AMANDA NAZARETH LARA
Projetos de Pesquisa
Unidades Organizacionais
P ICHC, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/48 - Laboratório de Imunologia, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/48 - Laboratório de Imunologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
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- A systematic review of adult tetanus-diphtheria-acellular (Tdap) coverage among healthcare workers(2019) RANDI, Bruno A.; SEJAS, Odeli Nicole Encinas; MIYAJI, Karina T.; INFANTE, Vanessa; LARA, Amanda N.; IBRAHIM, Karim Y.; LOPES, Marta H.; SARTORI, Ana Marli C.During the last decades pertussis incidence raised globally. Several vaccination strategies targeting adults to reduce pertussis among young infants have been proposed, including vaccination of healthcare workers (HCWs). The aim of this study was to analyse, by performing a systematic review of literature, published papers that evaluated Tdap coverage among HCWs, variables associated with vaccine uptake and efforts implemented to raise vaccination rates. We searched the MedLine, Embase, SCOPUS, LILACS, Web of Science and Cochrane for full-text studies that evaluated Tdap coverage in HCW. Two independent reviewers screened the articles and extracted the data. Twenty-eight studies published from 2009 to 2018 were reviewed. Most studies were conducted in the USA. Initial Tdap coverage varied from 6.1% to 63.9%. USA and France are the only two countries with studies evaluating Tdap coverage within HCWs using national data. In the USA, Tdap coverage in HCWs raised from 6.1% to 45.1% from 2007 to 2015. In the analysis of French national data, a Tdap coverage of 63.9% was observed. Five studies used interventions to raise Tdap coverage in HCWs. Two intervention studies implemented mandatory vaccination and three used educational strategies. All of them achieved coverages over 86%. Only eleven studies analysed the association of Tdap vaccination with variables of interest. Previous immunization with other vaccines recommended for HCWs (like influenza, hepatitis B and MMR) was positively associated with Tdap uptake in four studies. In conclusion, overall Tdap coverage among HCWs is low, but seems to increase over the years after the vaccine introduction and with implementation of interventions to increase coverage.
- Plant-made virus-like particle vaccines bearing the hemagglutinin of either seasonal (H1) or avian (H5) influenza have distinct patterns of interaction with human immune cells in vitro(2017) HENDIN, Hilary E.; PILLET, Stephane; LARA, Amanda N.; WU, Cheng-Ying; CHARLAND, Nathalie; LANDRY, Nathalie; WARD, Brian J.Introduction: The recent emergence of avian influenza strains has fuelled concern about pandemic preparedness since vaccines targeting these viruses are often poorly immunogenic. Weak antibody responses to vaccines have been seen across multiple platforms including plant-made VLPs. To better understand these differences, we compared the in vitro responses of human immune cells exposed to plant-made virus-like particle (VLP) vaccines targeting H1N1 (H1-VLP) and H5N1 (H5-VLP). Methods: Peripheral blood mononuclear cells (PBMC) from healthy adults were stimulated ex vivo with 2-5 mu g/mL VLPs bearing the hemagglutinin (HA) of either H1N1 (A/California/7/2009) or H5N1 (A/Indonesia/5/05). VLP-immune cell interactions were characterized by confocal microscopy and flow cytometry 30 min after stimulation with dialkylaminostyryl dye-labeled (DiD) VLP. Expression of CD69 and pro-inflammatory cytokines were used to assess innate immune activation 6 h after stimulation. Results: H1- and H5-VLPs rapidly associated with all subsets of human PBMC but exhibited unique binding preferences and frequencies. The H1-VLP bound to 88.7 1.6% of the CD19(+) B cells compared to only 21.9 +/- 1.8% bound by the H5-VLP. At 6 h in culture, CD69 expression on B cells was increased in response to H1-VLP but not H5-VLP (22.79 +/- 3.42% vs. 6.15 +/- 0.82% respectively: p < 0.0001). Both VLPs were rapidly internalized by CD14(+) monocytes resulting in the induction of pro-inflammatory cytokines (i.e.: IL-8, IL-1 beta, TNF alpha and IL-6). However, a higher concentration of the H5-VLP was required to induce a comparable response and the pattern of cytokine production differed between VLP vaccines. Conclusions: Plant -made VLP vaccines bearing H1 or H5 rapidly elicit immune activation and cytokine production in human PBMC. Differences in the VLP-immune cell interactions suggest that features of the HA proteins themselves, such as receptor specificity, influence innate immune responses. Although not generally considered for inactivated vaccines, the distribution and characteristics of influenza receptor(s) on the immune cells themselves may contribute to both the strength and pattern of the immune response generated.
