Day 1 :
Pathkind Diagnostics Pvt Ltd, New Delhi, India
Keynote: Prevalence of HPV genotypes in UAE
Time : 10:05-10:45
Ashok Rattan has expertise in Microbiology, Immunogenetics and Molecular Biology and holds important positions in academics (JN Medical College, Aligarh; AIIMS, New Delhi; Sharjah Medical College and Mahatma Gandhi Medical University, Jaipur); in industrial research (Ranbaxy New Drug Discovery and Fortis Clinical Research Ltd) and in Diagnostic labs (Religare SRL Diagnostics and Star Metropolis). He has published over 100 research papers in peer reviewed international journals. He has contributed more than a dozen chapters in different books and has conducted workshops on WHONET in all nine SEARO countries.
Infection with human papillomavirus is the cause of cervical cancer which is one of the leading causes of death in women. Infection is commoner in developing countries. For primary prevention vaccines are available. For secondary prevention cytological examination has been recommended which has recently been modified to contesting with molecular detection of virus. Information on genotype distribution in UAE is scanty. We used a multiplex PCR test (Seegene, South Korea) to examine simultaneously cytological examination and HPV genotype. Study was carried out to document the prevalence of genotypes in women attending clinics for routine screening. A total of 178 were included in the analysis. Sample for Pap smear or liquid-based cervical cytology carried out. For persons submitting Pap smear, an additional sample in eNAT was collected for HPV detection and genotyping while if Thin Prep LBC was available, the fluid was used. Of the 178 samples tested for HPV, 74 were from women under 30 years of age and 104 from those over 30 years, the age of persons studied ranged from 18 to 65 years. 79 HPV genotypes belong to 20 different genotypes were identified from 60 patients. 48 were Hr HPV genotypes and 31 were lr HPV. 33 were from persons below 30 years of age and 46 were from women over 30 years of age. The high risk genotype 16 was commonest (12) while lr genotype 42 (8), lr 6 (7) and lr 61 (6) were next in frequency. Hr genotype 18 (4) was fourth among the high risk genotypes after 52 (5) and 53 (5). Other hr genotypes detected were 66 (4), 68 (4) and 39 (4). 32 women were infected by one genotype while dual infection was observed in 12; multiple genotypes (three or more) were detected in seven women. Using the dual strategy of primary prevention by vaccination of females below 25 years and secondary prevention of five yearly screening by contesting, it is conceivable to have zero cervical cancer by 2020 in UAE, thus preventing a preventable cancer and providing the best preventive healthcare in the world.
University of California, Davis, USA
Keynote: Tuberculosis Translational research: Integrative approach in nonhuman primates to TB patients
Time : 10:45-11:25
Imran H Khan completed his PhD in Molecular and Cellular Biology at Albert Einstein College of Medicine, USA. His research program has focused on “Infectious diseases, intracellular signaling pathways and molecular biology for over 15 years”. Since 2002, he has worked on developing highly efficient and high throughput multiplex approaches for infectious disease biomarkers (e.g., tuberculosis). His research includes simultaneous analysis of multiple key components of cell signaling pathways in a single reaction vessel. In addition, he has employed novel approaches to study disease related biomarkers (e.g., immune biomarkers) in bodily fluids (e.g., plasma/serum) by combining the power of multiplexing systems and computational modeling.
