IgG Values Research Articles

Heterologous gam-COVID-vac (sputnik V)/mRNA-1273 (moderna) vaccination induces a stronger humoral response than homologous sputnik V in a real-world data analysis

ObjectivesTo compare the homologous prime-boost vaccination scheme of Gam-COVID-Vac (Sputnik V (SpV)) to its heterologous combination with mRNA-1273 (Moderna (Mod)) vaccine. MethodsSARS-CoV-2 anti-spike (S)-receptor binding domain (RBD) IgG concentration was assessed three to seven weeks after complete vaccination. Reactogenicity was evaluated by declared side events and medical assistance required until day 7 post boost. ResultsOf 190 participants enrolled, 105 received homologous SpV/SpV and the remaining heterologous SpV/Mod vaccination scheme, respectively. Median (interquartile range (IQR)) age was 54 (37–63) years, 132 out of 190 (69.5%) were female, and 46 out of 190 (24.2%) individuals had a prior confirmed COVID-19. Anti-S-RBD IgG median (IQR) titers were significantly higher for SpV/Mod (2511 (1476–3992) binding antibody units (BAU)/mL) than for SpV/SpV (582 (209–1609) BAU/mL; p < 0.001] vaccination scheme. In a linear model adjusted for age, gender, time to the serological assay, and time between doses, SpV/Mod (4.154 (6.585–615.554); p < 0.001] and prior COVID (3.732 (8.641–202.010); p < 0.001) were independently associated with higher anti-S-RBD IgG values. A higher frequency of mild and moderate adverse effects was associated with the heterologous scheme (20 of 85 (23.5%) vs. 13 of 105 (12.4%); p = 0.043 and 27 of 85 (31.8%) vs. 14 of 105 (13.3%); p = 0.002), respectively, although it was well tolerated by all individuals and no medical assistance was required. DiscussionThe heterologous SpV/Mod combination against SARS-CoV-2 is well tolerated and significantly increases humoral immune response as compared to the homologous SpV/SpV immunization.

MO912: Different Immunogenicity of Previous SARS-COV-2 Infection or Comirnaty Vaccine (BNT162B2, BioNTech/Pfizer) in Haemodialysis Patients

BACKGROUND AND AIMSThe pandemic emergency deriving from the SARS-CoV-2 infection has made it necessary to find effective strategies to preserve high-risk populations with severe comorbidities like haemodialysis patients. Adequate vaccination coverage is of vital importance, representing the main weapon to counter the spread of the virus.The purpose of our study was to evaluate the antibody response of our dialysis patients vaccinated with the Comirnaty-BioNTech/Pfizer vaccine in comparison with those with previous infection.METHODWe retrospectively analysed 52 patients referried to the Dialysis Unit of University Hospital G. Martino, Messina, from 2020 to 2021. Of these, 41 patients had never contracted SARS-CoV-2 (group A), while 11 patients had contracted the infection (group B). Serum samples were taken before vaccine administration, 3 months and 6 months after administration. A linear mixed model was performed on the measurements to analyse the difference in antibody response, comparing the values ​​of neutralizing IgG and anti-COVID-19 antibodies during time (Fig. 1).RESULTSThe results showed a statistically significant higher titre of anti-spike antibodies in patients with a previous infection (P = 0.003), with a stronger association at 6 months after infection. The linear mixed model showed a significant association over time between infection and antispike (ln U/L) in the univariate model, which was confirmed in the multivariate model {adjSlope: 2.9, [95% confidence interval (95% CI) 1.3–4.6]; P =.001}. No other variables were related to antispike.CONCLUSIONThese findings can raise novel questions on the role of natural immunity and antibody titre in the haemodialysis population.

Role of serology tests in COVID-19 non-hospitalized patients: A cross-sectional study.

