Alexis Garcia

An overview of adjuvant formulations and delivery systems

Adjuvants may promote immune responses: by recruiting professional antigen‐presenting cells (APCs) to the vaccination site, increasing the delivery of antigens to APCs, or by activating APCs to produce cytokines and by triggering T cell responses. Aluminium salts have been effective at promoting protective humoral immunity; however, they are not effective in generating cell‐mediated immunity. A number of different approaches have been developed to potentiate immune response and they have been partially successful. Research has been conducted into vaccine delivery systems (VDS); enhancing cross‐presentation by targeting antigens to (APCs). Antigen discovery has increased over the past decade, and consequently, it has accelerated vaccine development demanding a new generation of VDS that combines different types of adjuvants into specific formulations with greater activity. The new approaches offer a wide spectrum of opportunities in vaccine research with direct applications in the near future.

Metabolic syndrome and asthma.

Metabolic syndrome (MetS) is a syndrome that involves at least three disorders dyslipidemia, insulin resistance, obesity and/or hypertension. MetS has been associated with several chronic diseases in the adulthood; however, in the recent years, the syndrome was redefined in children. Girls with early menarche and asthma, and children with MetS and asthma that reach adulthood appear to have higher risk to develop severe or difficult to control asthma and a higher probability to suffer cardiovascular diseases. It has been proposed that patients with MetS and endocrinological disorders should be considered a different entity in which pharmacologic treatment should be adjusted according to the individual. Recent patents on the field have addressed new issues on how endocrine control should be managed along with asthma therapeutics. In the near future, new approaches should decrease the high morbidity and mortality associated to these types of patients.

HIV Vaccines: A Brief Overview

The scope of the article is to review the different approaches that have been used for HIV vaccines. The review is based on articles retrieved by PubMed and clinical trials from 1990 up to date. The article discusses virus complexity, protective and non‐protective immune responses against the virus, and the most important approaches for HIV vaccine development.

Beta 2 adrenergic receptor polymorphisms, at codons 16 and 27, and bronchodilator responses in adult Venezuelan asthmatic patients

BACKGROUND One of the gene polymorphisms often studied in asthmatic patients is the β2 adrenergic receptor (ADRβ2). Even though in the Venezuelan Mestizo population there is a high incidence of asthma, there are no direct reports of ADRβ2 gene polymorphism, and treatment response. The aim of this study was to assess, in this population, the gene frequency of ADRβ2 polymorphisms at codons 16 Arg/Gly and 27 Gln/Glu, allergen sensitization, and its relationship to bronchodilator response. METHODS Purified genomic DNA was obtained form 105 Mestizo asthmatic and 100 Mestizo healthy individuals from Venezuela. The two polymorphisms were assessed by PCR-RFLP. Patient sensitization to aeroallergens and their response to bronchodilatation were correlated. RESULTS Significant differences between patients and controls were recorded in: 1) the prevalence of Arg/Arg at codon 16 (28.6% in patients vs. 47% in controls, P<0.01), 2) the frequency of heterozygotes Arg/Gly (55% in patients vs. 35% in controls, P<0.01). Conversely, no differences in polymorphism frequencies were found at codon 27. The haplotypes Arg/Gly-Gln/Gln were more common in patients than controls (P <0.01), whereas the Arg/Arg-Gln/Glu combination prevailed in the control group (P<0.01). The Arg/Gly and Gln/Glu genotypes were associated with better responses after salbutamol. The asthmatic homozygotes Arg/Arg have higher sensitivity to aeroallergens. CONCLUSION The difference in Arg/Arg frequency between groups suggests that this could be a protective genotype although the asthmatic group had a higher sensitivity to aeroallergens. The asthmatic heterozygotes had better bronchodilator responses than the homozygotes.

Surfactant Protein D in Chronic Obstructive Pulmonary Disease (COPD)

In the recent years, a large number of potential biomarkers for Chronic Obstructive Pulmonary Disease (COPD) have been described. One of the important biomarkers is Surfactant Protein D (SPD) since serum SPD levels have been associated with lung function or health status in patients with severe COPD. Several interesting evidences of the protein and gene polymorphisms have been described. The present review highlights the current literature, recent patents and, future prospects of this important collection.

New Approaches to Chikungunya Virus Vaccine Development

Chikungunya virus (CHIKV) is a mosquito-borne human pathogen that affects millions of individuals each year by causing non-specific flu-like symptoms, with a characteristic rash accompanied by joint pain that may last for a long time after the resolution of the infection. Despite intense research efforts, no approved vaccine or antiviral therapy is yet available. This review is based on articles retrieved by PubMed and clinical trials since 1980 to present. Virus complexity, protective and non-protective immune responses against the virus, and the most important a new patented approaches for Chikungunya vaccine development are discussed.

SAT0363 Agreement Degree on the Adherence to Disease-Modifying Antirrheumatic Drugs (DMARD) Treatment in Rheumatoid Arthritis in Spain. Results of the Observar Study

Background Adherence to treatment in rheumatoid arthritis (RA) is influenced by numerous factors. Although patients with RA are aware that compliance is important for disease control, there is evidence that they often drop out the prescribed use of synthetic DMARDs. Objectives The OBSERVAR Study aims to confirm the lack of adherence to synthetic DMARDs in patients with RA and look for the main reasons for dropping out. Methods Between July and August 2014, 18 Spanish consultant rheumatologists were asked, using a two-round Delphi process, to determine the degree of agreement with multiple causes of non-compliance. These reasons were selected by a systematic literature search in PubMed and Google Scholar, based on scientific publications. 66 reasons were selected, divided into 3 blocks, related to patients, to healthcare professionals and inherent to the DMARD treatment itself. The degree of agreement with each of these was identified on a scale from 1 to 9 (minimum and maximum agreement). The consistency of these agreements was determined by two criteria: based on the group mean, and based on simultaneous observance of mean and median ≥7, standard deviation and interquartile range ≤1.00, and coefficient of variation ≤0.25. Results There was agreement with most of the statements selected (75.76%) and only one disagreement. Most frequent among the patient-related reasons were insufficient knowledge of the disease and importance of treatment adherence. The main reasons related to healthcare professionals were insufficient follow-up, lack of screening for non-compliant patients and lack of implementation of procedures aimed at improving adherence. With respect to treatment, general aspects were agreed such as the total number of pills or lack of reminder tools. When we applied the criterion of consistency of agreement, three reasons were highlighted (4.5%): not knowing what to do when the patient suffered an adverse event with the DMARD, lack of screening to detect non-compliant patients and lack of implementation of procedures to improve therapeutic compliance. Conclusions The lack of strict adherence by patients in the treatment of RA with synthetic DMARDs is relatively common. Most of the reasons given for this have been confirmed in our study. The situation must be improved by: establishing objectives agreed with the patient; teaching them properly about the disease, treatment, expected side effects, the importance of adherence and its consequences; and by trying to identify potentially non-compliant patients early and subsequent continuous monitoring of their adherence. Acknowledgements Roche Farma Spain Disclosure of Interest None declared