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Disseminated histoplasmosis due to histoplasma capsulatum in two Nigerian children.

Two cases of disseminated histoplasmosis caused by H. capsulatum in Nigerian children are reported. This is a rare infection in this part of the world. The main clinical features were fever, weight loss, lassitude, lymphadenopathy, hepatosplenomegaly and severe anaemia, features indistinguishable from those of tuberculosis, Hodgkins and other reticuloses. Recognition of this infection in this environment is possible if it is considered in the differential diagnosis of pyrexia of undetermined origin and appropriate laboratory tests carried out on suitable specimens such as bone marrow, splenic aspirate or biopsy material. Treatment of choice is amphotericin B given intravenously, starting with 0-25 mg/kg. and increasing slowly to 1 mg/kg. Other useful drugs are Septrin and rifampicin which can be given concurrently. Subcutaneous abscesses and multiple bone lesions occurred in both our cases presumably as a result of blood stream infection, or embolisation from endocarditis.

Amphotericin B↗

Immunochromatographic (rK39) strip test in the diagnosis of visceral leishmaniasis in Bangladesh.

Immunochromatographic strip test (ICT strip test) for the diagnosis of visceral leishmaniasis was evaluated in this study in the context of a case-control study. A total sixty consecutive cases of kala-azar admitted in all four Medicine Units of Mymensingh Medical College Hospital during the period of May 2002 to February 2003 was included here. Parasitological confirmation was done by demonstration of leishmania donovani bodies in bone marrow or splenic aspiration in all cases. A total 120 controls was taken of which sixty were asymptomatic endemic controls with no previous history of kala-azar and sixty were admitted patients suffering from diseases other than kala-azar (malaria, tuberculosis, enteric fever and chronic liver disease). ICT strip test for kala-azar was done in all cases and controls. Only 2 of the confirmed kala-azar cases were negative and the remaining 58 cases were positive for ICT strip test which gives the sensitivity of this test 96.6%. Among the controls, 118 were negative for ICT strip test and two of the asymptomatic controls were positive for this test with no clinical evidence of kala-azar. So, the estimated specificity of ICT strip test is 98.3%. The predictive value for a negative result was 98.3% and for a positive result was 96.6%. The ICT strip test is easy, quick, requires no technical facilities with higher sensitivity and specificity entails it to be the ideal test for the diagnosis of kala-azar in field level.

Adult↗

Gamma interferon-producing CD4+ T lymphocytes in the lung correlate with resistance to infection with Mycobacterium tuberculosis.

The human immune system efficiently limits the replication of Mycobacterium tuberculosis in most infected individuals. Only 5 to 10% of infected people develop clinical tuberculosis, a sign of the inability of the immune system to control the infection. We have studied the C3H/HeJ (C3H) and C57BL/6 (B6) inbred mouse strains, which differ in their susceptibility to tuberculosis, in order to ascertain the immunological determinants of a successful immune response against M. tuberculosis and to establish a system to identify genes that influence susceptibility to tuberculosis. We found that the resistant B6 mice were able to control infection in both the lung and spleen, while susceptible C3H mice were incapable of limiting bacteria growth, especially in the lung, and succumbed to infection within 4 weeks. We determined that the susceptibility of C3H mice was independent of the Toll-like receptor 4 (tlr4) genetic locus and allelic major histocompatibility complex differences. Although the splenic immune responses were similar in the two mouse strains, the local immune responses in the lungs of the infected mice differed greatly. The pulmonary immune response in resistant B6 mice was characterized by an early influx of both CD4+ and CD8+ lymphocytes that produced gamma interferon (IFN-gamma). In contrast, the immune response of C3H mice in the lung was characterized by a delayed and decreased influx of lymphocytes, which produced little IFN-gamma. These results suggest an important role for the early appearance of IFN-gamma-producing lymphocytes in the lung in resistance to infection with M. tuberculosis.

Animals↗

[Atypical presentation of a colorectal carcinoma].

