Rubella immunity rates in women of childbearing age in an urban teaching hospital

Rubella is a highly contagious viral infection that can cause devastating effects on a growing fetus. Although rubella can be prevented with the measles, mumps and rubella (MMR) vaccine, some individuals have a weak immune response and do not sustain an adequate antibody titer to protect against the disease. MMR antibody titers are not routinely assessed in the general population, although healthcare professionals, military workers and pregnant women are commonly screened. This study aimed to investigate rubella immunity rates in primiparous women. The authors believed that the nonimmunity rate would be substantial enough to justify potential rubella immunity screening in all women of childbearing age at annual gynecologic exams prior to pregnancy. Findings recommend obtaining a rubella titer, as well as a measles titer, when women present for their first gynecological visit.

Impact of Low-Dose Methotrexate–Adalimumab Combination Therapy on the Antibody Response Induced by the mRNA-1273 SARS-CoV-2 Vaccine: Case of an Elderly Patient with Rheumatoid Arthritis

Patients with rheumatoid arthritis (RA) are treated with drugs that may impact their immune responses to SARS-CoV-2 vaccines. We describe here the anti-Spike (anti-S) IgG and neutralizing antibody responses induced by the mRNA-1273 SARS-CoV-2 vaccine in a 78-years-old patient with RA, who received a low-dose combination therapy of methotrexate and adalimumab, shortly before vaccine administration. Both near-normal and impaired immune responses to vaccines have been reported previously in patients treated with these drugs. Our case report shows that, even at low doses, combined methotrexate-adalimumab therapy can be associated with a weak immune response to the mRNA1273 vaccine in elderly patients.

The features of HIV and SARS-CoV-2-coinfection in a pandemic

COVID-19 is known to undertake a severe course in several groups of patients. The review presents the latest data on the main features of COVID-19 course in HIV patients. People living with HIV, have not been found to be at a higher risk for acquiring COVID-19 and the disease runs a similar course compared to the general population in HIV patients on continuous antiretroviral therapy (ART) with a suppressed viral load and CD4+-T-lymphocytes count > 200 cells/μl. Fewer than expected HIV patients have been reported to be hospitalised, this leads to hypothesize that infection may be majorly asymptomatic in this group of patients owing to their weak immune response. The patient’s use of ART might also explain the comparatively milder disease course of COVID-19 seen in patients with HIV/SARS-CoV-2 coinfection. While ART use cannot be considered to be a protective factor against contracting the SARS-CoV-2, researchers assume that the therapy could stabilize the immune response in coinfected patients and thus prevent progression of the disease to the severe forms.

Immuno-epidemiological model of two-stage epidemic growth

Epidemiological data on seasonal influenza show that the growth rate of the number of infected individuals can increase passing from one exponential growth rate to another one with a larger exponent. Such behavior is not described by conventional epidemiological models. In this work an immuno-epidemiological model is proposed in order to describe this two-stage growth. It takes into account that the growth in the number of infected individuals increases the initial viral load and provides a passage from the first stage of epidemic where only people with weak immune response are infected to the second stage where people with strong immune response are also infected. This scenario may be viewed as an increase of the effective number of susceptible increasing the effective growth rate of infected.

Different Strategies for Cancer Treatment: Mathematical Modelling

We formulate and analyse a mathematical model describing immune response to avascular tumour under the influence of immunotherapy and chemotherapy and their combinations as well as vaccine treatments. The effect of vaccine therapy is considered as a parametric perturbation of the model. In the case of a weak immune response, neither immunotherapy nor chemotherapy is found to cause tumour regression to a small size, which would be below the clinically detectable threshold. Numerical simulations show that the efficiency of vaccine therapy depends on both the tumour size and the condition of immune system as well as on the response of the organism to vaccination. In particular, we found that vaccine therapy becomes more effective when used without time delay from a prescribed date of vaccination after surgery and is ineffective without preliminary treatment. For a strong immune response, our model predicts the tumour remission under vaccine therapy. Our study of successive chemo/immuno, immuno/chemo and concurrent chemoimmunotherapy shows that the chemo/immuno sequence is more effective while concurrent chemoimmunotherapy is more sparing.

