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1.
J Environ Manage ; 346: 119015, 2023 Nov 15.
Article in English | MEDLINE | ID: mdl-37738718

ABSTRACT

The interest in wastewater monitoring is always growing, with applications mainly aimed at detection of pollutants and at the environmental epidemiological surveillance. However, it often happens that the strategies proposed to manage these problems are inapplicable due to the lack of information on the hydraulics of the systems. To overcome this problem, the present paper develops and proposes a topological backtracking strategy for the optimal monitoring of sewer networks, which acts by subrogating the hydraulic information with the geometric ones, e.g., diameter and slope, thus not requiring any hydraulic simulation. The topological backtracking approach aims at evaluating an impact coefficient for each node of the network used to face with the problems of sensor location and network coverage for purposes related to the spread of contaminants and pathogens. Finally, the positioning of the sensors for each monitoring scheme is addressed by a priority rank, based on the efficiency of each sensor in terms of network coverage with respect to a specific weight (e.g., length, flow). The main goal is to design a monitoring scheme that provide the required coverage of the network by minimizing the number of sensors with respect to specific measurement threshold value. The results show the effectiveness of the strategy in supporting the optimal design with the topological-based backtracking approach without the necessity of performing hydraulic simulations, with great advantage in terms of required data and computational time.

2.
NPJ Vaccines ; 8(1): 100, 2023 Jul 13.
Article in English | MEDLINE | ID: mdl-37443176

ABSTRACT

The pediatric population receives the majority of vaccines globally, yet there is a paucity of studies on the transcriptional response induced by immunization in this special population. In this study, we performed a systems-level analysis of immune responses to the trivalent inactivated influenza vaccine adjuvanted with MF-59 in children (15-24 months old) and in young, healthy adults. We analyzed transcriptional responses elicited by vaccination in peripheral blood, as well as cellular and antibody responses following primary and booster vaccinations. Our analysis revealed that primary vaccination induced a persistent transcriptional signature of innate immunity; booster vaccination induced a transcriptional signature of an enhanced memory-like innate response, which was consistent with enhanced activation of myeloid cells assessed by flow cytometry. Furthermore, we identified a transcriptional signature of type 1 interferon response post-booster vaccination and at baseline that was correlated with the local reactogenicity to vaccination and defined an early signature that correlated with the hemagglutinin antibody titers. These results highlight an adaptive behavior of the innate immune system in evoking a memory-like response to secondary vaccination and define molecular correlates of reactogenicity and immunogenicity in infants.

3.
Trends Immunol ; 44(6): 424-434, 2023 06.
Article in English | MEDLINE | ID: mdl-37137805

ABSTRACT

The COVID-19 pandemic, caused by SARS-CoV-2, has caused an estimated 5 billion infections and 20 million deaths by respiratory failure. In addition to the respiratory disease, SARS-CoV-2 infection has been associated with many extrapulmonary complications not easily explainable by the respiratory infection. A recent study showed that the SARS-CoV-2 spike protein, which mediates cell entry by binding to the angiotensin-converting enzyme 2 (ACE2) receptor, signals through ACE2 to change host cell behavior. In CD8+ T cells, spike-dependent ACE2-mediated signaling suppresses immunological synapse (IS) formation and impairs their killing ability, leading to immune escape of virus-infected cells. In this opinion article, we discuss the consequences of ACE2 signaling on the immune response and propose that it contributes to the extrapulmonary manifestations of COVID-19.


Subject(s)
COVID-19 , Humans , Angiotensin-Converting Enzyme 2/metabolism , CD8-Positive T-Lymphocytes/metabolism , Immune Evasion , Pandemics , Protein Binding , SARS-CoV-2/metabolism
4.
Front Immunol ; 13: 904415, 2022.
Article in English | MEDLINE | ID: mdl-35990686

