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The Controlled Human Infection Model for Enterotoxigenic Escherichia coli. 肠毒性大肠杆菌的控制性人体感染模型。
3区 医学 Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/82_2021_242
Chad K Porter, Kawsar R Talaat, Sandra D Isidean, Alwine Kardinaal, Subhra Chakraborty, Ramiro L Gutiérrez, David A Sack, A Louis Bourgeois

The controlled human infection model (CHIM) for enterotoxigenic Escherichia coli (ETEC) has been instrumental in defining ETEC as a causative agent of acute watery diarrhea, providing insights into disease pathogenesis and resistance to illness, and enabling preliminary efficacy evaluations for numerous products including vaccines, immunoprophylactics, and drugs. Over a dozen strains have been evaluated to date, with a spectrum of clinical signs and symptoms that appear to replicate the clinical illness seen with naturally occurring ETEC. Recent advancements in the ETEC CHIM have enhanced the characterization of clinical, immunological, and microbiological outcomes. It is anticipated that omics-based technologies applied to ETEC CHIMs will continue to broaden our understanding of host-pathogen interactions and facilitate the development of primary and secondary prevention strategies.

肠毒性大肠杆菌 (ETEC) 的人类感染控制模型 (CHIM) 在确定 ETEC 为急性水样腹泻的致病菌、深入了解疾病的发病机制和抗病能力以及对疫苗、免疫乳剂和药物等多种产品进行初步疗效评估方面发挥了重要作用。迄今为止,已对十多种菌株进行了评估,其临床症状和体征似乎与自然发生的 ETEC 临床疾病相同。ETEC CHIM 的最新进展加强了对临床、免疫学和微生物学结果的描述。预计基于 omics 的技术应用于 ETEC CHIMs 将继续拓宽我们对宿主-病原体相互作用的理解,并促进一级和二级预防策略的开发。
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引用次数: 0
Controlled Human Infection with Bordetella pertussis. 百日咳博德特氏菌对人类的控制性感染。
3区 医学 Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/82_2022_260
H de Graaf, D Gbesemete, R C Read

Bordetella pertussis, a slow-growing Gram-negative coccobacillus and the causative agent of whooping cough, is one of the leading causes of vaccine-preventable death and morbidity globally. A state of asymptomatic human carriage has not yet been demonstrated by population studies but is likely to be an important reservoir for community transmission of infection. Such a carriage state may be a target for future vaccine strategies. This chapter presents a short summary of the characteristics of B. pertussis, which should be taken into account when developing a human challenge model and any future experimental medicine interventions. Three studies involving deliberate infection with B. pertussis have been described to date. The first of these was a scientifically and ethically unacceptable paediatric challenge study involving four children in 1930. The second was an investigation of a putative live vaccine using a genetically modified and attenuated strain of B. pertussis. Finally, a systematically constructed human challenge model using a wild-type, potentially pathogenic strain has been established. The latter study has demonstrated that deliberate induction of asymptomatic colonisation in humans is safe and immunogenic, with colonised participants exhibiting seroconversion to pertussis antigens. It has also shown nasal wash to be a more sensitive method of detecting the presence of B. pertussis than either pernasal swab or throat swab, and that B. pertussis carriage can be cleared effectively with Azithromycin. The development of this wild-type B. pertussis human challenge model will allow the investigation of host-pathogen and facilitate future vaccine development.

百日咳杆菌是一种生长缓慢的革兰氏阴性球菌,也是百日咳的病原体,是全球疫苗可预防的死亡和发病的主要原因之一。人群研究尚未证实无症状的人体携带状态,但很可能是社区传播感染的重要贮存库。这种携带状态可能是未来疫苗策略的目标。本章简要概述了百日咳杆菌的特征,在开发人类挑战模型和未来任何实验医学干预措施时都应考虑到这些特征。迄今已有三项涉及故意感染百日咳杆菌的研究。其中第一项是在 1930 年进行的一项在科学和伦理上都无法接受的儿科挑战研究,涉及四名儿童。第二项研究是对使用百日咳杆菌转基因减毒株的假定活疫苗的调查。最后,利用野生型、可能致病的菌株建立了一个系统的人类挑战模型。后一项研究表明,故意诱导人体无症状定植是安全的,而且具有免疫原性,定植者会出现百日咳抗原血清转换。该研究还表明,鼻腔清洗是比鼻拭子或喉拭子更灵敏的百日咳杆菌检测方法,而且百日咳杆菌携带可通过阿奇霉素有效清除。这种野生型百日咳杆菌人体挑战模型的开发将有助于研究宿主-病原体,并促进未来疫苗的开发。
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引用次数: 0
Experimental Urethral Infection with Neisseria gonorrhoeae. 淋病奈瑟菌实验性尿道感染
3区 医学 Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/82_2021_250
Andreea Waltmann, Joseph A Duncan, Gerald B Pier, Colette Cywes-Bentley, Myron S Cohen, Marcia M Hobbs

