Diseño de un protocolo de atención farmacéutica en rosácea

25 p.: il. -- Bibliogr.: p. 21-25En estos últimos años, la preocupación social por el estado de la piel ha llevado a desarrollar una cosmética científica que no sólo se interesa por la decoración de la piel sino por su mantenimiento y protección, así como por la prevención y tratamiento de patologías cutáneas. La rosácea es una de esas alteraciones dermatológicas. Se trata de una afección inflamatoria crónica que cursa con enrojecimiento inicialmente y que puede derivar en la aparición de telangiectasias y en ocasiones pápulas y pústulas. Existen cuatro subtipos de rosácea y su tratamiento depende de las manifestaciones clínicas que presente el paciente. En los casos más leves se utilizan tratamientos tópicos y en los más graves se recurre a medicamentos orales. En ocasiones el dermatólogo opta por la formulación magistral para conseguir individualizar el tratamiento a las características del paciente. Cada vez es más frecuente encontrarse en la farmacia comunitaria pacientes con síntomas de rosácea, por lo que es importante para el profesional sanitario adquirir un amplio conocimiento sobre esta patología y ofrecer un adecuado consejo farmacéutico además de mitigar los síntomas que puedan derivar de ella. Los protocolos resultan ser una herramienta esencial para ello. A lo largo del documento se describe una patología de interés actual en dermatología junto a su tratamiento, criterios de derivación al médico y un protocolo de atención farmacéutica que facilita la labor farmacéutica desde la farmacia comunitaria

Complete genome sequences of field isolates of Mycobacterium bovis and Mycobacterium caprae

Here we report the complete genome sequences of field isolates of Mycobacterium bovis and the related mycobacterial species, Mycobacterium caprae. The genomes of three M. bovis (MB1, MB3, MB4) and one M. caprae (MB2) field isolates with different virulence, prevalence, and host distribution phenotypes were sequenced.This research was supported by grant AGL2011-30041 from the Ministerio de Economía y Competitividad, Spain, by the Programa de Tecnologías Avanzadas en Vigilancia Sanitaria (TAVS) from the Comunidad de Madrid (ref. S2013/ABI-2747), the EU H2020 COllaborative Management Platform for detection and Analyses of (Re-) emerging and foodborne outbreaks in Europe (COMPARE) Grant 377/14, and by the EU FP7 grants ANTIGONE (project number 278976) and WildTBvac (project number 613779).Peer Reviewe

Testing Eurasian wild boar piglets for serum antibodies against Mycobacterium bovis

A. Che’ Amat et al.Animal tuberculosis (TB) caused by infection with Mycobacterium bovis and closely related members of the M. tuberculosis complex (MTC), is often reported in the Eurasian wild boar (. Sus scrofa). Tests detecting antibodies against MTC antigens are valuable tools for TB monitoring and control in suids. However, only limited knowledge exists on serology test performance in 2-6 month-old piglets. In this age-class, recent infections might cause lower antibody levels and lower test sensitivity. We examined 126 wild boar piglets from a TB-endemic site using 6 antibody detection tests in order to assess test performance. Bacterial culture (. n=. 53) yielded a M. bovis infection prevalence of 33.9%, while serum antibody prevalence estimated by different tests ranged from 19% to 38%, reaching sensitivities between 15.4% and 46.2% for plate ELISAs and between 61.5% and 69.2% for rapid immunochromatographic tests based on dual path platform (DPP) technology. The Cohen kappa coefficient of agreement between DPP WTB (Wildlife TB) assay and culture results was moderate (0.45) and all other serological tests used had poor to fair agreements. This survey revealed the ability of several tests for detecting serum antibodies against the MTC antigens in 2-6 month-old naturally infected wild boar piglets. The best performance was demonstrated for DPP tests. The results confirmed our initial hypothesis of a lower sensitivity of serology for detecting M. bovis-infected piglets, as compared to older wild boar. Certain tests, notably the rapid animal-side tests, can contribute to TB control strategies by enabling the setup of test and cull schemes or improving pre-movement testing. However, sub-optimal test performance in piglets as compared to that in older wild boar should be taken into account.This is a contribution to Spanish Government MINECO Plan Nacional I+D+I grant AGL2014-56305 and FEDER, to a contract between CDTI and Glenton, and to the EU FP7 grant WildTBvac #613779. Azlan Che Amat has a PhD grant from the Malaysian Government, and José Angel Barasona and Iratxe Diéz-Delgado acknowledge PhD grants from the Spanish Government.Peer Reviewe

