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PURPOSE: Although Common Variable Immunodeficiency (CVID) is considered the most prevalent symptomatic primary antibody deficiency (PAD), there is a population with symptomatic PADs that do not meet criteria for CVID. We analyzed clinical and immunological profiles of patients with different PADs to better understand the differences and similarities between CVID and other PADs. METHODS: We extracted clinical and laboratory data of patients with PADs from electronic medical records. Patients were categorized into CVID, IgG subclass 2 deficiency (IgG2D), IgG deficiency (IgGD) and selective antibody deficiency (sAbD) based on basal immunoglobulin levels and pneumococcal vaccine responses. We compared clinical and immunological characteristics in these groups. RESULTS: All patients, regardless of PAD types, showed similar frequencies of infections, bronchiectasis, and interstitial lung disease (ILD). Hematopoietic malignancies were more frequently found in the CVID than in the IgG2D, IgGD and sAbD groups, while the latter groups trended towards an increased frequency of connective tissue diseases (CTD). Low counts of natural killer (NK) cells were associated with malignancy, autoimmunity, and ILD in CVID but not in other PAD groups. CONCLUSIONS: Higher frequency of hematopoietic malignancy in CVID than in the other PADs and association of lower NK cell counts with non-infectious complications in CVID suggest a relationship between immune alterations and the development of non-infectious manifestations in PADs.

Mass antiparasitic drug administration programs and other control strategies have made important contributions in reducing the global prevalence of helminths. Schistosomiasis, however, continues to spread to new geographic areas. The advent of a viable vaccine and its deployment, coupled with existing control efforts, is expected to make significant headway towards sustained schistosomiasis control. In 2016, Science ranked the schistosomiasis vaccine as one of the top 10 vaccines that needs to be urgently developed. A vaccine that is effective against geographically distinct forms of intestinal/hepatic and urinary disease is essential to make a meaningful impact in global reduction of the disease burden. In this opinion article, we focus on salient features of schistosomiasis vaccines in different phases of the clinical development pipeline and highlight the Sm-p80-based vaccine which is now being prepared for human clinical trials.

Catheter-associated urinary tract infections (CAUTI) constitute about 40% of health-care associated infections in the United States. It is estimated that about 15% to 25% of hospitalized patients receive a urethral catheter at some point during hospitalization predisposing them to the development of CAUTI. Pathogenic bacteria colonize the surface of the catheter and develop highly resistant structures termed biofilms which protect them from the effects of diverse antibiotics. Escherichia coli are among the main causative agents of CAUTI. Due to the emergence of antibiotic resistant strains, it is critical to develop new novel antimicrobial agents. We recently showed that a novel anti-biofilm agent, Next Science, inhibited biofilm development by wound pathogens. In this study, we tried to determine if treating urinary tract catheters (UTC) with NS prevents the development if E. coli biofilms. Three types of UTCs were cut into small pieces that were treated with NS. Biofilm development by an E. coli laboratory strain and several E. coli clinical isolates on treated and untreated pieces was accomplished using the microtiter plate assay. Biofilms developed on inner and outer surfaces of the catheters were quantified by determining the number of microorganisms (colony forming units) on each piece and visualized using confocal laser scanning microscopy (CLSM). In comparison with untreated catheters, all three types of NS-treated catheters prevented biofilm development by tested E. coli strains. In addition, CLSM demonstrated the presence of E. coli biofilms on the inner and outer surfaces of the untreated but not treated catheters. Our results suggest that NS is a novel antimicrobial treatment to prevent biofilm development by pathogenic E. coli strains on UTCs.

Schistosomiasis is a neglected tropical disease (NTD) of public health importance. Despite decades of implementation of mass praziquantel therapy programs and other control measures, schistosomiasis has not been contained and continues to spread to new geographic areas. A schistosomiasis vaccine could play an important role as part of a multifaceted control approach. With regards to vaccine development, many biological bottlenecks still exist: the lack of reliable surrogates of protection in humans; immune interactions in co-infections with other diseases in endemic areas; the potential risk of IgE responses to antigens in endemic populations; and paucity of appropriate vaccine efficacy studies in nonhuman primate models. Research is also needed on the role of modern adjuvants targeting specific parts of the innate immune system to tailor a potent and protective immune response for lead schistosome vaccine candidates with the long-term aim to achieve curative worm reduction. This review summarizes the current status of schistosomiasis vaccine development.