IntroductionSevere acute respiratory syndrome coronavirus (SARS-CoV2) has imposed catastrophic impressions on the world. After all the focused researches conducted in the COVID-19 area, many features remain obscure. We have surveyed 1,363 outpatients with suspected COVID-19 in Tehran, Iran. The analysis emphasized on characteristics of patients with positive PCR or serology of SARS-CoV-2.MethodsThe nasopharyngeal swabs were tested for SARS-CoV2 PCR. Serum specimens were tested for SARS-CoV2 IgG and IgM. Clinical presentations of the patients, history of chronic diseases or drug use, contact with a possible COVID-19 patient and previous infection with SARS-COV2 were investigated.ResultsOf the total 1,363 investigated patients, 22% had positive SARS-CoV-2 PCRs, 82% had positive IgG, 38% had positive IgM, and 31% had both positive IgM and IgG values. Positive serologic tests were significantly associated with a positive PCR test obtained previously in the course of the current disease (P value<0.001).IgG and IgM antibody values were significantly associated with underlying disease, cough, fever, chills, fatigue, and myalgia (all P values <0.001). Dyspnea was significantly associated with IgG levels (P value = 0.01), yet it was not associated with IgM serology (P value = 0.2). Positive serology tests were not associated with symptoms of coryza.GI symptoms were not associated with positive IgG test (P value = 0.1), yet it did show an association with positive IgM test (P value = 0.02).Cough, fever, chills, myalgia fatigue, dyspnea, and GI symptoms were all significantly associated with positive PCR (all P values <0.001), and symptoms of coryza did not show a significant relationship (P value = 0.8).ConclusionAssessing antibody titers in outpatients is invaluable due to the epidemiological importance of investigations in mild or even asymptomatic cases. Since the number of such studies in non-hospitalized patients is not high, the current study can be used as a comparison model.

SARS-CoV-2 seroprevalence among healthcare personnel at a large health system in Atlanta

BackgroundEstimates of the prevalence of SARS-CoV-2 antibodies and factors associated with infection among healthcare personnel (HCP) vary widely. We conducted a serosurvey of HCP at a large public healthcare system in the Atlanta area. Materials and methodsAll employees of Grady Health System were invited to participate in mid-2020; a volunteer sample of those completing testing was included. Asymptomatic HCP were offered testing for IgG antibody and for SARS-CoV-2 RNA using polymerase chain reaction (PCR). Symptomatic HCP were offered PCR testing. Antibody index values for IgG and cycle threshold values for PCR were evaluated for those with a positive result. An online survey was distributed at the time of testing. Results624 of 1677 distributed surveys (37.2%) were completed by 608 unique HCP. The majority were female (76.4%) and provided clinical care (70.9%). The most common occupations were clinician (24.8%) and nurse (23.5%). 37 of 608 (6.1%) HCP had detectable IgG. Exposure to a confirmed case of COVID-19 outside of the hospital was associated with detectable IgG (12.8% vs 4.4%, p = 0.02), but exposure to a patient with COVID-19 was not. ConclusionsAmong HCP in a large healthcare system, 6.1% had detectable SARS-CoV-2 IgG. Seropositivity was associated with exposures outside of the healthcare setting.

EVALUATION OF IMMUNOLOGICAL MARKERS IN PATIENTS WITH PULMONARY TUBERCULOSIS IN SOME HOSPITALS IN UYO, AKWA IBOM STATE, NIGERIA

Pulmonary tuberculosis (PTB) remains a major public health problem especially in the developing countries. Literature evidence opines that serological markers associated with PTB infections enhance early diagnosis. This study employed CD4+ T-lymphocyte counts and total serum immunoglobulin to establish early diagnosis in PTB patients in Uyo. Sputum samples of 105 patients were screened for Acid Fast Bacilli, while blood (7ml) was collected for CD4+ T-lymphocyte counts and quantification of total serum using cytoflow counter and Enzyme linked Immunoassay, respectively. A prevalence of 12.4% was established for PTB infection among the patients. The mean differences between immunoglobulins levels in relation to CD4+ T-lymphocyte counts was not significant at p ˃ 0.05. The mean IgG value of PTB patients was 737.29 ± 435.8 mg/dL, while the apparently healthy subjects (AHS) had the mean IgG value of 23.15 ± 32.2 mg/dL. The mean IgA level in PTB patients (190.91 ± 94.8 mg/dL) was higher than that of AHS (126.81 ± 35.5 mg/dL). The mean IgM value of PTB patients and that of the AHS was 317.75 ± 146.11 and 50.00 ± 32.3 mg/dL, respectively. There was significant difference between the immunoglobulin levels of PTB patients and AHS at p &gt; 0.05 with respect to IgA and at p &gt; 0.001 with respect to IgG and IgM. This study has indicated that biomarkers of humoral immunity were significantly affected when compared with AHS, thus, this study would enhance knowledge of the health practitioners and enable them to grasp the role of biomarkers in

Hypogammaglobulinemia, infections and COVID-19 in people with multiple sclerosis treated with ocrelizumab

