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Splinter 分裂
Q1 Medicine Pub Date : 2024-02-15 DOI: 10.20411/pai.v8i2.681
Adrian M. Schnall
Splinter“Do what you need to,” I said.As though this was extractingan arrowhead buried in flesh, not a sliver of wood from a pinky.She my officemate, colleague,friend. But not – it occurred to me as she started to probe – a surgeon. Probably hadn’t fingered a forceps in years.What I warn my patients against every day – not wise to compromisewith convenience.I had no fear of pain.A dozen tours in the OR, years of drawing blood – we learn to distance, numb ourselves.Numb ourselves, that is, to the pain of another – my pinky should have taken itself to Urgent Care.Maybe there was hurt,but I never noticed. All I recall is a flood of sweetness, a drowsy warmth, as when the world is about to go dark.Sometimes as we’re fallingwe hear a voice calling in the distance.“Oh, shit – going vagal,” this one said.It sounded like mine.
她是我的同事、朋友,但不是--当她开始探查时我才想到--一个外科医生。她是我的同事、朋友,也是我的同事、朋友,但我突然意识到,她不是外科医生。我并不害怕疼痛。在手术室工作了十几次,多年的抽血经历让我们学会了保持距离,麻木自己。麻木自己,也就是麻木别人的疼痛--我的小指本该送去急诊。我所记得的只是一股甜美的洪流,一种昏昏欲睡的温暖,就像世界即将陷入黑暗时一样。有时,当我们坠落时,我们会听到远处有一个声音在呼唤。"哦,该死--要迷走了,"这个声音说,听起来像我的声音。
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引用次数: 0
Replication and Injury Associated With SARS-CoV-2 in Cultured Hepatocytes. 培养肝细胞中与 SARS-CoV-2 相关的复制和损伤
Q1 Medicine Pub Date : 2024-02-12 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i2.648
Suman Pradhan, Susan D Rouster, Jason T Blackard, Gary E Dean, Kenneth E Sherman

Background: Liver dysfunction is one of the hallmarks of SARS-CoV-2 infection. The mechanism(s) of hepatic injury in SARS-CoV-2 infection remains controversial with some reporting viral replication and cellular injury and others suggesting lack of replication and injury due to non-cytopathogenic etiologies. To investigate this further, we evaluated SARS-CoV-2 replication in immortalized hepatic cell lines and primary hepatocytes, examined whether cell injury was associated with apoptotic pathways, and also determined the effect of the antiviral remdesivir on these processes.

Methods: Immortalized hepatocyte cell lines (HepG2 and Huh7.5), as well as primary human hepatocytes, were exposed to SARS-CoV-2 at a multiplicity of infection of 0.1 PFU/mL. Viral replication was evaluated by plaque assays, immunohistochemical staining for the viral spike protein, and caspase-3 expression evaluated with and without exposure to remdesivir.

Results: All hepatocyte cell lines and primary hepatocytes supported active replication of SARS-CoV-2. Significant cytopathic effect was observed by light microscopy, and caspase-3 staining supported activation of apoptotic pathways. Remdesivir abrogated infection in a dose-dependent fashion and was not independently associated with hepatocyte injury.

Conclusion: Hepatocytes appear to be highly permissive of SARS-CoV-2 replication which leads to rapid cell death associated with activation of apoptotic pathways. Viral replication and hepatocytes injury are abrogated with remdesivir. We conclude that active viral replication is most likely a key contributor to liver enzyme abnormalities observed in the setting of acute SARS-CoV-2 infection.