ABSTRACT

The neonatal immune system is distinct from the immune system of older individuals rendering neonates vulnerable to infections and poor responders to vaccination. Adjuvants can be used as tools to enhance immune responses to co-administered antigens. Antibody (Ab) persistence is mediated by long-lived plasma cells that reside in specialized survival niches in the bone marrow, and transient Ab responses in early life have been associated with decreased survival of plasma cells, possibly due to lack of survival factors. Various cells can secrete these factors and which cells are the main producers is still up for debate, especially in early life where this has not been fully addressed. The receptor BCMA and its ligand APRIL have been shown to be important in the maintenance of plasma cells and Abs. Herein, we assessed age-dependent maturation of a broad range of bone marrow accessory cells and their expression of the survival factors APRIL and IL-6. Furthermore, we performed a comparative analysis of the potential of 5 different adjuvants; LT-K63, mmCT, MF59, IC31 and alum, to enhance expression of survival factors and BCMA following immunization of neonatal mice with tetanus toxoid (TT) vaccine. We found that APRIL expression was reduced in the bone marrow of young mice whereas IL-6 expression was higher. Eosinophils, macrophages, megakaryocytes, monocytes and lymphocytes were important secretors of survival factors in early life but undefined cells also constituted a large fraction of secretors. Immunization and adjuvants enhanced APRIL expression but decreased IL-6 expression in bone marrow cells early after immunization. Furthermore, neonatal immunization with adjuvants enhanced the proportion of plasmablasts and plasma cells that expressed BCMA both in spleen and bone marrow. Enhanced BCMA expression correlated with enhanced vaccine-specific humoral responses, even though the effect of alum on BCMA was less pronounced than those of the other adjuvants at later time points. We propose that low APRIL expression in bone marrow as well as low BCMA expression of plasmablasts/plasma cells in early life together cause transient Ab responses and could represent targets to be triggered by vaccine adjuvants to induce persistent humoral immune responses in this age group.


Subject(s)
Tuberculosis Vaccines , Tuberculosis , Adjuvants, Immunologic , Adjuvants, Pharmaceutic/metabolism , Animals , B-Cell Maturation Antigen/metabolism , Bone Marrow , Cell Survival , Immunity, Humoral , Interleukin-6/metabolism , Mice , Oligodeoxyribonucleotides/metabolism , Plasma Cells , Tetanus Toxoid , Tuberculosis/metabolism
5.
Chemosphere ; 303(Pt 1): 134955, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35613638

ABSTRACT

Almost 140 years of industrial exploitation have severely degraded the environment of Bagnoli Coroglio (BC), the westernmost neighborhood of the city of Naples (Italy). In this peculiar area, however, geogenic processes overlap with the impact of human activities, making it difficult to distinguish between anthropogenic and geogenic pollution sources. This is particularly true for Arsenic, the concentration of which in the marine sediments largely exceeds the tolerable level for human health and the background value for local pyroclastics. After several studies have used traditional tools based on multivariate statistics, this article attempts at tackling the problem via numerical modeling, which provides a deeper insight into the physics that governs the pollution process. Therefore, we use a particle tracking model to assess whether arsenic levels in the seabed can be affected by the influx of thermal water from an artificial channel outfalling at the westernmost part of the coast The climatic forcings that drive the marine circulation are simplified to basic "scenarios", in which wind and waves are stationary in strength and direction. Since the simulation time is much less than the contamination timescale, the comparison between numerical results and measurements is essentially qualitative and concerns the shape of contamination contours. It was found the primary forcing that enables seabed pollution is the tidal circulation, which, moreover, acts continuously in time. Quantitative arguments based on regression analysis suggest the discharge of thermal water explains almost a quarter of the observed pollution, which is consistent with previous research based on multivariate statistics.


