18 results on '"Isabel Nájera"'
Search Results
2. Retreatment with HBV siRNA Results in Additional Reduction in HBV Antigenemia and Immune Stimulation in the AAV-HBV Mouse Model
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Ellen Van Gulck, Nádia Conceição-Neto, Liese Aerts, Wim Pierson, Lore Verschueren, Mara Vleeschouwer, Vinod Krishna, Isabel Nájera, and Frederik Pauwels
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liver ,T-cell exhaustion ,sequencing ,Trem2 ,hepatitis surface antigen ,Microbiology ,QR1-502 - Abstract
Background and Aims: Treatment with siRNAs that target HBV has demonstrated robust declines in HBV antigens. This effect is also observed in the AAV-HBV mouse model, which was used to investigate if two cycles of GalNAc-HBV-siRNA treatment could induce deeper declines in HBsAg levels or prevent rebound, and to provide insights into the liver immune microenvironment. Methods: C57Bl/6 mice were transduced with one of two different titers of AAV-HBV for 28 days, resulting in stable levels of HBsAg of about 103 or 105 IU/mL. Mice were treated for 12 weeks (four doses q3wk) per cycle with 3 mg/kg of siRNA-targeting HBV or an irrelevant sequence either once (single treatment) or twice (retreatment) with an 8-week treatment pause in between. Blood was collected to evaluate viral parameters. Nine weeks after the last treatment, liver samples were collected to perform phenotyping, bulk RNA-sequencing, and immunohistochemistry. Results: Independent of HBsAg baseline levels, treatment with HBV-siRNA induced a rapid decline in HBsAg levels, which then plateaued before gradually rebounding 12 weeks after treatment stopped. A second cycle of HBV-siRNA treatment induced a further decline in HBsAg levels in serum and the liver, reaching undetectable levels and preventing rebound when baseline levels were 103 IU/mL. This was accompanied with a significant increase in inflammatory macrophages in the liver and significant upregulation of regulatory T-cells and T-cells expressing immune checkpoint receptors. Conclusions: Retreatment induced an additional decline in HBsAg levels, reaching undetectable levels when baseline HBsAg levels were 3log10 or less. This correlated with T-cell activation and upregulation of Trem2.
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- 2024
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3. Sustained Liver HBsAg Loss and Clonal T- and B-Cell Expansion upon Therapeutic DNA Vaccination Require Low HBsAg Levels
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Nádia Conceição-Neto, Wim Pierson, Maurizio Vacca, Matthias Beyens, Ben De Clerck, Liese Aerts, Birgit Voeten, Dorien De Pooter, Lore Verschueren, Koen Dockx, Mathias Vandenberk, Ewoud De Troyer, Kato Verwilt, Carl Van Hove, Mieke Verslegers, Leslie Bosseler, Marjolein Crabbe, Vinod Krishna, Isabel Nájera, and Ellen Van Gulck
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HBV ,single-cell-RNA sequencing ,liver ,cytotoxic CD8 T cells ,CD4 follicular helper T cells ,vaccine ,Medicine - Abstract
Background: Suppression of HBV DNA, inhibition of HBV surface (HBsAg) production and therapeutic vaccination to reverse HBV-specific T-cell exhaustion in chronic HBV patients are likely required to achieve a functional cure. In the AAV-HBV mouse model, therapeutic vaccination can be effective in clearing HBV when HBsAg levels are low. Using a single-cell approach, we investigated the liver immune environment with different levels of HBsAg and sustained HBsAg loss through treatment with a GalNAc-HBV-siRNA followed by therapeutic vaccination. Methods: AAV-HBV-transduced C57BL/6 mice were treated with GalNAc-HBV-siRNA to lower HBsAg levels and then vaccinated using a DNA vaccine. We used single-cell RNA and V(D)J sequencing to understand liver immune microenvironment changes. Results: GalNAc-HBV-siRNA, followed by therapeutic vaccination, achieved sustained HBsAg loss in all mice. This was accompanied by CD4 follicular helper T-cell induction, polyclonal activation of CD8 T cells and clonal expansion of plasma cells that were responsible for antibody production. Conclusions: This study provides novel insights into liver immune changes at the single-cell level, highlighting the correlation between induced reduction of HBsAg levels and clonal expansion of CD4, CD8 T cells and plasma cells in the liver upon HBV siRNA and subsequent therapeutic vaccination.
