The Experts below are selected from a list of 132 Experts worldwide ranked by ideXlab platform
David J Esteban - One of the best experts on this subject based on the ideXlab platform.
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genomic sequence and analysis of a Vaccinia virus isolate from a patient with a smallpox vaccine related complication
2006Co-Authors: Nanhai Chen, Inger K. Damon, Zehua Feng, Mark R L Buller, John D Osborne, Tiara Harms, Chris Upton, David J EstebanAbstract:Background Vaccinia virus (VACV)-DUKE was isolated from a lesion on a 54 year old female who presented to a doctor at the Duke University Medical Center. She was diagnosed with progressive Vaccinia and treated with Vaccinia Immune Globulin. The availability of the VACV-DUKE genome sequence permits a first time genomic comparison of a VACV isolate associated with a smallpox vaccine complication with the sequence of culture-derived clonal isolates of the Dryvax vaccine.
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Genomic sequence and analysis of a Vaccinia virus isolate from a patient with a smallpox vaccine-related complication
2006Co-Authors: Nanhai Chen, Zehua Feng, Tiara Harms, Chris Upton, R Mark L Buller, John Osborne, Inger Damon, David J EstebanAbstract:Background Vaccinia virus (VACV)-DUKE was isolated from a lesion on a 54 year old female who presented to a doctor at the Duke University Medical Center. She was diagnosed with progressive Vaccinia and treated with Vaccinia Immune Globulin. The availability of the VACV-DUKE genome sequence permits a first time genomic comparison of a VACV isolate associated with a smallpox vaccine complication with the sequence of culture-derived clonal isolates of the Dryvax vaccine. Results This study showed that VACV-DUKE is most similar to VACV-ACAM2000 and CLONE3, two VACV clones isolated from the Dryvax^® vaccine stock confirming VACV-DUKE as an isolate from Dryvax^®. However, VACV-DUKE is unique because it is, to date, the only Dryvax^® clone isolated from a patient experiencing a vaccine-associated complication. The 199,960 bp VACV-DUKE genome encodes 225 open reading frames, including 178 intact genes and 47 gene fragments. Between VACV-DUKE and the other Dryvax^® isolates, the major genomic differences are in fragmentation of the ankyrin-like, and kelch-like genes, presence of a full-length Interferon-α/β receptor gene, and the absence of a duplication of 12 ORFs in the inverted terminal repeat. Excluding this region, the DNA sequence of VACV-DUKE differs from the other two Dryvax^® isolates by less than 0.4%. DNA sequencing also indicated that there was little heterogeneity in the sample, supporting the hypothesis that virus from an individual lesion is clonal in origin despite the fact that the vaccine is a mixed population. Conclusion Virus in lesions that result from progressive Vaccinia following vaccination with Dryvax are likely clonal in origin. The genomic sequence of VACV-DUKE is overall very similar to that of Dryvax^® cell culture-derived clonal isolates. Furthermore, with the sequences of multiple clones from Dryvax^® we can begin to appreciate the diversity of the viral population in the smallpox vaccine.
Inger K. Damon - One of the best experts on this subject based on the ideXlab platform.
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severe eczema vaccinatum in a household contact of a smallpox vaccinee
2008Co-Authors: Surabhi Vora, Inger K. Damon, Vincent A Fulginiti, Stephen G Weber, Madelyn D Kahana, Sarah L Stein, Susan I Gerber, Sylvia Garciahouchins, Edith R LedermanAbstract:BACKGROUND: We report the first confirmed case of eczema vaccinatum in the United States related to smallpox vaccination since routine vaccination was discontinued in 1972. A 28-month-old child with refractory atopic dermatitis developed eczema vaccinatum after exposure to his father, a member of the US military who had recently received smallpox vaccine. The father had a history of inactive eczema but reportedly reacted normally to the vaccine. The child's mother also developed contact Vaccinia infection. METHODS: Treatment of the child included Vaccinia Immune Globulin administered intravenously, used for the first time in a pediatric patient; cidofovir, never previously used for human Vaccinia infection; and ST-246, an investigational agent being studied for the treatment of orthopoxvirus infection. Serological response to Vaccinia virus and viral DNA levels, correlated with clinical events, were utilized to monitor the course of disease and to guide therapy. Burn patient-type management was required, including skin grafts. RESULTS: The child was discharged from the hospital after 48 days and has recovered with no apparent systemic sequelae or significant scarring. CONCLUSION: This case illustrates the need for careful screening prior to administration of smallpox vaccine and awareness by clinicians of the ongoing vaccination program and the potential risk for severe adverse events related to Vaccinia virus.
