SARS-CoV-2 BNT162b2 vaccine-induced humoral response and reactogenicity in individuals with prior COVID-19 disease.

BACKGROUNDMost individuals with prior COVID-19 disease manifest long-term protective immune responses against reinfection. Accordingly, we tested the hypothesis that humoral immune and reactogenicity responses to a SARS-CoV-2 mRNA vaccine differ in individuals with and without prior COVID-19 disease.METHODSHealth care workers (n = 61) with (n = 30) and without (n = 31) prior COVID-19 disease received two 30 µg doses of Pfizer BNT162b2 vaccine 3 weeks apart. Serum IgG antibody against the spike receptor-binding domain; serum neutralizing activity; and vaccine reactogenicity were assessed longitudinally every 2 weeks for 56 days after the first injection.RESULTSThe COVID-19 group manifested more rapid increases in spike IgG antibody and serum neutralizing activity after the first vaccine dose but showed little or no increase after the second dose compared with the infection-naive group. In fact, spike IgG was at its maximum level after the first dose in 36% of the COVID-19 group versus 0% of the infection-naive group. Peak IgG antibody levels were lower but appeared to fall more slowly in the COVID-19 group versus the infection-naive group. Finally, adverse systemic reactions, e.g., fever, headache, and malaise, were more frequent and lasted longer after both the first and second injection in the COVID-19 group than in the infection-naive group.CONCLUSIONIndividuals with prior COVID-19 disease demonstrate a robust, accelerated humoral immune response to the first dose but an attenuated response to the second dose of BNT162b2 vaccine compared with controls. The COVID-19 group also experienced greater reactogenicity. Humoral responses and reactogenicity to BNT162b2 differ qualitatively and quantitatively in individuals with prior COVID-19 disease compared with infection-naive individuals.FUNDINGThis work was supported by Temple University institutional funds.

Tissue-engineered transcatheter vein valve.

Chronic venous insufficiency affects over 2 million patients in the US alone, with severe cases involving thousands of patients with chronic leg ulcers and potential amputation. Current treatment options are limited, with surgical repair of vein valves being the most effective but challenging solution. A transcatheter vein valve made from a biologically-engineered matrix possessing the ability to regenerate has the potential to provide both valve function and long-term hemocompatibility and durability because the matrix becomes endothelialized and populated with host tissue cells. We have developed a novel tissue-engineered transcatheter vein valve (TEVV) on a Nitinol stent and demonstrated function and durability in vitro. Tissue was grown from fibroblasts in fibrin gel so as to embed the stent, with a tubular extension of the engineered tissue from one end of the stent that was stitched along opposite sides and everted into the stent to form a bileaflet valve. Following decellularization, to create an "off-the-shelf" TEVV comprised of the resulting collagenous matrix, it was tested in a pulse duplicator to evaluate hydrodynamic properties for a range of flow rates. The TEVV was shown to have forward pressure drops in the range of 2-4 mmHg, low closing volume, and nil regurgitation. Further hydrodynamic tests were performed after crimping and then again after 1 million cycle durability testing, showing no degradation of valve performance or any visual damage to the matrix. The TEVV held over 600 mmHg backpressure after the durability testing, ensuring the valve would withstand pressure spikes well outside of the normal in vivo range. Catheter-based delivery into the ovine iliac vein demonstrated TEVV closing 2 weeks p.o. and endothelialization without thrombosis 8 weeks p.o.

Galectin-1 inhibition attenuates profibrotic signaling in hypoxia-induced pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is characterized by lung remodeling arising from epithelial injury, aberrant fibroblast growth, and excessive deposition of extracellular matrix. Repeated epithelial injury elicits abnormal wound repair and lung remodeling, often associated with alveolar collapse and edema, leading to focal hypoxia. Here, we demonstrate that hypoxia is a physiological insult that contributes to pulmonary fibrosis (PF) and define its molecular roles in profibrotic activation of lung epithelial cells. Hypoxia increased transcription of profibrotic genes and altered the proteomic signatures of lung epithelial cells. Network analysis of the hypoxic epithelial proteome revealed a crosstalk between transforming growth factor-ß1 and FAK1 (focal adhesion kinase-1) signaling, which regulated transcription of galectin-1, a profibrotic molecule. Galectin-1 physically interacted with and activated FAK1 in lung epithelial cells. We developed a novel model of exacerbated PF wherein hypoxia, as a secondary insult, caused PF in mice injured with subclinical levels of bleomycin. Hypoxia elevated expression of phosphorylated FAK1, galectin-1, and α-smooth muscle actin and reduced caspase-3 activation, suggesting aberrant injury repair. Galectin-1 inhibition caused apoptosis in the lung parenchyma and reduced FAK1 activation, preventing the development of hypoxia-induced PF. Galectin-1 inhibition also attenuated fibrosis-associated lung function decline. Further, galectin-1 transcript levels were increased in the lungs of IPF patients. In summary, we have identified a profibrotic role of galectin-1 in hypoxia signaling driving PF.

Counseling techniques to address male communication characteristics: an application of the extended parallel process model.

Evidence shows that the male ideology has a significant impact on men's health status. Men who adhere to the traditional masculine ideology may find messages regarding healthcare to be threatening. Pharmacists can use the Extended Parallel Process (EPP) Model to counsel men in a manner that reduces their feelings of fear and danger regarding their health while controlling feelings of vulnerability and susceptibility. When counseling men using the EPP Model, pharmacists are encouraged to use universal statements and open-ended questions to create patient awareness of the disease state and foster discussion. Furthermore, since men engage in limited nonverbal communication, pharmacists need to be direct and ask for feedback to gauge the patient's understanding of the counseling.