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- 2023
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4. Mericitabine and Either Boceprevir or Telaprevir in Combination with Peginterferon Alfa-2a plus Ribavirin for Patients with Chronic Hepatitis C Genotype 1 Infection and Prior Null Response: The Randomized DYNAMO 1 and DYNAMO 2 Studies.
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Heiner Wedemeyer, Xavier Forns, Christophe Hézode, Samuel S Lee, Astrid Scalori, Athina Voulgari, Sophie Le Pogam, Isabel Nájera, and James A Thommes
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Medicine ,Science - Abstract
Most patients with chronic hepatitis C virus (HCV) genotype 1 infection who have had a previous null response (
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- 2016
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5. Optimization of Modified Atmosphere Packaging for Sheep’s Milk Semi-Hard Cheese Wedges during Refrigerated Storage: Physicochemical and Sensory Properties
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Marta Albisu, Sonia Nieto, Olaia Martínez, María Ángeles Bustamante, Luis Javier R. Barron, and Ana Isabel Nájera
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Health (social science) ,modified atmosphere packaging ,vacuum ,sensory properties ,Plant Science ,cheese wedges ,ripened cheese preservation ,Health Professions (miscellaneous) ,Microbiology ,Food Science - Abstract
Modified atmosphere packaging (MAP) has become a good potential strategy to retain quality throughout the shelf life of perishable foods. The aim of this work was to evaluate different packaging atmospheres on semi-hard protected designation of origin Idiazabal cheese wedges. Six different packaging treatments (air, vacuum, and CO2/N2 gas mixtures in the ratio of 20/80, 50/50, 80/20, and 100/0% v/v, respectively) were studied. Changes in gas headspace composition, cheese gross composition, weight loss, pH, acidity, colour, and textural and sensory properties were investigated during 56 days of refrigerated storage at 5 ± 1 °C. MAP was the most effective preserving technique compared to air- and vacuum-packaging treatments. The cheese characteristics with the greatest discriminating weight in the preservation techniques were paste appearance, holes, flavour, a* (redness) and b* (yellowness) colour parameters, and slope to hardness. Air-packaged cheeses, on 35 day, presented a mouldy flavour. Vacuum packaging affected paste appearance (greasy, plastic marks, and non-homogeneous colour) and holes (occluded and unnatural appearance) starting after 14 packaging days. MAP mixtures with CO2 concentration between 50/50 and 80/20% CO2/N2 (v/v) are recommended to ensure sensory quality and stability in the distribution of these raw sheep-milk cheese wedges. The Basque Government (Consolidated Research Group IT944-16 and IT1568-22) provided financial support. Vitoria-Gasteiz, Spain.
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- 2023
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6. An In-Patient Nursing Documentation Application for Smart Phones
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Néstor J. Rodríguez, José A. Borges, Isabel Nájera, Joseph Marrero, Miguel A. Aleman, and Carlos A. Rivera
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It is a widely known fact that mobile hardware and software technologies are exponentially evolving. Even though the health industry is taking advantage of these technological advances, very little has been accomplished from a nursing perspective of electronic medical records documentation applications. Nursing tasks remain mostly documented via rudimentary, inefficient, and time-consuming pen and paper methods. There is very little research literature regarding the use electronic devices for nursing documentation. In this article we describe a nursing documentation system implemented for the Android platform running on smart phones. The system is a successor of a previous PDA-based nursing documentation system. The general functionality of the original PDA-based system is described as well as the validation of the user interfaces of the system. The new smart phone-based system is described and at the same time contrasted with the PDA-based system in terms of their user interfaces and interaction paradigms. In general, the transition from the PDA version to the smart phone version was painless because it was possible to transfer most of the user interface paradigms from de PDA system and also reuse the database that held its electronic medical record. We expect the new system to be more agile in terms of interaction because of the improved interaction paradigms of smart phones and also because many nurses will be using it on a very familiar device.