Approximately, two billion people worldwide are infected with Mycobacterium tuberculosis (M. tb.), the etiologic agent of tuberculosis (TB). A tenth of the infected individuals develop active disease. Active pulmonary TB is an inflammatory disease and is increasingly viewed as an imbalance of host immune responses to M. tb. infection. The current frontline diagnostic methods including sputum smear (SS) microscopy, and X-ray, are insensitive, inefficient, cumbersome or too expensive. The most widely used test, SS microscopy (WHO standard), test has a low sensitivity. Therefore, there is an urgent need for low cost, efficient, high-throughput and accurate diagnostic approaches. We have developed multiplex antibody biomarker based TB diagnostic system in pre-clinical research in non-human primates and tested it in TB patients. Data on immune biomarkers, microbiology, and CT imaging from proof-of-concept and subsequent field studies have shown that this approach will enable a scalable, flexible and cost effective model for diagnostic applications. In addition, we have published that 10 plasma cytokine/chemokine biomarkers representing host immune-responses in TB patients, are not only gender biased but concentrations of some of these biomarkers (e.g., IP-10, MIG, IL-16, IFN-α and G-CSF) progressively decreased in patients which responded to anti-tuberculosis treatment (ATT) with a cocktail of several drugs (isoniazid, rifampin, ethambutol, and pyrazinamide or streptomycin - WHO Standard). This decrease is strongly correlated with treatment success and can be used for monitoring efficacy of therapy. This is important because ATT is a drawn out process (at least six months), and early detection of patients who may not respond to therapy is important. One possible reason for not responding to ATT could be due to infection with multi-drug resistant (MDR) strain of M. tb. The standard culture based drug sensitivity testing can take several weeks. Therefore, there is a need for rapid molecular tests. A test, based on multiplex gene amplification (multiplex PCR), of several M. tb. genes involved in drug resistance, and multiplex detection of the relevant gene mutations to detect resistance against four TB drugs will also be discussed.
- Infection and Immune System | Pediatric infections | Foodborne & Waterborne Illnesses | Infection Control and Epidemiology | New Opportunities for Tuberculosis Control | Host and Microbial Genetics
Location: Barcelona, Spain
University of California, Davis, USA
Labormedizinisches zentrum Dr Risch, Liechtenstein
Labormedizinisches zentrum Dr Risch, Liechtenstein
Walter Fierz is a Clinical Immunologist and completed his basic training in Cellular Immunology with experimental work at Transplantation Immunology Unit of the Clinical Research Center in Harrow, London (UK) and at Max-Planck-Society working group for multiple sclerosis research in Würzburg (Germany). He completed his Master’s Degree in Health Information Management (MHIM) at Erasmus University in Rotterdam, Netherlands.
Many microorganisms use a survival strategy based on their interference with the immune system. Some viruses are able to do so by docking to receptors on host cells that are important for proper functioning of the immune system. A well-known example is HIV that uses the CD4 cell surface molecule to enter host lymphocytes and thereby attacking the immune system. A more complicated example is seen in multiple sclerosis (MS) where human herpes virus-6A (HHV-6A) infects astrocytes by docking to the CD46 molecule. Such HHV-6A infection has recently been postulated to enable Epstein-Barr viruses (EBV) to transform latently infected B-lymphocytes leading to the well-known phenomenon of oligoclonal immunoglobulin production and cellular immune response to HHV-6A and EBV as part of pathogenic mechanisms in MS. A more subtle pathogenic mechanism can be seen in the down-regulation of CD46 on astrocytes by the infecting HHV-6A. Since CD46 is central in regulating the complement system, a lack of CD46 leads to hyper-activation of the complement system. In fact, activation of the complement system in brain lesions is one of the pathogenic mechanisms in MS. It is postulated that a similar mechanism is central in the development of age-related macular degeneration (AMD). One of the earliest changes in the retina of AMD patients is the loss of CD46 expression in the retinal pigment epithelium (RPE) in the course of geographic atrophy. Furthermore, CD46 deficient mice spontaneously develop dry-type AMD-like changes in their retina. It is also well known that certain genetic polymorphisms in the complement-inhibiting pathways correlate with higher risks of AMD development. The hypothesis is that HHV-6A infection of the retina leads to down-regulation of CD46 and consequently to hyper-activation of the complement system in the eyes of susceptible individuals.
Società Italiana di Medicina Veterinaria Preventiva, Italy
Maurizio Ferri has more than 22 years of professional experience in the field of Veterinary Public Health and Food Safety. He performed EU assessment missions and delivered TAIEX training in Food Safety, and Veterinary Public Health. He has gained broad experience in evaluating Food Safety Microbiological Risk and completed his training on Quantitative Microbial Risk Assessment (QMRA) at University of Maryland, USA. His new research area focuses on “Use of data mining, network analysis tools for food safety, political and regulatory environment for sharing food pathogens genome sequences.