Subject(s)
Arsenic , Water Pollutants, Chemical , Arsenic/analysis , Bays , Environmental Monitoring , Geologic Sediments/analysis , Humans , Italy , Water/analysis , Water Pollutants, Chemical/analysis
6.
IEEE ASME Trans Mechatron ; 26(5): 2604-2615, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34658616

ABSTRACT

Continuum robots (CR) have been recently shown capable of micron-scale motion resolutions. Such motions are achieved through equilibrium modulation using indirect actuation for altering either internal preload forces or changing the cross-sectional stiffness along the length of a continuum robot. Previously reported, but unexplained, turning point behavior is modeled using two approaches. An energy minimization approach is first used to explain the source of this behavior. Subsequently, a kinematic model using internal constraints in multi-backbone CRs is used to replicate this turning point behavior. An approach for modeling the micro-motion differential kinematics is presented using experimental data based on the solution of a system of linear matrix equations. This approach provides a closed-form approximation of the empirical micro-motion kinematics and could be easily used for real-time control. A motivating application of image-based biopsy using 3D optical coherence tomography (OCT) is envisioned and demonstrated in this paper. A system integration for generating OCT volumes by sweeping a custom B-mode OCT probe is presented. Results showing high accuracy in obtaining 3D OCT measurements are shown using a commercial OCT probe. Qualitative results using a miniature probe integrated within the robot are also shown. Finally, closed-loop visual servoing using OCT data is demonstrated for guiding a needle into an agar channel. Results of this paper present what we believe is the first embodiment of a continuum robot capable of micro and macro motion control for 3D OCT imaging. This approach can support the development of new technologies for CRs capable of surgical intervention and micro-motion for ultra-precision tasks.

7.
NPJ Vaccines ; 6(1): 93, 2021 Jul 27.
Article in English | MEDLINE | ID: mdl-34315886

ABSTRACT

The primary goal of vaccination is the prevention of pathogen-specific infection. The indirect consequences may include maintenance of homeostasis through prevention of infection-induced complications; trained immunity that re-programs innate cells to respond more efficiently to later, unrelated threats; slowing or reversing immune senescence by altering the epigenetic clock, and leveraging the pool of memory B and T cells to improve responses to new infections. Vaccines may exploit the plasticity of the immune system to drive longer-term immune responses that promote health at a broader level than just the prevention of single, specific infections. In this perspective, we discuss the concept of "immune fitness" and how to potentially build a resilient immune system that could contribute to better health. We argue that vaccines may contribute positively to immune fitness in ways that are only beginning to be understood, and that life-course vaccination is a fundamental tool for achieving healthy aging.

8.
Comput Struct Biotechnol J ; 19: 3664-3672, 2021.
Article in English | MEDLINE | ID: mdl-34257845

ABSTRACT

Affinity measurement is a fundamental step in the discovery of monoclonal antibodies (mAbs) and of antigens suitable for vaccine development. Innovative affinity assays are needed due to the low throughput and/or limited dynamic range of available technologies. We combined microfluidic technology with quantum-mechanical scattering theory, in order to develop a high-throughput, broad-range methodology to measure affinity. Fluorescence intensity profiles were generated for out-of-equilibrium solutions of labelled mAbs and their antigen-binding fragments migrating along micro-columns with immobilized cognate antigen. Affinity quantification was performed by computational data analysis based on the Landau probability distribution. Experiments using a wide array of human or murine antibodies against bacterial or viral, protein or polysaccharide antigens, showed that all the antibody-antigen capture profiles (n = 841) generated at different concentrations were accurately described by the Landau distribution. A scale parameter W, proportional to the full-width-at-half-maximum of the capture profile, was shown to be independent of the antibody concentration. The W parameter correlated significantly (Pearson's r [p-value]: 0.89 [3 × 10-8]) with the equilibrium dissociation constant KD, a gold-standard affinity measure. Our method showed good intermediate precision (median coefficient of variation: 5%) and a dynamic range corresponding to KD values spanning from ~10-7 to ~10-11 Molar. Relative to assays relying on antibody-antigen equilibrium in solution, even when they are microfluidic-based, the method's turnaround times were decreased from 2 days to 2 h. The described computational modelling of antibody capture profiles represents a fast, reproducible, high-throughput methodology to accurately measure a broad range of antibody affinities in very low volumes of solution.

