Effect of immunoglobulin Y formulations on oral microorganisms in human subjects - A systematic review and meta-analysis of clinical trials

Background: Passive immunization using egg yolk-based antibodies has been tested against oral microorganisms. Our study assessed the effect of immunoglobulin Y (IgY) formulations on Streptococcus mutans, Porphyromonas gingivalis, and Candida albicans in human subjects. Highlights: VS and UT independently searched articles using keyword combinations in four search engines; studies in English were selected. Either parallel-arm or split-mouth randomized controlled trials on healthy human subjects were considered. Ten studies remained in the selection; six studies compared the effect of IgY formulations on S. mutans, three on P. gingivalis, and one on C. albicans. Five studies (422 subjects) compared the effect of IgY formulations on S. mutans. When fixed-effect model (FEM) was applied, the risk ratio (RR) (confidence interval [CI]) was found to be 7.81 (6.00, 10.18). Three studies (167 subjects) compared the effect of IgY formulations on P. gingivalis. When FEM was applied, the RR (CI) was found to be 0.06 (?0.03, 0.15) in relation to reduction in probing depth. When FEM was applied, for percentage reduction in bleeding on probing (BOP), the RR (CI) was 1.99 (1.64, 2.41). Only one study (26 subjects) was available of IgY formulation and C. albicans; hence meta-analysis was not performed. The search was extended using Google Scholar, Semantic Scholar, cross-references and by contacting authors and researchers in the field which further yielded five articles. . Conclusions: IgY formulations were effective in the reduction of S. mutans. They were not effective on P. gingivalis in relation to probing depth but were effective in relation to reduction in BOP. No harms were reported. Evidence is of low quality due to high heterogeneity. The ROB was moderate and publication bias was low.

Treatment of oral and maxillofacial dog bites in children / 口腔疾病防治

Objective @#To summarize experience treating dog bites in the oral and maxillofacial regions of children and provide a reference for clinical practice.@*Methods @#Nineteen children with dog bite wounds in the maxillofacial region were treated from July 2011 to June 2018 with primary debridement and suturing. A rabies vaccine, tetanus vaccine and human immunoglobulin as a passive immune agent were given via intramuscular injection. Anti-inflammatory therapy with amoxicillin and clavulanate potassium or other antibiotics. Follow-up observation and a retrospective analysis of the treatment effect were carried out.@*Results@#After treatment, among the 19 pediatric patients, 18 cases showed primary healing and 1 case showed secondary healing. The follow-up period ranged from six months to seven and a half years. No cases of rabies occurred.@*Conclusion @#For the treatment of patients with maxillofacial dog bite wounds, the first stage debridement and suture can reduce the scar after operation and is beneficial to the recovery of face.

Clinical and microbiological effects of egg yolk antibody against Porphyromonas gingivalis as an adjunct in the treatment of moderate to severe chronic periodontitis: a randomized placebo-controlled clinical trial

PURPOSE: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis. METHODS: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis. RESULTS: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects. CONCLUSIONS: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.

Avaliação do programa de uso da imunoglobulina palivizumabe no Estado de São Paulo, Brasil / Assessment of the program for use of the monoclonal antibody palivizumab in São Paulo State, Brazil / Evaluación del programa de uso de la inmunoglobulina palivizumab en el Estado de São Paulo, Brasil

O objetivo deste estudo foi avaliar o programa de uso da imunoglobulina palivizumabe no Estado de São Paulo, Brasil. Adotou-se o referencial de avaliação proposto por Donabedian, e os dados foram discutidos com base nas recomendações da Portaria que regulamenta o uso da palivizumabe em rede nacional e no Manual de Normas e Procedimentos para Vacinação. Foram incluídos os 16 locais de aplicação do estado, bem como 693 crianças/mães inscritas no programa em 2014 (85,1% da população elegível). Para avaliação da estrutura e processo foram criados escores que permitiram classificar os locais de aplicação em adequado, parcialmente adequado e inadequado, quando havia até 10%, de 11-20% e superior a 20% de desconformidades, respectivamente. Para a avaliação de resultado, buscou-se associação entre falha na tomada da palivizumabe e a necessidade de hospitalização por doença/sintomatologia respiratória, baseando-se em odds ratio pontual e intervalar, com intervalo de 95% de confiança e valor de p crítico < 0,05. Dos 11 postos de aplicação que tiveram estrutura classificada como adequada, apenas dois apresentaram processo adequado, quatro apresentaram processo inadequado e cinco parcialmente adequados. O risco de hospitalização em UTI por doença/sintomatologia respiratória aumentou em média 30% a cada falha (p = 0,003; OR = 1,30; IC95%: 1,09-1,55). Conclui-se que ter estrutura do programa de uso da imunoglobulina no Estado de São Paulo favorável não resultou, necessariamente, em processo adequado. Em geral, a situação da estrutura foi melhor do que a de processo. Mostrou-se relevante a aplicação de todas as doses da imunoglobulina para a prevenção de internação por doença/sintomatologia respiratória.