We report a 67 years old male with a history of pulmonary tuberculosis at the age of 15, that consults for malaise, weight loss and productive cough. Chest X ray examination showed a left pleural effusion. A pleural tap obtained a sterile exudate. A thorax CAT scan showed a proliferating mass in the splenic angle of the colon, with left lung and diaphragmatic invasion. Endoscopic biopsies confirmed the diagnosis of adenocarcinoma. The patient underwent a subtotal colectomy with partial excision of diaphragm and left lung. The pathological report showed a mucosecretory adenocarcinoma, infiltrating the pericolonic adipose tissue without adjacent organ infiltration and a chronic inflammatory process involving colonic serosa, diaphragm pleura, and lung. Adjuvant chemotherapy was indicated and the patient is asymptomatic and without evidences of tumor recurrence after a 24 months follow up.

Adenocarcinoma, Mucinous↗

Generation of a recombinant bacteriophage antibody library to mycobacterium tuberculosis.

Monoclonal antibodies to Mycobacterium tuberculosis (Mtb) may be useful for laboratory diagnosis, antigenic characterization, and studying the immune response to infection and vaccination. To investigate the potential of the recombinant phage antibody technique for the isolation of single-chain fragments (ScFv) reactive with Mtb culture proteins, we generated a bacteriophage antibody library from splenic tissue of mice immunized with heat-killed Mtb. Heavy- and light-chain immunoglobulin genes were isolated and amplified by the polymerase chain reaction (PCR), and the products were assembled into ScFv gene fragments and cloned into the pCANTAB5-E phagemid. Phagemids were introduced into E. coli TG1 by electrotransformation, followed by rescue of antibody-expressing phage using M13K07 helper-phage superinfection. Immunoselection of the Mtb phage library against Mtb cell wall extract or culture filtrate proteins selected antigen-specific and cross-reactive phage antibodies, none of which demonstrated reactivity to the immunodominant 65-kDa Mtb antigen. These results suggest that the phage antibody system has the potential to generate a diverse population of the reactive phage that may prove useful for investigating the immune response to Mtb infection and vaccination.

Animals↗

[Immunity characteristics induced by a genetic vaccine expressing Ag85B-ESAT6 fusion protein].

OBJECTIVE: To evaluate the humoral and cell-mediated immune responses induced by a genetic vaccine expressing the Ag85B-ESAT6 fusion protein, and to investigate its protective effect against Mycobacterium tuberculosis (MTB) challenge. METHODS: Fifty BALB/c mice were randomized into 5 groups and subjected to the following treatments respectively: immunization with normal saline, BCG, pcDNA3, A(Z)-pcDNA3-E(F) and E(Z)-pcDNA3-A(F) for 3 times at 2-week intervals. The stimulation index (SI) of the splenic lymphocytes from the immunized mice was measured by the methyl thiazolyl tetrazolium (MTT) method, and the level of secreted IFN-gamma upon antigen-specific stimulation was detected by ELISA. The immunized mice were intravenously infected with 10(5) colony forming unit (CFU) of MTB H(37)Rv. The numbers of MTB CFU in spleens were determined 4 weeks later. RESULTS: The specific antibody titers in the sera of mice immunized with plasmid A(Z)-pcDNA3-E(F) and E(Z)-pcDNA3-A(F) were 1:1,000 and 1:1,500 respectively, and the SI was 2.2 and 2.4 respectively, while the SI of the normal saline group and the plasmid pcDNA3 immunized group was only 0.9 and 1.1 respectively. The IFN-gamma concentrations in cultured supernatant of splenic lymphocytes from mice immunized with plasmid A(Z)-pcDNA3-E(F) [(5.48 +/- 0.38) ng/ml] and E(Z)-pcDNA3-A(F) [(5.76 +/- 0.51) ng/ml] were significantly higher than those of the normal saline group [(0.50 +/- 0.25) ng/ml] and the plasmid pcDNA3 immunized group [(1.20 +/- 0.33) ng/ml, P < 0.05], but were not significantly different with that of the BCG immunized group [(5.55 +/- 0.31) ng/ml]. Compared with plasmid pcDNA3 immunized group, the bacterial load (lg, CFU/g) in spleen was 6.08 +/- 0.25 which dramatically reduced in mice immunized with recombinant plasmids, but the protective efficacy of mice immunized with plasmid A(Z)-pcDNA3-E(F) (4.63 +/- 0.11) or E(Z)-pcDNA3-A(F) (4.50 +/- 0.32) was lower than that of the BCG vaccination group (4.09 +/- 0.27). CONCLUSION: The cell-mediated immune response induced by genetic vaccine expressing the Ag85B-ESAT6 fusion protein was similar to that induced by BCG immunization.