9.
Proc Natl Acad Sci U S A ; 118(3)2021 01 19.
Article in English | MEDLINE | ID: mdl-33431690

ABSTRACT

The COVID-19 pandemic is a shocking reminder of how our world would look in the absence of vaccination. Fortunately, new technologies, the pace of understanding new and existing pathogens, and the increased knowledge of the immune system allow us today to develop vaccines at an unprecedented speed. Some of the vaccine technologies that are fast-tracked by the urgency of COVID-19 may also be the answer for other health priorities, such as antimicrobial resistance, chronic infections, and cancer, that the post-COVID-19 world will urgently need to face. This perspective analyzes the way COVID-19 is transforming vaccinology and the opportunities for vaccines to have an increasingly important role in health and well-being.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Vaccination/trends , Vaccines , Vaccinology/trends , Humans , Vaccines/immunology , Vaccines/therapeutic use
10.
Front Immunol ; 11: 527310, 2020.
Article in English | MEDLINE | ID: mdl-33193301

ABSTRACT

Adjuvants enhance magnitude and duration of immune responses induced by vaccines. In this study we assessed in neonatal mice if and how the adjuvant LT-K63 given with a pneumococcal conjugate vaccine, Pnc1-TT, could affect the expression of tumor necrosis factor receptor (TNF-R) superfamily members, known to be involved in the initiation and maintenance of antibody responses; B cell activating factor receptor (BAFF-R) and B cell maturation antigen (BCMA) and their ligands, BAFF, and a proliferation inducing ligand (APRIL). Initially we assessed the maturation status of different B cell populations and their expression of BAFF-R and BCMA. Neonatal mice had dramatically fewer B cells than adult mice and the composition of different subsets within the B cell pool differed greatly. Proportionally newly formed B cells were most abundant, but they had diminished BAFF-R expression which could explain low proportions of marginal zone and follicular B cells observed. Limited BCMA expression was also detected in neonatal pre-plasmablasts/plasmablasts. LT-K63 enhanced vaccine-induced BAFF-R expression in splenic marginal zone, follicular and newly formed B cells, leading to increased plasmablast/plasma cells, and their enhanced expression of BCMA in spleen and bone marrow. Additionally, the induction of BAFF and APRIL expression occurred early in neonatal mice immunized with Pnc1-TT either with or without LT-K63. However, BAFF+ and APRIL+ cells in spleens were maintained at a higher level in mice that received the adjuvant. Furthermore, the early increase of APRIL+ cells in bone marrow was more profound in mice immunized with vaccine and adjuvant. Finally, we assessed, for the first time in neonatal mice, accessory cells of the plasma cell niche in bone marrow and their secretion of APRIL. We found that LT-K63 enhanced the frequency and APRIL expression of eosinophils, macrophages, and megakaryocytes, which likely contributed to plasma cell survival, even though APRIL+ cells showed a fast decline. All this was associated with enhanced, sustained vaccine-specific antibody-secreting cells in bone marrow and persisting vaccine-specific serum antibodies. Our study sheds light on the mechanisms behind the adjuvanticity of LT-K63 and identifies molecular pathways that should be triggered by vaccine adjuvants to induce sustained humoral immunity in early life.


Subject(s)
B-Lymphocytes/immunology , Bacterial Toxins/pharmacology , Enterotoxins/pharmacology , Escherichia coli Proteins/pharmacology , Immunity, Humoral/drug effects , Lymphocyte Activation/drug effects , Animals , Animals, Newborn , B-Lymphocytes/cytology , Mice
11.
Proc Natl Acad Sci U S A ; 117(39): 24443-24449, 2020 09 29.
Article in English | MEDLINE | ID: mdl-32900928

ABSTRACT

Polysaccharide-protein conjugates have been developed to overcome the T-independent response, hyporesponsiveness to repeated vaccination, and poor immunogenicity in infants of polysaccharides. To address the impact of polysaccharide length, typhoid conjugates made with short- and long-chain fractions of Vi polysaccharide with average sizes of 9.5, 22.8, 42.7, 82.0, and 165 kDa were compared. Long-chain-conjugated Vi (165 kDa) induced a response in both wild-type and T cell-deficient mice, suggesting that it maintains a T-independent response. In marked contrast, short-chain Vi (9.5 to 42.7 kDa) conjugates induced a response in wild-type mice but not in T cell-deficient mice, suggesting that the response is dependent on T cell help. Mechanistically, this was explained in neonatal mice, in which long-chain, but not short-chain, Vi conjugate induced late apoptosis of Vi-specific B cells in spleen and early depletion of Vi-specific B cells in bone marrow, resulting in hyporesponsiveness and lack of long-term persistence of Vi-specific IgG in serum and IgG+ antibody-secreting cells in bone marrow. We conclude that while conjugation of long-chain Vi generates T-dependent antigens, the conjugates also retain T-independent properties, leading to detrimental effects on immune responses. The data reported here may explain some inconsistencies observed in clinical trials and help guide the design of effective conjugate vaccines.


