The manifestations of the epidemic process in shigellosis and their theoretical interpretation]

This work, based on the retrospective analysis of shigellosis morbidity among organized groups of adults, as well as the whole population of the city, demonstrates the manifestations of the epidemic process. Water supply was common in the city, while water consumption was autonomous. The organized groups of adults did not use the products of the local milk-processing factory. The following facts were established. The dynamics of morbidity in Flexner's dysentery showed the change of dominating variants of the infective agent, which reflected the action of internal mechanisms of the development of the epidemic process. The role of Sonne dysentery in the total structure of shigellosis morbidity did not correlate with the consumption of milk and milk products. The theory of the self-regulation of the parasitic system and the theory of correspondence served as the basis for the theoretical interpretation of the manifestations of the epidemic process of Shigella infections. To ascertain the real correspondence of individual Shigella species to concrete transmission factors, further investigation are necessary.     

Shigellosis

Shigellosis is a global human health problem. Four species of Shigella i.e. S. dysenteriae, S. flexneri, S. boydii and S. sonnei are able to cause the disease. These species are subdivided into serotypes on the basis of O-specific polysaccharide of the LPS. Shigella dysenteriae type 1 produces severe disease and may be associated with life-threatening complications. The symptoms of shigellosis include diarrhoea and/or dysentery with frequent mucoid bloody stools, abdominal cramps and tenesmus. Shigella spp. cause dysentery by invading the colonic mucosa. Shigella bacteria multiply within colonic epithelial cells, cause cell death and spread laterally to infect and kill adjacent epithelial cells, causing mucosal ulceration, inflammation and bleeding. Transmission usually occurs via contaminated food and water or through person-to-person contact. Laboratory diagnosis is made by culturing the stool samples using selective/differential agar media. Shigella spp. are highly fragile organism and considerable care must be exercised in collecting faecal specimens, transporting them to the laboratories and in using appropriate media for isolation. Antimicrobial agents are the mainstay of therapy of all cases of shigellosis. Due to the global emergence of drug resistance, the choice of antimicrobial agents for treating shigellosis is limited. Although single dose of norfloxacin and ciprofloxacin has been shown to be effective, they are currently less effective against S. dysenteriae type 1 infection. Newer quinolones, cephalosporin derivatives, and azithromycin are the drug of choice. However, fluoroquinolone-resistant S. dysenteriae type 1 infection have been reported. Currently, no vaccines against Shigella infection exist. Both live and subunit parenteral vaccine candidates are under development. Because immunity to Shigella is serotype-specific, the priority is to develop vaccine against S. dysenteriae type 1 and S. flexneri type 2a. Shigella species are important pathogens responsible for diarrhoeal diseases and dysentery occurring all over the world. The morbidity and mortality due to shigellosis are especially high among children in developing countries. A recent review of literature (Kotloff et al.,1999) concluded that, of the estimated 165 million cases of Shigella diarrhoea that occur annually, 99% occur in developing countries, and in developing countries 69% of episodes occur in children under five years of age. Moreover, of the ca.1.1 million deaths attributed to Shigella infections in developing countries, 60% of deaths occur in the under-five age group. Travellers from developed to developing regions and soldiers serving under field conditions are also at an increased risk to develop shigellosis.     

The cyclicity and prognosis of shigellosis morbidity in Russia

The epidemic process (EP) of shigellosis morbidity proceeds in cycles. As shown in this study, cyclic curves are the sum of polyharmonic fluctuations, being the axis of EP. The duration of one cycle is 18 years, and its configuration is stably retained for a long time. In Nizhny Novgorod shigellosis morbidity is strongly correlated with air temperature is summer at the peak of cyclic rises and moderately correlated in the years of low morbidity. In some cities of the Russian Federation fluctuations of air temperature have been found of occur synchronously with disturbances of the magnetic field of the earth. The character and stability of EP cycles provide grounds for the prognostication of shigellosis morbidity. The current cycle will end in the year 2000, and then natural preconditions for a new cyclic rise will appear.     

