7 research outputs found

    Structural basis for Zika envelope domain III recognition by a germline version of a recurrent neutralizing antibody

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    Recent epidemics demonstrate the global threat of Zika virus (ZIKV), a flavivirus transmitted by mosquitoes. Although infection is usually asymptomatic or mild, newborns of infected mothers can display severe symptoms, including neurodevelopmental abnormalities and microcephaly. Given the large-scale spread, symptom severity, and lack of treatment or prophylaxis, a safe and effective ZIKV vaccine is urgently needed. However, vaccine design is complicated by concern that elicited antibodies (Abs) may cross-react with other flaviviruses that share a similar envelope protein, such as dengue virus, West Nile virus, and yellow fever virus. This cross-reactivity may worsen symptoms of a subsequent infection through Ab-dependent enhancement. To better understand the neutralizing Ab response and risk of Ab-dependent enhancement, further information on germline Ab binding to ZIKV and the maturation process that gives rise to potently neutralizing Abs is needed. Here we use binding and structural studies to compare mature and inferred-germline Ab binding to envelope protein domain III of ZIKV and other flaviviruses. We show that affinity maturation of the light-chain variable domain is important for strong binding of the recurrent VH3-23/VK1-5 neutralizing Abs to ZIKV envelope protein domain III, and identify interacting residues that contribute to weak, cross-reactive binding to West Nile virus. These findings provide insight into the affinity maturation process and potential cross-reactivity of VH3-23/VK1-5 neutralizing Abs, informing precautions for protein-based vaccines designed to elicit germline versions of neutralizing Abs

    Supplements, Diets and Other Complementary and Alternative Interventions in Adolescent Mental Health

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    Background: Complementary and alternative medicine (CAM) has become increasingly popular over the past 20 years and is used by many adolescents and their families. CAM includes a host of integrative approaches whose difference from traditional medicine center around its holistic rather than compartmentalized approach to the patient, in which evaluation of health and well-being considers the mind, body, and spirit. Methods: This article provides an overview of both pharmacologic and non-pharmacologic approaches, with a focus on 1) how CAM can be used in clinical practice; 2) how to best choose amongst available approaches guided by research findings that provide information to maximize safety and efficacy. Two hypothetical cases illustrate how to apply the research base of evidence to patients and thus avoid diagnostic pitfalls and safety concerns. Results: Current research points to the efficacy of CAM in adult and adolescent populations and the efficacy of interventions that include attention to good nutrition, regular exercise, sunlight, and hygiene, especially as these interventions may prevent or reduce the incidence of conduct disorder. Recent studies suggest that CAM treatments can improve overall functioning and reduce difficulties such as insomnia, depression and aggression that occur due to anxiety, attentional deficits, and mood disorders. Conclusions: It is important to acknowledge the current public perception that CAM treatments are less likely to cause serious adverse effects as compared to conventional treatments. More studies of adolescent populations critical to confirm which complementary and alternative medicine treatments are both safe and efficacious. An informed open-minded attitude to non-conventional approaches has the potential to improve outcomes and trust amongst parents, adolescents and mainstream medical and behavioral health staff
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