Gonorrhea rates and antibiotic resistance are both increasing. Neisseria gonorrhoeae (Ng) is an exclusively human pathogen and is exquisitely adapted to its natural host. Ng can subvert immune responses and undergoes frequent antigenic variation, resulting in limited immunity and protection from reinfection. Previous gonococcal vaccine efforts have been largely unsuccessful, and the last vaccine to be tested in humans was more than 35 years ago. Advancing technologies and the threat of untreatable gonorrhea have fueled renewed pursuit of a vaccine as a long-term sustainable solution for gonorrhea control. Despite the development of a female mouse model of genital gonococcal infection two decades ago, correlates of immunity or protection remain largely unknown, making the gonococcus a challenging vaccine target. The controlled human urethral infection model of gonorrhea (Ng CHIM) has been used to study gonococcal pathogenesis and the basis of anti-gonococcal immunity. Over 200 participants have been inoculated without serious adverse events. The Ng CHIM replicates the early natural course of urethral infection. We are now at an inflexion point to pivot the use of the model for vaccine testing to address the urgency of improved gonorrhea control. Herein we discuss the need for gonorrhea vaccines, and the advantages and limitations of the Ng CHIM in accelerating the development of gonorrhea vaccines.

淋病发病率和抗生素耐药性都在增加。淋病奈瑟菌(Ng)是一种专属于人类的病原体,对其自然宿主具有极强的适应性。淋病奈瑟菌可破坏免疫反应,并经常发生抗原变异,从而导致有限的免疫力和再感染保护。以往的淋球菌疫苗接种工作基本上都不成功,上一次在人类身上进行疫苗测试是在 35 年前。不断进步的技术和无法治疗的淋病所带来的威胁,促使人们重新将疫苗作为控制淋病的长期可持续解决方案。尽管二十年前就开发出了生殖器淋球菌感染的雌性小鼠模型,但免疫或保护的相关因素在很大程度上仍然未知,这使得淋球菌成为一个具有挑战性的疫苗目标。淋病受控人类尿道感染模型(Ng CHIM)已被用于研究淋球菌的发病机制和抗淋球菌免疫的基础。已有 200 多名参与者接种了该模型,未发生严重不良事件。Ng CHIM 复制了尿道感染的早期自然病程。我们现在正处于一个转折点,需要将该模型用于疫苗测试,以应对改善淋病控制的紧迫性。在此,我们将讨论对淋病疫苗的需求,以及 Ng CHIM 在加速淋病疫苗开发方面的优势和局限性。
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引用次数: 0
Lassa Virus Countermeasures. 拉沙病毒对策。
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/82_2022_261
Lilia I Melnik

Lassa Fever (LF) is a viral hemorrhagic fever endemic in West Africa. LF begins with flu-like symptoms that are difficult to distinguish from other common endemic diseases such as malaria, dengue, and yellow fever making it hard to diagnose clinically. Availability of a rapid diagnostic test and other serological and molecular assays facilitates accurate diagnosis of LF. Lassa virus therapeutics are currently in different stages of preclinical development. Arevirumab, a cocktail of monoclonal antibodies, demonstrates a great safety and efficacy profile in non-human primates. Major efforts have been made in the development of a Lassa virus vaccine. Two vaccine candidates, MeV-NP and pLASV-GPC are undergoing evaluation in phase I clinical trials.