Shigellosis murine model established by intraperitoneal and intranasal route of administration: a comparative comprehension overview

Shigellosis, a major cause of mortality and morbidity, requires development of effective intervention strategy for which animal model mimicking human pathology is essential. Among various animal models for shigellosis, mice being more convenient have been used wherein intraperitoneal and intranasal routes are preferred. With the aim to comprehend the comparative pathophysiological indicators, we have examined relatively high and low dose of Shigella flexneri administered through intraperitoneal and intranasal routes in mice. Characterization of these two models along with the resulting pathophysiology of shigellosis adds to our understanding and offers suitable models appropriate to the objectives of the study.     

New animal model of shigellosis in the Guinea pig: its usefulness for protective efficacy studies

It has been difficult to evaluate the protective efficacy of vaccine candidates against shigellosis, a major form of bacillary dysentery caused by Shigella spp. infection, because of the lack of suitable animal models. To develop a proper animal model representing human bacillary dysentery, guinea pigs were challenged with virulent Shigella flexneri serotype 2a (strains 2457T or YSH6000) or S. flexneri 5a (strain M90T) by the intrarectal (i.r.) route. Interestingly, all guinea pigs administered these Shigella strains developed severe and acute rectocolitis. They lost approximately 20% of their body weight and developed tenesmus by 24 h after Shigella infection. Shigella invasion and colonization of the distal colon were seen at 24 h but disappeared by 48 h following i.r. infection. Histopathological approaches demonstrated significant damage and destruction of mucosal and submucosal layers, thickened intestinal wall, edema, erosion, infiltration of neutrophils, and depletion of goblet cells in the distal colon. Furthermore, robust expression of IL-8, IL-1beta, and inducible NO synthase mRNA was detected in the colon from 6 to 24 h following Shigella infection. Most importantly, in our new shigellosis model, guinea pigs vaccinated with an attenuated S. flexneri 2a SC602 strain possessing high levels of mucosal IgA Abs showed milder symptoms of bacillary dysentery than did animals receiving PBS alone after Shigella infection. In the guinea pig, administration of Shigella by i.r. route induces acute inflammation, making this animal model useful for assessing the protective efficacy of Shigella vaccine candidates.     

痢疾菌苗研究进展

痢疾是全世界范围内流行的肠道传染病。随着分子生物学技术的发展,迄今已构建了新一代预防痢疾的疫苗,其中包括:具有侵袭力和不具侵袭力的单价口服活菌苗候选株;它们与大肠杆菌、伤寒沙门氏菌和血清型不同的痢疾杆菌组成的双价和三价菌苗候选株;以及以脂多糖和核糖体为基础的不经胃肠的组分菌。猴体和人体试验证明它们安全有效。预计在未来的10年中,将会有一个或几个安全有效的痢疾疫苗投放市场。     

The pathogenesis of Shigella flexneri infection: lessons from in vitro and in vivo studies

Shigella flexneri is a Gram-negative facultatively intracellular pathogen responsible for bacillary dysentery in humans. More than one million deaths occur yearly due to infections with Shigella spp. and the victims are mostly children of the developing world. The pathogenesis of Shigella centres on the ability of this organism to invade the colonic epithelium where it induces severe mucosal inflammation. Much information that we have gained concerning the pathogenesis of Shigella has been derived from the study of in vitro models of infection. Using these techniques, a number of the molecular mechanisms by which Shigella invades epithelial cells and macrophages have been identified. In vivo models of shigellosis have been hampered since humans are the only natural hosts of Shigella. However, experimental infection of macaques as well as the murine lung and rabbit ligated ileal loop models have been important in defining some of the immune and inflammatory components of the disease. In particular, the murine lung model has shed light on the development of systemic and local immune protection against Shigella infection. It would be naive to believe that any one model of Shigella infection could adequately represent the complexity of the disease in humans, and more sophisticated in vivo models are now necessary. These models require the use of human cells and tissue, but at present such models remain in the developmental stage. Ultimately, however, it is with such studies that novel treatments and vaccine candidates for the treatment and prevention of shigellosis will be designed.     

