental oxygen. Various strategies to reduce inflammatory cytokines have had some success in limiting cytokine storm and improving survival. Agonists of adenosine A2A receptors (A2AR) reduce cytokine release from most immune cells. Apadenoson is a potent and selective anti-inflammatory adenosine analog that reduces inflammation. When administered by subcutaneous osmotic pumps to mice infected with SARS CoV-2, Apadenoson was found to improve the outcomes of infection as measured by a decrease in weight loss, improved clinical symptoms, reduced levels of proinflammatory cytokines and chemokines in bronchial lavage (BAL) fluid, and enhanced survival of K18-hACE2 transgenic mice. These results support further examination of A2AR agonists as therapies for treating cytokine storm due to COVID-19.
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Affiliation(s)
- Barbara J. Mann
- Department of Medicine, Division of Infectious Diseases, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
- Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Preeti Chhabra
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Mingyang Ma
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Savannah G. Brovero
- Department of Medicine, Division of Infectious Diseases, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Riley T. Hannan
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Jeffrey M. Sturek
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Marieke K. Jones
- Claude Moore Health Sciences Library, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Joel Linden
- Department of Medicine, Division of Nephrology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Kenneth L. Brayman
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
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7
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Servellita V, Sotomayor Gonzalez A, Lamson DM, Foresythe A, Huh HJ, Bazinet AL, Bergman NH, Bull RL, Garcia KY, Goodrich JS, Lovett SP, Parker K, Radune D, Hatada A, Pan CY, Rizzo K, Bertumen JB, Morales C, Oluniyi PE, Nguyen J, Tan J, Stryke D, Jaber R, Leslie MT, Lyons Z, Hedman HD, Parashar U, Sullivan M, Wroblewski K, Oberste MS, Tate JE, Baker JM, Sugerman D, Potts C, Lu X, Chhabra P, Ingram LA, Shiau H, Britt W, Gutierrez Sanchez LH, Ciric C, Rostad CA, Vinjé J, Kirking HL, Wadford DA, Raborn RT, St George K, Chiu CY. Adeno-associated virus type 2 in US children with acute severe hepatitis. Nature 2023; 617:574-580. [PMID: 36996871 PMCID: PMC10170441 DOI: 10.1038/s41586-023-05949-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [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: 09/11/2022] [Accepted: 03/10/2023] [Indexed: 04/01/2023]
Abstract
As of August 2022, clusters of acute severe hepatitis of unknown aetiology in children have been reported from 35 countries, including the USA1,2. Previous studies have found human adenoviruses (HAdVs) in the blood from patients in Europe and the USA3-7, although it is unclear whether this virus is causative. Here we used PCR testing, viral enrichment-based sequencing and agnostic metagenomic sequencing to analyse samples from 16 HAdV-positive cases from 1 October 2021 to 22 May 2022, in parallel with 113 controls. In blood from 14 cases, adeno-associated virus type 2 (AAV2) sequences were detected in 93% (13 of 14), compared to 4 (3.5%) of 113 controls (P < 0.001) and to 0 of 30 patients with hepatitis of defined aetiology (P < 0.001). In controls, HAdV type 41 was detected in blood from 9 (39.1%) of the 23 patients with acute gastroenteritis (without hepatitis), including 8 of 9 patients with positive stool HAdV testing, but co-infection with AAV2 was observed in only 3 (13.0%) of these 23 patients versus 93% of cases (P < 0.001). Co-infections by Epstein-Barr virus, human herpesvirus 6 and/or enterovirus A71 were also detected in 12 (85.7%) of 14 cases, with higher herpesvirus detection in cases versus controls (P < 0.001). Our findings suggest that the severity of the disease is related to co-infections involving AAV2 and one or more helper viruses.
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Affiliation(s)
- Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Daryl M Lamson
- Wadsworth Center, New York State Department of Health, David Axelrod Institute, Albany, NY, USA
| | - Abiodun Foresythe
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Hee Jae Huh
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Adam L Bazinet
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Nicholas H Bergman
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Robert L Bull
- Federal Bureau of Investigation Laboratory Division/Scientific Response and Analysis Unit, Quantico, VA, USA
| | - Karla Y Garcia
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Jennifer S Goodrich
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Sean P Lovett
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Kisha Parker
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Diana Radune
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - April Hatada
- California Department of Public Health, Richmond, CA, USA
| | - Chao-Yang Pan
- California Department of Public Health, Richmond, CA, USA
| | - Kyle Rizzo
- California Department of Public Health, Richmond, CA, USA
| | - J Bradford Bertumen
- California Department of Public Health, Richmond, CA, USA
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | | | - Paul E Oluniyi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jenny Nguyen
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jessica Tan
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Doug Stryke
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Rayah Jaber
- Florida Department of Health, Tallahassee, FL, USA
| | | | - Zin Lyons
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Hayden D Hedman
- Centers for Disease Control and Prevention, Atlanta, CA, USA
- South Dakota Department of Health, Pierre, SD, USA
| | - Umesh Parashar
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | - Maureen Sullivan
- Association for Public Health Laboratories, Silver Spring, MD, USA
| | - Kelly Wroblewski
- Association for Public Health Laboratories, Silver Spring, MD, USA
| | | | | | - Julia M Baker
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | - David Sugerman
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | - Caelin Potts
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | - Xiaoyan Lu
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | - Preeti Chhabra
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | | | - Henry Shiau
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - William Britt
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Caroline Ciric
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Christina A Rostad
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, CA, USA
| | | | | | - R Taylor Raborn
- National Biodefense Analysis and Countermeasures Center (NBACC), Frederick, MD, USA
| | - Kirsten St George
- Wadsworth Center, New York State Department of Health, David Axelrod Institute, Albany, NY, USA
- Department of Biomedical Science, University at Albany, SUNY, Albany, NY, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA.
- Chan-Zuckerberg Biohub, San Francisco, CA, USA.
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8
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Roosa CA, Ma M, Chhabra P, Brayman K, Griffin D. Delivery of Dissociated Islets Cells within Microporous Annealed Particle Scaffold to Treat Type 1 Diabetes. Adv Ther (Weinh) 2022; 5:2200064. [PMID: 36405778 PMCID: PMC9674036 DOI: 10.1002/adtp.202200064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Indexed: 09/03/2023]
Abstract
Type 1 diabetes (T1D) is caused by the autoimmune loss of insulin-producing beta cells in the pancreas. The only clinical approach to patient management of blood glucose that doesn't require exogenous insulin is pancreas or islet transplantation. Unfortunately, donor islets are scarce and there is substantial islet loss immediately after transplantation due, in part, to the local inflammatory response. The delivery of stem cell-derived beta cells (e.g., from induced pluripotent stem cells) and dissociated islet cells hold promise as a treatment for T1D; however, these cells typically require re-aggregation in vitro prior to implantation. Microporous scaffolds have shown high potential to serve as a vehicle for organization, survival, and function of insulin-producing cells. In this study, we investigated the use of microporous annealed particle (MAP) scaffold for delivery of enzymatically dissociated islet cells, a model beta cell source, within the scaffold's interconnected pores. We found that MAP-based cell delivery enables survival and function of dissociated islets cells both in vitro and in an in vivo mouse model of T1D.
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Affiliation(s)
- Colleen A Roosa
- Department of Biomedical Engineering, University of Virginia, 415 Lane Rd, Charlottesville, Virginia 22903, USA
| | - Mingyang Ma
- Department of Surgery, University of Virginia, 1300 Jefferson Park Ave, Charlottesville, Virginia 22903, USA
| | - Preeti Chhabra
- Department of Surgery, University of Virginia, 1300 Jefferson Park Ave, Charlottesville, Virginia 22903, USA
| | - Kenneth Brayman
- Department of Surgery, University of Virginia, 1300 Jefferson Park Ave, Charlottesville, Virginia 22903, USA
| | - Donald Griffin
- Department of Biomedical Engineering, University of Virginia, 415 Lane Rd, Charlottesville, Virginia 22903, USA
- Department of Chemical Engineering, University of Virginia, 351 McCormick Rd, Charlottesville, Virginia 22904, USA
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9
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Mboko WP, Chhabra P, Valcarce MD, Costantini V, Vinjé J. Advances in understanding of the innate immune response to human norovirus infection using organoid models. J Gen Virol 2022; 103:10.1099/jgv.0.001720. [PMID: 35077345 PMCID: PMC8984994 DOI: 10.1099/jgv.0.001720] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Norovirus is the leading cause of epidemic and endemic acute gastroenteritis worldwide and the most frequent cause of foodborne illness in the United States. There is no specific treatment for norovirus infections and therapeutic interventions are based on alleviating symptoms and limiting viral transmission. The immune response to norovirus is not completely understood and mechanistic studies have been hindered by lack of a robust cell culture system. In recent years, the human intestinal enteroid/human intestinal organoid system (HIE/HIO) has enabled successful human norovirus replication. Cells derived from HIE have also successfully been subjected to genetic manipulation using viral vectors as well as CRISPR/Cas9 technology, thereby allowing studies to identify antiviral signaling pathways important in controlling norovirus infection. RNA sequencing using HIE cells has been used to investigate the transcriptional landscape during norovirus infection and to identify antiviral genes important in infection. Other cell culture platforms such as the microfluidics-based gut-on-chip technology in combination with the HIE/HIO system also have the potential to address fundamental questions on innate immunity to human norovirus. In this review, we highlight the recent advances in understanding the innate immune response to human norovirus infections in the HIE system, including the application of advanced molecular technologies that have become available in recent years such as the CRISPR/Cas9 and RNA sequencing, as well as the potential application of single cell transcriptomics, viral proteomics, and gut-on-a-chip technology to further elucidate innate immunity to norovirus.
