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Evaluation of the effect of melatonin on patients with COVID-19 admitted to ICU: A double-blind randomized clinical trial 褪黑素对新冠肺炎ICU住院患者疗效的评价:一项双盲随机临床试验
Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI: 10.1016/j.vacune.2025.100377
Mahmoud Ganjifard , Shokouh Ghafari , Adeleh Sahebnasagh , Mahboubeh Esmaeili , Ali Reza Amirabadizadeh , Azadeh Ebrahimzadeh , Parvin Askari , Razieh Avan

Introduction and objectives

This research aims to examine the efficacy of melatonin as an adjuvant therapeutic agent for COVID-19 patients in the intensive care unit.

Methods

A randomized, double-blind, placebo-controlled investigation was conducted on a group of hospitalized COVID-19 patients. Individuals were allocated into 2 groups: one group received a combination of 18 mg of melatonin and standard treatment for 14 days; the other group received a placebo in addition to standard treatment. Patients were evaluated at the beginning of the study as well as the 7th and 15th days to analyze changes in clinical symptoms, P/F ratio, and inflammatory markers.

Results

The study included patients with an average age of 57.80 ± 17.96 years, with an equal gender representation. The average length of hospital stay was 19.83 ± 4.45 days. Hypertension and diabetes were commonly observed comorbidities. There were no significant differences in the demographic characteristics between the 2 groups (P > .05). Additionally, there were no significant distinctions between the 2 groups in terms of clinical symptom improvement, mortality rate, adverse effects, and various blood markers (P > .05).

Conclusion

Our study's findings suggested that melatonin is unlikely to significantly affect the clinical status of COVID-19 patients.
本研究旨在探讨褪黑素作为辅助治疗剂对重症监护病房COVID-19患者的疗效。方法采用随机、双盲、安慰剂对照的方法对1组新冠肺炎住院患者进行调查。个体被分为两组:一组接受18 毫克褪黑激素和14 天的标准治疗;另一组在标准治疗的基础上接受安慰剂治疗。在研究开始时以及第7天和第15天对患者进行评估,以分析临床症状、P/F比率和炎症标志物的变化。结果入组患者平均年龄57.80±17.96 岁,性别平等。平均住院时间为19.83±4.45 d。高血压和糖尿病是常见的合并症。两组患者人口学特征差异无统计学意义(P >;. 05)。此外,两组在临床症状改善、死亡率、不良反应和各种血液标志物方面无显著差异(P >;. 05)。结论本研究结果提示,褪黑素对COVID-19患者的临床状态影响不大。
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引用次数: 0
The growing threat of monkeypox and the urgent need for vaccination in Pakistan 猴痘的威胁日益严重,巴基斯坦迫切需要接种疫苗
Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI: 10.1016/j.vacune.2025.100378
Alisha Saleem , Ashar Masood Khan , Danish Faheem , Bina Fawad
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引用次数: 0
The new genetically attenuated vaccines against poliomyelitis virus 抗脊髓灰质炎病毒的新型基因减毒疫苗
Pub Date : 2025-01-01 Epub Date: 2025-03-18 DOI: 10.1016/j.vacune.2025.100381
Jordi Reina , Julia Viana-Ramírez
There are two types of vaccines available against polio virus: the inactivated (Salk, IPV) and the oral/attenuated (Sabin, OPV). Live vaccines are highly effective in inducing protective immunity against certain infections, also favoring the cessation of their epidemic spread. There are three wild serotypes of the polio virus, however currently two of them, serotype 2 and 3, are considered eradicated so that the only one that still circulates in endemic countries is serotype 1. One of the problems of OPV, which cannot occur with IPV, is its possible reversion to the wild form, circulating as vaccinal poliovirus (cOPV) and its transmission to unvaccinated people, giving rise to paralytic processes associated with the vaccine. To avoid this phenomenon, new oral polio vaccines (nOPV-c1) with greater safety and less reversion have been developed by modifying and introducing a series of genetic modifications in the RNA of the virus. Different studies have shown that children who received OPV2-c1 presented a higher degree of attenuation and thermostability and a highly significant decrease in the ability to affect the nervous system and develop severe neurovirulence and possible post-vaccination polio. These studies establish the pathogenic and molecular bases in the most vulnerable child population that allowed the use of this new genetically attenuated vaccine in population vaccination campaigns.
现有两种脊髓灰质炎病毒疫苗:灭活疫苗(Salk, IPV)和口服/减毒疫苗(Sabin, OPV)。活疫苗在诱导对某些感染的保护性免疫方面非常有效,也有利于停止其流行传播。脊髓灰质炎病毒有三种野生血清型,但目前认为其中两种,即血清2型和血清3型已被根除,因此在流行国家仍在传播的唯一血清1型病毒。口服脊髓灰质炎的问题之一是,它可能恢复为野生形式,作为疫苗脊髓灰质炎病毒(cOPV)传播,并传播给未接种疫苗的人,导致与疫苗相关的瘫痪过程。为了避免这种现象,通过对病毒RNA进行修改和引入一系列遗传修饰,开发出了安全性更高、逆转程度更低的新型口服脊髓灰质炎疫苗(nOPV-c1)。不同的研究表明,接种OPV2-c1的儿童表现出更高程度的衰减和热稳定性,并且影响神经系统和发生严重神经毒力和可能的疫苗接种后脊髓灰质炎的能力显著下降。这些研究确定了最脆弱儿童人群的致病和分子基础,使这种新的基因减毒疫苗能够在人群疫苗接种运动中使用。
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引用次数: 0
Monitoring of hepatitis B infection in the elderly population of eastern Iran 伊朗东部老年人群乙型肝炎感染监测
Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI: 10.1016/j.vacune.2025.100373
Abdol Sattar Pagheh , Effat Alemzadeh , Eisa Nazar , Mitra Moodi , Farshad Sharifi , Ebrahim Miri-Moghaddam , Mohamad Taghi Rahimi , Soroush Mohammadi , Masood Ziaee

