4 research outputs found
Varicella immunity and vaccination
Varicella-zoster virus (VZV) is an air-borne, extremely contagious
herpesvirus. It causes chickenpox, which usually is a benign illness in
childhood. Adults, pregnant women and immunocompromised patients often
get a severe disease with complications. After infection the virus stays
latent in sensory ganglia. It can be reactivated and cause shingles if
the cellmediated immunity (CMI) deteriorates. In the western world more
than 90% of adults have had chickenpox. VZV vaccines have been introduced
in many countries. They have been included in the childhood vaccination
programme in e.g. the USA and Germany but not in Sweden due to lack of
knowledge on many aspects of long-term effects.
More detailed information on the nature of the VZV-specific immune
response is needed. To provide sufficient and reliable information the
studies must be performed at a large scale. Such studies have been
difficult since the methods for determination of antibody mediated
immunity to VZV are not well standardised and the conventional
lymphoproliferation assays for CMI are labour intensive.
We therefore developed a Flow-cytometric Assay of Specific Cell-mediated
Immune response in Activated whole blood (FASCIA) for the detection of
CMI against VZV. The results were more reproducible than with the
conventional method. The sensitivity and specificity in relation to the
VZV serostatus increased with immunophenotyping by cellsurface staining
of the proliferating cells. FASCIA is easy to handle, can be performed at
a large scale and is suitable for large scale studies on specific CMI.
Serology and FASCIA with immunophenotyping were used to compare the
VZV-specific CMI response before and after immunization against VZV in
VZV seronegative, adult persons and in controls with past chickenpox. One
year after vaccination the humoral and the CMI responses were lower in
the vaccinees than in persons with past infection. In a study to
determine the feasibility of co-administration of a VZV vaccine and the
measles, mumps, rubella (MMR) vaccine booster at 12 years of age, 5/17
VZV seronegative pupils did not seroconvert after one VZV vaccine. After
a second dose, 3/5 that could be examined seroconverted. VZV CMI was
measurable in one of them before the second dose, and in 3/3 after
vaccination. The VZV vaccine did not affect the MMR-response, but the age
group should be recommended 2 doses of VZV vaccine.
In the study, the seroprevalence for VZV was calculated to be 97% among
the 12 years-old, which was higher than expected. We therefore evaluated
if there has been a change in seroprevalence to VZV during the past 30
years, since the changes in social conditions and life-style in Sweden
may have affected the spread of the viruses. The seroprevalence for the
air-borne VZV had increased dramatically from 50% to 98%, and we suggest
that it may be due to a change in child care pattern. The seroprevalence
for HSV and EBV that infect by close contact had not changed
dramatically, but there seemed to have been an unexplainable increase in
the CMV sero prevalence
Combination of Zinc Hyaluronate and Metronidazole in a Lipid-Based Drug Delivery System for the Treatment of Periodontitis
Epidemiology of nontuberculous mycobacteria among patients with cystic fibrosis in Scandinavia
Background: Nontuberculous mycobacteria (NTM) are an emerging threat to cystic fibrosis (CF) patients but their epidemiology is not well described. Methods: In this retrospective observational study we identified all Scandinavian CF patients with a positive NTM culture from airway secretions from 2000 to the end of 2012 and used national CF databases to describe microbiological and clinical characteristics. Results: During the 13-year period 157 (11%) CF patients were culture positive for NTM at least once. Mycobacterium abscessus complex (MABSC) (45%) and Mycobacterium avium complex (MAC) (32%) were the predominant species with geographical differences in distribution. Younger patients were more prone to MABSC (p < 0.01). Despite treatment, less than one-third of MABSC patients with repeated positive cultures cleared their infection and a quarter had a lung transplant or died. Conclusion: NTM are significant CF pathogens and are becoming. more prevalent in Scandinavia. MABSC and MAC appear to target distinct patient groups. Having multiple positive cultures despite treatment conveys a poor outcome. (C) 2014 The Authors. Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society