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Affiliation(s)
- Wadzanai P. Mboko
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Preeti Chhabra
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Marta Diez Valcarce
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Veronica Costantini
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Jan Vinjé
- Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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10
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Chan MCW, Roy S, Bonifacio J, Zhang LY, Chhabra P, Chan JCM, Celma C, Igoy MA, Lau SL, Mohammad KN, Vinjé J, Vennema H, Breuer J, Koopmans M, de Graaf M. Detection of Norovirus Variant GII.4 Hong Kong in Asia and Europe, 2017-2019. Emerg Infect Dis 2021; 27:289-293. [PMID: 33350912 PMCID: PMC7774557 DOI: 10.3201/eid2701.203351] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
We report a new norovirus GII.4 variant, GII.4 Hong Kong, with low-level circulation in 4 Eurasia countries since mid-2017. Amino acid substitutions in key residues on the virus capsid associated with the emergence of pandemic noroviruses suggest that GII.4 Hong Kong has the potential to become the next pandemic variant.
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11
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Chhabra P, Rouhani S, Browne H, Peñataro Yori P, Siguas Salas M, Paredes Olortegui M, Moulton LH, Kosek MN, Vinjé J. Homotypic and Heterotypic Protection and Risk of Reinfection Following Natural Norovirus Infection in a Highly Endemic Setting. Clin Infect Dis 2021; 72:222-229. [PMID: 33501947 PMCID: PMC7840104 DOI: 10.1093/cid/ciaa019] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 07/08/2019] [Accepted: 01/08/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Norovirus is a leading cause of acute gastroenteritis worldwide, yet there is limited information on homotypic or heterotypic protection following natural infection to guide vaccine development. METHODS A total of 6020 stools collected from 299 Peruvian children between 2010 and 2014 were tested by norovirus real-time reverse-transcription polymerase chain reaction followed by sequence-based genotyping. Cox proportional hazards models were used to derive adjusted hazard ratios (HRs) of infection among children with vs without prior exposure. RESULTS Norovirus was detected in 1288 (21.3%) samples. GII.4 (26%), GII.6 (19%), and GI.3 (9%) viruses accounted for 54% of infections. Homotypic protection for GI.3 (HR, 0.35; P = .015), GI.7 (HR, 0.19; P = .022), GII.4 (HR, 0.39; P < .001), and GII.6 (HR, 0.52; P = .006) infections was observed. Hazard analysis showed that children with prior GII.4 infection exhibited heterotypic protection with a 48% reduction of subsequent GI.3 infection (HR, 0.52; P = .005). Prior exposure to GI.3, GII.2, and GII.17 infections enhanced susceptibility to subsequent infections with several other norovirus genotypes. CONCLUSIONS Children up to 2 years of age infected with GII.4 noroviruses demonstrated both homotypic and heterotypic protection to reinfection with other genotypes. These data support the need for ongoing vaccine development efforts with GII.4 as the main component and caution the inclusion of genotypes that may enhance susceptibility to infections.
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Affiliation(s)
- Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Saba Rouhani
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hannah Browne
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Pablo Peñataro Yori
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA.,Investigaciones Biomédicas, AB PRISMA, Iquitos, Peru
| | | | | | - Lawrence H Moulton
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA.,Investigaciones Biomédicas, AB PRISMA, Iquitos, Peru
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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12
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Tatusov RL, Chhabra P, Diez-Valcarce M, Barclay L, Cannon JL, Vinjé J. Human Calicivirus Typing tool: A web-based tool for genotyping human norovirus and sapovirus sequences. J Clin Virol 2020; 134:104718. [PMID: 33360859 DOI: 10.1016/j.jcv.2020.104718] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The family Caliciviridae consists of a genetically diverse group of RNA viruses that infect a wide range of host species including noroviruses and sapoviruses which cause acute gastroenteritis in humans. Typing of these viruses relies on sequence-based approaches, and therefore there is a need for rapid and accurate web-based typing tools. OBJECTIVE To develop and evaluate a web-based tool for rapid and accurate genotyping of noroviruses and sapoviruses. METHODS The Human Calicivirus Typing (HuCaT) tool uses a set of curated reference sequences that are compared to query sequences using a k-mer (DNA substring) based algorithm. Outputs include alignments and phylogenetic trees of the 12 top matching reference sequences for each query. RESULTS The HuCaT tool was validated with a set of 1310 norovirus and 239 sapovirus sequences covering all known human norovirus and sapovirus genotypes. HuCaT tool assigned genotypes to all queries with 100 % accuracy and was much faster (17 s) than BLAST (150 s) or phylogenetic analyses approaches. CONCLUSIONS The web-based HuCaT tool supports rapid and accurate genotyping of human noroviruses and sapoviruses.
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Affiliation(s)
- Roman L Tatusov
- Cherokee Nation Assurance, Arlington, VA, 22202, USA; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Preeti Chhabra
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marta Diez-Valcarce
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Leslie Barclay
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer L Cannon
- National Foundation for the Centers for Disease Control and Prevention Inc., Atlanta, GA, USA
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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13
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Chhabra P, Browne H, Huynh T, Diez-Valcarce M, Barclay L, Kosek MN, Ahmed T, Lopez MR, Pan CY, Vinjé J. Single-step RT-PCR assay for dual genotyping of GI and GII norovirus strains. J Clin Virol 2020; 134:104689. [PMID: 33260046 PMCID: PMC7816162 DOI: 10.1016/j.jcv.2020.104689] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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] [Received: 08/05/2020] [Revised: 10/21/2020] [Accepted: 11/06/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Noroviruses are the major cause of acute gastroenteritis (AGE) in people of all ages globally. Standardized genotyping is key for outbreak investigations and surveillance networks. OBJECTIVE Here we describe the validation of a one-step conventional RT-PCR assay for sequence-based dual typing of GI and GII noroviruses. This polymerase (P) and capsid (C) dual typing assay uses a combination of previously published oligonucleotide primers amplifying a genomic region spanning the 3'-end of ORF1 and 5'end of ORF2 resulting in a 579 bp product for GI and 570 bp product for GII viruses. RESULTS The limit of detection of the assay ranged from 5 to 50 copies of viral RNA per reaction for GI and GII. To validate the assay, we tested 2,663 noroviruspositive stool samples from outbreaks and sporadic cases of AGE in Bangladesh, Guatemala, Peru, and USA collected between 2010-2019, of which 2,392 (90 %) were genotyped successfully. Most of the known genotypes infecting humans (GI (n = 9) and GII (n = 23)) and P types (GI (n = 15), GII, (n = 20)) could be detected. The remaining 270 samples had low viral load (Ct > 30) by real-time RT-PCR. A panel of 166 samples positive for other enteric viruses (rotavirus, astrovirus, sapovirus, adenovirus type 40/41) tested negative. CONCLUSION The use of broadly reactive genotyping assays greatly strengthens exchange of standardized genotype data globally to monitor trends in genotype diversity which is important for both the development of vaccines and to measure their impact.