Objectives

This study aimed to investigate the prevalence of HBV infection and its associated risk factors in the elderly in Birjand.

Materials and methods

The present study was a part of the community-based prospective cohort study. Subjects over 60 years of age were assessed using standard questionnaires and blood factors. The samples were tested for HBsAg by enzyme-linked immunosorbent assay.

Results

Of 542 elderly people living in Birjand, 11 cases (2.03%) were positive. The median age of patients with HBsAg positive and negative was 69 (IQR: 63–77) years and 67 (IQR: 63–74) years, respectively. The results of the multiple logistic regression model showed that fatty liver disease was significantly associated with having hepatitis B (AOR (95% CI)=5.50 (1.16, 25.88)) (p < .05). However, there was no significant relationship found between variables age, sex, marital status, years of study, underlying diseases, body mass index, smoking, and blood factors with having hepatitis B (p > .05).

Conclusions

Even though there were only a few positive cases, leading to a non-significant report, it is crucial to emphasize the clinical significance and health and well-being of elderly individuals contracting hepatitis B. This information can be valuable in devising suitable disease management strategies for this age group.
目的调查英国老年人HBV感染的流行情况及其相关危险因素。材料和方法本研究是社区前瞻性队列研究的一部分。60岁以上 岁的受试者使用标准问卷和血液因子进行评估。采用酶联免疫吸附法检测HBsAg。结果542例老年人中,11例(2.03%)呈阳性。HBsAg阳性和阴性患者的中位年龄分别为69 (IQR: 63-77)岁和67 (IQR: 63-74)岁。多元logistic回归模型结果显示,脂肪肝与乙型肝炎显著相关(AOR (95% CI)=5.50 (1.16, 25.88)) (p <;. 05)。然而,年龄、性别、婚姻状况、学习年限、潜在疾病、体重指数、吸烟和血液因素与乙型肝炎之间没有显著关系(p >;. 05)。结论虽然报告的阳性病例较少,但重视老年人乙肝感染的临床意义和健康状况对制定适合该年龄组的疾病管理策略具有重要意义。
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引用次数: 0
Pertussis as a re-emerging disease. Epidemiological situation in the province of Salamanca 百日咳是一种再次出现的疾病。萨拉曼卡省的流行病学情况
Pub Date : 2025-01-01 Epub Date: 2025-03-20 DOI: 10.1016/j.vacune.2025.100379
Ana María Haro Pérez , Mar Jiménez Rodríguez , Saray Martín Monteagudo , Nieves Gutiérrez Zufiaurre

Objetives

Describe the evolution and characteristics of confirmed pertussis cases during the last 5 years, detect possible underreporting, study the burden of the pertussis on healthcare system at the current time and assess the effect of vaccination.