拉沙热是西非的一种地方性病毒性出血热。LF开始时出现流感样症状,难以与其他常见地方病(如疟疾、登革热和黄热病)区分,因此难以临床诊断。快速诊断测试和其他血清学和分子分析的可用性有助于LF的准确诊断。拉沙病毒疗法目前处于临床前开发的不同阶段。Arevirumab是一种单克隆抗体的混合物,在非人类灵长类动物中显示出极大的安全性和有效性。在研制拉沙病毒疫苗方面作出了重大努力。MeV-NP和pLASV-GPC两种候选疫苗正在I期临床试验中进行评估。
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引用次数: 0
Mechanisms and Consequences of Genetic Variation in Hepatitis C Virus (HCV). 丙型肝炎病毒(HCV)遗传变异的机制和后果。
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-15640-3_7
Andrea Galli, Jens Bukh

Chronic infection with hepatitis C virus (HCV) is an important contributor to the global incidence of liver diseases, including liver cirrhosis and hepatocellular carcinoma. Although common for single-stranded RNA viruses, HCV displays a remarkable high level of genetic diversity, produced primarily by the error-prone viral polymerase and host immune pressure. The high genetic heterogeneity of HCV has led to the evolution of several distinct genotypes and subtypes, with important consequences for pathogenesis, and clinical outcomes. Genetic variability constitutes an evasion mechanism against immune suppression, allowing the virus to evolve epitope escape mutants that avoid immune recognition. Thus, heterogeneity and variability of the HCV genome represent a great hindrance for the development of vaccines against HCV. In addition, the high genetic plasticity of HCV allows the virus to rapidly develop antiviral resistance mutations, leading to treatment failure and potentially representing a major hindrance for the cure of chronic HCV patients. In this chapter, we will present the central role that genetic diversity has in the viral life cycle and epidemiology of HCV. Incorporation errors and recombination, both the result of HCV polymerase activity, represent the main mechanisms of HCV evolution. The molecular details of both mechanisms have been only partially clarified and will be presented in the following sections. Finally, we will discuss the major consequences of HCV genetic diversity, namely its capacity to rapidly evolve antiviral and immunological escape variants that represent an important limitation for clearance of acute HCV, for treatment of chronic hepatitis C and for broadly protective vaccines.

慢性丙型肝炎病毒(HCV)感染是全球肝病发病率的重要因素,包括肝硬化和肝细胞癌。尽管HCV在单链RNA病毒中很常见,但它表现出显著的高水平遗传多样性,主要由易出错的病毒聚合酶和宿主免疫压力产生。HCV的高度遗传异质性导致了几种不同基因型和亚型的进化,对发病机制和临床结果具有重要影响。遗传变异构成了一种逃避免疫抑制的机制,允许病毒进化出逃避免疫识别的表位逃避突变体。因此,丙型肝炎病毒基因组的异质性和可变性是丙型肝炎病毒疫苗开发的一大障碍。此外,HCV的高遗传可塑性使病毒能够迅速产生抗病毒抗性突变,导致治疗失败,并可能成为慢性HCV患者治愈的主要障碍。在本章中,我们将介绍遗传多样性在HCV病毒生命周期和流行病学中的核心作用。整合错误和重组都是HCV聚合酶活性的结果,代表了HCV进化的主要机制。这两种机制的分子细节只是部分澄清,将在以下几节中介绍。最后,我们将讨论丙型肝炎病毒遗传多样性的主要后果,即其快速进化抗病毒和免疫逃逸变异的能力,这是急性丙型肝炎病毒清除、慢性丙型肝炎治疗和广泛保护性疫苗的重要限制。
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引用次数: 0
Outcomes of RIP Kinase Signaling During Neuroinvasive Viral Infection. 神经侵袭性病毒感染过程中 RIP 激酶信号转导的结果
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/82_2020_204
Brian P Daniels, Andrew Oberst

Neuroinvasive viral diseases are a considerable and growing burden on global public health. Despite this, these infections remain poorly understood, and the molecular mechanisms that govern protective versus pathological neuroinflammatory responses to infection are a matter of intense investigation. Recent evidence suggests that necroptosis, an immunogenic form of programmed cell death, may contribute to the pathogenesis of viral encephalitis. However, the receptor-interacting protein (RIP) kinases that coordinate necroptosis, RIPK1 and RIPK3, also appear to have unexpected, cell death-independent functions in the central nervous system (CNS) that promote beneficial neuroinflammation during neuroinvasive infection. Here, we review the emerging evidence in this field, with additional discussion of recent work examining roles for RIPK signaling and necroptosis during noninfectious pathologies of the CNS, as these studies provide important additional insight into the potential for specialized neuroimmune functions for the RIP kinases.

