Investigating the rationale for COPD maintenance therapy prescription across Europe, findings from a multi-country study.

This study aims to understand healthcare professionals' thoughts and motivations about optimal management and treatment of patients with chronic obstructive pulmonary disease (COPD). We conducted a DELPHI survey through an online questionnaire distributed to 220 panellists from six European countries and a discrete choice experiment to describe the relationship between selected clinical criteria and the initial COPD treatment of choice. One hundred twenty-seven panellists (general practitioners [GPs] and pulmonologists) completed the survey. Despite the familiarity and use (89.8%) of the GOLD classification for initial treatment selection, a frequent use of LAMA/LABA/ICS was noted. In fact, panellists agreed that inhaled corticosteroids (ICS) are over-prescribed in the primary care setting. Our study showed that GPs felt less confident than pulmonologists with ICS withdrawal. This mismatch observed between best practice and behaviour indicates the need to increase awareness and efforts to improve the adherence to guidelines in clinical practice.

The Anopheles gambiae salivary protein gSG6: an anopheline-specific protein with a blood-feeding role.

The Anopheles gambiae salivary gland protein 6 (gSG6) is a small protein specifically found in the salivary glands of adult female mosquitoes. We report here the expression of a recombinant form of the protein and we show that in vivo gSG6 is expressed in distal-lateral lobes and is secreted with the saliva while the female mosquito probes for feeding. Injection of gSG6 dsRNA into adult A. gambiae females results in decreased gSG6 protein levels, increased probing time and reduced blood feeding ability. gSG6 orthologs have been found so far only in the salivary glands of Anopheles stephensi and Anopheles funestus, both members of the Cellia subgenus. We report here the gSG6 sequence from five additional anophelines, four species of the A. gambiae complex and Anopheles freeborni, a member of the subgenus Anopheles. We conclude that gSG6 plays some essential blood feeding role and was recruited in the anopheline subfamily most probably after the separation of the lineage which gave origin to Cellia and Anopheles subgenera.

Novel peptide marker corresponding to salivary protein gSG6 potentially identifies exposure to Anopheles bites.

BACKGROUND: In order to improve malaria control, and under the aegis of WHO recommendations, many efforts are being devoted to developing new tools for identifying geographic areas with high risk of parasite transmission. Evaluation of the human antibody response to arthropod salivary proteins could be an epidemiological indicator of exposure to vector bites, and therefore to risk of pathogen transmission. In the case of malaria, which is transmitted only by anopheline mosquitoes, maximal specificity could be achieved through identification of immunogenic proteins specific to the Anopheles genus. The objective of the present study was to determine whether the IgG response to the Anopheles gambiae gSG6 protein, from its recombinant form to derived synthetic peptides, could be an immunological marker of exposure specific to Anopheles gambiae bites. METHODOLOGY/PRINCIPAL FINDINGS: Specific IgG antibodies to recombinant gSG6 protein were observed in children living in a Senegalese area exposed to malaria. With the objective of optimizing Anopheles specificity and reproducibility, we designed five gSG6-based peptide sequences using a bioinformatic approach, taking into consideration i) their potential antigenic properties and ii) the absence of cross-reactivity with protein sequences of other arthropods/organisms. The specific anti-peptide IgG antibody response was evaluated in exposed children. The five gSG6 peptides showed differing antigenic properties, with gSG6-P1 and gSG6-P2 exhibiting the highest antigenicity. However, a significant increase in the specific IgG response during the rainy season and a positive association between the IgG level and the level of exposure to Anopheles gambiae bites was significant only for gSG6-P1. CONCLUSIONS/SIGNIFICANCE: This step-by-step approach suggests that gSG6-P1 could be an optimal candidate marker for evaluating exposure to Anopheles gambiae bites. This marker could be employed as a geographic indicator, like remote sensing techniques, for mapping the risk of malaria. It could also represent a direct criterion of efficacy in evaluation of vector control strategies.

An insight into the sialome of the adult female mosquito Aedes albopictus.

To gain insight into the molecular repertoire of the adult female salivary glands of the tiger mosquito Aedes albopictus, we performed transcriptome and proteome analysis. cDNA clones were sequenced and assembled in clusters of related sequences and the corresponding genes assigned to one of three categories: housekeeping (H; 31%), secreted (S; 34%), or unknown (U; 35%) function. Among the putative secreted factors are proteins known to be widely distributed in the saliva of blood-sucking Diptera, such as D7 and antigen 5 family members, as well as proteins that are mosquito- or culicine-specific, i.e., the 30-kDa allergen or the 62-kDa and 34-kDa families, respectively. Expression of 15 of these salivary proteins was confirmed by Edman degradation. Tissue and sex specificity of selected transcripts were evaluated by RT-PCR and identified at least 32 genes whose expression is restricted or enriched in the female salivary glands of Ae. albopictus, whereas 17 additional genes were expressed in female glands and adult males but not in other tissues of adult females. For approximately one third of the genes analyzed, involvement in blood-feeding, sugar digestion, immune response, or other more generic physiological roles can be postulated; however, no functions can be suggested for the remaining sequences, which therefore likely represent either novel functions or novel molecules recruited during the evolution of hematophagy. Supplemental spreadsheets with hyperlinks to all sequences used in this manuscript are hyperlinked throughout the text and can be found at http://www.ncbi.nlm.nih.gov/projects/omes/#salivarytranscriptomes.