ObjectiveTo determine the influence of immunoglobulins (Ig) level on the rate of infections in people with multiple sclerosis (pwMS) treated with ocrelizumab. MethodsWe enrolled 109 consecutive pwMS treated with ocrelizumab with a mean follow-up of 2.69±0.56 (1.36-4.27) years. We have retrospectively searched our electronic database and the following information was collected: age, sex, MS characteristics, number of ocrelizumab cycles, infections, duration of the infection, hospitalization due to infection, treatment of the infection, and COVID-19 characteristics. Ig levels were measured within 14 days before each ocrelizumab infusion. ResultsNumber of pwMS with values of IgM and IgG below lower level of normal at baseline was 3 (2.8%) and 2 (2.8%), respectively; and before 6th cycle of ocrelizumab 5 (13.5%) and 5 (13.5%), respectively. Levels of IgM were steadily decreasing over time, while levels of IgG started to show statistically significant drop only after 5th cycle of ocrelizumab. 58.7% pwMS experienced infection during treatment, with a median number of infections per pwMS being 1, range 0-4. Female sex increased the risk of any infection (HR 2.561, 95%CI 1.382-4.774, p=0.003). Higher age and smaller drop in IgM before 3rd ocrelizumab cycle increased the risk for infection requiring hospitalization (HR 1.086, 95%CI 1.018-1.159, p=0.013 and HR 9.216, 95%CI 1.124-75.558, p=0.039, respectively). Longer disease duration increased the risk for COVID-19 (HR 1.075, 95%CI 1.002-1.154, p=0.045). ConclusionThe present findings broaden limited real-world data on infection and COVID-19 risk in pwMS treated with ocrelizumab.

The Effect of Vegetable Oils on some Physiological Traits in Adult Male Rats

The study was conducted in the animal house at the Faculty of Veterinary Medicine/ Tikrit University to investigate the effect of different concentrations of four types obtained from Al-Emad oil production company, which is grape seed oil, pumpkin oil, black seed oil and olive oil, with two types of commercial oils obtained from local markets, namely sunflower oil and corn oil, on some physiological characteristics of adult male rats with a number of 28 animal which had been divided in to 7 Groups , each one contained 4 animals. Animals underwent a lightening cycle which has been divided into 12 light hour and 12 dark hour, with a fixed temperature at 25± 2 º C. Animals had been left for one week to be adapted with the new conditions and to be sure of diseases privation. Food and water had been given continuously by oral dosing with sufficient quantities along the period of the process. The results have shown a significant increase in the gained weight of laboratory animals. There is also an increase in the total number of red blood cells, hemoglobin, granulosa cells, lymphocytes and platelets when adding grape seed oil, nigella oil, pumpkin oil and olive oil. And a decrease in the number of white blood cells compared to the addition of sunflower oil and corn oil. There is also an increase in the values of immunoglobulins IgA, IgM, IgE and IgG When adding grape seed oil, pumpkin seed oil, black seed oil and olive oil and a decrease in the values of the liver enzymes (ALT) and (AST) compared to the addition of sunflower oil and corn oil.

Serum immunoglobulin G as a discriminator of infection in follicular lymphoma patients undergoing chemotherapy with bendamustine in combination with rituximab

ABSTRACT Objectives: Chemotherapy, including bendamustine, usually causes lymphocytopaenia and hypogammaglobulinaemia as side effects in patients with haematological malignancies. Therefore, the possibility has been considered that these immunological adverse events induced by bendamustine may lead to infectious diseases. However, lymphocytopaenia and/or hypogammaglobulinaemia have not yet been shown to have a statistically significant association with infection in cancer patients who receive bendamustine. Methods: We retrospectively studied 27 patients with relapsed or refractory indolent follicular lymphoma who were treated with bendamustine and rituximab (BR). In order to elucidate relationships between immune-related laboratory parameters (i.e. peripheral blood leukocyte, neutrophil, lymphocyte and immunoglobulin G [IgG]) and infectious events, receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were performed. Results: Infectious diseases occurred in 11 patients (11/27, 41%), including 3 (3/27, 11%) with severe diseases. The area under the ROC curve (AUC) showed that the lowest IgG level during and after BR discriminated infectious events (cut-off value, 603 mg/dL) with 81.8% sensitivity and 68.8% specificity (AUC, 0.76; 95% CI, 0.52-0.90). Furthermore, a multivariate regression analysis revealed that the minimal serum IgG value during and after BR therapy was the only variable that was significantly associated with infection (odds ratio, 8.29; 95% CI, 1.19-57.62; p value, 0.03). Conclusion: Serum IgG ≤603 mg/dL during and after BR therapy was independently associated with an increased risk of infection. The monitoring of serum IgG during chemotherapy may help to predict the development of infection in blood cancer patients undergoing chemotherapy with bendamustine in combination with rituximab.