背景:肝功能异常是 SARS-CoV-2 感染的特征之一。关于 SARS-CoV-2 感染肝损伤的机制仍存在争议,一些人认为是病毒复制和细胞损伤,另一些人则认为是非致病性病因导致的复制和损伤。为了进一步研究这个问题,我们评估了 SARS-CoV-2 在永生化肝细胞系和原代肝细胞中的复制情况,研究了细胞损伤是否与细胞凋亡途径有关,还确定了抗病毒药物雷米替韦对这些过程的影响:方法: 用 0.1 PFU/mL 的感染倍率将永久化肝细胞系(HepG2 和 Huh7.5)和原代人类肝细胞暴露于 SARS-CoV-2 病毒。通过斑块检测、病毒尖峰蛋白的免疫组化染色评估病毒复制情况,并在接触和不接触雷米替韦的情况下评估caspase-3的表达:结果:所有肝细胞系和原代肝细胞都支持 SARS-CoV-2 的活跃复制。光镜下观察到明显的细胞病理效应,caspase-3染色支持凋亡途径的激活。雷米替韦能以剂量依赖的方式抑制感染,而且与肝细胞损伤无关:结论:肝细胞似乎对 SARS-CoV-2 复制具有高度容许性,这种复制会导致与细胞凋亡途径激活相关的快速细胞死亡。雷米地韦能抑制病毒复制和肝细胞损伤。我们的结论是,活跃的病毒复制很可能是导致急性 SARS-CoV-2 感染时肝脏酶异常的关键因素。
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引用次数: 0
Stable Levels of Antibodies Against Unrelated Toxoid Vaccines After COVID-19: COVID-19 Infection Does Not Affect Toxoid Vaccine Antibody Levels. COVID-19 病毒感染后,针对非相关类毒素疫苗的抗体水平保持稳定:COVID-19 感染不会影响类毒素疫苗抗体水平。
Q1 Medicine Pub Date : 2024-02-07 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i2.627
Suvi T Jokiranta, Simo Miettinen, Sami Salonen, Lauri Kareinen, Ruut Uusitalo, Essi M Korhonen, Jenni Virtanen, Ilkka Kivistö, Kirsi Aaltonen, Dina A Mosselhy, Tinja Lääveri, Anu Kantele, T Petteri Arstila, Hanna Jarva, Olli Vapalahti, Santtu Heinonen, Eliisa Kekäläinen

Background: Lymphopenia is common in COVID-19. This has raised concerns that COVID-19 could affect the immune system akin to measles infection, which causes immune amnesia and a reduction in protective antibodies.

Methods: We recruited COVID-19 patients (n = 59) in Helsinki, Finland, and collected plasma samples on 2 to 3 occasions during and after infection. We measured IgG antibodies to diphtheria toxin, tetanus toxoid, and pertussis toxin, along with total IgG, SARS-CoV-2 spike protein IgG, and neutralizing antibodies. We also surveyed the participants for up to 17 months for long-term impaired olfaction as a proxy for prolonged post-acute COVID-19 symptoms.

Results: No significant differences were found in the unrelated vaccine responses while the serological response against COVID-19 was appropriate. During the acute phase of the disease, the SARSCoV-2 IgG levels were lower in outpatients when compared to inpatients. SARS-CoV-2 serology kinetics matched expectations. In the acute phase, anti-tetanus and anti-diphtheria IgG levels were lower in patients with prolonged impaired olfaction during follow up than in those without.

Conclusions: We could not detect significant decline in overall humoral immunity during or after COVID-19 infection. In severe COVID-19, there appears to be a temporary decline in total IgG levels.

背景淋巴细胞减少症在 COVID-19 中很常见。这引起了人们的担忧,COVID-19 可能会影响免疫系统,类似于麻疹感染,导致免疫失忆和保护性抗体减少:我们在芬兰赫尔辛基招募了 COVID-19 患者(n = 59),并在感染期间和感染后收集了 2 至 3 次血浆样本。我们测定了白喉毒素、破伤风类毒素和百日咳毒素的 IgG 抗体,以及总 IgG、SARS-CoV-2 尖峰蛋白 IgG 和中和抗体。我们还对参与者进行了长达 17 个月的长期嗅觉受损情况调查,以此作为 COVID-19 急性发作后长期症状的替代指标:结果:与疫苗无关的反应没有发现明显差异,而针对 COVID-19 的血清反应是适当的。在疾病的急性期,门诊患者的 SARSCoV-2 IgG 水平低于住院患者。SARS-CoV-2 血清学动力学符合预期。在急性期,随访期间嗅觉长期受损的患者的抗破伤风和抗白喉 IgG 水平低于嗅觉未受损的患者:结论:在感染 COVID-19 期间或感染后,我们无法检测到整体体液免疫的显著下降。在重症 COVID-19 患者中,总 IgG 水平似乎会暂时下降。
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引用次数: 0
Machine Learning Bolsters Evidence That D1, Nef, and Tat Influence HIV Reservoir Dynamics. 机器学习增强了 D1、Nef 和 Tat 影响 HIV 储库动态的证据。
Q1 Medicine Pub Date : 2024-01-23 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i2.621
LaMont Cannon, Sophia Fehrman, Marilia Pinzone, Sam Weissman, Una O'Doherty

Background: The primary hurdle to curing HIV is due to the establishment of a reservoir early in infection. In an effort to find new treatment strategies, we and others have focused on understanding the selection pressures exerted on the reservoir by studying how proviral sequences change over time.

