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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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引用次数: 0
Raymond Schinazi Discusses the Discovery of Early Antiretroviral Agents and Sofosbuvir Raymond Schinazi讨论早期抗逆转录病毒药物和索非布韦的发现
Q1 Medicine Pub Date : 2023-11-06 DOI: 10.20411/pai.v8i2.624
Michael M. Lederman, Neil Greenspan
In this interview, Raymond Schinazi, PhD, Hon DSc, talks about his career with Michael M. Lederman, MD, and Neil S. Greenspan, MD, PhD, senior editors of Pathogens and Immunity. Dr. Schinazi has invented numerous powerful antiviral agents including the antiretrovirals lamivudine (3TC) and emtricitabine (FTC) and was instrumental in the discovery of the anti-hepatitis C agent sofosbuvir. These drugs have saved millions of lives and, here, Dr. Schinazi shares in detail how these agents were invented, how they work, and how they are being applied. He also offers his thoughts about newer approaches to treat viral infections.
在这次采访中,Raymond Schinazi博士,Hon DSc,谈到了他与Michael M. Lederman医学博士和Neil S. Greenspan医学博士,病原体和免疫资深编辑的职业生涯。他发明了许多强大的抗病毒药物,包括抗逆转录病毒药物拉米夫定(3TC)和恩曲他滨(FTC),并在发现抗丙型肝炎药物sofosbuvir方面发挥了重要作用。这些药物挽救了数百万人的生命,在这里,Schinazi博士详细分享了这些药物是如何发明的,它们是如何工作的,以及它们是如何应用的。他还提出了他对治疗病毒感染的新方法的看法。
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引用次数: 0
Raymond Schinazi Discusses the Discovery of Early Antiretroviral Agents and Sofosbuvir. Raymond Schinazi讨论早期抗逆转录病毒药物和索非布韦的发现。
Q1 Medicine Pub Date : 2023-11-06 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.624
Michael M Lederman, Neil S Greenspan
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引用次数: 0
The Evolution of Diagnostic Techniques in the Paleopathology of Tuberculosis: A Scoping Review. 结核病古病理学诊断技术的发展:范围界定综述。
Q1 Medicine Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.597
Veronica Papa, Francesco M Galassi, Elena Varotto, Andrea Gori, Mauro Vaccarezza

Tuberculosis (TB) is an ancient chronic infectious disease that remains a global health concern. In human remains, the most common and characteristic clinical signs are the skeletal modifications involving the spine, such as in Pott's disease. Diagnosing TB in ancient human remains is challenging. Therefore, in this systematic review, the authors investigated the studies assessing molecular diagnosis of Pott's disease in ancient human remains with the intention to survey the literature, map the evidence, and identify gaps and future perspectives on TB in paleopathology. Our systematic review offers a full contextualization of the history of Pott's disease in ancient times. Our search strategy was performed between August 2022 and March 2023. The authors initially identified 340 records, and 74 studies were finally included and assessed for qualitative analysis. Due to non-specific clinical signs associated with TB, how best to diagnose tuberculosis in human remains still represents a central point. Nevertheless, ancient DNA (aDNA) analysis, lipid biomarkers, and spoligotyping might be extremely useful tools in the study of TB in human remains. Moreover, we propose the extraction and study of immune response genes involved in innate and adaptive immunity versus Mycobacterium spp. as an innovative and vastly overlooked approach in TB paleopathology. Complementary methodologies should be integrated to provide the best approach to the study of TB in human remains.

肺结核是一种古老的慢性传染病,至今仍是全球健康问题。在人类遗骸中,最常见和最具特征性的临床症状是涉及脊椎的骨骼改变,例如Pott病。在古代人类遗骸中诊断结核病具有挑战性。因此,在这篇系统综述中,作者调查了评估古人类遗骸中Pott病分子诊断的研究,目的是调查文献,绘制证据图,并确定古病理学中结核病的差距和未来前景。我们的系统综述提供了古代波特病历史的完整背景。我们的搜索策略是在2022年8月至2023年3月之间执行的。作者最初确定了340份记录,74项研究最终被纳入并评估进行定性分析。由于与结核病相关的非特异性临床症状,如何最好地诊断人类遗骸中的结核病仍然是一个中心问题。然而,古代DNA(aDNA)分析、脂质生物标志物和孢子分型可能是研究人类遗骸中结核病的非常有用的工具。此外,我们建议提取和研究与对分枝杆菌的先天和适应性免疫有关的免疫反应基因。这是结核病古病理学中一种创新且被广泛忽视的方法。应整合补充方法,为研究人类遗骸中的结核病提供最佳方法。
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引用次数: 0
Genomic Characterization of 2 Cutibacterium acnes Isolates from a Surgical Site Infection Reveals Large Genomic Inversion. 从手术部位感染分离的2株痤疮杆菌的基因组特征揭示了大的基因组倒置。
Q1 Medicine Pub Date : 2023-10-05 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.606
D Garrett Brown, Taylor A Wahlig, Angela Ma, Laura K Certain, Peter N Chalmers, Mark A Fisher, Daniel T Leung