Campylobacter is the leading cause of zoonotic enteric infections worldwide and the most frequent foodborne pathogen in the European Union (EU). Due to a significant increasing trend of human cases in the EU Member states over the last eight years, Campylobacter is becoming a serious public health problem with associated economic cost and have drawn a great attention of the EU decision- makers. Epidemiological studies and molecular subtyping investigations have identified poultry as main reservoir of Campylobacter and poultry meat as a major source of human infection. Among the different control measures to reduce the prevalence of the pathogen throughout the broiler farm-to-fork continuum and the incidence of human infection, the adoption of a food microbiological criteria to be applied at slaughter and decontamination treatment of poultry carcases have seriously been considered by the EU Commission. The presentation provides an overview of the etiology, epidemiology and newly proposed control options of Campylobacter in the broiler meat chain as proposed by EFSA and highlights the public health importance of the un integrated and holistic approach according to one health concept to reduce the pathogen prevalence starting at poultry farm level followed by further measures later in the poultry chain and to reduce the human incidence. In addition, the need to streamline awareness campaigns aimed to prevent unhygienic practices and food cross-contamination at consumer’s home is underlined.
Third Military Medical University, China
Jintao Li is a Professor, Director and Principle Investigator in Department of Tropical Pathogens and Epidemiology, Institute of Tropical Medicine, Third Military Medical University (TMMU). She completed her Master’s Degree in Molecular Biology at Biotechnology Centre, Southwest University in 1996 and then became a Faculty in Genetics department, TMMU. She completed her PhD at Immunology Institute, PLA, TMMU in 2000 and became an Associate Professor and then Professor. From 2011-2012, she worked in Canada as a Visiting Scientist for one year. Now, she has published more than 100 academic papers in journals such as Science Translational Medicine, Journal of Immunology and European Journal of Immunology.
The available evidence suggests that dengue virus-specific T lymphocytes and cytokine storm play a pivotal role in the immuno pathogenesis of plasma leakage. Investigations are underway to identify the immune profiles associated with increased or decreased risk for severe disease. In this study, CD14+ cells from the peripheral blood mononuclear cells (PBMCs) of patients who recovered from DENV-1 infection were infected with DENV-1 or DENV-2 and co-cultured with memory T cells. We found that secondary infection with DENV-2 suppresses the cell reproductive capacity but forms more cell clones and more functional cells to produce more pro-inflammatory factors (IFN-γ, TNF-α, IL-6, IL-8, IL-12 and IL-17) and less regulatory cytokines (IL-10, TGF-β) which results in higher viral replication compared to secondary infection with DENV-1. Memory dengue virus-specific T cells which are induced in a primary dengue virus infection are reactivated by the heterologous serotype of dengue virus and antigen-presenting cells (APCs) during a secondary infection. Dramatically, less apoptosis and more continuous activation of T cells in secondary infection with hetero-serotype DENV were observed. This discovery which has not been reported previously may be the reasonable and vital interpretation for the cytokine storm and severe symptoms observed in secondary infection with DENV. In summary, secondary infection with hetero-serotype DENV elicits the relatively pathological immune response while secondary infection with homologous-serotype DENV induces the relatively protective immune response by activation-induced cell death (AICD) of T cells.
Tehran University of Medical Sciences, Iran
Fereshteh Ghiasvand is an Assistant Professor of Infectious Diseases Department at Tehran University of Medical Sciences.
Background: Endocrine diseases are common among men living with HIV (MLWH) known as curable etiology of depression. Depression impedes adherence to treatment and perceived quality of life.
Aim: The objective of this study was to evaluate depression after medical treatment of underlying endocrine diseases among Iranian MLWH.
Materials & Methods: We recruited a convenient sample of 296 MLWH at a referral HIV clinic from April 2013 to March 2014. In phase I (cross-sectional evaluation), all patients were interviewed using the beck depression inventory (BDI- II) questionnaire. In phase II, participants with moderate to severe depression (n=110, scores ≥21) were evaluated for endocrine diseases (evaluations: total testosterone, triiodothyronine, thyroxine, thyroid stimulating hormone, luteinizing hormone, follicle stimulating hormone and serum cortisol). 11 patients diagnosed with hypogonadism were finally considered for hormone replacement therapy. We re-evaluated changes in depressive symptoms with BDI-II.
Results: From 237 participants, 136 (75%) had BDI scores ≥21; 110 participated in the endocrine evaluations. Secondary hypogonadism (total testosterone ≤2.8 nmol/l; LH, FSH: normal) was the only observed abnormality in 10% (n=11) of the patients and hormone replacement was prescribed to seven of them for three months. All patients were re-evaluated for depression; significant changes were observed in final scores (p=0.027).
