Die Virushepatitis gehört weltweit zu einer der häufigsten viralen Erkrankungen. Doch durch die Entwicklung von immer effizienteren Impfstoffen kann bei einer frühzeitigen Immunisierung eine Infektion verhindert werden. Ziel dieser Arbeit war es, ein Patientenkollektiv zu untersuchen, welches eine Impfung mit einem Hepatitis B-Impfstoff erhalten hatte, und dieses mit Probanden zu vergleichen, die nicht immunisiert waren. Diese Proben wurden auf ihre serologische und zelluläre Reaktivität mittels ELISA und ELISpot untersucht. Im ELISA zeigte sich bei 95 % der geimpften Personen eine positive Serokonversion nach zurückliegender Hepatitis B-Impfung. Um den Impfstatus genauer zu analysieren und bei seronegativen geimpften Probanden den zellulären Arm des Immun-systems zu verifizieren, wurde mittels ELISpot die IFN-γ-Sekretion von HBs-reaktiven T-Zellen untersucht und mit den Ergebnissen, welche in der Serologie gewonnen wurden, verglichen. Dabei zeigte sich, dass die zelluläre Untersuchung bei 43 von 94 untersuchten Patientenproben (46 %) ein positives Ergebnis aufwies. Zweiundzwanzig der 48 geimpften Patienten (46 %) hatten eine antigenspezifische IFN-γ-Sekretion und 21 der 46 Proben der aktuell nicht geimpften Patienten fielen im ELISpot positiv aus. Bei zwei seronegativ geimpften Patienten konnte jeweils ein positives Ergebnis im ELISpot gezeigt werden. Ein direkter Zusammenhang zwischen der Höhe des anti-HBs-Titers im ELISA und Anzahl der spot-bildenden Zellen im ELISpot konnte nicht gezeigt werden. Die Ergebnisse dieser Arbeit zeigen, dass die serologische Untersuchung mittels ELISA weiterhin als Goldstandard verwendet werden soll, um den aktuellen Schutz gegenüber einer Hepatitis B-Infektion zu verifizieren. Durch die zelluläre Untersuchung mit dem ELISpot-Verfahren kann bei weiterer Testoptimierung in Zukunft eine Nachweismethode für seronegative Geimpfte entwickelt werden. Vor allem sollten diese mit Hilfe des ELISpots genauer analysiert werden, um gegebenenfalls bei nicht vorhandener humoralen Immunität und einer ebenfalls fehlenden zellulären Immunität prophylaktische Maßnahmen einzuleiten.

Thesis (PhD)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: See item for full text / AFRIKAANSE OPSOMMING: Sien item vir volteks

Made available in DSpace on 2015-02-04T21:42:06Z (GMT). No. of bitstreams: 1 Maria Heloiza.pdf: 504743 bytes, checksum: 4fde6c28fc11e48070d8c696d00b78e9 (MD5) Previous issue date: 2009-10-23 / Este estudo epidemiológico foi realizado com o objetivo de definir a soroprevalência das hepatites virais B e C em escolares que freqüentavam regularmente as escolas municipais de Ensino Fundamental no município de Santos, no período de novembro de 2008 a março de 2009,. Foram analisadas 98 amostras de sangue de escolares com idade entre 4 e 14 anos, através da técnica de ELISA, para detecção da presença de anticorpos anti-HVC, anti-HBc anti-HBs e HBsAg, Setenta e duas amostras foram positivas para a detecção do anti-HBs, mostrando uma eficácia na vacinação contra hepatite B de 75%. Em duas crianças foi detectada a presença do HVC, demonstrando uma prevalência de 2,8%. A pesquisa do anti-HBc foi positiva em duas crianças (prevalência de 2,8%) e o HBs-Ag foi detectado em uma criança (prevalência de 1,3%).

abstract: Vaccines against the arthropod-borne dengue virus (DENV) are still commercially nonexistent. A subunit immunization strategy may be of value, especially if a safe viral vector acts as a biologically active adjuvant. The DENV envelope protein (E), the main target for neutralizing immune responses, has three conformational domains. The immunoglobulin-like and independently folding domain III (DIII) contains epitopes that elicit highly specific neutralizing antibodies. The hepatitis B small surface antigen (HBsAg, S) was used as a scaffold to display DENV 2 DIII on a virus-like particle (VLP). A measles virus (MV) was engineered to vector HBsAg and the hybrid glycoprotein DIII-HBsAg in two different loci (DIII-S). Despite the relatively deleterious effect on replication caused by the insertion of two transcription cassettes, the recombinant virus MVvac2(DIII-S,S)P induced the secretion of DIII-S hybrid VLP with a similar sucrose density as HBsAg particles (1.10-1.12g/ml) and peaked at 48 h post-infection producing 1.3x106 TCID50/ml infectious MV units in vitro. A second recombinant virus, MVvac2(DIII-S)N, was engineered to vector only the hybrid DIII-S. However, it did not induce the secretion of hybrid HBsAg particles in the supernatant of infected cells. The immunogenicity of the recombinant viruses was tested in a MV-susceptible small animal model, the experimental group which received two 105 TCID50 I.P. doses of MVvac2(DIII-S,S)P in a 28 day interval developed a robust immune response against MV (1:1280), HBsAg (787 mIU/ml) and DENV2 (Log10 neutralization index of 1.2) on average. In summary, it is possible to display DENV E DIII on hybrid HBsAg particles vectored by MV that elicit an immune response. This forms the basis for a potential vaccine platform against DENV. / Dissertation/Thesis / Masters Thesis Biology 2015

