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Sökning: LAR1:gu > Forskningsöversikt > Holmgren Jan 1944

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1.
  • Bhattacharya, S, et al. (författare)
  • Public health. The cholera crisis in Africa.
  • 2009
  • Ingår i: Science (New York, N.Y.). - : American Association for the Advancement of Science (AAAS). - 1095-9203 .- 0036-8075. ; 324:5929
  • Forskningsöversikt (refereegranskat)abstract
    • Long-lasting cholera outbreaks in Africa suggest limitations in the current strategy of disease control.
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2.
  • Clemens, John D., et al. (författare)
  • Cholera
  • 2017
  • Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 390, s. 1539-1549
  • Forskningsöversikt (refereegranskat)abstract
    • © 2017 Elsevier Ltd Cholera is an acute, watery diarrhoeal disease caused by Vibrio cholerae of the O1 or O139 serogroups. In the past two centuries, cholera has emerged and spread from the Ganges Delta six times and from Indonesia once to cause global pandemics. Rational approaches to the case management of cholera with oral and intravenous rehydration therapy have reduced the case fatality of cholera from more than 50% to much less than 1%. Despite improvements in water quality, sanitation, and hygiene, as well as in the clinical treatment of cholera, the disease is still estimated to cause about 100 000 deaths every year. Most deaths occur in cholera-endemic settings, and virtually all deaths occur in developing countries. Contemporary understanding of immune protection against cholera, which results from local intestinal immunity, has yielded safe and protective orally administered cholera vaccines that are now globally stockpiled for use in the control of both epidemic and endemic cholera.
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3.
  • Clemens, John, et al. (författare)
  • New-generation vaccines against cholera
  • 2011
  • Ingår i: NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY. - 1759-5045. ; 8:12, s. 701-710
  • Forskningsöversikt (refereegranskat)abstract
    • Cholera is a major global health problem, causing approximately 100,000 deaths annually, about half of which occur in sub-Saharan Africa. Although early-generation parenteral cholera vaccines were abandoned as public health tools owing to their limited efficacy, newer-generation oral cholera vaccines have attractive safety and protection profiles. Both killed and live oral vaccines have been licensed, although only killed oral vaccines are currently manufactured and available. These killed oral vaccines not only provide direct protection to vaccinated individuals, but also confer herd immunity. The combination of direct vaccine protection and vaccine herd immunity effects makes these vaccines highly cost-effective and, therefore, attractive for use in developing countries. Administration of these oral vaccines does not require qualified medical personnel, which makes their use practical--even in developing countries. Although new-generation oral cholera vaccines should not be considered in isolation from other preventive approaches, especially improved water quality and sanitation, they represent important tools in the public health armamentarium to control both endemic and epidemic cholera.
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5.
  • Czerkinsky, C, et al. (författare)
  • Enteric vaccines for the developing world: a challenge for mucosal immunology.
  • 2009
  • Ingår i: Mucosal immunology. - : Elsevier BV. - 1935-3456 .- 1933-0219. ; 2:4, s. 284-7
  • Forskningsöversikt (refereegranskat)abstract
    • Enteric infections kill approximately two million children under the age of 5 in developing countries and cause more than four billion disease episodes worldwide each year. In addition, these diseases affect the growth, cognitive function, and quality of life negatively. There is an urgent need for vaccines that induce effective and long-lasting intestinal immunity against diarrheal infections, especially during infancy and early childhood. Yet, most vaccines available are formulated on an empirical basis. To date, arguably, vaccines have done more for immunologists than immunologists have done for vaccines.
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6.
  • Czerkinsky, Cecil, 1953, et al. (författare)
  • Vaccines against enteric infections for the developing world
  • 2015
  • Ingår i: Philosophical Transactions of the Royal Society B-Biological Sciences. - : The Royal Society. - 0962-8436 .- 1471-2970. ; 370:1671
  • Forskningsöversikt (refereegranskat)abstract
    • Since the first licensure of the Sabin oral polio vaccine more than 50 years ago, only eight enteric vaccines have been licensed for four disease indications, and all are given orally. While mucosal vaccines offer programmatically attractive tools for facilitating vaccine deployment, their development remains hampered by several factors: - limited knowledge regarding the properties of the gut immune system during early life; - lack of mucosal adjuvants, limiting mucosal vaccine development to live-attenuated or killed whole virus and bacterial vaccines; - limited knowledge of the factors contributing to oral vaccine under-performance in children from developing countries. There are now reasons to believe that the development of safe and effective mucosal adjuvants and of programmatically sound intervention strategies could enhance the efficacy of current and next-generation enteric vaccines, especially in lesser developed countries which are often co-endemic for enteric infections and malnutrition. These vaccines must be safe and affordable for the world's poorest, confer long-term protection and herd immunity, and must be able to contain epidemics.