Subject(s)
Bacterial Proteins/administration & dosage , Polysaccharides, Bacterial/administration & dosage , Salmonella Vaccines/administration & dosage , Salmonella typhi/immunology , T-Lymphocytes/immunology , Typhoid Fever/immunology , Animals , Antibodies, Bacterial/immunology , B-Lymphocytes/immunology , Bacterial Proteins/genetics , Bacterial Proteins/immunology , Female , Humans , Immunoglobulin G/immunology , Male , Mice , Polysaccharides, Bacterial/chemistry , Polysaccharides, Bacterial/genetics , Polysaccharides, Bacterial/immunology , Salmonella Vaccines/genetics , Salmonella Vaccines/immunology , Salmonella typhi/genetics , Typhoid Fever/microbiology , Typhoid Fever/prevention & control , Vaccines, Conjugate/administration & dosage , Vaccines, Conjugate/genetics , Vaccines, Conjugate/immunology
12.
Vaccine ; 38(37): 5896-5904, 2020 08 18.
Article in English | MEDLINE | ID: mdl-32713682

ABSTRACT

Prevention of infectious diseases through immunisation of the growing ageing adult population is essential to improve healthy ageing. However, many licenced and recommended vaccines for this age group show signs of waning of the protective effect due to declining immune responses (immuno-senescence) and decreasing vaccine uptake. Today's major challenge is to improve vaccine effectiveness and uptake and to deploy efficient vaccination strategies for this age group. The Vaccines and InfecTious diseases in the Ageing popuLation (VITAL) project, with partners from 17 academic & research groups and public institutes as well as seven industry collaborators, aims to address this challenge. The ambition is to provide evidence-based knowledge to local decision makers. Using a holistic and multidisciplinary approach and novel analytical methods, VITAL will provide tools that allow the development of targeted immunisation programs for ageing adults in European countries. The project is based on four pillars focussing on the assessment of the burden of vaccine-preventable diseases in ageing adults, the dissection of the mechanisms underlying immuno-senescence, the analysis of the clinical and economic public health impact of vaccination strategies and the development of educational resources for healthcare professionals. By the end of the project, a clear, detailed, and integrated program should be available for implementing a consistent, affordable, and sustainable vaccination strategy for ageing adults with regular evaluations of its impact over time.


Subject(s)
Communicable Diseases , Healthy Aging , Vaccines , Adult , Communicable Diseases/epidemiology , Europe , Humans , Public-Private Sector Partnerships , Vaccination
13.
Article in English | MEDLINE | ID: mdl-32305970

ABSTRACT

Vaccine development has traditionally been driven by the need to prevent high numbers of childhood deaths due to infectious disease. With few exceptions, vaccines for adults are the same as vaccines for infants, although it has long been apparent that they become less effective as age increases. It is only in the last few years that concerted efforts have commenced to develop life-long vaccination strategies through into older age. Impressive progress has been made in the field of vaccine technologies which, when they will be applied to vaccination of older adults, could change the landscape for disease prevention in this age group. The recently licensed adjuvanted herpes zoster vaccine shows that immunosenescence need not be a barrier to highly effective vaccination, and that highly effective vaccines for older adults can be achieved with good vaccine design. One of the greatest public health challenges of the 21st century is ensuring the health and well-being of the aged. New or improved vaccines targeting pathogens with a high disease burden in older adults have the potential to major contributions to the longevity and productivity of the older aged population.