Longitudinal profile of antibody response to SARS-CoV-2 in patients with COVID-19 in a setting from Sub-Saharan Africa: A prospective longitudinal study.

BackgroundSerological testing for SARS-CoV-2 plays an important role for epidemiological studies, in aiding the diagnosis of COVID-19, and assess vaccine responses. Little is known on dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia.MethodsIn this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune-assays (LFIAs), and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics.ResultsSerological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increases in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly to 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested, within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibody at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up.ConclusionsLongitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of seroassays before implementation. Factors associated with failure to seroconvert needs further research.

Factors Influencing Level and Persistence of Anti SARS-CoV-2 IgG after BNT162b2 Vaccine: Evidence from a Large Cohort of Healthcare Workers.

We aimed at evaluating quantitative IgG response to BNT162b2 COVID-19 vaccine among health care workers (HCW), and exploring the role of demographic, clinical, and occupational factors as predictors of IgG levels. On May 2021, among 6687 HCW at the largest tertiary care University-Hospital of Northwestern Italy, at a median of 15 weeks (Interquartile range-IQR 13.6–16.0) after second-dose, serological response was present in 99.8%. Seropositivity was >97% in all the subgroups, except those self-reporting immunodeficiency (94.9%). Overall, the median serological IgG value was 990 BAU/mL (IQR 551–1870), with most of subjects with previous SARS-CoV-2 infection or with shorter time lapse (2–8 weeks) between vaccination and serology with values in the highest quintile (>2080). At multivariable analysis, significant predictors of lower values were increasing age, male, current smoking, immunodeficiency, recent occupational contacts, and increasing time lapse from vaccination; conversely, previous infection and recent household contacts were significantly associated with higher IgG levels. Subjects with previous infection kept a very high level (around 2000 BAU/mL) up to 120 days. These results, besides supporting a high serological response up to 4–5 months, suggest predictive factors of faster decay of IgG levels that could be useful in tailoring vaccination strategies.

Effect of BNT162b2 booster dose on anti-SARS-CoV-2 spike trimeric IgG antibodies in seronegative individuals.

We provide here an updated analysis of an ongoing serosurveillance study, presenting data on the effect of a third dose of Pfizer/BioNTech BNT162b2 vaccine on serum anti-SARS-CoV-2 IgG antibodies. We tested baseline SARS-CoV-2 seronegative healthcare workers undergoing primary vaccination with the mRNA-based COVID-19 Comirnaty vaccine, followed by administration of homologous vaccine booster (third dose). Venous blood was collected before either dose of primary vaccination, at 1, 3 and 6months afterwards, as well as before and 1month after receiving the vaccine booster. The serum concentration of anti-SARS-CoV-2 IgG was assayed with DiaSorin Trimeric spike IgG immunoassay. The final study population included 53 SARS-CoV-2 seronegative healthcare workers (median age 46years; 60% females). A first peak of anti-SARS-CoV-2 spike trimeric IgG values was reached 1month after completing primary vaccination, after which the levels gradually declined until before receiving the vaccine booster. A second peak of anti-SARS-CoV-2 spike trimeric IgG concentration was observed 1month after receiving the vaccine booster dose (8,700kBAU/L), which was 39-fold higher than before receiving the vaccine booster (221kBAU/L; p<0.001), but was also nearly threefold higher compared to values seen at the first peak (2,990kBAU/L; p<0.001). The rate of subjects with protective anti-SARS-CoV-2 spike trimeric IgG values (i.e.,>264kBAU/L) increased from 47.2% to 100% after 1month from vaccine booster. These results support current policies fostering COVID-19 vaccine boosters to reinforce humoral immunity against SARS-CoV-2.

SerumCovid database: Description and preliminary analysis of serological COVID-19 diagnosis in healthcare workers.