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genomic sequence and analysis of a Vaccinia virus isolate from a patient with a smallpox vaccine related complication
2006Co-Authors: Nanhai Chen, Inger K. Damon, Zehua Feng, Mark R L Buller, John D Osborne, Tiara Harms, Chris Upton, David J EstebanAbstract:Background Vaccinia virus (VACV)-DUKE was isolated from a lesion on a 54 year old female who presented to a doctor at the Duke University Medical Center. She was diagnosed with progressive Vaccinia and treated with Vaccinia Immune Globulin. The availability of the VACV-DUKE genome sequence permits a first time genomic comparison of a VACV isolate associated with a smallpox vaccine complication with the sequence of culture-derived clonal isolates of the Dryvax vaccine.
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chimpanzee human mabs to Vaccinia virus b5 protein neutralize Vaccinia and smallpox viruses and protect mice against Vaccinia virus
2006Co-Authors: Zhaochun Chen, Scott K Smith, Inger K. Damon, Patricia L Earl, Jeffrey L. Americo, Andrew Sebrell, Suzanne U. Emerson, Gary H. Cohen, Yihua Zhou, Roselyn J. EisenbergAbstract:Chimpanzee Fabs against the B5 envelope glycoprotein of Vaccinia virus were isolated and converted into complete mAbs with human γ1 heavy chain constant regions. The two mAbs (8AH8AL and 8AH7AL) displayed high binding affinities to B5 (Kd of 0.2 and 0.7 nM). The mAb 8AH8AL inhibited the spread of Vaccinia virus as well as variola virus (the causative agent of smallpox) in vitro, protected mice from subsequent intranasal challenge with virulent Vaccinia virus, protected mice when administered 2 days after challenge, and provided significantly greater protection than that afforded by a previously isolated rat anti-B5 mAb (19C2) or by Vaccinia Immune Globulin. The mAb bound to a conformational epitope between amino acids 20 and 130 of B5. These chimpanzee/human anti-B5 mAbs may be useful in the prevention and treatment of Vaccinia virus-induced complications of vaccination against smallpox and may also be effective in the immunoprophylaxis and immunotherapy of smallpox.
Mike Bray - One of the best experts on this subject based on the ideXlab platform.
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postexposure prevention of progressive Vaccinia in scid mice treated with Vaccinia Immune Globulin
2011Co-Authors: Robert W Fisher, D. E. Scott, Jennifer L Reed, P J Snoy, Malgorzata G Mikolajczyk, Mike Bray, Michael KennedyAbstract:A recently reported case of progressive Vaccinia (PV) in an immunocompromised patient has refocused attention on this condition. Uniformly fatal prior to the licensure of Vaccinia Immune Globulin (VIG) in 1978, PV was still fatal in about half of VIG-treated patients overall, with a greater mortality rate in infants and children. Additional therapies would be needed in the setting of a smallpox bioterror event, since mass vaccination following any variola virus release would inevitably result in exposure of immunocompromised people through vaccination or contact with vaccinees. Well-characterized animal models of disease can support the licensure of new products when human studies are not ethical or feasible, as in the case of PV. We chose Vaccinia virus-scarified SCID mice to model PV. As in immunocompromised humans, Vaccinia virus-scarified SCID animals develop enlarging primary lesions with minimal or no inflammation, eventual distal virus spread, and lethal outcomes if left untreated. Postexposure treatment with VIG slowed disease progression, caused local lesion regression, and resulted in the healthy survival of most of the mice for more than 120 days. Combination treatment with VIG and topical cidofovir also resulted in long-term disease-free survival of most of the animals, even when initiated 7 days postinfection. These results support the possibility that combination treatments may be effective in humans and support using this SCID model of PV to test new antibody therapies and combination therapies and to provide further insights into the pathogenesis and treatment of PV.