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Made available in DSpace on 2016-12-23T13:49:05Z (GMT). No. of bitstreams: 1 Hepatite_B_Oculta_2012.pdf: 1487094 bytes, checksum: 098e451e5a2e2af112aa8508df956a77 (MD5) Previous issue date: 2012-02-29 / Occult hepatitis B (OHB) is defined as the presence of low levels of HBV DNA in the liver or serum of individuals testing hepatitis B surface antigen (HBsAg) negative. In most cases of OHB, sera are positive for hepatitis B core antibody. The literature contains quite a few studies on the prevalence of OHB in Brazil, as well as in the worldwide population. Such reports, often controversial, demonstrate that the OHB prevalence varies among healthy individuals or patients with diseases unrelated to the liver and patients with chronic liver disease. Despite efforts, it is necessary a better understanding of: the reasons for the persistence of low levels of HBV-DNA in the absence of detectable HBsAg, the potential risk of OHB transmission and its role in the progression and aggravation of some liver diseases. Therefore, it is interesting to know the prevalence of OHB indifferent population samples which allows de monitoring of carriers of the occult infection, followed prospectively in order to try to surprise the possible effects of the presence of low levels of HBV-DNA in these individuals. In this study we investigated the presence of Occult Hepatitis B in peripheral blood obtained from 520 healthy donors of Vitoria, Espirito Santo, with the aim of guiding policies to include or not the sensitive HBV-DNA nucleic acid amplification technique (NAT) screening in blood donations with a detection limit of 54UI/mL. In order to enable the molecular detection we had also developed a method that screens plasma samples in pools which is capable of detecting the presence of HBV in the ratio of 1:40.Through the technique of nested-PCR we found that 0,2% (1/520) had occult HBV in serum samples. Despite the low prevalence of OHB detected in the study, a considerable number of patients with occult HBV infection may not have been detected if the blood units were only tested for serological markers of HBV infection. So it is important to know the prevalence of OHB in one or more additional population groups, in order to follow up carriers of occult infection prospectively to determine possible effects of the presence of HBV-DNA in low concentrations in these individuals / A Hepatite B Oculta (HBO) é definida pela presença do DNA do VHB com carga viral geralmente baixa (<200UI/mL), no fígado ou soro de pessoas com antígeno de superfície (HBsAg) indetectável. Na maioria dos casos de HBO há positividade para o anticorpo contra o antígeno core da Hepatite B (anti-HBc). Na literatura constam poucos estudos sobre a prevalência da HBO no Brasil, bem como na população mundial. Existem relatos, muitas vezes controversos, que reportam frequências variáveis da HBO em indivíduos sem doença ou portadores de doença não relacionada com o fígado e em hepatopatas crônicos. Apesar dos esforços, faz-se necessário ainda uma melhor compreensão das razões para a persistência da baixa viremia do VHB na ausência de HBsAg detectável, do potencial risco de transmissão da HBO e do seu papel na progressão e agravamento de algumas hepatopatias. No estudo investigou-se a presença de HBO em 520 doadores de sangue de Vitória, Espírito Santo, com o objetivo de nortear políticas para incluir ou não a triagem molecular NAT (Nucleic Acid Amplification Technique ) de bolsas de sangue. Para viabilizar a detecção molecular desenvolveu-se também uma metodologia de extração em pool de amostrascapaz de detectar a presença do VHB na proporção de 1:40 com limite de detecção de 54UI/mL. Através da técnica de nested-PCR detectou-se a presença do VHB oculto em 0,2% (1/520) das amostras. Apesar da baixa prevalência de HBO detectada no estudo, um número considerável de portadores da infecção oculta podem não estar sendo detectados, se apenas a pesquisa de marcadores sorológicos da presença do VHB esta sendo realizada nas bolsas de sangue. Sendo assim é importante conhecer a prevalência da HBO em diferentes amostras da população para que se possa ter em mãos portadores da infecção oculta acompanhados prospectivamente a fim de tentar surpreender possíveis efeitos da presença do DNA do VHB em baixas concentrações nesses indivíduos