Serological databases represent an important source of information to perceive COVID-19 impact on health professionals involved in combating the disease. This paper describes SerumCovid, a COVID-19 serological database focused on the diagnosis of health professionals, providing a preliminary analysis to contribute to the understanding of the antibody response to the SARS-CoV-2. The study population comprises 321 samples from 236 healthcare and frontline workers fighting COVID-19 in Vitória de Santo Antão, Brazil. Samples were collected from at least six days of symptoms to more than 100 days. The used immunoenzymatic assays were Euroimmun Anti-SARS-CoV-2 ELISA IgG and IgA. The most common gender in SerumCovid is female, while the most common age group is between 30 and 39 years old. However, no statistical differences were observed in either genders or age categories. The most reported symptoms were fatigue, headaches, and myalgia. Still, some subjects presented positive results for IgA after 130 days. Based on a temporal analysis, we have not identified general patterns as subjects presented high and low values of IgA and IgG with different evolution trends. Unexpectedly, for subjects with both serological tests, the outcome of IgA and IgG tests were the same (either positive or negative) for more than 80% of the samples. Therefore, SerumCovid helps better understand how COVID-19 affected healthcare and frontline workers, which increases knowledge about the infection and enables direct prevention actions.

From the Editor’s Desk...

From the Editor’s Desk...

De-novo development of fragmented QRS during a six-month follow-up period in patients with COVID-19 disease and its cardiac effects

ObjectiveThe aim of this study is to examine the probability of de-novo fQRS in patients with mild COVID-19 disease, as an indicator of cardiac injury. MethodsData of 256 patients with normal admission electrocardiography and no comorbidities between 1.12.2020–31.12.2021, were examined retrospectively 6-month after mild COVID-19 disease. Patients were divided into two groups: fQRS+ group (n = 102) and non-fQRS group (n = 154). Relation between fQRS and other electrocardiography, echocardiographic and laboratory findings were investigated. ResultsNo significant difference was found between the groups among age and gender. Troponin-I and creatine kinase myocardial band values (retrospectively 9.10 ± 1.76 vs 0.74 ± 1.43, 34.05 ± 82.20 vs. 14.68 ± 4.42), COVID-19 IgG levels (45.78 ± 14.82 vs. 36.49 ± 17.68), diastolic dysfunction (39.21% vs. 15.07%), EF value (58.02 ± 1.95 vs. 64.27 ± 3.07), dyspnea (41.17% vs. 6.84%), post-COVID-19 tachycardia syndrome (19.6% vs. 2.74) were more frequent in fQRS+ group compared to non-fQRS group. The EF value was lower in the presence of fQRS in the high lateral leads (57.12 ± 1.99, 58.47 ± 1.79, p:0.018). There was a positive correlation between IgG value and endsystolic diameter, septum thickness and left atrium diameter. In multivariate analysis de-novo fQRS, dyspnea, high troponin and IgG values, diastolic dysfunction, low EF value and left atrial diameter were determined as independent risk factors for post-COVID-19 tachycardia syndrome in follow-up. ConclusionIn COVID-19 disease de-novo fQRS, dyspnea, high IgG and troponin value, left atrial diameter, lower EF value, diastolic dysfunction were associated with post-COVID-19 tachycardia syndrome. The de-novo fQRS in SARS-COV-2 may be a predictor of future more important adverse cardiovascular outcomes and this should alert clinicians.

The Effect of Ganoderma Lucidum Powder on some Immune Parameters in Rat

The impact of Ganoderma lucidum powder on both chemokines, IgG and C3 complement concentrations, as well as WBC types, was investigated in 60 ester citrine rats split between two groups, one of which was injected with Carbon tetrachloride CcL4 and the other with Ganoderma lucidum powder. They were not given this drug; instead, two concentrations of mushroom powder, 40 mg/ per kilo-gram of body weight and 80 mg/ per kilo gram of body weight, were utilized, along with a control group. The results revealed a clear increase in all immune factors measured, with a clear difference between males and females when compared to control samples, as well as an increase in the numbers of both neutrophils and lymphocytes in males for both concentrations, with a higher increase for the second concentration than the first, while the increase in females for both concentrations was similar. In the groups exposed to CcL4, an increase in the values of chemokines, IgG, and C3 as well as the number of neutrophils appeared in males in varying numbers for both concentrations, whereas the increase in females appeared in the second concentration higher than the first concentration of immune values, and the opposite was true for the number of white cells. The number of monocytes showed slight changes in both males and females under study with clear significant differences between C3, chemokine, white blood cell count, lymphocytes and monocytes.

