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Reports: MLB shortens draft to five rounds

Major League Baseball reportedly cut the 2020 draft down to five rounds on Friday, immediately drawing criticism.




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Roy Horn of Las Vegas magic duo Siegfried and Roy dies of COVID-19: report

Magician Roy Horn, who alongside Siegfried Fischbacher starred in a popular, long-running Las Vegas act built around rare tigers, died on Friday from of complications of COVID-19, the Las Vegas Review-Journal newspaper reported. He was 75.




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Reports of an insect apocalypse are overblown but still concerning

While an alarming 9 per cent of insects on land are being lost each decade, the state of the world’s insects is much more nuanced than warnings of an insect apocalypse




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APT trends report Q1 2020

For more than two years, the Global Research and Analysis Team (GReAT) at Kaspersky has been publishing quarterly summaries of advanced persistent threat (APT) activity. This is our latest installment, focusing on activities that we observed during Q1 2020.




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Secondhand Smoke Blocks Artery Repair

Title: Secondhand Smoke Blocks Artery Repair
Category: Health News
Created: 4/30/2008 2:00:00 AM
Last Editorial Review: 4/30/2008 12:00:00 AM




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Report: Polluted Air Puts Millions at Risk

Title: Report: Polluted Air Puts Millions at Risk
Category: Health News
Created: 5/2/2008 12:00:00 AM
Last Editorial Review: 5/2/2008 12:00:00 AM




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1/3 With Arthritis Report Anxiety or Depression

Title: 1/3 With Arthritis Report Anxiety or Depression
Category: Health News
Created: 4/30/2012 11:00:00 AM
Last Editorial Review: 4/30/2012 12:00:00 AM




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High Reps With Low Weights Builds Muscle, Too

Title: High Reps With Low Weights Builds Muscle, Too
Category: Health News
Created: 4/28/2012 11:01:00 AM
Last Editorial Review: 4/30/2012 12:00:00 AM




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Better Ways Needed to Track Drug Safety: Report

Title: Better Ways Needed to Track Drug Safety: Report
Category: Health News
Created: 5/1/2012 2:05:00 PM
Last Editorial Review: 5/2/2012 12:00:00 AM




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Less Invasive Heart Valve Replacement Works for Elderly: Study

Title: Less Invasive Heart Valve Replacement Works for Elderly: Study
Category: Health News
Created: 5/2/2012 6:05:00 PM
Last Editorial Review: 5/3/2012 12:00:00 AM




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Second Man Arrested in Tainted Letter Case, Officials Report

Title: Second Man Arrested in Tainted Letter Case, Officials Report
Category: Health News
Created: 4/27/2013 6:35:00 PM
Last Editorial Review: 4/29/2013 12:00:00 AM




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Lipsticks, Glosses Contain Toxic Metals: Report

Title: Lipsticks, Glosses Contain Toxic Metals: Report
Category: Health News
Created: 5/2/2013 10:35:00 AM
Last Editorial Review: 5/2/2013 12:00:00 AM




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Training Programs Protect Young Athletes From ACL Tears: Report

Title: Training Programs Protect Young Athletes From ACL Tears: Report
Category: Health News
Created: 4/28/2014 9:35:00 AM
Last Editorial Review: 4/28/2014 12:00:00 AM




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4 in 10 Americans Breathe Unhealthy Air: Report

Title: 4 in 10 Americans Breathe Unhealthy Air: Report
Category: Health News
Created: 4/29/2015 12:00:00 AM
Last Editorial Review: 4/30/2015 12:00:00 AM




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U.S. Health Report Card Finds Racial, Ethnic Disparities Persist

Title: U.S. Health Report Card Finds Racial, Ethnic Disparities Persist
Category: Health News
Created: 4/27/2016 12:00:00 AM
Last Editorial Review: 4/27/2016 12:00:00 AM




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Births of Triplets, Quadruplets on Decline in U.S.: Report

Title: Births of Triplets, Quadruplets on Decline in U.S.: Report
Category: Health News
Created: 4/28/2016 12:00:00 AM
Last Editorial Review: 4/28/2016 12:00:00 AM




