Lancet MicrobePub Date : 2025-04-04DOI: 10.1016/j.lanmic.2024.101028
Audrey Godin, Elizabeth B Brickley, Ruth I Connor, Wendy F Wieland-Alter, Margaret E Ackerman, Joshua A Weiner, John Modlin, Minetaro Arita, Ananda S Bandyopadhyay, Chris Gast, Xavier Sáez-Llorens, Ricardo W Rüttimann, Pierre Van Damme, Ilse De Coster, Peter F Wright
{"title":"Intestinal mucosal immune responses induced by novel oral poliovirus vaccine type 2 and Sabin monovalent oral poliovirus vaccine type 2: an analysis of data from four clinical trials.","authors":"Audrey Godin, Elizabeth B Brickley, Ruth I Connor, Wendy F Wieland-Alter, Margaret E Ackerman, Joshua A Weiner, John Modlin, Minetaro Arita, Ananda S Bandyopadhyay, Chris Gast, Xavier Sáez-Llorens, Ricardo W Rüttimann, Pierre Van Damme, Ilse De Coster, Peter F Wright","doi":"10.1016/j.lanmic.2024.101028","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.101028","url":null,"abstract":"<p><strong>Background: </strong>A novel oral polio vaccine type 2 (nOPV2), which is more genetically stable (ie, lower risks of reverting to neurovirulence) than the Sabin monovalent OPV2 (mOPV2), has been deployed to interrupt circulating vaccine-derived poliovirus type 2 (PV2) outbreaks. This study compares intestinal mucosal immune responses induced by nOPV2 and mOPV2.</p><p><strong>Methods: </strong>In this analysis, we evaluated intestinal mucosal immune responses in healthy participants of different ages (ie, infants aged 18-22 weeks, children aged 1-4 years, and adults aged 18-50 years) and vaccine backgrounds (ie, OPV2-experienced vs OPV2-naive). Participants were selected from two phase 2 trials of nOPV2, conducted in 2018-19 (infants and children, NCT03554798 [Panama]; adults, EudraCT 2018-001684-22-NCT04544787 [Belgium]), and two phase 4 historical control trials of mOPV2, conducted in 2015-16 (infants and children, NCT02521974 [Panama]; adults, EudraCT 2015-003325-33 [Belgium]). We measured PV2-specific neutralising activity and IgA concentrations in stools collected before and 14 days after vaccination.</p><p><strong>Findings: </strong>We compared data from 160 participants (ie, 47 infants, 47 children, and 66 adults) in the nOPV2 trials to 188 participants (ie, 42 infants, 46 children, and 100 adults) in the mOPV2 trials. Within each age group, one dose of nOPV2 or mOPV2 induced similar intestinal PV2-specific neutralisation and IgA responses on day 14. Responses diminished with age: among the OPV2-naive participants who received nOPV2, 27 (82%) of 33 infants, 17 (61%) of 28 children, and four (25%) of 16 adults had detectable PV2-specific neutralisation on day 14. Despite having similar median log<sub>10</sub> IgA responses (1·4 [IQR 1·0-2·2] vs 1·4 [1·1-1·7], p=0·34) and median log<sub>2</sub> neutralisation titres (1 [IQR 1-1] vs 1 [1-1·5], p=0·89) on day 14, a smaller percentage of OPV2-experienced adults shed vaccine virus than OPV2-naive adults upon nOPV2 challenge (20% vs 82%, p<0·0001).</p><p><strong>Interpretation: </strong>We found no evidence of differences in the intestinal mucosal immune responses induced by nOPV2 or Sabin mOPV2 and observed the strongest responses in infants.</p><p><strong>Funding: </strong>The Bill & Melinda Gates Foundation, Japan Agency for Medical Research and Development.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"101028"},"PeriodicalIF":20.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lancet MicrobePub Date : 2025-04-03DOI: 10.1016/j.lanmic.2024.101037
Anke Hemmerling, Caroline M Mitchell, Suuba Demby, Musie Gebremichael, Joseph Elsherbini, Jiawu Xu, Nondumiso Xulu, Johnathan Shih, Krista Dong, Vaneshree Govender, Vanessa Pillay, Nasreen Ismail, Gardenia Casillas, Jayajothi Moodley, Agnes Bergerat, Tess Brunner, Lenine Liebenberg, Sinaye Ngcapu, Ian Mbano, Laurel Lagenaur, Thomas P Parks, Thumbi Ndung'u, Douglas S Kwon, Craig R Cohen
