Summarization and Evaluation; Where are we today?!

PACLIC 21 / Seoul National University, Seoul, Korea / November 1-3, 200

Serologic Biomarkers in Pemphigus Monitoring: C-reactive Protein, Macrophage Migration Inhibitory Factor, and Prolactin Levels Versus Autoantibody Assays

Evaluation and monitoring of pemphigus vulgaris (PV) typically involve autoantibody detection by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF). We aimed to determine the levels of antipemphigus immunoglobulin (Ig) G autoantibodies using ELISA and IIF (as standard biomarkers), and compare it to prolactin, macrophage migration inhibitory factor (MIF), and C-reactive protein (CRP) (as nonstandard biomarkers) to determine which of these non-standard biomarkers is appropriate for PV monitoring. The experiment was performed before and during therapy. Anti-Dsg immunoglobulin G autoantibodies were measured using ELISA and IIF (as standard biomarkers) versus prolactin, MIF, and CRP (nonstandard), before 1 and 3 months after the treatment. Before beginning the treatment, the severity of the disease was determined using the pemphigus disease area Index (PDAI). We enrolled 60 newly diagnosed patients with PV (32 men and 28 women; mean age=43.8±14.2 years). Before treatment, the levels of anti-Dsg1, anti-Dsg3, and IIF were high and had a significant relationship with PDAI. PDAI also had a connection with the levels of CRP and prolactin. The anti-Dsg1, anti-Dsg3, IIF, and CRP titers decreased in patients treated with conventional (prednisolone plus azathioprine) and rituximab therapy during and after treatment. In conclusion, anti-Dsg1, anti-Dsg3, and IIF autoantibody titers remain standard biomarkers for assessing disease activity, severity, and PV monitoring. The trend of CRP was similar to that of anti-Dsg1, anti-Dsg3, and IIF. Thus, CRP may be used for PV monitoring

Whole Transcriptome-Based Skin Virome Profiling in Typical Epidermodysplasia Verruciformis Reveals α-, β-, and γ-HPV Infections

HPVs are DNA viruses include approximately 450 types that are classified into 5 genera (α-, β-, γ-, μ-, and ν-HPV). The γ- and β-HPVs are present in low copy numbers in healthy individuals; however, in patients with an inborn error of immunity, certain species of β-HPVs can cause epidermodysplasia verruciformis (EV), manifesting as recalcitrant cutaneous warts and skin cancer. EV presents as either typical or atypical. Manifestations of typical EV are limited to the skin and are caused by abnormal keratinocyte-intrinsic immunity to β-HPVs due to pathogenic sequence variants in TMC6, TMC8, or CIB1. We applied a transcriptome-based computational pipeline, VirPy, to RNA extracted from normal-appearing skin and wart samples of patients with typical EV to explore the viral and human genetic determinants. In 26 patients, 9 distinct biallelic mutations were detected in TMC6, TMC8, and CIB1, 7 of which are previously unreported to our knowledge. Additionally, 20 different HPV species, including 3 α-HPVs, 16 β-HPVs, and 1 γ-HPV, were detected, 8 of which are reported here for the first time to our knowledge in patients with EV (β-HPV-37, -47, -80, -151, and -159; α-HPV-2 and -57; and γ-HPV-128). This study expands the TMC6, TMC8, and CIB1 sequence variant spectrum and implicates new HPV subtypes in the pathogenesis of typical EV

Plasmid-Mediated Quinolone Resistance in Pseudomonas aeruginosa Isolated from Burn Patients in Tehran, Iran

Introduction: Plasmid-induced quinolone resistance has raised a great concern in the treatment of serious infections worldwide. The aims of this study were to determine the antibiotic susceptibility, the frequency of qepA, aac(6')-Ib and qnr genes by PCR and sequencing, and typing of the resistant isolates using repetitive extragenic palindromic sequence-based PCR (REPPCR) in Pseudomonas aeruginosa isolated from burn wound infections. Methods: In the current cross-sectional study, 149 P. aeruginosa were isolated from the burn wound samples of patients admitted to Motahari hospital in Tehran, Iran, from February to December 2016. The bacterial isolates were identified using standard laboratory methods and their antibiotic susceptibility to quinolones was evaluated using the standard Kirby-Bauer method, according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of aac(6')-Ib, qepA, qnrA, qnrB4, qnrB and qnrS genes was assessed using PCR and sequencing methods and clonal relationship of the resistant isolates was evaluated using REP-PCR method. Results: All (100%) isolates showed complete resistance to used quinolone compounds in this study. The qnr and qepA genes were not found, but all (100%) isolates were positive for the presence of aac(6')-Ib gene and the sequencing revealed that all (100%) belong to the aac(6')-Ib-cr variant. REP-PCR showed that the studied isolates belonged to three distinct clones of A (77.9%), B (18.1%), and C (4%). Conclusion: The findings of the present study indicated the presence of aac(6')-Ib-cr variant and lack of the contribution of qnr and qepA in the emergence of resistance to quinolones in P. aeruginosa isolated from burn patients. Considering the importance of clonal spread of these resistant isolates and their significant role in the development of clinical infections, especially in patients with burns, more attention should be paid to the prevention of the dissemination of these resistant isolates. Keywords: PCR; Pseudomonas aeruginosa; aac(6`)-Ib; gram-negative pathogens; plasmid-mediated quinolone resistance; qepA; qn

Plasmid-Mediated Quinolone Resistance in Pseudomonas aeruginosa Isolated from Burn Patients in Tehran, Iran.

Abstract INTRODUCTION: Plasmid-induced quinolone resistance has raised a great concern in the treatment of serious infections worldwide. The aims of this study were to determine the antibiotic susceptibility, the frequency of qepA, aac(6')-Ib, and qnr genes by PCR and sequencing, and typing of the resistant isolates using repetitive extragenic palindromic sequence-based PCR (REP-PCR) in Pseudomonas aeruginosa isolated from burn wound infections. MATERIAL AND METHODS: In the current cross-sectional study, 149 P. aeruginosa were isolated from the burn wound samples of patients admitted to Motahari hospital in Tehran, Iran, from February to December 2016. The bacterial isolates were identified using standard laboratory methods and their antibiotic susceptibility to quinolones was evaluated using the standard Kirby-Bauer method, according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of aac(6')-Ib, qepA, qnrA, qnrB4, qnrB, and qnrS genes was assessed using PCR and sequencing methods and clonal relationship of the resistant isolates was evaluated using REP-PCR method. RESULTS: All (100%) isolates showed complete resistance to used quinolone compounds in this study. The qnr and qepA genes were not found, but all (100%) isolates were positive for the presence of aac(6')-Ib gene and the sequencing revealed that all (100%) belong to the aac(6')-Ib-cr variant. REP-PCR showed that the studied isolates belonged to three distinct clones of A (77.9%), B (18.1%), and C (4%). CONCLUSION: The findings of the present study indicated the presence of aac(6')-Ib-cr variant and lack of the contribution of qnr and qepA in the emergence of resistance to quinolones in P. aeruginosa isolated from burn patients. Considering the importance of clonal spread of these resistant isolates and their significant role in the development of clinical infections, especially in patients with burns, more attention should be paid to the prevention of the dissemination of these resistant isolates