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Affiliation(s)
- Preeti Chhabra
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Hannah Browne
- National Foundation for the Centers for Disease Control and Prevention Inc., Atlanta, GA, USA
| | - Thalia Huynh
- California Department of Public Health, Richmond, CA, USA
| | | | - Leslie Barclay
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret N Kosek
- University of Virginia Division of Infectious Diseases and International Health, Charlottesville, VA, USA
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Chao-Yang Pan
- California Department of Public Health, Richmond, CA, USA
| | - Jan Vinjé
- Viral Gastroenteritis Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Chhabra P, Graaf MD, Parra GI, Chan MCW, Green K, Martella V, Wang Q, White PA, Katayama K, Vennema H, Koopmans MPG, Vinjé J. Corrigendum: Updated classification of norovirus genogroups and genotypes. J Gen Virol 2020; 101:893. [PMID: 32854814 DOI: 10.1099/jgv.0.001475] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Miranda de Graaf
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gabriel I Parra
- Division of Viral Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Martin Chi-Wai Chan
- Department of Microbiology, Stanley Ho Centre for Emerging Infectious Diseases and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, PR China
| | - Kim Green
- Caliciviruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Vito Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Qiuhong Wang
- Department of Veterinary Preventive Medicine, The Ohio State University, Wooster, OH, USA
| | - Peter A White
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney 2052, Australia
| | - Kazuhiko Katayama
- Laboratory of Viral infection I, Kitasato Institute for Life Sciences Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Harry Vennema
- Division for Virology, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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15
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Chhabra P, de Graaf M, Parra GI, Chan MCW, Green K, Martella V, Wang Q, White PA, Katayama K, Vennema H, Koopmans MPG, Vinjé J. Updated classification of norovirus genogroups and genotypes. J Gen Virol 2020; 100:1393-1406. [PMID: 31483239 DOI: 10.1099/jgv.0.001318] [Citation(s) in RCA: 440] [Impact Index Per Article: 110.0] [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: 12/16/2022] Open
Abstract
Noroviruses are genetically diverse RNA viruses associated with acute gastroenteritis in mammalian hosts. Phylogenetically, they can be segregated into different genogroups as well as P (polymerase)-groups and further into genotypes and P-types based on amino acid diversity of the complete VP1 gene and nucleotide diversity of the RNA-dependent RNA polymerase (RdRp) region of ORF1, respectively. In recent years, several new noroviruses have been reported that warrant an update of the existing classification scheme. Using previously described 2× standard deviation (sd) criteria to group sequences into separate clusters, we expanded the number of genogroups to 10 (GI-GX) and the number of genotypes to 48 (9 GI, 27 GII, 3 GIII, 2 GIV, 2 GV, 2 GVI and 1 genotype each for GVII, GVIII, GIX [formerly GII.15] and GX). Viruses for which currently only one sequence is available in public databases were classified into tentative new genogroups (GNA1 and GNA2) and genotypes (GII.NA1, GII.NA2 and GIV.NA1) with their definitive assignment awaiting additional related sequences. Based on nucleotide diversity in the RdRp region, noroviruses can be divided into 60 P-types (14 GI, 37 GII, 2 GIII, 1 GIV, 2 GV, 2 GVI, 1 GVII and 1 GX), 2 tentative P-groups and 14 tentative P-types. Future classification and nomenclature updates will be based on complete genome sequences and will be coordinated and disseminated by the international norovirus classification-working group.
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Affiliation(s)
- Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Miranda de Graaf
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gabriel I Parra
- Division of Viral Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Martin Chi-Wai Chan
- Department of Microbiology, Stanley Ho Centre for Emerging Infectious Diseases and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, PR China
| | - Kim Green
- Caliciviruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Vito Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Qiuhong Wang
- Department of Veterinary Preventive Medicine, The Ohio State University, Wooster, OH, USA
| | - Peter A White
- School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney 2052, Australia
| | - Kazuhiko Katayama
- Laboratory of Viral infection I, Kitasato Institute for Life Sciences Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Harry Vennema
- Division for Virology, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Urekar C, Acharya KK, Chhabra P, Reddi PP. A 50-bp enhancer of the mouse acrosomal vesicle protein 1 gene activates round spermatid-specific transcription in vivo†. Biol Reprod 2019; 101:842-853. [PMID: 31290539 PMCID: PMC6863968 DOI: 10.1093/biolre/ioz115] [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: 02/06/2019] [Revised: 06/04/2019] [Accepted: 07/03/2019] [Indexed: 11/12/2022] Open
Abstract
Enhancers are cis-elements that activate transcription and play critical roles in tissue- and cell type-specific gene expression. During spermatogenesis, genes coding for specialized sperm structures are expressed in a developmental stage- and cell type-specific manner, but the enhancers responsible for their expression have not been identified. Using the mouse acrosomal vesicle protein (Acrv1) gene that codes for the acrosomal protein SP-10 as a model, our previous studies have shown that Acrv1 proximal promoter activates transcription in spermatids; and the goal of the present study was to separate the enhancer responsible. Transgenic mice showed that three copies of the -186/-135 fragment (50 bp enhancer) placed upstream of the Acrv1 core promoter (-91/+28) activated reporter expression in testis but not somatic tissues (n = 4). Immunohistochemistry showed that enhancer activity was restricted to the round spermatids. The Acrv1 enhancer failed to activate transcription in the context of a heterologous core promoter (n = 4), indicating a likely requirement for enhancer-core promoter compatibility. Chromatin accessibility assays showed that the Acrv1 enhancer assumes a nucleosome-free state in male germ cells (but not liver), indicating occupancy by transcription factors. Southwestern assays (SWA) identified specific binding of the enhancer to a testis nuclear protein of 47 kDa (TNP47). TNP47 was predominantly nuclear and becomes abundant during the haploid phase of spermatogenesis. Two-dimensional SWA revealed the isoelectric point of TNP47 to be 5.2. Taken together, this study delineated a 50-bp enhancer of the Acrv1 gene for round spermatid-specific transcription and identified a putative cognate factor. The 50-bp enhancer could become useful for delivery of proteins into spermatids.
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Affiliation(s)
- Craig Urekar
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Kshitish K Acharya
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Preeti Chhabra
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Prabhakara P Reddi
- Department of Comparative Biosciences, College of Veterinary Medicine, University of Illinois Urbana Champaign, Champaign, Illinois, USA
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Nelson MI, Mahfuz M, Chhabra P, Haque R, Seidman JC, Hossain I, McGrath M, Ahmed AMS, Knobler S, Vinjé J, Ahmed T. Genetic Diversity of Noroviruses Circulating in a Pediatric Cohort in Bangladesh. J Infect Dis 2018; 218:1937-1942. [PMID: 30053045 PMCID: PMC6217719 DOI: 10.1093/infdis/jiy454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/20/2018] [Indexed: 01/02/2023] Open
Abstract
Noroviruses are a leading cause of diarrhea in children aged <5 years worldwide. We genotyped 88 viruses collected by active surveillance in a birth cohort of children <2 years of age in Dhaka, Bangladesh, during 2010-2013. Twenty-five of 31 (81%) established GI and GII genotypes were detected, with GII.4 as the predominant genotype (20%). Our results show that children in Bangladesh are infected with a great diversity of norovirus strains. Reinfections are common, but not with closely related genotypes. Birth cohort studies are critical to understand cross-protective immunity and advance the development of pediatric norovirus vaccines.
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Affiliation(s)
- Martha I Nelson
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Mustafa Mahfuz
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
| | - Preeti Chhabra
- Centers for Disease Control and Prevention, Atlanta, Georgia
- Synergy, Atlanta, Georgia
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
| | - Jessica C Seidman
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Iqbal Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
| | - Monica McGrath
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - A M Shamsir Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
| | - Stacey Knobler
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
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18
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Wilson CS, Chhabra P, Marshall AF, Morr CV, Stocks BT, Hoopes EM, Bonami RH, Poffenberger G, Brayman KL, Moore DJ. Healthy Donor Polyclonal IgMs Diminish B-Lymphocyte Autoreactivity, Enhance Regulatory T-Cell Generation, and Reverse Type 1 Diabetes in NOD Mice. Diabetes 2018; 67:2349-2360. [PMID: 30131391 PMCID: PMC6198348 DOI: 10.2337/db18-0456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/12/2018] [Indexed: 02/05/2023]
Abstract
Autoimmune diseases such as type 1 diabetes (T1D) arise from unrestrained activation of effector lymphocytes that destroy target tissues. Many efforts have been made to eliminate these effector lymphocytes, but none has produced a long-term cure. An alternative to depletion therapy is to enhance endogenous immune regulation. Among these endogenous alternatives, naturally occurring Igs have been applied for inflammatory disorders but have lacked potency in antigen-specific autoimmunity. We hypothesized that naturally occurring polyclonal IgMs, which represent the majority of circulating, noninduced antibodies but are present only in low levels in therapeutic Ig preparations, possess the most potent capacity to restore immune homeostasis. Treatment of diabetes-prone NOD mice with purified IgM isolated from Swiss Webster (SW) mice (nIgMSW) reversed new-onset diabetes, eliminated autoreactive B lymphocytes, and enhanced regulatory T-cell (Treg) numbers both centrally and peripherally. Conversely, IgM from prediabetic NOD mice could not restore this endogenous regulation, which represents an unrecognized component of T1D pathogenesis. Of note, IgM derived from healthy human donors was similarly able to expand human CD4 Tregs in humanized mice and produced permanent diabetes protection in treated NOD mice. Overall, these studies demonstrate that a potent, endogenous regulatory mechanism, nIgM, is a promising option for reversing autoimmune T1D in humans.
