RESUMO
BACKGROUND: Bordetella pertussis is among the leading causes of vaccine-preventable deaths and morbidity globally. Human asymptomatic carriage as a reservoir for community transmission of infections might be a target of future vaccine strategies, but has not been demonstrated. Our objective was to demonstrate that asymptomatic nasopharyngeal carriage of Bordetella pertussis is inducible in humans and to define the microbiological and immunological features of presymptomatic infection. METHODS: Healthy subjects aged 18-45 years with an antipertussis toxin immunoglobin G (IgG) concentration of <20 international units/ml were inoculated intranasally with nonattenuated, wild-type Bordetella pertussis strain B1917. Safety, colonization, and shedding were monitored over 17 days in an inpatient facility. Colonization was assessed by culture and quantitative polymerase chain reaction. Azithromycin was administered from Day 14. The inoculum dose was escalated, aiming to colonize at least 70% of participants. Immunological responses were measured. RESULTS: There were 34 participants challenged, in groups of 4 or 5. The dose was gradually escalated from 103 colony-forming units (0% colonized) to 105 colony-forming units (80% colonized). Minor symptoms were reported in a minority of participants. Azithromycin eradicated colonization in 48 hours in 88% of colonized individuals. Antipertussis toxin IgG seroconversion occurred in 9 out of 19 colonized participants and in none of the participants who were not colonized. Nasal wash was a more sensitive method to detect colonization than pernasal swabs. No shedding of Bordetella pertussis was detected in systematically collected environmental samples. CONCLUSIONS: Bordetella pertussis colonization can be deliberately induced and leads to a systemic immune response without causing pertussis symptoms. CLINICAL TRIALS REGISTRATION: NCT03751514.
Assuntos
Bordetella pertussis , Coqueluche , Adolescente , Adulto , Azitromicina/uso terapêutico , Humanos , Pessoa de Meia-Idade , Nasofaringe , Vacina contra Coqueluche , Coqueluche/prevenção & controle , Adulto JovemRESUMO
La Interleuquina 17 (IL-17) es una citoquina proinflamatoria con diversas funciones biológicas secretada por varios subtipos de células T activadas.Su receptor se encuentra en los distintos tipos celulares de un amplio rango de tejidos. La IL-17 se ha relacionado con el desarrollo de enfermedades autoinmunes, rechazo de aloinjertos, cáncer, respuestas de hipersensibilidad inmediatas y tardías y control de infecciones, entre ellas la respuesta inmune contra Mycobacterium tuberculosis. Esta revisión pretende abarcar los aspectos hasta ahora elucidados sobre las características, las vías de diferenciación de las células productoras de IL-17, así como la señalización y funciones de ésta.