Acyltransferases↗

Nexus of infection with human immunodeficiency virus, pulmonary tuberculosis and visceral leishmaniasis: a case report from Bihar, India.

A 37-year-old man was diagnosed as being infected with human immunodeficiency virus (HIV), tuberculosis (TB), tuberculoma of the brain, and visceral leishmaniasis (VL) at the Rajendra Memorial Institute of Medical Sciences in Bihar, India. He had taken anti-tuberculosis therapy (ATT) for two and a half months and had episodes of convulsions with loss of consciousness, tongue bites, and incontinence of urine. The results of a neurologic examination were normal except for a left plantar extensor. He was positive for both HIV-I (confirmed by Western blot) and VL (confirmed by splenic aspirate). Treatment was initiated with amphotericin B lipid complex, a four-drug regimen (rifampicin, isoniazid, ethambutol, and pyrazinamide) of ATT, highly active antiretroviral therapy, anti-convulsants, and other supportive therapies. A repeat computed tomography scan of the brain showed the disappearance of the lesion followed by gliosis. After six months, he was also cured of VL. The triad of infections (HIV, VL, and TB) is a real threat in Bihar as an emerging combination of diseases of public health importance. Keeping these facts in mind, efforts to develop simple and cost effective diagnostic techniques coupled with affordable therapeutic facilities are urgently needed in developing countries.

AIDS-Related Opportunistic Infections↗

Therapeutic effects of Ag85B and MPT64 DNA vaccines in a murine model of Mycobacterium tuberculosis infection.

A new improved therapeutic strategy for tuberculosis is urgently needed. In our previous work DNA vaccines encoding secreted proteins Ag85B and MPT64 have been reported to protect mice from following H37Rv challenge by prompting the Th1 response and we consider whether these vaccines have the therapeutic effect through the same mechanism. In the present study these two DNA vaccines were tested in a mouse tuberculosis model to confirm their immunotherapeutic effect. C57BL/6 mice infected with Mycobacterium tuberculosis were treated with pCDNA3.1, pcD85B, pcDMPT64, pcD85B plus pcDMPT64, respectively. The numbers of viable bacteria in lung and spleen were counted as log(10)CFU/g. The level of IFN-gamma, IL-4 and TNF-alpha released by spleen lymphocytes stimulated with PPD was detected with ELISA. Lungs and spleens were harvested for pathological analysis. The pcD85B group reduced the pulmonary and splenic bacterial loads of 1.2 and 0.7 logs, respectively compared with that of control mice, but the difference between pcDMPT64 group and control mice was not significant. Vaccination with pcD85B induced high level of IFN-gamma and TNF-alpha. No change of IL-4 level was found in all groups. The pathological change in lung in pcD85B group was slight, alveolar wall structure is clear and the lesions are constrained, while that in control group was extensive, alveoli and interalveolar septae are effaced. And there was no special change in spleen in all groups. In conclusion, Ag85B DNA vaccination has immunotherapeutic effects, and the effects may be associated with a switch to Th1 response and prompting production of cytokine TNF-alpha and INF-gamma synchronously. Therefore, MPT64 DNA vaccination has no immunotherapeutic effect on mice tuberculosis. Rather, the effects may be associated with its disability in switching improper immune status and with recalling a strong and early specific memory immune response against tuberculosis.

Acyltransferases↗

Decreased survival of guinea pigs infected with Mycobacterium tuberculosis after multiple BCG vaccinations.

The BCG vaccine for tuberculosis has an outstanding safety record, with only occasional reports of adverse reactions. In some countries multiple BCG vaccinations have been given to children, but with no apparent benefit. We show here that in the highly susceptible guinea pig model of Mycobacterium tuberculosis infection animals receiving three sequential injections of BCG began to die unexpectedly at times after aerosol challenge much earlier than animals receiving the vaccine only once. Animals receiving three injections with BCG had extensive, disseminated lesions in the lungs, spleen and liver that were similar to non-vaccinated animals. In these animals there was effacement of the pulmonary, hepatic and splenic architecture by extensive areas of fibrosis with residual granulomatous inflammation and necrosis. This contrasted to the saline control group in which active inflammation was accompanied by extensive areas of necrosis but with less fibrosis in the lungs and spleen. Granulomatous inflammation was less severe and was not complicated by necrosis or extensive fibrosis in animals receiving a single injection with BCG. These data indicate that multiple BCG vaccination, which is akin to super-infection with the living vaccine, leads to major organ failure pathology.

