Management of trichobezoar: case report and literature review

Trichobezoars (hair ball) are usually located in the stomach, but may extend through the pylorus into the duodenum and small bowel (Rapunzel syndrome). They are almost always associated with trichotillomania and trichophagia or other psychiatric disorders. In the literature several treatment options are proposed, including removal by conventional laparotomy, laparoscopy and endoscopy. We present our experience with four patients and provide a review of the recent literature. According to our experience and in line with the published results, conventional laparotomy is still the treatment of choice. In addition, psychiatric consultation is necessary to prevent relapses

Modulations of the Chicken Cecal Microbiome and Metagenome in Response to Anticoccidial and Growth Promoter Treatment

With increasing pressures to reduce or eliminate the use of antimicrobials for growth promotion purposes in production animals, there is a growing need to better understand the effects elicited by these agents in order to identify alternative approaches that might be used to maintain animal health. Antibiotic usage at subtherapeutic levels is postulated to confer a number of modulations in the microbes within the gut that ultimately result in growth promotion and reduced occurrence of disease. This study examined the effects of the coccidiostat monensin and the growth promoters virginiamycin and tylosin on the broiler chicken cecal microbiome and metagenome. Using a longitudinal design, cecal contents of commercial chickens were extracted and examined using 16S rRNA and total DNA shotgun metagenomic pyrosequencing. A number of genus-level enrichments and depletions were observed in response to monensin alone, or monensin in combination with virginiamycin or tylosin. Of note, monensin effects included depletions of Roseburia, Lactobacillus and Enterococcus, and enrichments in Coprococcus and Anaerofilum. The most notable effect observed in the monensin/virginiamycin and monensin/tylosin treatments, but not in the monensin-alone treatments, was enrichments in Escherichia coli. Analysis of the metagenomic dataset identified enrichments in transport system genes, type I fimbrial genes, and type IV conjugative secretion system genes. No significant differences were observed with regard to antimicrobial resistance gene counts. Overall, this study provides a more comprehensive glimpse of the chicken cecum microbial community, the modulations of this community in response to growth promoters, and targets for future efforts to mimic these effects using alternative approaches

CD4-Independent Human Immunodeficiency Virus Infection Involves Participation of Endocytosis and Cathepsin B

During a comparison of the infectivity of mNDK, a CD4-independent human immunodeficiency virus type 1 (HIV-1) strain, to various cell lines, we found that HeLa cells were much less susceptible than 293T and TE671 cells. Hybridoma cells between HeLa and 293T cells were as susceptible as 293T cells, suggesting that cellular factors enhance the mNDK infection in 293T cells. By screening a cDNA expression library in HeLa cells, cystatin C was isolated as an enhancer of the mNDK infection. Because cathepsin B protease, a natural ligand of cystatin C, was upregulated in HeLa cells, we speculated that the high levels of cathepsin B activities were inhibitory to the CD4-independent infection and that cystatin C enhanced the infection by impairing the excessive cathepsin B activity. Consistent with this idea, pretreatment of HeLa cells with 125 µM of CA-074Me, a cathepsin B inhibitor, resulted in an 8-fold enhancement of the mNDK infectivity. Because cathepsin B is activated by low pH in acidic endosomes, we further examined the potential roles of endosomes in the CD4-independent infection. Suppression of endosome acidification or endocytosis by inhibitors or by an Eps15 dominant negative mutant reduced the infectivity of mNDK in which CD4-dependent infections were not significantly impaired. Taken together, these results suggest that endocytosis, endosomal acidification, and cathepsin B activity are involved in the CD4-independent entry of HIV-1

Contribution of Intrinsic Reactivity of the HIV-1 Envelope Glycoproteins to CD4-Independent Infection and Global Inhibitor Sensitivity