This study aimed to assess the program for use of the monoclonal antibody palivizumab in São Paulo State, Brazil. The evaluation adopted the frame of reference proposed by Donabedian, and the data were discussed on the basis of the guidelines from the Ruling on the use of palivizumab in the national network and in the Manual on Standards and Procedures for Vaccination. Sixteen application services in the state were included, with 693 children/mothers enrolled in the program in 2014 (85.1% of the eligible population). For the structure and process evaluation, scores were created that allowed classifying the application services as adequate, partially adequate, and inadequate (non-compliance rates were ≤ 10%, 11-20%, and > 20%, respectively). Results were evaluated according to the association between failure to administer palivizumab and need for hospitalization due to respiratory disease/symptoms, based on the point and interval odds ratios, with 95% confidence interval and critical p-value < 0.05. Of the 11 application services whose structure was classified as adequate, only two showed adequate process, four showed inadequate process, and five partially adequate process. Risk of ICU admission due to respiratory disease/symptoms increased on average by 30% for each failure (p = 0.003; OR = 1.30; 95%CI: 1.09-1.55). In conclusion, having a favorable structure for the program for use of palivizumab in São Paulo State did not necessarily result in an adequate process. In general, the situation with the structure was better than the process. All doses of the monoclonal antibody need to be administered in order to prevent hospitalization from respiratory disease/symptoms.

El objetivo de este estudio fue evaluar el programa de uso de la inmunoglobulina palivizumab en el Estado de São Paulo, Brasil. Se adoptó el sistema referencial de evaluación propuesto por Donabedian, donde los datos se discutieron en base a las recomendaciones del decreto que regula el uso del palivizumab en la red nacional y en el Manual de Normas y Procedimientos para la Vacunación. Se incluyeron 16 espacios de aplicación en el estado, así como a 693 niños/madres inscritas en el programa en 2014 (85,1% de la población elegible). Para la evaluación de la estructura y proceso se crearon marcadores que permitieron clasificar los lugares de aplicación como: adecuado, parcialmente adecuado e inadecuado, cuando había hasta un 10%, de 11-20% y superior al 20% de discordancias, respectivamente. Para la evaluación del resultado, se buscó la asociación entre el fallo en la toma del palivizumab y la necesidad de hospitalización por enfermedad/sintomatología respiratoria, basándose en la razón de probabilidades puntual y con intervalos, con un intervalo del 95% de confianza y valor de p crítico < 0,05. De los 11 puestos de aplicación que contaron con una estructura clasificada como adecuada, solamente dos presentaron un proceso adecuado, cuatro presentaron proceso inadecuado y cinco parcialmente adecuados. El riesgo de hospitalización en la UTI por enfermedad/sintomatología respiratoria aumentó de media un 30% con cada fallo (p = 0,003; OR = 1,30; IC95%: 1,09-1,55). Se concluye que contar con una estructura del programa de uso de la inmunoglobulina en el Estado de São Paulo no resultó favorable, necesariamente, en un proceso adecuado. En general, la situación de la estructura fue mejor que la del proceso. Se mostró relevante la aplicación de todas las dosis de inmunoglobulina para la prevención del internamiento por enfermedad/sintomatología respiratoria.

Clinical research progress in immunotherapy against atherosclerosis / 上海交通大学学报（医学版）

Atherosclerosis is a chronic inflammatory disease,with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens.Subsequent investigations have revealed that an immunomodulatory strategy via active immunization against atherosclerotic plaque antigen(s) could potentially alleviate atherosclerosis.Substantial data from clinical investigations support the key role of immune system in atherosclerosis.So,it may be promising to develop immunotherapy against atherosclerosis.The paper reviews current status of immunization studies and possible associated immunemediated inflammatory mechanisms in atherosclerosis.

Impact of the use of immunoglobulin palivizumab in the State of São Paulo: a cohort study / Impacto do uso da imunoglobulina palivizumabe no Estado de São Paulo: estudo de coorte / Impacto del uso de la inmunoglobulina palivizumab en el Estado (provincia) de São Paulo: estudio de cohorte

ABSTRACT Introduction: the use of palivizumab as prophylaxis of the respiratory syncytial virus is not a consensus. In Brazil, it is a public health program, but other countries do not consider it cost-effective. Objective: to identify the rate of hospitalization in Intensive Care Unit for respiratory illness or symptoms among children who received the immunoglobulin palivizumab, the proportion of children who failed to take any of the recommended doses and the impact of that failure on hospitalization. Method: cohort study conducted with 693 children enrolled in the palivizumab program in 2014 (85.1% of the population), with monthly assessment from April to September through a telephone call to the mothers or caregiver. The probability of hospitalization in the Intensive Care Unit related to failure in taking the palivizumab, was analyzed through multiple logistic regression, with p<0,05. Results: the hospitalization rate was 18.2%; 2.3% of the children did not receive all the recommended immunoglobulin doses; the probability of hospitalization for respiratory illness or symptoms increased by an average of 29% at each missed dose (p=0.007; OR=1.29, CI=1.07-1.56). Conclusion: the increase in the chance of hospitalization related to missed immunoglobulin doses indicates the need to implement health education actions and active search for absent children by the health services.