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Summer Camp Prep for Kids With Allergies, Asthma

Title: Summer Camp Prep for Kids With Allergies, Asthma
Category: Health News
Created: 4/29/2017 12:00:00 AM
Last Editorial Review: 5/1/2017 12:00:00 AM




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Americans Uneasy With Push to Repeal Obamacare: <i>HealthDay/Harris Poll</i>

Title: Americans Uneasy With Push to Repeal Obamacare: HealthDay/Harris Poll
Category: Health News
Created: 5/4/2017 12:00:00 AM
Last Editorial Review: 5/4/2017 12:00:00 AM




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Health Tip: Preparing Nutritious Meals

Title: Health Tip: Preparing Nutritious Meals
Category: Health News
Created: 5/4/2017 12:00:00 AM
Last Editorial Review: 5/4/2017 12:00:00 AM




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House to Vote Thursday on Amended Bill to Repeal and Replace Obamacare

Title: House to Vote Thursday on Amended Bill to Repeal and Replace Obamacare
Category: Health News
Created: 5/4/2017 12:00:00 AM
Last Editorial Review: 5/4/2017 12:00:00 AM




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House OKs Republican Health Care Bill

Title: House OKs Republican Health Care Bill
Category: Health News
Created: 5/4/2017 12:00:00 AM
Last Editorial Review: 5/5/2017 12:00:00 AM




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First Death Reported in E. Coli Outbreak Tied to Romaine Lettuce

Title: First Death Reported in E. Coli Outbreak Tied to Romaine Lettuce
Category: Health News
Created: 5/2/2018 12:00:00 AM
Last Editorial Review: 5/3/2018 12:00:00 AM




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Care at VA Hospitals as Good or Better Than Elsewhere in U.S.: Report

Title: Care at VA Hospitals as Good or Better Than Elsewhere in U.S.: Report
Category: Health News
Created: 5/4/2018 12:00:00 AM
Last Editorial Review: 5/4/2018 12:00:00 AM




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Health Tip: Prepare for a Colonoscopy

Title: Health Tip: Prepare for a Colonoscopy
Category: Health News
Created: 5/4/2018 12:00:00 AM
Last Editorial Review: 5/4/2018 12:00:00 AM




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Mental Prep for Better Performance

Title: Mental Prep for Better Performance
Category: Health News
Created: 5/3/2019 12:00:00 AM
Last Editorial Review: 5/3/2019 12:00:00 AM




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Coronavirus Antibody Tests Show Inaccuracies, as Some States Prepare to Reopen

Title: Coronavirus Antibody Tests Show Inaccuracies, as Some States Prepare to Reopen
Category: Health News
Created: 4/25/2020 12:00:00 AM
Last Editorial Review: 4/27/2020 12:00:00 AM




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Researchers Report First U.S. Dog With Coronavirus

Title: Researchers Report First U.S. Dog With Coronavirus
Category: Health News
Created: 4/29/2020 12:00:00 AM
Last Editorial Review: 4/30/2020 12:00:00 AM




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Will Remdesivir Help COVID-19 Patients? Two Reports Provide Different Answers

Title: Will Remdesivir Help COVID-19 Patients? Two Reports Provide Different Answers
Category: Health News
Created: 4/29/2020 12:00:00 AM
Last Editorial Review: 4/30/2020 12:00:00 AM




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AHA News: Is This Nature's Healthier Meat Replacement?