Methods: To gain insights into the dynamics of the HIV reservoir we analyzed longitudinal near full-length sequences from 7 people living with HIV between 1 and 20 years following the initiation of antiretroviral treatment. We used this data to employ Bayesian mixed effects models to characterize the decay of the reservoir using single-phase and multiphasic decay models based on near full-length sequencing. In addition, we developed a machine-learning approach utilizing logistic regression to identify elements within the HIV genome most associated with proviral decay and persistence. By systematically analyzing proviruses that are deleted for a specific element, we gain insights into their role in reservoir contraction and expansion.

Results: Our analyses indicate that biphasic decay models of intact reservoir dynamics were better than single-phase models with a stronger statistical fit. Based on the biphasic decay pattern of the intact reservoir, we estimated the half-lives of the first and second phases of decay to be 18.2 (17.3 to 19.2, 95%CI) and 433 (227 to 6400, 95%CI) months, respectively.In contrast, the dynamics of defective proviruses differed favoring neither model definitively, with an estimated half-life of 87.3 (78.1 to 98.8, 95% CI) months during the first phase of the biphasic model. Machine-learning analysis of HIV genomes at the nucleotide level revealed that the presence of the splice donor site D1 was the principal genomic element associated with contraction. This role of D1 was then validated in an in vitro system. Using the same approach, we additionally found supporting evidence that HIV nef may confer a protective advantage for latently infected T cells while tat was associated with clonal expansion.

Conclusions: The nature of intact reservoir decay suggests that the long-lived HIV reservoir contains at least 2 distinct compartments. The first compartment decays faster than the second compartment. Our machine-learning analysis of HIV proviral sequences reveals specific genomic elements are associated with contraction while others are associated with persistence and expansion. Together, these opposing forces shape the reservoir over time.