Subject(s)
Immunosenescence/immunology , Vaccines/standards , Adjuvants, Immunologic/standards , Aged , Aged, 80 and over , Communicable Diseases/immunology , Herpes Zoster/prevention & control , Herpes Zoster Vaccine/therapeutic use , Humans , Middle Aged , Vaccination
14.
Front Immunol ; 11: 613496, 2020.
Article in English | MEDLINE | ID: mdl-33613536

ABSTRACT

Systems vaccinology has been applied to detect signatures of human vaccine induced immunity but its ability, together with high definition in vivo clinical imaging is not established to predict vaccine reactogenicity. Within two European Commission funded high impact programs, BIOVACSAFE and ADITEC, we applied high resolution positron emission tomography/computed tomography (PET/CT) scanning using tissue-specific and non-specific radioligands together with transcriptomic analysis of muscle biopsies in a clinical model systematically and prospectively comparing vaccine-induced immune/inflammatory responses. 109 male participants received a single immunization with licensed preparations of either AS04-adjuvanted hepatitis B virus vaccine (AHBVV); MF59C-adjuvanted (ATIV) or unadjuvanted seasonal trivalent influenza vaccine (STIV); or alum-OMV-meningococcal B protein vaccine (4CMenB), followed by a PET/CT scan (n = 54) or an injection site muscle biopsy (n = 45). Characteristic kinetics was observed with a localized intramuscular focus associated with increased tissue glycolysis at the site of immunization detected by 18F-fluorodeoxyglucose (FDG) PET/CT, peaking after 1-3 days and strongest and most prolonged after 4CMenB, which correlated with clinical experience. Draining lymph node activation peaked between days 3-5 and was most prominent after ATIV. Well defined uptake of the immune cell-binding radioligand 11C-PBR28 was observed in muscle lesions and draining lymph nodes. Kinetics of muscle gene expression module upregulation reflected those seen previously in preclinical models with a very early (~6hrs) upregulation of monocyte-, TLR- and cytokine/chemokine-associated modules after AHBVV, in contrast to a response on day 3 after ATIV, which was bracketed by whole blood responses on day 1 as antigen presenting, inflammatory and innate immune cells trafficked to the site of immunization, and on day 5 associated with activated CD4+ T cells. These observations confirm the use of PET/CT, including potentially tissue-, cell-, or cytokine/chemokine-specific radioligands, is a safe and ethical quantitative technique to compare candidate vaccine formulations and could be safely combined with biopsy to guide efficient collection of samples for integrated whole blood and tissue systems vaccinology in small-scale but intensive human clinical models of immunization and to accelerate clinical development and optimisation of vaccine candidates, adjuvants, and formulations.


Subject(s)
Adjuvants, Immunologic/metabolism , Fluorodeoxyglucose F18/metabolism , Lymph Nodes/metabolism , Muscles/metabolism , Transcriptome/immunology , Vaccines/metabolism , Adolescent , Adult , CD4-Positive T-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/metabolism , Cytokines/immunology , Female , Humans , Immunization/methods , Kinetics , Lymph Nodes/immunology , Male , Middle Aged , Muscles/immunology , Positron Emission Tomography Computed Tomography/methods , Vaccination/methods , Vaccines/immunology , Young Adult
15.
Gerontology ; 66(3): 238-248, 2020.
Article in English | MEDLINE | ID: mdl-31770750

ABSTRACT

As populations age globally, the health of older adults is looming larger on the agendas of public health bodies. In particular, the priority is to ensure that older adults remain healthy, independent, and engaged in their communities. In other words, ensuring that increasing life spans are matched by increasing "health spans," meaning years spent in good health. Chronic conditions such as cancer or respiratory and cardiovascular diseases account for the bulk of the disease burden in older adults, and the consensus is that these can best be tackled by effective primary prevention. However, given the diverse nature of older populations, whose prior health experiences can be complicated by multi-morbidity and poly-pharmacy, effective primary prevention can be challenging. One approach that is gaining momentum is what is called "precision" or P4 medicine. The acronym stands for "predictive, personalized, preventive, participatory" medicine, and is based on the premise that preventing disease is better than treating it. However, effective prevention requires the ability to predict disease risk for a given patient, the tailoring of treatment to their circumstances, and their consent for or participation in the offered treatment. A P4 approach may seem counter-intuitive, given that vaccination is generally considered a public health intervention. However, in this article, we discuss the application of P4 medicine as a complement to planning the vaccination of older individuals, with a special focus on the important role that vaccine-preventable infections play in the burden of non-communicable disease.