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- 2021
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7. Seasonal changes in the composition of bulk raw ewe's milk used for Idiazabal cheese manufacture
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Barron, Luis Javier R., Fernández de Labastida, Eva, Perea, Susana, Chávarri, Felisa, de Vega, Carmen, Soledad Vicente, Marı́a, Isabel Torres, Marı́a, Isabel Nájera, Ana, Virto, Mailo, Santisteban, Aránzazu, Pérez-Elortondo, Francisco José, Albisu, Marta, Salmerón, Jesús, Mendı́a, Carlos, Torre, Paloma, Clemente Ibáñez, Francisco, and de Renobales, Mertxe
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- 2001
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8. mRNA Therapeutic Vaccine for Hepatitis B Demonstrates Immunogenicity and Efficacy in the AAV-HBV Mouse Model
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Dorien De Pooter, Wim Pierson, Soheil Pourshahian, Koen Dockx, Ben De Clerck, Isabel Najera, Heather Davis, Ellen Van Gulck, and Daniel Boden
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chronic hepatitis B ,therapeutic vaccination ,mRNA vaccine ,lipid nanoparticles ,AAV-HBV mice ,HBsAg reduction ,Medicine - Abstract
Chronic infection with hepatitis B virus (HBV) develops in millions of patients per year, despite the availability of effective prophylactic vaccines. Patients who resolve acute HBV infection develop HBV-specific polyfunctional T cells accompanied by neutralizing antibodies, while in patients with chronic hepatitis B (CHB), immune cells are dysfunctional and impaired. We describe a lipid nanoparticle (LNP)-formulated mRNA vaccine, optimized for the expression of HBV core, polymerase, and surface (preS2-S) antigens with the aim of inducing an effective immune response in patients with CHB. Prime and prime/boost vaccination with LNP-formulated mRNA encoding for core, pol, and/or preS2-S dosing strategies were compared in naive C57BL/6 and BALB/c mice. Immune responses were assessed by IFN-γ ELISpot, intracellular cytokine staining (ICS), and ELISA for antibody production, whereas anti-viral efficacy was evaluated in the AAV-HBV mouse model. The mRNA vaccine induced strong antigen-specific polyfunctional T cell responses in these mouse models, accompanied by the emergence of anti-HBs and anti-HBe antibodies. After three immunizations, the antigen-specific immune stimulation resulted in up to 1.7 log10 IU/mL reduction in systemic HBV surface antigen (HBsAg), accompanied by a transient drop in systemic HBeAg, and this was observed in 50% of the AAV-HBV-transduced mice in the absence of additional modalities such as adjuvants, HBsAg reducing agents, or checkpoint inhibitors. However, no treatment-related effect on viremia was observed in the liver. These results warrant further optimization and evaluation of this mRNA vaccine as a candidate in a multimodal therapeutic regimen for the treatment of chronic HBV infection.