{"title":"Effect of the vaginal live biotherapeutic LACTIN-V (Lactobacillus crispatus CTV-05) on vaginal microbiota and genital tract inflammation among women at high risk of HIV acquisition in South Africa: a phase 2, randomised, placebo-controlled trial.","authors":"Anke Hemmerling, Caroline M Mitchell, Suuba Demby, Musie Gebremichael, Joseph Elsherbini, Jiawu Xu, Nondumiso Xulu, Johnathan Shih, Krista Dong, Vaneshree Govender, Vanessa Pillay, Nasreen Ismail, Gardenia Casillas, Jayajothi Moodley, Agnes Bergerat, Tess Brunner, Lenine Liebenberg, Sinaye Ngcapu, Ian Mbano, Laurel Lagenaur, Thomas P Parks, Thumbi Ndung'u, Douglas S Kwon, Craig R Cohen","doi":"10.1016/j.lanmic.2024.101037","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.101037","url":null,"abstract":"<p><strong>Background: </strong>Absence of vaginal lactobacilli and accompanying genital inflammation is associated with HIV acquisition. We aimed to assess how a vaginal live biotherapeutic containing Lactobacillus crispatus affects cervicovaginal microbiota and markers of HIV susceptibility in South African women.</p><p><strong>Methods: </strong>This randomised, placebo-controlled, phase 2 trial evaluated LACTIN-V (L crispatus CTV-05), a vaginal live biotherapeutic, compared with placebo in cisgender women in South Africa, aged 18-23 years, recruited at a community-based research clinic. Eligible participants with a Nugent score of 4-10 (indicating intermediate vaginal microbiota or bacterial vaginosis) completed 7 days of oral metronidazole and were randomly assigned (2:1) to LACTIN-V (2 × 10<sup>9</sup> colony forming units per dose) or placebo (the substrate alone) via an independently generated randomisation sequence. Pharmacists, participants, and investigators were masked to treatment assignment. The study product (or placebo) was dosed daily for 5 days in week 1, then twice per week for an additional 3 weeks. Adverse events were evaluated 4 weeks and 8 weeks after starting the study product. Vaginal swabs (for 16S rRNA sequencing of the vaginal microbiome) and cervicovaginal lavage (for Luminex analysis of immune markers) were collected before metronidazole treatment, before study product (or placebo) administration, and at the week 4 and week 8 follow-up visits. An endocervical cytobrush for flow cytometry analysis of immune cell populations (including CD3<sup>+</sup>CD4<sup>+</sup> T cells, and presence of CCR5 and the activation markers CD38 or HLA-DR) was collected before study product use and at 4 weeks and 8 weeks after study product use. The coprimary outcomes for the trial were (1) safety and acceptability of LACTIN-V, as measured by number of adverse events and a validated questionnaire; (2) presence of a Lactobacillus-dominant vaginal microbial community by 16S rRNA gene sequencing at week 4 and week 8; and (3) comparison of change in genital tract inflammatory markers from before metronidazole treatment to week 4 and week 8 between groups. Safety analyses were done in the intention-to-treat population and efficacy analyses in a modified intent-to-treat population (ie, excluding one person assigned placebo who erroneously received LACTIN-V). This trial is completed and registered on ClinicalTrials.gov (NCT05022212).</p><p><strong>Findings: </strong>45 Black South African women were randomly assigned to receive LACTIN-V (n=32) or placebo (n=13). One woman in each group discontinued the trial during the intervention and two women discontinued during the follow-up. No severe or serious adverse events were observed. Solicited adverse events occurred in 35 (78%) of 45 participants with no significant difference by group (risk ratio 1·17, 95% CI 0·79-1·75; p=0·44). All local solicited adverse events were mild. 32 (71%) of 45 particip","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"101037"},"PeriodicalIF":20.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lancet MicrobePub Date : 2025-04-02DOI: 10.1016/j.lanmic.2025.101131