Subject(s)
Chronic Disease/prevention & control , Precision Medicine/methods , Vaccination , Aged , Humans
16.
BMC Public Health ; 19(1): 1698, 2019 Dec 18.
Article in English | MEDLINE | ID: mdl-31852470

ABSTRACT

BACKGROUND: Despite the existence of efficacious vaccines, the burden of vaccine-preventable diseases remains high and the potential health benefits of paediatric, adolescent and adult vaccination are not being achieved due to suboptimal vaccine coverage rates. Based on emerging evidence that pharmacy-based vaccine interventions are feasible and effective, the European Interdisciplinary Council for Ageing (EICA) brought together stakeholders from the medical and pharmacy professions, the pharmaceutical industry, patient/ageing organisations and health authorities to consider the potential for pharmacy-based interventions to increase vaccine uptake. We report here the proceedings of this 3-day meeting held in March 2018 in San Servolo island, Venice, Italy, focussing firstly on examples from countries that have introduced pharmacy-based vaccination programmes, and secondly, listing the barriers and solutions proposed by the discussion groups. CONCLUSIONS: A range of barriers to vaccine uptake have been identified, affecting all target groups, and in various countries and healthcare settings. Ease of accessibility is a potentially modifiable determinant in vaccine uptake, and thus, improving the diversity of settings where vaccines can be provided to adults, for example by enabling community pharmacists to vaccinate, may increase the number of available opportunities for vaccination.


Subject(s)
Health Promotion/methods , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Pharmaceutical Services/organization & administration , Pharmacists , Vaccination/psychology , Vaccination/statistics & numerical data , Adult , Congresses as Topic , Europe , Female , Humans , Italy , Male , Middle Aged , Organizational Objectives , Professional Role
17.
Clin Immunol ; 209: 108275, 2019 12.
Article in English | MEDLINE | ID: mdl-31669193

ABSTRACT

An adjuvant system (AS37) has been developed containing a synthetic toll-like receptor agonist (TLR7a). We conducted a phase I randomized, observer-blind, dose-escalation study to assess the safety and immunogenicity of an investigational AS37-adjuvanted meningococcus C (MenC) conjugate vaccine in healthy adults (NCT02639351). A control group received a licensed MenC conjugate alum-adjuvanted vaccine. Eighty participants were randomized to receive one dose of control or investigational vaccine containing AS37 (TLR7a dose 12.5, 25, 50, 100 µg). All vaccines were well tolerated, apart from in the TLR7a 100 µg dose group, which had three reports (18.8%) of severe systemic adverse events. Four weeks after vaccination, human complement serum bactericidal assay seroresponse rates against MenC were 56-81% in all groups, and ELISA seroresponses were ≥81% for all AS37-adjuvanted vaccine groups (100% in 50 and 100 µg dose groups) and 88% in the control group. Antibody responses were maintained at six months after vaccination.


Subject(s)
Adjuvants, Immunologic/administration & dosage , Aluminum Hydroxide/immunology , Meningococcal Vaccines/immunology , Neisseria meningitidis/immunology , Toll-Like Receptor 7/immunology , Adult , Antibodies, Bacterial/immunology , Bacterial Vaccines/immunology , Female , Humans , Immunogenicity, Vaccine/immunology , Male , Middle Aged , Vaccination/methods , Young Adult
18.
Front Immunol ; 10: 2214, 2019.
Article in English | MEDLINE | ID: mdl-31616417

