A stochastic model for the mutation-selection balance in an infinite asexual population with a genome of fixed size

A stochastic model is presented which describes the evolution of a genome of a haploid species in an infinite population. The genome is a finite set of elements. The elements are divided into different classes according to their effect on the fitness of the organism. Repeated mutations of the genome elements are permitted, in particular positive mutations are introduced. The distribution of the deleterious elements in the genome with respect to the impact on the fitness is given after the replication step. The steady state is fully described including the distribution and the fitness.     

Production of Two Vaccinating Recombinant Rotavirus Proteins in the Milk of Transgenic Rabbits

Rotaviruses are the main cause of infantile viral gastroenteritis worldwide leading to approximately 500,000 deaths each year mostly in the developing world. For unknown reasons, live attenuated viruses used in classical vaccine strategies were shown to be responsible for intussusception (a bowel obstruction). New strategies allowing production of safe recombinant non-replicating rotavirus candidate vaccine are thus clearly needed. In this study we utilized transgenic rabbit milk as a source of rotavirus antigens. Individual transgenic rabbit lines were able to produce several hundreds of micrograms per ml of secreted recombinant VP2 and VP6 proteins in their milk. Viral proteins expressed in our model were immunogenic and were shown to induce a significant reduction in viral antigen shedding after challenge with virulent rotavirus in the adult mouse model. To our knowledge, this is the first report of transgenic mammal bioreactors allowing the rapid co-production of two recombinant viral proteins in milk to be used as a vaccine.     

轮状病毒疫苗研究现状

轮状病毒自上世纪70年代初发现至今,仍是婴幼儿病毒性腹泻最主要的病原体。每年约60万婴幼儿因轮状病毒感染导致严重脱水死亡。轮状病毒疫苗从上世纪90年代初开始研制,至今已有三种疫苗用于预防轮状病毒感染。这三种疫苗均为减毒活疫苗:其中包括单一血清型Rotarix、罗特威和重组5价疫苗RotaTeq。它们已在全球多国使用,有些国家已将其纳入免疫规划。疫苗的使用使人群轮状病毒感染下降,特别是死亡率明显减少。但也出现了一些问题,因此除了减毒活疫苗,也有一些实验室研究其他形式的疫苗,例如重组疫苗、灭活疫苗等。本文主要介绍轮状病毒疫苗的研究现状,为我国轮状病毒疫苗的研究、使用和推广提供一定理论依据。     

轮状病毒疫苗研究进展及其转基因植物疫苗的开发前景

轮状病毒是目前婴幼儿秋冬季腹泻的最主要病原物,作者通过轮状病毒减毒株疫苗,亚单位疫苗和DNA疫苗研究进展的综合分析,指出了减毒株疫苗在实际应用中存在的弊端,论述了开发新型轮状病毒疫苗,特别是转基因植物疫苗的必要性和可行性。     

Rotavirus infection enhances lipopolysaccharide-induced intussusception in a mouse model

Unexpected reports of intussusception after vaccination with the live tetravalent rotavirus vaccine RotaShield resulted in voluntary withdrawal of the vaccine. Intussusception, a condition in which the intestine acutely invaginates upon itself, is the most common cause of intestinal obstruction in children. We report here the development of a mouse model to study rotavirus-induced intussusception. In this model, both homologous murine and heterologous simian rotavirus strains significantly enhanced the rate of lipopolysaccharide (LPS)-induced intussusception, and this enhancement was replication dependent, requiring rotavirus doses of greater than one 50% infectious dose. Rotavirus-induced intussusceptions did not have observable lymphoid lead points, despite the induction of intestinal lymphoid hyperplasia after rotavirus infection. Intussusceptions are also postulated to result from altered intestinal motility, but rotavirus infection had no effect on gastrointestinal transit. LPS-induced intussusception is associated with the induction of inflammatory mediators, and intussusception rates can be modified by inflammatory antagonists. We show that rotavirus infection significantly enhanced serum tumor necrosis factor alpha and gamma interferon cytokine levels after LPS treatment compared to uninfected mice. Together, these data suggest that rotavirus infection sensitized mice to the inflammatory effects of subsequent LPS treatment to enhance intussusception rates.     

