Vacunas en situaciones especiales. Embarazo, inmunodepresión, transplante

En las recomendaciones de vacunación de grupos de población que por su situación de salud requieren medidas específicas deben conjugarse: Las limitaciones en la aplicación de determinadas vacunas por la mayor probabilidad de efectos secundarios en estos pacientes (por ejemplo la aplicación de vacunas de virus vivos en pacientes inmunodeprimidos). El mayor riesgo de infección frente a determinados agentes que genera la patología o situación inmunitaria del paciente, y que determina un mayor interés sanitario de la aplicación de las vacunas frente a los mismos. La menor respuesta inmunitaria a las vacunas, por la menor capacidad de respuesta del sistema inmune de estos pacientes. La consideración de estos tres factores, en el marco de una creciente evidencia de la importancia sanitaria de las estrategias de vacunación diseñadas específicamente para cada grupo de pacientes por los efectos protectores y la disminución de la incidencia o gravedad de las infecciones frente a las que se ha inmunizado, está llevando, en la última década, al diseño de calendarios de vacunación específicos, así como a un creciente impulso de estrategias de vacunación específicas para garantizar la captación y cumplimiento de estos calendarios. En este artículo se revisan las siguientes situaciones: Embarazo; Inmunosupresión ; Inmunodepresión ; Trasplante de progenitores hematopoyéticos ; Asplenia ; Trasplante de órganos sólidos. Se reseña la importancia de que toda mujer esté protegida frente a la rubéola antes del embarazo, y de la administración de esta vacuna en el post-parto a aquellas mujeres que no hubieran sido vacunadas previamente. Así mismo se insiste en la necesidad de la vacunación antigripal anual en el 2º o 3º trimestre del embarazo y de la importancia de la vacunación frente al tétanos antes del parto en las mujeres que no hayan completado previamente su vacunación. El paciente receptor de progenitores hematopoyéticos, independientemente de la edad, requiere la revacunación con todas las vacunas del calendario infantil, a las que debe añadirse la vacuna antineumocócica, antihaemophilus influenzae tipo b y antigripal, además de otras vacunas vinculadas a riesgos individuales. Los pacientes asplénicos presentan un alto riesgo de infecciones provocadas por bacterias capsuladas, por lo que cobra especial trascendencia la vacunación frente al neumococo, el Hib y el meningococo, además de la vacunación antigripal anual. Los pacientes sometidos a programa de trasplante de órgano sólido suponen un colectivo específico en el que debe programarse la aplicación de las vacunas antes del trasplante dada la mejor respuesta inmune en ese momento, y la vacunación postrasplante, según la situación inmune previa. Se destaca la importancia de la prevención pretrasplante frente a la varicela y la hepatitis B, así como las recomendaciones específicas de vacunación según el tipo de trasplante: frente al neumococo, el Haemophilus influenzae tipo b, la gripe, la Hepatitis A, etc, además de completar el calendario de vacunación infantil en los menores de 14 años, y de estar vacunado frente al tétanos, difteria, sarampión, rubéola, parotiditis y gripe anualmente en los adultos. Un aspecto a resaltar es la importancia de la vacunación del entorno del paciente inmunodeprimido, en especial en caso de trasplante, así como las consideraciones a tener en cuenta en las vacunas recomendadas a los convivientes

Comparison of micrometeorological techinques for estimating ammonia emission from covered slurry storage and land spreading of cattle slurry

The micrometeorological mass-balance integrated horizontal flux (IHF) technique has been commonly employed for measuring ammonia (NH3) emissions inon-field experiments. However, the inverse-dispersion modeling technique, such as the backward Lagrangian stochastic (bLS) modeling approach, is currently highlighted as offering flexibility in plot design and requiring a minimum number of samplers (Ro et al., 2013). The objective of this study was to make a comparison between the bLS technique with the IHF technique for estimating NH3 emission from flexible bag storage and following landspreading of dairy cattle slurry. Moreover, considering that NH3 emission in storage could have been non uniform, the effect on bLS estimates of a single point and multiple downwind concentration measurements was tested, as proposed by Sanz et al. (2010)

Epidemiology and molecular characterisation of Ehrlichia phagocytophila in relation to emerging ehrlichiae