背景:治愈艾滋病病毒的主要障碍是在感染早期建立病毒库。为了找到新的治疗策略,我们和其他人通过研究前病毒序列如何随时间变化,重点了解了对病毒库施加的选择压力:为了深入了解艾滋病病毒库的动态变化,我们分析了 7 名艾滋病病毒感染者在开始接受抗逆转录病毒治疗后 1 到 20 年间的纵向近全长序列。我们利用这些数据采用贝叶斯混合效应模型,使用基于近全长测序的单相和多相衰减模型来描述病毒库的衰减特征。此外,我们还开发了一种机器学习方法,利用逻辑回归来识别 HIV 基因组中与前病毒衰变和持久性最相关的元素。通过系统分析因特定元素而被删除的前病毒,我们深入了解了它们在病毒库收缩和扩张中的作用:我们的分析表明,完整病毒库动态的双相衰减模型比单相模型更好,统计拟合度更高。根据完整病毒库的双相衰变模式,我们估计衰变第一阶段和第二阶段的半衰期分别为 18.2 个月(17.3 到 19.2 个月,95%CI)和 433 个月(227 到 6400 个月,95%CI)。相比之下,有缺陷的前病毒的动态变化则不同,两种模式都没有明确的优势,双相模式第一阶段的半衰期估计为 87.3 个月(78.1 到 98.8 个月,95%CI)。对 HIV 基因组进行核苷酸水平的机器学习分析表明,剪接供体位点 D1 的存在是与收缩相关的主要基因组元素。D1 的这一作用随后在体外系统中得到了验证。使用同样的方法,我们还发现了支持性证据,即 HIV nef 可能会给潜伏感染的 T 细胞带来保护性优势,而 tat 则与克隆扩增有关:完整病毒库衰变的性质表明,长寿命的 HIV 病毒库至少包含两个不同的部分。第一部分比第二部分衰减得更快。我们对 HIV 病毒序列的机器学习分析表明,特定的基因组元素与收缩有关,而其他元素则与持续存在和扩展有关。随着时间的推移,这些对立的力量共同塑造了病毒库。
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引用次数: 0
Normospermic Patients Infected With Ureaplasma parvum: Role of Dysregulated miR-122-5p, miR-34c-5, and miR-141-3p 感染副猪脲原体的正常精子症患者:失调的 miR-122-5p、miR-34c-5 和 miR-141-3p 的作用
Q1 Medicine Pub Date : 2024-01-05 DOI: 10.20411/pai.v8i2.603
Marilena Galdiero, Carlo Trotta, Maria Teresa Schettino, Luigi Cirillo, Francesca Paola Sasso, Francesco Petrillo, A. Petrillo
Background: Ureaplasma parvum (UP) is a causative agent of non-gonococcal urethritis, involved in the pathogenesis of prostatitis and epididymitis, and it could impair human fertility. Although UP infection is a frequent cause of male infertility the study evidence assessing their prevalence and the association in patients with infertility is still scarce. The molecular processes leading to defects in spermatozoa quality are not completely investigated. MicroRNAs (miRNAs) have been extensively reported as gene regulatory molecules on post-transcriptional levels involved in various biological processes such as gametogenesis, embryogenesis, and the quality of sperm, oocyte, and embryos.Methods: Therefore, the study design was to demonstrate that miRNAs in body fluids like sperm could be utilized as non-invasive diagnostic biomarkers for pathological and physiological conditions such as infertility. A post-hoc bioinformatics analysis was carried out to predict the pathways modulated by the miRNAs dysregulated in the differently motile spermatozoa.Results: Here it is shown that normospermic patients infected by UP had spermatozoa with increased quantity of superoxide anions, reduced expression of miR-122-5p, miR-34c-5, and increased miR-141-3p compared with non-infected normospermic patients. This corresponded to a reduction of sperm motility in normospermic infected patients compared with normospermic non-infected ones. A target gene prediction presumed that an essential role of these miRNAs resided in the regulation of lipid kinase activity, accounting for the changes in the constitution of spermatozoa membrane lipids caused by UP. Conclusions: Altogether, the data underline the influence of UP on epigenetic mechanisms regulating spermatozoa motility. 
背景:副脲原体(UP)是非淋球菌性尿道炎的致病菌,参与前列腺炎和附睾炎的发病,并可能损害人类的生育能力。尽管UP感染是男性不育症的常见原因,但评估其发病率及其与不育症患者关系的研究证据仍然很少。导致精子质量缺陷的分子过程尚未完全研究清楚。微RNA(miRNA)作为转录后水平的基因调控分子,参与了配子发生、胚胎发生以及精子、卵细胞和胚胎质量等各种生物过程,已被广泛报道:因此,研究设计旨在证明精子等体液中的 miRNA 可用作不孕症等病理和生理状况的非侵入性诊断生物标志物。研究人员还进行了事后生物信息学分析,以预测不同运动能力精子中的 miRNA 受调控的途径:结果表明:与未感染UP的正常精子症患者相比,感染UP的正常精子症患者精子中的超氧阴离子数量增加,miR-122-5p、miR-34c-5表达量减少,miR-141-3p表达量增加。这与正常精子症患者的精子活力比正常非精子症患者的精子活力下降相对应。通过对目标基因的预测,推测这些 miRNA 在调节脂质激酶活性方面发挥着重要作用,这也是 UP 导致精子膜脂质构成发生变化的原因。结论总之,这些数据强调了 UP 对调节精子活力的表观遗传机制的影响。
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引用次数: 0
Arterial Stiffness and Oxidized LDL Independently Associated With Post-Acute Sequalae of SARS-CoV-2 动脉僵化和氧化低密度脂蛋白与 SARS-CoV-2 急性发作后的症状无关
Q1 Medicine Pub Date : 2023-12-20 DOI: 10.20411/pai.v8i2.634
Sokratis N. Zisis, Jared C. Durieux, Christian Mouchati, Nicholas Funderburg, Kate Ailstock, Mary Chong, Danielle Labbato, Grace McComsey
