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At least 235 records · Page 13Linked to original sources
PubMed2006

Economic evaluation of varicella vaccination in Spain: results from a dynamic model.

Varicella is a universal childhood disease in Spain, causing approximately 400,000 cases, 1,500 hospitalizations and 15 deaths every year. The aim of this study is to determine the economic impact of childhood varicella vaccination on the burden of disease and associated costs by using a dynamic model. The analysis is based on the varicella transmission model developed by Halloran and adapted to the Spanish context. Cost data (Euro, 2004) were derived from previous studies and official tariffs. Two vaccination scenarios were analysed: (1) routine vaccination program for children aged 1-2 years, and (2) routine vaccination program for children aged 1-2 years completed by a catch-up program during the first year of vaccine marketing for children aged 2-11 years. The analysis considers that a similar coverage rate to the MMR one would be achieved (97.15%). A societal perspective, including direct and indirect costs, and a health care payor perspective were adopted. A probabilistic sensitivity analysis was performed. A routine vaccination program has a positive impact on varicella-related morbidity: the number of varicella cases is estimated to be reduced by 89%, and 1230 hospitalizations are prevented. From the societal perspective, scenario (1) is cost-saving whether or not indirect costs are considered (-51 and -4%, respectively). From the Health Care System the strategy is cost-effective, with a cost-effectiveness ratio estimated at 3,982 Euro per life-year gained, although it leads to a small increase in the costs. Considering the impact of vaccination on morbidity and costs, a routine childhood vaccination program against varicella is worth while in Spain without taking into account the potential impact on HZ.

Adolescent↗
PubMed2006

Enhancement of neutralizing activity of influenza virus-specific antibodies by serum components.

The role of serum components in enhancing virus neutralizing (VN) activity of influenza virus A/PR/8/34 hemagglutinin (HA)-specific MAbs in vitro was investigated. The degree of enhancement depended on the MAb's fine specificity and heavy chain isotype and on type of serum. Greatest enhancement (>100-fold) was seen with sera from immunodeficient mice that lacked serum immunoglobulin. At least two serum components were involved: C1q and a heat-resistant factor. C1q was mandatory for enhancement, and other components of the complement system were not required. C1q appeared to operate by improving MAb-mediated inhibition of virus attachment to host cells and was most effective with MAbs that inhibited virus attachment poorly on their own. The heat-resistant factor enhanced VN activity only in the presence of C1q and appeared to operate by enhancing VN activity at a post-attachment stage.

Animals↗
PubMed2002

Probing T cell membrane organization using dimeric MHC-Ig complexes.

In this report, we review a novel method for probing the membrane organization of T cells using dimeric major histocompatibility complexes (MHC), MHC-Ig. MHC-Ig complexes are useful reagents for quantitative analysis of binding data since their valency is controlled. These complexes can be easily labeled and loaded with a variety of peptides. A binding assay using these dimers and quantitative analysis of the MHC-Ig dimer-T cell binding curves is described in detail. Using this approach, we show that the organization of TCR on activated T cells is different from TCR organization on nai;ve T cells. The implications of these findings are discussed with regards to current models of T cell recognition. This analysis offers insight into how T cell controls their biological range of responsiveness. Specifically, these findings reveal the biophysical basis of the ability of activated T cells to recognize low amounts of antigen independent of costimulation.

Animals↗
PubMed2003

The rescaling method for quantifying the turnover of cell populations.

The dynamic nature of immune responses requires the development of appropriate experimental and theoretical tools to quantitatively estimate the division and death rates which determine the turnover of immune cells. A number of papers have used experimental data from BrdU and D-glucose labels together with a simple random birth-death model to quantify the turnover of immune cells focusing on HIV/SIV infections [Mohri et al. 279 (1998) 1223-1227, Hellerstein et al. 5 (1999) 83-89, Bonhoeffer et al. 164 (2000) 5049-5054, Mohri et al. 87 (2001) 1277-1287]. We show how uncertainties in the assumptions of the random birth-death model may lead to substantial errors in the parameters estimated. We then show how more accurate estimates can be obtained from the more recent CFSE data which allow to track the number of divisions each cell has undergone. Specifically, we: (i) describe a general stage-structured model of cell division where the probabilities of division and death are functions of time since the previous division; (ii) develop a rescaling method to identify invariant parameters (i.e. the ones that are independent of the specific functions describing division and death); (iii) show how these invariant parameters can be estimated, and (iv) illustrate this technique by applying it to CFSE data taken from the literature.

Adoptive Transfer↗
PubMed2003

The critical vaccination fraction for heterogeneous epidemic models.

Given a population with m heterogeneous subgroups, a method is developed for determining minimal vaccine allocations to prevent an epidemic by setting the reproduction number to 1. The framework is sufficiently general to apply to several epidemic situations, such as SIR, SEIR and SIS models with vital dynamics. The reproduction number is the largest eigenvalue of the linearized system round the local point of equilibrium of the model. Using the Perron-Frobenius theorem, an exact method for generating solutions is given and the threshold surface of critical vaccine allocations is shown to be a compact, connected subset of a regular (m-1)-dimensional manifold. Populations with two subgroups are examined in full. The threshold curves are either hyperbolas or straight lines. Explicit conditions are given as to when threshold elimination is achievable by vaccinating just one or two groups in a multi-group population and expressions for the critical coverage are derived. Specific reference is made to an influenza A model. Separable or proportionate mixing is also treated. Conditions are conjectured for convexity of the threshold surface and the problem of minimizing the amount of vaccine used while remaining on the threshold surface is discussed.