Adjuvants, Immunologic↗

Redefining the role of splenectomy in patients with idiopathic splenomegaly.

BACKGROUND: Despite extensive work-up to establish the cause of splenomegaly, splenectomy may be required for diagnosis in certain situations. The aim of this study was to find out the role of diagnostic splenectomy in the current era. METHODS: Between January 1989 and June 2004, 211 patients underwent splenectomy for indications other than trauma. In 41 (19%) patients, splenectomy was carried out for diagnostic purposes. Retrospective analysis of these patients was done for the purpose of the study. RESULTS: All patients who underwent diagnostic splenectomy had a complete haemogram, biochemical tests for liver and renal function, bone marrow biopsy and abdominal ultrasonography before splenectomy. There were 28 (68%) men and 13 (32%) women with median age of 37 years (range, 6-62 years). The median duration of symptoms was 12 months (range, 1-180 months). Common presentations were fever (n = 27; 66%), malaise (n = 26; 63%), pallor (n = 33; 80%) and gross splenomegaly (n = 27; 66%). Thirty-two (78%) patients had hypersplenism. Splenic lesions were shown in 14 (34%) patients on ultrasonogram and in 16 (39%) patients on contrast-enhanced computed tomography scan of the abdomen. Open splenectomy was carried out in all patients. Seventeen (41%) patients had postoperative complications. Among these, three (7%) patients had postoperative bleeding. One patient died because of acute respiratory distress syndrome. Final histopathology of the spleen showed lymphoma in 15 (37%), tuberculosis in five (12%) and other lesions in five (12%) patients. Sixteen (39%) patients had only congestive splenomegaly. CONCLUSION: A high proportion of patients presenting with idiopathic splenomegaly will have underlying haematological malignancies even in tropical countries. The clinical presentation, laboratory profile and imaging findings were not helpful in differentiating between patients with haematological malignancies and non-malignant conditions. Splenectomy still has an important role in establishing the pathology in patients presenting with idiopathic splenomegaly.

Adolescent↗

Multiple reflective channels in the spleen: a sonographic sign of portal hypertension.

We consistently observed small "reflective channels" (RCs) in the splenic parenchyma in patients with portal hypertension (PHT). The purpose of this study was to investigate the frequency of this sign in PHT and in splenic disorders unrelated to PHT compared to normal controls. The significance of this sign in the diagnosis of PHT and in differentiating PHT splenomegalies from others was also assessed. A total of 337 patients underwent sonographic examination of the spleen: 147 normal, 75 non-PHT splenic pathologies, and 115 with PHT. The RCs were scored from grade 0 to 3 by counting the number in an area of 12 mm2 in the splenic parenchyma. Of 222 normal and non-PHT spleens, 174 (78%) showed grade 0, 44 (20%) grade 1, four grade 2 (1%), and none showed grade 3 RCs. Of 115 PHT cases, 17 showed grade 0, 25 grade 1, 44 grade 2, and 29 showed grade 3 RCs. The sensitivity of this sign was 0.85 with a specificity of 0.77 and an accuracy of 0.80 in detecting PHT (p < 0.001). The interobserver and intraobserver variation for grading was insignificant (p > 0.1). The RCs could be explained by periarterial fibrosis and dilatation of venous sinuses with increased collagen in their walls, which is known to occur in PHT. The vascular nature on ultrasound (US) was confirmed by the presence of flow on color Doppler. This sign is readily differentiated from the calcifications of tuberculosis, histoplasmosis, sickle cell infarcts, and phleboliths; it serves as a useful aid in diagnosing and differentiating PHT splenomegaly from non-PHT splenomegaly.

Adolescent↗

[Distribution and contrast enhanced CT appearance of abdominal tuberculous lymphadenopathy].