OBJECTIVE: COVID-19 survivors can experience lingering symptoms known as post-acute sequelae of SARS-CoV-2 (PASC) that appear in different phenotypes, and its etiology remains elusive. We assessed the relationship of endothelial dysfunction with having COVID and PASC.METHODS: Data was collected from a prospectively enrolled cohort (n=379) of COVID-negative and COVID-positive participants with and without PASC. Primary outcomes, endothelial function (measured by reactive hyperemic index [RHI]), and arterial elasticity (measured by augmentation index standardized at 75 bpm [AI]), were measured using the FDA approved EndoPAT. Patient characteristics, labs, metabolic measures, markers of inflammation, and oxidized LDL (ox-LDL) were collected at each study visit, and PASC symptoms were categorized into 3 non-exclusive phenotypes: cardiopulmonary, neurocognitive, and general. COVID-negative controls were propensity score matched to COVID-negative-infected cases using the greedy nearest neighbor method.RESULTS: There were 14.3% of participants who were fully recovered COVID positive and 28.5% who were COVID positive with PASC, averaging 8.64 ± 6.26 total number of symptoms. The mean RHI was similar across the cohort and having COVID or PASC was not associated with endothelial function (P=0.33). Age (P<0.0001), female sex (P<0.0001), and CRP P=0.04) were positively associated with arterial stiffness, and COVID positive PASC positive with neurological and/or cardiopulmonary phenotypes had the worst arterial elasticity (highest AI). Values for AI (P=0.002) and ox-LDL (P<0.0001) were independently and positively associated with an increased likelihood of having PASC. CONCLUSION: There is evidence of an independent association between PASC, ox-LDL, and arterial stiffness with neurological and/or cardiopulmonary phenotypes having the worst arterial elasticity. Future studies should continue investigating the role of oxidative stress in the pathophysiology of PASC.
目的:COVID-19幸存者会出现被称为SARS-CoV-2急性后遗症(PASC)的挥之不去的症状,这些症状会以不同的表型出现,而其病因仍然难以捉摸。我们对内皮功能障碍与 COVID 和 PASC 的关系进行了评估。方法:我们从 COVID 阴性和 COVID 阳性、伴有或不伴有 PASC 的人群(379 人)中收集了数据。使用 FDA 批准的 EndoPAT 测量主要结果、内皮功能(通过反应性充血指数 [RHI] 测量)和动脉弹性(通过以 75 bpm [AI] 为标准的增强指数 [AI] 测量)。在每次就诊时收集患者特征、实验室检查结果、代谢指标、炎症标记物和氧化低密度脂蛋白(ox-LDL),并将 PASC 症状分为 3 种非排他性表型:心肺、神经认知和一般。结果:14.3%的参与者为 COVID 阳性完全康复者,28.5%为 COVID 阳性伴有 PASC,平均症状总数为 8.64 ± 6.26。整个组群的平均 RHI 相似,COVID 或 PASC 与内皮功能无关(P=0.33)。年龄(P<0.0001)、女性性别(P<0.0001)和 CRP(P=0.04)与动脉僵化呈正相关,而 COVID 阳性、PASC 阳性且伴有神经和/或心肺表型的患者动脉弹性最差(AI 最高)。AI值(P=0.002)和ox-LDL值(P<0.0001)与出现PASC的可能性增加呈独立正相关。结论:有证据表明,PASC、ox-LDL 和动脉僵化之间存在独立关联,神经和/或心肺表型患者的动脉弹性最差。未来的研究应继续调查氧化应激在 PASC 病理生理学中的作用。
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引用次数: 0
Highlights from the Inaugural HIV Reservoirs and Immune Control Conference, October 1st–4th 2023, Malahide Ireland 2023 年 10 月 1 日至 4 日在爱尔兰马拉海德举行的首届艾滋病病毒储库与免疫控制会议要点
Q1 Medicine Pub Date : 2023-12-19 DOI: 10.20411/pai.v8i1.653
Una O’Doherty, J. M. Picado, A. Sáez-Cirión
The inaugural FASEB HIV Reservoirs and Immune Control Conference brought researchers together from across the globe to discuss reservoir dynamics in clinical cohorts. It extended over 4 days in the seaside town of Malahide, Ireland. The scientific sessions covered a broad range of topics, including: 1) HIV pathogenesis and control, 2) reservoirs and viral expression, 3) pediatric reservoirs, 4) innate immunity and B cell responses, 5) environmental factors affecting pathogenesis, 6) loss of virologic control, and 7) HIV-2. The following article provides a brief summary of the meeting proceedings and includes a supplementary document with the meeting abstracts. 
首届 FASEB HIV 储库与免疫控制会议汇聚了来自全球各地的研究人员,共同讨论临床队列中的储库动态。会议在爱尔兰的海滨小镇马拉海德(Malahide)举行,历时四天。科学会议涵盖了广泛的主题,包括1) HIV 发病机制和控制,2) 病毒库和病毒表达,3) 儿科病毒库,4) 先天免疫和 B 细胞反应,5) 影响发病机制的环境因素,6) 病毒失控,7) HIV-2。以下文章简要概述了会议情况,并包括一份会议摘要补充文件。
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引用次数: 0
Carbon Dioxide Monitoring Demonstrates Variations in the Quality of Ventilation on Public Transportation Buses and University Student Shuttle Vans and Identifies Effective Interventions. 二氧化碳监测显示了公共交通巴士和大学生穿梭车通风质量的变化,并确定了有效的干预措施。
Q1 Medicine Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.619
David Henry Greentree, Brigid M Wilson, Curtis J Donskey