RESUMO Introdução: o uso da palivizumabe como profilaxia do vírus sincicial respiratório não é consenso. No Brasil, constitui programa de saúde pública, mas outros países não a consideram custo-efetiva. Objetivo: identificar a taxa de hospitalização em Unidade de Terapia Intensiva por doença ou sintomatologia respiratória entre crianças que receberam imunoglobulina palivizumabe, a proporção de crianças que falharam na tomada de alguma das doses indicadas e o impacto dessa falha na hospitalização. Método: estudo de coorte, incluídas 693 crianças inscritas no programa em 2014 (85,1% da população), com seguimento mensal de abril a setembro, por ligação telefônica às mães/responsáveis. A chance de hospitalização, em Unidade de Terapia Intensiva, em função da falha, foi avaliada por regressão logística múltipla, adotando-se p crítico <0,05. Resultados: a taxa de hospitalização foi de 18,2%; não receberam todas as doses da imunoglobulina 2,3% das crianças; a chance de hospitalização por doença ou sintomatologia respiratória aumentou, em média, 29% a cada falha na tomada de alguma dose (p=0,007; OR=1,29, IC=1,07-1,56). Conclusão: o aumento da chance de hospitalização na vigência de falha na tomada de alguma dose da imunoglobulina indica a necessidade de implementação de ações de educação em saúde e busca ativa de crianças faltosas pelos serviços de saúde.

RESUMEN Introducción: el uso de la palivizumab como profilaxis del virus sincitial respiratorio no es consenso a nivel mundial. En el Brasil, está incluido en el programa de salud pública, pero en otros países no se lo considera costo-efectivo. Objetivo: identificar el porcentaje de hospitalización en Unidades de Terapia Intensiva por enfermedad o sintomatología respiratoria entre niños que recibieron inmunoglobulina palivizumab, determinar la proporción de niños que no tomaron alguna de las dosis indicadas y el impacto de dicha falla en la hospitalización. Método: estudio de cohorte, realizado entre 693 niños inscriptos en el programa en 2014 (85,1% de la población), con seguimiento mensual de abril a septiembre, a través de pláticas telefónicas con las madres/responsables. La probabilidad de hospitalización en una Unidad de Terapia Intensiva, en función de la falla, se evaluó por regresión logística múltiple, adoptando el p crítico <0,05. Resultados: la tasa de hospitalización fue del 18,2%; el 2,3% de los niños no recibió todas las dosis de la inmunoglobulina; la probabilidad de hospitalización por enfermedad o sintomatología respiratoria aumentó en un promedio del 29% a cada falla en la toma de alguna dosis (p = 0,007; OR = 1,29, IC = 1,07-1,56). Conclusión: el aumento de la probabilidad de hospitalización cuando hay falla en la ingestión de alguna dosis de la inmunoglobulina indica la necesidad de implantar acciones educativas en salud y que los servicios de salud se ocupen eficazmente de buscar a los niños faltantes.

Prospective birth cohort in a hyperendemic dengue area in Northeast Brazil: methods and preliminary results / Coorte de nascimento prospectiva em uma área hiperendêmica em dengue no Nordeste do Brasil: métodos e resultados preliminares / Cohorte de nacimientos en un área hiperendémica en dengue en el nordeste de Brasil: métodos y resultados preliminares

Abstract Dengue cases have increased in younger age groups in Brazil. Maternal anti-dengue antibodies can have a protective effect in the first months of life, but their decline can increase the risk of severe dengue. A prospective birth cohort was established in 2011-2012 in the city of Recife, Pernambuco State, Brazil, to determine the incidence of serotype-specific dengue infection and the kinetics of transferred maternal anti-dengue antibodies in the first years of life. This article describes the design, methods and preliminary results of this cohort study. 354 children underwent clinical and laboratory monitoring for two years, with 15% losses to follow-up. The overall rate of new infections was approximately 10% in the first year of follow-up. Information on the force of serotype-specific dengue infection and the evaluation of transferred maternal antibodies can contribute to understanding dengue etiopathogenesis.