Material and methods

Retrospective observational study of pertussis cases reported in the province of Salamanca and patients diagnosed with pertussis by PCR by the Microbiology of the reference hospital, from January 2018 to March 2024.

Results

A total of 58 cases of pertussis were detected, 42 correspond to the period November 2023 – March 2024. Thirty-five (60.3%) were reported as EDO. A total of 48% were not vaccinated, and the average time from the last dose of the vaccine to diagnóstico in vaccinated people was 136.3 days (SD 40) in children under 1 year of age and 605.3 days (SD 407) in the 1–4 year-old group. Twelve cases (20.7%) required hospitalization (3 under 1 year old, 1 under 2 years old, 1 under 7 years old, 2 between 34 and 64 years old and 5 over 65 years old), of which 7 (58.3%) were not vaccinated.

Conclusions

The epidemiological evolution of pertussis shows a significant increase in 2023–2024, both in childhood and in adulthood, despite detecting underreporting. Vaccination is one of the fundamental strategies for the prevention of pertussis, the risk of which increases with the time elapsed since the last dose of vaccine, so vaccination coverage should be promoted in all age groups and in specific groups of risk, with the introduction of diphtheria-tetanus-pertussis in booster doses.
目的描述最近5 年百日咳确诊病例的演变和特点,发现可能的漏报,研究当前百日咳对卫生系统的负担,并评估疫苗接种的效果。材料与方法对2018年1月至2024年3月萨拉曼卡省报告的百日咳病例和参考医院微生物学PCR诊断的百日咳患者进行回顾性观察研究。结果共检出百日咳58例,其中2023年11月~ 2024年3月42例。35例(60.3%)报告为EDO。总共有48%的人没有接种疫苗,1 岁以下儿童从最后一剂疫苗到diagnóstico接种疫苗的平均时间为136.3 天(SD 40), 1 - 4 岁组为605.3 天(SD 407)。12例(20.7%)需要住院治疗(1岁以下 3例,2岁以下 1例,7岁以下 1例,34 - 64岁 2例,65岁以上 5例),其中7例(58.3%)未接种疫苗。结论2023-2024年,儿童和成人百日咳的流行病学演变显示出明显的增加,尽管发现了漏报。疫苗接种是预防百日咳的基本战略之一,自最后一剂疫苗接种以来,百日咳的风险随着时间的推移而增加,因此应通过引入白喉-破伤风-百日咳加强剂,在所有年龄组和特定风险群体中促进疫苗接种覆盖率。
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引用次数: 0
COVID-19 story: Entry and immune response COVID-19故事:进入和免疫反应
Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI: 10.1016/j.vacune.2025.100380
Ali Mohammed Ashraf , Marwan Y. Al-Maqtoofi , Ahmed A. Burghal
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the pandemic of the coronavirus disease 2019 (COVID-19) that emerged in December 2019 in Wuhan city, China. Understanding the SARS-CoV-2 entry, invasion and infection mechanism is crucial for vaccine development. The immune system is divided into 2 parts: the innate immune system and the adaptive immune system, and they work in essential and powerful ways for SARS-CoV-2 managing and reducing COVID-19 infections. Spike proteins (S) of SARS-CoV-2 are a pivotal key during the viral invasion of the host cells. Cell surface receptors facilitate binding and then membrane fusion for virus endocytosis and causing infection. Host cells are covered with receptors for viral S proteins binding, such as the human angiotensin-converting enzyme 2 receptor. The innate immune responses initiate after viral antigen detection via a set of pathogen recognition receptors, including the Toll-like receptors (TLRs) family. TLRs are largely inducible in most body cell types. After SARS-CoV-2 antigen recognition, cellular sensors stimulate the production of interferons and