Ehrlichia phagocytophila (Genus Ehrlichia, Order Rickettsiales) is the pathogen responsible for Tick-borne fever, a disease of high morbidity in susceptible ruminants. These bacteria appear to be almost identical at serological and molecular level to granulocytic Ehrlichia species recently diagnosed in humans, dogs and horses of Europe and the United States.A molecular description of different isolates of the pathogen is given. Samples were derived from wild and domestic vertebrate hosts from the UK, where Tick-borne fever is endemic. Molecular characterisation of a fragment from the groE operon gene showed higher nucleotide variation than at 16S rDNA level. Human and equine isolates from Europe differed from North American samples, which at 16S appeared to be identical. Further differences were also found between ruminant and non-ruminant granulocytic samples from Europe. Genomic analysis of less conserved genes appears necessary to provide more useful phylogenetic information that will help to clarify the relationship between closely related bacterial species.Populations of the vector tick, Ixodes ricinus, were sampled and analysed to determine the prevalence of infection and clarify their role in the epidemiology of the disease. The studies indicated a low infection prevalence that seems, however, enough to maintain the pathogen in nature. The prevalence varied according to widespread sites across Britain but it was always lower than expected from information in the literature. Attempts to determine the efficiency of latent infection in sheep to transmit Ehrlichia to ticks were unsuccessful.A seroepidemiological survey was undertaken using IFAT and involving samples from suspected vertebrate reservoirs of infection such as dogs, cats, horses, and deer in order to determine if those species were exposed to the pathogen and the range of hosts for the bacteria in widespread sites across Britain. The results suggested high rates of exposure in dogs from rural areas and wild roe deer. Cats showed also a high seroprevalence indicating the three vertebrate hosts were exposed to E. phagocytophila and mounted an immune response towards the pathogen. It remains to be elucidated if dogs, cats and horses are accidental or competent reservoirs of infection. The presence of E. phagocytophila in roe deer blood and spleen samples was confirmed by PCR. Tick counts from deer legs ratified that all three stages of tick (larvae, nymphs and adults) were able to feed simultaneously upon roe deer thus supporting their role as competent reservoirs for both ticks and E. phagocytophila together with the serological and molecular evidence.Cytoecetes ondiri, an African relative of Ehrlichia phagocytophila, was shown to cross-react in immunoblots with E. equi and in IFAT with E. phagocytophila antigens thus confirming a close antigenic relationship.ELISA were developed using crude E. equi and E. phagocytophila as antigens and samples from several vertebrate species. The assays were validated with previous results obtained by IFAT. Data suggested that E. equi is a useful surrogate antigen for serologic studies until E. phagocytophila is routinely grown in culture. The antigenic structure of Ehrlichia was further characterised using mitochondria as surrogate antigens under the evidence of the phylogenetic relationship between the organelles and the bacteria. Ehrlichia are classified in the a-subgroup of Proteobacteria, which are believed to be the closest relatives to mitochondria. Sera from experimentally inoculated animals recognised mitochondrial antigens prior and after exposure but the responses were significantly higher after infection and challenge. Further work should be directed towards the successful cultivation of the pathogen as for HGE and E. equi in order to develop more reliable serological tests for E. phagocytophila for future epidemiological surveys. Identification of the major antigenic components of the organism will also help towards vaccine development

Expression of interferon-alpha subtypes in peripheral mononuclear cells from patients with chronic hepatitis C: a role for interferon-alpha5

Interferon (IFN)-alpha is a family of antiviral proteins encoded by different genes. The biological significance of the existence of various IFN-alpha subtypes is not clear. We have investigated the interferon system in chronic hepatitis C virus (HCV) infection, a disease that responds to interferon-alpha2 therapy in only a limited proportion of cases. We analysed the expression of interferon regulatory factor (IRF)-1, IRF-2, and IFN-alpha subtypes in nonstimulated and Sendai virus-stimulated peripheral blood mononuclear cells (PBMC) from HCV infected patients and healthy controls. We observed that the IRF-1 mRNA and IRF-1/IRF-2 ratios were increased in PBMC from hepatitis C patients with respect to normal subjects. Sendai virus stimulation of PBMC led to a significant increase in the levels of IRF-1, IRF-2 and IFN-alpha mRNAs and in the production of IFN-alpha protein with respect to basal values in healthy controls as well as in patients with HCV infection. In addition, we found that while natural HCV infection induced increased IFN-alpha5 expression in PBMC, in vitro infection of these cells with Sendai virus caused a raise in the expression of IFN-alpha8 in both patients and normal controls. In summary, our results indicate that virus-induced activation of the IFN system in human PBMC is associated with selective expression of individual IFN-alpha subtypes, IFN-alpha5 being the specific subtype induced in PBMC from patients with chronic HCV infection