Die Entwicklung einer mukosal verabreichbaren, effektiven DNA-Vakzine gegen Infektionskrankheiten oder Tumorerkrankungen auf der Basis invasiver attenuierter Bakterien ist eine vielversprechende Alternative zu bisherigen parenteralen Strategien der genetischen Vakzinierung. Innerhalb dieser Arbeit wurden Salmonellen-Impfstämme für die orale Übertragung eines eukaryontischen Expressionsplasmids mit dem kleinen Oberflächenantigen des Hepatitis-B-Virus (HBsAg) als Modellantigen optimiert. Die kontinuierliche Sezernierung von Plasmiden als filamentöse Phagenpartikel wurde als ein erster Ansatz getestet, um mit lebenden Bakterien eine DNA-Vakzine innerhalb infizierter Zellen freizusetzen. Die Salmonellen-vermittelte Phagensekretion in der Wirtszelle ist jedoch nicht effizient genug, die Expression des Transgens zu vermitteln. Alternativ wurde ein Ansatz gewählt, durch eine spontan induzierte Lyse der Impfbakterien, Plasmid-DNA in die Wirtszelle zu übertragen. Dazu wurde ein neuartiges bakterielles Autolysesystem etabliert, basierend auf einem Zwei-Phasen-Expressionssystem und von Bakteriophagen abgeleiteten Lysedeterminanten. Dieses System ermöglicht erstmals die kontinuierliche Freisetzung von Plasmid-DNA und Proteinen aus einzelnen, lysierenden Salmonellen innerhalb einer sonst gesunden bakteriellen Gesamtpopulation. Innerhalb infizierter COS7-Zellen führt die Freisetzung des porenformierenden Proteins Listeriolysin O durch autolytische Salmonellen zur Zerstörung der Vakuole, in der die Impfbakterien replizieren, und erleichtert somit den Transfer der Plasmid-DNA aus den Bakterien in das Zytoplasma der Wirtszelle. Die Lysedeterminante und die eukaryontische Expressionskassette für HBsAg wurden auf einem Plasmid kombiniert, sowie eine Kassette zur konstitutiven Expression des Histon-ähnlichen Proteins aus Thermotoga maritima (TmHU) in ein solches Konstrukt integriert. TmHU stabilisiert die Plasmiderhaltung unter nicht selektiven Bedingungen und besitzt das Potential, die Effizienz der DNA-Translokation innerhalb der Wirtszelle zu erhöhen. Durch die orale Gabe optimierter autolytischer Impfbakterien konnte eine potente HBsAg-spezifische Antikörperantwort sowie eine zytotoxische zelluläre Antwort induziert werden. Bereits die einmalige Gabe der autolytischen Bakterien induzierte eine höhere antigenspezifische Antikörperantwort, als die herkömmliche intramuskuläre DNA-Vakzine. Das im Rahmen dieser Arbeit entwickelte Konzept autolytischer Salmonellen stellt also eine neuartige, effiziente Strategie für den mukosalen DNA-Transfer dar. Die Übertragung des Konzeptes der Autolyse auf andere bakterielle Trägersysteme ist möglich und kann zur Erweiterung des Anwendungspektrums bakterieller Vektoren beitragen. / The development of an effective mucosal DNA vaccine against infectious diseases or tumors based on invasive attenuated bacteria is a very promising alternative to common parenteral routes of genetic vaccination. This work aimed at the optimization of Salmonella vaccine strains for the oral delivery of an eukaryotic expression plasmid encoding the small Hepatitis B Virus surface antigen (HBsAg), here used as model antigen. The continuous secretion of plasmids as filamentous phage particles was first tested as a mean for the delivery of the DNA vaccine by living bacteria inside infected host cells. However, Salmonella-mediated phage secretion inside cells did not suffice for the induction of transgene expression. As alternative approach, inducible spontanous lysis of bacteria was used to mediate the release of plasmid DNA into host cells. For this purpose a novel bacterial autolytic system was established on the basis of a two-phase expression system and lysis determinants derived from bacteriophages. This system allows for the first time the continuous release of plasmid DNA and proteins from only few lysing Salmonella within an otherwise healthy bacterial population. Inside COS7 cells the release of the pore-forming protein listeriolysin O by autolytic Salmonella mediates the destruction of the Salmonella-harbouring vacuole, thereby facilitating the transfer of plasmid DNA from bacteria into the host cell cytoplasm. The lysis determinant was combined with the eukaryotic expression cassette for HBsAg on one plasmid. In addition, a cassette for the constitutive expression of TmHU, a histon-like protein derived from Thermotoga maritima, was integrated in such vector. TmHU stabilizes the plasmid propagation in the absence of selective pressure and has the potential to increase the efficiency of plasmid translocation inside the host cell. The oral administration of the optimized autolytic bacteria stimulated a potent HBsAg-specific antibody response as well as a cytotoxic cellular response. Already a single inoculation of the oral vaccine induced a higher specific antibody response than the conventional intramuscular DNA vaccine. Therefore the concept of autolytic Salmonella carrier strains developed in this work constitutes a novel efficient strategy for mucosal DNA delivery. The transfer of this concept to other bacterial carriers is possible and may widen the application field for bacterial vectors.