Complex links between natural tuberculosis and porcine circovirus type 2 infection in wild boar

Individuals in natural populations are exposed to a diversity of pathogens which results in coinfections. The aim of this study was to investigate the relation between natural infection with tuberculosis (TB) due to infection by bacteria of the Mycobacterium tuberculosis complex and porcine circovirus type 2 (PCV2) in free-ranging Eurasian wild boar (Sus scrofa). Apparent prevalence for TB lesions and PCV2 infection was extremely high in all age classes, including piglets (51% for TB; 85.7% for PCV2). Modeling results revealed that the relative risk of young (less than 2 years old) wild boar to test positive to PCV2 PCR was negatively associated with TB lesion presence. Also, an interaction between TB, PCV2, and body condition was evidenced: in wild boar with TB lesions probability of being PCV2 PCR positive increased with body condition, whereas this relation was negative for wild boar without TB lesions. This study provides insight into the coinfections occurring in free-ranging host populations that are naturally exposed to several pathogens at an early age. Using TB and PCV2 as a case study, we showed that coinfection is a frequent event among natural populations that takes place early in life with complex effects on the infections and the hosts.This is a contribution to Plan Nacional I + D + i AGL2011-30041 from MINECO and ANTIGONE (Project no. 278976). Ph.D students (BBB, IDD, and JAB) were supported by predoctoral grants from JCCM and MINECO.Peer Reviewe

Assessment of an oral Mycobacterium bovis BCG vaccine and an inactivated M. bovis preparation for wild boar in terms of adverse reactions, vaccine strain survival, and uptake by nontarget species

Wildlife vaccination is increasingly being considered as an option for tuberculosis control. We combined data from laboratory trials and an ongoing field trial to assess the risk of an oral Mycobacterium bovis BCG vaccine and a prototype heat-inactivated Mycobacterium bovis preparation for Eurasian wild boar (Sus scrofa). We studied adverse reactions, BCG survival, BCG excretion, and bait uptake by nontarget species. No adverse reactions were observed after administration of BCG (n = 27) or inactivated M. bovis (n = 21). BCG was not found at necropsy (175 to 300 days postvaccination [n = 27]). No BCG excretion was detected in fecal samples (n = 162) or in urine or nasal, oral, or fecal swab samples at 258 days postvaccination (n = 29). In the field, we found no evidence of loss of BCG viability in baits collected after 36 h (temperature range, 11°C to 41°C). Camera trapping showed that wild boar (39%) and birds (56%) were the most frequent visitors to bait stations (selective feeders). Wild boar activity patterns were nocturnal, while diurnal activities were recorded for all bird species. We found large proportions of chewed capsules (29%) (likely ingestion of the vaccine) and lost baits (39%) (presumably consumed), and the proportion of chewed capsules showed a positive correlation with the presence of wild boar. Both results suggest proper bait consumption (68%). These results indicate that BCG vaccination in wild boar is safe and that, while bait consumption by other species is possible, this can be minimized by using selective cages and strict timing of bait deployment.This is a contribution to Plan Nacional I+D+i AGL2011-30041 from the Ministerio de Economía y Competitividad (MINECO), Spain, and FEDER and to EU FP7 grant WildTBvac. B.B.-B. and I.D.-D. were supported by MINECO grants BES-2009-017401 and BES-2012-052490, respectively. J.A.B. was supported by MICINN grant FPU12/00980.Peer Reviewe

Comparative genomics of field isolates of Mycobacterium bovis and M. caprae provides evidence for possible correlates with bacterial viability and virulence