Reciprocal regulation of NF-kB (Relish) and subolesin in the tick vector, Ixodes scapularis

[Background]: Tick Subolesin and its ortholog in insects and vertebrates, Akirin, have been suggested to play a role in the immune response through regulation of nuclear factor-kappa B (NF-kB)-dependent and independent gene expression via interaction with intermediate proteins that interact with NF-kB and other regulatory proteins, bind DNA or remodel chromatin to regulate gene expression. The objective of this study was to characterize the structure and regulation of subolesin in Ixodes scapularis. I. scapularis is a vector of emerging pathogens such as Borrelia burgdorferi, Anaplasma phagocytophilum and Babesia microti that cause in humans Lyme disease, anaplasmosis and babesiosis, respectively. The genome of I. scapularis was recently sequenced, and this tick serves as a model organism for the study of vector-host-pathogen interactions. However, basic biological questions such as gene organization and regulation are largely unknown in ticks and other arthropod vectors. [Principal Findings]: The results presented here provide evidence that subolesin/akirin are evolutionarily conserved at several levels (primary sequence, gene organization and function), thus supporting their crucial biological function in metazoans. These results showed that NF-kB (Relish) is involved in the regulation of subolesin expression in ticks, suggesting that as in other organisms, different NF-kB integral subunits and/or unknown interacting proteins regulate the specificity of the NF-kB-mediated gene expression. These results suggested a regulatory network involving cross-regulation between NF-kB (Relish) and Subolesin and Subolesin auto-regulation with possible implications in tick immune response to bacterial infection. [Significance]: These results advance our understanding of gene organization and regulation in I. scapularis and have important implications for arthropod vectors genetics and immunology highlighting the possible role of NF-kB and Subolesin/Akirin in vector-pathogen interactions and for designing new strategies for the control of vector infestations and pathogen transmission.This research was supported by grants BFU2008-01244/BMC and BFU2011-23896 to JF, the Oklahoma Agricultural Experimental Grant 1669 and the Walter R. Sitlington Endowed Chair for Food Animal Research to KMK, and the EU FP7 ANTIGONE project number 278976. V. Naranjo was funded by the European Social Fund and the Junta de Comunidades de Castilla-La Mancha (Program FSE 2007-2013), Spain. N. Ayllón was funded by Ministerio de Educación y Ciencia (MEC), Spain.Peer Reviewe

Draft Genome Sequences of Anaplasma phagocytophilum, A. marginale, and A. ovis Isolates from Different Hosts

Here, we report the draft genome sequences of isolates of Anaplasma phagocytophilum, Anaplasma marginale, and Anaplasma ovis. The genomes of A. phagocytophilum (human), A. marginale (cattle), and A. ovis (goat) isolates from the United States were sequenced and characterized. This is the first report of an A. ovis genome sequence

Common Strategies, Different Mechanisms to Infect the Host: Anaplasma and Mycobacterium

Intracellular bacteria such as Anaplasma spp. and Mycobacterium spp. pose a risk to human and animal populations worldwide. The main function of immune response cells is to eliminate invading pathogens. However, pathogens can deregulate host cell function and turn defense cells into suitable hosts. Intracellular bacterial have a smaller genome, compared to the host cell, thus requiring efficient mechanisms for survival and persistence within the host by inducing sustained changes in cell function and immune response. Bacterial epigenetic regulation of host cell gene transcription appears to be a general mechanism that enhances pathogen survival while altering host cell function and facilitating infection. Anaplasma phagocytophilum leads to modified host cell gene transcription and phenotype by epigenetically altering host chromatin. Mycobacterial infection of human cells also results in host gene silencing using a mechanism that involves HDAC complex formation and histone deacetylation. Membrane proteins are essential for cell invasion in both pathogens, and can regulate and protect the pathogen against the host response. Understanding the mechanisms employed by these bacteria to infect the host could contribute to develop effective interventions for the control of tuberculosis and anaplasmosis. This review focuses on the common strategies employed by two zoonotic pathogens, Anaplasma and Mycobacterium spp., highlighting also the different mechanisms used to infect host cells