Heterotypic passive protection induced by synthetic peptides corresponding to VP7 and VP4 of bovine rotavirus.

We have evaluated the potential of two peptides derived from highly conserved regions of rotavirus outer capsid proteins (VP7 and VP4) to act as a rotavirus vaccine. The capacity of peptides coupled to rotavirus VP6 spherical particles to provide passive protection in a murine model was compared with the protection induced by peptide-keyhole limpet hemocyanin (KLH) conjugates. Female mice were immunized a total of three times before and during pregnancy. Suckling mouse pups were challenged at 7 days of age with either homologous or heterologous rotavirus serotypes. The efficacy of vaccination was determined by analyzing the clinical symptoms and measuring xylose adsorption in the intestine. In this model the VP4 peptide-VP6 conjugate provided protection equal to that obtained using bovine rotavirus (BRV) as the immunogen. The VP7 peptide-VP6 conjugate provided slightly less protection than the VP4 peptide-VP6 conjugate. A mixture of the VP4 peptide-VP6 and VP7 peptide-VP6 conjugates provided better heterologous protection than immunization with BRV. In contrast, KLH-conjugated peptides provided only partial protection. The significance of a synthetic-peptide-based rotavirus vaccine in the prevention of rotavirus infections is discussed.     

轮状病毒灭活疫苗和减毒活疫苗序贯免疫的体液免疫应答效果

目的:评价采用轮状病毒灭活疫苗进行初始免疫,减毒活疫苗进行加强免疫的序贯免疫方案的体液免疫应答效果。方法:将实验小鼠随机分为4组(口服疫苗组、序贯疫苗组、口服对照组及序贯对照组),按相应方案免疫后,ELISA检测血清轮状病毒特异性IgG和IgA、肠道轮状病毒特异性IgA;微量中和实验检测血清病毒特异性中和抗体;同时采用ELISA分析口服活疫苗后病毒排出情况。结果:与对照组相比,序贯疫苗组小鼠产生的轮状病毒特异性血清IgG、IgA、中和抗体及肠道IgA水平显著升高。与口服疫苗组相比,序贯疫苗组的免疫方案诱发的轮状病毒特异性血清IgG、IgA、中和抗体水平显著升高,肠道IgA水平两组间没有显著差异。同时,与口服疫苗组相比,序贯疫苗组中轮状病毒灭活疫苗进行的初始免疫未影响第一次口服活疫苗后病毒的排出量和排出时间,但序贯疫苗组第二次口服活疫苗后病毒的排出量迅速减少,排毒时间快速缩短,与口服疫苗组第三次服苗后病毒的排出量和排出时间相似。结论: 轮状病毒灭活疫苗和减毒活疫苗序贯免疫可有效诱发小鼠全身和黏膜局部的体液免疫应答,该方案将有可能成为轮状病毒疫苗临床应用的候选方案。     

Protective Immunity Induced by Oral Immunization with a Rotavirus DNA Vaccine Encapsulated in Microparticles

DNA vaccines are usually given by intramuscular injection or by gene gun delivery of DNA-coated particles into the epidermis. Induction of mucosal immunity by targeting DNA vaccines to mucosal surfaces may offer advantages, and an oral vaccine could be effective for controlling infections of the gut mucosa. In a murine model, we obtained protective immune responses after oral immunization with a rotavirus VP6 DNA vaccine encapsulated in poly(lactide-coglycolide) (PLG) microparticles. One dose of vaccine given to BALB/c mice elicited both rotavirus-specific serum antibodies and intestinal immunoglobulin A (IgA). After challenge at 12 weeks postimmunization with homologous rotavirus, fecal rotavirus antigen was significantly reduced compared with controls. Earlier and higher fecal rotavirus-specific IgA responses were noted during the peak period of viral shedding, suggesting that protection was due to specific mucosal immune responses. The results that we obtained with PLG-encapsulated rotavirus VP6 DNA are the first to demonstrate protection against an infectious agent elicited after oral administration of a DNA vaccine.     

