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Altawalbeh SM, Wateska AR, Nowalk MP, Lin CJ, Harrison LH, Schaffner W, Zimmerman RK, Smith KJ. Cost-effectiveness of an in-development adult-formulated 21-valent pneumococcal conjugate vaccine in US adults aged 50 years or older. Vaccine 2024; 42:3024-3032. [PMID: 38580515 DOI: 10.1016/j.vaccine.2024.04.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/07/2024]
Abstract
Indirect effects of childhood pneumococcal conjugate vaccines (PCV) have diminished the cost-effectiveness of current adult vaccine recommendations. An in-development adult-formulated 21-valent pneumococcal conjugate vaccine (PCV21) may play a critical role in reducing pneumococcal illness by targeting a larger number of serotypes responsible for adult pneumococcal infections. This study assesses the cost-effectiveness of PCV21 in US adults aged 50 years or older compared with currently recommended pneumococcal vaccines, from both the societal and healthcare perspectives. A Markov model evaluated the lifetime cost-effectiveness of PCV21 (given at age 50 years only, at ages 50/65 years, and risk-based at ages < 65 years plus age-based at age 65 years) compared to no vaccination and to currently recommended pneumococcal vaccines given either as currently recommended or routinely at ages 50/65 years. The analysis was conducted in hypothetical Black and non-Black cohorts aged 50 years or older, with and without considering childhood pneumococcal vaccination indirect effects. Model parameters were based on US data. Parameter uncertainty was assessed using 1-way and probabilistic sensitivity analyses. From the societal perspective, PCV21 at ages 50/65 years compared to PCV21 at age 50 years cost $7,410 per quality adjusted life year (QALY) gained in Black cohort analyses and $85,696/QALY gained in the non-Black cohort; PCV21 at ages 50/65 years had the most favorable public health outcomes. From the healthcare perspective, compared to no vaccination, PCV21 at age 50 years cost $46,213/QALY gained in the Black cohort and $86,629/QALY in non-Blacks. All other strategies were dominated in both cohorts and from both perspectives. When considering childhood pneumococcal vaccination indirect effects, costs of PCV21 at ages 50/65 years remained less than $140,000/QALY gained from the societal perspective in both populations. PCV21 is potentially cost-effective compared to currently approved pneumococcal vaccines in adults aged 50 years or older from both the societal and healthcare perspectives.
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Affiliation(s)
- Shoroq M Altawalbeh
- Jordan University of Science and Technology, Faculty of Pharmacy, Irbid, Jordan.
| | - Angela R Wateska
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | | | - Chyongchiou J Lin
- The Ohio State University College of Nursing, Columbus, OH, United States.
| | - Lee H Harrison
- Center for Genomic Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - William Schaffner
- Vanderbilt University School of Medicine, Nashville, TN, United States.
| | | | - Kenneth J Smith
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
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Tembo G, Mayuni M, Kamng'ona R, Chimgoneko L, Chiwala G, Sichone S, Galafa B, Thole F, Mkandawire C, Chirwa AE, Nsomba E, Nkhoma V, Ngoliwa C, Toto N, Makhaza L, Muyaya A, Kudowa E, Henrion MYR, Dula D, Morton B, Chikaonda T, Gordon SB, Jambo KC. Poor association between 13-valent pneumococcal conjugate vaccine-induced serum and mucosal antibody responses with experimental Streptococcus pneumoniae serotype 6B colonisation. Vaccine 2024; 42:2975-2982. [PMID: 38570270 PMCID: PMC11056720 DOI: 10.1016/j.vaccine.2024.03.055] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/23/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Pneumococcal carriage is the primary reservoir for transmissionand a prerequisite for invasive pneumococcal disease. Pneumococcal Conjugate Vaccine 13 (PCV13) showed a 62% efficacy in protection against experimental Streptococcus pneumoniae serotype 6B (Spn6B) carriage in a controlled human infection model (CHIM) of healthy Malawian adults. We, therefore, measured humoral responses to experimental challenge and PCV-13 vaccination and determined the association with protection against pneumococcal carriage. METHODS We vaccinated 204 young, healthy Malawian adults with PCV13 or placebo and nasally inoculated them with Spn6B at least four weeks post-vaccination to establish carriage. We collected peripheral blood and nasal lining fluid at baseline, 4 weeks post-vaccination (7 days pre-inoculation), 2, 7, 14 and > 1 year post-inoculation. We measured the concentration of anti-serotype 6B Capsular Polysaccharide (CPS) Immunoglobulin G (IgG) and IgA antibodies in serum and nasal lining fluid using the World Health Organization (WHO) standardised enzyme-linked immunosorbent assay (ELISA). RESULTS PCV13-vaccinated adults had higher serum IgG and nasal IgG/IgA anti-Spn6B CPS-specific binding antibodies than placebo recipients 4 to 6 weeks post-vaccination, which persisted for at least a year after vaccination. Nasal challenge with Spn6B did not significantly alter serum or nasal anti-CPS IgG binding antibody titers with or without experimental pneumococcal carriage. Pre-challenge titers of PCV13-induced serum IgG and nasal IgG/IgA anti-Spn6B CPS binding antibodies did not significantly differ between those that got experimentally colonised by Spn6B compared to those that did not. CONCLUSION This study demonstrates that despite high PCV13 efficacy against experimental Spn6B carriage in young, healthy Malawian adults, robust vaccine-induced systemic and mucosal anti-Spn6B CPS binding antibodies did not directly relate to protection.
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Affiliation(s)
- G Tembo
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi.
| | - M Mayuni
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - R Kamng'ona
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - L Chimgoneko
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - G Chiwala
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - S Sichone
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - B Galafa
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - F Thole
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - C Mkandawire
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - A E Chirwa
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - E Nsomba
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - V Nkhoma
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - C Ngoliwa
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - N Toto
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - L Makhaza
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - A Muyaya
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - E Kudowa
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - M Y R Henrion
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi; Liverpool School of Tropical Medicine, Clinical Sciences Department, Pembroke Place, Liverpool, UK
| | - D Dula
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - B Morton
- Liverpool School of Tropical Medicine, Clinical Sciences Department, Pembroke Place, Liverpool, UK
| | - T Chikaonda
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - S B Gordon
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi; Liverpool School of Tropical Medicine, Clinical Sciences Department, Pembroke Place, Liverpool, UK
| | - K C Jambo
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi; Liverpool School of Tropical Medicine, Clinical Sciences Department, Pembroke Place, Liverpool, UK.
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Sempere J, Yuste J. Nasopharyngeal colonization and invasive disease in Streptococcus pneumoniae: Two critical aspects of the pneumococcal pathogenesis with many similarities. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:169-171. [PMID: 38575275 DOI: 10.1016/j.eimce.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Julio Sempere
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Yuste
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
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Ríos E, Pérez M, Sanz JC, Delgado-Iribarren A, Rodríguez-Avial I. Efficacy of delafloxacin alone and in combination with cefotaxime against cefotaxime non-susceptible invasive isolates of Streptococcus pneumoniae. Rev Esp Quimioter 2024; 37:158-162. [PMID: 38226580 PMCID: PMC10945109 DOI: 10.37201/req/107.2023] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/20/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE We assessed the in vitro activity of delafloxacin and the synergy between cefotaxime and delafloxacin among cefotaxime non-susceptible invasive isolates of Streptococcus pneumoniae (CNSSP). METHODS A total of 30 CNSSP (cefotaxime MIC > 0.5 mg/L) were studied. Serotyping was performed by the Pneumotest-Latex and Quellung reaction. Minimum inhibitory concentrations (MICs) of delafloxacin, levofloxacin, penicillin, cefotaxime, erythromycin and vancomycin were determined by gradient diffusion strips (GDS). Synergistic activity of delafloxacin plus cefotaxime against clinical S. pneumoniae isolates was evaluated by the GDS cross method. RESULTS Delafloxacin showed a higher pneumococcal activity than its comparator levofloxacin (MIC50, 0.004 versus 0.75 mg/L and MIC90, 0.047 versus >32 mg/L). Resistance to delafloxacin was identified in 7/30 (23.3%) isolates, belonging to serotypes 14 and 9V. Synergy between delafloxacin and cefotaxime was detected in 2 strains (serotypes 19A and 9V). Antagonism was not observed. Addition of delafloxacin increased the activity of cefotaxime in all isolates. Delafloxacin susceptibility was restored in 5/7 (71.4%) strains. CONCLUSIONS CNSSP showed a susceptibility to delafloxacin of 76.7%. Synergistic interactions between delafloxacin and cefotaxime were observed in vitro among CNSSP by GDS cross method.
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Affiliation(s)
- E Ríos
- Esther Ríos Dueñas, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid. Plaza Ramón y Cajal, s/n 28040 Madrid, Spain.
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Shizukuishi S, Ogawa M, Kuroda E, Hamaguchi S, Sakuma C, Kakuta S, Tanida I, Uchiyama Y, Akeda Y, Ryo A, Ohnishi M. Pneumococcal sialidase promotes bacterial survival by fine-tuning of pneumolysin-mediated membrane disruption. Cell Rep 2024; 43:113962. [PMID: 38483905 DOI: 10.1016/j.celrep.2024.113962] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/24/2024] [Accepted: 02/28/2024] [Indexed: 04/02/2024] Open
Abstract
Pneumolysin (Ply) is an indispensable cholesterol-dependent cytolysin for pneumococcal infection. Although Ply-induced disruption of pneumococci-containing endosomal vesicles is a prerequisite for the evasion of endolysosomal bacterial clearance, its potent activity can be a double-edged sword, having a detrimental effect on bacterial survivability by inducing severe endosomal disruption, bactericidal autophagy, and scaffold epithelial cell death. Thus, Ply activity must be maintained at optimal levels. We develop a highly sensitive assay to monitor endosomal disruption using NanoBiT-Nanobody, which shows that the pneumococcal sialidase NanA can fine-tune Ply activity by trimming sialic acid from cell-membrane-bound glycans. In addition, oseltamivir, an influenza A virus sialidase inhibitor, promotes Ply-induced endosomal disruption and cytotoxicity by inhibiting NanA activity in vitro and greater tissue damage and bacterial clearance in vivo. Our findings provide a foundation for innovative therapeutic strategies for severe pneumococcal infections by exploiting the duality of Ply activity.
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Affiliation(s)
- Sayaka Shizukuishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan; Department of Microbiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Michinaga Ogawa
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Eisuke Kuroda
- Department of Transformative Infection Control Development Studies, Osaka University Graduate School of Medicine, Osaka, Japan; Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan
| | - Shigeto Hamaguchi
- Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan; Department of Transformative Analysis for Human Specimen, Osaka University Graduate School of Medicine, Osaka, Japan; Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan
| | - Chisato Sakuma
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Soichiro Kakuta
- Laboratory of Morphology and Image Analysis, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Cellular and Molecular Neuropathology, Research Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Isei Tanida
- Department of Cellular and Molecular Neuropathology, Research Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasuo Uchiyama
- Department of Cellular and Molecular Neuropathology, Research Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yukihiro Akeda
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan; Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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Damilakis E, Meier CR, Huber CA, Lill M, Schneider C. Assessing prescription of antibiotics after vaccination against pneumococcal pneumonia; using prescription sequence symmetry analysis. Clin Microbiol Infect 2024; 30:375-379. [PMID: 37805031 DOI: 10.1016/j.cmi.2023.10.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVES Prescription sequence symmetry analysis (PSSA) is used to detect adverse event signals using administrative claims databases. In this study, we investigated whether PSSA can be applied to gauge the effects of PCV13 vaccination on antibiotic prescription rates in elderly patients. METHODS We studied prescription records of patients aged 65 or older between 1 January 2014 and 31 December 2020, from the Helsana Swiss claims database. PSSA was performed to explore the relationship between 13-valent pneumococcal conjugate vaccine (PCV13) and six antibiotics recommended by the Swiss Society of Infectious Diseases for community-acquired pneumonia treatment (amoxicillin-clavulanate, azithromycin, clarithromycin, doxycycline, levofloxacin, and moxifloxacin), three additional antibiotics (amoxicillin, ciprofloxacin, and fosfomycin), and ten control drugs. RESULTS Amoxicillin-clavulanate, clarithromycin, and levofloxacin were more likely to be prescribed before than after vaccination, for all time windows between 25 and 104 weeks. Adjusted sequence ratio (ASR) values ranged from 0.599 to 0.614, 0.508 to 0.568, and 0.514 to 0.752, respectively. Lower prescription rates after vaccination were also observed for azithromycin (all time windows between 38 and 104 weeks, ASR 0.705-0.739) and moxifloxacin (all time windows between 52 and 104 weeks, ASR 0.658-0.772). PCV13 did not have statistically significant associations with doxycycline, amoxicillin, ciprofloxacin, fosfomycin, or any of the ten controls. DISCUSSION The lower prescription rate of antibiotics for community-acquired pneumonia after vaccination could be attributed to a protective effect of PCV13. This novel application of PSSA can be used to compare the real-world impact of other vaccines on drug consumption.
