A model to control the epidemic of H5N1 influenza at the source

Background  

No country is fully prepared for a 1918-like pandemic influenza. Averting a pandemic of H5N1 influenza virus depends on the successful control of its endemicity, outbreaks in poultry and occasional spillage into human which carries a case-fatality rate of over 50%. The use of perimetric depopulation and vaccination has failed to halt the spread of the epidemic. Blanket vaccination for all poultry over a large geographical area is difficult. A combination of moratorium, segregation of water fowls from chickens and vaccination have been proved to be effective in the Hong Kong Special Administrative Region (HKSAR) since 2002 despite endemicity and outbreaks in neighbouring regions. Systematic surveillance in southern China showed that ducks and geese are the primary reservoirs which transmit the virus to chickens, minor poultry and even migratory birds.     

Access to hepatitis C medicines

Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world’s largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines.     

Antibody-enhanced cross-presentation of self antigen breaks T cell tolerance

We have developed a model of autoimmunity to investigate autoantibody-mediated cross-presentation of self antigen. RIP-mOVA mice, expressing OVA in pancreatic beta cells, develop severe autoimmune diabetes when given OT-I cells (OVA-specific CD8(+) T cells) and anti-OVA IgG but not when given T cells alone. Anti-OVA IgG is not directly injurious to the islets but rather enhances cross-presentation of apoptotic islet antigen to the OT-I cells, leading to their differentiation into potent effector cells. Antibody-driven effector T cell activation is dependent on the presence of activating Fc receptors for IgG (FcgammaRs) and cross-priming DCs. As a consequence, diabetes incidence and severity was reduced in mice lacking activating FcgammaRs. An intact complement pathway was also required for disease development, as C3 deficiency was also partially protective. C3-deficient animals exhibited augmented T cell priming overall, indicating a proinflammatory role for complement activation after the T cell priming phase. Thus, we show that autoreactive antibody can potently enhance the activation of effector T cells in response to cross-presented self antigen, thereby contributing to T cell-mediated autoimmunity.     

东洞庭湖洲滩钉螺消长规律及影响因素

目的探讨东洞庭湖区洲滩钉螺的消长规律及影响因素,为控制和消灭钉螺提供科学依据。方法选择岳阳县老港村飘尾洲为试点,收集2002～2007年6月的气象、水位资料;现场观察各年度的钉螺分布、消长及环境变化情况;分析钉螺分布的特点及其与气象、水位、环境变化的关系。结果钉螺的分布呈负二项分布,各年度的钉螺密度有一定差异,秋季钉螺密度高于春季,但差异无统计学意义（2003年例外,P〉0.05）。年平均气温、湿度、累计降雨量、日照时间和水位无明显差异（P〉0.05）,钉螺密度和钉螺死亡率与气象因素和水位无明显相关（P〉0.05）,但地理环境变化和人畜活动会对钉螺的分布产生一定程度的影响。结论一般自然情况下,东洞庭湖区的气候和水位相对稳定,对洲滩钉螺的分布和消长无明显影响,影响钉螺孳生分布的主要因素是地理环境变化和人畜活动。