Daily ReCAP May 10, 2017

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The latest news on chronic, acute, and preventive care across the health care landscape.

Chronic: Increased Levels of Vitamin D Unlikely to Reduce Asthma, Atopic Dermatitis Risk

Despite prior findings suggesting that low levels of vitamin D were associated with increased rates of asthma, atopic dermatitis, and high levels of IgE, a new study published inPLOS Medicinefound no statistically significant difference among rates of these conditions in individuals with or without lower levels of vitamin D. However, the authors noted that the results do not exclude an association between the outcomes and levels of 1,25-dihydroxyvitamin D. More work is needed to determine whether the results hold up in non-European populations and individuals with vitamin D deficiency. “Our findings suggest that previous associations between low vitamin D and atopic disease could be due to spurious associations with other factors,” said lead author Dr. Despoina Manousaki. “Efforts to increase vitamin D levels will probably not result in decreased risk of adult and pediatric asthma, atopic dermatitis, or elevated IgE levels.”

Acute: Point-of-Care Flu Diagnostic Predicted Influenza A with 70% Accuracy

A newly developed point-of-care diagnostic test could one day help physicians ward off the rapid spread of the flu. Current flu diagnostics are time consuming and require multiple processing tests using expensive equipment that can only be performed in specialized facilities. In a study published inAnalytical Chemistry, investigators sought to develop a cheap, easy-to-use test that could be used at the hospital or in a physician’s office. The novel device incorporates viral lysis, target protein capture, labeling, rinsing, and an enzyme-drive color change all in one. To use the device, the user must swab the inside of a patient’s nose and insert the swab into the device, twirling it around for 10 seconds. After approximately 35 minutes, the test produces a visual readout that can be seen with the naked eye or captured with a smartphone camera. In the study, investigators trained staff at a children’s hospital to use the device and test it on 25 patients during a flu outbreak. The device could detect influenza A with 70% accuracy, and the cost of materials and reagents for one of the single-use devices is less than $6.

Preventive: Novel Method Could Build Better Vaccine Adjuvants for Infectious Diseases

In a study published inmBio, investigators used a method called bacterial enzymatic combinatorial chemistry (BECC) to create functionally diverse molecules that could potentially be used to develop better vaccines for infectious diseases. Currently, scientists use an empirical trial-and-error approach to develop vaccine adjuvants. Since the 1930s, aluminum gels and salts have been used, and monophosphoryl lipid A (MPLA) has been used since 2009. It is known that some bacteria produce specific structures of lipid A that are proinflammatory, which allows the body to quickly and easily recognize them at very low amounts. For the new study, the investigators build upon this idea. However, they found that many other bacteria had lipid A molecules that were not immunostimulatory. The investigators used the normal lipopolysaccharides (LPS) biosynthesis pathway in gram-negative bacteria to synthesize unique lipid A structures based on the presence or absence of specific phosphate, acyl, and carbohydrate groups from various species to create novel, rationally-designed lipid A molecules. To develop structurally distinct LPS molecules, the investigators applied BECC within an avirulent strain of Yersinia pestis and then screened them to determine whether they could induce proinflammatory responses. The investigators identified lead candidates that demonstrated minimal immunostimulation in mouse splenocytes, human primary blood, mononuclear cells, and human monocyte-derived dendritic cells. To date, the investigators’ list of 50 to 70 molecules has been narrowed down to approximately 6 that have potential adjuvant activity.

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