This is an open access article distributed under the terms of the Creative Commons Attribution License.-- et al.Mycobacteria of the Mycobacterium tuberculosis complex (MTBC) greatly affect humans and animals worldwide. The life cycle of mycobacteria is complex and the mechanisms resulting in pathogen infection and survival in host cells are not fully understood. Recently, comparative genomics analyses have provided new insights into the evolution and adaptation of the MTBC to survive inside the host. However, most of this information has been obtained using M. tuberculosis but not other members of the MTBC such as M. bovis and M. caprae. In this study, the genome of three M. bovis (MB1, MB3, MB4) and one M. caprae (MB2) field isolates with different lesion score, prevalence and host distribution phenotypes were sequenced. Genome sequence information was used for whole-genome and protein-targeted comparative genomics analysis with the aim of finding correlates with phenotypic variation with potential implications for tuberculosis (TB) disease risk assessment and control. At the whole-genome level the results of the first comparative genomics study of field isolates of M. bovis including M. caprae showed that as previously reported for M. tuberculosis, sequential chromosomal nucleotide substitutions were the main driver of the M. bovis genome evolution. The phylogenetic analysis provided a strong support for the M. bovis/M. caprae clade, but supported M. caprae as a separate species. The comparison of the MB1 and MB4 isolates revealed differences in genome sequence, including gene families that are important for bacterial infection and transmission, thus highlighting differences with functional implications between isolates otherwise classified with the same spoligotype. Strategic protein-targeted analysis using the ESX or type VII secretion system, proteins linking stress response with lipid metabolism, host T cell epitopes of mycobacteria, antigens and peptidoglycan assembly protein identified new genetic markers and candidate vaccine antigens that warrant further study to develop tools to evaluate risks for TB disease caused by M. bovis/M.caprae and for TB control in humans and animals.This research was supported by grants AGL2014-56305 and IPT-2011-0735-010000 from Ministerio de Economía y Competitividad, Spain, and the European Union FP7 ANTIGONE grant 278976 and Horizon 2020 COMPARE Grant 377/14.Peer Reviewe

Complete Genome Sequences of Field Isolates of Mycobacterium bovis and Mycobacterium caprae

Here we report the complete genome sequences of field isolates of Mycobacterium bovis and the related mycobacterial species, Mycobacterium caprae. The genomes of three M. bovis (MB1, MB3, MB4) and one M. caprae (MB2) field isolates with different virulence, prevalence, and host distribution phenotypes were sequenced

Comparative Proteomics Identifies Host Immune System Proteins Affected by Infection with Mycobacterium bovis

[Abstract] Mycobacteria of the Mycobacterium tuberculosis complex (MTBC) greatly impact human and animal health worldwide. The mycobacterial life cycle is complex, and the mechanisms resulting in pathogen infection and survival in host cells are not fully understood. Eurasian wild boar (Sus scrofa) are natural reservoir hosts for MTBC and a model for mycobacterial infection and tuberculosis (TB). In the wild boar TB model, mycobacterial infection affects the expression of innate and adaptive immune response genes in mandibular lymph nodes and oropharyngeal tonsils, and biomarkers have been proposed as correlates with resistance to natural infection. However, the mechanisms used by mycobacteria to manipulate host immune response are not fully characterized. Our hypothesis is that the immune system proteins under-represented in infected animals, when compared to uninfected controls, are used by mycobacteria to guarantee pathogen infection and transmission. To address this hypothesis, a comparative proteomics approach was used to compare host response between uninfected (TB-) and M. bovis-infected young (TB+) and adult animals with different infection status [TB lesions localized in the head (TB+) or affecting multiple organs (TB++)]. The results identified host immune system proteins that play an important role in host response to mycobacteria. Calcium binding protein A9, Heme peroxidase, Lactotransferrin, Cathelicidin and Peptidoglycan-recognition protein were under-represented in TB+ animals when compared to uninfected TB- controls, but protein levels were higher as infection progressed in TB++ animals when compared to TB- and/or TB+ adult wild boar. MHCI was the only protein over-represented in TB+ adult wild boar when compared to uninfected TB- controls. The results reported here suggest that M. bovis manipulates host immune response by reducing the production of immune system proteins. However, as infection progresses, wild boar immune response recovers to limit pathogen multiplication and promote survival, facilitating pathogen transmission.[Author Summary] Mycobacteria of the Mycobacterium tuberculosis complex (MTBC) are zoonotic pathogens representing a serious health problem for humans and animals worldwide. The life cycle of mycobacteria is complex, and the mechanisms resulting in pathogen infection and survival in host cells are not fully understood. Eurasian wild boar are natural reservoir hosts for MTBC and a model for mycobacterial infections and tuberculosis. The results of this study broaden our understanding of the molecular epidemiology of zoonotic tuberculosis and fill important gaps in knowledge of this topic. The results suggested that mycobacteria manipulate host immune response by reducing the production of immune system proteins. However, as infection progresses, wild boar immune response recovers to limit pathogen multiplication and promote survival, facilitating pathogen transmission. As previously reported in other obligate intracellular bacteria, host-mycobacteria interactions probably reflect a co-evolutionary process in which pathogens evolved mechanisms to subvert host response to establish infection, but hosts also evolved mechanisms to limit pathogen infection and promote survival. Subsequently, mycobacteria benefit from host survival by increasing the probability for transmission to continue their life cycle. These results provide relevant information to develop tools to evaluate risks for tuberculosis caused by MTBC and for disease control in humans and animals.This research was supported by grants AGL2014-56305 and IPT-2011-0735-010000 from Ministerio de Economía y Competitividad, Spain, and the European Union FP7 ANTIGONE grant 278976 and Horizon 2020 COMPARE Grant 377/14. LMH was supported by a University of Castilla La Mancha (UCLM) fellowship. MV was supported by the Research Plan of UCLM.Peer reviewe