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- 2024
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9. 'Investigación, Análisis y Elaboración del Diseño de un Programa de Promoción de Servicios en la Biblioteca Central Universitaria UJED'-Edición Única
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Silvia Isabel Nájera Tejada and ITESM-Universidad Virtual
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- 2005
10. Point mutant frequencies in the pol gene of human immunodeficiency virus type 1 are two- to threefold lower than those of env
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Joaquín Dopazo, Isabel Nájera, África Holguín, Esteban Domingo, and Miguel E. Quiñones-Mateu
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Nonsynonymous substitution ,viruses ,Immunology ,Mutant ,Molecular Sequence Data ,Viral quasispecies ,Biology ,Genes, env ,Virus ,Gene Frequency ,Virology ,Humans ,Point Mutation ,Nucleotide ,Amino Acid Sequence ,Gene ,Genetics ,chemistry.chemical_classification ,Point mutation ,virus diseases ,Molecular biology ,Genes, pol ,Reverse transcriptase ,Infectious Diseases ,chemistry ,HIV-1 ,Sequence Analysis - Abstract
Nucleotide sequences have been determined for the HIV-1 genomic regions encoding codons 41-108 and 181-219 of reverse transcriptase (RT) (pol gene), and codons 198-331 of gp120 (the C2V3 domains; env gene). Eighty-one HIV-1 samples from patients treated or untreated with RT inhibitors were used to sequence pol and 28 HIV-1 samples were used to sequence env. Several individual quasispecies have also been analyzed. All HIV-1 isolates belonged to subtype B. Point mutant frequencies and nucleotide diversities for pol were at most two- to threefold lower than env, with the proportion of nonsynonymous mutations ranging from 33 to 67%. A new variability index that takes into account the type of amino acid substitution as well as genetic distances between the compared sequences is introduced, and its main features for sequence comparisons emphasized. Extension of the calculations to gag, pol, and env sequences contained in the current HIV-1 database confirmed the high mutant frequencies for all HIV-1 genomic regions. The results indicate that although env is more tolerant to insertions and deletions than pol, point mutant frequencies for HIV-1 regions encoding nonstructural proteins are only two- to threefold lower than for regions encoding structural proteins. This implies the occurrence of frequent changes in HIV-1 phenotypes that are dependent on amino acid substitutions in viral enzymes.
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- 1996
11. Identification of HCV Resistant Variants against Direct Acting Antivirals in Plasma and Liver of Treatment Naïve Patients
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V. Stalin Raj, Gadissa Bedada Hundie, Anita C. Schürch, Saskia L. Smits, Suzan D. Pas, Sophie Le Pogam, Harry L. A. Janssen, Rob J. de Knegt, Albert D. M. E. Osterhaus, Isabel Najera, Charles A. Boucher, and Bart L. Haagmans
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Medicine ,Science - Abstract
Abstract Current standard-of-care treatment of chronically infected hepatitis C virus (HCV) patients involves direct-acting antivirals (DAA). However, concerns exist regarding the emergence of drug -resistant variants and subsequent treatment failure. In this study, we investigate potential natural drug-resistance mutations in the NS5B gene of HCV genotype 1b from treatment-naïve patients. Population-based sequencing and 454 deep sequencing of NS5B gene were performed on plasma and liver samples obtained from 18 treatment- naïve patients. The quasispecies distribution in plasma and liver samples showed a remarkable overlap in each patient. Although unique sequences in plasma or liver were observed, in the majority of cases the most dominant sequences were shown to be identical in both compartments. Neither in plasma nor in the liver codon changes were detected at position 282 that cause resistance to nucleos(t)ide analogues. However, in 10 patients the V321I change conferring resistance to nucleos(t)ide NS5B polymerase inhibitors and in 16 patients the C316N/Y/H non-nucleoside inhibitors were found mainly in liver samples. In conclusion, 454-deep sequencing of liver and plasma compartments in treatment naïve patients provides insight into viral quasispecies and the pre-existence of some drug-resistant variants in the liver, which are not necessarily present in plasma.