inflammatory cytokines, which are crucial for controlling viral replication and dissemination. The cellular and humoral responses of the adaptive immune system antibody-producing B-cells, CD4 + T-cells to evoke the immune response, and CD8 + T-cells to kill infected cells. This review outlines the process of virus entry and detection by pattern recognition receptors and antiviral defence by both innate immunity and adaptive immunity for developing immunological memory that can help in vaccines and understanding the immune response to SARS-CoV-2.
严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)是2019年12月在中国武汉市出现的2019冠状病毒病(COVID-19)大流行的罪魁祸首。了解SARS-CoV-2的进入、侵袭和感染机制对疫苗开发至关重要。免疫系统分为两部分:先天免疫系统和适应性免疫系统,它们在SARS-CoV-2管理和减少COVID-19感染方面发挥着重要而有力的作用。SARS-CoV-2的刺突蛋白(Spike protein, S)是病毒入侵宿主细胞的关键。细胞表面受体促进结合,然后膜融合病毒内吞和引起感染。宿主细胞覆盖着与病毒S蛋白结合的受体,如人血管紧张素转换酶2受体。先天免疫反应通过一系列病原体识别受体,包括toll样受体(TLRs)家族,在病毒抗原检测后启动。tlr在大多数体细胞类型中都是可诱导的。在SARS-CoV-2抗原识别后,细胞传感器刺激干扰素和炎症细胞因子的产生,这对控制病毒复制和传播至关重要。适应性免疫系统的细胞和体液反应——产生抗体的b细胞、引起免疫反应的CD4 + t细胞和杀死感染细胞的CD8 + t细胞。本文概述了模式识别受体进入和检测病毒以及先天免疫和适应性免疫的抗病毒防御过程,以形成免疫记忆,有助于疫苗和理解对SARS-CoV-2的免疫反应。
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引用次数: 0
Next-generation oral polio vaccine: The solution to reach eradication? 下一代口服脊髓灰质炎疫苗:根除脊髓灰质炎的解决方案?
Pub Date : 2024-10-01 Epub Date: 2024-10-29 DOI: 10.1016/j.vacune.2024.10.004
Nuria Torner
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引用次数: 0
Designing an immuno-epitope candidate vaccine from (Opa, ProA, ProB, RmpM and BamD) proteins against Neisseria gonorrhoeae and Neisseria meningitides 利用(Opa、ProA、ProB、RmpM 和 BamD)蛋白设计针对淋病奈瑟菌和脑膜炎奈瑟菌的免疫表位候选疫苗
Pub Date : 2024-10-01 Epub Date: 2024-11-14 DOI: 10.1016/j.vacune.2024.10.009
Ali Adel Dawood
The development of a conventional vaccine against gonococci has been difficult since there are no precise correlates of immune protection and the mechanisms of protective immunity are not yet understood. However, the drop in gonorrhea infections might be attributed to the development of vaccines based on Neisseria meningitidis' outer membrane. The goal of this research was to develop a multi-epitope vaccination utilizing proteins from N. meningitidis and Neisseria gonorrhoeae. A Neisseria Multi-Epitope Vaccine (NMEV), containing Opa, ProA, ProB, RmpM, and BamD, was developed using immunophysicochemical informatics techniques. The vaccine consists of 297 amino acids. Antigenicity and sensitivity to NMEV were evaluated. NMEV generates a substantial amount of immune cells and cytokines. The total quality factor of the NMEV 2D structure is around 91%. The vaccine's safety, effectiveness, and other properties make it an attractive option for in vitro and in vivo testing. The suggested NMEV subunit vaccine has the potential to elicit a strong immune response, necessitating additional in vitro and in vivo studies to eliminate Neisseria infections.
由于没有精确的免疫保护相关因素,保护性免疫的机制也尚未被了解,因此很难开发出针对淋球菌的常规疫苗。不过,淋病感染率的下降可能要归功于基于奈瑟氏脑膜炎球菌外膜的疫苗的开发。这项研究的目标是利用脑膜炎奈瑟菌和淋病奈瑟菌的蛋白质开发一种多表位疫苗。利用免疫物理化学信息学技术开发了一种奈瑟菌多表位疫苗(NMEV),其中包含 Opa、ProA、ProB、RmpM 和 BamD。该疫苗由 297 个氨基酸组成。对 NMEV 的抗原性和敏感性进行了评估。NMEV 产生了大量的免疫细胞和细胞因子。NMEV 二维结构的总质量因子约为 91%。该疫苗的安全性、有效性和其他特性使其成为体外和体内测试的一个有吸引力的选择。建议的 NMEV 亚单位疫苗有可能引起强烈的免疫反应,因此有必要进行更多的体外和体内研究,以消除奈瑟氏菌感染。