Los usos del concepto de intervención en el colectivo profesional de Trabajo Social. Elementos para su problematización

The present work carries out a study on the uses of the concept of intervention in Social Work. Starting from a reflective exercise rooted in the contributions of Iamamoto, the ostrategic versatility of the keyword “ntervention” in the professional field is reviewed, highlighting certain discomforts regarding its “official” use in academic discourse and the issues surrounding “colonial” uses in the fieldwork of social operators. This critique is particularly informed by the contributions of two authors and their ethnographic methods: Merklen and Fassin. In the context of social policies and Social Work in Argentina, the concept of social and/or professional intervention serves as a framework that provides a sense of security in strengthening the role and status of policies and professional training. However, this recognition also allows us to identify a series of problems inherent in its everyday application, both in university training and in its implementation as a guiding principle in professional practice within social policies.El presente trabajo realiza un estudio sobre los usos del concepto intervención en el Trabajo Social. Partiendo de un ejercicio reflexivo sostenido en los aportes de Iamamoto, se revisita la polivalencia estratégica en el campo profesional de la palabra clave intervención, ciertos malestares en relación a su uso «oficial» en el discurso académico y los problemas de los usos «coloniales» del concepto en el trabajo de campo de operadores/as de lo social; esto último, en especial a partir de la contribución de las obras de dos autores, en especial sus trabajos etnográficos, nos referimos a Merklen y Fassin. En el campo de las políticas sociales y del Trabajo Social en Argentina, el concepto de intervención social y/o profesional, brinda cierta seguridad a la hora de fortalecer el papel y el estatuto de las políticas y la formación profesional. Este reconocimiento nos permite, por un lado, observar sus marcas y también registrar una serie de problemas en sus usos en lo cotidiano del oficio, tanto en la formación universitaria como en la gestión de sus usos como adn para revisar el trabajo profesional en el campo de las políticas sociales

Oral vaccination with heat inactivated Mycobacterium bovis activates the complement system to protect against tuberculosis

Tuberculosis (TB) remains a pandemic affecting billions of people worldwide, thus stressing the need for new vaccines. Defining the correlates of vaccine protection is essential to achieve this goal. In this study, we used the wild boar model for mycobacterial infection and TB to characterize the protective mechanisms elicited by a new heat inactivated Mycobacterium bovis vaccine (IV). Oral vaccination with the IV resulted in significantly lower culture and lesion scores, particularly in the thorax, suggesting that the IV might provide a novel vaccine for TB control with special impact on the prevention of pulmonary disease, which is one of the limitations of current vaccines. Oral vaccination with the IV induced an adaptive antibody response and activation of the innate immune response including the complement component C3 and inflammasome. Mycobacterial DNA/RNA was not involved in inflammasome activation but increased C3 production by a still unknown mechanism. The results also suggested a protective mechanism mediated by the activation of IFN-γ producing CD8+ T cells by MHC I antigen presenting dendritic cells (DCs) in response to vaccination with the IV, without a clear role for Th1 CD4+ T cells. These results support a role for DCs in triggering the immune response to the IV through a mechanism similar to the phagocyte response to PAMPs with a central role for C3 in protection against mycobacterial infection. Higher C3 levels may allow increased opsonophagocytosis and effective bacterial clearance, while interfering with CR3-mediated opsonic and nonopsonic phagocytosis of mycobacteria, a process that could be enhanced by specific antibodies against mycobacterial proteins induced by vaccination with the IV. These results suggest that the IV acts through novel mechanisms to protect against TB in wild boar.This research was supported by Plan Nacional I+D+I AGL2011-30041 from Ministerio de Economía y Competitividad (MINECO), Spain and FEDER. This is also a contribution to EU FP7 grant WildTBvac and the EU FP7 ANTIGONE project number 278976. R.C. Galindo was funded by MEC, Spain. B. Beltrán-Beck was supported by MINECO grant BES-2009-017401.Peer Reviewe