Title: AHA News: Is This Nature's Healthier Meat Replacement?
Category: Health News
Created: 3/27/2020 12:00:00 AM
Last Editorial Review: 3/30/2020 12:00:00 AM




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Repatha (evolocumab)

Title: Repatha (evolocumab)
Category: Medications
Created: 2/28/2020 12:00:00 AM
Last Editorial Review: 2/28/2020 12:00:00 AM




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PMC Continues to Expand its Role as a Repository for Federally and Privately-funded Research

Since March 2016, the NIH Manuscript Submission (NIHMS) system has added support for researchers from the following federal agencies to deposit in PMC any manuscripts that fall under the agency’s public access policy:

  • Assistant Secretary for Preparedness and Response (ASPR/HHS; intramural only at this time)
  • Environmental Protection Agency (EPA; intramural only at this time)
  • National Aeronautics and Space Administration (NASA; intramural/civil servants and grantees)

Manuscript deposit support for all Administration for Community Living (ACL/HHS) researchers will be available in NIHMS by October 2017 and for Department of Homeland Security researchers in early 2018.

Additionally, the Bill & Melinda Gates Foundation Open Access Policy now requires their grantees to make their published research results available in PMC immediately upon publication under a Creative Commons Attribution (CC-BY) license. Manuscript deposit support is not provided in NIHMS for Gates-funded researchers; rather the final published version of any Gates-funded article is to be deposited directly to PMC by the publisher or a funder-supported data provider without author involvement. More information on this open access policy is available on the Gates Foundation website.

PMC will continue to update the list of participating funding agencies at Public Access and PMC as support is implemented.




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New responsive PubMed site replaces PubMed Mobile

Our new, responsive PubMed site replaces PubMed Mobile. You now have the full PubMed experience on any size screen, including the ability to save and email citations, use the Clipboard, and send citations to My NCBI Collections on your mobile device.




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New PubMed to Replace Legacy PubMed in Mid-May

​The new PubMed will become the default site on or after May 18, 2020. A new, yellow banner has been added to legacy PubMed to notify users of the timing.




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Intense Exercise Can Trigger Heart Trouble in the Unprepared

Title: Intense Exercise Can Trigger Heart Trouble in the Unprepared
Category: Health News
Created: 3/2/2020 12:00:00 AM
Last Editorial Review: 3/3/2020 12:00:00 AM




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What Is an Umbilical Hernia Repair Surgery?

Title: What Is an Umbilical Hernia Repair Surgery?
Category: Procedures and Tests
Created: 4/13/2020 12:00:00 AM
Last Editorial Review: 4/13/2020 12:00:00 AM




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U.S. Primary Care Docs Unprepared for Surge in Alzheimer's Cases

Title: U.S. Primary Care Docs Unprepared for Surge in Alzheimer's Cases
Category: Health News
Created: 3/11/2020 12:00:00 AM
Last Editorial Review: 3/11/2020 12:00:00 AM




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Don't Use Pricey New HIV PrEP Drug When Generics Available: Study

Title: Don't Use Pricey New HIV PrEP Drug When Generics Available: Study
Category: Health News
Created: 3/9/2020 12:00:00 AM
Last Editorial Review: 3/10/2020 12:00:00 AM




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Second HIV Patient Reportedly 'Cured'

Title: Second HIV Patient Reportedly 'Cured'
Category: Health News
Created: 3/9/2020 12:00:00 AM
Last Editorial Review: 3/10/2020 12:00:00 AM




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New Study Shakes Up Thinking on Hormone Replacement Therapy

Title: New Study Shakes Up Thinking on Hormone Replacement Therapy
Category: Health News
Created: 12/13/2019 12:00:00 AM
Last Editorial Review: 12/13/2019 12:00:00 AM




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Replace That Old Carpet to Shield Your Kids From Toxins

Title: Replace That Old Carpet to Shield Your Kids From Toxins
Category: Health News
Created: 4/29/2020 12:00:00 AM
Last Editorial Review: 4/30/2020 12:00:00 AM




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First Good Evidence That Brain Hits 'Replay' While You Sleep

Title: First Good Evidence That Brain Hits 'Replay' While You Sleep
Category: Health News
Created: 5/5/2020 12:00:00 AM
Last Editorial Review: 5/6/2020 12:00:00 AM




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Elucidation of Pelareorep Pharmacodynamics in A Phase I Trial in Patients with KRAS-Mutated Colorectal Cancer

