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Evaluating Potential Vaccine Antigens in both the <i>Chlamydia trachomatis</i>and <i>Chlamydia muridarum</i>intravaginal Mouse Challenge Models

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World Journal of Vaccines 2019年第2期9卷 49-69页

作者： Robin M. Kaufhold Melissa A. Boddicker Jodie A. Field Bob J. Lucas Joseph M. Antonello Amy S. Espeseth Julie M. Skinner Jon H. Heinrichs Jeffrey G. Smith Department of Infectious Diseases/Vaccines MRL (West Point PA) Merck & Co. Inc. Kenilworth NJ USA Present Address Teva Pharmaceuticals West Chester Pennsylvania USA Department of Biometrics Research MRL (West Point PA) Merck & Co. Inc. Kenilworth NJ USA Present Address Sanofi Pasteur Swiftwater Pennsylvania USA Present Address Moderna Therapeutics Cambridge Massachusetts USA

Identifying relevant animal challenge models adds to the complexity of human vaccine development. Murine challenge models have been the most utilized animal model for Chlamydia trachomatis vaccine development. The question arises as to whether the C. trachomatis or C. muridarum pre-clinical model is optimal. We compared C. muridarum and C. trachomatis intravaginal challenge models in a combined total of seventy-five studies evaluating potential vaccine candidates. In 100% (42/42) of C. muridarum studies, mice immunized with Chlamydia elementary bodies (EB) demonstrated a significant reduction in urogenital bacterial shedding as measured by qPCR (p C. trachomatis studies. We have evaluated proposed vaccine antigens in both models and observed immunization with Chlamydia major outer membrane protein (MOMP) vaccine formulations to be protective (p C. trachomatis model, and immunization with PmpD p82 translocator domain was not protective in either model. We also observed in both models that depletion of CD4+ T-cells in MOMP-immunized mice resulted in diminished protective immunity but animals were still able to reduce the infection level. In contrast, mice immunized with live EBs by intraperitoneal route did not require CD4+ T-cells to resolve urogenital infection from intravaginal challenge in either model. Overall, we have found the C. muridarum model to be a more robust, reliable, and reproducible model for vaccine antigen discovery.

关键词： Chlamydia Mouse Challenge Model intravaginal Challenge Sexually Transmitted Diseases

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Efficacy and safety of oral solution dosed misoprostol versus misoprostol vaginally in labour induction

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Open Journal of Obstetrics and Gynecology 2013年第9期3卷 673-679页

作者： Longinos Aceituno Velasco María Teresa Sánchez Barroso María Huertas Segura García Valois González Acosta Ramón de la Fuente Pedrosa Ana Barqueros Ramírez Luis Delgado Martínez Encarna Ruiz Martínez Gynaecologic Clinic Management Unit Hospital “La Inmaculada” (Huercal-Overa) Healthcare Management Area North of Almeria Andalusian Health Service Andalusian Spain

Background: Labour induction is one of the most common medical procedures in obstetrics. The aim is to end the pregnancy when continuity is a risk to mother or fetus. Its main side effect is the increase in the cesarean rate, compared to spontaneous onset deliveries. On the other hand, mortality and morbidity in cesareans are higher. The most common pharmacological drugs used for induction are prostaglandins: dinoprostone and misoprostol. The “gold standard” for labour induction is vaginal misoprostol. The oral route is also effective and also has several benefits like faster onset and easear administration. In recent years several publications state that the administration of misoprostol oral solution, given in doses gradually, is associated with a lower cesarean and hyperstimulation rate than the cases where vaginal misoprostol has been used in pregnant women with unripe cervix. Furthermore, being its half life shorter, it may be very useful in case of uterine hyperstimulation and, probably, a high percentage of women prefer this oral administration to the vaginal one. The objective of this study is to compare the efficacy, safety and side effects on mother and fetus on use of oral versus vaginal administration for induction of labour for prolonged gestation (41 weeks) and premature rupture of membranes, both with live fetus. Methods/Design: Design: double blind controlled trial. Study population: Pregnant women whose labour will be induced due to premature rupture of membranes or prolonged gestation. Inclusion Criteria: 1) Bishop Test equal to or less than 7;2) Single pregnancy;3) Pregnancy at term (37 - 42 weeks);4) No history of uterine surgery;5) Cephalic presentation;6) Live fetus;7) No prostaglandins contraindications. Discussion: Nowadays induction rates are very high, ranging from 25% to 30% approximately. In these cases caesarean rates are higher than when the delivery starts spontaneously. That is one of the main reasons why caesareans have increased, ma

关键词： Cervical Ripening Labour Induction Misoprostol Administration Oral intravaginal Oxytocin Dinoprostone Pregnancy Prolonged Fetal Membranes Premature Rupture

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Severe Pelvic Organ Prolapse with Large Vaginal Mucosal Defect Underwent Laparoscopic Shull’s Uterosacral Ligament Colpo-Suspension and TVM Operation by Two Stage Surgery

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Open Journal of Obstetrics and Gynecology 2017年第4期7卷 395-399页

作者： Yasuyuki Kinjo Kazuaki Yoshimura Hitomi Nakagawa Kazuaki Nishimura Toru Hachisuga Department of Obstetrics and Gynecology Wakamatsu Hospital of University of Occupational and Environmental Health Kitakyushu Japan Department of Obstetrics and Gynecology University of Occupational and Environmental Health Kitakyushu Japan

A 75-year-old woman complained of anuria and a sense of discomfort with severe pelvic organ prolapse (POP). We planned tension-free vaginal mesh (TVM) surgery after curing mucosal defects and completing treatment for diabetes mellitus. Anuria and pyelonephritis relapsed repeatedly due to the failure of ring pessary therapy. Surgical treatment was required emergently. We performed a total laparoscopic hysterectomy and uterosacral ligament colpo-suspension (Shull’s method). Although the vaginal apex was supported to a good position, cystocele occurred six months after the initial surgery. A TVM procedure for recurrent cystocele was performed after curing the mucosal defects, and after the improvement of glycemic control. Transvaginal native tissue repair has the advantages of low risk of ureter injury, firm colpo-suspension, and no need for mesh usage. On the other hand, it is not good at treating cystocele. Transvaginal native tissue repair should prove to be a useful surgical option for apical support without mesh.

关键词： Pelvic Organ Prolapse intravaginal Mucosal Defect Laparoscopic Native Tissue Repair Transvaginal Mesh Surgery

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