Resumo Casos de dengue têm aumentado em grupos etários mais jovens no Brasil. Anticorpos antidengue maternos podem exercer efeito protetor nos primeiros meses de vida, mas seu declínio pode aumentar o risco de dengue grave. Uma coorte de nascimento prospectiva foi estabelecida na cidade do Recife, Pernambuco, Brasil, entre 2011-2012, para determinar a incidência de infecção sorotipo-específica do dengue e cinética dos anticorpos antidengue materno-transferidos nos primeiros anos de vida. Este artigo descreve o desenho, os métodos e resultados preliminares deste estudo de coorte. Trezentas e cinquenta e quatro crianças foram acompanhadas clínico e laboratorialmente por dois anos, com 15% de perdas de seguimento. A taxa global de novas infecções foi de aproximadamente 10% na coorte de crianças no primeiro ano de seguimento. Informações sobre a força de infecção sorotipo-específica do dengue nos primeiros anos de vida, bem como a avaliação da cinética de anticorpos materno-transferidos poderão contribuir para a compreensão da etiopatogenia da doença.

Resumen Los casos de dengue han aumentado en los grupos de edad más jóvenes en Brasil. Los anticuerpos antidengue maternos pueden ejercer un efecto protector en los primeros meses de vida, pero su decremento puede aumentar el riesgo de dengue grave. Una cohorte de nacimientos prospectiva se estableció en la ciudad de Recife, Pernambuco, Brasil, entre 2011-2012, para determinar la incidencia de infección serotipo-específica de dengue y la cinética de los anticuerpos antidengue materno-transferidos durante los primeros años de vida. Este artículo describe el diseño, los métodos y resultados preliminares de este estudio de cohorte. 354 niños fueron acompañados clínicamente y en laboratorio durante dos años, con un 15% de pérdidas en el seguimiento. La tasa global de nuevas infecciones fue de aproximadamente un 10% en la cohorte de niños durante el primer año de seguimiento. La información sobre la fuerza de infección serotipo-específica del dengue en los primeros años de vida, así como la evaluación de la cinética de los anticuerpos materno-transferidos, podrá contribuir a la comprensión de la etiopatogenia de la enfermedad.

Prevention of mother-to-child transmission of hepatitis B virus:controversies and focuses of current strategies / 临床肝胆病杂志

Mother-to-child transmission (MTCT)is an important way of hepatitis B virus (HBV)transmission.Blocking the HBV MTCT has a great significance for the prevention and treatment of hepatitis B.This article reviews the current blocking strategies implemented in the antepar-tum,peripartum,and postpartum stages,and summarizes the controversies existing in the blocking strategies in different stages.The significance of HBV occult infection and germ cell transmission in the HBV MTCT is analyzed.The results indicate that the current strategies for the prevention of hepatitis B MTCT need further improvement.Attentions should be focused on HBV occult infection and germ cell transmission.

Um estudo do rendimento do veneno de cobras corais brasileiras e seu uso na avaliação do soro antielapídico / A study on venom yield of Brazilian coralsnakes and its use in the evaluation of antielapidic serum

Objetivos: Investigar a correlação entre quantidade de veneno produzido por uma cobra coral verdadeira e o tamanho da mesma, e avaliar a produção e o uso do soro antielapídico, levando em conta tamanho, capacidade inoculatória e variabilidade de espécies dessas cobras nasdiversas regiões do Brasil.Métodos: Para avaliação da diversidade e distribuição geográfica, foi realizada pesquisa bibliográfica e eletrônica no site oficial da SociedadeBrasileira de Herpetologia. Para obtenção de dados sobre epidemiologia dos acidentes elapídicos, foi pesquisado o Sistema de Informação de Agravos a Notificação do Ministério da Saúde. Dados de quantidade de veneno e tamanho das cobras das quais o mesmo foi extraído foram obtidos em trabalho de campo realizado entre os anos de 1986 e 2010, que estavam armazenadas no banco de venenos do Centro de Estudos e Pesquisas Biológicas da Pontifícia Universidade Católica de Goiás.Resultados: A maior diversidade de espécies de cobras corais verdadeiras está na região Norte e a maior casuística de acidentes elapídicos na região Nordeste. A análise de regressão linear mostrou forte correlação entre tamanho corporal e quantidade de veneno extraído. A maioria das espécies de cobras corais apresenta tamanho pequeno ou médio. Foi identificada uma diversidade de 35 táxons de cobras corais no Brasil, enquanto o soro antielapídico em uso no País é produzido a partir de três espécies.Conclusões: Devido ao porte reduzido, que resulta em baixa capacidade inoculatória, a recomendação de altas doses de soro antielapídico na ocorrência de acidentes com cobras corais deveria ser revista. Entretanto, a especificidade do veneno de cada espécie gera preocupação sobre a eficácia do soro antielapídico produzido a partir de um número reduzido de espécies de cobras corais.