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- 2017
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12. Author Correction for Jones et al., 'Identification of the I38T PA Substitution as a Resistance Marker for Next-Generation Influenza Virus Endonuclease Inhibitors'
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Jeremy C. Jones, Gyanendra Kumar, Subrata Barman, Isabel Najera, Stephen W. White, Richard J. Webby, and Elena A. Govorkova
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Microbiology ,QR1-502 - Published
- 2018
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13. Nucleolar Relocalization of RBM14 by Influenza A Virus NS1 Protein
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Grant Beyleveld, Daniel J. Chin, Elena Moreno Del Olmo, Jade Carter, Isabel Najera, Cristian Cillóniz, and Megan L. Shaw
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NS1 protein ,RNA interference ,influenza virus ,systems biology ,virus-host interactions ,Microbiology ,QR1-502 - Abstract
ABSTRACT Viruses utilize a number of host factors in order to carry out their replication cycles. Influenza A virus (IAV) and human respiratory syncytial virus (RSV) both infect the tissues of the respiratory tract, and as such we hypothesize that they might require similar host factors. Several published genome-wide screens have identified putative IAV host factors; however, there is significant discordance between their hits. In order to build on this work, we integrated a variety of “OMICS” data sources using two complementary network analyses, yielding 51 genes enriched for both IAV and RSV replication. We designed a targeted small interfering RNA (siRNA)-based assay to screen these genes against IAV under robust conditions and identified 13 genes supported by two IAV subtypes in both primary and transformed human lung cells. One of these hits, RNA binding motif 14 (RBM14), was validated as a required host factor and furthermore was shown to relocalize to the nucleolus upon IAV infection but not with other viruses. Additionally, the IAV NS1 protein is both necessary and sufficient for RBM14 relocalization, and relocalization also requires the double-stranded RNA (dsRNA) binding capacity of NS1. This work reports the discovery of a new host requirement for IAV replication and exposes a novel example of interplay between IAV NS1 and the host protein, RBM14. IMPORTANCE Influenza A virus (IAV) and respiratory syncytial virus (RSV) present major global disease burdens. There are high economic costs associated with morbidity as well as significant mortality rates, especially in developing countries, in children, and in the elderly. There are currently limited therapeutic options for these viruses, which underscores the need for novel research into virus biology that may lead to the discovery of new therapeutic approaches. This work extends existing research into host factors involved in virus replication and explores the interaction between IAV and one such host factor, RBM14. Further study to fully characterize this interaction may elucidate novel mechanisms used by the virus during its replication cycle and open new avenues for understanding virus biology.
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- 2018
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14. Identification of the I38T PA Substitution as a Resistance Marker for Next-Generation Influenza Virus Endonuclease Inhibitors
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Jeremy C. Jones, Gyanendra Kumar, Subrata Barman, Isabel Najera, Stephen W. White, Richard J. Webby, and Elena A. Govorkova
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PA polymerase ,antiviral ,antiviral resistance ,endonuclease ,influenza virus ,Microbiology ,QR1-502 - Abstract
ABSTRACT The clinical severity and annual occurrence of influenza virus epidemics, combined with the availability of just a single class of antivirals to treat infections, underscores the urgent need to develop new anti-influenza drugs. The endonuclease activity within the viral acidic polymerase (PA) protein is an attractive target for drug discovery due to the critical role it plays in viral gene transcription. RO-7 is a next-generation PA endonuclease inhibitor of influenza A and B viruses, but its drug resistance potential is unknown. Through serial passage of influenza A(H1N1) viruses in MDCK cells under selective pressure of RO-7, we identified an I38T substitution within the PA endonuclease domain that conferred in vitro resistance to RO-7 (up to a 287-fold change in 50% effective concentration [EC50]). I38T emerged between 5 and 10 passages, and when introduced into recombinant influenza A(H1N1) viruses, alone conferred RO-7 resistance (up to an 81-fold change in EC50). Cocrystal structures of mutant and wild-type endonuclease domains with RO-7 provided the structural basis of resistance, where a key hydrophobic interaction between RO-7 and the Ile38 side chain is compromised when mutated to the polar threonine. While Ile38 does not have a crucial role in coordinating the endonuclease active site, the switch to threonine does affect the polymerase activity of some viruses and influences RO-7 affinity for the PAN target (i.e., the ≈200-residue N-terminal domain of PA). However, the change does not lead to a complete loss of replication activity in vitro. Our results predict that RO-7-resistant influenza viruses carrying the I38T substitution may emerge under treatment. This should be taken into consideration for clinical surveillance and in refinement of these drugs. IMPORTANCE The effectiveness of antiviral drugs can be severely compromised by the emergence of resistant viruses. Therefore, determination of the mechanisms by which viruses become resistant is critical for drug development and clinical use. RO-7 is a compound that potently inhibits influenza virus replication and belongs to a new class of drugs in late-stage clinical trials for treatment of influenza virus infection. Here we demonstrate that a single amino acid change acquired under prolonged virus exposure to RO-7 renders influenza viruses significantly less susceptible to its inhibitory effects. We have discovered how the mutation can simultaneously interfere with drug activity and still maintain efficient virus replication. These findings have important implications for the development of more effective derivatives of RO-7-like drugs and provide guidance for how to monitor the emergence of resistance.