The association between micronutrients and the SARS-CoV-2-specific antibodies in convalescent patients

BackgroundVarious micronutrients play key roles in the immune responses to viral infection, antibody synthesis, and susceptibility to infection. This study aimed to investigate the role of micronutrients on the immune responses following SARS-CoV-2 infection.MethodsTo evaluate humoral immunity following SARS-CoV-2 infection, the levels of SARS-CoV-2-specific IgM and IgG, as well as the concentrations of different micronutrients, were determined in 36 convalescent COVID-19 patients 60 days after infection. Furthermore, the correlation between biochemical and hematological parameters, clinical features, and the changes in adiposity with SARS-CoV-2 antibodies was evaluated.ResultsSerum IgM and IgG antibodies were detected in 38.8% and 83.3% of recovered patients after 60 days of COVID-19 infection, respectively. The values of SARS-CoV-2-specific IgG were negatively correlated with the number of the platelet. Moreover, the values of SARS-CoV-2-specific IgM were positively correlated with LDH and the vitamin B12 concentration. Furthermore, a gender-specific association of SARS-CoV-2-specific IgG and IgM with vitamins D as well as with B9 and zinc was observed. A significant negative correlation was observed between the values of IgG with vitamin D in male participants and a positive correlation was detected between IgG values and B9 in female participants. Moreover, IgM levels with serum zinc values in females were negatively correlated.ConclusionOur study suggests the potential role of micronutrients in gender-specific humoral immunity following SARS-CoV-2 infection. Further studies are required with a greater sample of subjects to substantiate the validity and robustness of our findings.

Programmable and monitorable intradermal vaccine delivery using ultrasound perforation array

Skin disruptions of micrometer- or submillimeter-diameter generated by microneedle or laser ablation can be used for intradermal vaccination. Here, we report a new skin-disruption method that uses highly-focused ultrasound to controllably perforate murine skin. We showed that programming of ultrasound parameters varied skin perforation area from 0.078 ± 0.045 mm2 to 1.295 ± 0.279 mm2. The skin perforation area increased with increasing ultrasound pressure and exposure time, and decreased with increasing ultrasound frequency and incidence angle. Moreover, successful perforation can be monitored using ultrasound pulse-echo imaging. We found that ultrasound perforation elevated local skin expression of heat shock protein 70 and effectively attracted MHC II-positive immune cells after intradermal delivery of Hepatitis B surface antigen (HBsAg). We demonstrated that the antigen dose delivered by ultrasound perforation can be effectively modulated via programmable perforation arrays (comprised of 1 × 2, 1 × 3, 1 × 5 or 3 × 3 areas of exposure). Using a 1 × 3 perforation array for vaccination, the measured mean optical density (OD) value of serum anti-HBsAg IgG was slightly higher than that of intradermal injection. The addition of an adjuvant of recombinant cholera toxin B further increased OD values of anti-HBsAg IgG. This ultrasound perforation method holds great promise for monitorable and programmable intradermal vaccination.

Assessment of S-Specific IgG and IgM Positive Rates in Healthy Hospital Staff Members Vaccinated with the Inactivated SARS-CoV-2 Vaccine.

Widespread vaccination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine makes the assessment of antibodies' positive rates essential. In this study, a total of 378 hospital staff members vaccinated with the vaccine were selected as research subjects. Serum-specific IgG and IgM against the SARS-CoV-2 spike protein (S) were detected, and S-specific IgG and IgM positive rates were analyzed in different age and sex groups, as was the serological pattern of IgG/IgM. The positive rates of IgG and IgM were 92.06% and 44.44%, respectively. The percentage of both IgG and IgM positive (IgG+IgM+) was 43.92%. A total of 182 vaccinees (46.90%) were IgG positive and IgM negative (IgG+IgM-), and 28 vaccinees (7.41%) were negative for both IgG and IgM (IgG-IgM-); 2 participants were positive for IgM alone (IgG-IgM+). In sex subgroups, the rate of IgM positivity was significantly higher in the male group than in the female group (p = 0.027). In different age subgroups, positive rates for IgG in the young group were significantly higher than those in the other group (p = 0.035). Furthermore, ratios of sample values to cutoff values (S/CO values) for IgG in vaccinees who were S-specific IgG positive were compared, and the S/CO values of IgG were significantly higher in the younger group than in the other group (p < 0.001). When comparing the influence of sex on two specific serological patterns (IgG+IgM- and IgG+IgM+), a significant difference in positivity rates was detected (p = 0.011). Male vaccinees were more likely than females to have an IgG+IgM+ pattern.