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henry kempe and the birth of Vaccinia Immune Globulin
2004Co-Authors: Mike BrayAbstract:This issue of Clinical Infectious Diseases contains 2 articles about VIG. In one, Hopkins et al. [1] describe the pharmacokinetics and safety of a new preparation formulated for intravenous use. In the other, Hopkins and Lane [2] review all English-language articles describing the use of the original, intramuscularly injected product to treat a variety of vaccination complications. These include 2 potentially lethal conditions: progressive Vaccinia, in which the vaccination site
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pathogenesis and potential antiviral therapy of complications of smallpox vaccination
2003Co-Authors: Mike BrayAbstract:Vaccination against smallpox may result in a variety of complications, ranging in severity from benign to lethal. Universal vaccination was halted in the US in 1972, so almost half the present population has never been vaccinated. Because side effects occur most often in first-time vaccinees, current plans for rapid large-scale vaccination in the event of bioterrorist attack raise concerns about the occurrence of a large number of adverse events. Most complications result from the excessive replication of Vaccinia virus, making them potential targets for antiviral therapy. Effective treatment is especially needed for persons with atopic dermatitis or eczema, who are unusually susceptible to the initiation and spread of Vaccinia infection because of defects of innate immunity in the skin, and for individuals with defective cell-mediated immunity, who are unable to eliminate Vaccinia infection once it has begun. In the past, many complications were treated with Vaccinia Immune Globulin (VIG) and/or the antiviral drug methisazone, but neither was tested in placebo-controlled trials. New antiviral drugs are now available, but have not yet been evaluated for treating Vaccinia infections in humans. Both laboratory research and clinical studies are needed to help prevent serious complications in any major vaccination campaign.
Nanhai Chen - One of the best experts on this subject based on the ideXlab platform.
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genomic sequence and analysis of a Vaccinia virus isolate from a patient with a smallpox vaccine related complication
2006Co-Authors: Nanhai Chen, Inger K. Damon, Zehua Feng, Mark R L Buller, John D Osborne, Tiara Harms, Chris Upton, David J EstebanAbstract:Background Vaccinia virus (VACV)-DUKE was isolated from a lesion on a 54 year old female who presented to a doctor at the Duke University Medical Center. She was diagnosed with progressive Vaccinia and treated with Vaccinia Immune Globulin. The availability of the VACV-DUKE genome sequence permits a first time genomic comparison of a VACV isolate associated with a smallpox vaccine complication with the sequence of culture-derived clonal isolates of the Dryvax vaccine.
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Genomic sequence and analysis of a Vaccinia virus isolate from a patient with a smallpox vaccine-related complication
2006Co-Authors: Nanhai Chen, Zehua Feng, Tiara Harms, Chris Upton, R Mark L Buller, John Osborne, Inger Damon, David J EstebanAbstract:Background Vaccinia virus (VACV)-DUKE was isolated from a lesion on a 54 year old female who presented to a doctor at the Duke University Medical Center. She was diagnosed with progressive Vaccinia and treated with Vaccinia Immune Globulin. The availability of the VACV-DUKE genome sequence permits a first time genomic comparison of a VACV isolate associated with a smallpox vaccine complication with the sequence of culture-derived clonal isolates of the Dryvax vaccine. Results This study showed that VACV-DUKE is most similar to VACV-ACAM2000 and CLONE3, two VACV clones isolated from the Dryvax^® vaccine stock confirming VACV-DUKE as an isolate from Dryvax^®. However, VACV-DUKE is unique because it is, to date, the only Dryvax^® clone isolated from a patient experiencing a vaccine-associated complication. The 199,960 bp VACV-DUKE genome encodes 225 open reading frames, including 178 intact genes and 47 gene fragments. Between VACV-DUKE and the other Dryvax^® isolates, the major genomic differences are in fragmentation of the ankyrin-like, and kelch-like genes, presence of a full-length Interferon-α/β receptor gene, and the absence of a duplication of 12 ORFs in the inverted terminal repeat. Excluding this region, the DNA sequence of VACV-DUKE differs from the other two Dryvax^® isolates by less than 0.4%. DNA sequencing also indicated that there was little heterogeneity in the sample, supporting the hypothesis that virus from an individual lesion is clonal in origin despite the fact that the vaccine is a mixed population. Conclusion Virus in lesions that result from progressive Vaccinia following vaccination with Dryvax are likely clonal in origin. The genomic sequence of VACV-DUKE is overall very similar to that of Dryvax^® cell culture-derived clonal isolates. Furthermore, with the sequences of multiple clones from Dryvax^® we can begin to appreciate the diversity of the viral population in the smallpox vaccine.
Robert J. Hopkins - One of the best experts on this subject based on the ideXlab platform.