Phase I Trial of the Anti–Lewis Y Drug Immunoconjugate BR96-Doxorubicin in Patients With Lewis Y–Expressing Epithelial Tumors

PURPOSE: We conducted a phase I clinical trial of BR96-Doxorubicin (BR96-Dox), a chimeric anti–Lewis Y (LeY) monoclonal antibody conjugated to doxorubicin, in patients whose tumors expressed the LeY antigen. The study aimed to determine the toxicity, maximum-tolerated dose, pharmacokinetics, and immunogenicity of BR96-Dox. PATIENTS AND METHODS: This was a phase I dose escalation study. BR96-Dox was initially administered alone as a 2-hour infusion every 3 weeks. The occurrence of gastrointestinal (GI) toxicity necessitated the administration of BR96-Dox as a continuous infusion over 24 hours and use of antiemetics and antigastritis premedication. Patients experiencing severe GI toxicity underwent GI endoscopy. All patients underwent restaging after two cycles. RESULTS: A total of 66 patients predominantly with metastatic colon and breast cancer were enrolled onto the study. The most common side effects were GI toxicity, fever, and elevation of pancreatic lipase. At higher doses, BR96-Dox was associated with nausea, vomiting, and endoscopically documented exudative gastritis of the upper GI tract, which was dose-limiting at a maximum dose of 875 mg/m2 (doxorubicin equivalent, 25 mg/m2) administered every 3 weeks. Toxicity was reversible and generally of short duration. Premedication with the antiemetic Kytril (granisetron hydrochloride; SmithKline Beecham, Philadelphia, PA), the antacid omeprazole, and dexamethasone was most effective in ameliorating GI toxicity. A dose of 700 mg/m2 BR96-Dox (doxorubicin equivalent, 19 mg/m2) every 3 weeks was determined to be the optimal phase II dose when administered with antiemetic and antigastritis prophylaxis. BR96-Dox deposition on tumor tissue was documented immunohistochemically and by confocal microscopy. At the 550-mg/m2 dose, the half-life (mean ± SD) of BR96 and doxorubicin was 300 ± 95 hours and 43 ± 4 hours, respectively. BR96-Dox elicited a weak immune response in 37% of patients. Objective clinical responses were seen in two patients. CONCLUSION: BR96-Dox provides a unique strategy to deliver doxorubicin to LeY-expressing tumor and was well tolerated at doses of 700 mg/m2 every 3 weeks. BR96-Dox was not associated with the typical side-effect profile of native doxorubicin and can potentially deliver high doses of doxorubicin to antigen-expressing tumors. A phase II study in doxorubicin-sensitive tumors is warranted.

Studies on the survival of homografts of skin and ovarian tissue in rats

The expectation of survival of skin homografts in a strain of albino rats has been compared with that of ovarian homografts made subcutaneously in ovariectomized recipients. It was found that a degree of genetic—and therefore antigenic—difference between donor and host that will lead to the breakdown of skin homografts is only rarely sufficient to affect the continued functional activity of ovarian homografts. Ovarian homografts implanted into ovariectomized recipients which had previously received skin homografts from the same donor failed to survive in nearly all those animals which had reacted vigorously against their skin homografts. It seems, therefore, that the majority of ovarian homografts are themselves incapable of provoking reactions, but are not exempt from the immunity elicited by previous homografts of the donor’s skin. Thus skin and ovary share at least some antigens in common. The most likely reasons why ovarian homografts are more successful than skin homografts are (1) that ovarian tissue is characterized by fewer genetically defined ‘histocompatibility' antigens than skin, and (2) that the ‘histocompatibility’ antigens of ovarian tissue are feeble, being capable of eliciting only a weak immune response, if any.