Akaninyene Otu, Vinesh Patel, Stuart Bond, Sarah Chadwick, Bassey Ebenso, Mamoon Aldeyab, Jade Lee-Milner, Victoria Hemming, Kathyrn Deakin, Maria Marcolin
{"title":"The intersection of socioeconomic deprivation and antimicrobial resistance: refocusing on a key determinant.","authors":"Akaninyene Otu, Vinesh Patel, Stuart Bond, Sarah Chadwick, Bassey Ebenso, Mamoon Aldeyab, Jade Lee-Milner, Victoria Hemming, Kathyrn Deakin, Maria Marcolin","doi":"10.1016/j.lanmic.2025.101131","DOIUrl":"https://doi.org/10.1016/j.lanmic.2025.101131","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"101131"},"PeriodicalIF":20.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lancet MicrobePub Date : 2025-04-01DOI: 10.1016/j.lanmic.2024.100984
Meagan E Deming MD PhD , Prof Elizabeth R Brown ScD , Monica A McArthur MD PhD , Stephanie J Schrag DPhil , Melissa Arvay PhD , Mike Humphrys MS , Prof Jacques Ravel PhD , Jeffrey Adelglass MD , Brandon Essink MD , David B Musante MD , Rebecca Maguire MPH , Richard Gorman MD , Elizabeth Formentini MSN MBA , Robin Mason MS MBA , Merlin L Robb MD , Prof Kathleen M Neuzil MD MPH , Rekha R Rapaka MD PhD , Peter Wolff MHA , Prof Karen L Kotloff MD , Michael Waters
{"title":"Vaccine efficacy of NVX-CoV2373 against SARS-CoV-2 infection in adolescents in the USA: an ancillary study to a phase 3, observer-blinded, randomised, placebo-controlled trial","authors":"Meagan E Deming MD PhD , Prof Elizabeth R Brown ScD , Monica A McArthur MD PhD , Stephanie J Schrag DPhil , Melissa Arvay PhD , Mike Humphrys MS , Prof Jacques Ravel PhD , Jeffrey Adelglass MD , Brandon Essink MD , David B Musante MD , Rebecca Maguire MPH , Richard Gorman MD , Elizabeth Formentini MSN MBA , Robin Mason MS MBA , Merlin L Robb MD , Prof Kathleen M Neuzil MD MPH , Rekha R Rapaka MD PhD , Peter Wolff MHA , Prof Karen L Kotloff MD , Michael Waters","doi":"10.1016/j.lanmic.2024.100984","DOIUrl":"10.1016/j.lanmic.2024.100984","url":null,"abstract":"<div><h3>Background</h3><div>Although existing COVID-19 vaccines are known to be highly effective against severe disease and death, data are needed to assess their ability to reduce SARS-CoV-2 infection. We aimed to estimate the efficacy of the NVX-CoV2373 protein subunit vaccine against SARS-CoV-2 infection, regardless of symptoms, among adolescents.</div></div><div><h3>Methods</h3><div>We performed an ancillary observational study (SNIFF) to the phase 3, observer-blinded, randomised, placebo-controlled PREVENT-19 trial that assessed vaccine efficacy against symptomatic COVID-19 in the USA. Participants in the PREVENT-19 trial included healthy adolescents aged 12–17 years and with no history of laboratory-confirmed SARS-CoV-2 infection. They were randomly assigned (2:1) to receive either the NVX-CoV2373 (Novavax, Gaithersburg, MD, USA) vaccine (immediate NVX-CoV2373 group) or placebo (delayed NVX-CoV2373 group) on days 0 and 21 (initial series). After 2 months, in a crossover series, participants received two doses, 21 days apart, of the intervention that they did not receive in their initial series. Participants at 47 of the PREVENT-19 sites were invited to participate in the SNIFF study and self-collect nasal swabs at home twice weekly for SARS-CoV-2 testing to assess vaccine efficacy against SARS-CoV-2 infection. This primary outcome was defined as the first identification of SARS-CoV-2 detected by RT-PCR, regardless of symptoms, with onset within 4 weeks after the second dose