The Use of Exercise Challenge Testing and Fractional Exhaled Nitric Oxide in Diagnosis of Chest Tightness Variant Asthma in Children

Background: Chest tightness variant asthma (CTVA) in children presents with chest tightness as the sole manifestation. Diagnostic tests are needed given the lack of typical asthma symptoms. The present study aimed to investigate the diagnostic value of exercise challenge testing (ECT) and fractional exhaled nitric oxide (FeNO) in pediatric CTVA. Methods: We included 98 children aged 6–13 years with chest tightness as the sole symptom for >4 weeks. All subjects underwent FeNO measurement, spirometry and ECT, and received 4-week budesonide/formoterol treatment. According to treatment responses, children were categorized into CTVA (n = 12) and non-CTVA (n = 86) groups. Differences in clinical characteristics and FeNO, spirometry, and ECT results were compared between the two groups. The FeNO and ECT diagnostic performances were determined using receiver operating characteristic (ROC) curve analysis. Results: Children with CTVA exhibited significantly higher Mycoplasma pneumoniae IgG, total IgE, and FeNO values; greater post-ECT forced expiratory volume in 1 s (FEV₁) fall; and more frequent sensitization to mites and pets than those without CTVA. Further logistic regression revealed that higher FEV₁ fall (OR, 1.39; 95% CI: 1.11–1.74; p = 0.004) and higher FeNO values (OR, 1.04; 95% CI: 1.01–1.08; p = 0.014) were risk factors associated with CTVA. FEV₁ fall and FeNO had similar areas under the ROC curve (AUCs) (0.79 vs. 0.78; p = 0.924), and their optimal CTVA-prediction cutoff values were 9.9% and 15.0 ppb, respectively. The AUC of FEV₁ fall and FeNO combination was higher at 0.86 (95% CI: 0.78–0.93); however, no difference was observed using the single test (p > 0.05). Their combination exhibited a relatively higher sensitivity than that of FEV₁ fall alone (0.75 vs. 0.67) and higher positive predictive value than that of FeNO alone (0.60 vs. 0.29). Conclusion: CTVA is a cause of unexplained recurrent chest tightness in children. FeNO ≥15.0 ppb and post-ECT FEV₁ fall ≥9.9% are diagnostically valuable for CTVA in children, with their combination potentially contributing to greater diagnostic accuracy.

Effectiveness of Anti-Cluster of Differentiation 20 as a Disease-Modifying Therapy in Multiple Sclerosis Across Its Different Phenotypes at the University Hospital of Caen.

BackgroundMultiple sclerosis is a chronic, demyelinating disorder occurring primarily as two main forms of relapsing-remitting multiple sclerosis (RRMS) found predominantly in women, and primary progressive multiple sclerosis (PPMS) occurring predominantly in men. In this retrospective single-center study, we aimed to explore the effects of anti-cluster of differentiation (CD)20 treatment for both relapsing-remitting and primary progressive forms of multiple sclerosis (MS) in a population-based cohort treated at the university hospital. MethodologyThe diagnostic factors being assessed were forms of multiple sclerosis (MS), age at first relapse, whereas therapeutic factors were age at first disease-modifying therapy (DMT), age at starting anti-CD20, reason to switch to anti-CD20 and the duration of anti-CD20 treatment. Primary outcomes measured were number of relapses and progression in disability as measured by the Expanded Disability Status Scale, while secondary outcomes measures being assessed number of cerebral lesions on MRI and level of IgG at the beginning and end of the 12-month treatment.ResultsTreatment with anti-CD20 demonstrated a reduction in number of relapses 12 months after treatment, no change in the progression of disability in RRMS type, but an increase in PPMS type. No change was observed in cerebral MRI lesions at the end of treatment after 12 months. A statistically significant reduction in serum IgG value was observed after 12 months from the start of treatment, where only one out of 26 (3.8%) patients developed hypogammaglobulinemia with IgG less than 6 g/L but none developed hypogammaglobulinemia of less than 5 g/L.ConclusionAnti-CD20 antibodies as disease-modifying therapy can profoundly impact the course and progression of MS in both its forms if utilized at an earlier stage in patients and therefore greatly improve the quality of life in patients living with multiple sclerosis.