Expert Exchange

PAI Senior Editors Robert Bonomo, MD, and Michael Lederman, MD, Talk With Arturo Casadevall, MD, PhD

Dr. Arturo Casadevall shares insight into his childhood, what motivated him to go into biomedical research, the impact of the AIDS epidemic, and the lessons learned that he imparts to younger scientists.

>>20 Minute Video plus Transcript.  

 

 

Featured Articles

Effectiveness of Ultraviolet-C Light and a High-Level Disinfection Cabinet for Decontamination of N95 Respirators
Jennifer L. Cadnum, Daniel F. Li1, Sarah N. Redmond, Amrita R. John, Basya Pearlmutter, Curtis J. Donskey
Background: Shortages of personal protective equipment (PPE) including N95 respirators are an urgent concern in the setting of the global COVID-19 pandemic. Decontamination of PPE could be useful to maintain adequate supplies, but there is uncertainty regarding the efficacy of decontamination technologies.
Conclusions: UV-C could be useful to reduce contamination on N95 respirators. However, the UV-C technologies studied did not meet pre-established criteria for decontamination under the test conditions used. The high-level disinfection cabinet was more effective and met criteria for disinfection with an extended cycle.

 

Defining HIV and SIV Reservoirs in Lymphoid Tissues
Claire Deleage1, Stephen W. Wietgrefe, Gregory Del Prete, David R. Morcock, Xing Pei Hao, Michael Piatak, Jr., Julian Bess1, Jodi L. Anderson, Katherine E. Perkey, Cavan Reilly, Joseph M. McCune, Ashley T. Haase, Jeffrey D. Lifson, Timothy W. Schacker, Jacob D. Estes
Abstract: A primary obstacle to an HIV-1 cure is long-lived viral reservoirs, which must be eliminated or greatly reduced. Cure strategies have largely focused on monitoring changes in T cell reservoirs in peripheral blood (PB), even though the lymphoid tissues (LT) are primary sites for viral persistence. To track and discriminate viral reservoirs within tissue compartments we developed a specific and sensitive next-generation in situ hybridization approach to detect vRNA, including vRNA+ cells and viral particles (“RNAscope”), vDNA+ cells (“DNAscope”) and combined vRNA and vDNA with immunohistochemistry to detect and phenotype active and latently infected cells in the same tissue section. RNAscope is highly sensitive with greater speed of analysis compared to traditional in situ hybridization. The highly sensitive and specific DNAscope detected SIV/HIV vDNA+ cells, including duplexed detection of vDNA and vRNA or immunophenotypic markers in the same section. Analysis of LT samples from macaques prior to and during combination antiretroviral therapy demonstrated that B cell follicles are an important anatomical compartment for both latent and active viral persistence during treatment. These new tools should allow new insights into viral reservoir biology and evaluation of cure strategies.

 

Fungal Diseases in the 21st Century: The Near and Far Horizons
Arturo Casadevall
Abstract: Fungal diseases became a major medical problem in the second half of the 20th century when advances in modern medicine together with the HIV epidemic resulted in large numbers of individuals with impaired immunity. Fungal diseases are difficult to manage because they tend to be chronic, hard to diagnose, and difficult to eradicate with antifungal drugs. This essay considers the future of medical mycology in the 21st century, extrapolating from current trends. In the near horizon, the prevalence of fungal diseases is likely to increase, as there will be more hosts with impaired immunity and drug resistance will inevitably increase after selection by antifungal drug use. We can expect progress in the development of new drugs, diagnostics, vaccines, and immunotherapies. In the far horizon, humanity may face new fungal diseases in association with climate change. Some current associations between chronic diseases and fungal infections could lead to the establishment of fungi as causative agents, which will greatly enhance their medical importance. All trends suggest that the importance of fungal diseases will increase in the 21st century, and enhanced human preparedness for this scourge will require more research investment in this group of infectious diseases.

 

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