The role of antibodies in the treatment of SARS-CoV-2 virus infection, and evaluating their contribution to antibody-dependent enhancement of infection

Antibodies play a crucial role in the immune response, in fighting off pathogens as well as helping create strong immunological memory. Antibody-dependent enhancement (ADE) occurs when non-neutralising antibodies recognise and bind to a pathogen, but are unable to prevent infection, and is widely known and is reported as occurring in infection caused by several viruses. This narrative review explores the ADE phenomenon, its occurrence in viral infections and evaluates its role in infection by SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19). As of yet, there is no clear evidence of ADE in SARS-CoV-2, though this area is still subject to further study

Functionalisation of inorganic material surfaces with Staphylococcus protein A : a molecular dynamics study

Staphylococcus protein A (SpA) is found in the cell wall of Staphylococcus aureus bacteria. Its ability to bind to the constant Fc regions of antibodies means it is useful for antibody extraction, and further integration with inorganic materials can lead to the development of diagnostics and therapeutics. We have investigated the adsorption of SpA on inorganic surface models such as experimentally relevant negatively charged silica, as well as positively charged and neutral surfaces, by use of fully atomistic molecular dynamics simulations. We have found that SpA, which is itself negatively charged at pH7, is able to adsorb on all our surface models. However, adsorption on charged surfaces is more specific in terms of protein orientation compared to a neutral Au (111) surface, while the protein structure is generally well maintained in all cases. The results indicate that SpA adsorption is optimal on the siloxide-rich silica surface, which is negative at pH7 since this keeps the Fc binding regions free to interact with other species in solution. Due to the dominant role of electrostatics, the results are transferable to other inorganic materials and pave the way for new diagnostic and therapeutic designs where SpA might be used to conjugate antibodies to nanoparticles

Candida albicans and Napkin Dermatitis: Relationship and Lesion Severity Correlation

Introduction: Napkin Dermatitis (ND) is a common problem in infancy that affects almost every child during the early months and years of their lifetime. It is a skin disease that becomes a challenge for both parents and physicians because of its frequency and difficulty in eliminating all of the causative factors in diapered infants. Usually Napkin dermatitis is self-limiting but when associated with Candida albicans (C. albicans) seems to be moderate to severe.Aim: The aim of the present study was to determine the colonization of C. albicans in children with Napkin dermatitis and to correlate between intensity of C. albicans colonization and the severity of napkin rash.Patients and Methods: This case-controlled study was conducted at Qassim University pediatric outpatient clinics, during the period from August 2014 to July 2015. Sixty patients with diaper dermatitis and 33 healthy controls were enrolled to this study. Sociodemographic and clinical data were obtained from the parents of each participant using questionnaires Paired (stool and skin) samples were collected from all cases and healthy control children. The samples were cultured on differential and selective chromogenic medium for isolation and initial identification of candida species. Identification confirmation of the isolates was determined by the Vitek 2 compact automated system.Results: Diaper dermatitis shows significant outcome to washing diaper area (per day) (P=0.001), History of diarrhea last 7 Days (P˂0.001), skin lab results (+/-) for Candida albicans, (P˂0.001), skin colony count, (P˂0.001), However, there is no correlation to age (P=0.828), gender (P=0.368) and feeding style (P=0.401).Conclusion: The severity score of napkin dermatitis was significantly observed among cases with diaper dermatitis (p-value<0.001) and control children (p-value<0.001) respectively.Keywords: Candida albicans; Napkin dermatitis; Diaper dermatitis; Vitek 2 compact system; Qassim

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)