Control mediante vacunación de la tuberculosis en su principal reservorio silvestre en España, el jabalí

The control of diseases shared with wildlife requires the development of strategies that will reduce pathogen transmission between wildlife and both domestic animals and human beings. Disease control can be achieved by different means, including: (1) preventive actions, (2) arthropod vector control, (3) host population control, habitat management or reproductive control, and (4) vaccination. The present thesis approaches control options of shared diseases where wildlife plays a significant role in maintenance using the control of animal tuberculosis (TB) in wild boar (Sus scrofa) by vaccination as a case study. TB has an impact over Public Health, economy and wildlife management and conservation. TB is also the perfect example of a shared disease as these pathogens are capable to infect and produce disease in multiple animal species, domestic and wild, including humans. In particular, the role of wildlife reservoirs in TB maintenance is increasingly acknowledged worldwide. In Spain, wild boar is recognized as the main wild reservoir. Vaccination is perceived as a feasible disease control option for cost effective and long-term TB control in wildlife. Wildlife vaccination goal is to control rather than eradicate disease and prioritizes population over individuals ultimately aiming to reduce disease burden and spread of infection at the population level in targeted and sympatric species. The only licensed vaccine against TB is Bacille Calmette–Guérin (BCG). Despite being the only commercial option, it does not provide sterilizing immunity and has variable efficacy in humans and animals. Hence, the continued search of new vaccine candidates (more protective or suitable for field use as the recently developed heat-inactivated M. bovis, IV) and alternative immunization strategies (such as heterologous protocols). The main objectives of this thesis were to evaluate the impact attained by vaccination and feasibility of this measure in real-life settings and to explore in the laboratory vaccine combinations that provide enhanced protection. These objectives were addressed in: Chapter I: Assessment of safety and efficacy of parenteral IV candidate in a wild boar farm under natural TB transmission Chapter II: Compare the impact of two vaccines (BCG and IV) in free-ranging wild boar populations (managed and not) under natural TB transmission and the feasibility of vaccinating large areas. Questions that could not be tested in field such as exploring the influence of vaccination success gradients, the effect of long-term vaccination and vaccination cessation on population and disease dynamics under different initial prevalence/transmission scenarios were answered by mathematical models. Chapter III: To test BCG and IV combinations (heterologous vaccination) under controlled laboratory conditions in order to improve vaccine efficacy. The conclusions arising from these works are: Chapter I: Parenteral vaccination with IV is safe and protects farmed wild boar, and eventually pigs, from disease (66% TB reduction). Chapter II: Oral vaccination via baits in free-ranging wild boar piglets is feasible and resulted in the vaccination of more than 70% of wild boar piglets. Oral vaccination with BCG under field conditions did not lead to significant reductions in TB disease prevalence. Oral vaccination with IV under field conditions resulted in a significant reduction of TB prevalence after four years of vaccine deployment only in the population belonging to the managed site (34% decrease). Long-term vaccination would be able to control but not to eradicate disease and will have an impact over population dynamics (increased abundance via decreased mortality) according to modeling results. Vaccine success is greater if applied over well-defined populations (farmed or managed), with low to moderate prevalence (10 to 50%) and targeting a large proportion of the population. Chapter III: Heterologous vaccination regimes involving BCG and IV do not provide improved protection in the wild boar model as compared to homologous regimes. Homologous regimes are the best option for vaccination of wild boar and pigs against TB. Moreover, vaccine sequence dramatically influenced the outcome underlining the relevance of studying the effects of sensitization in the outcome of vaccination Vaccination is a realistic option to contain TB in wild boar, ideally as part of an integrated control strategy that combines several tools, targets all the epidemiologically relevant hosts and involves all the interested stakeholders