No abstract

The vaccinia virus (VACV) Lister strain was one of the vaccine strains that enabled smallpox eradication. Although the strain is most often harmless, there have been numerous incidents of mild to life-threatening accidents with this strain and others. In an attempt to further attenuate the Lister strain, we investigated the role of 5 genomic regions known to be deleted in the modified VACV Ankara (MVA) genome in virulence in immunodeficient mice, immunogenicity in immunocompetent mice, and vaccine efficacy in a cowpox virus challenge model. Lister mutants were constructed so as to delete each of the 5 regions or various combinations of these regions. All of the mutants replicated efficiently in tissue culture except region I mutants, which multiplied more poorly in human cells than the parental strain. Mutants with single deletions were not attenuated or only moderately so in athymic nude mice. Mutants with multiple deletions were more highly attenuated than those with single deletions. Deleting regions II, III, and V together resulted in total attenuation for nude mice and partial attenuation for SCID mice. In immunocompetent mice, the Lister deletion mutants induced VACV specific humoral responses equivalent to those of the parental strain but in some cases lower cell-mediated immune responses. All of the highly attenuated mutants protected mice from a severe cowpox virus challenge at low vaccine doses. The data suggest that several of the Lister mutants combining multiple deletions could be used in smallpox vaccination or as live virus vectors at doses equivalent to those used for the traditional vaccine while displaying increased safety.Vaccinia virus (VACV) has displayed extraordinary efficacy as a live attenuated vaccine since it has enabled the eradication of smallpox, one of the most deadly infectious diseases for mankind. Although smallpox vaccination is no longer routinely employed, some countries continue to vaccinate selected populations because of the fear of biological warfare or bioterrorism. During the course of their use, the smallpox vaccines were responsible for numerous vaccine-associated accidents like eczema vaccinatum and progressive vaccinia in individuals with immune deficiencies or skin disorders. Encephalitis was also long recognized as a very serious vaccine-related risk with an unknown predisposition (35), and vaccine-induced myopericarditis has been documented as an adverse event (27, 32). It is therefore not surprising that a good deal of research has been devoted to designing strategies that reduce the risks associated with smallpox vaccination (52). Further attenuation of the smallpox vaccine has also been sought because VACV is an attractive live virus vector for vaccination against infectious diseases and displays promising activity as a vector for prophylaxis and therapy of cancer (25).Modified vaccinia virus Ankara (MVA) was one of the first VACV strains shown to be highly attenuated in small-animal models and safe in human trials (42,66). MVA was isolated during the 1960s fr...

The first WHO international standard for Epstein-Barr virus (EBV) (WHO EBV standard) for nucleic acid amplification technology (NAT)-based assays was commercialized in January 2012 by the National Institute for Biological Standards and Control. In the study reported here, we compared whole-blood EBV DNA load (EDL) results from 12 French laboratories for seven samples (Quality Controls for Molecular Diagnostics 2013 proficiency panel) in order to determine whether expression in international units reduces interlaboratory variability in whole-blood EDLs. Each testing laboratory used a conversion factor to convert EDL results from copies per milliliter to international units per milliliter. This conversion factor was calculated from the WHO EBV standard according to the protocol described in this study (nine laboratories) or the recommendations of the PCR kit suppliers (three laboratories). The interlaboratory variability in whole-blood EDL results was reduced after standardization of the results using the WHO EBV standard. For the seven samples tested, standard deviations (SD) ranged from 0.41 to 0.55 when the results were expressed in log copies per milliliter, whereas the SD ranged from 0.17 to 0.32 when results were given in log international units per milliliter. Comparing the variance data (F test), we showed that the dispersion of whole-blood EDL results was significantly lower when they were expressed in log international units per milliliter (P < 0.001 for six of seven samples and P < 0.05 for one sample with a low mean EDL of 2.62 log IU/ml). This study showed that the use of the WHO EBV standard could improve the homogeneity of whole-blood EDL results between laboratories as well as the monitoring of patients at high risk of posttransplant lymphoproliferative disorders or other EBV-associated diseases. Primary Epstein-Barr virus (EBV) infection is the cause of the vast majority of cases of infectious mononucleosis and the subsequent lifelong persistence of EBV in the host, which, although mostly asymptomatic, can lead to the development of several lymphoid and epithelial cancers in immunosuppressed and immunocompetent individuals (1, 2).With the rapid development of real-time quantitative PCR, the measurement of EBV DNA load (EDL) during these EBV-associated diseases has been largely implemented in clinical practice (3-5). The monitoring of EDL in blood is required for transplant recipients at risk of posttransplantation lymphoproliferative disorders (PTLDs) and could also be a surrogate marker for the adjustment of the immunosuppressive regimen in these patients (6, 7). EDL measurement in plasma also appears to be a useful biomarker for the management of EBV-associated undifferentiated nasopharyngeal carcinoma (8). Although less clearly demonstrated, EDL measurements could also be helpful in other clinical situations such as severe or atypical infectious mononucleosis and other EBV-associated malignancies in immunosuppressed or immunocompetent patients (3, 9).Besides the debates on the clinical utility ...