Development of a heterologous, multigenotype vaccine against hepatitis C virus infection.

BACKGROUND: Unquestionably viral diversity and genetic heterogeneity in hepatitis C virus (HCV) infection and other viral diseases play an essential role in viral immune escape and the development of chronicity. Despite this knowledge most vaccine approaches against HCV have excluded this important issue. Moreover the feasibility of developing an effective HCV vaccine has been questioned, mainly because prophylactic immunity against HCV cannot be achieved in chimpanzees by either vaccination or previous HCV infection, and reinfection in men has been reported, most likely due to genetic shift and immune escape. To analyse and characterize a new technique of a 'multigenotype'- and/or 'library'-vaccine, we established an envelope 1 (E1) plasmid vaccine against HCV and characterized humoral and cellular immune responses after vaccination in a mouse model. MATERIAL AND METHODS: Normally genetic information of one or two target proteins is cloned into a DNA-vaccine. In our approach we cloned a defined number of different genotypes and subtypes (defined vaccine, DV) or the genetic information from 20 patients (undefined) into a plasmid (library vaccine, LV). RESULTS: As expected, immunized animals showed both stronger humoral (ELISA) and cellular (T-cell proliferation, ELISPOT) immune responses against genotype 1, since the stimulating antigen was genotype 1 derived. However, not all genotype 1 immunized animals recognized this viral antigen leading to the assumption that some epitopes lost their immunogenicity through a change in the amino acid sequence. Interestingly, some of the genotype 4 and 5 immunized mice sera were able to react against E1 protein. CONCLUSION: Most of the assays showed immune reactivity against the DV or LV vaccine demonstrating the cross-reactive potential of such a vaccination approach. This cloning and immunization strategy based on the viral heterogeneity of the virus has in our view major implications for HCV, a virus with a broad viral genetic diversity, and may become in the future in the context of DNA- or viral-based vaccination strategies a possibility to overcome viral immune escape both in the prophylactic or therapeutic setting.

Prophylactic and therapeutic vaccination with dendritic cells against hepatitis C virus infection.

Antigen uptake and presentation capacities enable DC to prime and activate T cells. Recently, several studies demonstrated a diminished DC function in hepatitis C virus (HCV) infected patients showing impaired abilities to stimulate allogenic T cells and to produce IFN-gamma in HCV infected patients. Moreover, DC of patients who have resolved HCV infection behave like DC from healthy donors responding to maturation stimuli, decrease antigen uptake, up-regulate expression of appropriate surface marker, and are potent stimulators of allogenic T cells. A number of studies have demonstrated in tumour models and models of infectious diseases strong induction of immune responses after DC vaccination. Because DC are essential for T-cell activation and since viral clearance in HCV infected patients is associated with a vigorous T-cell response, we propose a new type of HCV vaccine based on ex vivo stimulated and matured DC loaded with HCV specific antigens. This vaccine circumvents the impaired DC maturation and the down regulated DC function of HCV infected patients in vivo by giving the necessary maturation stimuli and the HCV antigens in a different setting and location ex vivo. Strong humoral and cellular immune responses were detected after HCV core DC vaccination. Furthermore, DC vaccination shows partial protection in a therapeutic and prophylactic model of HCV infection. In conclusion, mice immunized with HCV core pulsed DC generated a specific antiviral response in a mouse HCV challenge model. Our results indicate that HCV core pulsed DC may serve as a new modality for immunotherapy of HCV especially in chronically infected patients.

The simultaneous recurrent neural network for addressing the scaling problem in static optimization.

A trainable recurrent neural network, Simultaneous Recurrent Neural network, is proposed to address the scaling problem faced by neural network algorithms in static optimization. The proposed algorithm derives its computational power to address the scaling problem through its ability to "learn" compared to existing recurrent neural algorithms, which are not trainable. Recurrent backpropagation algorithm is employed to train the recurrent, relaxation-based neural network in order to associate fixed points of the network dynamics with locally optimal solutions of the static optimization problems. Performance of the algorithm is tested on the NP-hard Traveling Salesman Problem in the range of 100 to 600 cities. Simulation results indicate that the proposed algorithm is able to consistently locate high-quality solutions for all problem sizes tested. In other words, the proposed algorithm scales demonstrably well with the problem size with respect to quality of solutions and at the expense of increased computational cost for large problem sizes.

A simulation of dynamic tasks routing to improve cooperation in intensive care units.