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- 2018
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15. Similar prevalence of low-abundance drug-resistant variants in treatment-naive patients with genotype 1a and 1b hepatitis C virus infections as determined by ultradeep pyrosequencing.
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Severine Margeridon-Thermet, Sophie Le Pogam, Lewyn Li, Tommy F Liu, Nancy Shulman, Robert W Shafer, and Isabel Najera
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Medicine ,Science - Abstract
Hepatitis C virus (HCV) variants that confer resistance to direct-acting-antiviral agents (DAA) have been detected by standard sequencing technology in genotype (G) 1 viruses from DAA-naive patients. It has recently been shown that virological response rates are higher and breakthrough rates are lower in G1b infected patients than in G1a infected patients treated with certain classes of HCV DAAs. It is not known whether this corresponds to a difference in the composition of G1a and G1b HCV quasispecies in regards to the proportion of naturally occurring DAA-resistant variants before treatment.We used ultradeep pyrosequencing to determine the prevalence of low-abundance (
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- 2014
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16. A Sustainable Material for Sheep’s Cheese Wedges Stored under Different Atmosphere Conditions
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Ana Isabel Nájera, Maider Murua, Olaia Martínez, Marta Albisu, and Luis Javier R. Barron
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packaging ,recyclable material ,cheese preservation ,modified atmosphere ,vacuum ,Chemical technology ,TP1-1185 - Abstract
This study is based on the need to improve packaging sustainability in the food industry. Its aim was to assess the performance of a recyclable plastic material for semi-hard sheep’s cheese wedges packaging as an alternative to conventional non-sustainable plastic materials. Four different packaging treatments (air, vacuum, and CO2/N2 gas mixtures 50/50 and 80/20% (v/v)) were studied. Changes in gas headspace composition, sensory properties, cheese gross composition, weight loss, pH, colour, and texture profile were investigated at 5 ± 1 °C storage for 56 days. The sensory analysis indicated that vacuum packaging scored the worst in paste appearance and holes, and air atmosphere the worst in flavour; it was concluded that cheeses were unfit from day 14–21 onwards. Air and vacuum packaging were responsible for most of the significant changes identified in the texture profile analysis, and most of these happened in the early stages of storage. The colour parameters a* and b* differentiated the air packaging from the rest of the conditions. As in previous studies using conventional plastic materials, modified atmosphere packaging, either CO2/N2 50/50 or 80/20% (v/v), was the most effective preserving technique to ensure the quality of this type of cheese when comparing air and vacuum packaging treatments.
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- 2024
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17. Existence of hepatitis C virus NS5B variants naturally resistant to non-nucleoside, but not to nucleoside, polymerase inhibitors among untreated patients.