Background: Cutibacterium acnes is a common commensal of human skin but may also present as an opportunistic pathogen in prosthetic joint and wound infections. Unfortunately, few complete genomes of C. acnes are publicly available, and even fewer are of isolates associated with infection. Here we report the isolation, characterization, and complete genomes of 2 C. acnes isolates from a surgical site infection of an elbow.

Methods: We used standard microbiological methods for phenotypic characterization and performed whole genome sequencing on 2 C. acnes isolates using a combination of short-read and long-read sequencing.

Results: Antibiotic susceptibility testing showed beta-lactamase negative and low minimal inhibitory concentrations to all antibiotics tested, with the exception of metronidazole. We assembled complete genomes of the 2 isolates, which are approximately 2.5 megabases in length. The isolates belong to the single-locus sequence type (SLST) H1 and the multi-locus sequence type (MLST) IB. Both isolates have similar composition of known virulence genes, and we found no evidence of plasmids but did find phage-associated genes. Notably, the 2 genomes are 99.97% identical but contain a large genomic inversion encompassing approximately half of the genome.

Conclusions: This is the first characterization of this large-scale genomic inversion in nearly identical isolates from the same wound. This report adds to the limited numbers of publicly available infection-associated complete genomes of C. acnes.

背景:痤疮皮肤杆菌是人类皮肤的常见共生菌,但也可能作为一种机会性病原体出现在人工关节和伤口感染中。不幸的是,很少有完整的痤疮梭菌基因组公开,与感染相关的分离株的基因组更少。在这里,我们报道了从肘部手术部位感染中分离出的2株痤疮梭菌的分离物、特征和完整基因组。方法:我们使用标准微生物学方法进行表型表征,并使用短读和长读测序相结合的方法对2个痤疮梭菌分离株进行全基因组测序。结果:除甲硝唑外,所有受试抗生素的药敏试验均显示β-内酰胺酶阴性,最低抑菌浓度较低。我们组装了这两个分离株的完整基因组,长度约为2.5兆碱基。分离株属于单基因座序列型(SLST)H1和多基因座序列类型(MLST)IB。这两种分离株的已知毒力基因组成相似,我们没有发现质粒的证据,但确实发现了噬菌体相关基因。值得注意的是,这两个基因组有99.97%的相同性,但包含大约一半基因组的大基因组反转。结论:这是首次在来自同一伤口的几乎相同的分离株中对这种大规模基因组倒置进行表征。这份报告增加了有限数量的可公开获得的与感染相关的痤疮梭菌完整基因组。
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引用次数: 0
Military Medicine and Medical Research as a Source of Inspiration and Innovation to Solve National Security and Health Challenges in the 21st Century. 军事医学和医学研究是解决21世纪国家安全和健康挑战的灵感和创新来源。
Q1 Medicine Pub Date : 2023-09-08 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.596
Nanak S Dhillon, Nayeon Jeon, Umut A Gurkan, Anirban Sen Gupta, Robert A Bonomo, Lawrence F Drummy, Mei Zhang, Mark R Chance

The history of military medicine and research is rife with examples of novel treatments and new approaches to heal and cure soldiers and others impacted by war's devastation. In the 21st century, new threats, like climate change, are combined with traditional threats, like geopolitical conflict, to create novel challenges for our strategic interests. Extreme and inaccessible environments provide heightened risks for warfighter exposure to dangerous bacteria, viruses, and fungi, as well as exposure to toxic substances and extremes of temperature, pressure, or both providing threats to performance and eroding resilience. Back home, caring for our veterans is also a health-care priority, and the diseases of veterans increasingly overlap with the health needs of an aging society. These trends of climate change, politics, and demographics suggest performance evaluation and resilience planning and response are critical to assuring both warfighter performance and societal health. The Cleveland ecosystem, comprising several hospitals, a leading University, and one of the nation's larger Veteran's Health Administration systems, is ideal for incubating and understanding the response to these challenges. In this review, we explore the interconnections of collaborations between Defense agencies, particularly Air Force and Army and academic medical center-based investigators to drive responses to the national health security challenges facing the United States and the world.