KRAS mutation is a negative predictive biomarker of anti-EGFR agents in patients with metastatic colorectal cancer (mCRC), and remains an elusive target. Pelareorep, a double-stranded RNA virus selectively replicates in KRAS-mutated cells, and is synergistic with irinotecan. A dose escalation trial of FOLFIRI/bevacizumab [irinotecan (150–180 mg/m2) and pelareorep (1 x 1010 TCID50–3 x 1010 TCID50)] was implemented in adult patients with oxaliplatin refractory/intolerant, KRAS-mutant mCRC. Pelareorep was administered intravenously over 1 hour on days 1–5 every 4 weeks. Additional studies included pharmacokinetics, tumor morphology, and immune responses. Among FOLFIRI-naïve patients, the highest dose of FOLFIRI/bevacizumab (180 mg/m2 irinotecan) and pelareorep (3 x 1010 TCID50) was well tolerated, without a dose-limiting toxicity. At the recommended phase II dose, 3 of 6 patients (50%) had a partial response; the median progression-free and overall survival (PFS, OS) were 65.6 weeks and 25.1 months, respectively. Toxicities included myelosuppression, fatigue, and diarrhea. Transmission electron microscopy revealed viral factories (viral collections forming vesicular structures), at various stages of development. Immunogold staining against viral capsid -1 protein demonstrated viral "homing" in the tumor cells. The nucleus displayed sufficient euchromatin regions suggestive of active transcription. Flow cytometry revealed rapid dendritic cell maturation (48 hours) with subsequent activation of cytotoxic T cells (7 days). The combination of pelareorep with FOLFIRI/bevacizumab is safe. The PFS and OS data are encouraging and deserve further exploration. Pelareorep leads to a clear recurrent immune stimulatory response with cytotoxic T-cell activation, and homes and replicates in the tumor.




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3D Printed Teeth with Enamel and Dentin Layer for Educating Dental Students in Crown Preparation

Commonly used model teeth are so far uniform in color and hardness. There is no discrimination between enamel and dentin part of a tooth. This condition makes it difficult to train a preparation technique, which is adapted to real tooth substance. The aim of this study was to design and establish a 3D printed tooth with different layers for enamel and dentin for education in crown preparation. A printable tooth with different layers for enamel and dentin was designed, and all 38 fourth-year dental students in the first clinical course in prosthodontics and 30 experienced dentists were trained during a voluntary hands-on course in 2019. Prior to the study, the students had used standard model teeth and real-teeth models in their preclinical education. They had experience in caries removal and preparation on real patients. The perceived benefits of the 3D printed tooth were evaluated by a questionnaire. All individuals in both groups completed the questionnaire, for a 100% response rate. The results showed that the printed tooth was given an overall mean grade of 2.3 (students) and 2.0 (experts) on a scale from 1=excellent to 5=poor. The difference in hardness between the dentin and enamel layer was given a mean of 2.4 (students and experts) and the difference in color a 1.7 (students) and 1.8 (experts). The tooth model with the prepared tooth illustrating an ideal preparation was graded 1.6 (students and experts). In this study, the students had the opportunity to learn a correct crown preparation on a printed tooth with different material properties for enamel and dentin. The learning effect with this tooth model was rated as good on the questionnaire by both students and expert dentists.




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Oral Health-Related Quality of Life of Children: An Assessment of the Relationship between Child and Caregiver Reporting

Purpose: Oral and craniofacial conditions or diseases can impact an individual's health and quality of life. The purpose of this study was to assess the perceived oral health related quality of life (OHRQoL) of children, and evaluate the reported level of agreement between caregivers and their children.Methods: Purposive sampling was used to recruit children ages 8-15, and their caregivers from a dental clinic in a pediatric hospital for this descriptive, cross-sectional study. A modified version of a validated measure, Child Oral Health Impact Profile-Short Form (COHIP-SF), was used for a 22-item questionnaire encompassing three subscales: oral health, functional well-being, and social emotional well-being. Two additional items were included to assess child/caregiver's level of agreement. A dental chart review was also conducted to assess the child's overbite, overjet, and decayed surfaces. Data were analyzed through descriptive statistics and examined for assumptions of normality and linearity.Results: Sixty child/caregiver pairs (n=120) participated in this study. Overbite, overjet and decayed surfaces were not found to be related to any OHRQoL variable, including child/caregiver ratings and overall agreement (p>.05). Average OHRQoL scores for caregivers found to be more positive those of their children (p=.02). Agreement between caregivers and the child's gender was shown to be significant (p=.01). Female child scores differed significantly from males with respect to their caregiver responses (p=.02). Caregivers rated a higher OHRQoL for female children, thus overestimating their female child's reported OHRQoL.Conclusions: The moderate level of agreement found between children and caregivers reinforces the importance of including the child, as well as the caregiver, when assessing OHRQoL.