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Affiliation(s)
- Christopher S Wilson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Preeti Chhabra
- Department of Surgery, University of Virginia, Charlottesville, VA
| | - Andrew F Marshall
- Department of Pediatrics, Ian Burr Division of Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, TN
| | - Caleigh V Morr
- Department of Pediatrics, Ian Burr Division of Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, TN
| | - Blair T Stocks
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Emilee M Hoopes
- Department of Pediatrics, Ian Burr Division of Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, TN
| | - Rachel H Bonami
- Department of Medicine, Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Greg Poffenberger
- Department of Medicine, Division of Endocrinology, Vanderbilt University Medical Center, Nashville, TN
| | | | - Daniel J Moore
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
- Department of Pediatrics, Ian Burr Division of Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, TN
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19
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Chhabra P, Spano AJ, Bowers D, Ren T, Moore DJ, Timko MP, Wu M, Brayman KL. Evidence for the Role of the Cecal Microbiome in Maintenance of Immune Regulation and Homeostasis. Ann Surg 2018; 268:541-549. [PMID: 29994931 DOI: 10.1097/sla.0000000000002930] [Citation(s) in RCA: 8] [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] [Indexed: 02/05/2023]
Abstract
OBJECTIVE (S) Our objective was to investigate alterations in the cecal microbial composition during the development of type 1 diabetes (T1D) with or without IgM therapy, and correlate these alterations with the corresponding immune profile. METHODS (1) Female nonobese diabetic (NOD) mice treated with IgM or saline (n = 20/group) were divided into 5-week-old nondiabetic; 9 to 12-week-old prehyperglycemic stage-1; ≥13-week-old prehyperglycemic stage-2; and diabetic groups. 16S rRNA libraries were prepared from bacterial DNA and deep-sequenced. (2) New-onset diabetic mice were treated with IgM (200 μg on Days 1, 3, and 5) and their blood glucose monitored for 2 months. RESULTS Significant dysbiosis was observed in the cecal microbiome with the progression of T1D development. The alteration in microbiome composition was characterized by an increase in the bacteroidetes:firmicutes ratio. In contrast, IgM conserved normal bacteroidetes:firmicutes ratio and this effect was long-lasting. Furthermore, oral gavage using cecal content from IgM-treated mice significantly diminished the incidence of diabetes compared with controls, indicating that IgM specifically affected mucosa-associated microbes, and that the affect was causal and not an epiphenomenon. Also, regulatory immune cell populations (myeloid-derived suppressor cells and regulatory T cells) were expanded and insulin autoantibody production diminished in the IgM-treated mice. In addition, IgM therapy reversed hyperglycemia in 70% of new-onset diabetic mice (n = 10) and the mice remained normoglycemic for the entire post-treatment observation period. CONCLUSIONS The cecal microbiome appears to be important in maintaining immune homeostasis and normal immune responses.
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Affiliation(s)
- Preeti Chhabra
- Department of Surgery, University of Virginia, Charlottesville, VA
| | - Anthony J Spano
- Department of Biology, University of Virginia, Charlottesville, VA
| | - Daniel Bowers
- Department of Surgery, University of Virginia, Charlottesville, VA
| | - Tiantian Ren
- Department of Biology, University of Virginia, Charlottesville, VA
| | - Daniel J Moore
- Department of Pediatrics, Vanderbilt University, Nashville, TN
| | - Michael P Timko
- Department of Biology, University of Virginia, Charlottesville, VA
| | - Martin Wu
- Department of Biology, University of Virginia, Charlottesville, VA
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20
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Bowers DT, Olingy CE, Chhabra P, Langman L, Merrill PH, Linhart RS, Tanes ML, Lin D, Brayman KL, Botchwey EA. An engineered macroencapsulation membrane releasing FTY720 to precondition pancreatic islet transplantation. J Biomed Mater Res B Appl Biomater 2018; 106:555-568. [PMID: 28240814 PMCID: PMC5572559 DOI: 10.1002/jbm.b.33862] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/28/2016] [Accepted: 01/26/2017] [Indexed: 02/06/2023]
Abstract
Macroencapsulation is a powerful approach to increase the efficiency of extrahepatic pancreatic islet transplant. FTY720, a small molecule that activates signaling through sphingosine-1-phosphate receptors, is immunomodulatory and pro-angiogenic upon sustained delivery from biomaterials. While FTY720 (fingolimod, Gilenya) has been explored for organ transplantation, in the present work the effect of locally released FTY720 from novel nanofiber-based macroencapsulation membranes is explored for islet transplantation. We screened islet viability during culture with FTY720 and various biodegradable polymers. Islet viability is significantly reduced by the addition of high doses (≥500 ng/mL) of soluble FTY720. Among the polymers screened, islets have the highest viability when cultured with poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). Therefore, PHBV was blended with polycaprolactone (PCL) for mechanical stability and electrospun into nanofibers. Islets had no detectable function ex vivo following 5 days or 12 h of subcutaneous implantation within our engineered device. Subsequently, we explored a preconditioning scheme in which islets are transplanted 2 weeks after FTY720-loaded nanofibers are implanted. This allows FTY720 to orchestrate a local regenerative milieu while preventing premature transplantation into avascular sites that contain high concentrations of FTY720. These results provide a foundation and motivation for further investigation into the use of FTY720 in preconditioning sites for efficacious islet transplantation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 555-568, 2018.
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Affiliation(s)
- Daniel T Bowers
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
| | - Claire E Olingy
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, 30332-0363
| | - Preeti Chhabra
- Department of Surgery, University of Virginia, Charlottesville, Virginia, 22903
| | - Linda Langman
- Department of Surgery, University of Virginia, Charlottesville, Virginia, 22903
| | - Parker H Merrill
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
| | - Ritu S Linhart
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
| | - Michael L Tanes
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
| | - Dan Lin
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
| | - Kenneth L Brayman
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
- Department of Surgery, University of Virginia, Charlottesville, Virginia, 22903
| | - Edward A Botchwey
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, 22903
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, 30332-0363
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21
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Chhabra P, Gregoricus N, Weinberg GA, Halasa N, Chappell J, Hassan F, Selvarangan R, Mijatovic-Rustempasic S, Ward ML, Bowen M, Payne DC, Vinjé J. Comparison of three multiplex gastrointestinal platforms for the detection of gastroenteritis viruses. J Clin Virol 2017; 95:66-71. [PMID: 28889082 DOI: 10.1016/j.jcv.2017.08.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/22/2017] [Accepted: 08/25/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Viruses are major etiological agents of childhood gastroenteritis. In recent years, several molecular platforms for the detection of viral enteric pathogens have become available. OBJECTIVE/STUDY DESIGN We evaluated the performance of three multiplex platforms including Biofire's Gastrointestinal Panel (FilmArray), Luminex xTAG® Gastrointestinal Pathogen Panel (GPP), and the TaqMan Array Card (TAC) for the detection of five gastroenteritis viruses using a coded panel of 300 archived stool samples. RESULTS The FilmArray detected a virus in 199 (96.1%) and the TAC in 172 (83.1%) of the 207 samples (187 samples positive for a single virus and 20 samples positive for more than one virus) whereas the GPP detected a virus in 100 (78.7%) of the 127 (97 positive for one virus and three positive for more than one virus) samples. Overall the clinical accuracy was highest for the FilmArray (98%) followed by TAC (97.2%) and GPP (96.9%). The sensitivity of the FilmArray, GPP and TAC platforms was highest for rotavirus (100%, 95.8%, and 89.6%, respectively) and lowest for adenovirus type 40/41 (97.4%, 57.9% and 68.4%). The specificity of the three platforms ranged from 95.6% (rotavirus) to 99.6% (norovirus/sapovirus) for the FilmArray, 99.6% (norovirus) to 100% (rotavirus/adenovirus) for GPP, and 98.9% (astrovirus) to 100% (rotavirus/sapovirus) for TAC. CONCLUSION The FilmArray demonstrated the best analytical performance followed by TAC. In recent years, the availability of multi-enteric molecular testing platforms has increased significantly and our data highlight the strengths and weaknesses of these platforms.
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Affiliation(s)
- Preeti Chhabra
- Synergy America, Inc., Atlanta, GA, United States; Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nicole Gregoricus
- Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Geoffrey A Weinberg
- University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, NY, United States
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, Nashville, TN, United States
| | - James Chappell
- Department of Pediatrics, Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ferdaus Hassan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals, Kansas City, MO, United States
| | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals, Kansas City, MO, United States
| | - Slavica Mijatovic-Rustempasic
- Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - M Leanne Ward
- Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michael Bowen
- Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Daniel C Payne
- Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jan Vinjé
- Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, United States.
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22
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Aneja J, Chavan BS, Huria A, Goel P, Kohli N, Chhabra P. Perceived stress and its psychological correlates in pregnant women: an Indian study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1364284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jitender Aneja
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Anju Huria
- Department of Obstetrics & Gynaecology, Government Medical College & Hospital, Chandigarh, India
| | - Poonam Goel
- Department of Obstetrics & Gynaecology, Government Medical College & Hospital, Chandigarh, India
| | - Navneet Kohli
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Preeti Chhabra
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
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23
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Chhabra P, Ranjan P, Cromeans T, Sambhara S, Vinjé J. Critical role of RIG-I and MDA5 in early and late stages of Tulane virus infection. J Gen Virol 2017; 98:1016-1026. [PMID: 28530548 DOI: 10.1099/jgv.0.000769] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Human noroviruses are a major cause of acute gastroenteritis worldwide, but the lack of a robust cell culture system or small animal model have hampered a better understanding of innate immunity against these viruses. Tulane virus (TV) is the prototype virus of a tentative new genus, Recovirus, in the family Caliciviridae. Its epidemiology and biological properties most closely resemble human norovirus. The host innate immune response to RNA virus infection primarily involves pathogen-sensing toll-like receptors (TLRs) TLR3 and TLR7 and retinoic acid-inducible gene I-like receptor RIG-I and melanoma differentiation associated gene 5 (MDA5). In this study, by using siRNA knockdown, we report that TV infection in LLC-MK2 cells results in an early [3 h post infection (h p.i.), P<0.05] RIG-I-dependent and type I interferon-mediated antiviral response, whereas an MDA5-mediated antiviral effect was observed at later (12 h p.i.; P<0.05) stages of TV replication. Induction of RIG-I and MDA5 was critical for inhibition of TV replication. Furthermore, pre-activation of the RIG-I/MDA5 pathway prevented TV replication (>900-fold decrease; P<0.05), suggesting that RIG-I and MDA5 ligands could be used to develop novel preventive and therapeutic measures against norovirus.
