Two randomized trials of effect of live attenuated influenza vaccine on pneumococcal colonization

The human nasopharynx is frequently colonized by Streptococcus pneumoniae (the pneumococcus), serving as the reservoir for transmission, a state which necessarily precedes invasive pneumococcal infection. Influenza infection increases pneumococcal colonization density and dysregulates host immune responses, increasing the risk of secondary bacterial pneumonia and death

A Cross-Sectional Study of Household Biomass Fuel Use among a Periurban Population in Malawi

Rationale: The Global Burden of Disease Study suggests almost 3.5 million people die as a consequence of household air pollution every year. Respiratory diseases including chronic obstructive pulmonary disease and pneumonia in children are strongly associated with exposure to household air pollution. Smoke from burning biomass fuels for cooking, heating, and lighting is the main contributor to high household air pollution levels in low-income countries like Malawi. A greater understanding of biomass fuel use in Malawi should enable us to address household air pollution–associated communicable and noncommunicable diseases more effectively. Objectives: To conduct a cross-sectional analysis of biomass fuel use and population demographics among adults in Blantyre, Malawi. Methods: We used global positioning system–enabled personal digital assistants to collect data on location, age, sex, marital status, education, occupation, and fuel use. We describe these data and explore associations between demographics and reported fuel type. Measurements and Main Results: A total of 16,079 adults participated (nine households refused); median age was 30 years, there was a similar distribution of men and women, 60% were married, and 62% received secondary school education. The most commonly reported occupation for men and women was “salaried employment” (40.7%) and “petty trader and marketing” (23.5%), respectively. Charcoal (81.5% of households), wood (36.5%), and electricity (29.1%) were the main fuels used at home. Only 3.9% of households used electricity exclusively. Lower educational and occupational attainment was associated with greater use of wood. Conclusions: This large cross-sectional study has identified extensive use of biomass fuels in a typical sub-Saharan Africa periurban population in which women and people of lower socioeconomic status are disproportionately affected. Biomass fuel use is likely to be a major driver of existing communicable respiratory disease and the emerging noncommunicable disease (especially respiratory and cardiovascular) epidemic in this region. Our data will help inform the rationale for specific intervention studies and the development of appropriately targeted public health strategies to tackle this important and poverty-related global health problem

Novel Analysis of Immune Cells from Nasal Microbiopsy Demonstrates Reliable, Reproducible Data for Immune Populations, and Superior Cytokine Detection Compared to Nasal Wash

The morbidity and mortality related to respiratory tract diseases is enormous, with hundreds of millions of individuals afflicted and four million people dying each year. Understanding the immunological processes in the mucosa that govern outcome following pathogenic encounter could lead to novel therapies. There is a need to study responses at mucosal surfaces in humans for two reasons: (i) Immunological findings in mice, or other animals, often fail to translate to humans. (ii) Compartmentalization of the immune system dictates a need to study sites where pathogens reside. In this manuscript, we describe two novel non-invasive nasal mucosal microsampling techniques and their use for measuring immunological parameters: 1) using nasal curettes to collect cells from the inferior turbinate and; 2) absorptive matrices to collect nasal lining fluid. Both techniques were well tolerated and yielded reproducible and robust data. We demonstrated differences in immune populations and activation state in nasal mucosa compared to blood as well as compared to nasopharyngeal lumen in healthy adults. We also found superior cytokine detection with absorptive matrices compared to nasal wash. These techniques are promising new tools that will facilitate studies of the immunological signatures underlying susceptibility and resistance to respiratory infections

(Alessandro Testa, 2014) Il Carnevale dell'uomo animale. Le dimensioni storiche e socio-culturali di una festa appenninica

Post-intervention sampling steps and summary estimates. (DOCX 19 kb

Comparison of samples collected by nasal wash and nasal curette.

<p>(A) Epithelial (open circles) and immune (closed circles) and cell yields were compared between nasal wash pellets and nasal curette samples. Individuals samples and median and interquartile range are shown. (B) Median proportions of granulocytes, T cells, monocytes, lineage^- HLA-DR⁺ and uncharacterized cells among immune cells in nasal curette (n = 139 individuals) and nasal wash (n = 8) samples. *p < 0.05, ***p < 0.001, ****p < 0.0001 Mann-Whitney test.</p

Comparison of samples from nasal mucosa and blood.

<p>(A) Median proportions of granulocytes, T cells, monocytes, lineage^- HLA-DR⁺ and uncharacterized cells among immune cells in blood (n = 10) and nasal curette (n = 139). **** p < 0.0001 Mann-Whitney test. (B) The percentage of HLA-DR⁺ T cells in blood and nasal curette samples and mean fluorescent intensity (MFI) of HLA-DR and CD66b on granulocytes was measured for blood, nasal curette and nasal wash (n = 8) samples. Median and interquartile range are shown. *p < 0.05, ***p < 0.001 Kruskal-Wallis, followed by Dunn’s Multiple Comparison Test. (C) Multi-dimensional scaling analysis shows the clustering of samples from blood (grey circles), nasal curette (open squares, 11 randomly selected) and nasal wash (black triangles). The epithelial cell yield, activation state of granulocytes and composition of the immune cells were taken into account. Kruskal stress = 5.8% and Analysis of Similarity ANOSIM p-value = 0.001.</p

Nasal curettage yields reproducible and consistent results over time.

<p>(A) The percentage of granulocytes (closed circles) and T cells (open circles) in 218 nasal cell samples collected over a five month period (n = 117 volunteers, sampled up to five times). Individual samples and loess curves are depicted for both populations. (B, C) The correlation for individuals in four repeated measurements over a 33-day period for (B) granulocytes and (C) T cells.</p