Shigellosis in Karachaevo-Cherkes Republic in 1996-2005

Incidence and etiologic structure of shigellosis in Karachaevo-Cherkes Republic for 10 years are analyzed and compared with same characteristics in Russia overall. Sharp rise of shigellosis cases number is detected in 2003-2005 as well as predominance of Shigella sonnei represented by biovar Ilg. It was shown that Shigella strains with different resistance to tetracycline and chloramphenicol circulate in Karachaevo-Cherkes Republic.     

Plant‐based oral vaccines against zoonotic and non‐zoonotic diseases

The shared diseases between animals and humans are known as zoonotic diseases and spread infectious diseases among humans. Zoonotic diseases are not only a major burden to livestock industry but also threaten humans accounting for >60% cases of human illness. About 75% of emerging infectious diseases in humans have been reported to originate from zoonotic pathogens. Because antibiotics are frequently used to protect livestock from bacterial diseases, the development of antibiotic‐resistant strains of epidemic and zoonotic pathogens is now a major concern. Live attenuated and killed vaccines are the only option to control these infectious diseases and this approach has been used since 1890. However, major problems with this approach include high cost and injectable vaccines is impractical for >20 billion poultry animals or fish in aquaculture. Plants offer an attractive and affordable platform for vaccines against animal diseases because of their low cost, and they are free of attenuated pathogens and cold chain requirement. Therefore, several plant‐based vaccines against human and animals diseases have been developed recently that undergo clinical and regulatory approval. Plant‐based vaccines serve as ideal booster vaccines that could eliminate multiple boosters of attenuated bacteria or viruses, but requirement of injectable priming with adjuvant is a current limitation. So, new approaches like oral vaccines are needed to overcome this challenge. In this review, we discuss the progress made in plant‐based vaccines against zoonotic or other animal diseases and future challenges in advancing this field.     

Development of a new guinea-pig model of shigellosis

Shigellosis is a major form of bacillary dysentery caused by Shigella spp. To date, there is no suitable animal model to evaluate the protective efficacy of vaccine candidates against this pathogen. Here, we describe a successful experimental shigellosis in the guinea-pig model, which has shown the characteristic features of human shigellosis. This model yielded reproducible results without any preparatory treatment besides cecal ligation. In this study, guinea-pigs were discretely infected with virulent Shigella dysenteriae type 1 and Shigella flexneri type 2a into the cecocolic junction after ligation of the distal cecum. All the experimental animals lost ～10% of their body weight and developed typical dysentery within 24-h postinfection. In the histological analysis, distal colon showed edema, hemorrhage, exudation and inflammatory infiltrations in the lamina propria. Orally immunized animals with heat-killed S. dysenteriae type 1 and S. flexneri type 2a strains showed high levels of serum immunoglobulin G (IgG) and mucosal IgA antibodies and conferred significant homologous protective immunity against subsequent challenges with the live strains. The direct administration of shigellae into the cecocolic junction induces acute inflammation, making this animal model useful for assessing shigellosis and evaluating the protective immunity of Shigella vaccine candidates.     

Mathematical modeling and prognosis of incidence of enteric anthroponoses with aqueous route of transmission

Using data on long-term dynamics of epidemic process of acute enteric infections enteric with aqueous route of transmission (typhoid fever, shigellosis caused by Shigella flexneri, hepatitis A, rotavirus gastroenteritis, etc.)the equation of regression was developed with the help of Chebyshev's polynoms. Predicted incidences of these infections for 2005 were on 61.2-99.5% in agree with the real ones on two territories of north region of West Siberia. Predicted incidence for 2006 is reflecting tendencies of epidemic process of mentioned infections.     