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Affiliation(s)
- Emmanouil Damilakis
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Christoph R Meier
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Carola A Huber
- Department of Health Sciences, Helsana Group, Zürich, Switzerland
| | - Markus Lill
- Division of Computational Pharmacy, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Cornelia Schneider
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
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Nanushaj D, Kono M, Sakatani H, Murakami D, Hotomi M. Nucleic acid sensing Toll-like receptors 3 and 9 play complementary roles in the development of bacteremia after nasal colonization associated with influenza co-infection. Exp Anim 2024; 73:50-60. [PMID: 37532523 PMCID: PMC10877144 DOI: 10.1538/expanim.23-0001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 07/30/2023] [Indexed: 08/04/2023] Open
Abstract
Streptococcus pneumoniae can cause mortality in infant, elderly, and immunocompromised individuals owing to invasion of bacteria to the lungs, the brain, and the blood. In building strategies against invasive infections, it is important to achieve greater understanding of how the pneumococci are able to survive in the host. Toll-like receptors (TLRs), critically important components in the innate immune system, have roles in various stages of the development of infectious diseases. Endosomal TLRs recognize nucleic acids of the pathogen, but the impact on the pneumococcal diseases of immune responses from signaling them remains unclear. To investigate their role in nasal colonization and invasive disease with/without influenza co-infection, we established a mouse model of invasive pneumococcal diseases directly developing from nasal colonization. TLR9 KO mice had bacteremia more frequently than wildtype in the pneumococcal mono-infection model, while the occurrence of bacteremia was higher among TLR3 KO mice after infection with influenza in advance of pneumococcal inoculation. All TLR KO strains showed poorer survival than wildtype after the mice had bacteremia. The specific and protective role of TLR3 and TLR9 was shown in developing bacteremia with/without influenza co-infection respectively, and all nucleic sensing TLRs would contribute equally to protecting sepsis after bacteremia.
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Affiliation(s)
- Denisa Nanushaj
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Research Building 9F, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Masamitsu Kono
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Research Building 9F, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Hideki Sakatani
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Research Building 9F, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Daichi Murakami
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Research Building 9F, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Muneki Hotomi
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Research Building 9F, 811-1 Kimiidera, Wakayama 641-8510, Japan
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Bahadori Z, Shafaghi M, Sabzevari J, Madanchi H, Ranjbar MM, Mousavi SF, Shabani AA. Design, development, and assessment of a novel multi-peptide vaccine targeting PspC, PsaA, and PhtD proteins of Streptococcus pneumoniae. Int J Biol Macromol 2024; 258:128924. [PMID: 38143051 DOI: 10.1016/j.ijbiomac.2023.128924] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Pneumococcus is the top cause of diseases such as pneumonia/meningitis, and of secondary infections after viral respiratory diseases like COVID-19/flu. Pneumococcal protein-based vaccines consisting of proteins with various functions in virulence might provide a qualified alternative for present vaccines. In this project, PspC, PsaA, and PhtD proteins were considered to anticipate B/T-cell epitopes using immunoinformatics to develop 4 multi-peptide constructs (C, A, and D individual constructs, and a fusion construct CAD). We tested whether vaccination with CAD is able to elicit more efficient protective responses against infection than vaccination with the individual constructs or combination of C + A + D. Based on the in silico results, the constructs were predicted to be antigenic, soluble, non-toxic, and stable, and also be able to provoke humoral/cellular immune reactions. When mice were immunized with the fusion protein, significantly higher levels of IgG and cytokines were induced in serum. The IgG in the fusion group had an effective bioactivity for pneumococcus clearance utilizing the complement pathway. The mice immunized with fusion protein were the most protected from challenge. This report for the first time presents a novel multi-peptide vaccine composed of immunodominant peptides of PspC, PsaA, and PhtD. In general, the experimental results supported the immunoinformatics predictions.
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Affiliation(s)
- Zohreh Bahadori
- Department of Medical Biotechnology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran; Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
| | - Mona Shafaghi
- Department of Medical Biotechnology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran; Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
| | - Jahangir Sabzevari
- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Hamid Madanchi
- Department of Medical Biotechnology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran; Drug Design and Bioinformatics Unit, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran; Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Mehdi Ranjbar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education, and Extension Organization (AREEO), Karaj, Iran
| | | | - Ali Akbar Shabani
- Department of Medical Biotechnology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
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Ideguchi S, Yamamoto K, Takazono T, Fukuda Y, Tashiro T, Shizukuishi S, Chang B, Ogawa M, Izumikawa K, Yanagihara K, Yatera K, Mukae H. Clinical features relating to pneumococcal colony phase variation in hospitalized adults with pneumonia. J Med Microbiol 2024; 73. [PMID: 38189377 DOI: 10.1099/jmm.0.001784] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Background. Streptococcus pneumoniae is a major causative bacteria of pneumonia and invasive pneumococcal disease (IPD); however, the mechanisms underlying its severity and invasion remain to be defined. Pneumococcal colonies exhibit opaque and transparent opacity phase variations, which have been associated with invasive infections and nasal colonization, respectively, in animal studies. This study evaluated the relationship between the opacity of pneumococcal colonies and the clinical presentation of pneumococcal pneumonia.Methods. This retrospective study included adult patients hospitalized with pneumococcal pneumonia between 2012 and 2019 at four tertiary medical institutions. Pneumococcal strains from lower respiratory tract specimens were determined for their serotypes and microscopic colony opacity, and the association between the opacity phase and the severity of pneumonia was evaluated. Serotypes 3 and 37 with mucoid colony phenotypes were excluded from the study because their colony morphologies were clearly different.Results. A total of 92 patients were included. Most patients were older adults (median age: 72 years) and males (67 %), and 59 % had community-acquired pneumonia. Of the 92 patients, 41 (45 %), 12 (13 %), and 39 (42 %) patients had opaque, transparent, and mixed variants in their pneumococcal colony, respectively. The opaque and non-opaque pneumococcal variants had no statistically significant difference in patient backgrounds. Although the pneumonia severity index score did not differ between the opaque and non-opaque groups, the rate of bacteremia was significantly higher in the opaque group than in the non-opaque group. Serotype distribution was similar between the groups.Conclusions. Opaque pneumococcal variants may cause pneumonia and invasive diseases in humans. This study could help elucidate IPD, and opacity assessment may serve as a predictor for IPD.
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Affiliation(s)
- Shuhei Ideguchi
- First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuko Yamamoto
- First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Takahiro Tashiro
- Department of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Sayaka Shizukuishi
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Bin Chang
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Michinaga Ogawa
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koichi Izumikawa
- Department of Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, Hospital of the University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Guzzi L, Sambade JM, Christin MD, Rodriguez Cairoli F, Rodriguez A, Vicario S, Hinojosa Del Carpio M, Molinos J, Dimitroff P. Reduction in the incidence of invasive infections caused by encapsulated bacteria after the onset of the COVID-19 pandemic. Rev Argent Microbiol 2024; 56:62-68. [PMID: 37517907 DOI: 10.1016/j.ram.2023.06.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
Interaction between severe acute respiratory coronavirus 2 (SARS-CoV-2) and IIEB remains under investigation. Objective: to compare IIEB incidence before and during COVID-19 pandemic, and assess incidence of coinfection with COVID-19 and case fatality. A cross-sectional study was performed on data from a centralized microbiology laboratory serving a network of healthcare centers comprising 713 pediatric and adult inpatient beds, expanded by 20% during the pandemic. Three periods were evaluated: (1) pre-pandemic: March 1, 2019-February 29, 2020; (2) pandemic year 1: March 1, 2020-February 28, 2021; (3) pandemic year 2: March 1, 2021-July 31, 2021. Descriptive statistical analysis was performed. 56 502 samples (96% blood cultures) from 27224 patients were analyzed. Of these, 54 samples (from 54 patients) were positive for encapsulated bacteria. IIEB incidence was: 167.4, 32.6, and 50.4 per 100000 samples for periods 1, 2, and 3, respectively. Twelve IIEB episodes occurred during the pandemic period: 10 Streptococcus pneumoniae, and 2 Haemophilus influenzae, of which 7 were SARS-CoV-2/S. pneumoniae coinfections, with an incidence of 5.68 per 10000 COVID-19-related hospitalizations (0.056%). IIEB case fatality was 31%, 29%, and 60% for each period, respectively, 3/7 patients with coinfection died (43%). Case fatality for invasive pneumococcal disease (IPD) in patients without COVID-19, was 32.5%. Significant reduction in IIEB incidence was observed during the pandemic, coinciding with implementation of containment measures. The incidence of SARS-CoV-2/S. pneumoniae coinfection was low, with higher case fatality than IPD patients without COVID-19.
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Affiliation(s)
- Leda Guzzi
- Clínica Olivos, Swiss Medical Group, Vicente López, Argentina; Sociedad Argentina de Infectología, Argentina.
| | | | | | | | - Alejandra Rodriguez
- Servicio de Microbiología Clínica, Swiss Medical Group, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Vicario
- Servicio de Microbiología Clínica, Swiss Medical Group, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Juan Molinos
- Clínica Olivos, Swiss Medical Group, Vicente López, Argentina
| | - Pablo Dimitroff
- Clínica Olivos, Swiss Medical Group, Vicente López, Argentina
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11
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Miranda BA, Freitas GJC, Leocádio VAT, Costa MC, Emídio ECP, Ribeiro NQ, Carmo PHF, Gouveia-Eufrásio L, Hubner J, Tavares LP, Arifa RDN, Brito CB, Silva MF, Teixeira MM, Paixão TA, Peres NTA, Fagundes CT, Santos DA. Secondary Streptococcus pneumoniae infection increases morbidity and mortality during murine cryptococcosis. Immunology 2024; 171:92-103. [PMID: 37814467 DOI: 10.1111/imm.13701] [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: 04/13/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
Microorganisms that cause pneumonia and translocate to the central nervous system (CNS) are responsible for high mortality worldwide. The fungus Cryptococcus gattii (Cg) and the bacteria Streptococcus pneumoniae (Sp) target the same infection organs. This study aimed to investigate the consequences of secondary Sp infection during murine cryptococcosis. Mice infected with Sp after Cg showed significantly increased lethality and a drop in scores of motor behaviour, neuropsychiatric status and autonomous function. Previous Cg infection favoured Sp multiplication in the lungs, causing intense inflammation and necrosis, with further increased bacterial translocation to the spleen, liver and brain. This phenotype was associated with increased platelet-activating factor receptor (Pafr) gene expression, reduced M1 macrophage recruitment, and high levels of proinflammatory mediators. Strategies to overcome early mortality (i.e., infection of Pafr-/- mice, treatment with IL-1 inhibitor or corticoid) were insufficient to revert this phenotype. These results suggest that Cg infection makes the lung microenvironment favourable for Sp colonization and dissemination. Altogether, it leads to an exacerbated and ineffective inflammatory response, decisive for the increased morbidity and mortality during coinfection. In conclusion, our results highlight the importance of more studies addressing coinfections and their consequences in the host, aiming to establish more effective therapeutical strategies.
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Affiliation(s)
- Bárbara A Miranda
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gustavo J C Freitas
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Victor A T Leocádio
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marliete C Costa
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Elúzia C P Emídio
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Noelly Q Ribeiro
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo H F Carmo
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ludmila Gouveia-Eufrásio
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Josy Hubner
- Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana P Tavares
- Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Raquel D N Arifa
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Camila B Brito
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Monique F Silva
- Departamento de Patologia/Laboratório de Patologia Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mauro M Teixeira
- Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tatiane A Paixão
- Departamento de Patologia/Laboratório de Patologia Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Nalu T A Peres
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Caio T Fagundes
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniel A Santos
- Departamento de Microbiologia/Laboratório de Micologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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12
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Pruis M, Yildirim M, Sandberg Y. [A woman with a purple-red nose]. Ned Tijdschr Geneeskd 2023; 168:D7917. [PMID: 38175570] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
This case concerns a 56-year-old female without medical history, who presents with a purple-red discoloration of the nose without clinical signs of sepsis. The patient rapidly deteriorates into multi-organ failure based on a pneumococcal sepsis with purpura fulminans.