of the initial vaccination series until the second dose of the crossover series. Secondary outcomes were vaccine efficacy against asymptomatic and minimally symptomatic SARS-CoV-2 infection, durability of vaccine efficacy against SARS-CoV-2 infection, and durability of vaccine efficacy against asymptomatic and minimally symptomatic infections. Outcomes were analysed in the modified intention-to-treat population, which included all participants without previous SARS-CoV-2 infection and was restricted to participants enrolled within 4 weeks of the second dose of the primary (primary analysis population) or crossover (post-crossover analysis population) series. This study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT04611802</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between June 1 and Dec 17, 2021, 1196 (53·2%) of the 2247 adolescent participants recruited in the PREVENT-19 trial enrolled in the SNIFF study. The primary analysis population included 471 participants in the immediate NVX-CoV2373 group and 220 in the delayed NVX-CoV2373 group. Incidence of SARS-CoV-2 infection was 14·9 cases per 100 person-years (95% CI 7·9–25·5) in the immediate group and 54·2 cases per 100 person-years (33·6–82·9) in the delayed group; vaccine efficacy was 73·5% (95% CI 47·1–86·7; p=0·0002). Incidence of minimally symptomatic or asymptomatic SARS-CoV-2 infection was 10·3 cases per 100 person-years","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 100984"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lancet MicrobePub Date : 2025-04-01DOI: 10.1016/j.lanmic.2024.101036
Rajesh Parsanathan
{"title":"Reassessing the role of butyrate-producing bacteria in infection risk","authors":"Rajesh Parsanathan","doi":"10.1016/j.lanmic.2024.101036","DOIUrl":"10.1016/j.lanmic.2024.101036","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 101036"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Causes, patterns, and epidemiology of tattoo-associated infections since 1820","authors":"Sunghyun Yoon PhD , Sandeep Kondakala PhD , Soumana Daddy-Gaoh PhD , Steven Foley PhD , Ohgew Kweon PhD , Seong-Jae Kim PhD","doi":"10.1016/j.lanmic.2024.101006","DOIUrl":"10.1016/j.lanmic.2024.101006","url":null,"abstract":"<div><div>Despite increased awareness and public health initiatives, the incidence of microbial infections related to tattoos has increased since 2000. Building on the first paper in this two-part Series, which detailed the microbiological aspects of tattoo-related infections over the past two centuries from 1820 to 2023, this second paper describes the patterns, causes, and other related epidemiological factors of these infections. Since 2000, bacterial outbreaks, particularly those caused by non-tuberculous mycobacteria, have increased, prompting a re-evaluation of tattoos as a serious public health risk. Insufficient hygiene practices have been the primary cause of microbial infections, with contaminated tattoo inks also contributing substantially, leading to 11 outbreaks and subsequent ink recalls. Although rare, the tattooing process can occasionally lead to life-threatening infections and fatalities. Tattoos by both professional and non-professional artists were associated with infections, suggesting that regulated environments do not necessarily eliminate risk. Additionally, individuals with compromised immune systems, especially those with HIV, were particularly vulnerable to infections such as <em>Leishmania</em>. Although permanent make-up is often perceived as safer than conventional tattoos, infections still occur, with 11 cases reported since 2010. Furthermore, polymicrobial infections involving multiple pathogens have posed challenges for diagnosis and treatment. Overall, these insights highlight the historical and emerging patterns of tattoo-related infections and can inform the development of more effective public health guidelines, enhance preventive measures, and guide future research on reducing the risks associated with tattoos.</div></div>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 101006"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lancet MicrobePub Date : 2025-04-01DOI: 10.1016/j.lanmic.2024.100987