神经侵袭性病毒疾病对全球公共卫生造成了巨大且日益沉重的负担。尽管如此,人们对这些感染仍然知之甚少,而控制感染的保护性神经炎症反应和病理性神经炎症反应的分子机制也是一个需要深入研究的问题。最近的证据表明,坏死(一种程序性细胞死亡的免疫原性形式)可能是病毒性脑炎的发病机制之一。然而,协调坏死凋亡的受体相互作用蛋白(RIP)激酶 RIPK1 和 RIPK3 在中枢神经系统(CNS)中似乎也有意想不到的、不依赖于细胞死亡的功能,在神经侵入性感染期间促进有益的神经炎症。在此,我们回顾了这一领域新出现的证据,并进一步讨论了最近研究 RIPK 信号传导和坏死在中枢神经系统非感染性病理过程中的作用的工作,因为这些研究为 RIP 激酶发挥特殊神经免疫功能的潜力提供了重要的补充见解。
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引用次数: 0
Cell Killing by Reovirus: Mechanisms and Consequences. Reovirus 杀死细胞:机制与后果
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/82_2020_225
Andrew McNamara, Katherine Roebke, Pranav Danthi

Infection of host cells by mammalian reovirus in culture or in tissues of infected animals results in cell death. Cell death of infected neurons and myocytes contributes to the pathogenesis of reovirus-induced encephalitis and myocarditis in a newborn mouse model. Thus, reovirus-induced cell death has been used to investigate the basis of viral disease. Depending on the cell type, infection of host cells by reovirus results in one of two forms of cell death-apoptosis and necroptosis. In addition to the obvious differences in how these two forms of cell death are executed, the mechanisms by which reovirus infection initiates and transduces signals that lead to each of these types of cell death are distinct. In this review, we discuss how apoptosis and necroptosis are triggered by events at different stages of infection. We also describe how innate immune recognition of reovirus genomic material and type I interferon signaling pathways connect with the core components of the apoptosis and necroptosis machinery. The impact of different cell death mediators on viral pathogenesis and the potential of reovirus as an oncolytic vector are also outlined.

哺乳动物雷诺病毒在培养液中或感染动物的组织中感染宿主细胞会导致细胞死亡。在新生小鼠模型中,受感染神经元和心肌细胞的细胞死亡是再病毒诱发脑炎和心肌炎的发病机制之一。因此,再病毒诱导的细胞死亡已被用于研究病毒性疾病的基础。根据细胞类型的不同,宿主细胞感染雷诺病毒后会导致两种形式的细胞死亡--细胞凋亡和坏死。除了这两种细胞死亡形式的执行方式存在明显差异外,重组病毒感染启动和传递导致这两种细胞死亡的信号的机制也各不相同。在本综述中,我们将讨论细胞凋亡和坏死是如何在感染的不同阶段被触发的。我们还描述了先天性免疫对重组病毒基因组材料的识别和 I 型干扰素信号通路如何与细胞凋亡和坏死机制的核心组成部分相联系。我们还概述了不同细胞死亡介质对病毒发病机制的影响,以及重组病毒作为溶瘤载体的潜力。
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引用次数: 3
Sex-Linked Differences in Malaria Risk Across the Lifespan. 终生疟疾风险的性别相关差异。
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-35139-6_7
Jessica Briggs, Margaret Murray, Jason Nideffer, Prasanna Jagannathan

Despite the high burden of malaria worldwide, there is surprisingly scarce research on sex-based differences in malaria outside of pregnancy. A more thorough understanding of sexual dimorphism in malaria, and what underlies these sex-based differences, could elucidate the underlying mechanisms driving malaria pathogenesis and has the potential to inform malaria control efforts, including new vaccines. This review summarizes our current understanding of sex-based differences in the epidemiology of malaria across the lifespan, potential sex- or gender-based mechanisms driving these differences, and the knowledge gaps that need to be addressed.