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Affiliation(s)
- Melinda Pruis
- Maasstad Ziekenhuis, afd. Interne Geneeskunde, Rotterdam
- Contact: M. Pruis
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13
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Brusletto BS, Hellerud BC, Øvstebø R, Brandtzaeg P. Neisseria meningitidis accumulate in large organs during meningococcal sepsis. Front Cell Infect Microbiol 2023; 13:1298360. [PMID: 38089821 PMCID: PMC10713808 DOI: 10.3389/fcimb.2023.1298360] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Neisseria meningitidis (Nm) is the cause of epidemic meningitis and fulminant meningococcal septicemia. The clinical presentations and outcome of meningococcal septic shock is closely related to the circulating levels of lipopolysaccharides (LPS) and of Neisseria meningitidis DNA (Nm DNA). We have previously explored the distribution of Nm DNA in tissues from large organs of patients dying of meningococcal septic shock and in a porcine meningococcal septic shock model. Objective 1) To explore the feasibility of measuring LPS levels in tissues from the large organs in patients with meningococcal septic shock and in a porcine meningococcal septic shock model. 2) To evaluate the extent of contamination of non-specific LPS during the preparation of tissue samples. Patients and methods Plasma, serum, and fresh frozen (FF) tissue samples from the large organs of three patients with lethal meningococcal septic shock and two patients with lethal pneumococcal disease. Samples from a porcine meningococcal septic shock model were included. Frozen tissue samples were thawed, homogenized, and prepared for quantification of LPS by Pyrochrome® Limulus Amoebocyte Lysate (LAL) assay. Results N. meningitidis DNA and LPS was detected in FF tissue samples from large organs in all patients with meningococcal septic shock. The lungs are the organs with the highest LPS and Nm DNA concentration followed by the heart in two of the three meningococcal shock patients. Nm DNA was not detected in any plasma or tissue sample from patients with lethal pneumococcal infection. LPS was detected at a low level in all FF tissues from the two patients with lethal pneumococcal disease. The experimental porcine meningococcal septic shock model indicates that also in porcinis the highest LPS and Nm DNA concentration are detected in lungs tissue samples. The quantification analysis showed that the highest concentration of both Nm DNA and LPS are in the organs and not in the circulation of patients with lethal meningococcal septic shock. This was also shown in the experimental porcine meningococcal septic shock model. Conclusion Our results suggest that LPS can be quantified in mammalian tissues by using the LAL assay.
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Affiliation(s)
| | | | - Reidun Øvstebø
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Petter Brandtzaeg
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Pediatrics, Oslo University Hospital, Nydalen, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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14
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Vitallé J, Zenarruzabeitia O, Merino-Pérez A, Terrén I, Orrantia A, Pacho de Lucas A, Iribarren JA, García-Fraile LJ, Balsalobre L, Amo L, de Andrés B, Borrego F. Human IgM hiCD300a + B Cells Are Circulating Marginal Zone Memory B Cells That Respond to Pneumococcal Polysaccharides and Their Frequency Is Decreased in People Living with HIV. Int J Mol Sci 2023; 24:13754. [PMID: 37762055 PMCID: PMC10530418 DOI: 10.3390/ijms241813754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
CD300a is differentially expressed among B cell subsets, although its expression in immunoglobulin (Ig)M+ B cells is not well known. We identified a B cell subset expressing CD300a and high levels of IgM (IgMhiCD300a+). The results showed that IgMhiCD300a+ B cells were CD10-CD27+CD25+IgDloCD21hiCD23-CD38loCD1chi, suggesting that they are circulating marginal zone (MZ) IgM memory B cells. Regarding the immunoglobulin repertoire, IgMhiCD300a+ B cells exhibited a higher mutation rate and usage of the IgH-VDJ genes than the IgM+CD300a- counterpart. Moreover, the shorter complementarity-determining region 3 (CDR3) amino acid (AA) length from IgMhiCD300a+ B cells together with the predicted antigen experience repertoire indicates that this B cell subset has a memory phenotype. IgM memory B cells are important in T cell-independent responses. Accordingly, we demonstrate that this particular subset secretes higher amounts of IgM after stimulation with pneumococcal polysaccharides or a toll-like receptor 9 (TLR9) agonist than IgM+CD300a- cells. Finally, the frequency of IgMhiCD300a+ B cells was lower in people living with HIV-1 (PLWH) and it was inversely correlated with the years with HIV infection. Altogether, these data help to identify a memory B cell subset that contributes to T cell-independent responses to pneumococcal infections and may explain the increase in severe pneumococcal infections and the impaired responses to pneumococcal vaccination in PLWH.
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Affiliation(s)
- Joana Vitallé
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
- Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocío University Hospital, CSIC, University of Seville, 41013 Seville, Spain
| | - Olatz Zenarruzabeitia
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
| | - Aitana Merino-Pérez
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
| | - Iñigo Terrén
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
| | - Ane Orrantia
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
| | - Arantza Pacho de Lucas
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain;
- Immunology Service, Cruces University Hospital, 48903 Barakaldo, Spain
| | - José A. Iribarren
- Department of Infectious Diseases, Donostia University Hospital, Biodonostia Health Research Institute, 20014 Donostia-San Sebastián, Spain;
| | - Lucio J. García-Fraile
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department of Internal Medicine, La Princesa University Hospital, 28006 Madrid, Spain
| | - Luz Balsalobre
- Laboratory of Microbiology, UR Salud, Infanta Sofía University Hospital, 28702 Madrid, Spain;
| | - Laura Amo
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
- Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
| | - Belén de Andrés
- Immunobiology Department, Carlos III Health Institute, 28220 Madrid, Spain;
| | - Francisco Borrego
- Immunopathology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (O.Z.); (A.M.-P.); (I.T.); (A.O.); (L.A.)
- Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
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15
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Kuroda E, Koizumi Y, Piao Z, Nakayama H, Tomono K, Oishi K, Hamaguchi S, Akeda Y. Establishment of a modified opsonophagocytic killing assay for anti-pneumococcal surface protein A antibody. J Microbiol Methods 2023; 212:106804. [PMID: 37543109 DOI: 10.1016/j.mimet.2023.106804] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023]
Abstract
Streptococcus pneumoniae (pneumococcus) is a pathogenic gram-positive bacterium that causes pneumonia, meningitis, and sepsis. Pneumococcal surface protein A (PspA) induces antibodies that protect against lethal infections by pneumococci. PspA is a choline-binding protein present on the cell surface of almost all pneumococcal strains and is a non-capsular polysaccharide vaccine candidate. For research and development of PspA-based vaccines, an in-vitro test system to measure the activity of functional antibodies capable of killing pneumococci is essential. The opsonophagocytic killing (OPK) assay is used to evaluate the opsonic activity of functional antibodies induced by capsular polysaccharide (CPS)-based vaccines (standard OPK assay). Despite the potential of anti-PspA antibodies to protect against lethal infections in mice, the standard OPK assay fails to evaluate anti-PspA antibodies. Using a pneumococcal surface protein C-deficient strain and extending the incubation time of opsonized bacteria, complement, and HL-60 cells reportedly results in enhanced bactericidal activity (modified OPK assay). We aimed to measure the bactericidal activity of anti-PspA antibodies in intact pneumococcal strains. We optimized the pneumococcal culture method used in the OPK assay to increase the efficiency of anti-PspA antibody-mediated phagocytosis of HL-60 cells. As thick capsules hinder phagocytosis, we attempted to obtain pneumococci with thin capsules through an improved culture method. As pneumococci attached to cells exhibit thin capsules, pneumococci cultured in Todd Hewitt yeast extract (THY) broth were spread on blood agar plates and incubated for 4 h. cpsA mRNA transcript levels in pneumococci cultured on blood agar were lower than those in pneumococci cultured in THY broth. OPK activity against pneumococci expressing PspA of clades 1-5 was reasonably well detected using pneumococci cultured on blood agar in the modified OPK assay. The modified OPK assay for anti-PspA antibody using pneumococci cultured on blood agar represents a useful assay to determine the killing activity of functional anti-PspA antibodies against pneumococci.
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Affiliation(s)
- Eisuke Kuroda
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; Division of Infection Control and Prevention, Osaka University Hospital, Osaka University, Suita, Osaka, Japan; Department of Transformative Infection Control Development Studies, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Suita, Osaka, Japan
| | - Yuka Koizumi
- Discovery Research Department, Innovative Vaccine Research and Development Division, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
| | - Zhenyu Piao
- Biotechnology Section, Biomedical Science Center, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
| | - Hiroki Nakayama
- Discovery Research Department, Innovative Vaccine Research and Development Division, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; Division of Infection Control and Prevention, Osaka University Hospital, Osaka University, Suita, Osaka, Japan
| | | | - Shigeto Hamaguchi
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; Division of Infection Control and Prevention, Osaka University Hospital, Osaka University, Suita, Osaka, Japan; Division of Fostering Required Medical Human Resources, Center for Infectious Disease Education and Research (CiDER), Osaka University, Suita, Osaka, Japan; Department of Transformative Analysis for Human Specimen, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital, Osaka University, Suita, Osaka, Japan; Thailand-Japan Research Collaboration Centre on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
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16
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Green AE, Pottenger S, Monshi MS, Barton TE, Phelan M, Neill DR. Airway metabolic profiling during Streptococcus pneumoniae infection identifies branched chain amino acids as signatures of upper airway colonisation. PLoS Pathog 2023; 19:e1011630. [PMID: 37669280 PMCID: PMC10503754 DOI: 10.1371/journal.ppat.1011630] [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: 04/10/2023] [Revised: 09/15/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023] Open
Abstract
Streptococcus pneumoniae is a leading cause of community-acquired pneumonia and bacteraemia and is capable of remarkable phenotypic plasticity, responding rapidly to environmental change. Pneumococcus is a nasopharyngeal commensal, but is responsible for severe, acute infections following dissemination within-host. Pneumococcus is adept at utilising host resources, but the airways are compartmentalised and those resources are not evenly distributed. Challenges and opportunities in metabolite acquisition within different airway niches may contribute to the commensal-pathogen switch when pneumococcus moves from nasopharynx into lungs. We used NMR to characterise the metabolic landscape of the mouse airways, in health and during infection. Using paired nasopharynx and lung samples from naïve animals, we identified fundamental differences in metabolite bioavailability between airway niches. Pneumococcal pneumonia was associated with rapid and dramatic shifts in the lung metabolic environment, whilst nasopharyngeal carriage led to only modest change in upper airway metabolite profiles. NMR spectra derived from the nasopharynx of mice infected with closely-related pneumococcal strains that differ in their colonisation potential could be distinguished from one another using multivariate dimensionality reduction methods. The resulting models highlighted that increased branched-chain amino acid (BCAA) bioavailability in nasopharynx is a feature of infection with the high colonisation potential strain. Subsequent analysis revealed increased expression of BCAA transport genes and increased intracellular concentrations of BCAA in that same strain. Movement from upper to lower airway environments is associated with shifting challenges in metabolic resource allocation for pneumococci. Efficient biosynthesis, liberation or acquisition of BCAA is a feature of adaptation to nasopharyngeal colonisation.
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Affiliation(s)
- Angharad E. Green
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sian Pottenger
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Manal S. Monshi
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Thomas E. Barton
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Marie Phelan
- Highfield NMR Facility, Liverpool Shared Research Facilities (LIV-SRF), University of Liverpool, Liverpool, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Molecular, Systems and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Daniel R. Neill
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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17
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Zink N. Gegen Pneumokokkeninfektionen: 5 Vakzine stehen zur Verfügung. MMW Fortschr Med 2023; 165:18. [PMID: 37653298 DOI: 10.1007/s15006-023-2936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Nicola Zink
- Springer Medizin Verlag GmbH, Aschauer Str. 30, 81549, München, Germany
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18
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Li T, Huang J, Yang S, Chen J, Yao Z, Zhong M, Zhong X, Ye X. Pan-Genome-Wide Association Study of Serotype 19A Pneumococci Identifies Disease-Associated Genes. Microbiol Spectr 2023; 11:e0407322. [PMID: 37358412 PMCID: PMC10433855 DOI: 10.1128/spectrum.04073-22] [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: 10/06/2022] [Accepted: 06/04/2023] [Indexed: 06/27/2023] Open
Abstract
Despite the widespread implementation of pneumococcal vaccines, hypervirulent Streptococcus pneumoniae serotype 19A is endemic worldwide. It is still unclear whether specific genetic elements contribute to complex pathogenicity of serotype 19A isolates. We performed a large-scale pan-genome-wide association study (pan-GWAS) of 1,292 serotype 19A isolates sampled from patients with invasive disease and asymptomatic carriers. To address the underlying disease-associated genotypes, a comprehensive analysis using three methods (Scoary, a linear mixed model, and random forest) was performed to compare disease and carriage isolates to identify genes consistently associated with disease phenotype. By using three pan-GWAS methods, we found consensus on statistically significant associations between genotypes and disease phenotypes (disease or carriage), with a subset of 30 consistently significant disease-associated genes. The results of functional annotation revealed that these disease-associated genes had diverse predicted functions, including those that participated in mobile genetic elements, antibiotic resistance, virulence, and cellular metabolism. Our findings suggest the multifactorial pathogenicity nature of this hypervirulent serotype and provide important evidence for the design of novel protein-based vaccines to prevent and control pneumococcal disease. IMPORTANCE It is important to understand the genetic and pathogenic characteristics of S. pneumoniae serotype 19A, which may provide important information for the prevention and treatment of pneumococcal disease. This global large-sample pan-GWAS study has identified a subset of 30 consistently significant disease-associated genes that are involved in mobile genetic elements, antibiotic resistance, virulence, and cellular metabolism. These findings suggest the multifactorial pathogenicity nature of hypervirulent S. pneumoniae serotype 19A isolates and provide implications for the design of novel protein-based vaccines.