军事医学和研究史上充斥着治愈士兵和其他受战争破坏影响的人的新疗法和新方法的例子。在21世纪,气候变化等新威胁与地缘政治冲突等传统威胁相结合,给我们的战略利益带来了新的挑战。极端和难以接近的环境增加了作战人员接触危险细菌、病毒和真菌的风险,也增加了接触有毒物质和极端温度、压力的风险,或两者都对性能和恢复力构成威胁。在国内,照顾退伍军人也是医疗保健的优先事项,退伍军人的疾病与老龄化社会的健康需求越来越重叠。气候变化、政治和人口统计的这些趋势表明,绩效评估、恢复力规划和应对对于确保作战人员的绩效和社会健康至关重要。克利夫兰的生态系统由几家医院、一所领先的大学和美国较大的退伍军人健康管理系统之一组成,是孵化和了解应对这些挑战的理想选择。在这篇综述中,我们探讨了国防机构之间的合作关系,特别是空军和陆军以及学术医疗中心的调查人员之间的合作,以推动应对美国和世界面临的国家卫生安全挑战。
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引用次数: 0
Immunohematologic Biomarkers in COVID-19: Insights into Pathogenesis, Prognosis, and Prevention. COVID-19免疫血液学生物标志物:发病机制、预后和预防的见解。
Q1 Medicine Pub Date : 2023-06-26 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.572
David R Sweet, Michael L Freeman, David A Zidar

Coronavirus disease 2019 (COVID-19) has had profound effects on the health of individuals and on healthcare systems worldwide. While healthcare workers on the frontlines have fought to quell multiple waves of infection, the efforts of the larger research community have changed the arch of this pandemic as well. This review will focus on biomarker discovery and other efforts to identify features that predict outcomes, and in so doing, identify possible effector and passenger mechanisms of adverse outcomes. Identifying measurable soluble factors, cell-types, and clinical parameters that predict a patient's disease course will have a legacy for the study of immunologic responses, especially stimuli, which induce an overactive, yet ineffectual immune system. As prognostic biomarkers were identified, some have served to represent pathways of therapeutic interest in clinical trials. The pandemic conditions have created urgency for accelerated target identification and validation. Collectively, these COVID-19 studies of biomarkers, disease outcomes, and therapeutic efficacy have revealed that immunologic systems and responses to stimuli are more heterogeneous than previously assumed. Understanding the genetic and acquired features that mediate divergent immunologic outcomes in response to this global exposure is ongoing and will ultimately improve our preparedness for future pandemics, as well as impact preventive approaches to other immunologic diseases.

2019冠状病毒病(新冠肺炎)对全球个人健康和医疗系统产生了深远影响。尽管前线的医护人员一直在努力平息多波感染,但更大的研究界的努力也改变了这场疫情的格局。这篇综述将侧重于生物标志物的发现和其他努力,以确定预测结果的特征,并在这样做的过程中,确定不良结果的可能效应器和乘客机制。识别可测量的可溶性因子、细胞类型和预测患者病程的临床参数,将为研究免疫反应,特别是刺激,产生过度活跃但无效的免疫系统留下遗产。随着预后生物标志物的确定,一些已经在临床试验中代表了治疗兴趣的途径。新冠疫情条件迫切需要加快目标识别和验证。总之,这些关于生物标志物、疾病结果和治疗效果的新冠肺炎研究表明,免疫系统和对刺激的反应比以前假设的更为异质。了解在应对这种全球暴露时介导不同免疫结果的遗传和后天特征正在进行中,并将最终改善我们对未来流行病的准备,以及对其他免疫疾病的预防方法产生影响。
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引用次数: 0
A Community-Driven Framework to Prioritize the Use of Donated Human Biological Materials in the Context of HIV Cure-Related Research at the End of Life. 一个社区驱动的框架,在生命末期与艾滋病治疗相关的研究中优先使用捐赠的人类生物材料。
Q1 Medicine Pub Date : 2023-05-24 eCollection Date: 2023-01-01 DOI: 10.20411/pai.v8i1.583
Karine Dubé, Thomas J Villa, Jeff Taylor, Andy Kaytes, David J Moore, Susan J Little, Antoine Chaillon, Davey M Smith, Sara Gianella

Initiated in 2017 after extensive community engagement, the Last Gift program enrolls altruistic volunteers willing to donate their cells and tissues at the end of life to allow studies on HIV reservoir dynamics across anatomical sites. As the Last Gift team received tissue requests outside the scope of HIV cure research, we noticed the absence of guiding frameworks to help prioritize the use of altruistically donated human biological materials. In this commentary, we present a proposed framework for prioritizing the use of donated human biological materials within and outside the end-of-life (EOL) HIV cure research context, using the Last Gift study as an example. First, we discuss regulatory and policy considerations, and highlight key ethical values to guide prioritization decisions. Second, we present our prioritization framework and share some of our experiences prioritizing requests for donated human biological materials within and outside EOL HIV cure research.