Child↗
PubMed1998

Dynamic phenotypic restructuring of the CD4 and CD8 T-cell subsets with age in healthy humans: a compartmental model analysis.

In healthy humans, phenotypic restructuring occurs with age within the CD3+ T-lymphocyte complement. This is characterized by a non-linear decrease of the percentage of 'naive' (CD45RA+) cells and a corresponding non-linear increase of the percentage of 'memory' (CD45R0+) cells among both the CD4+ and CD8+ T-cell subsets. We devised a simple compartmental model to study the age-dependent kinetics of phenotypic restructuring. We also derived differential equations whose parameters determined yearly gains minus losses of the percentage and absolute numbers of circulating naive cells, yearly gains minus losses of the percentage and absolute numbers of circulating memory cells, and the yearly rate of conversion of naive to memory cells. Solutions of these evaluative differential equations demonstrate the following: (1) the memory cell complement 'resides' within its compartment for a longer time than the naive cell complement within its compartment for both CD4 and CD8 cells; (2) the average, annual 'turnover rate' is the same for CD4 and CD8 naive cells. In contrast, the average, annual 'turnover rate' for memory CD8 cells is 1.5 times that of memory CD4 cells; (3) the average, annual conversion rate of CD4 naive cells to memory cells is twice that of the CD8 conversion rate; (4) a transition in dynamic restructuring occurs during the third decade of life that is due to these differences in turnover and conversion rates, between and from naive to memory cells.

Adolescent↗
PubMed2002

Quantitative aspects of signal transduction by the receptor with high affinity for IgE.

Identification of the major components, how these interact with each other, and the modifications that follow in the sequence of events triggered by the receptor with high affinity for IgE, is progressing rapidly. A new challenge is to understand these interactions quantitatively. We present the fundamentals of the mechanistic model we are testing through mathematical modeling. The object is to see if the predictions of the model fit with the experimental results.

Animals↗
PubMed2002

A quantitative approach for studying IgE-FcepsilonRI aggregation.

Aggregation of cell surface receptors is a ubiquitous means of initiating signal transduction in many cellular systems. In this manuscript, we describe a combined theoretical and experimental approach based on multiparameter flow cytometry for measuring the time course of ligand induced aggregation of IgE-FcepsilonRI on RBL cells. By fluorescently labeling both the ligand and surface IgE (sIgE), we have developed an assay that permits us to simultaneously measure both occupancy of sIgE combining sites and association of antigen with the cell surface. This allows for a direct calculation of the degree of receptor aggregation present on the cell. By employing new mixing technologies developed for flow cytometry, we are able to look at aggregation in the sub second time domain. To extend our work, we have synthesized a new set of chemically well defined ligands (of valences 1-3) to use as probes in our studies. We show that the magnitude of the cellular response is dramatically increased as the valence of our ligand is raised from two to three.

Animals↗
PubMed2003

Accessory proteins and the assembly of human class I MHC molecules: a molecular and structural perspective.

The cell-surface presentation of antigenic peptides by class I major histocompatibility complex (MHC) molecules to CD8+ T-cell receptors is part of an immune surveillance mechanism aimed at detecting foreign antigens. This process is initiated in the endoplasmic reticulum (ER) with the folding and assembly of class I MHC molecules which are then transported to the cell surface via the secretory pathway. In recent years, several accessory proteins have been identified as key components of the class I maturation process in the ER. These proteins include the lectin chaperones calnexin (CNX) and calreticulin (CRT), the thiol-dependent oxidoreductase ERp57, the transporter associated with antigen processing (TAP), and the protein tapasin. This review presents the most recent advances made in characterizing the biochemical and structural properties of these proteins, and discusses how this knowledge advances our current understanding of the molecular events underlying the folding and assembly of human class I MHC molecules in the ER.

Antigen Presentation↗
PubMed1999

Molecular analysis of the combining site of a monoclonal antibody against spermine.

The structural basis of the binding of the polyamine spermine to the monoclonal antibody SPM8-2 was studied using computer modelling, ELISA methods and chemical modifications of the binding site residues. Paratope modelling showed that the antibody combining site forms a highly negatively charged cavity mainly shaped by aspartic acid and tyrosine residues which contact the tetra-positively charged spermine molecule by electrostatic interactions and hydrogen bondings. The importance of the electrostatic environment for spermine binding to SPM8-2 is emphasised by the strong dependency on pH and ionic strength. Specific chemical modifications of carboxylate groups and tyrosine residues of the antibody adsorbed to microtiter plates resulted in decreased binding of the N1-biotin-spermine conjugate used to monitor the activity of the antibody. These observations are consistent with a key role of aspartate and tyrosine residues in complex formation with spermine. These studies, important to our understanding of antibody-hapten specificity, may also shed light on important motifs responsible for protein-polyamine interactions.