Vaccination against shigellosis: is it the path that is difficult or is it the difficult that is the path?

Following several decades of research, there is not yet a convincing vaccine against shigellosis. It is still difficult, in spite of the breadth of strategies (i.e. live attenuated oral, killed oral, subunit parenteral) to select an optimal option. Two approaches are clearly emerging: (i) live attenuated deletion mutants based on rational selection of genes that are key in the pathogenic process, and (ii) conjugated detoxified polysaccharide parenteral vaccines, or more recently conjugated synthetic carbohydrates. Some of these approaches have already undergone phase I and II clinical trials with promising results, but important issues have also emerged, particularly the discrepancy between colonization and immunogenic potential of live attenuated vaccine candidates depending upon the population concerned (i.e. non endemic vs. endemic areas). Efforts are needed to definitely establish the proof of concept of these approaches, and thus the need for clinical trials which should also soon explore the possibility to associate different serotypes, in response to serotype specific protection against shigellosis. More basic research is also required to improve what we can still consider as first-generation vaccines, and to explore possible new paradigms including the search for cross-protective antigens.     

The results of a seroepidemiologic study of Newcastle dysentery

Differences in the monthly distribution in the number of seropositive individuals among children and adults in years with different intensity of the epidemic process have been revealed. Immunity in cases of dysentery caused by S. newcastle reflects the yearly and seasonal activation of the epidemic process in this Shigella infection both in children and adults, the seroconversion characteristics observed in the year of a high morbidity level being a more objective criterion indicating the beginning of the activation of the epidemic process in dysentery caused by S. newcastle in comparison with the commonly registered morbidity level.     

不同蛋白载体的痢疾多糖结合疫苗小鼠免疫原性对比试验

试验中以小鼠为动物模型,对不同蛋白载体的痢疾多糖结合疫苗进行免疫效果观察。3种福氏2a痢疾结合疫苗和3种宋内氏痢疾结合疫苗分别皮下免疫NIH小鼠,同时设置O-SP(O-特异性多糖)对照组,免疫3针,在不同免疫针次间采血,用ELISA测定抗体滴度。单独使用福氏2aO-SP和宋内氏O-SP免疫后,小鼠血清中几乎没有抗LPS IgG抗体产生,而用结合疫苗免疫后,小鼠血清中产生了抗LPS IgG抗体,且第二次、第三次免疫后,小鼠血清中抗LPS IgG抗体水平有显著升高,表明结合疫苗具有加强免疫应答效应。三种不同的痢疾结合疫苗相比较,F2a-O-SP-rEPA结合疫苗较F2a-O-SP-TT结合疫苗和F2a-0-SP—DT结合疫苗的小鼠抗LPS IgG抗体水平高,S-O-SP-rEPA结合疫苗较S-O-SP-TT结合疫苗和S-O-SP—CRM9,结合疫苗的小鼠抗LPS IgG抗体水平高。以rEPA作为载体的痢疾结合疫苗比DT,TT作为载体的痢疾结合疫苗的免疫原性要强。     

Construction and characterization of a live attenuated Shigella flexneri 2a vaccine strain, sf301 Delta virG and dsbA33G]

Construction and characterization of a live attenuated Shigella flexneria 2a sf301 vaccine strain to prevent the endemic of shigellosis. Using Chinese majority epidemic Shigella flexneri 2a serotype sf301 as the target, p Delta virG, a deletion derivation of the virG gene in the SacB suicide vector pCVD442 and pDsbA33G, an mutant of a disulfide bond catalyst DsbA, replaced its 33 amiano acid Cystine by Glycerin in pCVD442, were used to generate a attenuated mutant strain sf301: Delta virG: DsbA33 G. Its virulence was evaluated by Sereny test, the invasive ability was detected by HeLa cell invasive assay, immunogenicity was detected by immunized Guinea pigs through inoculated guinea pigs' conjunctive sac. Sereny test was negative and HeLa invasive assay showed sf301: Delta virG: DsbA33 G retained partial invasive ability. In contrast to control group, sf301: Delta virG: DsbA33 G could induced significantly high antibody levels of IgA and IgG against sf301 LPS in animal's mucosal lavage fluids and sera in both primary immunization protocol and boosting protocol. The numbers of ASCs in local draining lymph nodes and spleens were significantly higher than control group. The immune response to sf301: Delta virG: DsbA33 G could provide completely protection from the challenge of wild type sf301. sf301: Delta virG: DsbA33 G is a safe and effective oral candidate vaccine to prevent the infection of Shigella strains.     