Aims: To investigate the correlation between the amount of venom produced by a true coral snake and its size, and to evaluate the production and use of antielapidic serum, taking into account size, innoculatory power, and variability of these species in different regions of Brazil.Methods: To assess the diversity and geographic distribution we conducted a bibliographic review and electronic search in the official site of the Brazilian Herpetological Society. Diseases Report Information System of the Ministry of Health was consulted to obtain data on the epidemiology of elapidic accidents. Data on amount of extracted venom and size of the snakes were obtained from work conducted between 1986 and 2010, which data were stored in the venom database of the Centre for Studies and Biological Research of the Catholic University of Goiás.Results: The greatest diversity of species of coral snakes are in the Northern region and the largest sample of Micrurus accidents in the Northeast region. Linear regression analysis showed a strong correlation between body size and amount of venom extracted. Most species of coral snake have small or medium size. A diversity of 35 taxa of coral snakes in Brazil has been identified, while the antielapidic serum in use in this country is produced from three species.Conclusions: Due to the small size, which results in low innoculatory capacity, recommending high doses of antielapidic serum in accidents with coral snakes should be revised. However, the specificity of the venom of each species raises concerns about the effectiveness of antielapidic serum produced from a small number of species of coral snakes.

Recent Advances in Toxoplasma gondii Immunotherapeutics

Toxoplasmosis is an opportunistic infection caused by the protozoan parasite Toxoplasma gondii. T. gondii is widespread globally and causes severe diseases in individuals with impaired immune defences as well as congenitally infected infants. The high prevalence rate in some parts of the world such as South America and Africa, coupled with the current drug treatments that trigger hypersensitivity reactions, makes the development of immunotherapeutics intervention a highly important research priority. Immunotherapeutics strategies could either be a vaccine which would confer a pre-emptive immunity to infection, or passive immunization in cases of disease recrudescence or recurrent clinical diseases. As the severity of clinical manifestations is often greater in developing nations, the development of well-tolerated and safe immunotherapeutics becomes not only a scientific pursuit, but a humanitarian enterprise. In the last few years, much progress has been made in vaccine research with new antigens, novel adjuvants, and innovative vaccine delivery such as nanoparticles and antigen encapsulations. A literature search over the past 5 years showed that most experimental studies were focused on DNA vaccination at 52%, followed by protein vaccination which formed 36% of the studies, live attenuated vaccinations at 9%, and heterologous vaccination at 3%; while there were few on passive immunization. Recent progress in studies on vaccination, passive immunization, as well as insights gained from these immunotherapeutics is highlighted in this review.

Aditivos alimentares na dieta de bovinos confinados / Feed additives in feedlot diets

O objetivo do presente trabalho foi avaliar o efeito da inclusão do preparado de anticorpos policlonais (PAP) e/ou da monensina sódica (MON) sobre o desempenho, as características da carcaça, o perfil de ácidos graxos da carcaça (PAG) e a concentração de lipoproteínas sanguíneas (CLS) de bovinos confinados. O delineamento experimental foi inteiramente ao acaso, em arranjo fatorial 2 x 2, com medidas repetidas no tempo, sendo os fatores a inclusão ou não de MON e PAP avaliados em dois períodos, em que 72 bovinos machos da raça Brangus, não castrados, foram alocados em 24 baias (três animais/baia), totalizando seis repetições por tratamento. Não foi observado efeito (P>0,05) da inclusão do PAP para nenhuma das varáveis de desempenho e características de carcaça. Contudo, foi observado efeito (P<0,05) da inclusão de MON, em que animais que receberam MON apresentaram maiores ganho de peso diário (1,666 vs. 1,552), ganho de peso total (179,95 vs. 167,68), peso vivo final (474,86 vs. 459,61), peso de carcaça quente (248,46 vs. 240,20), melhor conversão alimentar (5,57 vs. 5,79) e reduzido custo para ganhar um quilo de peso vivo (3,06 vs. 3,18). Ainda não foi observado efeito principal (P>0,05) dos aditivos para o PAG e a CLS. Assim, a inclusão do PAP não foi boa alternativa à substituição da MON. Por outro lado, a inclusão do PAP não afetou negativamente os itens estudados.

This study was designed to test the effects of polyclonal antibody preparation (PAP) against several rumen bacteria and/or monensin (MON) on feedlot performance, carcass characteristics, fatty acid profile and blood lipoprotein concentrations in yearling bulls. Seventy-two Brangus yearling bulls were distributed in a completely randomized design with 2 x 2 factorial arrangements of treatments with six replications; factors were the inclusion or not of PAP or MON, measured over two phases. No significant (P>0.05) PAP main effects were observed for any of the feedlot performance and carcass trait variables. However, significant (P>0.05) MON main effects were observed, where animals receiving MON had higher (P<0.05) average daily gain (1.666 vs. 1.552), total weight gain (179.95 vs. 167.68), final body weight (474.86 vs. 459.61), hot carcass weight (248.46 vs. 240.20), better feed: gain ratio (5.57 vs. 5.79) and better cost to gain one kilo of body weight (3.06 vs. 3.18). No significant (P>0.05) main effects due to feed additives were observed for carcass fatty acid profile and blood lipoprotein concentrations. Therefore, the inclusion of PAP was not a good alternative to replace MON. On the other hand, feeding PAP did not negatively impact the items studied.