Amino Acid Sequence↗
PubMed2002

The structure of Fc receptor/Ig complexes: considerations on stoichiometry and potential inhibitors.

Recently, Fc receptors for immunoglobulins moved further into the focus of pure and applied research as a role in the induction and development of autoimmune diseases and allergies is becoming more probable. Indeed by connecting the humoral with the cellular immune response FcRs possess an important role in the immune system in which the initial, crucial step is the binding of an immunoglobulin to the cell bound receptor. Thereafter a variety of effector functions depending on the cell and the receptor is triggered. This key event could recently be visualised with the solution of the crystal structure of a human Fc receptor in complex with its native ligand the Fc fragment of IgG1. In this paper the reasons for a 1:1 stoichiometry between Fc receptor and Fc Fragment and the medical applications of potential inhibitors of complex formation are highlighted.

Autoimmune Diseases↗
PubMed2000

Molecular interactions of coreceptor CD8 and MHC class I: the molecular basis for functional coordination with the T-cell receptor.

In recent years, substantial progress has been made towards understanding the molecular basis for CD8 binding to class I MHC and the coreceptor's role in cytotoxic T-cell activation. Here, we review the structural, mechanistic and functional studies that point to a model of coordination of T-cell receptor and CD8 signaling that might provide the key to cytotoxic T-cell activation.

Animals↗
PubMed2002

Comparison of the cost and effectiveness of two strategies for maintaining hepatitis B immunity in hemodialysis patients.

A decision-analysis model was developed to compare the strategies to maintain hepatitis B virus (HBV) immunity in hemodialysis patients who responded to the primary HBV vaccine. Our hypothesis is that the routine, annual administration of the vaccine booster to all hemodialysis patients (non-screening strategy) is more cost-effective than the current strategy of vaccination based on anti-HBs titers (screening strategy). Under baseline assumptions, the screening strategy was less costly and was associated with fewer HBV infections than the non-screening strategy. The results of our model did not support our hypothesis, and indicate that regularly screening patients for HBV immunity before revaccination is less costly and more effective than the empiric vaccination of hemodialysis patients.

Algorithms↗
PubMed2003

Foot-and-mouth disease vaccine potency testing: determination and statistical validation of a model using a serological approach.

European foot-and-mouth disease vaccine manufacturers are required to quantify the efficacy of their product in accordance with the European Pharmacopoeia (EP). The method used most often to establish the potency of foot-and-mouth disease vaccines requires viral challenge of vaccinated cattle. Alternative approaches, such as challenge-free serological assessments have many advantages over existing methods and could be used if robust statistical models could be developed that related antibody titres to protection from challenge. Logistic regression analysis of data from two independent research laboratories, representing six of the seven main serotypes of FMD, permitted the parameterisation of these models and indicated that a significant relationship existed between antibody titre and probability of protection. Furthermore, no significant differences were observed in the parameters of logistic models fitted to different strains within the serotypes A, O, and SAT-3, or when strains from serotypes A, O, and Asia-1, or SAT-1 and SAT-3, were combined. However, significant differences in the model parameters did exist between different laboratories. Using these models a bootstrap analysis suggested that for vaccines that induced consistently high titres, as few as six to eight individual animals could be used to establish with confidence the minimum protective doses that would protect 50% of vaccinated animals. We conclude that a serologically evaluated truncated test that eliminates the need to virus challenge cattle is a credible alternative for quantifying vaccine potency.

Algorithms↗
PubMed1998

Modelling the incidence of measles in Canada: an assessment of the options for vaccination policy.

A range of vaccination policy options for improving the control of measles in Canada is investigated using a mathematical model to simulate transmission of the disease. Results suggest that a catch up campaign giving a second dose of vaccine to children aged up to 18 years would have an immediate impact on transmission, which could be maintained by the introduction of a routine second dose at either 18 months or 5 years of age. Introducing a routine second dose of vaccine without a catch up campaign would allow continued endemic transmission of measles among older children for at least 10-15 years.

Adolescent↗
PubMed2001

The role of the DR4 shared epitope in selection and commitment of autoreactive T cells in rheumatoid arthritis.

The mechanistic basis for HLA associations with RA is still unknown in spite of 20 years of disease association studies and a detailed characterization of HLA class II alleles associated with disease. Analysis of the structural interactions between DR4 susceptibility molecules and T cells specific for the peptide-MHC complex suggests a mechanism for directed T-cell selection and amplification in which RA-associated genetic polymorphisms bias intermolecular recognition. New immunologic models for illustrating the importance of regulated thresholds for T-cell activation based on avidity between the TCR, MHC, and peptide offer insight into a potential mechanism in which the disease-associated HLA molecules create an autoimmune-prone individual by virtue of a biased TCR selection and T-cell amplification process. New tools such as the use of HLA-DR4 tetramers provide the ability to identify and monitor the presence of such autoreactive T cells in the periphery of individuals and patients and should assist in further testing of the multistep model for RA pathways presented in this article.

Arthritis, Rheumatoid↗