ABSTRACT

Immaturity of the immune system contributes to poor vaccine responses in early life. Germinal center (GC) activation is limited due to poorly developed follicular dendritic cells (FDC), causing generation of few antibody-secreting cells (ASCs) with limited survival and transient antibody responses. Herein, we compared the potential of five adjuvants, namely LT-K63, mmCT, MF59, IC31, and alum to overcome limitations of the neonatal immune system and to enhance and prolong responses of neonatal mice to a pneumococcal conjugate vaccine Pnc1-TT. The adjuvants LT-K63, mmCT, MF59, and IC31 significantly enhanced GC formation and FDC maturation in neonatal mice when co-administered with Pnc1-TT. This enhanced GC induction correlated with significantly enhanced vaccine-specific ASCs by LT-K63, mmCT, and MF59 in spleen 14 days after immunization. Furthermore, mmCT, MF59, and IC31 prolonged the induction of vaccine-specific ASCs in spleen and increased their persistence in bone marrow up to 9 weeks after immunization, as previously shown for LT-K63. Accordingly, serum Abs persisted above protective levels against pneumococcal bacteremia and pneumonia. In contrast, alum only enhanced the primary induction of vaccine-specific IgG Abs, which was transient. Our comparative study demonstrated that, in contrast to alum, LT-K63, mmCT, MF59, and IC31 can overcome limitations of the neonatal immune system and enhance both induction and persistence of protective immune response when administered with Pnc1-TT. These adjuvants are promising candidates for early life vaccination.


Subject(s)
Adjuvants, Immunologic/pharmacology , Antibody-Producing Cells/drug effects , Bone Marrow/drug effects , Germinal Center/drug effects , Spleen/drug effects , Alum Compounds/pharmacology , Animals , Animals, Newborn , Antibodies, Bacterial/blood , Bacterial Toxins/pharmacology , Bone Marrow/immunology , Cholera Toxin/pharmacology , Drug Combinations , Enterotoxins/pharmacology , Escherichia coli Proteins/pharmacology , Immunoglobulin G/blood , Mice , Oligodeoxyribonucleotides/pharmacology , Oligopeptides/pharmacology , Pneumococcal Vaccines/administration & dosage , Polysorbates/pharmacology , Spleen/immunology , Squalene/pharmacology
19.
NPJ Vaccines ; 4: 39, 2019.
Article in English | MEDLINE | ID: mdl-31583123

ABSTRACT

Reactogenicity represents the physical manifestation of the inflammatory response to vaccination, and can include injection-site pain, redness, swelling or induration at the injection site, as well as systemic symptoms, such as fever, myalgia, or headache. The experience of symptoms following vaccination can lead to needle fear, long-term negative attitudes and non-compliant behaviours, which undermine the public health impact of vaccination. This review presents current knowledge on the potential causes of reactogenicity, and how host characteristics, vaccine administration and composition factors can influence the development and perception of reactogenicity. The intent is to provide an overview of reactogenicity after vaccination to help the vaccine community, including healthcare professionals, in maintaining confidence in vaccines by promoting vaccination, setting expectations for vaccinees about what might occur after vaccination and reducing anxiety by managing the vaccination setting.

20.
Sci Data ; 6(1): 149, 2019 08 13.
Article in English | MEDLINE | ID: mdl-31409798

ABSTRACT

Biomedical informatics has traditionally adopted a linear view of the informatics process (collect, store and analyse) in translational medicine (TM) studies; focusing primarily on the challenges in data integration and analysis. However, a data management challenge presents itself with the new lifecycle view of data emphasized by the recent calls for data re-use, long term data preservation, and data sharing. There is currently a lack of dedicated infrastructure focused on the 'manageability' of the data lifecycle in TM research between data collection and analysis. Current community efforts towards establishing a culture for open science prompt the creation of a data custodianship environment for management of TM data assets to support data reuse and reproducibility of research results. Here we present the development of a lifecycle-based methodology to create a metadata management framework based on community driven standards for standardisation, consolidation and integration of TM research data. Based on this framework, we also present the development of a new platform (PlatformTM) focused on managing the lifecycle for translational research data assets.


Subject(s)
Information Dissemination , Medical Informatics , Translational Research, Biomedical , Humans , Metadata , User-Computer Interface
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