Cooperation between Health Care Professionals is essential for the quality of care. Workflow systems could improve the transfer of informations and responsibilities within Health Care Actors. We have proposed a conversation-based Workflow in order to modelize the therapeutics plan in the ICU. In such a complex field, the flexibility of the workflow system is essential for the system to be usable. We have introduced some dynamicity by adding roles in the model. With the use of roles, the dynamicity of the workflow is assumed by the routing process. We need to use simulation to be able to study the impact of routing algorythms on the efficiency of the coordination.

A regional university hospital in the framework of a regional information network: the experience of Lille.

Information is essential for the taking care of the patients and is also a guarantee for the quality of cares. In this objective, the University Hospital of Lille has developed for 10 years a politic based on information and communication divided in 3 phases: 1. The University Hospital has developed a HIS based on the communication between hospitals and medical centers for a better sharing of data concerning the patient. 2. The second phase consisted in the integration of external platforms to the HIS with a middleware. 3. The actual phase consists in the opening of the HIS to the external environment of the hospital and especially to the GPs through a Regional Medical Information System.

An asynchronous co-operative model for co-ordinating medical unit activities.

CSCW is devoted to the analysis of interactions among human beings when performing their work together (Ellis et al., Commun. ACM 1 (34) (1991) 38-58). The main fields of application are work organisation, healthcare, education and training. Our main goal is to study the co-operative models allowing task co-ordination and conflict management between actors within a distributed environment, particularly in medical units. We do not aim to produce a practical system suitable for near-term deployment in the intensive care units (ICU), but rather an experimental system that performs and co-ordinates a range of intelligent planning tasks in ICU activities. The emphasis will be put especially on asynchronous co-operation. We apply the Workflow approach to ICU organisation through the analysis and the proposal of a co-operative model.

Activation of RNase L by 2',5'-oligoadenylates. Kinetic characterization.

Ribonuclease L (RNase L), the 2',5'-oligoadenylate-dependent ribonuclease, is one of the cellular antiviral systems with enhanced activity in the presence of interferon. A reaction scheme has been developed to model the sequence of steps necessary for the activation of RNase L (Cole, J. L., Carroll, S. S., Blue, E. S., Viscount, T., and Kuo, L. C. (1997) J. Biol. Chem. 272, 19187-19192). The model comprises three sequential binding steps: the binding of activator to enzyme monomer, the subsequent dimerization of the activated monomer to form the active enzyme dimer, followed by the binding of substrate prior to catalysis. The model is used to evaluate the activation of RNase L by several synthetic analogs of the native activator. The 5'-phosphate of the activator has been determined to be an important structural determinant for the efficient activation of RNase L, and its loss caused a loss of activator affinity of 2-3 orders of magnitude. The length of activator is not an important determinant of activator potency for the activator analogs examined. The specific activity of the enzyme under conditions of saturation of activator binding and complete dimerization of the activated monomers varies only by about a factor of 3 for the activators examined, indicating that once dimerized in the presence of any of these activators, the enzyme exhibits a similar catalytic activity.

Cleavage of oligoribonucleotides by the 2',5'-oligoadenylate- dependent ribonuclease L.

RNase L, the 2',5' oligoadenylate-dependent ribonuclease, is one of the enzyme systems important in the cellular response to interferon. When activated in the presence of 2',5'-linked oligoadenylates, RNase L can catalyze the cleavage of synthetic oligoribonucleotides that contain dyad sequences of the forms UU, UA, AU, AA, and UG, but it cannot catalyze the cleavage of an oligoribonucleotide containing only cytosines. The primary site of the cleavage reaction with the substrate C11UUC7 has been defined to be 3' of the UU dyad by labeling either the 5' or the 3' end of the oligoribonucleotide and by examining the reaction products on polyacrylamide sequencing gels. Reaction time courses have been used to determine the kinetic parameters of the cleavage reactions. The effect of the overall length of the oligomeric substrate as well as the sequence of the bases around the position of the cleavage site on the kinetics of the cleavage reaction has been examined. The efficiency with which activated RNase L catalyzes the cleavage of the substrate C11UUC7 is 1.9 x 10(7) m-1 s-1. Because the cleavage of the synthetic oligoribonucleotide can be used to monitor the steady-state kinetics of catalysis by activated RNase L, this method offers an advantage over previous methods of assay for RNase L activity.

PLACO: a cooperative architecture for managing workflow in CCU.

Computer-Supported Cooperative Work (CSCW) is a multi-disciplinary research theme involving software developers, computer scientists, as well as psychologists and sociologists. CSCW is devoted to the analysis of interactions among humans when performing their work in a collaborative way. The main application fields are work organization, healthcare, education and training. The term of Groupware, as defined by C.A. Ellis, refers to software that assists groups of people in communicating, in collaborating and in coordinating their activities. Our objective is to study software architectures allowing task coordination and conflict management between participants within a distributed environment, in particular medical units. We do not aim to produce a practical system suitable for near-term deployment in the Critical Care Unit (CCU), but rather a "proof of concept", an experimental system that performs and coordinates a range of intelligent planning tasks in CCU activities. The emphasis will be put especially on asynchronous cooperation since the work of physicians and nurses is discontinuous.