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Modulation of Monocyte-Driven Myositis in Alphavirus Infection Reveals a Role for CX3CR1+ Macrophages in Tissue Repair

ABSTRACT

Arthritogenic alphaviruses such as Ross River and Chikungunya viruses cause debilitating muscle and joint pain and pose significant challenges in the light of recent outbreaks. How host immune responses are orchestrated after alphaviral infections and lead to musculoskeletal inflammation remains poorly understood. Here, we show that myositis induced by Ross River virus (RRV) infection is driven by CD11bhi Ly6Chi inflammatory monocytes and followed by the establishment of a CD11bhi Ly6Clo CX3CR1+ macrophage population in the muscle upon recovery. Selective modulation of CD11bhi Ly6Chi monocyte migration to infected muscle using immune-modifying microparticles (IMP) reduced disease score, tissue damage, and inflammation and promoted the accumulation of CX3CR1+ macrophages, enhancing recovery and resolution. Here, we detail the role of immune pathology, describing a poorly characterized muscle macrophage subset as part of the dynamics of alphavirus-induced myositis and tissue recovery and identify IMP as an effective immunomodulatory approach. Given the lack of specific treatments available for alphavirus-induced pathologies, this study highlights a therapeutic potential for simple immune modulation by IMP in infected individuals in the event of large alphavirus outbreaks.

IMPORTANCE Arthritogenic alphaviruses cause debilitating inflammatory disease, and current therapies are restricted to palliative approaches. Here, we show that following monocyte-driven muscle inflammation, tissue recovery is associated with the accumulation of CX3CR1+ macrophages in the muscle. Modulating inflammatory monocyte infiltration using immune-modifying microparticles (IMP) reduced tissue damage and inflammation and enhanced the formation of tissue repair-associated CX3CR1+ macrophages in the muscle. This shows that modulating key effectors of viral inflammation using microparticles can alter the outcome of disease by facilitating the accumulation of macrophage subsets associated with tissue repair.




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Peptidoglycan Hydrolases RipA and Ami1 Are Critical for Replication and Persistence of Mycobacterium tuberculosis in the Host

ABSTRACT

Synthesis and cleavage of the cell wall polymer peptidoglycan (PG) are carefully orchestrated processes and are essential for the growth and survival of bacteria. Yet, the function and importance of many enzymes that act on PG in Mycobacterium tuberculosis remain to be elucidated. We demonstrate that the activity of the N-acetylmuramyl-l-alanine amidase Ami1 is dispensable for cell division in M. tuberculosis in vitro yet contributes to the bacterium’s ability to persist during chronic infection in mice. Furthermore, the d,l-endopeptidase RipA, a predicted essential enzyme, is dispensable for the viability of M. tuberculosis but required for efficient cell division in vitro and in vivo. Depletion of RipA sensitizes M. tuberculosis to rifampin and to cell envelope-targeting antibiotics. Ami1 helps sustain residual cell division in cells lacking RipA, but the partial redundancy provided by Ami1 is not sufficient during infection, as depletion of RipA prevents M. tuberculosis from replicating in macrophages and leads to dramatic killing of the bacteria in mice. Notably, RipA is essential for persistence of M. tuberculosis in mice, suggesting that cell division is required during chronic mouse infection. Despite the multiplicity of enzymes acting on PG with redundant functions, we have identified two PG hydrolases that are important for M. tuberculosis to replicate and persist in the host.