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Affiliation(s)
- Ting Li
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jiayin Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shimin Yang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jianyu Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhenjiang Yao
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Minghao Zhong
- Department of Prevention and Health Care, The Sixth People’s Hospital of Dongguan City, Guangdong, China
| | - Xinguang Zhong
- Department of Prevention and Health Care, The Sixth People’s Hospital of Dongguan City, Guangdong, China
| | - Xiaohua Ye
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
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19
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Echlin H, Iverson A, Sardo U, Rosch JW. Airway proteolytic control of pneumococcal competence. PLoS Pathog 2023; 19:e1011421. [PMID: 37256908 PMCID: PMC10259803 DOI: 10.1371/journal.ppat.1011421] [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: 07/07/2022] [Revised: 06/12/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
Streptococcus pneumoniae is an opportunistic pathogen that colonizes the upper respiratory tract asymptomatically and, upon invasion, can lead to severe diseases including otitis media, sinusitis, meningitis, bacteremia, and pneumonia. One of the first lines of defense against pneumococcal invasive disease is inflammation, including the recruitment of neutrophils to the site of infection. The invasive pneumococcus can be cleared through the action of serine proteases generated by neutrophils. It is less clear how serine proteases impact non-invasive pneumococcal colonization, which is the key first step to invasion and transmission. One significant aspect of pneumococcal biology and adaptation in the respiratory tract is its natural competence, which is triggered by a small peptide CSP. In this study, we investigate if serine proteases are capable of degrading CSP and the impact this has on pneumococcal competence. We found that CSP has several potential sites for trypsin-like serine protease degradation and that there were preferential cleavage sites recognized by the proteases. Digestion of CSP with two different trypsin-like serine proteases dramatically reduced competence in a dose-dependent manner. Incubation of CSP with mouse lung homogenate also reduced recombination frequency of the pneumococcus. These ex vivo experiments suggested that serine proteases in the lower respiratory tract reduce pneumococcal competence. This was subsequently confirmed measuring in vivo recombination frequencies after induction of protease production via poly (I:C) stimulation and via co-infection with influenza A virus, which dramatically lowered recombination events. These data shed light on a new mechanism by which the host can modulate pneumococcal behavior and genetic exchange via direct degradation of the competence signaling peptide.
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Affiliation(s)
- Haley Echlin
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Amy Iverson
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Ugo Sardo
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Jason W. Rosch
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
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Wang X, Zhao Y, Wang D, Liu C, Qi Z, Tang H, Liu Y, Zhang S, Cui Y, Li Y, Liu R, Shen Y. ALK-JNK signaling promotes NLRP3 inflammasome activation and pyroptosis via NEK7 during Streptococcus pneumoniae infection. Mol Immunol 2023; 157:78-90. [PMID: 37001294 DOI: 10.1016/j.molimm.2023.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023]
Abstract
Streptococcus pneumoniae (S. pneumoniae), a clinically important pathogen worldwide, causes serious invasive diseases, such as pneumonia, otitis media, and meningitis. The NLR family pyrin domain-containing 3 (NLRP3) inflammasome, an important component of the innate immune system, plays a key role in defense against pathogen infection; however the specific activation mechanism induced by S. pneumoniae infection is not fully understood. Here, primary mouse macrophages were selected as the in vitro cell model, and the effect of kinases on S. pneumoniae infection-induced NLRP3 inflammasome activation was investigated in vivo and in vitro using the western blot/RT-PCR/Co-IP/immunofluorescence staining/ELISA with or without kinase inhibitor or siRNA pretreatment. In this study, we found that the formation of the NEK7-NLRP3 complex significantly increased during S. pneumoniae infection and that anaplastic lymphoma kinase (ALK) and Jun N-terminal kinase (JNK) were phosphorylated rapidly. ALK and JNK inhibitors significantly reduced the ability of bacterial killing, the gene expression of NLRP3 inflammasome, the formation of apoptosis-associated speck-like protein containing caspase-recruitment domain (ASC) specks and the NEK7-NLRP3 complex, which in turn decreased the activation level of NLRP3 inflammasome-associated molecules and the maturation of interleukin-1β (IL-1β). In addition, ALK regulated the phosphorylation of JNK. Interestingly, the ALK/JNK/NEK7-NLRP3 signaling pathway is also involved in regulating pyroptosis and IL-1β secretion triggered by S. pneumoniae infection. In conclusion, our data suggest, for the first time, that the ALK/JNK/NEK7-NLRP3 signaling pathway may play an important role in NLRP3 inflammasome activation and pyroptosis and consequently regulate the host immune response upon S. pneumoniae infection.
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Affiliation(s)
- Xia Wang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yan Zhao
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China
| | - Dan Wang
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China
| | - Chang Liu
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou 571199, PR China
| | - Zhi Qi
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou 571199, PR China
| | - Huixin Tang
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China
| | - Yashan Liu
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China
| | - Shiqi Zhang
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China
| | - Yali Cui
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yingying Li
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan 610041, PR China.
| | - Ruiqing Liu
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China; The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, PR China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, PR China; Artificial Cell Engineering Technology Research Center, Tianjin 300170, PR China; Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, PR China.
| | - Yanna Shen
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, PR China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou 571199, PR China.
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21
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LaFon DC, Woo H, Fedarko N, Azar A, Hill H, Tebo AE, Martins TB, Han MK, Krishnan JA, Ortega VE, Barjaktarevic I, Kaner RJ, Hastie A, O'Neal WK, Couper D, Woodruff PG, Curtis JL, Hansel NN, Nahm MH, Dransfield MT, Putcha N. Reduced quantity and function of pneumococcal antibodies are associated with exacerbations of COPD in SPIROMICS. Clin Immunol 2023; 250:109324. [PMID: 37030524 PMCID: PMC10171244 DOI: 10.1016/j.clim.2023.109324] [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: 01/31/2023] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 04/10/2023]
Abstract
While hypogammaglobulinemia is associated with COPD exacerbations, it is unknown whether frequent exacerbators have specific defects in antibody production/function. We hypothesized that reduced quantity/function of serum pneumococcal antibodies correlate with exacerbation risk in the SPIROMICS cohort. We measured total pneumococcal IgG in n = 764 previously vaccinated participants with COPD. In a propensity-matched subset of n = 200 with vaccination within five years (n = 50 without exacerbations in the previous year; n = 75 with one, n = 75 with ≥2), we measured pneumococcal IgG for 23 individual serotypes, and pneumococcal antibody function for 4 serotypes. Higher total pneumococcal IgG, serotype-specific IgG (17/23 serotypes), and antibody function (3/4 serotypes) were independently associated with fewer prior exacerbations. Higher pneumococcal IgG (5/23 serotypes) predicted lower exacerbation risk in the following year. Pneumococcal antibodies are inversely associated with exacerbations, supporting the presence of immune defects in frequent exacerbators. With further study, pneumococcal antibodies may be useful biomarkers for immune dysfunction in COPD.
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Affiliation(s)
- David C LaFon
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States; UAB Lung Health Center, Birmingham, AL, United States.
| | - Han Woo
- Johns Hopkins University, Baltimore, MD, United States
| | - Neal Fedarko
- Johns Hopkins University, Baltimore, MD, United States
| | - Antoine Azar
- Johns Hopkins University, Baltimore, MD, United States
| | - Harry Hill
- Department of Pathology, University of Utah Health and ARUP Laboratories, Salt Lake City, UT, United States
| | - Anne E Tebo
- Department of Pathology, University of Utah Health and ARUP Laboratories, Salt Lake City, UT, United States; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Thomas B Martins
- Department of Pathology, University of Utah Health and ARUP Laboratories, Salt Lake City, UT, United States
| | - MeiLan K Han
- Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, United States
| | | | | | - Igor Barjaktarevic
- Pulmonary and Critical Care, University of California Los Angeles, Los Angeles, CA, United States
| | | | - Annette Hastie
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Wanda K O'Neal
- Marisco Lung Institute, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - David Couper
- University of North Carolina Department of Biostatistics, Chapel Hill, NC, United States
| | | | - Jeffrey L Curtis
- Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, United States; VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | | | - Moon H Nahm
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States; Department of Microbiology, University of Alabama at Birmingham, United States
| | - Mark T Dransfield
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States; UAB Lung Health Center, Birmingham, AL, United States; Birmingham VA Medical Center, Birmingham, AL, United States
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22
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Ganaie FA, Saad JS, Lo SW, McGee L, Bentley SD, van Tonder AJ, Hawkins P, Keenan JD, Calix JJ, Nahm MH. Discovery and Characterization of Pneumococcal Serogroup 36 Capsule Subtypes, Serotypes 36A and 36B. J Clin Microbiol 2023; 61:e0002423. [PMID: 36971549 PMCID: PMC10117043 DOI: 10.1128/jcm.00024-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/20/2023] [Indexed: 03/29/2023] Open
Abstract
Streptococcus pneumoniae can produce a wide breadth of antigenically diverse capsule types, a fact that poses a looming threat to the success of vaccines that target pneumococcal polysaccharide (PS) capsule. Yet, many pneumococcal capsule types remain undiscovered and/or uncharacterized. Prior sequence analysis of pneumococcal capsule synthesis (cps) loci suggested the existence of capsule subtypes among isolates identified as "serotype 36" according to conventional capsule typing methods. We discovered these subtypes represent two antigenically similar but distinguishable pneumococcal capsule serotypes, 36A and 36B. Biochemical analysis of their capsule PS structure reveals that both have the shared repeat unit backbone [→5)-α-d-Galf-(1→1)-d-Rib-ol-(5→P→6)-β-d-ManpNAc-(1→4)-β-d-Glcp-(1→] with two branching structures. Both serotypes have a β-d-Galp branch to Ribitol. Serotypes 36A and 36B differ by the presence of a α-d-Glcp-(1→3)-β-d-ManpNAc or α-d-Galp-(1→3)-β-d-ManpNAc branch, respectively. Comparison of the phylogenetically distant serogroup 9 and 36 cps loci, which all encode this distinguishing glycosidic bond, revealed that the incorporation of Glcp (in types 9N and 36A) versus Galp (in types 9A, 9V, 9L, and 36B) is associated with the identity of four amino acids in the cps-encoded glycosyltransferase WcjA. Identifying functional determinants of cps-encoded enzymes and their impact on capsule PS structure is key to improving the resolution and reliability of sequencing-based capsule typing methods and discovering novel capsule variants indistinguishable by conventional serotyping methods.
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Affiliation(s)
- Feroze A. Ganaie
- Department of Medicine, Division of Pulmonary/Allergy/Critical Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jamil S. Saad
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Stephanie W. Lo
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Lesley McGee
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stephen D. Bentley
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Andries J. van Tonder
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Paulina Hawkins
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jeremy D. Keenan
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Juan J. Calix
- Department of Medicine, Division of Pulmonary/Allergy/Critical Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Moon H. Nahm
- Department of Medicine, Division of Pulmonary/Allergy/Critical Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
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23
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Cho SJ, Pronko A, Yang J, Pagan K, Stout-Delgado H. Role of Cholesterol 25-Hydroxylase (Ch25h) in Mediating Innate Immune Responses to Streptococcus pneumoniae Infection. Cells 2023; 12:570. [PMID: 36831236 PMCID: PMC9953875 DOI: 10.3390/cells12040570] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
Alveolar macrophages (AM) are long-lived tissue-resident innate immune cells of the airways. AM are key effectors of recognition, initiation, and resolution of the host defense against microbes and play an essential role in mediating host responses to Streptococcus pneumoniae infection. Lipid metabolism in AM can significantly impact cellular function and biology. Dysregulated metabolism contributes to an accumulation of lipids, unfolded protein response induction, and inflammatory cytokine production. Our study was designed to investigate the impact of Ch25h on mediating innate immune responses by macrophages during S. pneumoniae infection. Using wild-type and Ch25-/- mice, we examined the role of cholesterol metabolism on inflammatory cytokine production and bacterial clearance. Our results demonstrate that Ch25h plays an important role in the initiation and intensity of cytokine and chemokine production in the lung during S. pneumoniae infection. In the absence of Ch25h, there was enhanced phagocytosis and bacterial clearance. Taken together, our findings demonstrate the important role of Ch25h in modulating host responsiveness to S. pneumoniae infection.
