COVID-19: A pluralistic and integrated approach for efficient management of the pandemic

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which triggered the ongoing pandemic, was first discovered in China in late 2019. SARS-CoV-2 is a respiratory virus responsible for coronavirus disease 2019 (COVID-19) that often manifests as a pneumonic syndrome. In the context of the pandemic, there are mixed views on the data provided by epidemiologists and the information collected by hospital clinicians about their patients. In addition, the literature reports a large proportion of patients free of pneumonia vs a small percentage of patients with severe pneumonia among confirmed COVID-19 cases. This raises the issue of the complexity of the work required to control or contain the pandemic. We believe that an integrative and pluralistic approach will help to put the analyses into perspective and reinforce collaboration and creativity in the fight against this major scourge. This paper proposes a comprehensive and integrative approach to COVID-19 research, prevention, control, and treatment to better address the pandemic. Thus, this literature review applies a pluralistic approach to fight the pandemic.     

Polymorphisms in the K13-Propeller Gene in Artemisinin-Susceptible Plasmodium falciparum Parasites from Bougoula-Hameau and Bandiagara,Mali

Artemisinin-resistant Plasmodium falciparum malaria has been documented in southeast Asia and may already be spreading in that region. Molecular markers are important tools for monitoring the spread of antimalarial drug resistance. Recently, single-nucleotide polymorphisms (SNPs) in the PF3D7_1343700 kelch propeller (K13-propeller) domain were shown to be associated with artemisinin resistance in vivo and in vitro. The prevalence and role of K13-propeller mutations are poorly known in sub-Saharan Africa. K13-propeller mutations were genotyped by direct sequencing of nested polymerase chain reaction (PCR) amplicons from dried blood spots of pre-treatment falciparum malaria infections collected before and after the use of artemisinin-based combination therapy (ACT) as first-line therapy in Mali. Although K13-propeller mutations previously associated with delayed parasite clearance in Cambodia were not identified, 26 K13-propeller mutations were identified in both recent samples and pre-ACT infections. Parasite clearance time was comparable between infections with non-synonymous K13-propeller mutations and infections with the reference allele. These findings suggest that K13-propeller mutations are present in artemisinin-sensitive parasites and that they preceded the wide use of ACTs in Mali.     

Spatial Patterns of Plasmodium falciparum Clinical Incidence,Asymptomatic Parasite Carriage and Anopheles Density in Two Villages in Mali

Heterogeneity in malaria exposure is most readily recognized in areas with low-transmission patterns. By comparison, little research has been done on spatial patterns in malaria exposure in high-endemic settings. We determined the spatial clustering of clinical malaria incidence, asymptomatic parasite carriage, and Anopheles density in two villages in Mali exposed to low- and mesoendemic-malaria transmission. In the two study areas that were < 1 km² in size, we observed evidence for spatial clustering of Anopheles densities or malaria parasite carriage during the dry season. Anopheles density and malaria prevalence appeared associated in some of our detected hotspots. However, many households with high parasite prevalence or high Anopheles densities were located outside the identified hotspots. Our findings indicate that within small villages exposed to low- or mesoendemic-malaria transmission, spatial patterns in mosquito densities and parasite carriage are best detected in the dry season. Considering the high prevalence of parasite carriage outside detected hotspots, the suitability of the area for targeting control efforts to households or areas of more intense malaria transmission may be limited.     

Prevalence of HIV and HCV infections in two populations of Malian women and serological assays performances

AIM:To estimate the prevalence of human immunodeficiency virus(HIV) and hepatitis C virus(HCV) infections in women in Mali and to evaluate the performance of serological assays.METHODS:Two prospective studies were conducted in 2009 and 2010 in Mali.They concerned first,1000 pregnant women attending six reference health centers in Bamako(Malian capital) between May 26 and June 16,2009;and secondly,231 women over 50 years who consulted general practitioners of two hospitals in Bamako between October 25 and December 24,2010.Blood samples were collected and kept frozen in good condition before analysis.All samples depicted as positive using HIV/HCV enzyme immuno-assay screening assays were submitted to confirmation analysis.Molecular markers of HCV were characterized.RESULTS:The seroprevalence of HIV and HCV in the population of pregnant women was 4.1% and 0.2% respectively.Among older women the seroprevalence was higher and similar for HIV and HCV(6.1% vs 6.5%).The anti-HIV prevalence was not different in young and older women(4.1% vs 6.1%).In contrast,the anti-HCV prevalence was higher in older compared to younger women(6.5% vs 0.2%,P < 0.01).Of 2 pregnant women who were HCV seropositive,only one was polymerase chain reaction(PCR) reactive and infected by genotype 2,with a viral load of 1600 IU/mL.Regarding older women who were HCV seropositive,13 out of 15 were PCR reactive,infected by genotype 1 or 2.Globally HCV genotype 2 was predominant.The positive predictive value(PPV) measured with VIKIA HIV test in young women was 100% therefore significantly higher than the 87.5% measured in older women(P < 0.05).Conversely,the PPV measured with Monolisa HCV assay in older women was 88.2% and higher than the 14.3% measured in younger women(P < 0.01).CONCLUSION:Whereas HIV prevalence was similar in both subpopulations HCV was more frequent among older women(P < 0.01).The PPV of screening assays varied with the age of the subjects.     

Current management of liver diseases and the role of multidisciplinary approach

Liver is an organ having extremely diversified functions, ranging from metabolic and synthetic to detoxification of harmful chemicals. The multifunctionality of the liver in principle requires the multidisciplinary and pluralistic interventions for its management. Several studies have investigated liver function, dysfunction and clinic. This editorial work discusses new ideas, challenges and perspectives of current research regarding multidisciplinary and pluralistic management of liver diseases. In one hand the discussions have carried out on the involvement of extracellular vesicles, Na⁺/H⁺ exchangers, severe acute respiratory syndrome coronavirus 2 and Epstein–Barr virus infections, Drug-induced liver injury, sepsis, pregnancy, and food supplements in hepatic disorders. In the other hand this study has discussed hepatocellular carcinoma algorithms and new biochemical and imaging experiments pertaining to liver diseases. Relevant articles with an impact index value "> 0" from reference citation analysis, which is an open multidisciplinary citation analysis database based on artificial intelligence technology, have served for the study’s argumentation. This work may be a useful tool for the clinical practice and research in managing and investigating liver disorders.     

IL4‐induced gene 1 is secreted at the immune synapse and modulates TCR activation independently of its enzymatic activity

Amino‐acid catabolizing enzymes produced by mononuclear phagocytes play a central role in regulating the immune response. The mammalian phenylalanine‐catabolizing enzyme IL4‐induced gene 1 (IL4I1) inhibits effector T lymphocyte proliferation and facilitates regulatory T‐cell development. IL4I1 expression by macrophages of various human tumors may affect patient prognosis as it facilitates tumor escape from the T‐cell response in murine models. Its enzymatic activity appears to participate in its effects, but some actions of IL4I1 remain unclear. Here, we show that the presence of IL4I1 during T‐cell activation decreases early signaling events downstream of TCR stimulation, resulting in global T‐cell inhibition which is more pronounced when there is CD28 costimulation. Surprisingly, the enzymatic activity of IL4I1 is not involved. Focal secretion of IL4I1 into the immune synaptic cleft and its binding to CD3⁺ lymphocytes could be important in IL4I1 immunosuppressive mechanism of action.