IMPORTANCE Tuberculosis (TB) is a major global heath burden, with 1.6 million people succumbing to the disease every year. The search for new drugs to improve the current chemotherapeutic regimen is crucial to reducing this global health burden. The cell wall polymer peptidoglycan (PG) has emerged as a very successful drug target in bacterial pathogens, as many currently used antibiotics target the synthesis of this macromolecule. However, the multitude of genes encoding PG-synthesizing and PG-modifying enzymes with apparent redundant functions has hindered the identification of novel drug targets in PG synthesis in Mycobacterium tuberculosis. Here, we demonstrate that two PG-cleaving enzymes are important for virulence of M. tuberculosis. In particular, the d,l-endopeptidase RipA represents a potentially attractive drug target, as its depletion results in the clearance of M. tuberculosis from the host and renders the bacteria hypersusceptible to rifampin, a frontline TB drug, and to several cell wall-targeting antibiotics.




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Repurposed Drugs That Block the Gonococcus-Complement Receptor 3 Interaction Can Prevent and Cure Gonococcal Infection of Primary Human Cervical Epithelial Cells

ABSTRACT

In the absence of a vaccine, multidrug-resistant Neisseria gonorrhoeae has emerged as a major human health threat, and new approaches to treat gonorrhea are urgently needed. N. gonorrhoeae pili are posttranslationally modified by a glycan that terminates in a galactose. The terminal galactose is critical for initial contact with the human cervical mucosa via an interaction with the I-domain of complement receptor 3 (CR3). We have now identified the I-domain galactose-binding epitope and characterized its galactose-specific lectin activity. Using surface plasmon resonance and cellular infection assays, we found that a peptide mimic of this galactose-binding region competitively inhibited the N. gonorrhoeae-CR3 interaction. A compound library was screened for potential drugs that could similarly prohibit the N. gonorrhoeae-CR3 interaction and be repurposed as novel host-targeted therapeutics for multidrug-resistant gonococcal infections in women. Two drugs, methyldopa and carbamazepine, prevented and cured cervical cell infection by multidrug-resistant gonococci by blocking the gonococcal-CR3 I-domain interaction.

IMPORTANCE Novel therapies that avert the problem of Neisseria gonorrhoeae with acquired antibiotic resistance are urgently needed. Gonococcal infection of the human cervix is initiated by an interaction between a galactose modification made to its surface appendages, pili, and the I-domain region of (host) complement receptor 3 (CR3). By targeting this crucial gonococcal–I-domain interaction, it may be possible to prevent cervical infection in females. To this end, we identified the I-domain galactose-binding epitope of CR3 and characterized its galactose lectin activity. Moreover, we identified two drugs, carbamazepine and methyldopa, as effective host-targeted therapies for gonorrhea treatment. At doses below those currently used for their respective existing indications, both carbamazepine and methyldopa were more effective than ceftriaxone in curing cervical infection ex vivo. This host-targeted approach would not be subject to N. gonorrhoeae drug resistance mechanisms. Thus, our data suggest a long-term solution to the growing problem of multidrug-resistant N. gonorrhoeae infections.




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Reply to Losick, "Concerns about Continuing Claims that a Protein Complex Interacts with the Phosphorelay"




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Merkel Cell Polyomavirus DNA Replication Induces Senescence in Human Dermal Fibroblasts in a Kap1/Trim28-Dependent Manner