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8.
  • Holmgren, Jan, 1944, et al. (författare)
  • Mucosal immunity and vaccines
  • 2005
  • Ingår i: Nature Medicine. - : Springer Science and Business Media LLC. - 1078-8956 .- 1546-170X. ; 11:4, s. S45-S53
  • Forskningsöversikt (refereegranskat)
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9.
  • Holmgren, Jan, 1944 (författare)
  • Sublingual vaccination.
  • 2011
  • Ingår i: Human vaccines. - 1554-8619. ; 7:1, s. 110-4
  • Forskningsöversikt (refereegranskat)abstract
    • The sublingual route has been used for many years to deliver drugs and small molecules to the bloodstream. Surprisingly, the potential of this route for delivering vaccines has received very little if any attention until recently. During the past few years, a number of laboratories have documented the efficacy of sublingual immunization for inducing a broad range of immune responses in different experimental animal systems using a variety of antigens, including soluble proteins, inert particulate antigens (killed viruses, virus-like particles, bacterial extracts) as well as live-attenuated viruses. In most cases, systemic and mucosal immune responses, including humoral and cytotoxic T-cell responses were induced in both mucosal and extra-mucosal tissues. Overall, sublingual immunization was comparable to nasal immunization regarding the magnitude, breadth, and anatomic dissemination of the induced immune responses. Importantly, and contrary to nasal administration, sublingual administration did not redirect antigens and/or adjuvants to the brain. Here we review the results of pre-clinical studies using animal models of respiratory, intestinal and genital infections. These promising results provide a foundation for testing the approach in humans.
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10.
  • Sanchez, J, et al. (författare)
  • Cholera toxin - a foe & a friend
  • 2011
  • Ingår i: INDIAN JOURNAL OF MEDICAL RESEARCH. - 0971-5916. ; 133:2, s. 153-163
  • Forskningsöversikt (refereegranskat)abstract
    • After De΄s pivotal demonstration in 1959 of a diarrhoeogenic exo-enterotoxin in cell-free culture filtrates from Vibrio cholerae (of classical biotype), much insight has been gained about cholera toxin (CT), which is arguably now the best known of all microbial toxins. The subunit structure and function of CT, its receptor (the GM1 ganglioside), and its effects on the cyclic AMP system and on intestinal secretion were defined in the 1970s, and the essential aspects of the genetic organization in the 1980s. Recent findings have generated additional perspectives. The 3D-crystal structure of CT has been established, the CT-encoding operon has been shown to be carried by a non-lytic bacteriophage, and in depth knowledge has been gained on how the bacterium controls CT gene expression in response to cell density and various environmental signals. The mode of entry into target cells and the intracellular transport of CT are becoming clearer. CT has become the prototype enterotoxin and a widely used tool for elucidating important aspects of cell biology and physiology, e.g., cell membrane receptors, the cyclic AMP system, G proteins, as well as normal and pathological ion transport mechanisms. In immunology, CT has emerged as a potent, widely used experimental adjuvant, and the strong oral-mucosal immunogenicity of the non-toxic B-subunit (CTB) has led to the use of CTB as a protective antigen together with killed vibrios in a widely licensed oral cholera vaccine. CTB has also been shown to promote immunological tolerance against certain types of mucosally co-administered antigens, preferably tissue antigens linked to the CTB molecule; this has stimulated research and development to use CTB in this context for treatment of autoimmune and allergic diseases. In summary, in the 50 years after De΄s discovery of CT, this molecule has emerged from being the cholera patient΄s "foe" to also becoming a highly useful scientist΄s "friend".
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