尽管全世界的疟疾负担很高,但关于妊娠期以外疟疾性别差异的研究却少得惊人。更彻底地了解疟疾的两性异形,以及这些基于性别的差异背后的原因,可以阐明驱动疟疾发病机制的潜在机制,并有可能为疟疾控制工作提供信息,包括新疫苗。这篇综述总结了我们目前对疟疾流行病学在整个生命周期中基于性别的差异的理解,驱动这些差异的潜在基于性别或性别的机制,以及需要解决的知识差距。
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引用次数: 0
Sex-Differential and Non-specific Effects of Vaccines Over the Life Course. 疫苗在整个生命过程中的性别差异和非特异性作用。
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-35139-6_9
Laura A St Clair, Sabal Chaulagain, Sabra L Klein, Christine Stabell Benn, Katie L Flanagan

Biological sex and age have profound effects on immune responses throughout the lifespan and impact vaccine acceptance, responses, and outcomes. Mounting evidence from epidemiological, clinical, and animal model studies show that males and females respond differentially to vaccination throughout the lifespan. Within age groups, females tend to produce greater vaccine-induced immune responses than males, with sex differences apparent across all age groups, but are most pronounced among reproductive aged individuals. Females report more adverse effects following vaccination than males. Females, especially among children under 5 years of age, also experience more non-specific effects of vaccination. Despite these known sex- and age-specific differences in vaccine-induced immune responses and outcomes, sex and age are often ignored in vaccine research. Herein, we review the known sex differences in the immunogenicity, effectiveness, reactogenicity, and non-specific effects of vaccination over the lifespan. Ways in which these data can be leveraged to improve vaccine research are described.

生物性别和年龄对整个生命周期的免疫反应有着深远的影响,并影响疫苗的接受、反应和结果。来自流行病学、临床和动物模型研究的越来越多的证据表明,雄性和雌性在整个生命周期中对疫苗接种的反应不同。在年龄组内,女性往往比男性产生更大的疫苗诱导免疫反应,所有年龄组的性别差异都很明显,但在育龄人群中最为明显。女性在接种疫苗后报告的不良反应比男性多。女性,尤其是5岁以下的儿童,也会经历更多的疫苗接种的非特异性影响。尽管疫苗诱导的免疫反应和结果存在这些已知的性别和年龄特异性差异,但在疫苗研究中,性别和年龄往往被忽视。在此,我们回顾了疫苗接种在整个寿命内的免疫原性、有效性、反应原性和非特异性影响方面的已知性别差异。介绍了利用这些数据改进疫苗研究的方法。
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引用次数: 0
Biological Sex and Pregnancy Affect Influenza Pathogenesis and Vaccination. 生物学性别和妊娠影响流感发病机制和疫苗接种。
3区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-35139-6_5
Patrick S Creisher, Kumba Seddu, Alice L Mueller, Sabra L Klein

Males and females differ in the outcome of influenza A virus (IAV) infections, which depends significantly on age. During seasonal influenza epidemics, young children (< 5 years of age) and aged adults (65+ years of age) are at greatest risk for severe disease, and among these age groups, males tend to suffer a worse outcome from IAV infection than females. Following infection with pandemic strains of IAVs, females of reproductive ages (i.e., 15-49 years of age) experience a worse outcome than their male counterparts. Although females of reproductive ages experience worse outcomes from IAV infection, females typically have greater immune responses to influenza vaccination as compared with males. Among females of reproductive ages, pregnancy is one factor linked to an increased risk of severe outcome of influenza. Small animal models of influenza virus infection and vaccination illustrate that immune responses and repair of damaged tissue following IAV infection also differ between the sexes and impact the outcome of infection. There is growing evidence that sex steroid hormones, including estrogens, progesterone, and testosterone, directly impact immune responses during IAV infection and vaccination. Greater consideration of the combined effects of sex and age as biological variables in epidemiological, clinical, and animal studies of influenza pathogenesis is needed.

男性和女性感染甲型流感病毒(IAV)的结果不同,这在很大程度上取决于年龄。在季节性流感流行期间,幼儿(<5岁)和老年人(65岁)+ 年龄)患严重疾病的风险最大,在这些年龄组中,男性感染IAV的结果往往比女性更糟。感染新冠病毒株后,育龄女性(即15-49岁)的结局比男性更糟。尽管育龄女性感染IAV的后果更糟,但与男性相比,女性通常对流感疫苗有更大的免疫反应。在育龄女性中,怀孕是导致流感严重后果风险增加的一个因素。流感病毒感染和疫苗接种的小动物模型表明,感染IAV后的免疫反应和受损组织的修复也因性别而异,并影响感染的结果。越来越多的证据表明,性类固醇激素,包括雌激素、孕酮和睾酮,在IAV感染和疫苗接种期间直接影响免疫反应。在流感发病机制的流行病学、临床和动物研究中,需要更多地考虑性别和年龄作为生物学变量的综合影响。
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引用次数: 0
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Current topics in microbiology and immunology
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