ABSTRACT

Merkel cell polyomavirus (MCPyV) is the only polyomavirus known to be associated with tumorigenesis in humans. Similarly to other polyomaviruses, MCPyV expresses a large tumor antigen (LT-Ag) that, together with a small tumor antigen (sT-Ag), contributes to cellular transformation and that is of critical importance for the initiation of the viral DNA replication. Understanding the cellular protein network regulated by MCPyV early proteins will significantly contribute to our understanding of the natural MCPyV life cycle as well as of the mechanisms by which the virus contributes to cellular transformation. We here describe KRAB-associated protein 1 (Kap1), a chromatin remodeling factor involved in cotranscriptional regulation, as a novel protein interaction partner of MCPyV T antigens sT and LT. Kap1 knockout results in a significant increase in the level of viral DNA replication that is highly suggestive of Kap1 being an important host restriction factor during MCPyV infection. Differently from other DNA viruses, MCPyV gene expression is unaffected in the absence of Kap1 and Kap1 does not associate with the viral genome. Instead, we show that in primary normal human dermal fibroblast (nHDF) cells, MCPyV DNA replication, but not T antigen expression alone, induces ataxia telangiectasia mutated (ATM) kinase-dependent Kap1 S824 phosphorylation, a mechanism that typically facilitates repair of double-strand breaks in heterochromatin by arresting the cells in G2. We show that MCPyV-induced inhibition of cell proliferation is mainly conferred by residues within the origin binding domain and thereby by viral DNA replication. Our data suggest that phosphorylation of Kap1 and subsequent Kap1-dependent G2 arrest/senescence represent host defense mechanisms against MCPyV replication in nHDF cells.

IMPORTANCE We here describe Kap1 as a restriction factor in MCPyV infection. We report a novel, indirect mechanism by which Kap1 affects MCPyV replication. In contrast with from other DNA viruses, Kap1 does not associate with the viral genome in MCPyV infection and has no impact on viral gene expression. In MCPyV-infected nHDF cells, Kap1 phosphorylation (pKap1 S824) accumulates because of genomic stress mainly induced by viral DNA replication. In contrast, ectopic expression of LT or LT MCPyV mutants, previously shown to be important for induction of genotoxic stress, does not result in a similar extent of pKap1 accumulation. We show that cells actively replicating MCPyV accumulate pKap1 (in a manner dependent on the presence of ATM) and display a senescence phenotype reflected by G2 arrest. These results are supported by transcriptome analyses showing that LT antigen, in a manner dependent on the presence of Kap1, induces expression of secreted factors, which is known as the senescence-associated secretory phenotype (SASP).




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Vaccine-Induced Th1-Type Response Protects against Invasive Group A Streptococcus Infection in the Absence of Opsonizing Antibodies

ABSTRACT

Recent global advocacy efforts have highlighted the importance of development of a vaccine against group A Streptococcus (GAS). Combo5 is a non-M protein-based vaccine that provides protection against GAS skin infection in mice and reduces the severity of pharyngitis in nonhuman primates. However, Combo5 with the addition of aluminum hydroxide (alum) as an adjuvant failed to protect against invasive GAS infection of mice. Here, we show that formulation of Combo5 with adjuvants containing saponin QS21 significantly improves protective efficacy, even though all 7 adjuvants tested generated high antigen-specific IgG antibody titers, including alum. Detailed characterization of Combo5 formulated with SMQ adjuvant, a squalene-in-water emulsion containing a TLR4 agonist and QS21, showed significant differences from the results obtained with alum in IgG subclasses generated following immunization, with an absence of GAS opsonizing antibodies. SMQ, but not alum, generated strong interleukin-6 (IL-6), gamma interferon (IFN-), and tumor necrosis alpha (TNF-α) responses. This work highlights the importance of adjuvant selection for non-M protein-based GAS vaccines to optimize immune responses and protective efficacy.

IMPORTANCE Availability of a group A Streptococcus vaccine remains an unmet public health need. Here, we tested different adjuvant formulations to improve the protective efficacy of non-M protein vaccine Combo5 in an invasive disease model. We show that novel adjuvants can dramatically shape the type of immune response developed following immunization with Combo5 and significantly improve protection. In addition, protection afforded by Combo5 is not mediated by opsonizing antibodies, believed to be the main correlate of protection against GAS infections. Overall, this report highlights the importance of adjuvant selection in raising protective immune responses against GAS invasive infection. Adjuvants that can provide a more balanced Th1/Th2-type response may be required to optimize protection of GAS vaccines, particularly those based on non-M protein antigens.