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24
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Zafar MA, Costa-Terryl A, Young TM. The Two-Component System YesMN Promotes Pneumococcal Host-to-Host Transmission and Regulates Genes Involved in Zinc Homeostasis. Infect Immun 2023; 91:e0037522. [PMID: 36537790 PMCID: PMC9872629 DOI: 10.1128/iai.00375-22] [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: 08/25/2022] [Accepted: 11/27/2022] [Indexed: 01/25/2023] Open
Abstract
The ability to sense and respond rapidly to the dynamic environment of the upper respiratory tract (URT) makes Streptococcus pneumoniae (Spn) a highly successful human pathogen. Two-component systems (TCSs) of Spn sense and respond to multiple signals it encounters allowing Spn to adapt and thrive in various host sites. Spn TCS have been implicated in their ability to promote pneumococcal colonization of the URT and virulence. As the disease state can be a dead-end for a pathogen, we considered whether TCS would contribute to pneumococcal transmission. Herein, we determined the role of YesMN, an understudied TCS of Spn, and observe that YesMN contributes toward pneumococcal shedding and transmission but is not essential for colonization. The YesMN regulon includes genes involved in zinc homeostasis and glycan metabolism, which are upregulated during reduced zinc availability in a YesMN-dependent fashion. Thus, we identified the YesMN regulon and a potential molecular signal it senses that lead to the activation of genes involved in zinc homeostasis and glycan metabolism. Furthermore, in contrast to Spn monoinfection, we demonstrate that YesMN is critical for high pneumococcal density in the URT during influenza A virus (IAV) coinfection. We attribute reduced colonization of the yesMN mutant possibly due to increased association with and clearance by the mucus covering the URT epithelial surface. Thus, our results highlight the dynamic interactions that occur between Spn and IAV in the URT, and the role that TCSs play in modulation of these interactions.
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Affiliation(s)
- M. Ammar Zafar
- Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Alicia Costa-Terryl
- Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Taylor M. Young
- Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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25
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Mt-Isa S, Chumbley JR, Crawford EL, Banniettis N, Buchwald UK, Weaver J, Weiss T. An indirect treatment comparison (ITC) and matching-adjusted indirect comparison (MAIC) between a 15-valent (V114) and a 20-valent (PCV20) pneumococcal conjugate vaccine among healthy infants. Expert Rev Vaccines 2023; 22:906-917. [PMID: 37846456 DOI: 10.1080/14760584.2023.2270039] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Immunogenicity between 15-valent V114 (PCV15) and 20-valent PCV20 pneumococcal conjugate vaccines in healthy infants is compared in an indirect treatment comparison and matching-adjusted indirect comparison. Hypotheses: immunogenicity of V114 is non-inferior to PCV20 for all PCV13 serotypes, and superior to PCV20 for serotype 3 based on lower bound margins. METHODS Two phase 3 pivotal studies on 3 + 1 pediatric vaccination schedule at age 2, 4, 6, and 12-15 months compared V114 (N = 858) to PCV13 (N = 856) and PCV20 (N = 1001) to PCV13 (N = 987). Infant's age and race in V114 study were matched to those in PCV20 study. Primary endpoints were serotype-specific Immunoglobulin G (IgG) response rate difference (RRD) 30 days post-dose (PD)3; IgG geometric mean concentration (GMC) ratios 30 days PD3 and PD4. RESULTS V114 was non-inferior (m a r g i n R R D >-10%-point; m a r g i n G M C r a t i o >0.5) to PCV20 (p-value <0.001) for all endpoints. V114 was superior (m a r g i n R R D >0%-point; m a r g i n G M C r a t i o >1.2) to PCV20 (p-value <0.001) for serotype 3: RRD was 34.5% (95%CI 27.9%-41.1%) PD3, and IgG GMC ratios were 2.39 (95%CI 2.12-2.68) PD3 and 2.15 (95%CI 1.90-2.41) PD4. CONCLUSION Immune response to V114 administered in a 3 + 1 schedule in healthy infants was considered non-inferior to PCV20 for all 13 PCV13 serotypes and superior for serotype 3 PD3 and PD4. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov identifiers NCT03893448, NCT04382326.
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Affiliation(s)
- Shahrul Mt-Isa
- Biostatistics and Research Decision Sciences, MSD, Zürich, Switzerland
| | - Justin R Chumbley
- Biostatistics and Research Decision Sciences, MSD, Zürich, Switzerland
| | - Emma L Crawford
- Biostatistics and Research Decision Sciences, MSD (UK) Limited, London, UK
| | | | | | - Jessica Weaver
- Center for Observational and Real-World Evidence, Merck & Co.,Inc, Rahway, NJ, USA
| | - Thomas Weiss
- Center for Observational and Real-World Evidence, Merck & Co.,Inc, Rahway, NJ, USA
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26
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Gingerich AD, Royer F, McCormick AL, Scasny A, Vidal JE, Mousa JJ. Synergistic Protection against Secondary Pneumococcal Infection by Human Monoclonal Antibodies Targeting Distinct Epitopes. J Immunol 2023; 210:50-60. [PMID: 36351696 PMCID: PMC9898123 DOI: 10.4049/jimmunol.2200349] [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] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/19/2022] [Indexed: 01/04/2023]
Abstract
Streptococcus pneumoniae persists as a leading cause of bacterial pneumonia despite the widespread use of polysaccharide-based vaccines. The limited serotype coverage of current vaccines has led to increased incidence of nonvaccine serotypes, as well as an increase in antibiotic resistance among these serotypes. Pneumococcal infection often follows a primary viral infection such as influenza virus, which hinders host defense and results in bacterial spread to the lungs. We previously isolated human monoclonal Abs (mAbs) against the conserved surface Ag pneumococcal histidine triad protein D (PhtD), and we demonstrated that mAbs to this Ag are protective against lethal pneumococcal challenge prophylactically and therapeutically. In this study, we elucidated the mechanism of protection of a protective anti-pneumococcal human mAb, PhtD3, which is mediated by the presence of complement and macrophages in a mouse model of pneumococcal infection. Treatment with mAb PhtD3 reduced blood and lung bacterial burden in mice, and mAb PhtD3 is able to bind to bacteria in the presence of the capsular polysaccharide, indicating exposure of surface PhtD on encapsulated bacteria. In a mouse model of secondary pneumococcal infection, protection mediated by mAb PhtD3 and another mAb targeting a different epitope, PhtD7, was reduced; however, robust protection was restored by combining mAb PhtD3 with mAb PhtD7, indicating a synergistic effect. Overall, these studies provide new insights into anti-pneumococcal mAb protection and demonstrate, to our knowledge, for the first time, that mAbs to pneumococcal surface proteins can protect against secondary pneumococcal infection in the mouse model.
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Affiliation(s)
- Aaron D Gingerich
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Fredejah Royer
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Anna L McCormick
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, Athens, GA
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Anna Scasny
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS; and
| | - Jorge E Vidal
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS; and
| | - Jarrod J Mousa
- Center for Vaccines and Immunology, College of Veterinary Medicine, University of Georgia, Athens, GA;
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA
- Department of Biochemistry and Molecular Biology, Franklin College of Arts and Sciences, University of Georgia, Athens, GA
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27
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Zhou ML, Wang ZR, Li YB, Kudinha T, Wang J, Wang Y, Xiao M, Xu YC, Liu ZY, Hsueh PR. Rapid identification of Streptococcus pneumoniae serotypes by cpsB gene-based sequetyping combined with multiplex PCR. J Microbiol Immunol Infect 2022; 55:870-879. [PMID: 34924338 DOI: 10.1016/j.jmii.2021.11.004] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/07/2021] [Accepted: 11/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/PURPOSE Streptococcus pneumoniae is an important human pathogen that causes invasive infections in adults and children. Accurate serotyping is important to study its epidemiological distribution and to assess vaccine efficacy. METHODS Invasive S. pneumoniae isolates (n = 300) from 27 teaching hospitals in China were studied. The Quellung reaction was used as the gold standard to identify the S. pneumoniae serotypes. Subsequently, multiplex PCR and cpsB gene-based sequetyping methods were used to identify the serotypes. RESULTS Based on the Quellung reaction, 299 S. pneumoniae isolates were accurately identified to the serotype level and 40 different serotypes were detected. Only one strain was non-typeable, and five most common serotypes were identified: 23F (43, 14.3%), 19A (41, 13.7%), 19F (41, 13.7%), 3 (31, 10.3%), and 14 (27, 9.0%). Overall, the multiplex PCR method identified 73.3 and 20.7% of the isolates to the serotype and cluster levels, respectively, with 1.7% of the isolates misidentified. In contrast, the cpsB sequetyping method identified 59.0 and 30.3% of the isolates to the serotype and cluster levels, respectively, and 7% were misidentified. CONCLUSIONS The cpsB gene sequetyping method combined with multiplex PCR, can greatly improve the accuracy and efficiency of serotyping, besides reducing the associated costs.
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Affiliation(s)
- Meng-Lan Zhou
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Zi-Ran Wang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Yan-Bing Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Timothy Kudinha
- Charles Sturt University, Leeds Parade, Orange, NSW, Australia; Regional and Rural, NSW Health Pathology, Orange Hospital, NSW 2800, Australia
| | - Jian Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yao Wang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Meng Xiao
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Ying-Chun Xu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China.
| | - Zheng-Yin Liu
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Ph.D Programme for Aging, School of Medicine, China Medical University, Taichung, Taiwan; Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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28
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Nyazika TK, Sibale L, Phiri J, De Ste Croix M, Jasiunaite Z, Mkandawire C, Malamba R, Kankwatira A, Manduwa M, Ferreira DM, Nyirenda TS, Oggioni MR, Mwandumba HC, Jambo KC. Intracellular survival of Streptococcus pneumoniae in human alveolar macrophages is augmented with HIV infection. Front Immunol 2022; 13:992659. [PMID: 36203580 PMCID: PMC9531125 DOI: 10.3389/fimmu.2022.992659] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
People Living with HIV (PLHIV) are at an increased risk of pneumococcal pneumonia than HIV-uninfected adults, but the reasons for this are still not well understood. We investigated whether alveolar macrophages (AM) mediated control of pneumococcal infection is impaired in PLHIV compared to HIV-uninfected adults. We assessed anti-bactericidal activity against Streptococcus pneumoniae of primary human AM obtained from PLHIV and HIV-uninfected adults. We found that pneumococcus survived intracellularly in AMs at least 24 hours post ex vivo infection, and this was more frequent in PLHIV than HIV-uninfected adults. Corroborating these findings, in vivo evidence showed that PLHIV had a higher propensity for harboring S. pneumoniae within their AMs than HIV-uninfected adults. Moreover, bacterial intracellular survival in AMs was associated with extracellular propagation of pneumococcal infection. Our data suggest that failure of AMs to eliminate S. pneumoniae intracellularly could contribute to the increased risk of pneumococcal pneumonia in PLHIV.
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Affiliation(s)
- Tinashe K. Nyazika
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Lusako Sibale
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Joseph Phiri
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Megan De Ste Croix
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Zydrune Jasiunaite
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Christopher Mkandawire
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Rose Malamba
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Anstead Kankwatira
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Miriam Manduwa
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Daniela M. Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Tonney S. Nyirenda
- Department of Pathology, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Marco R. Oggioni
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
- Dipartimento di Farmacia e Biotecnologie, Universita di Bologna, Bologna, Italy
| | - Henry C. Mwandumba
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kondwani C. Jambo
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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29
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Chang B, Morita M, Nariai A, Kasahara K, Kakutani A, Ogawa M, Ohnishi M, Oishi K. Invasive Streptococcus oralis Expressing Serotype 3 Pneumococcal Capsule, Japan. Emerg Infect Dis 2022; 28:1720-1722. [PMID: 35876607 PMCID: PMC9328907 DOI: 10.3201/eid2808.212176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We report 2 adult cases of invasive disease in Japan caused by Streptococcus oralis that expressed the serotype 3 pneumococcal capsule and formed mucoid colonies. Whole-genome sequencing revealed that the identical serotype 3 pneumococcal capsule locus and hyl fragment were recombined into the genomes of 2 distinct S. oralis strains.
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30
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Oehmcke-Hecht S, Maletzki C, Surabhi S, Siemens N, Khaimov V, John LM, Peter SM, Hammerschmidt S, Kreikemeyer B. Procoagulant Activity of Blood and Microvesicles Is Disturbed by Pneumococcal Pneumolysin, Which Interacts with Coagulation Factors. J Innate Immun 2022; 15:136-152. [PMID: 35843205 PMCID: PMC10643893 DOI: 10.1159/000525479] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/06/2022] [Indexed: 11/17/2023] Open
Abstract
The coagulation and contact systems are parts of the innate immune system as they prevent bleeding and dissemination of pathogens and also contribute to microbial killing by inflammatory reactions and the release of antimicrobial peptides. Here, we investigated the influence of Streptococcus pneumoniae on the coagulation and contact system. S. pneumoniae (pneumococci), but no other investigated streptococcal species, impairs coagulation of blood by autolysis and release of pneumolysin. Defective blood coagulation results from the lysis of tissue factor-producing mononuclear cells and their procoagulant microvesicles, which are the main trigger for blood coagulation during sepsis. In addition, pneumolysin binds coagulation and contact system factors, but this does not result in activation. Thus, pneumococci modulate activation of the coagulation system by releasing pneumolysin, which could potentiate lung injury during pneumonia.