Workflow: a new modeling concept in critical care units.

The term Groupware concerns computer-based systems that support groups of people engaged in a common task (goal) and that provide an interface to a shared environment [1]. The absence of a common tool for exchanges between physicians and nurses causes a multiplication of paper supports for the recording of information. Our objective is to study software architectures in particular medical units that allow task coordination and managing conflicts between participants within a distributed environment. The final goal of this research is to propose a computer solution that could answer the user requirements in Critical Care Units (CCUs). This paper describes the Workflow management approach [5] for supporting group work in health care field. The emphasis is especially on asynchronous cooperation. This approach was applied to CCUs through the analysis and the proposal of a new architecture [6]. We shall limit ourselves to explaining control board and analyzing the message management we support.

Inhibition of HIV-1 reverse transcriptase by a quinazolinone and comparison with inhibition by pyridinones. Differences in the rates of inhibitor binding and in synergistic inhibition with nucleoside analogs.

6-Chloro-(4S)-cyclopropyl-3,4-dihydro-4-((2-pyridyl)-ethynyl)quinazol in- 2(1H)-one (L-738,372) is representative of a novel structural class of nonnucleoside inhibitors of human immunodeficiency virus, strain 1 (HIV-1), reverse transcriptase (RT), the quinazolinones. L-738,372 is a reversible inhibitor of HIV-1 RT and is noncompetitive against dTTP with a Ki of 140 nM with poly(rA).oligo(dT) as primer-template. Mixed noncompetitive inhibition by L-738,372 was observed against poly(rC).oligo(dG) as primer-template. This quinazolinone binds to RT at a site that overlaps the binding site of other nonnucleoside inhibitors as evidenced by the ability of L-738,372 to displace bound radiolabeled L-696,229, a member of the pyridinone class of inhibitors of HIV-1 RT, from complexes of RT and primer-template. Inhibition by L-738,372 shows slow binding characteristics in reactions with all of the primer-templates employed. Synergistic inhibition of RT activity was evident in combinations of L-738,372 and any of the nucleoside analogs, azidothymidine triphosphate, dideoxyinosine triphosphate, or dideoxycytosine triphosphate. The azidothymidine-resistant form of RT (D67N, K70R, T215Y, K219Q) is inhibited by L-738,372 with 2-3-fold more potency than is the wild-type RT. Comparison of inhibition by L-738,372 with inhibition by pyridinone inhibitors reveals differences in synergistic inhibition with nucleoside analogs and in the rates of binding of the inhibitors.

Sensitivity of HIV-1 reverse transcriptase and its mutants to inhibition by azidothymidine triphosphate.

HIV-1 reverse transcriptase can catalyze the addition of either azidothymidine monophosphate (AZTMP) or thymidine monophosphate (dTMP) to a primer strand opposite template adenosine bases. The ratio of incorporation of AZTMP to dTMP as catalyzed by HIV-1 reverse transcriptase has been determined to be 0.4 using an RNA-DNA duplex substrate prepared from oligonucleotides with sequences taken from the HIV-1 genome sequence. Slight variations are found for the incorporation ratio of the two nucleotides on other substrates. Substrates containing more than one adenosine in the single-stranded part of the template allow for more chances to incorporate AZTMP and less full-length product. Variations in the intensity of bands on an autoradiograph of a DNA sequencing gel corresponding to different positions of incorporation of AZTMP suggest that not all template adenosine positions offer the same level of discrimination against incorporation of AZTMP. A reverse transcriptase containing a set of four mutations (D67N, K70R, T215Y, K219Q) known to cause resistance to AZT in cell culture assays has a ratio of incorporation that is 0.77 +/- 0.03 times the ratio for the wild-type reverse transcriptase opposite one specific template adenosine. In contrast, a hybrid mutant containing the same four mutations that cause resistance to AZT and an additional mutation, Y181C, which by itself causes resistance to the non-nucleoside inhibitor L-697,661 [Sardana et al. (1992), J. Biol. Chem. 267, 17526-17530], has a ratio of incorporation that is 1.34 +/- 0.01 times that of the wild-type, indicating that the hybrid mutant enzyme is more susceptible to inhibition by AZTTP than the wild-type reverse transcriptase.(ABSTRACT TRUNCATED AT 250 WORDS)