Comparing Antibiotic Self-Medication in Two Socio-Economic Groups in Guatemala City: A Descriptive Cross-Sectional Study

Background Self-medication with antibiotics may result in antimicrobial resistance and its high prevalence is of particular concern in Low to Middle Income Countries (LMIC) like Guatemala. A better understanding of self-medication with antibiotics may represent an opportunity to develop interventions guiding the rational use of antibiotics. We aimed to compare the magnitude of antibiotic self-medication and the characteristics of those who self-medicate in two pharmacies serving disparate socio-economic communities in Guatemala City. Methods We conducted a descriptive, cross-sectional study in one Suburban pharmacy and one City Center pharmacy in Guatemala City. We used a questionnaire to gather information about frequency of self-medication, income and education of those who self-medicate. We compared proportions between the two pharmacies, using two-sample z-test as appropriate. Results Four hundred and eighteen respondents completed the survey (221 in the Suburban pharmacy and 197 in the City Center pharmacy). Most respondents in both pharmacies were female (70%). The reported monthly income in the suburban pharmacy was between $1,250.00-$2,500.00, the city-center pharmacy reported a monthly income between $125.00-$625.00 (p \u3c 0.01). Twenty three percent of Suburban pharmacy respondents and 3% in the City Center pharmacy completed high school (p \u3c 0.01). Proportion of self-medication was 79% in the Suburban pharmacy and 77% in City Center pharmacy. In both settings, amoxicillin was reported as the antibiotic most commonly used. Conclusions High proportions of self-medication with antibiotics were reported in two pharmacies serving disparate socio-economic groups in Guatemala City. Additionally, self-medicating respondents were most often women and most commonly self-medicated with amoxicillin. Our findings support future public health interventions centered on the regulation of antibiotic sales and on the potential role of the pharmacist in guiding prescription with antibiotics in Guatemala

Neutrophils are essential for induction of vaccine-like effects by antiviral monoclonal antibody immunotherapies

International audienceUsing a mouse retroviral model, we have shown that mAb-based immunotherapy can induce life-long endogenous protective immunity (vaccine-like effects). This observation has potentially important consequences for treating life-threatening human viral infections. Here, we investigated the role of neutrophils in this effect. Neutrophils are innate immunity effector cells with well-established microbe-killing activities that are rapidly mobilized upon infection. They are also emerging as orchestrators of innate and adaptive immunities. However, their immunomodulatory activity during antiviral mAb immunotherapies has never been studied. Our data reveal that neutrophils have an essential role in immunotherapy-induced immune protection of infected mice. Unexpectedly, neutrophils have a limited effect in controlling viral propagation upon passive immunotherapy administration, which is mostly mediated by NK cells. Instead, neutrophils operate as essential inducers of a potent host humoral antiviral response. Thus, neutrophils play an unexpected key role in protective immunity induction by antiviral mAbs. Our work opens approaches to improve antiviral immunotherapies, as it suggests that preserving neutrophil functions and counts might be required for achieving mAb-induced protective immunity

Magnetic properties of M2P4O12 ( M = Ni, Co, Cu)

We have discussed thermodynamic properties from susceptibilities and specific heat mesurements of isostructural one-dimensional M2P4O12 system. The compounds show different magnetic behaviours, varied from ferromagnetic to antiferromagnetic ordering.We have discussed thermodynamic properties from susceptibilities and specific heat mesurements of isostructural one-dimensional M2P4O12 system. The compounds show different magnetic behaviours, varied from ferromagnetic to antiferromagnetic ordering