- Long-term protection after hepatitis B vaccination in people living with HIV(2017) LARA, Amanda Nazareth; SARTORI, Ana Marli; FONSECA, Marise Oliveira; LOPES, Marta HeloisaBackground: Hepatitis B vaccine is important in people living with HIV (PLHIV) since both viruses have the same transmission routes and co-infection has greater morbidity. PLHIV usually have poor response to hepatitis B vaccine. The duration of immunity in PLHIV is unknown. The objective of this study is to evaluate the duration of serological response and clinical protection provided by hepatitis B vaccination in PLHIV. Methods: Retrospective study of a PLHIV cohort primarily vaccinated for hepatitis B virus (HBV) from 2001 to 2002. Markers of infection and protection from HBV were investigated in those individuals who were still attending the outpatient clinic, in sao Paulo, Brazil from 2012 to 2014. Three groups were analyzed. Group 1: adults who responded to primary vaccine series. Group 2: non-responders to primary vaccine series. Group 3: subjects from both Groups 1 and 2 who did not receive any booster doses after seroconversion. Results: A cohort of 121 PLHIV was analyzed for seroconversion and persistence of anti-HBs. The majority were female (54.5%) and mean age was 50.1 years. After 11 years, none of the patients had serologic evidence of HBV infection. Overall, 41/58 (70.7%) of the initial responders (Group 1) had maintained anti-HBs >= 10 mIU/mL. Greater CD4+ values and anti-HBs > 100 mIU/mL at the time of first vaccine series were associated with persistence of anti-HBs. During the time of evaluation, 35/63 (55.6%) of the initial non-responders (Group 2) successfully seroconverted (anti-HBs >= 10 mlU/mL) in response to one or more booster doses. From the time of their seroconversion, 70 of the patients did not receive any further booster doses (Group 3). After 10 years, 54/70 (77.1%) of these individuals has maintained anti-HBs > 10 mIU/mL. Conclusions: Evaluation of long-term immunity for hepatitis B in PLHIV following vaccination showed a strong persistence of anti-HBs and no serologic evidence of HBV infection. Boosters may be effective in PLHIV non-responders to primary vaccination.
- A randomized, double-blind, non-inferiority trial comparing the immunogenicity and safety of two seasonal inactivated influenza vaccines in adults(2023) VANNI, Tazio; SALOMAO, Maria da Grada; VISCONDI, Juliana Yukari Kodaira; BRAGA, Patricia Emilia; SILVA, Anderson da; PIORELLI, Roberta de Oliveira; SANTOS, Joane do Prado; GATTAS, Vera Lucia; LUCCHESI, Maria Beatriz Bastos; OLIVEIRA, Mayra Martho Moura de; KOIKE, Marcelo Eiji; CAMPOS, Lucia M. A.; COELHO, Eduardo B.; WECKX, Lily Yin; LARA, Amanda Nazareth; PAIVA, Terezinha M.; TIMENETSKY, Maria do Carmo S. T.; PRECIOSO, Alexander RobertoBackground: To enhance the production and availability of influenza vaccines in different regions of the world is paramount to mitigate the global burden of this disease. Instituto Butantan developed and man-ufactured an embryonated egg-based inactivated split-virion trivalent seasonal influenza vaccine as part of a technology transfer partnership with Sanofi Pasteur.Methods: This is a phase IV, randomized, double-blind, active-controlled, multicenter clinical trial includ-ing adults 18-60 and > 60 years recruited during the 2019 southern hemisphere influenza season. Subjects were randomized 1:1 to receive either the Sanofi Pasteur Trivalent Seasonal Influenza Vaccine (SP-TIV) or Instituto Butantan Trivalent Seasonal Influenza Vaccine (IB-TIV). Hemagglutinin inhibition antibody titers were assessed pre-vaccination and 21 days post-vaccination.Results: 624 participants were randomized and vaccinated. In both intention-to-treat and per-protocol analysis, non-inferiority of the SP-TIV versus IB-TIV was demonstrated for the three influenza strains. In the per-protocol analysis, the SP-GMT/IB-GMT ratios for H1N1, H3N2, and B were 0.9 (95%CI, 0.7- 1.1), 1.2 (95%CI, 1.0-1.4), and 1.1 (95%CI, 0.9-1.3), respectively. Across vaccination groups, the most com-mon adverse reactions (AR) were limited to the injection-site, including pain and tenderness. The major-ity of the ARs were graded 1 and/or 2 and lasted less than one day. No serious adverse reaction was observed.Conclusion: This study demonstrated the non-inferiority of the immunogenicity of a single-dose of Instituto Butantan versus a single dose of the Sanofi Pasteur Seasonal Trivalent Influenza Vaccine in adults. Both vaccines were well tolerated and presented similar safety profiles.(c) 2023 Elsevier Ltd. All rights reserved.