Search results
Found 7174 matches for
Antibiotic use attributable to RSV infections during infancy - an international prospective birth cohort study
Background Early-life antibiotic use impacts microbiome composition and contributes to the emergence of antimicrobial resistance. Despite respiratory syncytial virus (RSV) being a leading cause of acute respiratory infections (ARI), accurate estimates of antibiotic use attributable to RSV are lacking. Objectives To assess RSV-associated antibiotic use during the first year of life. Patients and methods The RESCEU birth cohort study followed healthy term infants, born (n = 9154) between 1 July 2017 and 31 July 2020 from five European countries, to identify RSV-ARI hospitalizations during infancy. In a nested cohort (n = 993), we performed active RSV surveillance by collecting nasal swabs in case of ARI symptoms during RSV seasons (October-April). Antibiotic use during hospitalization was identified through chart review, while outpatient data were collected via parental questionnaires. Results In the total cohort, antibiotics were used in 22.8% of RSV hospitalizations (33/145) and 62.5% of RSV intensive care admissions (5/8). In the nested cohort, antibiotics were used in 5.2% of any-severity RSV-ARI (13/250) and 9.9% of medically attended RSV-ARI (13/131). This results in an estimated incidence of 1.3% (95%CI: 0.8-2.0) of healthy term infants receiving ≥1 course of antibiotics associated with RSV infection in their first year, with an incidence rate of 1.1 RSV-associated antibiotic prescriptions per 1000 infant-months (95%CI: 0.6-1.9). As such, RSV accounts for 22.9% of antibiotic prescriptions for ARI during RSV seasons. Conclusions One in 77 healthy term infants receives antibiotics during RSV infection before their first birthday. Real-world evidence is needed to establish the impact of RSV immunization on antibiotic use during infancy.
Two distinct subpopulations of human stem-like memory T cells exhibit complementary roles in self-renewal and clonal longevity.
T stem cell-like memory cells (TSCM cells) are considered to be essential for the maintenance of immune memory. The TSCM population has been shown to have the key properties of a stem cell population: multipotency, self-renewal and clonal longevity. Here we show that no single population has all these stem cell properties, instead the properties are distributed. We show that the human TSCM population consists of two distinct cell subpopulations which can be distinguished by the level of their CD95 expression (CD95int and CD95hi). Crucially, using long-term in vivo labelling of human volunteers, we establish that these are distinct populations rather than transient states of the same population. These two subpopulations have different functional profiles ex vivo, different transcriptional patterns, and different tissue distributions. They also have significantly different TREC content indicating different division histories and we find that the frequency of CD95hi TSCM increases with age. Most importantly, CD95hi and CD95int TSCM cells also have very different dynamics in vivo with CD95hi cells showing considerably higher proliferation but significantly reduced clonal longevity compared with CD95int TSCM. While both TSCM subpopulations exhibit considerable multipotency, no single population of TSCM cells has both the properties of self-renewal and clonal longevity. Instead, the "stemness" of the TSCM population is generated by the complementary dynamic properties of the two subpopulations: CD95int TSCM which have the property of clonal longevity and CD95hi TSCM which have the properties of expansion and self-renewal. We suggest that together, these two populations function as a stem cell population.
A systematic review on patient and public attitudes toward health monitoring technologies across countries.
The market for digital health monitoring is expanding rapidly, with technologies that track health information and provide access to medical data promising benefits for users, particularly in areas with limited healthcare resources. To understand user attitudes toward these technologies, we conducted a systematic review of literature with primary data about patient and public perspectives. We synthesized 562 studies (2000-2023) from PubMed, Embase, ACM Digital Library, IEEE Xplore, Web of Science, and Scopus, including qualitative, quantitative, and mixed-methods research. We revealed a significant geographic bias, with most research concentrated in few countries, and identified access gaps in both Global South and Global North. While users generally showed positive attitudes toward health monitoring technologies, they expressed various concerns. We provide suggestions for future research to enhance the socially responsible integration of technology in healthcare. One important limitation of our approach is using English-language search terms. This potentially excluded relevant studies from underrepresented countries.
In Vitro Characterization of the Immune Response to an Epitope Ensemble Vaccine Against Rhinovirus in Pediatric Asthma and Adults With Chronic Obstructive Pulmonary Disease: Protocol for an Observational and Exploratory Study.
BACKGROUND: Human rhinoviruses (HRVs) are the leading cause of upper respiratory tract infections, responsible for over half of all such infections. Infection rates among young children can reach as high as 8-12 episodes per year. While HRV infections typically result in mild common colds, they can also lead to more severe respiratory conditions, often in conjunction with bacterial coinfections. In addition, HRVs are implicated in the exacerbation of obstructive respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). T-cell responses play a crucial role in the immune defense against HRV. However, in patients with obstructive respiratory diseases, altered or dysregulated T-cell responses to HRV may not only fail to efficiently eliminate the virus but can also exacerbate inflammation and airway remodeling. Therefore, a deeper understanding of T-cell-mediated responses in the context of HRV infection, especially in vulnerable populations like those with COPD, is critical. It can provide new insights into mechanisms of both protection and disease exacerbation, potentially guiding the development of targeted therapies or vaccines that enhance protective immunity while minimizing harmful inflammation. OBJECTIVE: This study aims to (1) determine the population-wide coverage of HRV-specific T-cell responses, (2) characterize HRV-specific T-cell recall responses in disease cohorts compared to age-match healthy controls, and (3) identify biomarkers of protection and susceptibility within disease cohorts through a comparative analysis. METHODS: Participants with asthma and those with COPD, aged 5-15 and 40-70 years, respectively, will be recruited alongside healthy age-matched controls. Peripheral blood samples will be collected following informed consent from adult participants and from parents or guardians of minors, as applicable. Clinical, demographic, immunological, and genetic responses will be assessed both prior to and following in vitro stimulation with a pool of HRV-specific T-cell epitopes. Flow cytometry and functional assays will be used to analyze T-cell responses to HRV epitopes in the context of obstructive respiratory diseases. RESULTS: This study was funded in January 2023 by the Ministry of Science and Innovation of Spain. The primary aim of the study was achieved within the same year. Recruitment for the secondary and tertiary aims is currently ongoing. Preliminary findings highlight the potential significance of HRV-specific T-cell responses in individuals with asthma and those with COPD. A detailed characterization of these immune responses will provide critical insights into host-pathogen interactions and may serve as a foundation for the development of effective T-cell-based vaccines or immunotherapies targeting HRV. CONCLUSIONS: Here, we present an ethically approved study protocol for an observational and exploratory study investigating a novel epitope-based vaccine targeting HRV, with a focus on pediatric asthma and adult COPD cohort populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/73383.