Conclusions: Evaluation and treatment of hypogonadism can help clinicians to reduce or control depression among people living with HIV; hence improving treatment compliance and patient outcomes.
UP-Philippine General Hospital, Philippines
Vaneza Leah A Espino is currently working as an expertise at UP-Philippine General Hospital, Philippines. She has published numerous research papers and articles in reputed journals and has various other achievements in the related studies. She has extended her valuable service towards the scientific community with her extensive research work.
Background: Use of central venous catheters (CVCs) ensures stable access in critically ill patients but is associated with increased infection rates. CVC with antimicrobials has been recommended for infection reduction in adults. A review of antibiotic-impregnated CVCs’ usefulness in children is needed.
Aim: Aim of this study is to determine the effectiveness of antibiotic-impregnated CVCs in reducing infection in children.
Search Methods: Extensive search of MEDLINE, Cochrane Database of Systematic Reviews and Cochrane Register of Controlled Trials, Clinicaltrials.gov and Google scholar was done for trials published until June 2016. Reference lists from retrieved journals were checked for relevant articles.
Selection Criteria: RCTs evaluating antibiotic-impregnated was compared with standard CVCs for reducing infection in children.
Data Collection and Analysis: Two authors assessed trial quality and extracted data. Statistical analysis was done using Review Manager with fixed or random effects model. Outcomes were: Bloodstream infection, hypersensitivity, thrombosis, mortality, site infection, length of ICU and hospital stay. Dichotomous data were presented as risk ratios (RR), continuous data as mean differences with 95% confidence intervals (CIs).
Results: Two low quality trials (n=1773) were analyzed showing non-significant reduction of bloodstream infection in the antibiotic-impregnated group compared to standard catheters (RR 0.49; 95% CI 0.23-1.02, I2=0%) with no increased risk of thrombosis (RR 1.04 95% CI 0.84-1.28, I2=0%). No statistical difference was seen in the duration of ICU and hospital stay.
Conclusions: The use of antibiotic-impregnated CVCs cannot be recommended at this time. Decision of its use will depend on the clinical judgment after consideration of the costs and benefits. More RCTs are needed to reinforce the evidence.
Weizmann Institute of Science, Israel
Yifat Ofir-Birin is pursuing her Post-doctorate Degree at Dr. Neta Regev - Rudzki’s lab. She is leading an area of research which focuses on “Intercellular communication between malaria parasites and its human host via extracellular vesicles, exosomes”. During 2013-2015, She was a Senior Scientist at Evogene R&D while leading an innovative research team in order to find new genes which improve crops traits. She completed her PhD thesis under the supervision of Professor Ehud Razin. Her thesis demonstrates “The structure and function of the Ap4A-LysRS-MITF pathway in mast cells.
Malaria, kills up to a million people each year, is caused by the protozoa of the genus Plasmodium falciparum (Pf). These vector-born parasites cycle between mosquitoes and humans and, in both contexts, are faced with an unstable and hostile environment. To ensure survival and transmission, the malaria parasite must infect and survive in the human host and differentiate into sexual forms that are competent for transmission to mosquitoes. We found for the first time that Pf-infected red blood cells (iRBCs) directly exchange cargo between them using nano-vesicles (exosomes). These tiny vesicles are capable of delivering protected genes to target cells. Cell-cell communication is a critically important mechanism for information exchange that promotes cell survival. How Pf parasites sense their host environment and coordinate their actions remain one of the greatest mysteries in malaria. Moreover, our understanding in the mechanism regulate human immune response to malaria infection is poor. Here, we found that malaria-derived exosomes carry remarkable cargo providing a secure and efficient mode for signal delivery. We developed an exosomes tracking assay and could measure Pf exosomes uptake by different cell types. Moreover, although early life-stages of Pf-iRBC are considered immunologically inert, our initial observations show that ring-stage derived exosomes are immunogenic. We show that exosomes can specifically activate and induce pro-inflammatory responses, resulting in interferon type I response. This is a new area of malaria research which may shed a light on the ability of malaria parasite to manipulate their host response.