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Affiliation(s)
- Sonja Oehmcke-Hecht
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
| | - Claudia Maletzki
- Department of Medicine, Clinic III-Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Surabhi Surabhi
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Nikolai Siemens
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Valeria Khaimov
- Institute for ImplantTechnology and Biomaterials e.V., Rostock, Germany
| | - Lisa Marie John
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
| | - Sina Mariella Peter
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Bernd Kreikemeyer
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
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31
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Palani S, Bansal S, Verma AK, Bauer C, Shao S, Uddin MB, Sun K. Type I IFN Signaling Is Essential for Preventing IFN-γ Hyperproduction and Subsequent Deterioration of Antibacterial Immunity during Postinfluenza Pneumococcal Infection. J Immunol 2022; 209:128-135. [PMID: 35705254 PMCID: PMC9247018 DOI: 10.4049/jimmunol.2101135] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
Postinfluenza bacterial pneumonia is a significant cause of hospitalization and death in humans. The mechanisms underlying this viral and bacterial synergy remain incompletely understood. Recent evidence indicates that influenza-induced IFNs, particularly type I IFN (IFN-I) and IFN-γ, suppress antibacterial defenses. In this study, we have investigated the relative importance and interplay of IFN-I and IFN-γ pathways in influenza-induced susceptibility to Streptococcus pneumoniae infection. Using gene-deficient mouse models, as well as in vivo blocking Abs, we show that both IFN-I and IFN-γ signaling pathways contribute to the initial suppression of antibacterial immunity; however, IFN-γ plays a dominant role in the disease deterioration, in association with increased TNF-α production and alveolar macrophage (AM) depletion. We have previously shown that IFN-γ impairs AM antibacterial function and thereby acute bacterial clearance. The findings in this study indicate that IFN-γ signaling also impairs AM viability and αβ T cell recruitment during the progression of influenza/S. pneumoniae coinfection. Macrophages insensitive to IFN-γ mice express a dominant-negative mutant IFN-γR in mononuclear phagocytes. Interestingly, macrophages insensitive to IFN-γ mice exhibited significantly improved recovery and survival from coinfection, despite delayed bacterial clearance. Importantly, we demonstrate that IFN-I receptor signaling is essential for preventing IFN-γ hyperproduction and animal death during the progression of postinfluenza pneumococcal pneumonia.
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Affiliation(s)
- Sunil Palani
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX; and
| | - Shruti Bansal
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Atul K Verma
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX; and
| | - Christopher Bauer
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Shengjun Shao
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX; and
| | - Md Bashir Uddin
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX; and
| | - Keer Sun
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX; and
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
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32
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Pike J, Leidner AJ, Chesson H, Stoecker C, Grosse SD. Data-Related Challenges in Cost-Effectiveness Analyses of Vaccines. Appl Health Econ Health Policy 2022; 20:457-465. [PMID: 35138601 PMCID: PMC9233035 DOI: 10.1007/s40258-022-00718-z] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 05/13/2023]
Abstract
Cost-effectiveness analyses (CEAs) are often prepared to quantify the expected economic value of potential vaccination strategies. Estimated outcomes and costs of vaccination strategies depend on numerous data inputs or assumptions, including estimates of vaccine efficacy and disease incidence in the absence of vaccination. Limitations in epidemiologic data can meaningfully affect both CEA estimates and the interpretation of those results by groups involved in vaccination policy decisions. Developers of CEAs should be transparent with regard to the ambiguity and uncertainty associated with epidemiologic information that is incorporated into their models. We describe selected data-related challenges to conducting CEAs for vaccination strategies, including generalizability of estimates of vaccine effectiveness, duration and functional form of vaccine protection that can change over time, indirect (herd) protection, and serotype replacement. We illustrate how CEA estimates can be sensitive to variations in specific epidemiologic assumptions, with examples from CEAs conducted for the USA that assessed vaccinations against human papillomavirus and pneumococcal disease. These challenges are certainly not limited to these two case studies and may be relevant to other vaccines.
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Affiliation(s)
- Jamison Pike
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Road NE, Atlanta, GA, 30329, USA.
| | - Andrew J Leidner
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Harrell Chesson
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA, USA
| | - Charles Stoecker
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Scott D Grosse
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
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33
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Yeraliyeva L, Issayeva A, Tanbayeva G, Katarbayev A, Tanirbergenova A, Ksetaeva G, Khadzhiyeva A. PNEUMONIA AMONG CHILDREN UNDER 1 YEAR OF AGE: ANALYSIS OF INCIDENCE AND HOSPITAL MORTALITY FROM 2010 TO 2020 IN THE REPUBLIC OF KAZAKHSTAN. Georgian Med News 2022:138-140. [PMID: 36318858] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Aim - to analyze the dynamics of morbidity and mortality from pneumonia in children under 1 year of age in the Republic of Kazakhstan for 10 years since the introduction of vaccination against pneumococcal infection in the National Immunization Schedule of the Republic of Kazakhstan in 2010. A retrospective cross-sectional study was carried out using the statistical collection of the National Scientific Center for Health Development named after S. Kairbekova from 2010 to 2020. The criterion for the study of epidemiology was the incidence of pneumonia in children under 1 year of age per 1000 children. The indicator compared with 2010 in the year, the incidence decreased by 34.0 cases, and amounted to 20.1 cases. In 2010, it was 54.1 cases. Analyzing the lethality of children from pneumonia by region, we also decided to show the top 5 regions with a high rate. This list in 2010 included Akmola (n=149.7), Turkestan (n=79.7), West Kazakhstan (n=76.9), Kostanay regions (n=66.1) and the city of Nur-Sultan (until 2019, the city of Astana) (n=69.5). The indicator for the republic in 2010 was 54.1 cases per 1,000 children. The incidence per 1000 children in 6 regions and 1 city is higher than the republican indicator. In 2020, in Kazakhstan, the incidence of pneumonia in children under 1-year-old per 1000 children was 20.1 cases. In such regions as Akmola, Turkestan, North Kazakhstan, Kostanay and Zhambyl regions, the indicators are the highest in the country. From 2010 to 2020, the incidence of pneumonia in children under 1 year of age tends to decrease in Kazakhstan, however, the city of Almaty shows a relatively high proportion of the total mortality for all diseases under 1 year of age. This work is analytical, and further work with a study of immunization of children against pneumococcal infection is required for a full study. A curve should be plotted on parental refusals to vaccinate over a given period of time.
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Affiliation(s)
- L Yeraliyeva
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan; NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
| | - A Issayeva
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan;NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
| | - G Tanbayeva
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan;NJSC "Al-Farabi Kazakh National University", Almaty, Republic of KazakhstanNJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan; NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
| | - A Katarbayev
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan; NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
| | - A Tanirbergenova
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan; NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
| | - G Ksetaeva
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan; NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
| | - A Khadzhiyeva
- NJSC "National Medical University" named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; "National Scientific Center for Phthisiopulmonology" of the Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan; NJSC "Al-Farabi Kazakh National University", Almaty, Republic of Kazakhstan
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34
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Miyashita L, Shears R, Foley G, Semple S, Kadioglu A, Grigg J. Underground railway particulate matter and susceptibility to pneumococcal infection. EBioMedicine 2022; 80:104063. [PMID: 35598440 PMCID: PMC9127572 DOI: 10.1016/j.ebiom.2022.104063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Concentrations of particulate matter less than 10 microns (PM10) on underground railways are higher than those near urban roads. Traffic-related PM10 increases pneumococcal infection via increasing the expression of platelet-activating factor receptor (PAFR), a receptor co-opted by pneumococci to adhere to cells. To date, it is unknown whether underground railway PM10 increases pneumococcal infection. This study sought to determine the effect of London Underground (LU) PM10 on; i) pneumococcal adhesion to airway cells, and ii) susceptibility to pneumococcal disease. METHODS A549 cells and human primary airway epithelial cells were cultured with 20 µg/mL PM10 from the Bakerloo (B-PM10) and Jubilee (J-PM10) line platforms of Baker Street station. PAFR expression was assessed by flow cytometry, and pneumococcal adhesion by colony forming unit (CFU) counts. Traffic-related PM10 was collected next to a main road near the station's entrance. The PAFR blocker CV3988 and the antioxidant N-acetyl cysteine were used to assess the role of PAFR-mediated pneumococcal adhesion and oxidative stress respectively. Pneumococcal infection of mice was done after exposure to 3×80 μg doses of intranasal LU-PM10. FINDINGS In A549 cells, human primary nasal cells, and human primary bronchial epithelial cells, B-PM10 and J-PM10 increased PAFR expression and pneumococcal adhesion. Stimulated adhesion was abrogated by CV3988 and N-acetyl cysteine. Traffic-related PM10 stimulated increased adhesion compared with B-PM10. B-PM10 and J-PM10 increased lung and blood CFU and mortality in mice. Treatment of B-PM10-exposed mice with CV3988 reduced blood CFU. INTERPRETATION LU-PM10 increases pneumococcal adhesion to airway cells and susceptibility to invasive disease in mice. FUNDING The Medical College of Saint Bartholomew's Hospital Trust, and the UK Medical Research Council Programme Grant (MR/P011284/1).
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Affiliation(s)
- Lisa Miyashita
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK
| | - Rebecca Shears
- The Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Gary Foley
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Scotland
| | - Aras Kadioglu
- The Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK.
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35
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Mitsi E, McLenaghan D, Wolf AS, Jones S, Collins AM, Hyder-Wright AD, Goldblatt D, Heyderman RS, Gordon SB, Ferreira DM. Thirteen-Valent Pneumococcal Conjugate Vaccine-Induced Immunoglobulin G (IgG) Responses in Serum Associated With Serotype-Specific IgG in the Lung. J Infect Dis 2022; 225:1626-1631. [PMID: 34159375 PMCID: PMC9071286 DOI: 10.1093/infdis/jiab331] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Pneumococcal conjugate vaccine (PCV) efficacy is lower for noninvasive pneumonia than invasive disease. In this study, participants were immunized with 13-valent PCV (PCV13) or hepatitis A vaccine (control). Bronchoalveolar lavage samples were taken between 2 and 6 months and serum at 4 and 7 weeks postvaccination. In the lung, anti-capsular immunoglobulin G (IgG) levels were higher in the PCV13 group compared to controls for all serotypes, except 3 and 6B. Systemically, IgG levels were elevated in the PCV13 group at 4 weeks for all serotypes, except serotype 3. IgG in bronchoalveolar lavage and serum positively correlated for nearly all serotypes. PCV13 shows poor immunogenicity to serotype 3, implying lack of protective efficacy. Clinical Trials Registration. ISRCTN 45340436.
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Affiliation(s)
- Elena Mitsi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Daniella McLenaghan
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Asia-Sophia Wolf
- National Institute for Health Research Global Health Mucosal Pathogens Research Unit, Division of Infection and Immunity, University College London, London, United Kingdom
| | - Scott Jones
- Institute of Child Health, University College London, London, United Kingdom
| | - Andrea M Collins
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Angela D Hyder-Wright
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - David Goldblatt
- Institute of Child Health, University College London, London, United Kingdom
| | - Robert S Heyderman
- National Institute for Health Research Global Health Mucosal Pathogens Research Unit, Division of Infection and Immunity, University College London, London, United Kingdom
| | - Stephen B Gordon
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | - Daniela M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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36
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Abruzzo AR, Aggarwal SD, Sharp ME, Bee GCW, Weiser JN. Serotype-Dependent Effects on the Dynamics of Pneumococcal Colonization and Implications for Transmission. mBio 2022; 13:e0015822. [PMID: 35289642 PMCID: PMC9040870 DOI: 10.1128/mbio.00158-22] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
Capsule-switch mutants were compared to analyze how serotype affects the success of Streptococcus pneumoniae (Spn) during colonization and transmission. Strains of multiple serotypes were tested in highly susceptible infant mice, both singly and in competitive assays. Our findings demonstrated a role of serotype, apart from genetic background, in competitive success of strains, but this depended on timing postinoculation. As is the case for natural carriage, there was a hierarchy of success among serotypes using capsule-switch strains. The long-term dominance of a serotype was established within the first 4 h after acquisition, suggesting an effect independent of Spn-induced host responses. The hierarchy of serotype dominance correlated with decreased clearance rather than increased growth in vivo. Competitive assays staggering the timing of challenge showed that the first strain to dominate the niche sustained its competitive advantage, potentially explaining how increased density from delayed early clearance could result in serotype-dependent success. Effector molecules of intrastrain competition (fratricide), regulated by the competence operon in a quorum-sensing mechanism, were required for early niche dominance. This suggested a winner-takes-all scenario in which serotype is a major factor in achieving early niche dominance, such that once a strain reaches a threshold density it is able to exclude competitors through fratricide. Serotype was also an important determinant of transmission dynamics, although transit to a recipient host depended on effects of serotype different from its contribution to the dominance of colonization in the donor host. IMPORTANCE Capsule is the major virulence factor and surface antigen of the opportunistic respiratory pathogen Streptococcus pneumoniae (Spn). Strains of Spn express at least 100 structurally and immunologically distinct types (serotypes) of capsule, but for unknown reasons only a few are common. The effect of serotypes during the commensal interactions of Spn and its host, colonization and transmission, was tested. This was carried out by comparing genetically modified strains differing only in serotype in infant mouse models. Results show that serotype is an important factor in a strain's success during colonization. This was attributed to the effect of serotype on early clearance of the organism in the host. Competitive factors expressed by Spn (in a mechanism referred to as fratricide) allow the strain gaining this initial advantage to then dominate the upper respiratory tract niche. Serotype also plays an important role in a strain's success during transmission from one host to another.