CD32 ligation promotes the activation of CD4+T cells

Low affinity receptors for the Fc portion of IgG (FcγRs) represent a critical link between innate and adaptive immunity. Immune complexes (ICs) are the natural ligands for low affinity FcγRs, and high levels of ICs are usually detected in both, chronic viral infections and autoimmune diseases. The expression and function of FcγRs in myeloid cells, NK cells and B cells have been well characterized. By contrast, there are controversial reports about the expression and function of FcγRs in T cells. Here, we demonstrated that ∼2% of resting CD4+ T cells express cell surface FcγRII (CD32). Analysis of CD32 expression in permeabilized cells revealed an increased proportion of CD4+CD32+ T cells (∼9%), indicating that CD4+ T cells store a CD32 cytoplasmic pool. Activation of CD4+ T cells markedly increased the expression of CD32 either at the cell surface or intracellularly. Analysis of CD32 mRNA transcripts in activated CD4+ T cells revealed the presence of both, the stimulatory FcγRIIa (CD32a) and the inhibitory FcγRIIb (CD32b) isoforms of CD32, being the CD32a:CD32b mRNA ratio ∼5:1. Consistent with this finding, we found not only that CD4+ T cells bind aggregated IgG, used as an IC model, but also that CD32 ligation by specific mAb induced a strong calcium transient in CD4+ T cells. Moreover, we found that pretreatment of CD4+ T cells with immobilized IgG as well as cross-linking of CD32 by specific antibodies increased both, the proliferative response of CD4+ T cells and the release of a wide pattern of cytokines (IL-2, IL-5, IL-10, IL-17, IFN-γ, and TNF-α) triggered by either PHA or anti-CD3 mAb. Collectively, our results indicate that ligation of CD32 promotes the activation of CD4+ T cells. These findings suggest that ICs might contribute to the perpetuation of chronic inflammatory responses by virtue of its ability to directly interact with CD4+ T cells through CD32a, promoting the activation of T cells into different inflammatory profiles.Fil: Holgado, María Pía. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Sananez, Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Raiden, Silvina Claudia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Geffner, Jorge Raúl. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Arruvito, Maria Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentin

Annexin-V positive extracellular vesicles level is increased in severe COVID-19 disease

ObjectivesTo evaluate extracellular vesicles levels in a cohort of SARS-CoV-2’s patients hospitalized in an intensive care unit with and without COVID-19 associated thromboembolic events.MethodsIn this study, we aim to assess endothelial and platelet membrane-derived extracellular vesicles levels in a cohort of SARS-CoV-2 patients with and without COVID-19-associated thromboembolic events who were hospitalized in an intensive care unit. Annexin-V positive extracellular vesicles levels were prospectively assessed by flow cytometry in one hundred twenty-three critically ill adults diagnosed with acute respiratory distress syndrome associated with a SARS-CoV-2 infection, ten adults diagnosed for moderate SARS-CoV-2 infection and 25 healthy volunteers.ResultsOn our critically ill patients, thirty-four patients (27.6%) had a thromboembolic event, Fifty-three (43%) died. Endothelial and platelet membrane-derived extracellular vesicles were drastically increased in SARS-CoV-2 patients hospitalized in the ICU compared to healthy volunteers. Moreover a slighty higher small/large ratio for platelets membrane-derived extracellular vesicles in patients was linked to thrombo-embolic events.ConclusionA comparison between total annexin-V positive extracellular vesicles levels in severe and moderate SARS-CoV-2 infection and healthy controls showed a significant increase in patients with severe infection and their sizes could be considered as biomarkers of SARS-CoV-2 associated thrombo-embolic events

Rôle des polynucléaires neutrophiles et du FcgRIV dans les effets vaccinaux induit par immunothérapie antivirale par anticorps monoclonaux