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2004. Clinical efficacy of intramuscular Vaccinia Immune Globulin: a literature review. Clin. Infect. Dis
2016Co-Authors: Robert J. Hopkins, Michael J. LaneAbstract:(See the editorial commentary by Bray on pages 767–9 and the article by Hopkins et al. on pages 759–66) Background. Numerous literature reports describe clinical efficacy of intramuscular Vaccinia Immune Globulin (VIG) for complications of smallpox vaccination, prophylaxis of individuals with contraindications to vaccination, and prevention of smallpox among close contacts of patients with smallpox. Methods. We reviewed the literature regarding VIG treatment and prophylaxis of smallpox vaccine compli-cations and the use of VIG as a preventative measure for close contacts of patients with smallpox. Results. Data regarding intramuscular administration of VIG for treatment of smallpox vaccine complications occurred in 16 articles, none of which reported formal controlled trials. The indications for treatment include generalized Vaccinia, progressive Vaccinia, eczema vaccinatum, and certain accidental implantations. Six publications suggest VIG efficacy for prophylaxis of Vaccinial superinfection of eczema, burns, chickenpox, immunosuppression, pregnancy, or certain skin conditions. Prophylactic VIG has also been used in healthy military recruits to reduce the incidence of postVaccinial encephalitis. The use of intramuscular administration of VIG to prevent smallpox in contacts of patients with documented cases of smallpox is reported in 4 studies that compare contacts who received intramuscular administration of VIG with those who did not and in 1 observational study, with varying but promising results
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clinical efficacy of intramuscular Vaccinia Immune Globulin a literature review
2004Co-Authors: Robert J. Hopkins, Michael J. LaneAbstract:Background Numerous literature reports describe clinical efficacy of intramuscular Vaccinia Immune Globulin (VIG) for complications of smallpox vaccination, prophylaxis of individuals with contraindications to vaccination, and prevention of smallpox among close contacts of patients with smallpox. Methods We reviewed the literature regarding VIG treatment and prophylaxis of smallpox vaccine complications and the use of VIG as a preventative measure for close contacts of patients with smallpox. Results Data regarding intramuscular administration of VIG for treatment of smallpox vaccine complications occurred in 16 articles, none of which reported formal controlled trials. The indications for treatment include generalized Vaccinia, progressive Vaccinia, eczema vaccinatum, and certain accidental implantations. Six publications suggest VIG efficacy for prophylaxis of Vaccinial superinfection of eczema, burns, chickenpox, immunosuppression, pregnancy, or certain skin conditions. Prophylactic VIG has also been used in healthy military recruits to reduce the incidence of postVaccinial encephalitis. The use of intramuscular administration of VIG to prevent smallpox in contacts of patients with documented cases of smallpox is reported in 4 studies that compare contacts who received intramuscular administration of VIG with those who did not and in 1 observational study, with varying but promising results. Conclusions Although controlled clinical trials do not exist to support the use of VIG for treatment of Vaccinia-related complications or prophylaxis among individuals with contraindications to smallpox vaccination, available data suggest that VIG reduces morbidity and mortality associated with progressive Vaccinia (Vaccinia necrosum) and eczema vaccinatum. Furthermore, VIG seems to prevent Vaccinial superinfection in patients with inflammatory skin diseases or burns, given the low incidence of vaccina-related complications associated with these conditions.
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safety and pharmacokinetic evaluation of intravenous Vaccinia Immune Globulin in healthy volunteers
2004Co-Authors: Robert J. Hopkins, William Kramer, William C Blackwelder, Minal Ashtekar, Lynda Hague, Gregory Berezuk, David W Smith, Philip T LeeseAbstract:Background. Vaccinia Immune Globulin (VIG) administered via the intramuscular route has historically been used for the treatment of complications of smallpox vaccination. Intravenous formulations of VIG are required to improve tolerability and pharmacokinetic profile. Methods. We conducted 2 separate studies to evaluate the feasibility of administration of an intravenous formulation of antiVaccinia Immune Globulin (VIGIV). The first study assessed the pharmacokinetics and safety of a newly manufactured lyophilized VIG product for intravenous administration (VIGIV-lyo). Seventy-eight healthy volunteers received an intravenous infusion of VIGIV-lyo at doses of 100 mg/kg, 200 mg/kg, or 500 mg/ kg. In the second study, we evaluated the safety of a liquid product of VIGIV (VIGIV-liq) in 33 healthy volunteers receiving an intravenous infusion of 100 mg/kg VIGIV-liq. Results. The geometric mean titer of VIG at the target dose (100 mg/kg) after intravenous administration is 2.5 times higher than the predicted geometric mean titer after intramuscular injection (P<.001). The pharmacokinetics of VIGIV-lyo are linear for doses from 100 mg/kg through 500 mg/kg. Administration of the 200-mg/ kg and 500-mg/kg doses of VIGIV-lyo does not result in markedly higher adverse event rates. The adverse event rates observed with the liquid product are comparable to those seen with the lyophilized product. Conclusions. These 2 studies suggest that intravenous administration of VIG is well tolerated and results in a more favorable pharmacokinetic profile than does VIG administered intramuscularly.