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Affiliation(s)
- Annie R. Abruzzo
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Surya D. Aggarwal
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Molly E. Sharp
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Gavyn Chern Wei Bee
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Jeffrey N. Weiser
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
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37
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Menghani SV, Cutcliffe MP, Sanchez-Rosario Y, Pok C, Watson A, Neubert MJ, Ochoa K, Wu HJJ, Johnson MDL. N, N-Dimethyldithiocarbamate Elicits Pneumococcal Hypersensitivity to Copper and Macrophage-Mediated Clearance. Infect Immun 2022; 90:e0059721. [PMID: 35311543 PMCID: PMC9022595 DOI: 10.1128/iai.00597-21] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/12/2022] [Indexed: 12/26/2022] Open
Abstract
Streptococcus pneumoniae is a Gram-positive, encapsulated bacterium that is a significant cause of disease burden in pediatric and elderly populations. The rise in unencapsulated disease-causing strains and antimicrobial resistance in S. pneumoniae has increased the need for developing new antimicrobial strategies. Recent work by our laboratory has identified N,N-dimethyldithiocarbamate (DMDC) as a copper-dependent antimicrobial against bacterial, fungal, and parasitic pathogens. As a bactericidal antibiotic against S. pneumoniae, DMDC's ability to work as a copper-dependent antibiotic and its ability to work in vivo warranted further investigation. Here, our group studied the mechanisms of action of DMDC under various medium and excess-metal conditions and investigated DMDC's interactions with the innate immune system in vitro and in vivo. Of note, we found that DMDC plus copper significantly increased the internal copper concentration, hydrogen peroxide stress, nitric oxide stress, and the in vitro macrophage killing efficiency and decreased capsule. Furthermore, we found that in vivo DMDC treatment increased the quantity of innate immune cells in the lung during infection. Taken together, this study provides mechanistic insights regarding DMDC's activity as an antibiotic at the host-pathogen interface.
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Affiliation(s)
- Sanjay V. Menghani
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
- Medical Scientist Training M.D.-Ph.D. Program (MSTP), University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Madeline P. Cutcliffe
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Yamil Sanchez-Rosario
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Chansorena Pok
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Alison Watson
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Miranda J. Neubert
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Klariza Ochoa
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Hsin-Jung Joyce Wu
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
- Arizona Arthritis Center, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
| | - Michael D. L. Johnson
- Department of Immunobiology, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
- Valley Fever Center for Excellence, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
- BIO5 Institute, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
- Asthma and Airway Disease Research Center, University of Arizona College of Medicine—Tucson, Tucson, Arizona, USA
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Chaguza C, Ebruke C, Senghore M, Lo SW, Tientcheu PE, Gladstone RA, Tonkin-Hill G, Cornick JE, Yang M, Worwui A, McGee L, Breiman RF, Klugman KP, Kadioglu A, Everett DB, Mackenzie G, Croucher NJ, Roca A, Kwambana-Adams BA, Antonio M, Bentley SD. Comparative Genomics of Disease and Carriage Serotype 1 Pneumococci. Genome Biol Evol 2022; 14:evac052. [PMID: 35439297 PMCID: PMC9048925 DOI: 10.1093/gbe/evac052] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/14/2022] Open
Abstract
The isolation of Streptococcus pneumoniae serotypes in systemic tissues of patients with invasive disease versus the nasopharynx of healthy individuals with asymptomatic carriage varies widely. Some serotypes are hyper-invasive, particularly serotype 1, but the underlying genetics remain poorly understood due to the rarity of carriage isolates, reducing the power of comparison with invasive isolates. Here, we use a well-controlled genome-wide association study to search for genetic variation associated with invasiveness of serotype 1 pneumococci from a serotype 1 endemic setting in Africa. We found no consensus evidence that certain genomic variation is overrepresented among isolates from patients with invasive disease than asymptomatic carriage. Overall, the genomic variation explained negligible phenotypic variability, suggesting a minimal effect on the disease status. Furthermore, changes in lineage distribution were seen with lineages replacing each other over time, highlighting the importance of continued pathogen surveillance. Our findings suggest that the hyper-invasiveness is an intrinsic property of the serotype 1 strains, not specific for a "disease-associated" subpopulation disproportionately harboring unique genomic variation.
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Affiliation(s)
- Chrispin Chaguza
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Darwin College, University of Cambridge, Silver Street, Cambridge, UK
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Chinelo Ebruke
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Madikay Senghore
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie W. Lo
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Peggy-Estelle Tientcheu
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rebecca A. Gladstone
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Department of Biostatistics, University of Oslo, Oslo, Norway
| | - Gerry Tonkin-Hill
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Jennifer E. Cornick
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Marie Yang
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Archibald Worwui
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Lesley McGee
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert F. Breiman
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Keith P. Klugman
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aras Kadioglu
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Dean B. Everett
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
| | - Grant Mackenzie
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Murdoch Children’s Research Institute, Parkville, Melbourne, VIC, Australia
- London School of Hygiene & Tropical Medicine, London, UK
| | - Nicholas J. Croucher
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Anna Roca
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- London School of Hygiene & Tropical Medicine, London, UK
| | - Brenda A. Kwambana-Adams
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, UK
| | - Martin Antonio
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- London School of Hygiene & Tropical Medicine, London, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Stephen D. Bentley
- Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
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Nahm MH, Yu J, Calix JJ, Ganaie F. Ficolin-2 Lectin Complement Pathway Mediates Capsule-Specific Innate Immunity Against Invasive Pneumococcal Disease. Front Immunol 2022; 13:841062. [PMID: 35418983 PMCID: PMC8996173 DOI: 10.3389/fimmu.2022.841062] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Reports conflict regarding which lectin-microbial ligand interactions elicit a protective response from the lectin pathway (LP) of complement. Using fluorescent microscopy, we demonstrate the human lectin ficolin-2 binds to Streptococcus pneumoniae serotype 11A capsule polysaccharide dependent on the O-acetyltransferase gene wcjE. This triggers complement deposition and promotes opsonophagocytosis of encapsulated pneumococci. Even partial loss of ficolin-2 ligand expression through wcjE mutation abrogated bacterial killing. Ficolin-2 did not interact with any pneumococcal non-capsule structures, including teichoic acid. We describe multiple 11A clonal derivatives expressing varying degrees of wcjE-dependent epitopes co-isolated from single blood specimens, likely representing microevolutionary shifts towards wcjE-deficient populations during invasive pneumococcal disease (IPD). We find epidemiological evidence of wcjE impairing pneumococcal invasiveness, supporting that the LP's ficolin-2 axis provides innate, serotype-specific serological protection against IPD. The fact that the LP is triggered by only a few discrete carbohydrate ligands emphasizes the need to reevaluate its impact in a glycopolymer-specific manner.
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Affiliation(s)
- Moon H. Nahm
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jigui Yu
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Juan J. Calix
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Feroze Ganaie
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Stevens JP, Lively A, Jerris R, Yildirim I, Lantis P. Recognition and Outcomes of Pneumococcal Meningitis in 2 Tertiary Pediatric Hospitals Since the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine. Pediatr Emerg Care 2022; 38:e354-e359. [PMID: 33181795 DOI: 10.1097/pec.0000000000002288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aims of the study were to analyze the demographics, presentation, laboratory findings, and complications of pediatric Streptococcus pneumoniae meningitis since the introduction of the 13-valent pneumococcal conjugate vaccine, to improve recognition, and to minimize patient morbidity and mortality. METHODS This study used a retrospective analysis of pediatric pneumococcal meningitis cases at 2 tertiary healthcare systems in the Southeastern United States from 2010 to 2018. RESULTS We describe 21 cases of pneumococcal meningitis. All patients presented with fever, 95% had altered mental status by history or examination, and 48% had meningeal signs. Forty-three percent had seen another provider within 48 hours of admission. Forty-eight percent had delay in lumbar puncture (LP) of more than 6 hours after antibiotic administration, decreasing rates of positive cerebrospinal fluid cultures from 100% to 40% (P < 0.001). Decision to delay LP was due to either low suspicion for meningitis (n = 4) or clinical instability (n = 6) and was associated with lower rates of meningeal signs (P = 0.014) and higher rates of altered mental status on examination (P = 0.031). Fourteen patients (67%) were up-to-date on pneumococcal immunization. Serotypes were determined in 16 cases, with 2 patients (13%) immunized against the strain that infected them. Primary outcomes included seizures (48%), hearing loss (48%), cranial nerve palsy (33%), and death (5%). Delay in LP with low suspicion for meningitis was associated with longer hospital length of stay approaching statistical significance (P = 0.053). CONCLUSIONS Pneumococcal meningitis remains a relevant and potentially fatal disease despite widespread use of 13-valent pneumococcal conjugate vaccine. Its diagnosis is often delayed during interactions with physicians, which may put patients at increased risk for poor clinical outcomes.
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Zhu X, Li X. Pneumococcal vaccine effect on hospitalisation rates of pneumonia in children: A meta-analysis. Int J Clin Pract 2021; 75:e14739. [PMID: 34388857 DOI: 10.1111/ijcp.14739] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/28/2021] [Accepted: 06/27/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Since the appearance of the pneumococcal conjugate vaccine, the frequency of community-acquired pneumonia hospitalisations was decreased significantly especially in children below the age of 2 years, but its effects are still conflicting. This meta-analysis study was performed to assess the relationship between the effects of different types of pneumococcal conjugate vaccines compared with each other on the frequency of community-acquired pneumonia hospitalisations in children aged below 2 years. METHODS Through a systematic literature search up to December 2020, 20 studies were found recording relationships between the effects of different types of pneumococcal conjugate vaccines compared with each other on the frequency of community-acquired pneumonia hospitalisations in children aged below 2 years. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated between different types of pneumococcal conjugate vaccines compared with each other on the frequency of community-acquired pneumonia hospitalisations in children below the age of 2 years using the dichotomous methods with a random or fixed-effect model. RESULTS The pneumococcal conjugate vaccine 10 was significantly related to a lower hospitalisation rate for pneumonia (OR, 0.64; 95% CI, 0.51-0.81, P < .001) compared with no vaccine and (OR, 0.78; 95% CI, 0.68-0.90, P < .001) compared with pneumococcal conjugate vaccine 7. The pneumococcal conjugate vaccine 13 was significantly related to a lower hospitalisation rate for pneumonia (OR, 0.63; 95% CI, 0.56-0.71, P < .001) compared with no vaccine and (OR, 0.56; 95% CI, 0.36-0.89, P = .01) compared with pneumococcal conjugate vaccine 7. The pneumococcal conjugate vaccine 13 was significantly related to a lower hospitalisation rate for pneumonia (OR, 0.67; 95% CI, 0.48-0.93, P = .02) compared with pneumococcal conjugate vaccine 10. CONCLUSIONS The pneumococcal conjugate vaccines 10 or 13 may have independent relationships in reducing the frequency of community-acquired pneumonia hospitalisations in children aged below 2 years compared with no vaccine or pneumococcal conjugate vaccines 7. Also, the pneumococcal conjugate vaccine 13 may have the same independent relationship compared with pneumococcal conjugate vaccines 10. Further studies are needed to solidify the findings to other vaccines to have evidence-based information that could help in establishing future immunisation strategies.
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Affiliation(s)
- Xiuling Zhu
- Department of Pediatrics, Yiwu Central Hospital, Zhejiang, China
| | - Xiaofei Li
- Department of Infectious Diseases, Yiwu Central Hospital, Zhejiang, China
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Cassir N, Luciani L, Ferrieux D, Levasseur A, Fournier PE, Parola P. Pneumococcal pneumonia among shipyard workers: Inside the features of disease onset. Travel Med Infect Dis 2021; 44:102183. [PMID: 34688890 DOI: 10.1016/j.tmaid.2021.102183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 09/21/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Several outbreaks of pneumococcal pneumonia among shipyard workers have been described. In this study, following a previous report of grouped cases, we aimed to elucidate the features of disease onset. METHODS We compared the population characteristics of shipyard workers with a confirmed diagnosis of pneumococcal pneumonia (N = 38) to those of workers without pneumonia (N = 53). We compared nine S. pneumoniae strains isolated from patients with pneumonia by capsular serotyping, multi-locus sequence typing, and whole genome sequencing. RESULTS Shipyard workers with Streptococcus pneumoniae pneumonia were more frequently from Italy (P = 0.016), had at least one underlying condition (P = 0.024), lived on-board the ship (P = 0.009). None of these factors was independent by multivariate analysis. While capsular serotyping enabled us to identify four different serotypes: 4 (n = 5), 8 (n = 2), 9 N (n = 1), and 3 (n = 1), by sequence typing, we distinguished five sequence types (STs): ST801 (n = 4), ST205 (n = 2), ST1220 (n = 1), ST1280 (n = 1), and ST66 (n = 1). Whole genome sequencing confirmed the results obtained by MLST. Genomes of isolates of the same sequence type were similar with ≤80 single-nucleotide polymorphisms. CONCLUSIONS We confirmed that the onset of pneumococcal infection among shipyard workers was attributable to both a person-to-person spread of single strains of S. pneumoniae and a shift of different strains from commensal to pathogen under favourable conditions (professional exposure, viral infections). Control measures should therefore be implemented by taking into account these features.