PURPOSE: To clarify the contrast enhanced CT features and anatomic distribution of the disseminated vs non-disseminated tuberculosis (TB) involving abdominal lymph nodes. MATERIALS AND METHODS: The contrast enhanced CT findings of abdominal lymphadenopathy in 25 patients, including disseminated TB associated with miliary TB of the lung (n = 5) and non-disseminated TB (n = 20), were retrospectively evaluated in a blind review to assess our criteria of morphology, density and location of the involved lymphadenopathy. RESULTS: The enhancement patterns of disseminated TB were not different from those of non-disseminated TB. Ninety-six percent of the patients had peripheral rim enhancement, and 60% showed a multilocular appearance. The enlarged lymph nodes of TB were less than 4 cm in diameter. Lymphadenopathy caused by hematogenous dissemination often accompanied splenic involvement showing multiple low-density foci in the spleen. The predominant sites of lymphadenopathy of disseminated TB were hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric, and both upper and lower portions of the retroperitoneal lymph nodes, whereas non-disseminated TB mainly involved hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric and upper retroperitoneal lymph nodes, excluding the lower retroperitoneal lymph nodes. By combining contrast enhancement patterns and the anatomic distribution of lymphadenopathy shown on the contrast enhanced CT images, reviewers made a correct diagnoses of tuberculosis in 94%, of cases, with a specificity of 95% and sensitivity of 92%. CONCLUSION: Contrast enhanced CT patterns correlate well with the pathologic features of tuberculous lymphadenopathy. A different anatomic distribution between disseminated and non-disseminated TB involving the lower retropentoneal lymph nodes was recognized in this study.

Abdomen↗

Autopsy findings in a human immunodeficiency virus-infected population over 2 decades: influences of gender, ethnicity, risk factors, and time.

OBJECTIVES: To examine autopsy pathology in an urban population infected with the human immunodeficiency virus (HIV) and to determine if age at death and disease frequencies are associated with gender, HIV risk factors, ethnicity, and therapeutic era. DESIGN AND METHODS: Retrospective analysis of autopsy data from 394 HIV-infected adults. The population was divided into 3 therapeutic eras for analysis: group A, 1979-1986; group B, 1987-1995; and group C, 1996-2000. RESULTS: Women died at significantly younger ages than men (mean +/- SEM age, 38.9 +/- 1.0 years vs 42.5 +/- 0.64 years), even after adjustment for risk factors, ethnicity, and therapeutic era. This age discrepancy occurred despite a lower prevalence of arteriosclerosis, cachexia, and hepatitis B in women and no significant differences in the frequencies of other infectious diseases. Whites had a longer survival than patients of other ethnicities (mean age at death, 44.7 +/- 1.2 years for whites, 39.9 +/- 0.80 years for blacks, and 41.3 +/- 0.87 years for Hispanic individuals). Renal, cardiac, and splenic pathologies, Mycobacterium avium-intracellulare (MAI) infection, and cachexia were more common in blacks than in whites and/or Hispanic individuals, and cytomegalovirus and systemic lymphoma were more common in whites and Hispanic individuals than in blacks. Diseases associated with intravenous drug use were hepatitis C, cirrhosis, and tuberculosis; those with all sexual risk factors, cytomegalovirus infection, herpes simplex virus infection, and Pneumocystis carinii pneumonia; and those with homosexual risk, Kaposi sarcoma and MAI infection. The prevalence of many disease entities changed over time: compared with the other groups, group C had lower prevalences of many viral and fungal illnesses, MAI infection, systemic lymphoma, cachexia, and Kaposi sarcoma and higher prevalences of hepatitis, cirrhosis, arteriosclerosis, staphylococcal and streptococcal infections, and traumatic lesions. When the data were adjusted for changing demographic and risk composition, the only significant changes in disease frequency for period C were decreased prevalences of PCP and Kaposi sarcoma and increased prevalences of cirrhosis and arteriosclerosis. CONCLUSIONS: Significant gender- and ethnicity-related differences in age of death occurred in this HIV-infected population, and these differences were not explained by the frequencies of diseases. The lower prevalences of PCP and Kaposi sarcoma in group C are likely a reflection of the impact of potent therapies on causes of mortality. The higher prevalences of cirrhosis and arteriosclerosis suggest that entities not targeted by antiretroviral reconstitution of immunity will play an increasingly important role in HIV-related mortality in the future.

Adult↗

Comparative immunogenicity of BCG substrains for mice.

