Sample pooling: burden or solution?

BackgroundPool-testing strategies combine samples from multiple people and test them as a group. A pool-testing approach may shorten the screening time and increase the test rate during times of limited test availability and inadequate reporting speed. Pool testing has been effectively used for a wide variety of infectious disease screening settings. Historically, it originated from serological testing in syphilis. During the current coronavirus disease 2019 (COVID-19) pandemic, pool testing is considered across the globe to inform opening strategies and to monitor infection rates after the implementation of interventions.AimsThis narrative review aims to provide a comprehensive overview of the global efforts to implement pool testing, specifically for COVID-19 screening.SourcesData were retrieved from a detailed search for peer-reviewed articles and preprint reports using Medline/PubMed, medRxiv, Web of Science, and Google up to 21st March 2021, using search terms “pool testing”, “viral”, “serum”, “SARS-CoV-2” and “COVID-19”.ContentThis review summarizes the history and theory of pool testing. We identified numerous peer-reviewed articles that describe specific details and practical implementation of pool testing. Successful examples as well as limitations of pool testing, in general and specifically related to the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA and antibodies, are reviewed. While promising, significant operational, pre-analytical, logistical, and economic challenges need to be overcome to advance pool testing.ImplicationsThe theory of pool testing is well understood and numerous successful examples from the past are available. Operationalization of pool testing requires sophisticated processes that can be adapted to the local medical circumstances. Special attention needs to be paid to sample collection, sample pooling, and strategies to avoid re-sampling.     

猪囊尾蚴病免疫和诊断抗原的分子生物学研究进展

猪囊尾蚴病是一种危害严重的人兽共患寄生虫病。猪囊尾蚴特异性和保护性抗原的研究是猪带绦虫病、猪囊尾蚴病免疫和诊断的基础。天然抗原来源有限,限制了其应用,而重组抗原的应用可解决质量控制和抗原来源的问题。该文就近年来猪囊尾蚴病免疫和诊断抗原的分子生物学研究进展进行了综述。     

Vaccination against atherosclerosis: An overview

Atherosclerosis, an inflammatory disorder involving innate and adaptive immune responses with both atheroprotective and proatherogenic roles, is a life wasting and economic demanding disorder that continues to be the leading cause of morbidity and mortality worldwide. Thus, the need for a long-lasting and highly effective treatment has made researchers to find new strategies. Many efforts made thus far to reduce the burden of the disease have been toward the modification of cardiovascular risk factors.Vaccination against atherosclerosis has been investigated as a promising strategy to overcome the disorder. Several kinds of vaccination methods have been investigated mostly in mice, with promising results in the attenuation of atherosclerosis, inflammation, and lipid concentration. The most conflicting part of this strategy is finding appropriate antigens and adjuvants. Some antigens have been used, including OxLDL, apoB100, CETP, PCSK9, HSP60, MHC-II-derived peptides, and interleukins. The DNA-based vaccination method has opened a new window in this field. There is an increasing necessity for developing an effective, economical, long-lasting, accessible, and convenient vaccination method. There are large gaps in evidence for the selection of proper human sampling to test the vaccines, route of delivery, safety, strength, scheduling, and side effects, all of which must be considered in clinical trials in the future.     

The DNA damage response induces antigen presenting cell‐like functions in fibroblasts

The DNA damage response (DDR) alerts the immune system to the danger posed by DNA damage through the induction of damage‐associated molecular pattern molecules, chemokines, and ligands for activating immune receptors such as lymphocyte function‐associated antigen 1 (LFA‐1), NKG2D, and DNAX accessory molecule 1 (DNAM‐1). Here we provide evidence that OVA^257–264‐pulsed fibroblasts gain the ability to activate naïve OT‐I CD8⁺ T cells in response to DNA damage. The ability of fibroblasts to activate OT‐I CD8⁺ T cells depended on the upregulation of ICAM‐1 on fibroblasts and DNAM‐1 expression of CD8⁺ T cells. OVA^257–264‐pulsed fibroblasts were able to induce a protective T‐cell response against B16‐OVA cells in a DDR‐dependent manner. Hence, the DDR may alert the immune system to the presence of potentially dangerous cells by upregulating the expression of ligands that can induce the activation of innate and adaptive immune cells.     

Reactive arthritis induced by intravesical BCG therapy for bladder cancer: our clinical experience and systematic review of the literature

Objective

Intravesical instillation of BCG (ivBCG) is an effective and safe immunotherapy of bladder carcinoma but it may have, as side effect, a reactive arthritis (ReA). The authors describe 5 cases observed during their own clinical experience along with the updated review of the literature on this topic.

Methods

Seventy-three papers were present in the world literature, each reporting almost 1 case for a total of 112 patients. However, the review focused on 61 papers, selected on the basis of reporting suitable for a correct clinical evaluation; thus, a total of 89 patients, including the cases observed in our clinic, were carefully analyzed.

Results

Among the 89 patients identified 73 were males and 16 females. Europe is the geographical area with the higher number of reports, namely 80.6% of the papers including 74.2% of the patients. The Mediterranean area accounts for 62.9% of the papers and 59.6% of the cases. The symptoms of ReA appeared after a mean number of instillations of 5.8. Polyarthritis was present in 55.1%, oligoarthritis in 37.0% and monoarthritis in 7.9%. Polyarthritis was symmetric in 51.0% and asymmetric in 49.0% of the cases; oligoarthritis was symmetric in 33.3% and asymmetric in 66.7% of the cases. Overall, an asymmetric distribution of arthritis was present in 59.6%. Knee and ankle were the joints most frequently involved. The antigen HLA B27 was positive in 42.6%. The synovial fluid analysis was defined as flogistic–aseptic in 71.9% of the patients. Arthritis was recovered within 6 months in 93.2% of the cases and in 70.5% of the patients within the first two months. NSAIDs and corticosteroids, alone or in conjunction with other drugs, are used in 65.1% and in 40.4% of the cases, respectively. The clinical features of ivBCG ReA are compared with ReA from other triggering agents, from which it differs for some clinical aspects and overlaps for others.

Conclusions

Compared with a previous report, this review allows to modify some figures of this topic as a reduced prevalence of polyarthritis (from 70% to 55.1%) and of spinal and sacroiliac involvement; polyarthritis remains the more frequent clinical pattern of ivBCG ReA that, however, is characterized by rather asymmetrical distribution and involvement of the large joints of lower limbs. A definite linkage to HLA B27 is present, although without prognostic value. Moreover, arthritis is aseptic, has a latency time from antigen exposure, and is associated with extra-articular features as commonly observed in ReA from other triggering agents. Arthritis is usually benign and rarely develops into a chronic form. NSAIDs and/or corticosteroids are largely effective. Noteworthy, the overall clinical picture of arthritis triggered by ivBCG emerging from this updated review is comparable to that of ReA from other bacterial agents.     

日本血吸虫病诊断抗原研究进展

血吸虫病免疫诊断技术的发展为血吸虫病控制做出了重要贡献。血吸虫抗原检测特异性抗体是目前血吸虫病免疫诊断的常用方法,所使用的抗原可分为粗制虫源抗原、纯化虫源抗原和重组抗原。研制高敏感性、高特异性和具有早期诊断价值的抗原是免疫诊断研究的重点。本文对近年日本血吸虫病诊断抗原研究进展进行了综述。