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Affiliation(s)
- Preeti Chhabra
- Gastroenteritis and Respiratory Viruses Laboratory Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Priya Ranjan
- Immunology and Pathogenesis Branch, Influenza Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | | | - Suryaprakash Sambhara
- Immunology and Pathogenesis Branch, Influenza Division, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jan Vinjé
- Gastroenteritis and Respiratory Viruses Laboratory Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
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24
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Bhatt V, Parrish J, Chhabra P, Nute S. Miniplate temporary orthodontic bone anchorage devices for maxillary molar intrusion — the challenges. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.896] [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: 10/19/2022]
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25
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Bhatt V, Parrish J, Kerai T, Nute S, Singh A, Chhabra P. Patient satisfaction with orthognathic treatment — does the view change with time? Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1076] [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: 10/19/2022]
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26
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Abstract
Human noroviruses are a leading cause of epidemic and sporadic gastroenteritis worldwide. Because most infections are either spread directly via the person-to-person route or indirectly through environmental surfaces or food, contaminated fomites and inanimate surfaces are important vehicles for the spread of the virus during norovirus outbreaks. We developed and evaluated a protocol using macrofoam swabs for the detection and typing of human noroviruses from hard surfaces. Compared with fiber-tipped swabs or antistatic wipes, macrofoam swabs allow virus recovery (range 1.2-33.6%) from toilet seat surfaces of up to 700 cm2. The protocol includes steps for the extraction of the virus from the swabs and further concentration of the viral RNA using spin columns. In total, 127 (58.5%) of 217 swab samples that had been collected from surfaces in cruise ships and long-term care facilities where norovirus gastroenteritis had been reported tested positive for GII norovirus by RT-qPCR. Of these 29 (22.8%) could be successfully genotyped. In conclusion, detection of norovirus on environmental surfaces using the protocol we developed may assist in determining the level of environmental contamination during outbreaks as well as detection of virus when clinical samples are not available; it may also facilitate monitoring of effectiveness of remediation strategies.
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Affiliation(s)
- Geun Woo Park
- Division of Viral Diseases, Centers for Disease Control and Prevention;
| | - Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention
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27
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Chhabra P, Gregoricus N, Weinberg G, Halasa N, Chappell JD, Hassan F, Selvarangan R, Ward L, Bowen MD, Payne D, Vinjé J. Comparison of Three Commercial Multiplex Gastrointestinal Platforms for the Detection of Gastroenteritis Viruses. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole Gregoricus
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Geoffrey Weinberg
- Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Natasha Halasa
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Ferdaus Hassan
- Children's Mercy Hospital and Clinics, Kansas City, Missouri
| | | | - Leanne Ward
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael D. Bowen
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel Payne
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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28
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Kulkarni R, Patel A, Bhalla S, Chhabra P, Cherian S, Chitambar SD. Characterization of GII.4 noroviruses circulating among children with acute gastroenteritis in Pune, India: 2005-2013. Infect Genet Evol 2015; 37:163-73. [PMID: 26611824 DOI: 10.1016/j.meegid.2015.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 11/09/2015] [Accepted: 11/17/2015] [Indexed: 12/16/2022]
Abstract
Genogroup II genotype 4 noroviruses (GII.4 NoVs), an important cause of sporadic childhood gastroenteritis worldwide, undergo continuous evolution leading to the periodic emergence of novel variants. The present study was undertaken for surveillance of GII.4 NoVs and identification and characterization of GII.4 variants circulating among children with sporadic gastroenteritis in Pune, India during 2005-2013. Among the 12 GII genotypes detected in the study, GII.4 was predominant. Sequencing and phylogenetic analysis of ORF2 (major capsid protein VP1 gene) of the GII.4 NoVs revealed circulation of seven GII.4 variants, Hunter_2004 (2005-2007), Yerseke_2006a (2006), DenHaag_2006b (2007), Osaka_2007 (2007-2009), Apeldoorn_2007 (2008), New Orleans_2009 (2008-2012) and Sydney_2012 (2013), with the Pune strains grouping with the contemporary global reference strains. The Hunter_2004, Osaka_2007 and New Orleans_2009 variants showed prolonged circulation, with the Hunter_2004 and New Orleans_2009 variants differentiating into temporally separated sub-clusters. Analysis of VP1 sequences and predicted structures of the GII.4 variants identified variant specific amino acid positions, particularly in and near (within 8A(°)) the epitopes A-E, displaying differences in the sequence and physicochemical characteristics of the different variants. Comparison with the reference strains of each of the GII.4 variants revealed up to 11 amino acid substitutions at the variant specific positions in the GII.4 strains from Pune. Amino acid variations were also noted among the strains of the same GII.4 variant in Pune. The strains of different sub-clusters identified in the Hunter_2004 and New Orleans_2009 variants showed differences in sequence and physicochemical properties of either or all of the epitopes A, C and E. The study thus describes the temporal variations and diversity of the GII.4 strains in Pune and emphasizes continuous monitoring and analysis of the GII.4 variants.
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Affiliation(s)
- Ruta Kulkarni
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Amit Patel
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Shilpa Bhalla
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Preeti Chhabra
- Enteric Viruses Group, National Institute of Virology, Pune, India
| | - Sarah Cherian
- Bioinformatics Group, National Institute of Virology, Pune, India
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Affiliation(s)
- P Chhabra
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Haryana and Punjab, India
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Lukhmana S, Bhasin SK, Chhabra P, Bhatia MS. Family caregivers' burden: A hospital based study in 2010 among cancer patients from Delhi. Indian J Cancer 2015; 52:146-51. [DOI: 10.4103/0019-509x.175584] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Dengue infection is one of the most common viral hemorrhagic fevers seen in the tropical countries, including India. Its presentation varies from an acute self-resolving febrile illness to life-threatening hemorrhagic shock and multiorgan dysfunction leading to death. Neurological presentations are uncommon and limited to case reports only. Most common neurological manifestations being encephalitis, acute inflammatory demyelinating polyradiculoneuropathy, transverse myelitis, and acute disseminated encephalomyelitis.Hypokalemic quadriparesis as a presenting feature of dengue is extremely rare. Here, we report this case of a 33-year-old female, who presented with hypokalemic quadriparesis and was subsequently diagnosed as dengue infection.
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Affiliation(s)
- N Gupta
- Department of Medicine, PG Student University College of Medical Sciences, Dilshad Garden, Delhi University, Delhi, India
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Chhabra P, Sutherland DE, Brayman KL. In brief. Curr Probl Surg 2014. [DOI: 10.1067/j.cpsurg.2013.10.003] [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: 02/05/2023]
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Ramesh A, Chhabra P, Brayman KL. Pancreatic islet transplantation in type 1 diabetes mellitus: an update on recent developments. Curr Diabetes Rev 2013; 9:294-311. [PMID: 23721158 DOI: 10.2174/15733998113099990063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 02/08/2023]
Abstract
Type 1 diabetes mellitus is an autoimmune disease that is characterized by the destruction of the islets of Langerhans cells which produce insulin. The current gold standard treatment is exogenous insulin injection, but this is onerous for the patients, and can lead to severe complications. Another approach involves transplanting pancreatic islet cells in order to restore endogenous insulin production under physiologic regulation. Although there has been some success with this treatment plan, there have been several hurdles. The largest hurdle is improving the 5 year survival of the graft, which is currently at 10%. In order to do so, there has been research into better locations for the graft, better isolation techniques, alternate immune suppression regimens, and novel transplantation methodologies utilizing encapsulated grafts. Another hurdle for pancreatic islet transplantation is that current methodologies require islets from several pancreata in order to create one successful graft, which leads to difficulties since there is a limited supply. However, there has been research looking into single donor transplants and porcine xenografts to increase the supply and address this problem. In this article, we review the current state of research regarding pancreatic islet transplantation.