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Sophie Le Pogam, Amritha Seshaadri, Alan Kosaka, Sophie Chiu, Hyunsoon Kang, Steven Hu, Sonal Rajyaguru, Julian Symons, Nick Cammack, Isabel Nájera, Le Pogam, Sophie, Seshaadri, Amritha, Kosaka, Alan, Chiu, Sophie, Kang, Hyunsoon, Hu, Steven, Rajyaguru, Sonal, Symons, Julian, Cammack, Nick, and Nájera, Isabel
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HEPATITIS C ,HEPATITIS C virus ,MEDICAL experimentation on humans ,MEDICAL research - Abstract
Objectives: To characterize the effect of hepatitis C virus (HCV) polymerase intrinsic genetic heterogeneity on the inhibitory activity of nucleoside and non-nucleoside HCV polymerase inhibitors.Methods: The sensitivity of genotype (GT) 1 HCV NS5B clinical isolates from treatment-naive patients to nucleoside and non-nucleoside polymerase inhibitors was assessed. The genetic diversity at the population level, as well as that of their quasispecies, was correlated with the observed reduced sensitivity to inhibitors.Results: R1479 and NM107 (nucleoside analogues that have entered Phase 2 clinical trials as prodrugs R1626 and NM283, respectively) were similarly active across the tested clinical isolates. Resistance mutations to nucleoside analogues were not observed in any of the isolates. However, the activity of the non-nucleoside thumb II inhibitor NNI-1, palm I inhibitors NNI-2 and NNI-3, and palm II inhibitor HCV-796 was reduced across different isolates. This reduction in inhibitory activity for non-nucleoside inhibitors (NNIs) was, in most cases, correlated with the existence of known NNI resistance mutations in the NS5B polymerase population of the clinical isolates, as detected by population sequencing. Resistance mutations to NNIs were also observed at a low frequency within the clinical isolates' viral quasispecies that allowed for their rapid selection upon drug selective pressure.Conclusions: The higher frequency of known NNI resistance mutations or polymorphisms known to affect their antiviral potency when compared with the lack of detection of resistance mutations to the nucleoside analogues suggests a potential for primary reduced responsiveness as well as faster development of clinically significant resistance. [ABSTRACT FROM AUTHOR]- Published
- 2008
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18. DAUPHINE: a randomized phase II study of danoprevir/ritonavir plus peginterferon alpha-2a/ribavirin in HCV genotypes 1 or 4
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Gregory T. Everson, Julian Zhou, Peter Ferenci, Ellen S. Yetzer, Eric M. Yoshida, Savino Bruno, Pietro Andreone, Curtis Cooper, Nancy S. Shulman, Sophie Le Pogam, Teresita Beltran-Jaramillo, Mercidita T. Navarro, Mitchell L. Shiffman, Athina Voulgari, Isabel Najera, Christophe Hézode, Michael J. Brunda, Stefan Zeuzem, Gregory Everson, Curtis Cooper, Christophe Hézode, Mitchell L. Shiffman, Eric Yoshida, Teresita Beltran-Jaramillo, Pietro Andreone, Savino Bruno, Peter Ferenci, Stefan Zeuzem, Michael Brunda, Sophie Le Pogam, Isabel Nájera, Julian Zhou, Mercidita T. Navarro, Athina Voulgari, Nancy S. Shulman, and Ellen S. Yetzer
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Adult ,Cyclopropanes ,Male ,hepatitis C virus ,medicine.medical_specialty ,Genotype ,Lactams ,Proline ,Lactams, Macrocyclic ,Hepatitis C virus ,Population ,Phases of clinical research ,Hepacivirus ,Isoindoles ,danoprevir ,medicine.disease_cause ,Gastroenterology ,response- guided therapy ,Polyethylene Glycols ,chemistry.chemical_compound ,Internal medicine ,medicine ,Humans ,hepatitis C viru ,education ,Adverse effect ,Sulfonamides ,education.field_of_study ,Ritonavir ,Hepatology ,business.industry ,Ribavirin ,Incidence (epidemiology) ,Danoprevir ,Interferon-alpha ,Hepatitis C ,Virology ,Recombinant Proteins ,chemistry ,RNA, Viral ,Drug Therapy, Combination ,Female ,business ,medicine.drug - Abstract
Background & Aims Danoprevir is a hepatitis C virus (HCV) protease inhibitor with activity against genotypes (G)1/G4, which is maintained at lower doses by ritonavir-boosting. We report results of a large, randomized, active-controlled phase IIb study of ritonavir-boosted danoprevir (danoprevir/r) plus peginterferon alpha-2a/ribavirin (P/R) in treatment-naive patients with HCV G1/4 infection. Methods Treatment-naive patients with HCV G1/4 infection were randomized to twice-daily danoprevir/r 200/100 mg (A, n = 92); 100/100 mg (B, n = 93); or 50/100 mg (C, n = 94) plus P/R for 24 weeks; twice-daily danoprevir/r 100/100 mg (D, n = 94) plus P/R for 12 or 24 weeks; or P/R alone (E, n = 44) for 48 weeks. Patients in the response-guided therapy arm (D) with an extended rapid virological response (eRVR2: HCV RNA
- Published
- 2014
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