Aplicaciones terapéuticas de las inmunoglobulinas humanas en Pediatría / Therapeutic applications of human immunoglobulines in Pediatrics

En la actualidad existen diversos productos farmacéuticos constituidos por inmunoglobulinas (fundamentalmente IgG), purificadas por diversos métodos, lo que implica que pueden ser administradas por diversas vías (intramuscular, intravenosa y subcutánea). Estos productos tienen un amplio espectro de indicaciones en diversas enfermedades. Las inmunoglobulinas son los efectores finales de la respuesta inmune humoral, por lo que sus indicaciones fundamentales incluyen la terapia de reemplazo en enfermedades que cursan con déficit en la producción de anticuerpos, las situaciones en que se necesita de manera inmediata la presencia de anticuerpos neutralizantes, como en las terapias posexposición, y en enfermedades que cursan con disrregulación de la respuesta inmune

There are presently several pharmaceuticals made up of immunoglobulines (fundamentally IgG) purified by several methods, which means that they can be administered by different routes (intramuscularly, intravenously and subcutaneously). These products have a wide spectrum of prescriptions for several diseases. The immunoglobulins are the final effectors of the humoral immune response, so their fundamental prescriptions cover replacement therapies in diseases with antibody production deficit, situations requiring immediate presence of neutralizing antibodies such as post-exposure therapies, and diseases with immune response deregulation

Nuevas vacunas contra la morfina/heroína / Novel Vaccines against morphine/heroin

Drug addiction is one of the most important health problems in the world. This psychiatry disease results in the death of about 500 000 individuals annually in the world. Despite this scenario, the development of effective drug therapies against this disease has been slow and not very successful. In recent years, new alternative pharmacological strategies against drug addiction have been designed and validated. Among them are vaccines against drugs like nicotine, morphine or cocaine and their subsequent use in immunotherapeutic pharmacological procedures for the treatment of addictive behaviors of drug consumption, both in animal models and in humans. These strategies are based on the experimental design and synthesis of various structural formulations of therapeutic vaccines against drugs of abuse. When dosed in active immunization schedules, they induce the production of specific antibodies, which recognize and bind these substances in the intravascular space and prevent the drug permeability through the blood brain barrier, resulting in decreased effects of drugs into the brain. In 2006, our research group at the National Institute of Psychiatry Ramón de la Fuente Muñiz (INPRFM) achieved and consolidated the design, synthesis, application and validation of immunoprotective therapeutic effects against relapse to morphine/heroin addiction in a rodent animal model, a model vaccine for potential human use against addiction to morphine/heroin. This model shows immunogenic capacities (high and sustained titers of highly specific antibodies) and immunoprotection (attenuates the effect up to 15mg/kg sc morphine) that the structural vaccine models competing have not been matched, which makes it the leading vaccine model against the addictive effects of heroin and morphine.

La adicción a una droga de abuso representa uno de los problemas sanitarios más importantes ya que esta patología genera la muerte de cerca de 500 000 sujetos anualmente en el mundo. A pesar de este panorama, el desarrollo de terapias farmacológicas efectivas contra esta enfermedad es lento y poco exitoso. En los últimos años se han diseñado y validado nuevas estrategias farmacológicas alternativas contra la adicción a drogas de abuso, como las vacunas y su uso en procedimientos farmacológicos inmunoterapéuticos para el tratamiento de esas conductas tanto en modelos de animales como en el humano. Estas nuevas estrategias experimentales están basadas en el diseño y síntesis de diversas formulaciones estructurales de vacunas terapéuticas contra las sustancias de abuso las cuales, al ser dosificadas en esquemas de inmunización activa, inducen la producción de anticuerpos séricos específicos que reconocen y se unen a estas sustancias en el espacio intravascular sistémico e impiden que crucen la barrera hematoencefálica, con lo cual disminuyen sus efectos en el cerebro. En el año 2006 nuestro grupo de trabajo en el Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (INPRFM) logró y consolidó el diseño, síntesis, aplicación y validación de efectos terapéuticos inmunoprotectores contra recaídas al consumo adictivo de morfina/heroína, en un modelo animal con roedores y su escalamiento potencial para uso humano contra la adicción a esas sustancias. Este modelo muestra capacidades inmunogénicas (títulos altos y sostenidos de anticuerpos altamente específicos) y de inmunoprotección (atenúa el efecto de hasta 15mg/Kg sc de morfina) que los modelos estructurales de vacuna desarrollados por otros grupos de investigadores no han podido igualar. Esto lo convierte en un modelo líder de vacuna contra los efectos adictivos de la heroína y morfina.