Scott Jones PhD , Bethany Hicks BSc , Helen Callaby MRCP , Daniel Bailey PhD , N Claire Gordon DPhil , Tommy Rampling DPhil , Catherine Houlihan PhD , Rachael Jones FRCP , Marcus Pond PhD , Ravi Mehta MRCP , Deborah Wright PGDip , Clarissa Oeser PhD , Simon Tonge MSc , Ezra Linley PhD , Cathy Rowe MSc , Bassam Hallis PhD , Ashley Otter PhD
{"title":"Assessment of MpoxPlex, a high-throughput and multiplexed immunoassay: a diagnostic accuracy study","authors":"Scott Jones PhD , Bethany Hicks BSc , Helen Callaby MRCP , Daniel Bailey PhD , N Claire Gordon DPhil , Tommy Rampling DPhil , Catherine Houlihan PhD , Rachael Jones FRCP , Marcus Pond PhD , Ravi Mehta MRCP , Deborah Wright PGDip , Clarissa Oeser PhD , Simon Tonge MSc , Ezra Linley PhD , Cathy Rowe MSc , Bassam Hallis PhD , Ashley Otter PhD","doi":"10.1016/j.lanmic.2024.100987","DOIUrl":"10.1016/j.lanmic.2024.100987","url":null,"abstract":"<div><h3>Background</h3><div>In May, 2022, the first global outbreak of mpox (formerly known as monkeypox) occurred. In response, public health agencies in the UK have made smallpox vaccines available to individuals at the highest risk of infection. With mpox cases still being detected globally, novel tools are required to aid with diagnosis, serosurveillance, and the evaluation of immune responses following infection and immunisation with current and new vaccine candidates. Here, we describe the development of a multiplexed immunoassay, MpoxPlex, able to measure IgG responses to 12 <em>Orthopoxvirus</em> antigens concurrently and distinguish between responses to infection and vaccination.</div></div><div><h3>Methods</h3><div>Using the Luminex (DiaSorin, Saluggia, Italy) platform, antibody responses to vaccinia virus (VACV) antigens B5, A27, and A33 and monkeypox virus (MPXV) antigens E8, B6, B2, M1, A27, A35, H3, A29, and A5 were assessed in serum from individuals after MPXV infection (n=24) and after vaccination (n=75) with modified VACV Ankara-Bavarian Nordic. Assay characteristics and cutoffs were calculated by fitting receiver operating characteristic curves to the median fluorescence intensities of these positive samples and negative samples that were run alongside (n=435). P values were calculated using non-parametric Mann–Whitney, Kruskal–Wallis, and Dunn’s multiple comparisons tests.</div></div><div><h3>Findings</h3><div>Using the results from a combination of eight antigens, we were able to distinguish samples as either post-vaccination or post-infection from negative samples with a sensitivity of 98% and a specificity of 95%. IgG responses to MPXV antigen A27 were able to distinguish post-MPXV infection with a sensitivity of 88% and a specificity of 97%. VACV antigen A27 and MPXV antigens A29 and A5 provided little diagnostic advantage.</div></div><div><h3>Interpretation</h3><div>With additional benefits over current serological assays, we believe this assay will provide substantial insight into the current global outbreak of mpox. MpoxPlex shows use for both serosurveillance and immunological studies of vaccination and infection.</div></div><div><h3>Funding</h3><div>Grant-in-aid funding to the Emerging Pathogen Serology Group at Porton Down, UK Health Security Agency.</div></div>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 100987"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}