Human immunodeficiency virus (HIV-1) enters cells following sequential activation of the high-potential-energy viral envelope glycoprotein trimer by target cell CD4 and coreceptor. HIV-1 variants differ in their requirements for CD4; viruses that can infect coreceptor-expressing cells that lack CD4 have been generated in the laboratory. These CD4-independent HIV-1 variants are sensitive to neutralization by multiple antibodies that recognize different envelope glycoprotein epitopes. The mechanisms underlying CD4 independence, global sensitivity to neutralization and the association between them are still unclear. By studying HIV-1 variants that differ in requirements for CD4, we investigated the contribution of CD4 binding to virus entry. CD4 engagement exposes the coreceptor-binding site and increases the “intrinsic reactivity” of the envelope glycoproteins; intrinsic reactivity describes the propensity of the envelope glycoproteins to negotiate transitions to lower-energy states upon stimulation. Coreceptor-binding site exposure and increased intrinsic reactivity promote formation/exposure of the HR1 coiled coil on the gp41 transmembrane glycoprotein and allow virus entry upon coreceptor binding. Intrinsic reactivity also dictates the global sensitivity of HIV-1 to perturbations such as exposure to cold and the binding of antibodies and small molecules. Accordingly, CD4 independence of HIV-1 was accompanied by increased susceptibility to inactivation by these factors. We investigated the role of intrinsic reactivity in determining the sensitivity of primary HIV-1 isolates to inhibition. Relative to the more common neutralization-resistant (“Tier 2-like”) viruses, globally sensitive (“Tier 1”) viruses exhibited increased intrinsic reactivity, i.e., were inactivated more efficiently by cold exposure or by a given level of antibody binding to the envelope glycoprotein trimer. Virus sensitivity to neutralization was dictated both by the efficiency of inhibitor/antibody binding to the envelope glycoprotein trimer and by envelope glycoprotein reactivity to the inhibitor/antibody binding event. Quantitative differences in intrinsic reactivity contribute to HIV-1 strain variability in global susceptibility to neutralization and explain the long-observed relationship between increased inhibitor sensitivity and decreased entry requirements for target cell CD4

Correction to: Body-color plasticity of the English grain aphid in response to light in both laboratory and field conditions (Evolutionary Ecology, (2021), 35, 1, (147-162), 10.1007/s10682-020-10088-4)

International audienceIn the original publication of the article, the second last sentence in the abstract was published incorrectly. The sentence “it is possible to turn aphids from red back to green within a few days, and from green back to red within a couple of weeks (low-to-high and high-tolow light intensities, respectively)” should read as “it is possible to turn aphids from green back to red within a few days, and from red back to green within a couple of weeks (lowto- high and high-to-low light intensities, respectively)”. The original article has been corrected. © 2020, Springer Nature Switzerland AG

Immunogenicity of Two Doses of ChAdOx1 nCoV-19 Vaccine in Lung Transplant Recipients

Purpose Lung transplant recipients (LTR) are at higher risk to develop severe SARS-CoV2 pneumonia, due to the immunosuppressive regimen, which further hampers their immune response to vaccination. Indeed, is has been shown that LTR mount weak antibody response after SARS-CoV2 mRNA vaccination. Nevertheless, the immunogenicity of ChAdOx1 nCoV-19 vaccine has not yet been studied in LTR. Methods 49 lung-transplant SARS-CoV2 seronegative recipients were enrolled in a prospective cohort study and received the two doses regimen, day 0 and day 90, of the ChAdOx1 nCoV-19 vaccine. Immune response was assessed by measuring total anti-SARS-CoV2 antibodies (Anti-SARS-CoV2 total Ig immunoassay, Ortho Clinical Diagnostics, USA) at D0, D24, D84, D112 and D180. Endpoints At D180, 25% of LTR had positive total antibody levels (positivity threshold, > 1 (sample signal/threshold value). Age, CMV status, gender and initial respiratory disease had no influence on the immune response. Immune response was improved in patients whose immunosuppressive regimen did not include mycophenolate mofetil (53% versus 0%, p < 0.0001), and in patients who were transplanted for more than 18 months (0% versus 41%, p < 0.05), probably due to more aggressive immunosuppressive regimen in recently transplanted patients. Conclusions Immunogenicity of ChAdOx1 nCoV-19 vaccine is poor in LTR, with only one in four patients mounting significant anti-SARS-CoV2 immune response at D180. Of note, according to expert recommendations, most LTR received an heterologous booster dose with a SARS-CoV2 mRNA vaccine (BNT162b2). Additional serological analyses are planned to decipher whether vaccinal response is improved after the third dose in LTR. Results will be updated accordingly and presented at the 42nd ISHLT Congress