Background: There is a risk for transmission of severe acute respiratory syndrome 2 (SARS-CoV-2) and other respiratory viruses in motor vehicles, particularly if ventilation is inadequate.

Methods: We used carbon dioxide monitoring to examine the quality of ventilation in several public transportation buses and in university student shuttle vans in the Cleveland metro area during peak and non-peak travel times. Carbon dioxide levels above 800 parts per million (ppm) were considered an indicator of suboptimal ventilation for the number of people present. In the shuttle vans, we evaluated the impact of an intervention to improve ventilation.

Results: In large articulated buses with 2 ventilation systems, carbon dioxide concentrations never exceeded 800 ppm, whereas in standard buses with 1 ventilation system concentrations rose above 800 ppm during peak travel times and on some trips during non-peak travel times. In shuttle vans, the ventilation system was not turned on during routine operation, and carbon dioxide levels rose above 800 ppm on all trips during peak and non-peak travel times. In the shuttle vans, an intervention involving operation of the existing ventilation system resulted in a significant reduction in carbon dioxide levels (mean concentration, 1,042 no intervention versus 785 with intervention; P < 0.001).

Conclusions: Our findings demonstrate substantial variability in the quality of ventilation in public transportation buses and university shuttle vans. There is a need for efforts to assess and optimize ventilation in motor vehicles used for public transportation to reduce the risk for aerosol-mediated transmission of respiratory viruses. Carbon dioxide monitoring may provide a useful tool to assess and improve ventilation.

背景:机动车中存在严重急性呼吸综合征2 (SARS-CoV-2)和其他呼吸道病毒传播的风险,特别是在通风不足的情况下。方法:采用二氧化碳监测方法,对克利夫兰市区多辆公共交通公交车和大学生班车在高峰和非高峰时段的通风质量进行了检测。二氧化碳浓度超过百万分之800 (ppm)被认为是在场人数通风不佳的指标。在穿梭车中,我们评估了改善通风的干预措施的影响。结果:在有两个通风系统的大型铰接式公交车上,二氧化碳浓度从未超过800 ppm,而在有一个通风系统的标准公交车上,二氧化碳浓度在高峰行驶时间和非高峰行驶时间的一些行程中上升到800 ppm以上。在穿梭车上,通风系统在日常运行中没有打开,在高峰和非高峰旅行时间的所有行程中,二氧化碳水平都超过了800ppm。在穿梭车中,涉及操作现有通风系统的干预导致二氧化碳水平显著降低(平均浓度,未干预为1,042,干预为785;P < 0.001)。结论:我们的研究结果表明,公共交通巴士和大学穿梭车的通风质量存在很大差异。有必要努力评估和优化用于公共交通的机动车辆的通风,以减少气溶胶介导的呼吸道病毒传播的风险。二氧化碳监测可能为评估和改善通风提供有用的工具。
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引用次数: 0
Vishva Dixit Shares Insights on His Early Influences, Research Career, Key Findings, and What it Takes to Be Successful in Science. Vishva Dixit分享了他早期的影响,研究生涯,主要发现以及如何在科学上取得成功。
Q1 Medicine Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i2.643
Neil S Greenspan
In this interview, Vishva Dixit, MD, talks with Neil S. Greenspan, MD, PhD, senior editor of Pathogens and Immunity aboutwhat his career in science has revealed about biology in humans, but also what it has revealed about how to be successful in science. Dr. Dixit is a world-famous immunologist and biochemist who has made major contributions to the study of innate immunity in general and particularly to understanding inflammasome activation. He is vice president and senior fellow in physiological chemistry at Genentech.
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引用次数: 0
Dynamics of T-cell Responses Following COVID-19 mRNA Vaccination and Breakthrough Infection in Older Adults. 老年人COVID-19 mRNA疫苗接种和突破感染后t细胞反应的动态变化
Q1 Medicine Pub Date : 2023-11-17 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.613
Sneha Datwani, Rebecca Kalikawe, Francis Mwimanzi, Sarah Speckmaier, Richard Liang, Yurou Sang, Rachel Waterworth, Fatima Yaseen, Hope R Lapointe, Evan Barad, Mari L DeMarco, Daniel T Holmes, Janet Simons, Julio S G Montaner, Marc G Romney, Zabrina L Brumme, Mark A Brockman

