Quantitative and qualitative analysis of antibody response after dose sparing intradermal 2009 H1N1 vaccination

Letter to the editorpostprin

Strongyloidiasis in a nonagenarian who previously worked in conservancy services

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Paradoxical deterioration during anti-tubercular treatment in a dialysis patient on maintenance steroid therapy

We report a 38-year-old Chinese woman with lupus nephritis on peritoneal dialysis and long-term maintenance steroid therapy. This patient developed paradoxical deterioration during anti-tubercular therapy for tuberculous lymphadenitis. The deterioration resolved spontaneously without change to pharmacotherapy. Paradoxical deterioration that may spontaneously resolve is a potential complication of anti-tubercular treatment in patients on long-term renal replacement therapy.published_or_final_versio

Prevalence of influenza vaccination and associated factors among Chinese nursing home health care workers

BACKGROUND: Influenza vaccination (IV) in nursing home health care workers (nHCWs) can reduce mortality of nursing home older adults. There is no study examining the prevalence of IV in Chinese nHCWs ...postprin

Chemoprophylaxis in colorectal cancer: Current concepts and a practical algorithm for use

Colorectal cancer (CRC) is the second most common lethal cancer in the Western world. There is a 10 to 20 years lead time from normal mucosa to carcinoma which offers a window of opportunity to modify and prevent the outcome of CRC, with its incipient morbidity and mortality. The objective of this paper is to review the evidence for chemoprophylaxis in CRC, identify currently used agents and determine their role in the current management algorithm of CRC. Large cohort-control and randomised controlled trials in the most studied chemoprophylaxis agents are reviewed. Currently, the role for chemoprophylaxis in CRC remains a niche area, with celecoxib the only recommended agent for use in patients with familial polyposis syndromes. However, the role of chemoprophylaxis is likely to grow significantly in the next decade as understanding of the stepwise tumorigenesis cascade becomes better understood and current clinical trials are completed. © 2010 Informa UK Ltd.postprin

Effectiveness of influenza vaccination in institutionalised older adults: a systematic review

This journal suppl. entitled: 19th Medical Research Conference; Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong KongBACKGROUND: Influenza infection is common among institutionalised older adults. Many non-randomised observational studies on influenza vaccination suggested that it could reduce influenza-related hospitalizations and mortality in institutionalised older adults. Criticism regarding the effectiveness of influenza vaccine estimated by non-randomised observational studies includes the frailty selection bias and use of non-specific outcome like all-cause mortality. A systematic review of studies of influenza vaccination in institutionalized older adults to ...postprin

Prevalence of past or current Hepatitis B infection and factors for non-vaccination in Chinese patients with inflammatory bowel diseases

The Conference program's website is located at http://jsibd.jp/1staocc/program.htmlPoster Oral: PO-46Information on the prevalence and natural history of chronic hepatitis B (HBV) among Asian IBD patients are scarce. Moreover, the prevalence of HBV vaccination coverage in Asian IBD patients remains unknown. AIM: We determined the prevalence and clinical course of current and past HBV infection among Chinese IBD patients. We also determined the proportion of Chinese IBD patients without protective antibody against HBV and factors associated with non-vaccination. METHODS: All patients attending our IBD Clinic had blood tests for viral hepatitis B markers. The prevalence of current and past infection with HBV, and effective HBV vaccination were determined. We also identified for risk factors associated with non-vaccination. RESULTS: A total of 267 Chinese IBD (166 ulcerative colitis and 101 Crohn’s disease) patients were studied. The mean follow up was 10.5 years. Current HBV infection was detected in 6.7% patients whereas 28.5% had evidence of past HBV infection. One hundred and two (38.2%) patients had no detectable anti-HBs antibodies. Multivariate analysis found that young age of diagnosis (OR 1.021; 95% CI 1.00 – 1.04) and the use of thiopurines (OR 0.51; 95%CI 0.29 – 0.91) were associated with absence of anti-HBs. Deranged liver function was detected in 27 (10.1%) IBD patients including three (16.7%) HBsAg-positive patients. The corresponding proportion of patients with liver derangement was 7.9% in patients with past HBV infection, 8.9% in HBsAg-negative patients without anti-HBs and 11.2% in patients with effective HBV vaccination (P = 0.71). CONCLUSION: Current and past infection with HBV was detected in about one-third of Chinese IBD patients. Approximately 40% of IBD patients lacked protective antibody against HBV. The use of thiopurines and young age of diagnosis was associated with non-vaccination among Chinese IBD patients. A more intensive HBV vaccination program with regular monitoring of anti-HBs may be needed in this group of patients.published_or_final_versio

Identification of dominant ADCC epitopes on hemagglutinin antigen of pandemic H1N1 influenza virus

Antibody-dependent cell-mediated cytotoxicity (ADCC) bridges innate and adaptive immunity, and it involves both humoral and cellular immune responses. ADCC has been found to be a main route of immune protection against viral infections in vivo. Hemagglutinin (HA) of influenza virus is highly immunogenic and considered the most important target for immune protection. Several potent cross-reactive HA-specific neutralizing monoclonal antibodies (MAbs) have been reported, and their conserved neutralizing epitopes have been revealed, but there has been no report so far about ADCC epitopes on HA. Here we identified two dominant ADCC epitopes, designated E1 (amino acids [aa] 92 to 117) and E2 (aa 124 to 159), on HA of pandemic H1N1 influenza virus by epitope mapping of convalescent-phase plasma IgG antibodies from six H1N1-infected human subjects in China that exhibited different levels of ADCC activity. The E1 and E2 ADCC epitopes overlapped with immunodominant epitopes of HA. Depletion of purified patient plasma IgG antibodies with EBY100 yeast cells expressing E1 or E2 decreased the ADCC activity of the IgG antibodies. E1 and E2 sequences were found to be highly conserved in H1N1 strains but less so in other subtypes of influenza A viruses. Our study may aid in designing immunogens that can elicit antibodies with high ADCC activity. Vaccine immunogens designed to include the structural determinants of potent broadly neutralizing antibodies and ADCC epitopes may confer comprehensive immune protection against influenza virus infection.postprin