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Affiliation(s)
- Arjun Ramesh
- Department of Surgery, University of Virginia, Charlottesville, VA 22908-0709, USA
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35
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Chhabra P, Payne DC, Szilagyi PG, Edwards KM, Staat MA, Shirley SH, Wikswo M, Nix WA, Lu X, Parashar UD, Vinjé J. Etiology of viral gastroenteritis in children <5 years of age in the United States, 2008-2009. J Infect Dis 2013; 208:790-800. [PMID: 23757337 DOI: 10.1093/infdis/jit254] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Although rotavirus and norovirus cause nearly 40% of severe endemic acute gastroenteritis (AGE) in children <5 years of age in the United States, there are limited data on the etiologic role of other enteric viruses in this age group. METHODS We conducted active population-based surveillance in children presenting with AGE to hospitals, emergency departments, and primary care clinics in 3 US counties. Stool specimens from these children and from age-matched healthy controls collected between October 2008 and September 2009 were tested for enteric adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus. Typing was performed by sequencing and phylogenetic analysis. RESULTS Adenovirus, astrovirus, sapovirus, parechovirus, bocavirus, and aichivirus were detected in the stool specimens of 11.8%, 4.9%, 5.4%, 4.8%, 1.4%, and 0.2% of patients with AGE and 1.8%, 3.0%, 4.2%, 4.4%, 2.4%, and 0% of healthy controls, respectively. Adenovirus (type 41), astrovirus (types 1, 2, 3, 4, and 8), sapovirus (genogroups I and II), parechovirus (types 1, 3, 4, and 5), and bocavirus (types 1, 2, and 3) were found cocirculating. CONCLUSIONS Adenovirus, astrovirus, and sapovirus infections were detected in 22.1% of the specimens from children <5 years of age who had medical visits for AGE and tested negative for rotavirus and norovirus. No causal role for parechovirus and bocavirus was found.
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Affiliation(s)
- Preeti Chhabra
- Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Abstract
Type 1 diabetes mellitus (T1D) is a chronic, multifactorial autoimmune disease that involves the progressive destruction of pancreatic β-cells, ultimately resulting in the loss of insulin production and secretion. The goal of clinical intervention is to prevent or arrest the onset and progression of autoimmunity, reverse β-cell destruction, and restore glycometabolic and immune homeostasis. Despite promising outcomes observed with islet transplantation and advancements in immunomodulatory therapies, the need for an effective cell replacement strategy for curing T1D still persists. Stem cell therapy offers a solution to the cited challenges of islet transplantation. While the regenerative potential of stem cells can be harnessed to make available a self-replenishing supply of glucose-responsive insulin-producing cells, their immunomodulatory properties may potentially be used to prevent, arrest, or reverse autoimmunity, ameliorate innate/alloimmune graft rejection, and prevent recurrence of the disease. Herein, we discuss the therapeutic potential of stem cells derived from a variety of sources for the cure of T1D, for example, embryonic stem cells, induced pluripotent stem cells, bone marrow-derived hematopoietic stem cells, and multipotent mesenchymal stromal cells derived from bone marrow, umbilical cord blood, and adipose tissue. The benefits of combinatorial approaches designed to ensure the successful clinical translation of stem cell therapeutic strategies, such as approaches combining effective stem cell strategies with islet transplantation, immunomodulatory drug regimens, and/or novel bioengineering techniques, are also discussed. To conclude, the application of stem cell therapy in the cure for T1D appears extremely promising.
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Affiliation(s)
- Preeti Chhabra
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Kenneth L. Brayman
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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Kang G, Desai R, Arora R, Chitamabar S, Naik TN, Krishnan T, Deshpande J, Gupte MD, Venkatasubramaniam S, Gentsch JR, Parashar UD, Mathew A, Anita, Ramani S, Sowmynarayanan TV, Moses PD, Agarwal I, Simon A, Bose A, Arora R, Chhabra P, Fadnis P, Bhatt J, Shetty SJ, Saxena VK, Mathur M, Jadhav A, Roy S, Mukherjee A, Singh NB. Diversity of circulating rotavirus strains in children hospitalized with diarrhea in India, 2005-2009. Vaccine 2013; 31:2879-83. [PMID: 23624096 DOI: 10.1016/j.vaccine.2013.04.030] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/07/2013] [Accepted: 04/09/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND India accounts for 22% of the 453,000 global rotavirus deaths among children <5 years annually. The Indian Rotavirus Strain Surveillance Network provides clinicians and public health partners with valuable rotavirus disease surveillance data. Our analysis offers policy-makers an update on rotavirus disease burden with emphasis on regional shifts in rotavirus strain epidemiology in India. METHODS Children <5 years requiring hospitalization for acute gastroenteritis were selected from 10 representative hospitals in 7 cities throughout India between November 2005 through June 2009. We used a modified World Health Organization protocol for rotavirus surveillance; stool specimens were collected and tested for rotavirus using enzyme immunoassay and reverse-transcription polymerase chain reaction. RESULTS A total of 7285 stool specimens collected were tested for rotavirus, among which 2899 (40%) were positive for rotavirus. Among the 2899 rotavirus detections, a G-type could not be determined for 662 (23%) and more than one G type was detected in 240 (8%). Of 1997 (69%) patients with only one G-type, the common types were G1 (25%), G2 (21%), G9 (13%), and G12 (10%). The proportion of rotavirus infections attributed to G12 infections rose from 8% to 39% in the Northern region and from 8% to 24% in the Western region. CONCLUSIONS This study highlights the large, ongoing burden of rotavirus disease in India, as well as interesting regional shifts in rotavirus strain epidemiology, including an increasing detection of G12 rotavirus strains in some regions. While broad heterotypic protection from rotavirus vaccination is expected based on pre- and post-licensure data from other settings, effectiveness assessments and rotavirus strain monitoring after vaccine introduction will be important.
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Chhabra P, Linden J, Lobo P, Okusa MD, Brayman KL. The immunosuppressive role of adenosine A2A receptors in ischemia reperfusion injury and islet transplantation. Curr Diabetes Rev 2012; 8:419-33. [PMID: 22934547 PMCID: PMC4209001 DOI: 10.2174/157339912803529878] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 06/15/2012] [Accepted: 06/18/2012] [Indexed: 02/08/2023]
Abstract
Activation of adenosine A2A receptors (A2AR) reduces inflammation by generally inhibiting the activation of pro-inflammatory cells, decreasing endothelial adhesion molecule expression and reducing the release of proinflammatory cytokine mediators. Numerous preclinical studies using selective A2AR agonists, antagonists, A2AR knockout as well as chimeric mice have suggested the therapeutic potential of A2AR agonists for the treatment of ischemia reperfusion injury (IRI) and autoimmune diseases. This review summarizes the immunosuppressive actions of A2AR agonists in murine IRI models of liver, kidney, heart, lung and CNS, and gives details on the cellular effects of A2AR activation in neutrophils, macrophages, dendritic cells, natural killer cells, NKT cells, T effector cells and CD4+CD25+FoxP3+ T regulatory cells. This is discussed in the context of cytokine mediators involved in inflammatory cascades. Whilst the role of adenosine receptor agonists in various models of autoimmune disease has been well-documented, very little information is available regarding the role of A2AR activation in type 1 diabetes mellitus (T1DM). An overview of the pathogenesis of T1DM as well as early islet graft rejection in the immediate peri-transplantation period offers insight regarding the use of A2AR agonists as a beneficial intervention in clinical islet transplantation, promoting islet graft survival, minimizing early islet loss and reducing the number of islets required for successful transplantation, thereby increasing the availability of this procedure to a greater number of recipients. In summary, the use of A2AR agonists as a clinical intervention in IRI and as an adjunct to clinical immunesuppressive regimen in islet transplantation is highlighted.
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Affiliation(s)
- Preeti Chhabra
- Department of Surgery, University of Virginia School of Medicine, P.O. Box 800709, Charlottesville, VA 22908-0709, USA.
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Chhabra P, Schlegel K, Okusa MD, Lobo PI, Brayman KL. Naturally occurring immunoglobulin M (nIgM) autoantibodies prevent autoimmune diabetes and mitigate inflammation after transplantation. Ann Surg 2012; 256:634-41. [PMID: 22964733 PMCID: PMC3875377 DOI: 10.1097/sla.0b013e31826b4ba9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [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] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate whether polyclonal serum naturally occurring immunoglobulin M (nIgM) therapy prevents the onset and progression of autoimmune diabetes and promotes islet allograft survival. BACKGROUND nIgM deficiency is associated with an increased tendency toward autoimmune disease development. Elevated levels of nIgM anti-leukocyte autoantibodies are associated with fewer graft rejections. METHODS Four- to five-week-old female nonobese diabetic (NOD) littermates received intraperitoneal nIgM or phosphate-buffered saline/bovine serum albumin/immunoglobulin G (100 μg followed by 50-75 μg biweekly) until 18 weeks of age. C57BL/6 recipients of 300 BALB/c or 50 C57BL/6 islet grafts received saline or nIgM. RESULTS Eighty percent control mice (n = 30) receiving saline became diabetic by 18 to 20 weeks of age. In contrast, none of 33 of nIgM-treated mice became diabetic (P < 0.0001). Discontinuing therapy resulted in hyperglycemia in only 9 of 33 mice at 22 weeks postdiscontinuation, indicating development of β-cell unresponsiveness. nIgM therapy initiated at 11 weeks of age resulted in hyperglycemia in only 20% of treated animals (n = 20) compared with 80% of controls (P < 0.0001). Treatment of mildly diabetic mice with nIgM (75 μg 3× per week) restored normoglycemia (n = 5), whereas severely diabetic mice required minimal dose islet transplant with nIgM to restore normoglycemia (n = 4). The mean survival time of BALB/c islet allografts transplanted in streptozotocin-induced diabetic C57BL/6 mice was 41.2 ± 3.3 days for nIgM-treated recipients (n = 4, fifth recipient remains normoglycemic) versus 10.2 ± 2.6 days for controls (n = 5) (P < 0.001). Also, after syngeneic transplantation, time taken to return to normoglycemia was 15.4 ± 3.6 days for nIgM-treated recipients (n = 5) and more than 35 days for controls (n = 4). CONCLUSIONS nIgM therapy demonstrates potential in preventing the onset and progression of autoimmune diabetes and in promoting islet graft survival.
