Giovanni Faggioni

Background/Objectives: Routine smallpox vaccination ended after eradication, leaving uncertainty about the persistence of vaccinia virus (VACV)-neutralizing antibodies and their activity against the monkeypox virus (MPXV) responsible for the 2022 outbreak. We assessed both responses in an Italian serum-bank cohort. Methods: We analyzed sera collected in 2016–2022 from 287 individuals born in or before 1974, whose presumed vaccination status was inferred from birth year, and 100 individuals born in 1977–1982. Neutralization of VACV ACAM2000 and an Italian clade IIb MPXV isolate was measured using the 50% plaque reduction neutralization test (PRNT₅₀). We compared paired titers and calculated the proportions with titers ≥1:20, a putative threshold for VACV applied to MPXV for homogeneity, lacking any specific information. Results: In the earlier birth cohort, VACV-neutralizing antibodies were detected at titers ≥1:10 in 207/287 samples (72.1%) and MPXV-neutralizing antibodies in 137/287 (47.7%). Titers ≥1:20 were found in 121/287 (42.16%; 95% CI 36.59–47.94) for VACV and 68/287 (23.69%; 95% CI 19.14–28.94) for MPXV. MPXV titers were lower than paired VACV titers (p < 0.0001), and titers against the two viruses were positively correlated (Spearman’s rs = 0.90, p < 0.0001). All 100 sera from the younger birth cohort were negative for both viruses. Conclusions: VACV-neutralizing antibodies remained detectable in many individuals from cohorts likely vaccinated in childhood, including some individuals presumed vaccinated more than 60 years ago. Cross-neutralization of MPXV was less frequent and weaker. Integrated prospective investigations combining functional serology with T-cell responses in representative populations might be helpful for preparedness in case of deliberate release of variola virus. Real-world vaccine effectiveness data are crucial for epidemic emergency management of mpox.

Dengue virus infection remains a significant public health challenge in endemic regions, with growing evidence of autochthonous transmission in Europe. Assessing serological exposure in high-risk populations such as military personnel deployed to endemic areas is essential to quantify exposure risk and support operational decision-making, particularly regarding pre-deployment counselling and risks associated with secondary infection. We conducted a cross-sectional study involving 1355 members of the Italian Armed Forces, measuring anti-dengue IgG antibodies by ELISA and collecting data on deployment history and exposure risk. Overall, IgG seropositivity was 8.12%, with significantly higher prevalence among individuals reporting travel or deployment to endemic regions (24.71%) compared with non-exposed personnel (4.27%). Seropositivity increased with age and correlated with a CDC-derived cumulative dengue risk score (Spearman’s ρ = 0.299, p < 0.0001). A multivariable logistic regression model including age and exposure risk achieved an AUC of 0.75, while machine-learning models provided complementary predictive assessment, with random forest reaching an AUC of 0.79. These findings indicate substantial anti-dengue IgG seropositivity compatible with previous dengue exposure among Italian military personnel, particularly those deployed to endemic settings. The study highlights the need for targeted surveillance and risk-based preventive strategies, and supports the use of exposure-based models to improve epidemiological assessment and inform vaccination strategies in mobile populations.

Background: Isolated locoregional relapse (ILRR) after curative treatment for early breast cancer (BC) is associated with poor prognosis. Treatment strategies are poorly standardized. We aimed at exploring prognostic factors and long-term outcomes of ILRR. Patients and methods: Overall, 1070 patients diagnosed with stage I-III BC between 2000 and 2007 were identified from a large mono-institutional dataset, with long follow up. Among these, 66 patients (6%) presented an ILRR as first BC event and 33% subsequently presented a distant recurrence (DR) (22/66). Results: In the overall study cohort, patients with ILRR presented a significantly higher risk of DR compared to those without ILRR (P < .001). However, while being diagnosed with a DR was significantly associated with a worse overall survival (OS), ILRR was not. In the subgroup of patients with ILRR (N = 66), more advanced nodal status at initial diagnosis and HER2-positivity on the ILRR were significantly associated with worse distant relapse-free interval (DRFI) post-ILRR and worse OS post-ILRR. Moreover, switching from HR+ primary BC to HR− ILRR was associated with worse OS post-ILRR. In multivariate analyses, nodal involvement at primary diagnosis remained independently associated with both DRFI and OS post-ILRR, while HER2+ ILRR was independently associated with worse OS post-ILRR. Conclusion: Patients diagnosed with ILRR after curative treatment for primary BC are at higher risk of subsequent DR, highlighting the need for prompt diagnosis and treatment of ILRR. Moreover, biological recharacterization of ILRR provides potential key prognostic and predictive factors, such as HR loss, allowing personalization of treatment and follow-up after ILRR.

Dengue remains one of the most significant tropical diseases, with its geographic range continuing to expand. The etiological agent of the disease is dengue virus, a term that groups four closely related viruses defined as serotypes. The four dengue virus serotypes elicit distinct serological responses, and their replacement or co-circulation in endemic regions can result in major outbreaks. The identification of the circulating serotypes is essential for surveillance and clinical management. Here we describe a novel method for the detection and serotyping of the four dengue virus serotypes using a single plex multicolor real-time RT-qPCR. The method takes advantage of a highly informative dataset that includes a realistic representation of globally circulating strains, allowing the selection of a universal primer pair and four serotype-specific hydrolysis probes. The method has been extensively tested and the results support its use in surveillance studies as well as in clinical settings.

The clinical manifestations of SARS-CoV-2 infection may range from asymptomatic or minor conditions to severe and life-threatening outcomes. The respiratory system is a principal target of the virus and in the majority of cases of severe disease, an acute form of pneumonia develops. Despite concerted global efforts to elucidate the pathogenic mechanisms of COVID-19, the progression of the infection leading to pulmonary damage remains poorly understood. The present study aimed to analyse the immunological profile of subjects with a previous SARS-CoV-2 infection and predisposition to lung injury. The results showed a strong correlation between IgG anti-membrane antibodies and lung injury.

We performed next-generation sequencing (NGS), phylogenetic analysis, gene flows, and N- and O-glycosylation prediction on SARS-CoV-2 genomes collected from lab-confirmed cases from different Italian regions. To this end, a total of 111 SARS-CoV-2 genomes collected in Italy between 29 January and 27 March 2020 were investigated. The majority of the genomes belonged to lineage B.1, with some descendant lineages. The gene flow analysis showed that the spread occurred mainly from the north to the center and to the south of Italy, as confirmed by epidemiological data. The mean evolutionary rate estimated here was 8.731 × 10⁻⁴ (95% highest posterior density, HPD intervals 5.809 × 10⁻⁴ to 1.19 × 10⁻³), in line with values reported by other authors. The dated phylogeny suggested that SARS-CoV-2 lineage B.1 probably entered Italy between the end of January and early February 2020. Continuous molecular surveillance is needed to trace virus circulation and evolution.