轮状病毒VP4亚单位疫苗研究进展

轮状病毒是全球范围内导致5岁以下婴幼儿严重腹泻的主要病原体,造成了巨大的经济负担和社会负担。疫苗预防接种是控制轮状病毒感染最为有效的手段,但在轮状病毒导致的死亡率较高的非洲和亚洲部分低收入国家,目前已经上市的轮状病毒疫苗的有效性较低,且会增加肠套叠的风险。更加安全、有效的轮状病毒疫苗对于降低轮状病毒感染导致的发病率和死亡率具有重要意义。目前,各国科研人员试图从多个方面提高轮状病毒疫苗的有效性,非复制型基因工程亚单位疫苗是目前轮状病毒疫苗研究的主要方向。文中就目前轮状病毒亚单位疫苗,特别是基于VP4蛋白的亚单位疫苗的研究进展进行了综述,以期对轮状病毒疫苗的发展提供借鉴意义。     

Optimal control of a rabies epidemic model with a birth pulse

A system of ordinary differential equations describes the population dynamics of a rabies epidemic in raccoons. The model accounts for the dynamics of a vaccine, including loss of vaccine due to animal consumption and loss from factors other than racoon uptake. A control method to reduce the spread of disease is introduced through temporal distribution of vaccine packets. This work incorporates the effect of the seasonal birth pulse in the racoon population and the attendant increase in new-borns which are susceptible to the diseases, analysing the impact of the timing and length of this pulse on the optimal distribution of vaccine packets. The optimization criterion is to minimize the number of infected raccoons while minimizing the cost of distributing the vaccine. Using an optimal control setting, numerical results illustrate strategies for distributing the vaccine depending on the timing of the infection outbreak with respect to the birth pulse.     

Investigating barriers to the protective efficacy provided by rotavirus vaccines in African infants

Julie Bines discusses an accompanying study by Sheila Isanaka and colleagues on nutrient supplementation and immune responses to rotavirus vaccination.