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Affiliation(s)
- Nadim Cassir
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France.
| | - Léa Luciani
- IHU-Méditerranée Infection, Marseille, France
| | | | - Anthony Levasseur
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Pierre-Edouard Fournier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ IRD, AP-HM, VITROME, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ IRD, AP-HM, VITROME, Marseille, France
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Foran C, Lapthorne S, Faller E, Sadlier C. Importance of vaccination for disease prevention in post-splenectomy patients. BMJ Case Rep 2021; 14:e243283. [PMID: 34625437 PMCID: PMC8504173 DOI: 10.1136/bcr-2021-243283] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/04/2022] Open
Abstract
A fit middle aged man presented to the emergency department with headache, myalgia, vomiting, fever and rigours. He was hypotensive with mottled peripheries, tachycardic and dyspnoeic. The only significant medical history noted was an emergency splenectomy 30 years previously following a road traffic accident. The patient had been on prophylactic antibiotics initially and was vaccinated in line with recommendations at the time following splenectomy with no significant health issues in the intervening years. The patient was treated empirically for septic shock and meningitis based on presentation and admitted to the intensive care unit for pressor support and subsequently required intubation and ventilation. Investigations revealed bilateral pneumonia. Streptococcal pneumoniae urinary antigen and serum S. pneumoniae PCR were positive supporting a diagnosis of invasive pneumococcal infection. A lumbar puncture was negative for meningitis. Distal mottling affecting all limbs progressed with resultant bilateral upper limb digit and below knee amputation. The patient subsequently required extensive rehabilitation. Following a prolonged tertiary and rehabilitation hospital admission, the patient made an exceptional recovery and was discharged home with ongoing appropriate support and home adaptation.
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Affiliation(s)
- Claire Foran
- Department of Medicine, Cork University Hospital, Cork, Ireland
| | - Susan Lapthorne
- Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
| | - Eamonn Faller
- Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
| | - Corinna Sadlier
- Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
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Wall N, Godlee A, Geh D, Jones C, Faustini S, Harvey R, Penn R, Chanouzas D, Nightingale P, O’Shea M, Richter A, Moss P, Cunningham A, Harper L. Latent Cytomegalovirus Infection and Previous Capsular Polysaccharide Vaccination Predict Poor Vaccine Responses in Older Adults, Independent of Chronic Kidney Disease. Clin Infect Dis 2021; 73:e880-e889. [PMID: 33728434 PMCID: PMC8366832 DOI: 10.1093/cid/ciab078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) are more prone to severe infection. Vaccination is a key strategy to reduce this risk. Some studies suggest vaccine efficacy may be reduced in patients with CKD, despite preserved maintenance of long-term responses to some pathogens and vaccines. Here, we investigated immune responses to 2 vaccines in patients with CKD to identify predictors of immunological responsiveness. METHODS Individuals >65 years old, with or without nondialysis CKD (n = 36 and 29, respectively), were vaccinated with a nonadjuvanted seasonal influenza vaccine (T-dependent) and Pneumovax23 (23-valent pneumococcal polysaccharide [PPV23], T-independent). Humoral responses were measured at baseline, day 28, and 6 months. Lymphocyte subset and plasma cell/blast analyses were performed using flow cytometry. Cytomegalovirus (CMV) serotyping was assessed by enzyme-linked immunosorbent assay. RESULTS Only modest responsiveness was observed to both vaccines, independent of CKD status (25% adequate response in controls vs. 12%-18% in the CKD group). Unexpectedly, previous immunization with PPV23 (median 10-year interval) and CMV seropositivity were associated with poor PPV23 responsiveness in both study groups (P < .001 and .003, respectively; multivariable linear regression model). Patients with CKD displayed expanded circulating populations of T helper 2 and regulatory T cells, which were unrelated to vaccine responses. Despite fewer circulating B cells, patients with CKD were able to mount a similar day 7 plasma cell/blast response to controls. CONCLUSION Patients with nondialysis CKD can respond similarly to vaccines as age- and sex-matched healthy individuals. CKD patients display an immune signature that is independent of vaccine responsiveness. Prior PPV23 immunization and CMV infection may influence responsiveness to vaccination. Clinical Trials Registration. NCT02535052.
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Affiliation(s)
- Nadezhda Wall
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Alexandra Godlee
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Daniel Geh
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Charlotte Jones
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Sian Faustini
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Ruth Harvey
- National Institute for Biological Standards and Control, Potters Bar, UK
| | - Rebecca Penn
- National Institute for Biological Standards and Control, Potters Bar, UK
| | - Dimitrios Chanouzas
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Peter Nightingale
- Institute Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Matthew O’Shea
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Alex Richter
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Adam Cunningham
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Lorraine Harper
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
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Wasserman M, Chapman R, Lapidot R, Sutton K, Dillon-Murphy D, Patel S, Chilson E, Snow V, Farkouh R, Pelton S. Twenty-Year Public Health Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines in US Children. Emerg Infect Dis 2021; 27:1627-1636. [PMID: 34013855 PMCID: PMC8153862 DOI: 10.3201/eid2706.204238] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Pneumococcal conjugate vaccines (PCVs) have been used in the United States since 2000. To assess the cumulative 20-year effect of PCVs on invasive pneumococcal disease (IPD) incidence among children <5 years of age, we analyzed Active Bacterial Core Surveillance data, conducted a literature review, and modeled expected and observed disease. We found that PCVs have averted >282,000 cases of IPD, including ≈16,000 meningitis, ≈172,000 bacteremia, and ≈55,000 bacteremic pneumonia cases. In addition, vaccination has prevented 97 million healthcare visits for otitis media, 438,914-706,345 hospitalizations for pneumonia, and 2,780 total deaths. IPD cases declined 91%, from 15,707 in 1997 to 1,382 in 2019. Average annual visits for otitis media declined 41%, from 78 visits/100 children before PCV introduction to 46 visits/100 children after PCV13 introduction. Annual pneumonia hospitalizations declined 66%-79%, from 110,000-175,000 in 1997 to 37,000 in 2019. These findings confirm the substantial benefits of PCVs for preventing IPD in children.
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Erhabor GE, Olowookere OO, Adebusoye LA, Arawomo AO. Adult Pneumococcal Vaccination: A Review of Current Status and Challenges in Nigeria. West Afr J Med 2021; 38:583-595. [PMID: 34180212] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Pneumococcus is a major cause of life-threatening invasive infections accounting for considerable morbidity and mortality among older adult population. The burden of pneumococcal infections (non-invasive) is mostly determined by Community Acquired Pneumonia. Globally and from public health perspective, vaccination has been recognised as a preventive measure of infectious diseases, thereby reducing health care cost, morbidity and mortality. Most high-income countries have included the pneumococcal vaccination in their mandatory and voluntary vaccination policies. However, many low and middleincome countries of the world have not adequately addressed the issue of adult pneumococcal vaccine. This overview describes the current status of pneumococcal vaccination and strategies to reduce the rate of pneumonia in this age group. Our aim is to stimulate the adoption of policies and production of national guidelines for the use of pneumococcal vaccines in Sub-Saharan Africa.
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Affiliation(s)
- G E Erhabor
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - O O Olowookere
- Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Oyo State, Nigeria
| | - L A Adebusoye
- Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Oyo State, Nigeria
| | - A O Arawomo
- Department of Medicine, UniOsun Teaching Hospital, Osogbo, Osun State, Nigeria
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Mannino Avila E, Stucky Fisher E, Rhee K. True Versus False Bacteremia in Infants and Children Less Than 3 Years of Age. Pediatr Emerg Care 2021; 37:e307-e312. [PMID: 30106869 DOI: 10.1097/pec.0000000000001585] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to examine patient history as well as clinical and laboratory features associated with true bacteremia versus false bacteremia in previously healthy febrile children ages 0 to 36 months in the era of polyvalent conjugate pneumococcal immunization. METHODS Using retrospective chart review, we examined history, physical examination, and laboratory characteristics associated with true and false bacteremia. We included subjects under 3 years old, with a positive blood culture obtained in the emergency department or clinic from July 2011 to July 2013, and fever defined as a temperature of greater than or equal to 100.4°F by history or examination. We excluded those with a previously known underlying disease process that could increase the risk for positive blood culture, for example, immunodeficiency, cancer, cystic fibrosis, or significant skin disorders such as severe eczema, as well as patients with any indwelling central line, shunt, or other implanted device, or recent hospitalization for a febrile illness. RESULTS Thirty subjects (24%) had true bacteremia, and 97 (76%) had false bacteremia. In the multivariable logistic regression analysis, exposure to sick contacts (odds ratio, 0.1; 95% confidence interval, 0.01-0.6; P = 0.01) and increased hours to positive blood culture (odds ratio, 0.8; 95% confidence interval, 0.8-0.9; P < 0.001) remained significant factors associated with false bacteremia. Age, maximum reported temperature, and reported days of fever were not associated with true bacteremia. CONCLUSIONS We found that previously healthy children with true bacteremia are more likely to grow bacteria faster on blood culture and lack exposure to sick contacts than children with false bacteremia.
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Affiliation(s)
| | | | - Kyung Rhee
- Division of Academic General Pediatrics, San Diego/Rady Children's Hospital San Diego, University of California, San Diego, CA
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48
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Weight CM, Jochems SP, Adler H, Ferreira DM, Brown JS, Heyderman RS. Insights Into the Effects of Mucosal Epithelial and Innate Immune Dysfunction in Older People on Host Interactions With Streptococcus pneumoniae. Front Cell Infect Microbiol 2021; 11:651474. [PMID: 34113578 PMCID: PMC8185287 DOI: 10.3389/fcimb.2021.651474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/10/2021] [Indexed: 12/21/2022] Open
Abstract
In humans, nasopharyngeal carriage of Streptococcus pneumoniae is common and although primarily asymptomatic, is a pre-requisite for pneumonia and invasive pneumococcal disease (IPD). Together, these kill over 500,000 people over the age of 70 years worldwide every year. Pneumococcal conjugate vaccines have been largely successful in reducing IPD in young children and have had considerable indirect impact in protection of older people in industrialized country settings (herd immunity). However, serotype replacement continues to threaten vulnerable populations, particularly older people in whom direct vaccine efficacy is reduced. The early control of pneumococcal colonization at the mucosal surface is mediated through a complex array of epithelial and innate immune cell interactions. Older people often display a state of chronic inflammation, which is associated with an increased mortality risk and has been termed 'Inflammageing'. In this review, we discuss the contribution of an altered microbiome, the impact of inflammageing on human epithelial and innate immunity to S. pneumoniae, and how the resulting dysregulation may affect the outcome of pneumococcal infection in older individuals. We describe the impact of the pneumococcal vaccine and highlight potential research approaches which may improve our understanding of respiratory mucosal immunity during pneumococcal colonization in older individuals.
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Affiliation(s)
- Caroline M. Weight
- Research Department of Infection, Division of Infection and Immunity, University College London, London, United Kingdom
| | - Simon P. Jochems
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Hugh Adler
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals National Health Service (NHS) Foundation Trust, Liverpool, United Kingdom
| | - Daniela M. Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jeremy S. Brown
- Respiratory Medicine, University College London, London, United Kingdom
| | - Robert S. Heyderman
- Research Department of Infection, Division of Infection and Immunity, University College London, London, United Kingdom
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Abstract
We discovered 3 invasive, multidrug-resistant Streptococcus pneumoniae isolates of vaccine-refractory capsular serotype 3 that recently arose within the successful sequence type 271 complex through a serotype switch recombination event. Mapping genomic recombination sites within the serotype 3/sequence type 271 progeny revealed a 55.9-kb donated fragment that encompassed cps3, pbp1a, and additional virulence factors.
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Rana MS, Usman M, Alam MM, Mere MO, Ikram A, Zaidi SSZ, Salman M, Sharif S, Umair M, Khurshid A, Mujtaba G. Impact of COVID-19 pandemic on Measles surveillance in Pakistan. J Infect 2021; 82:414-451. [PMID: 33039503 PMCID: PMC7543746 DOI: 10.1016/j.jinf.2020.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Muhammad Suleman Rana
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan.
| | - Muhammad Usman
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Muhammad Masroor Alam
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Mohammad Osama Mere
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Aamer Ikram
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Syed Sohail Zahoor Zaidi
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Muhammad Salman
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Salman Sharif
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Massab Umair
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Adnan Khurshid
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
| | - Ghulam Mujtaba
- Department of Virology, National Institute of Health, Park Road, Chak Shehzad, Islamabad 45500, Pakistan
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