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引用次数: 0
Plant system as a versatile and robust platform for the development of vaccines against arboviral infections 将植物系统作为开发预防虫媒病毒感染疫苗的多功能稳健平台
Pub Date : 2024-10-01 Epub Date: 2024-11-14 DOI: 10.1016/j.vacune.2024.10.010
Balamurugan Shanmugaraj , Nivetha Loganathan , Harish Mani Chandra
Arboviral infections are predominantly transmitted by arthropods causing significant mortality, morbidity, and represent a major global health concern. These infections pose significant economic burdens especially in endemic regions. Dengue, chikungunya, yellow fever, and zika are the most common arboviral diseases spread by Aedes mosquitoes. Extensive research has been conducted on vector surveillance and vector control strategies to limit the arboviral transmission. However, vaccines remain the most powerful tool in the fight against infectious diseases. Over the years, significant progress has been made in developing vaccines against several infectious diseases. The global disease burden has been drastically reduced due to effective vaccination. The continual threat of arboviral outbreaks necessitates the need for effective vaccine and therapeutic development. For most arboviral diseases, vaccines are not available. Recently, plant-based vaccine development represents a promising platform for the rapid supply of antigens and antibodies for developing diagnostic kits or vaccines against pathogens. The concept of producing pharmaceutically significant and commercially viable therapeutic proteins in plants is defined as molecular farming. Substantial efforts have been made in this field, with improved expression strategies, refinement of downstream processing, and sufficient evidence showing the immunogenicity and efficacy of plant-produced recombinant proteins. Currently, few plant-produced vaccine antigens have reached the clinical trials. Notably, the plant-produced COVID-19 vaccine, Covifenz has been approved by Canada, and plant-produced influenza candidates showed safety and efficacy in clinical trials. In this review, we briefly summarize the potential of plant-derived vaccines in the fight against arboviral infections.
节肢动物病毒感染主要通过节肢动物传播,造成大量死亡和发病,是全球关注的主要健康问题。这些感染造成了巨大的经济负担,尤其是在流行地区。登革热、基孔肯雅热、黄热病和寨卡病是伊蚊传播的最常见的虫媒病毒疾病。为了限制虫媒病毒的传播,人们对病媒监测和病媒控制策略进行了广泛的研究。然而,疫苗仍然是抗击传染病最有力的工具。多年来,针对几种传染病的疫苗研发取得了重大进展。有效的疫苗接种大大减轻了全球疾病负担。由于虫媒病毒爆发的威胁持续存在,因此有必要开发有效的疫苗和疗法。对于大多数虫媒病毒疾病,目前还没有疫苗。最近,以植物为基础的疫苗开发为快速提供抗原和抗体以开发病原体诊断试剂盒或疫苗提供了一个前景广阔的平台。在植物中生产具有药用价值和商业价值的治疗蛋白的概念被定义为分子农业。人们在这一领域做出了巨大努力,改进了表达策略,完善了下游处理过程,并有充分证据表明植物生产的重组蛋白具有免疫原性和有效性。目前,很少有植物生产的疫苗抗原进入临床试验阶段。值得注意的是,植物生产的 COVID-19 疫苗 Covifenz 已获得加拿大批准,植物生产的流感候选疫苗在临床试验中显示出安全性和有效性。在这篇综述中,我们简要总结了植物源疫苗在抗击虫媒病毒感染方面的潜力。
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引用次数: 0
Measles eradication: Still a long and winding road 根除麻疹:道路依然漫长而曲折
Pub Date : 2024-10-01 Epub Date: 2024-10-29 DOI: 10.1016/j.vacune.2024.10.002
Fernando Moraga-Llop , Magda Campins-Martí
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引用次数: 0
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Vacunas (English Edition)
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