Monoclonal antibodies (mAbs) are now considered as a true therapeutic alternative for treating severe viral infections. Figure out their multiple mechanisms of action is therefore crucial to improve their therapeutic effect. Using a mouse model of viral infection (the FrCasE retrovirus-induced leukemia), the team showed that a short immunotherapy with a neutralizing mAb induces long-term protective antiviral immunity ("vaccine" effects) which is Fc-dependent. Notably, immune complexes (IC) formed with therapeutic mAbs and viral determinants induce the activation of immune cells, especially dendritic cells (DCs) via their interaction with FcγRs expressed on the cell’s surface. However, IC-FcγR interactions can involve different cells of the immune system in addition to DCs, such as macrophages, monocytes or neutrophils, which differentially express FcγRs. In this context, it is important to identify which FcγRs and which FcγR-expressing cells are crucial in the induction of vaccine effects induced by mAbs. It’s the reason why my thesis work has focused on the study of the role of neutrophils and FcγRs in the modulation of immune response by mAbs. This study is based on the Fc-dependent nature of the induction of a protective immune response by mAbs and the immunomodulatory properties of neutrophils, described in different pathological situations but never studied in an mAbs antiviral immunotherapy context. To this end, I used different approaches in vitro, ex vivo and in vivo.By using the FrCasE infection model, it has been shown that neutrophils as well as FcγRIV have a crucial role in the induction of vaccine effects by mAbs, notably via the induction of a long-term protective antiviral humoral response. Moreover the in vitro experiments, highlighted that neutrophils are more effectively activated by IC compared to virus alone and that different pro-inflammatory and/or immunomodulating cytokines (i.e.TNFα and type I and type II interferons) potentiate the activation of neutrophils induced by IC. My work also revealed that viral infection and immunotherapy modulate the expression of different FcγRs, and notably they induce the overexpression of FcγRIV on two distinct populations of neutrophils (differentiated by their expression levels of the Ly6G surface marker: Ly6Ghi and Ly6Gint) and inflammatory monocytes. Finally, my work shows that immunotherapy with Mab modulates the chemokinic and cytokinic secretion profiles of these 3 FcγRIV-over-expressing cell, although the nature of the secretion profiles differs according to the cell type and evolves over time. These results suggest that the immunomodulatory effect of mAbs is based on the activation of different actors of the early immune response by inducing the secretion of chemokines and cytokines necessary for the orchestration of the immune response. They also suggest a potential cooperation between these different actors in the establishment of protective immunity.Altogether, these results show a key immunomodulator role of FcγRIV as well as of different cells expressing it in the induction of a protective immune response by antiviral mAb. They might have important consequences for the improvement of Mab-based immunotherapies.Les anticorps monoclonaux (AcM) sont désormais considérés comme une alternative thérapeutique crédible pour traiter les infections virales graves. Comprendre leurs multiples mécanismes d’action est donc crucial pour améliorer leur effet thérapeutique. En utilisant un modèle d’infection virale chez la souris (leucémie induite par le rétrovirus FrCasE), l’équipe a montré qu’une immunothérapie courte par un AcM neutralisant induisait une immunité antivirale protectrice sur le long-terme (effets « vaccinaux ») qui est dépendante du fragment Fc de l’AcM. Ainsi, des immuns complexes (IC) formés à partir de l’AcM thérapeutique et de déterminants viraux, induisent l’activation de cellules immunitaires, notamment les cellules dendritiques (DCs), via leur interaction avec les FcRs exprimés à la surface des cellules. Cependant, ces interactions IC-FcR peuvent également concerner d’autres cellules du système immunitaire outre que les DCs, telles que les macrophages, monocytes ou bien encore les neutrophiles, qui expriment elles aussi les FcRs à leur surface et ce de façon différentielle. Dans ce contexte, il est important d’identifier quels FcRs et quelles cellules les exprimant sont essentiels à l’induction des effets vaccinaux par les AcM. C’est pourquoi mes travaux thèse se sont focalisés sur l’étude du rôle des neutrophiles et des FcγRs dans la modulation de la réponse immune par les AcM. Cette étude repose sur le caractère Fc-dépendant de l’induction d’une réponse immune protectrice par les AcM ainsi que sur les propriétés immunomodulatrices des neutrophiles, qui ont été décrites dans différents contextes pathologiques mais jamais étudiées dans le cadre d’une immunothérapie antivirale par AcM. Pour cela, j’ai utilisé différentes approches in vitro, ex vivo et in vivo.En utilisant le modèle d’infection par FrCasE, il a été montré que les neutrophiles ainsi que le FcγRIV ont un rôle crucial dans l’induction des effets vaccinaux par les AcM, notamment via l’induction d’une réponse humorale antivirale endogène protectrice à très long-terme. De plus lors d’expériences in vitro, il a également été souligné que les neutrophiles sont plus efficacement activés par les IC comparé au virus seul et que différentes cytokines pro-inflammatoires et/ou immunomodulatrices (telles que le TNF et les intérferons de type I et II) potentialisent l’activation des neutrophiles induite par les IC. Mes travaux ont aussi mis en évidence que l’infection virale et l’immunothérapie modulent l’expression des FcRs, et notamment induisent la surexpression du FcRIV sur deux populations distinctes de neutrophiles (différentiées par le niveau d’expression du marqueur de surface Ly6G: Ly6Ghi et Ly6Gint) et sur les monocytes inflammatoires. Enfin, mes travaux montrent que l’immunothérapie par AcM module les profils de sécrétion chimiokinique et cytokinique de ces 3 types cellulaires surexprimant le FcRIV, bien que la nature des profils de sécrétion varie en fonction du type cellulaire et évolue au cours du temps. Ces résultats suggèrent que l’effet immunomodulateur des AcM repose sur l’activation de différents acteurs de la réponse immunitaire précoce, en induisant la sécrétion de chimiokines et de cytokines nécessaires à l’orchestration de la réponse immune. Ils suggèrent aussi une coopération entre ces différents acteurs dans la mise en place d’une immunité protectrice.Pour finir l’ensemble de mes travaux ont mis en évidence un rôle immunomodulateur clé du FcyRIV, ainsi que des différentes cellules l’exprimant, dans l’induction d’une réponse immune protectrice induite par des AcM antiviraux. Ces révélations pourraient avoir des conséquences importantes dans l'amélioration des immunothérapies à base d'AcM

Regulation von Sphingobasen während der Zelltodreaktion und abiotischem Stress in ArabidopsisArabidopsis thalianathaliana