O-Acetylation in the O-specific polysaccharide isolated from Shigella flexneri serotype 2a

Shigella flexneri causes diarrheal diseases especially in infants and children in developing countries. Modifications of the lipopolysaccharide (LPS) molecule, like bacteriophage-mediated glucosylation and acetylation of the O-specific chain (O-SP), are important for the LPS antigenicity and consequently for the immunogenicity of the polysaccharide-based vaccines against shigellosis. Here, we report the degree of O-acetylation and the localisation of O-acetyl groups and side-chain glucose substitution in the O-SP (scheme) in different preparations of S. flexneri type 2a LPS. [structure: see text]     

Tendencies in the epidemic process of dysentery in Ryazan

In shigellosis caused by Sh. sonnei and Sh. flexneri the epidemic process was found to have considerable difference in the tendencies and pace of its development. Shigellosis which dominated in the etiological structure at the period following 1966 was dysentery caused by Sh. sonnei; it showed the tendency towards a decrease in morbidity rate. Dysentery caused by Sh. flexneri was second in respect to the frequency of its occurrence after 1966 and showed the tendency towards increase. The simultaneous circulation of Sh. sonnei and Sh. flexneri, the differences in the epidemiology of these types of shigellosis make it imperative that they be studied separately, taking into ccount their etiological selectivity to the main routes of transmitting the infection.     

Clinical trials of Shigella vaccines: two steps forward and one step back on a long, hard road

More than 50 years of research has yielded numerous Shigella vaccine candidates that have exemplified both the promise of vaccine-induced prevention of shigellosis and the impediments to developing a safe and effective vaccine for widespread use, a goal that has yet to be attained. This Review discusses the most advanced strategies for Shigella vaccine development, the immune responses that are elicited following disease or vaccination, the factors that have accelerated or impeded Shigella vaccine development and our ideas for the way forward.     

Colicin Typing as an Epidemiological Tool in the Investigation of Outbreaks of Shigella sonnei

Shigella sonnei has become the most frequently reported cause of shigellosis in the United States. Since Shigella subgroup D has no other serotypes, colicin production has been used as a basis for differentiating and identifying epidemiologically related strains. The results of colicin typing 115 cultures of S. sonnei from eight outbreaks of shigellosis occurring in widely separated regions of the United States support the usefulness of this technique. In each outbreak, the cultures were either of the same colicin type or were uniformly untypable. Unrelated cases yielded a variety of types. Definitions of the relative frequencies and geographic distributions of the various strains of S. sonnei in the United States await an accumulation of experience with the method.     

Historical Advances in Structural and Molecular Biology and How They Impacted Vaccine Development

Vaccines are among the greatest tools for prevention and control of disease. They have eliminated smallpox from the planet, decreased morbidity and mortality for major infectious diseases like polio, measles, mumps, and rubella, significantly blunted the impact of the COVID-19 pandemic, and prevented viral induced cancers such as cervical cancer caused by human papillomavirus. Recent technological advances, in genomics, structural biology, and human immunology have transformed vaccine development, enabling new technologies such as mRNA vaccines to greatly accelerate development of new and improved vaccines. In this review, we briefly highlight the history of vaccine development, and provide examples of where advances in genomics and structural biology, paved the way for development of vaccines for bacterial and viral diseases.