经过广泛的社区参与,"最后的礼物 "计划于 2017 年启动,招募愿意在生命终结时捐献细胞和组织的利他主义志愿者,以便开展跨解剖部位的 HIV 储库动态研究。在 "最后的礼物 "团队收到艾滋病治愈研究范围之外的组织请求时,我们注意到缺乏指导框架来帮助确定利他捐赠的人类生物材料的优先使用顺序。在这篇评论中,我们以 "最后的礼物 "研究为例,提出了在生命终结(EOL)HIV 治愈研究范围内外优先使用捐赠人体生物材料的建议框架。首先,我们讨论了监管和政策方面的考虑因素,并强调了指导优先决策的关键伦理价值。其次,我们介绍了我们的优先排序框架,并分享了我们在生命末期 (EOL) HIV 治愈研究中和生命末期 (EOL) 以外的捐赠人体生物材料申请优先排序方面的一些经验。
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引用次数: 0
HIV-1 is Transported into the Central Nervous System by Trafficking Infected Cells. HIV-1通过运输感染细胞进入中枢神经系统。
Q1 Medicine Pub Date : 2023-01-23 eCollection Date: 2022-01-01 DOI: 10.20411/pai.v7i2.524
Laura P Kincer, Gretja Schnell, Ronald Swanstrom, Melissa B Miller, Serena Spudich, Joseph J Eron, Richard W Price, Sarah B Joseph

Background: In this work, we carried out a cross-sectional study examining HIV-1 and HCV free virus concentrations in blood and cerebrospinal fluid (CSF) to determine whether HIV-1 enters the central nervous system (CNS) passively as virus particles or in the context of migrating infected cells. If virions migrate freely across the blood-cerebrospinal fluid barrier (BCSFB) or the blood-brain barrier (BBB) then HCV and HIV-1 would be detectable in the CSF at proportions similar to that in the blood. Alternatively, virus entry as an infected cell would favor selective entry of HIV-1.

Methods: We measured HIV-1 and HCV viral loads in the CSF and blood plasma of 4 co-infected participants who were not on antiviral regimens for either infection. We also generated HIV-1 env sequences and performed phylogenetic analyses to determine whether HIV-1 populations in the CSF of these participants were being maintained by local replication.

Results: While CSF samples taken from all participants had detectable levels of HIV-1, HCV was not detectable in any of the CSF samples despite participants having HCV concentrations in their blood plasma, which exceeded that of HIV-1. Further, there was no evidence of compartmentalized HIV-1 replication in the CNS (Supplementary Figure 1). These results are consistent with a model where HIV-1 particles cross the BBB or the BCSFB within infected cells. In this scenario, we would expect HIV-1 to reach the CSF more readily because the blood contains a much greater number of HIV-infected cells than HCV-infected cells.

Conclusions: HCV entry into the CSF is restricted, indicating that virions do not freely migrate across these barriers and supporting the concept that HIV-1 is transported across the BCSFB and/or BBB by the migration of HIV-infected cells as part of an inflammatory response or normal surveillance.

背景:在这项工作中,我们开展了一项横断研究,检测血液和脑脊液(CSF)中HIV-1和HCV游离病毒浓度,以确定HIV-1是作为病毒颗粒被动进入中枢神经系统(CNS),还是在迁移感染细胞的背景下进入中枢神经系统(CNS)。如果病毒粒子在血-脑脊液屏障(BCSFB)或血-脑屏障(BBB)中自由迁移,那么HCV和HIV-1在脑脊液中的检测比例将与在血液中的检测比例相似。或者,病毒作为受感染细胞进入将有利于HIV-1的选择性进入。方法:我们测量了4名合并感染的参与者脑脊液和血浆中的HIV-1和HCV病毒载量,他们没有接受任何一种感染的抗病毒治疗。我们还生成了HIV-1环境序列,并进行了系统发育分析,以确定这些参与者脑脊液中的HIV-1种群是否通过局部复制得以维持。结果:虽然从所有参与者采集的CSF样本中检测到HIV-1水平,但在任何CSF样本中均未检测到HCV,尽管参与者的血浆中HCV浓度超过HIV-1浓度。此外,没有证据表明HIV-1在中枢神经系统中存在区隔性复制(补充图1)。这些结果与HIV-1颗粒在感染细胞内穿过血脑屏障或BCSFB的模型一致。在这种情况下,我们预计HIV-1更容易到达脑脊液,因为血液中含有的hiv感染细胞比hcv感染细胞多得多。结论:HCV进入脑脊液受到限制,表明病毒粒子不能自由迁移穿过这些屏障,并支持HIV-1通过hiv感染细胞的迁移穿越BCSFB和/或血脑屏障的概念,作为炎症反应或正常监测的一部分。
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引用次数: 0
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