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Affiliation(s)
- Preeti Chhabra
- Department of Surgery, Division of Transplantation, University of Virginia School of Medicine, Charlottesville, VA
| | - Kailo Schlegel
- Department of Medicine, Division of Nephrology, University of Virginia School of Medicine, Charlottesville, VA
| | - Mark D. Okusa
- Department of Medicine, Division of Nephrology, University of Virginia School of Medicine, Charlottesville, VA
| | - Peter I. Lobo
- Department of Medicine, Division of Nephrology, University of Virginia School of Medicine, Charlottesville, VA
| | - Kenneth L. Brayman
- Department of Surgery, Division of Transplantation, University of Virginia School of Medicine, Charlottesville, VA
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Abstract
BACKGROUND Use of multivariable logistic regression (MLR) modeling has steeply increased in the medical literature over the past few years. Testing of model assumptions and adequate reporting of MLR allow the reader to interpret results more accurately. AIMS To review the fulfillment of assumptions and reporting quality of MLR in selected Indian medical journals using established criteria. SETTING AND DESIGN Analysis of published literature. MATERIALS AND METHODS Medknow.com publishes 68 Indian medical journals with open access. Eight of these journals had at least five articles using MLR between the years 1994 to 2008. Articles from each of these journals were evaluated according to the previously established 10-point quality criteria for reporting and to test the MLR model assumptions. STATISTICAL ANALYSIS SPSS 17 software and non-parametric test (Kruskal-Wallis H, Mann Whitney U, Spearman Correlation). RESULTS One hundred and nine articles were finally found using MLR for analyzing the data in the selected eight journals. The number of such articles gradually increased after year 2003, but quality score remained almost similar over time. P value, odds ratio, and 95% confidence interval for coefficients in MLR was reported in 75.2% and sufficient cases (>10) per covariate of limiting sample size were reported in the 58.7% of the articles. No article reported the test for conformity of linear gradient for continuous covariates. Total score was not significantly different across the journals. However, involvement of statistician or epidemiologist as a co-author improved the average quality score significantly (P=0.014). CONCLUSIONS Reporting of MLR in many Indian journals is incomplete. Only one article managed to score 8 out of 10 among 109 articles under review. All others scored less. Appropriate guidelines in instructions to authors, and pre-publication review of articles using MLR by a qualified statistician may improve quality of reporting.
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Affiliation(s)
- R Kumar
- Department of Biostatistics and Medical Informatics, University College of Medical Sciences, Delhi, India
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Chitambar S, Gopalkrishna V, Chhabra P, Patil P, Verma H, Lahon A, Arora R, Tatte V, Ranshing S, Dhale G, Kolhapure R, Tikute S, Kulkarni J, Bhardwaj R, Akarte S, Pawar S. Diversity in the enteric viruses detected in outbreaks of gastroenteritis from Mumbai, Western India. Int J Environ Res Public Health 2012; 9:895-915. [PMID: 22690171 PMCID: PMC3367285 DOI: 10.3390/ijerph9030895] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 02/02/2012] [Accepted: 03/01/2012] [Indexed: 02/03/2023]
Abstract
Faecal specimens collected from two outbreaks of acute gastroenteritis that occurred in southern Mumbai, India in March and October, 2006 were tested for seven different enteric viruses. Among the 218 specimens tested, 95 (43.6%) were positive, 73 (76.8%) for a single virus and 22 (23.2%) for multiple viruses. Single viral infections in both, March and October showed predominance of enterovirus (EV, 33.3% and 40%) and rotavirus A (RVA, 33.3% and 25%). The other viruses detected in these months were norovirus (NoV, 12.1% and 10%), rotavirus B (RVB, 12.1% and 10%), enteric adenovirus (AdV, 6.1% and 7.5%), Aichivirus (AiV, 3% and 7.5%) and human astrovirus (HAstV, 3% and 0%). Mixed viral infections were largely represented by two viruses (84.6% and 88.9%), a small proportion showed presence of three (7.7% and 11%) and four (7.7% and 0%) viruses in the two outbreaks. Genotyping of the viruses revealed predominance of RVA G2P[4], RVB G2 (Indian Bangladeshi lineage), NoV GII.4, AdV-40, HAstV-8 and AiV B types. VP1/2A junction region based genotyping showed presence of 11 different serotypes of EVs. Although no virus was detected in the tested water samples, examination of both water and sewage pipelines in gastroenteritis affected localities indicated leakages and possibility of contamination of drinking water with sewage water. Coexistence of multiple enteric viruses during the two outbreaks of gastroenteritis emphasizes the need to expand such investigations to other parts of India.
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Affiliation(s)
- Shobha Chitambar
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Varanasi Gopalkrishna
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Preeti Chhabra
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Pooja Patil
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Harsha Verma
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Anismrita Lahon
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Ritu Arora
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Vaishali Tatte
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Sujata Ranshing
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Ganesh Dhale
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Rajendra Kolhapure
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Sanjay Tikute
- Enteric Viruses Group, National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune 411001, India; (V.G.); (P.C.); (P.P.); (H.V.); (R.A.); (A.L.); (V.T.); (S.R.); (G.D.); (R.K.); (S.T.)
| | - Jagannath Kulkarni
- Department of Pathology, Gokuldas Tejpal Hospital, Lokmanya Tilak Marg, Fort, Mumbai 400001, India;
| | - Renu Bhardwaj
- Department of Microbiology, Sir Jamshedjee Jeejeebhoy Hospital, Byculla, Mumbai 400008, India;
| | - Sulbha Akarte
- Department of Preventive and Social Medicine, Sir Jamshedjee Jeejeebhoy Hospital, Byculla, Mumbai 400008, India; (S.A.); (S.P.)
| | - Sashikant Pawar
- Department of Preventive and Social Medicine, Sir Jamshedjee Jeejeebhoy Hospital, Byculla, Mumbai 400008, India; (S.A.); (S.P.)
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Bowers DT, Chhabra P, Langman L, Botchwey EA, Brayman KL. FTY720-loaded poly(DL-lactide-co-glycolide) electrospun scaffold significantly increases microvessel density over 7 days in streptozotocin-induced diabetic C57b16/J mice: preliminary results. Transplant Proc 2011; 43:3285-7. [PMID: 22099778 DOI: 10.1016/j.transproceed.2011.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Nanofiber scaffolds could improve islet transplant success by physically mimicking the shape of extracellular matrix and by acting as a drug-delivery vehicle. Scaffolds implanted in alternate transplant sites must be prevascularized or very quickly vascularized following transplantation to prevent hypoxia-induced islet necrosis. The local release of the S1P prodrug FTY720 induces diameter enlargement and increases in length density. The objective of this preliminary study was to evaluate length and diameter differences between diabetic and nondiabetic animals implanted with FTY720-containing electrospun scaffolds using intravital imaging of dorsal skinfold window chambers. METHODS Electrospun mats of randomly oriented fibers we created from polymer solutions of PLAGA (50:50 LA:GA) with and without FTY720 loaded at a ratio of 1:200 (FTY720:PLAGA by wt). The implanted fiber mats were 4 mm in diameter and ∼0.2 mm thick. Increases in length density and vessel diameter were assessed by automated analysis of images over 7 days in RAVE, a Matlab program. RESULTS Image analysis of repeated measures of microvessel metrics demonstrated a significant increase in the length density from day 0 to day 7 in the moderately diabetic animals of this preliminary study (P < .05). Furthermore, significant differences in length density at day 0 and day 3 were found between recently STZ-induced moderately diabetic and nondiabetic animals in response to FTY720 local release (P < .05, Student t test). CONCLUSIONS Driving the islet revascularization process using local release of factors, such as FTY720, from biodegradable polymers makes an attractive system for the improvement of islet transplant success. Preliminary study results suggest that a recently induced moderately diabetic state may potentiate the mechanism by which local release of FTY720 from polymer fibers increases length density of microvessels. Therefore, local release of S1P receptor-targeted drugs is under further investigation for improvement of transplanted islet function.