Sphingobasen (LCBs) sind die Bausteine der Biosynthese von Sphingolipiden. Sie werden als Strukturelemente der pflanzlichen Zellmembran definiert und spielen eine wichtige Rolle für das Schicksal der Zellen. Komplexe Ceramide machen einen wesentlichen Teil der gesamten Sphingolipide aus, die einen großen Teil der eukaryotischen Membranen bilden. Gleichzeitig sind LCBs bekannte Signalmoleküle für zelluläre Prozesse in Eukaryonten und sind an Signalübertragungswegen in Pflanzen beteiligt. Es hat sich gezeigt, dass hohe LCB-Konzentrationen mit der Induktion des programmierten Zelltods sowie mit dem durch Pathogene ausgelösten Zelltod in Verbindung stehen. Mehrere Studien haben die regulierende Funktion der Sphingobasen beim programmierten Zelltod (PCD) in Pflanzen bestätigt: (i) Spontaner PCD und veränderte Zelltodreaktionen, die durch mutierte verwandte Gene des Sphingobasen-Stoffwechsels verursacht werden. (ii) Zelltodbedingungen erhöhen den Gehalt an LCBs. (iii) PCD aufgrund eines gestörten Sphingolipid-Stoffwechsels, der durch von nekrotrophen Krankheitserregern produzierte Toxine wie Fumonisin B1 (FB1) hervorgerufen wird. Um den Zelltod zu verhindern und die Zelltodreaktion zu kontrollieren, kann daher die Regulierung des Gehalts an freien LCBs entscheidend sein. Die Ergebnisse der vorliegenden Studie stellten das Verständnis der Sphingobasen und Sphingolipidspiegel während der PCD in Frage. Wir lieferten eine detaillierte Analyse der Sphingolipidspiegel, die Zusammenhänge zwischen bestimmten Sphingolipidarten und dem Zelltod aufzeigte. Darüber hinaus ermöglichte uns die Untersuchung der Sphingolipid-Biosynthese ein Verständnis des Fluxes nach Akkumulation hoher LCB-Konzentrationen. Weitere Analysen von Abbauprodukten oder Sphingolipid-Mutantenlinien wären jedoch erforderlich, um vollständig zu verstehen, wie die Pflanze mit hohen Mengen an Sphingobasen umgeht.Sphingolipid long-chain bases (LCBs) are the building blocks of the biosynthesis of sphingolipids. They are defined as structural elements of the plant cell membrane and play an important role determining the fate of the cells. Complex ceramides represent a substantial fraction of total sphingolipids which form a major part of eukaryotic membranes. At the same time, LCBs are well known signaling molecules of cellular processes in eukaryotes and are involved in signal transduction pathways in plants. High levels of LCBS have been shown to be associated with the induction of programmed cell death as well as pathogen-derived toxin-induced cell death. Indeed, several studies confirmed the regulatory function of sphingobases in plant programmed cell death (PCD): (i) Spontaneous PCD and altered cell death reaction caused by mutated related genes of sphingobase metabolism. (ii) Cell death conditions increases levels of LCBs. (iii) PCD due to interfered sphingolipid metabolism provoked by toxins produced from necrotrophic pathogens, such as Fumonisin B1 (FB1). Therefore, to prevent cell death and control cell death reaction, the regulation of levels of free LCBs can be crucial. The results of the present study challenged the comprehension of sphingobases and sphingolipid levels during PCD. We provided detailed analysis of sphingolipids levels that revealed correlations of certain sphingolipid species with cell death. Moreover, the investigation of sphingolipid biosynthesis allowed us to understand the flux after the accumulation of high LCB levels. However, further analysis of degradation products or sphingolipid mutant lines, would be required to fully understand how high levels of sphingobases are being treated by the plant

A comparison of the magnetospheric specification model, the Hardy et al. model, and satellite observations for precipitating auroral electron energy fluxes

A semi-quantitative comparison has been made of the observed and calculated precipitating electron energy fluxes for the April 1988 magnetic storm. Electron energy fluxes were calculated by the Rice Magnetospheric Specification Model (MSM), a comprehensive model of the inner magnetospheric environment, and by the Hardy et al. model, a statistical model of electron precipitation in the auroral zone. The MSM correlates better with the observed fluxes than does the Hardy et al. model in terms of auroral boundaries, latitudinal profile and extent, and the actual magnitude of the energy flux. The sources of error in the MSM are probably: (1) Artificial flux dropouts created near the ionospheric projection of the model outer boundary, (2) an overestimate of the convection electric field, and (3) errors in locating the polar cap boundary