Sorovacinação antirrábica: aspectos epidemiológicos e implicações para a assistência de enfermagem / Anti-rabies serovaccination: epidemiological aspects and implications for nursing care

This study was developed with the purpose to search for relevant knowledge concerning nursing care for individuals exposed to the rabies virus and submitted to post-exposure anti-rabies serovaccination. The authors aimed at evaluating the epidemiological aspects of accidents involving household and wild animals occurring in 2007 and patients assisted at a reference hospital located in the mid-southern region of São Paulo State. They also aimed at identifying the relevance of nurses' actions by describing aspects of care provision. The method adopted was exploratory, retrospective and descriptive of the epidemiological aspects of the accidents and of the care provided to these patients by referring to information in their medical charts. Fifty-one charts of patients aged 17 to 81 years, considered to be at risk and with indication for post-exposure prophylaxis against human rabies were evaluated. It was found that nursing care provision to these patients presents low complexity although it requires properly trained professionals. It was possible to identify the relevance of nurses' actions in care provision and procedures related to anti-rabies prophylaxis; however, consistent information concerning nursing care was not observed.

Este estudo foi desenvolvido com a finalidade de buscar conhecimentos relevantes para a assistência de enfermagem a indivíduos expostos ao vírus da raiva submetidos à sorovacinação antirrábica pós-exposição. Os autores se propuseram a realizar esta pesquisa com os objetivos de verificar aspectos epidemiológicos dos acidentes por animais domésticos e silvestres ocorridos no ano de 2007 que foram atendidos em um hospital de referência localizado na região centro-sul do Estado de São Paulo, e identificar a relevância das ações do enfermeiro, descrevendo aspectos do cuidado. O método adotado foi exploratório, retrospectivo e descritivo dos aspectos epidemiológicos dos acidentes e da assistência a esses indivíduos por meio de informações constantes nos prontuários dos pacientes. Foram avaliados 51 prontuários de pacientes com idades entre 17 e 81 anos, considerados em situação de risco, com indicação de profilaxia pós-exposição contra raiva humana. Constatou-se que a assistência de enfermagem a esses pacientes é de baixa complexidade, embora requeira profissionais com preparo adequado para esse atendimento. Foi possível identificar a relevância das ações do enfermeiro na assistência e nos procedimentos relacionados aos cuidados que devem ser seguidos na profilaxia antirrábica, porém não foram encontradas informações consistentes sobre a assistência de enfermagem.

Production of Monoclonal Antibodies Specific to FimA of Porphyromonas gingivalis and Their Inhibitory Activity on Bacterial Binding

BACKGROUND: The FimA of Porphyromonas gingivalis is a crucial pathogenic component of the bacteria and has been implicated as a target for vaccine development against the periodontal diseases. METHODS: In this study, the purified fimbriae (FimA subunit polymers) protein was used for immunization in their native form and B hybridoma clones producing antibodies specific to FimA were established. RESULTS: The monoclonal antibodies prepared from selected two clones, designated #123 (IgG2b/ kappa) and #265 (IgG1/kappa), displayed different patterns of binding activity against the cognate antigen. Both antibodies reacted with conformational epitopes expressed by partially dissociated oligomers, but not with monomer as elucidated by Western blot analysis. Ascites fluid containing the monoclonal antibodies showed the inhibitory activity against P. gingivalis to saliva-coated hydroxyapatite beads, an in vitro model for the pellicle-coated tooth surface. CONCLUSION: These results suggest that the monoclonal antibodies could be used as vaccine material against the periodontal diseases through passive immunization.

Antibodies against electronegative LDL inhibit atherosclerosis in LDLr-/- mice

In order to determine the effect of antibodies against electronegative low-density lipoprotein LDL(-) on atherogenesis, five groups of LDL low receptor-deficient (LDLr-/-) mice (6 per group) were immunized with the following antibodies (100 µg each): mouse anti-LDL(-) monoclonal IgG2b, rabbit anti-LDL(-) polyclonal IgG or its Fab fragments and mouse irrelevant monoclonal IgG and non-immunized controls. Antibodies were administered intravenously one week before starting the hypercholesterolemic diet (1.25 percent cholesterol) and then every week for 21 days. The passive immunization with anti-LDL(-) monoclonal IgG2b, polyclonal antibody and its derived Fab significantly reduced the cross-sectional area of atherosclerotic lesions at the aortic root of LDLr-/- mice (28.8 ± 9.7, 67.3 ± 17.02, 56.9 ± 8.02 µm² (mean ± SD), respectively) compared to control (124.9 ± 13.2 µm²). Vascular cell adhesion molecule-1 protein expression, quantified by the KS300 image-analyzing software, on endothelium and the number of macrophages in the intima was also decreased in aortas of mice treated with anti-LDL(-) monoclonal antibody (3.5 ± 0.70 per field x 10) compared to controls (21.5 ± 3.5 per field x 10). Furthermore, immunization with the monoclonal antibody decreased the concentration of LDL(-) in blood plasma (immunized: 1.0 ± 1.4; control: 20.5 ± 3.5 RLU), the amount of cholesterol oxides in plasma (immunized: 4.7 ± 2.7; control: 15.0 ± 2.0 pg COx/mg cholesterol) and liver (immunized: 2.3 ± 1.5; control: 30.0 ± 26.0 pg COx/mg cholesterol), and the hepatic content of lipid hydroperoxides (immunized: 0.30 ± 0.020; control: 0.38 ± 0.15 ng/mg protein). In conclusion, antibodies against electronegative LDL administered intravenously may play a protective role in atherosclerosis.