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Affiliation(s)
- D T Bowers
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA
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Gatski M, Martin DH, Theall K, Amedee A, Clark RA, Dumestre J, Chhabra P, Schmidt N, Kissinger P. Mycoplasma genitalium infection among HIV-positive women: prevalence, risk factors and association with vaginal shedding. Int J STD AIDS 2011; 22:155-9. [PMID: 21464453 DOI: 10.1258/ijsa.2010.010320] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined the prevalence and factors associated with Mycoplasma genitalium (MG) infection among HIV-positive women and the association between MG and vaginal HIV-1 RNA shedding. HIV-positive women attending an outpatient clinic in New Orleans, Louisiana, USA, from 2002 to 2005 were examined for a battery of sexually transmitted infections (STIs) and underwent a behavioural survey. A selected subset had a measurement of vaginal shedding analysed. Of the 324 HIV-positive women, 32 (9.9%) were infected with MG. HIV-positive women with MG were more likely to be co-infected with Neisseria gonorrhoeae and Chlamydia trachomatis and to have had ≥1 male sexual partners in the last month. In the subset (n = 164), no differences were found in the presence of detectable vaginal HIV-1 RNA between women infected and not infected with MG (30.8% versus 34.8% shedding; P = 0.69). While MG was a common co-STI in this sample of HIV-positive women, it was not associated with vaginal HIV shedding.
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Affiliation(s)
- M Gatski
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, LA, USA
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Hodgins S, De Brito SA, Chhabra P, Côté G. Anxiety disorders among offenders with antisocial personality disorders: a distinct subtype? Can J Psychiatry 2010; 55:784-91. [PMID: 21172099 DOI: 10.1177/070674371005501206] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES about 50% of men with antisocial personality disorder (APD) present a comorbid anxiety disorder. Historically, it was thought that anxiety limited criminal activity and the development of APD, but recent evidence suggests that heightened responsiveness to threat may lead to persistent violent behaviour. Our study aimed to determine the prevalence of APD comorbid with anxiety disorders among offenders and the association of these comorbid disorders with violent offending. METHOD a random sample of 495 male penitentiary inmates completed an interview using the Diagnostic Interview Schedule. After excluding men with psychotic disorders, 279 with APD were retained. All authorized access to their criminal records. RESULTS two-thirds of the prisoners with APD presented a lifetime anxiety disorder. Among them, one-half had the onset of their anxiety disorder before they were aged 16 years. Among the offenders with APD, those with, compared with those without, anxiety disorders presented significantly more symptoms of APD, were more likely to have begun their criminal careers before they were aged 15 years, to have diagnoses of alcohol and (or) drug abuse and (or) dependence, and to have experienced suicidal ideas and attempts. While there were no differences in the mean number of convictions for violent offences between APD prisoners with and without anxiety disorders, more of those with anxiety disorders had been convicted of serious crimes involving interpersonal violence. CONCLUSIONS among men with APD, a substantial subgroup present life-long anxiety disorders. This pattern of comorbidity may reflect a distinct mechanism underlying violent behaviour and signalling the need for specific treatments.
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Affiliation(s)
- Sheilagh Hodgins
- Institute of Psychiatry, King's College London, London, England.
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Chhabra P, Walimbe AM, Chitambar SD. Complete genome characterization of Genogroup II norovirus strains from India: Evidence of recombination in ORF2/3 overlap. Infection, Genetics and Evolution 2010; 10:1101-9. [DOI: 10.1016/j.meegid.2010.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 07/03/2010] [Accepted: 07/05/2010] [Indexed: 12/25/2022]
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Chhabra P, Wang K, Zeng Q, Jecmenica M, Langman L, Linden J, Ketchum RJ, Brayman KL. Adenosine A(2A) agonist administration improves islet transplant outcome: Evidence for the role of innate immunity in islet graft rejection. Cell Transplant 2010; 19:597-612. [PMID: 20350347 DOI: 10.3727/096368910x491806] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Activation of adenosine A(2A) receptors inhibits inflammation in ischemia/reperfusion injury, and protects against cell damage at the injury site. Following transplantation 50% of islets die due to inflammation and apoptosis. This study investigated the effects of adenosine A(2A) receptor agonists (ATL146e and ATL313) on glucose-stimulated insulin secretion (GSIS) in vitro and transplanted murine syngeneic islet function in vivo. Compared to vehicle controls, ATL146e (100 nM) decreased insulin stimulation index [SI, (insulin)(high glucose)/(insulin)(low glucose)] (2.36 +/- 0.22 vs. 3.75 +/- 0.45; n = 9; p < 0.05). Coculture of islets with syngeneic leukocytes reduced SI (1.41 +/- 0.17; p < 0.05), and this was restored by ATL treatment (2.57 +/- 0.18; NS). Addition of a selective A(2A)AR antagonist abrogated ATL's protective effect, reducing SI (1.11 +/- 0.42). ATL treatment of A(2A)AR(+/+) islet/A(2A)AR(-/-) leukocyte cocultures failed to protect islet function (SI), implicating leukocytes as likely targets of A(2A)AR agonists. Diabetic recipient C57BL/6 mice (streptozotocin; 250 mg/kg, IP) received islet transplants to either the renal subcapsular or hepatic-intraportal site. Recipient mice receiving ATL therapy (ATL 146e or ATL313, 60 ng/kg/min, IP) achieved normoglycemia more rapidly than untreated recipients. Histological examination of grafts suggested reduced cellular necrosis, fibrosis, and lymphocyte infiltration in agonist-treated animals. Administration of adenosine A(2A) receptor agonists (ATL146e or ATL313) improves in vitro GSIS by an effect on leukocytes, and improves survival and functional engraftment of transplanted islets by inhibiting inflammatory islet damage in the peritransplant period, suggesting a potentially significant new strategy for reducing inflammatory islet loss in clinical transplantation.
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Affiliation(s)
- Preeti Chhabra
- Department of Surgery, University of Virginia, Charlottesville, 22908-0709, USA
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Arora R, Chhabra P, Chitambar SD. Genetic diversity of genotype G1 rotaviruses co-circulating in western India. Virus Res 2009; 146:36-40. [DOI: 10.1016/j.virusres.2009.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 07/31/2009] [Accepted: 08/21/2009] [Indexed: 11/27/2022]
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Chhabra P, Walimbe AM, Chitambar SD. Molecular characterization of three novel intergenotype norovirus GII recombinant strains from western India. Virus Res 2009; 147:242-6. [PMID: 19941918 DOI: 10.1016/j.virusres.2009.11.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2009] [Revised: 11/16/2009] [Accepted: 11/17/2009] [Indexed: 01/31/2023]
Abstract
The phenomenon of recombination has been widely described among noroviruses (NoVs) in the past few years. In a NoV surveillance study conducted in western India, 3 novel and 3 known combinations of RNA-dependent RNA polymerase (RdRp) and capsid genes were identified in genogroup (G) II NoV strains. The present study pertains to the characterization of three novel intergenotype NoV GII recombinant strains. RT-PCRs were carried out for the amplification of nearly complete RdRp and complete capsid genes spanning ORF1/2 overlap of three strains followed by sequencing of the amplicons. The recombination event was confirmed by phylogenetic analysis using Bayesian MCMC approach, SimPlot analysis and Maximum chi(2) method. Three novel intergenotype (GII) recombinations of GII.b/GII.18, GII.1/GII.12 and GII.3/GII.13 specificities were identified respectively in the strains PC03, PC24 and PC25 for the first time. The breakpoint in the novel recombinants was placed in the vicinity of the 20 bp ORF1/2 overlap, a common hotspot known to exist in NoV recombinants. The capsid genes of all of the 3 recombinants were closely related to their counter parts in reference strains however, a high degree of variation emerged in the polymerase genes especially of PC24 and PC25 in comparison to the reference strains.
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Affiliation(s)
- Preeti Chhabra
- Enteric Viruses Department, National Institute of Virology, Pune, India
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Chitambar SD, Arora R, Chhabra P. Molecular characterization of a rare G1P[19] rotavirus strain from India: evidence of reassortment between human and porcine rotavirus strains. J Med Microbiol 2009; 58:1611-1615. [PMID: 19679684 DOI: 10.1099/jmm.0.012856-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study pertains to the characterization of a human rotavirus strain (NIV929893) with a rare specificity of G1P[19]. Three structural genes (VP4, VP6 and VP7) and one non-structural gene (NSP4) of strain NIV929893 were subjected to RT-PCR for amplification of entire coding regions. All of the amplicons were sequenced to carry out phylogenetic analysis. The complete amino acid sequences of the VP7 and VP4 gene products showed clustering of the VP7 gene with G1 strains of human origin and the VP4 gene with P[19] strains of porcine origin. The two viral proteins VP6 and NSP4, described previously as genetically linked proteins, were shown to be subgroup II and genotype B of human and porcine origins, respectively. The findings of this study provide evidence of reassortment between VP7/VP6 genes of humans and VP4/NSP4 genes of porcine species and an independent segregation of VP6 and NSP4 genes in a group A human rotavirus strain with G1P[19] specificity.
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Affiliation(s)
- Shobha D Chitambar
- Enteric Viruses Department, National Institute of Virology, Pune 411001, India
| | - Ritu Arora
- Enteric Viruses Department, National Institute of Virology, Pune 411001, India
| | - Preeti Chhabra
- Enteric Viruses Department, National Institute of Virology, Pune 411001, India
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