Introduction: While older adults generally mount weaker antibody responses to a primary COVID-19 vaccine series, T-cell responses remain less well characterized in this population. We compared SARS-CoV-2 spike-specific T-cell responses after 2- and 3-dose COVID-19 mRNA vaccination and subsequent breakthrough infection in older and younger adults.

Methods: We quantified CD4+ and CD8+ T-cells reactive to overlapping peptides spanning the ancestral SARS-CoV-2 spike protein in 40 older adults (median age 79) and 50 younger health care workers (median age 39), all COVID-19 naive, using an activation-induced marker assay. T-cell responses were further assessed in 24 participants, including 8 older adults, who subsequently experienced their first SARS-CoV-2 breakthrough infection.

Results: A third COVID-19 mRNA vaccine dose significantly boosted spike-specific CD4+ and CD8+ T-cell frequencies to above 2-dose levels in older and younger adults. T-cell frequencies did not significantly differ between older and younger adults after either dose. Multivariable analyses adjusting for sociodemographic, health, and vaccine-related variables confirmed that older age was not associated with impaired cellular responses. Instead, the strongest predictors of CD4+ and CD8+ T-cell frequencies post-third-dose were their corresponding post-second-dose frequencies. Breakthrough infection significantly increased both CD4+ and CD8+ T-cell frequencies, to comparable levels in older and younger adults. Exploratory analyses revealed an association between HLA-A*02:03 and higher post-vaccination CD8+ T-cell frequencies, which may be attributable to numerous strong-binding HLA-A*02:03-specific CD8+ T-cell epitopes in the spike protein.

Conclusion: Older adults mount robust T-cell responses to 2- and 3-dose COVID-19 mRNA vaccination, which are further boosted following breakthrough infection.

虽然老年人通常对COVID-19初级疫苗系列产生较弱的抗体反应,但这一人群的t细胞反应仍然不太清楚。我们比较了老年人和年轻人接种2剂和3剂COVID-19 mRNA疫苗以及随后的突破性感染后的SARS-CoV-2刺突特异性t细胞反应。方法:我们使用激活诱导的标记物测定方法,量化了40名老年人(中位年龄79岁)和50名年轻医护人员(中位年龄39岁)的CD4+和CD8+ t细胞对跨越祖先SARS-CoV-2刺突蛋白重叠肽的反应。进一步评估了24名参与者的t细胞反应,其中包括8名老年人,他们随后首次经历了SARS-CoV-2突破感染。结果:第三种COVID-19 mRNA疫苗剂量显著提高老年人和年轻人的峰值特异性CD4+和CD8+ t细胞频率至2剂量以上。两种剂量后,老年人和年轻人之间的t细胞频率没有显著差异。对社会人口统计学、健康和疫苗相关变量进行调整的多变量分析证实,年龄较大与细胞反应受损无关。相反,第三次给药后CD4+和CD8+ t细胞频率的最强预测因子是它们对应的第二次给药后频率。突破性感染显著增加CD4+和CD8+ t细胞频率,在老年人和年轻人中达到相当水平。探索性分析显示,HLA-A*02:03与较高的接种后CD8+ t细胞频率之间存在关联,这可能归因于刺突蛋白中大量强结合的HLA-A*02:03特异性CD8+ t细胞表位。结论:老年人对2剂和3剂COVID-19 mRNA疫苗产生强大的t细胞应答,并在突破感染后进一步增强。
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Pathogens and Immunity
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