The introduction of rotavirus vaccines into the national immunization programs globally has made a major impact on diarrhea-related hospitalizations and deaths. By 2020, 107 countries had introduced rotavirus vaccines, either nationally or regionally, including 52 countries in Africa and Asia eligible for funding through the Global Alliance for Vaccines and Immunization (Gavi) [1]. This represents a major step toward reducing under 5-year child mortality, the impact of rotavirus disease on child health, and the economic burden on families and the healthcare system. A remaining challenge is the lower vaccine protective efficacy observed in children in low- and middle-income countries (LMICs) where the mortality and hospitalizations due to severe rotavirus disease still occur [1]. The role of nutrition in influencing the immune response to a rotavirus vaccine is the focus of the accompanying paper by Isanaka and colleagues published in this issue of PLOS Medicine [2].Understanding why over 87% of children vaccinated with a rotavirus vaccine in low child mortality countries are protected against severe rotavirus disease compared to approximately 44% (27% to 59%) of children in high child mortality countries is not well understood [3]. As an orally administered vaccine, initial focus has been on factors that could neutralize the live vaccine virus within the gut lumen. Most rotavirus vaccines are administered in a buffered formulation to reduce the risk of neutralization of the vaccine virus by gastric acid [4]. In early clinical trials, fasting prior to vaccination was applied in an effort to reduce the potential impact of breast milk antibodies. This is now not considered necessary [5]. A difference in the gut microbiome in infants from high-income and LMICs has been observed, although the administration of a probiotic did not result in improved rotavirus vaccine immunogenicity [6,7]. Rotaviruses use histo-blood group antigens present on the gut epithelial surface in the initial phase of virus attachment and cellular entry [8]. It has been proposed that population variability in histo-blood group antigen phenotype, specifically Lewis and secretor status, may explain the genotype diversity of rotavirus between regions and the responses observed to live oral rotavirus vaccines that may be VP4 [P] genotype dependent [8].Childhood malnutrition is associated with reduced immune responses to a range of infections, and in the immune response to vaccines, including rotavirus vaccines [9]. Macro and/or micronutrient deficiencies have been linked to a range of abnormalities in T and B cell function, mucosal immunity, cytokine production, and responses [9]. However, there are limited data on the impact of maternal nutritional supplements on the immune responses following vaccination of their infants. Isanaka and colleagues’ cluster-randomized study was nested within a double-blind, placebo control vaccine efficacy trial. It evaluated the effect of 3 different maternal nutritional supplements on serum antirotavirus immunoglobulin A (IgA) seroconversion following administration of 3 doses of the oral rotavirus vaccine Rotasiil (G1, G2, G3, G4, G9) in infants in Niger [2]. The daily supplements were commenced prior to 30 week’s gestation in a population of women at risk of macro- and micro-nutrient malnutrition, although maternal anthropometry and micronutrient status before and after supplementation is not reported. The supplement options included the “standard of care” iron−folic acid (IFA) supplement, a multi-micronutrient (MMN) supplement at levels at or double the US recommended dietary allowance for pregnant women, or the same MMN supplement with an additional energy and protein component. As all groups received a supplement, this study was designed to provide a comparison between supplement groups rather than a comparison with no supplement. Across all supplement groups, the serum antirotavirus IgA seroconversion following administration of 3 doses of Rotasiil was modest at 39.6% and only 10% greater than that observed in the placebo group (29.0%). The rate of seroconversion did not differ between supplement groups, although serum IgA geometric mean titres were not reported. In similar study in The Gambia, an enhanced antibody response to the diphtheria-tetanus-pertussis (DPT) vaccine was observed in the infants of mothers who had received a prenatal MMN and protein−energy supplement, when compared to those who received the “standard of care” iron−folate supplement [10]. Of note, the supplement used in The Gambia study contained more energy and protein when compared to the MMN plus energy and protein used in this study in Niger (The Gambia study versus Niger study; energy [kcal]: 746 versus 237; protein [grams]: 20.8 versus 5.2; lipids [grams]: 52.6 versus 20). Whether the differences reported in vaccine immune responses between these 2 studies reflect these differences in the composition of the supplement, differences specific to the vaccine (DPT versus rotavirus vaccine), study sample size or characteristics of the study population requires further study.Rotavirus vaccines save lives and prevent hospitalizations due to rotavirus disease in children. Efforts to improve the level of protection provided by rotavirus vaccines, particularly in LMICs, have the potential to maximize the impact on these vaccines on global child health. Improving the nutritional status of infants through the provision of macro- and micro-nutrient supplements to pregnant mothers in high-risk populations may optimize immune responses to rotavirus vaccines; however, the specific composition of the prenatal supplement requires further investigation.     

Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models

Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but results have varied. To better understand the magnitude and sources of variability in model projections, we undertook a comparative analysis of transmission dynamic models for rotavirus. We fit five models to reported rotavirus gastroenteritis (RVGE) data from England and Wales, and evaluated outcomes for short- and long-term vaccination effects. All of our models reproduced the important features of rotavirus epidemics in England and Wales. Models predicted that during the initial year after vaccine introduction, incidence of severe RVGE would be reduced 1.8-2.9 times more than expected from the direct effects of the vaccine alone (28-50% at 90% coverage), but over a 5-year period following vaccine introduction severe RVGE would be reduced only by 1.1-1.7 times more than expected from the direct effects (54-90% at 90% coverage). Projections for the long-term reduction of severe RVGE ranged from a 55% reduction at full coverage to elimination with at least 80% coverage. Our models predicted short-term reductions in the incidence of RVGE that exceeded estimates of the direct effects, consistent with observations from the United States and other countries. Some of the models predicted that the short-term indirect benefits may be offset by a partial shifting of the burden of RVGE to older unvaccinated individuals. Nonetheless, even when such a shift occurs, the overall reduction in severe RVGE is considerable. Discrepancies among model predictions reflect uncertainties about age variation in the risk and reporting of RVGE, and the duration of natural and vaccine-induced immunity, highlighting important questions for future research.     