Placental transfer of Haemophilus influenzae type b antibodies in malnourished pregnant women

This study evaluated the vaccination response to Haemophilus influenzae type b (Hib) in malnourished pregnant women (MN), cord blood (CB) and in infants at two and six months of age for comparison with a control group (C). Twenty-eight malnourished pregnant women and 29 pregnant controls were immunized with conjugated Act-HIB® in the third trimester of pregnancy. Blood samples were collected from all before the immunization, during labor (post immunization), and from CB. All infants were immunized with Hib vaccine according to normal vaccine schedule and sera were collected at two and six months of age. Antibody levels to polyribosylribitol phosphate (PRP) were similar for both groups. Preimmunization: MN 1.94 µg/mL, C 1.68 µg/mL; post-vaccination: MN 18.53 µg/mL and C 17.55 µg/mL; in CB from MN 14.46 µg/mL and from C 17.04 µg/mL. Infants from MN and C mothers presented respectively at two months: 5.18 µg/mL and 8.60 µg/mL and at six months: MN 3.42 µg/mL and C 2.18 µg/mL. Antibody levels were similar in both groups studied (p = 0.485), however the vertical transmission rate was 14 percent lower in the MN pregnant group. Levels of antibodies > 0.15 µg/mL were found in all newborns from the MN pregnant group. Pregnant MN presented an immunological response to Hib vaccine similar to group C, however, vertical transmission rate of antibodies to PRP in the MN pregnant group was 14 percent lower than that in C, suggesting a less efficient passage of antibodies within this group.

Immunoglobulins for Prophylaxis or Treatment of Infectious Diseases

Administration of antibodies as a passive immunization is indicated for the replacement of deficiencies, prophylaxis or amelioration of infectious diseases for susceptible individuals and those at high risk for complications of infections. Antibodies can be administered either as human or animal plasma or serum, as pooled human immunoglobulin (IG) for intravenous or intramuscular use, as high-titer human IG from immunized or convalescing donors, or as monoclonal antibodies. Immunoglobulins are widely used for prevention of hepatitis A and measles and specific immunoglobulins are used for prevention of hepatitis B, tetanus, rabies, and varicella in susceptible people. A humanized murine monoclonal antibodies against respiratory syncytial virus have been licensed. This paper reviews the current use and recommendation of antibody products for the prevention and treatment of infectious diseases.

Research and Development on Immunotherapy of Alzheimer's Disease / 上海第二医科大学学报

Alzheimer's disease(AD),the most common form of dementia,it is lack of effective cure or preventive treatment.Dementias in the elder are an increasing medical,social and economic problems and current treatments are only mildly effective.Recently,amyloid-beta protein(A?) has become a major therapeutic target.A? vaccine treatment can improve cognition in the patients with AD,but adverse events,such as meningencephalitis were observed in clinical study.The passive A? immunotherapy in humans is effective with possible safety.However,patients need to be monitored carefully.

Immunoprophylactic studies with a 43 kDa human circulating filarial antigen and a cross reactive 120 kDa Brugia malayi sodium dodecyl sulphate soluble antigen in filariasis.

Bancroftian filariasis is a major public health problem affecting about 120 million people all over the world. Immunoprophylaxis may serve as an additional adjunct along with chemotherapy and anti larval measures for successful filaria control. Circulating filarial antigen fraction (CFA2-6) containing 43 kDa antigen and adult Brugia malayi sodium dodecyl sulphate (S DS) soluble antigen fraction BmA-2 with a 120 kDa molecule were earlier shown to be reactive with endemic normal sera by immunoblotting and indirect ELISA techniques. BmA-2 was found to be highly cross reactive with CFA2-6. Sera raised against both the antigen fractions showed about 9 0 % cytotoxicity to the parasites in the presence of jird peritoneal cells in in vitro as well as by in situ micropore chamber implantation technique. Further in in vivo studies using animal model, jirds CFA2-6 and BmA-2 could induce about 90% protection to infection in immunized animals. In passive transfer studies of immunity it has been observed that BmA-2 induced protection is mainly antibody mediated.