Immunogenicity of four substrains of BCG was studied in mice vaccinated by the intravenous route and evaluated through pulmonary density and through splenic, hepatic and pulmonary indexes (weight of the organ/weight of the animalx100). In addition, tuberculin sensitivity was determined by measuring the thickness of the inoculated leg. All four strains (BCG Brazil, BCG Prague, BCG Russia and BCG Glaxo) showed intermediary virulence (0.78 -- 0.85) between pathogenic mycobacteria, i.e., M. tuberculosis and non-pathogenic mycobacteria, such as M. fortuitum, without however revealing differences among themselves in regard to pulmonary density. Reinoculation of vaccinated animals by the intravenous route, contrary to the subcutaneous route, resulted in significant increase (P less than 0.05) in the organs, except for the spleen. The tuberculin hypersensitivity induced by the four strains was significant and it was possible to distinguish BCG Brazil from BCG Glaxo. The substrain BCG Brazil proved to be the most immunogenic, followed by BCG Prague, whereas BCG-Glaxo proved to be the weakest vaccine.

Animals↗

Ultrasonographic findings and differentiation of benign and malignant focal splenic lesions.

The purpose of this study was to analyse the sonographic findings of focal splenic lesions with an attempt to differentiate benign lesions from malignancies. The sonographic findings of 53 cases of verified focal splenic lesions, excluding post-traumatic haematomas and phleboliths, were retrospectively analysed. Of the 53 cases, 30 cases (57%) were benign and 23 cases (43%) were malignant. The malignancies included lymphoma (n=13), metastases (n=10); while the benign lesions included cysts (n=17), infarcts (n=3), and abscesses (n=5), and one case each of haemangioma, hamartoma, spontaneous rupture, tuberculosis, and lymphangioma. Significant differences were noted between the benign and malignant groups with respect to the presence of solitary lesions (p<0.0001), anechoic mass (p<0. 0001), lesions with highly echogenic foci due to gas or calcification (p = 0.0303), hyperechoic/mixed echoic lesions (p<0. 0001), presence of extrasplenic abdominal masses (p<0.0001), and nodules with the target sign (p<0.0001). Solitary lesions, anechoic mass, and lesions with highly echogenic foci due to gas or calcification each had a positive predictive value of 85%, 100%, and 100%, respectively, for the lesions to be benign. The multifocal/diffuse lesions, presence of extrasplenic abdominal masses, hyperechoic/mixed echoic lesions, and nodules with the target sign each had a positive predictive value of 70%, 100%, 70%, and 100%, respectively, for the lesions to be malignant. In summary, focal lesions with anechoic pattern or echogenic foci due to gas or calcification are suggestive signs of benign process. The sonographic observations of multifocal or diffuse solid lesions, especially those associated with target sign or extrasplenic abdominal masses are suggestive of malignancy.

Adolescent↗

Comparative study on the immunogenicity between Hsp70 DNA vaccine and Hsp65 DNA vaccine in human Mycobacterium tuberculosis.

The BALB/c mice were immunized with Hsp70 DNA and Hsp65 DNA vaccines in human Mycobacterium tuberculosis. Eight weeks after immunization, the eyeballs were removed, blood and spleen taken, and intraperitoneal macrophages were harvested. The lymphocytic stimulating index (SI) was used to measure the cellular proliferating ability and NO release to measure the phagocytic activity of the macrophages. With ELISA kit, the levels of interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) in serum and the splenic lymphocytic cultured supernatant were detected. The results showed that after the mice were immunized with 100 micrograms/mouse of Hsp70 DNA vaccine intramuscularly, the splenic lymphocytic proliferating ability in the mice was significantly increased as compared with that in the control group, vector group and Hsp65 DNA vaccine group (P < 0.01); The contents of NO in the intraperitoneal macrophages of the mice were significantly lower than in the control group and Hsp65 DNA vaccine group (P < 0.01); The levels of serum IL-2 in the mice were significantly higher than in the control group, but there was no statistical difference between Hsp65 DNA group and vector group (P > 0.05); The contents of serum IFN-gamma in the mice were significantly higher than in the control group, but significantly lower than in the Hsp65 DNA vaccine group (P < 0.05). It was indicated that immunization with Hsp70 DNA vaccine could obviously enhance the immune response, but its intensity seemed inferior to Hsp65 DNA vaccine. The anti-infection mechanisms and clinical use in the future of the vaccines of Hsp70 DNA and Hsp65 DNA are worth further studying.

Animals↗