轮状病毒四价灭活疫苗的制备及在小鼠的免疫原性研究

制备轮状病毒四价灭活疫苗,观察其在小鼠体内的抗体应答情况。实验采用轮状病毒原液经凝胶过滤层析纯化,灭活后配制四价疫苗,肌肉注射免疫小鼠,ELISA法测定小鼠血清IgA、IgG。将单价G1、G2、G3、G4型灭活病毒原液及四价轮状病毒灭活疫苗免疫小鼠后,均可刺激产生针对RV的高水平的特异性IgG抗体,但IgA应答较弱。表明四价轮状病毒灭活疫苗在小鼠中具备很好的免疫原性。     

Understanding reduced rotavirus vaccine efficacy in low socio-economic settings

Introduction

Rotavirus vaccine efficacy ranges from >90% in high socio-economic settings (SES) to 50% in low SES. With the imminent introduction of rotavirus vaccine in low SES countries, understanding reasons for reduced efficacy in these settings could identify strategies to improve vaccine performance.

Methods

We developed a mathematical model to predict rotavirus vaccine efficacy in high, middle and low SES based on data specific for each setting on incidence, protection conferred by natural infection and immune response to vaccination. We then examined factors affecting efficacy.

Results

Vaccination was predicted to prevent 93%, 86% and 51% of severe rotavirus gastroenteritis in high, middle and low SES, respectively. Also predicted was that vaccines are most effective against severe disease and efficacy declines with age in low but not high SES. Reduced immunogenicity of vaccination and reduced protection conferred by natural infection are the main factors that compromise efficacy in low SES.

Discussion

The continued risk of severe disease in non-primary natural infections in low SES is a key factor underpinning reduced efficacy of rotavirus vaccines. Predicted efficacy was remarkably consistent with observed clinical trial results from different SES, validating the model. The phenomenon of reduced vaccine efficacy can be predicted by intrinsic immunological and epidemiological factors of low SES populations. Modifying aspects of the vaccine (e.g. improving immunogenicity in low SES) and vaccination program (e.g. additional doses) may bring improvements.     

A Cost Effectiveness and Capacity Analysis for the Introduction of Universal Rotavirus Vaccination in Kenya: Comparison between Rotarix and RotaTeq Vaccines

Background

Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination.

Methods

Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain.

Results

The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix.

Conclusion

Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability.     

Removing the Age Restrictions for Rotavirus Vaccination: A Benefit-Risk Modeling Analysis

Background

To minimize potential risk of intussusception, the World Health Organization (WHO) recommended in 2009 that rotavirus immunization should be initiated by age 15 weeks and completed before 32 weeks. These restrictions could adversely impact vaccination coverage and thereby its health impact, particularly in developing countries where delays in vaccination often occur.

Methods and Findings

We conducted a modeling study to estimate the number of rotavirus deaths prevented and the number of intussusception deaths caused by vaccination when administered on the restricted schedule versus an unrestricted schedule whereby rotavirus vaccine would be administered with DTP vaccine up to age 3 years. Countries were grouped on the basis of child mortality rates, using WHO data. Inputs were estimates of WHO rotavirus mortality by week of age from a recent study, intussusception mortality based on a literature review, predicted vaccination rates by week of age from USAID Demographic and Health Surveys, the United Nations Children''s Fund (UNICEF) Multiple Indicator Cluster Surveys (MICS), and WHO-UNICEF 2010 country-specific coverage estimates, and published estimates of vaccine efficacy and vaccine-associated intussusception risk. On the basis of the error estimates and distributions for model inputs, we conducted 2,000 simulations to obtain median estimates of deaths averted and caused as well as the uncertainty ranges, defined as the 5th–95th percentile, to provide an indication of the uncertainty in the estimates.We estimated that in low and low-middle income countries a restricted schedule would prevent 155,800 rotavirus deaths (5th–95th centiles, 83,300–217,700) while causing potentially 253 intussusception deaths (76–689). In contrast, vaccination without age restrictions would prevent 203,000 rotavirus deaths (102,000–281,500) while potentially causing 547 intussusception deaths (237–1,160). Thus, removing the age restrictions would avert an additional 47,200 rotavirus deaths (18,700–63,700) and cause an additional 294 (161–471) intussusception deaths, for an incremental benefit-risk ratio of 154 deaths averted for every death caused by vaccine. These extra deaths prevented under an unrestricted schedule reflect vaccination of an additional 21%–25% children, beyond the 63%–73% of the children who would be vaccinated under the restricted schedule. Importantly, these estimates err on the side of safety in that they assume high vaccine-associated risk of intussusception and do not account for potential herd immunity or non-fatal outcomes.

Conclusions

Our analysis suggests that in low- and middle-income countries the additional lives saved by removing age restrictions for rotavirus vaccination would far outnumber the potential excess vaccine-associated intussusception deaths. Please see later in the article for the Editors'' Summary     

Diseases with chronic stage in a population with varying size

An epidemiological model of hepatitis C with a chronic infectious stage and variable population size is introduced. A non-structured baseline ODE model which supports exponential solutions is discussed. The normalized version where the unknown functions are the proportions of the susceptible, infected, and chronic individuals in the total population is analyzed. It is shown that sustained oscillations are not possible and the endemic proportions either approach the disease-free or an endemic equilibrium. The expanded model incorporates the chronic age of the individuals. Partial analysis of this age-structured model is carried out. The global asymptotic stability of the infection-free state is established as well as local asymptotic stability of the endemic non-uniform steady state distribution under some additional conditions. A numerical method for the chronic-age-structured model is introduced. It is shown that this numerical scheme is consistent and convergent of first order. Simulations based on the numerical method suggest that in the structured case the endemic equilibrium may be unstable and sustained oscillations are possible. Closer look at the reproduction number reveals that treatment strategies directed towards speeding up the transition from acute to chronic stage in effect contribute to the eradication of the disease.     

A Working Model of a Sieve Tube

A working model of a sieve tube is described, based upon thePressure-Flow Hypothesis. The flow of solution in the sievetube is envisaged as being due to the joint influence of anaxial turgor pressure gradient and a lateral water potentialdifference which causes an intake of water along the tube. Inthis second respect the model differs from that originally suggestedby Münch. The model comprises a length of dialysis tubing rendered semi-permeable,incorporating capillary resistances at regular intervals. Asucrose solution is pumped into one end and collected at theother, the whole being submerged in water. Turgor pressures and concentrations along the model were recordedat intervals; thus the approach to the steady state was followed.In the steady state ¹⁴C-sucrose was introduced to the solutionbeing pumped and its approach to a steady distribution in themodel was followed. Important conclusions reached are that the Munch Pressure-FlowHypothesis implies a pressure profile convex upwards, a velocityincrease down the phloem, and an exponential fall in tracerconcentration without its lateral leakage.     

Prospects for new viral vaccines

Animal virology has made outstanding contributions to preventive medicine by the development of vaccines for the control of infectious disease in man and animals. Cost-benefit analysis indicates substantial savings in health care costs from the control of diseases such as smallpox, poliomyelitis, yellow fever and measels. Areas for further development include vaccines for influenza (living, attenuated virus), the herpes group (varicella: cytomegalovirus), respiratory syncytial virus, rotavirus and hepatitis A, B, and non A/non B. The general options for vaccine formulation are discussed with particular emphasis on approaches with the use of viral genetics to 'tailor make' vaccine viruses with defined growth potential in laboratory systems, low pathogenicity, and defined antigens. Current progress with the development of an inactivated hepatitis B vaccine is reviewed as a case study in vaccine development. The impact of recent experiments in cloning hepatitis B virus DNA in E. coli on the production of a purified viral polypeptide vaccine is assessed.     

Effective prophylaxis against rotavirus diarrhea using a combination of <Emphasis Type="Italic">Lactobacillus rhamnosus</Emphasis> GG and antibodies

Background  

Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an evaluation of the therapeutic potential of different probiotics and their combination with anti - rotavirus antibodies in a mouse model of rotavirus diarrhea.