Macrophages play a prominent role in wound healing. In the early stages, they promote inflammation and remove pathogens, wound debris, and cells that have apoptosed. Later in the repair process, they dampen inflammation and secrete factors that regulate the proliferation, differentiation, and migration of keratinocytes, fibroblasts, and endothelial cells, leading to neovascularisation and wound closure. The macrophages that coordinate this repair process are complex: they originate from different sources and have distinct phenotypes with diverse functions that act at various times in the repair process. Macrophages in individuals with diabetes are altered, displaying hyperresponsiveness to inflammatory stimulants and increased secretion of pro-inflammatory cytokines. They also have a reduced ability to phagocytose pathogens and efferocytose cells that have undergone apoptosis. This leads to a reduced capacity to remove pathogens and, as efferocytosis is a trigger for their phenotypic switch, it reduces the number of M2 reparative macrophages in the wound. This can lead to diabetic foot ulcers (DFUs) forming and contributes to their increased risk of not healing and becoming infected, and potentially, amputation. Understanding macrophage dysregulation in DFUs and how these cells might be altered, along with the associated inflammation, will ultimately allow for better therapies that might complement current treatment and increase DFU’s healing rates.

Incidence of disease due to dengue (DENV), chikungunya (CHIKV) and yellow fever (YFV) viruses is increasing in many parts of the world. The viruses are primarily transmitted by Aedes aegypti, a highly domesticated mosquito species that is notoriously difficult to control. When transinfected into Ae. aegypti, the intracellular bacterium Wolbachia has recently been shown to inhibit replication of DENVs, CHIKV, malaria parasites and filarial nematodes, providing a potentially powerful biocontrol strategy for human pathogens. Because the extent of pathogen reduction can be influenced by the strain of bacterium, we examined whether the wMel strain of Wolbachia influenced CHIKV and YFV infection in Ae. aegypti. Following exposure to viremic blood meals, CHIKV infection and dissemination rates were significantly reduced in mosquitoes with the wMel strain of Wolbachia compared to Wolbachia-uninfected controls. However, similar rates of infection and dissemination were observed in wMel infected and non-infected Ae. aegypti when intrathoracic inoculation was used to deliver virus. YFV infection, dissemination and replication were similar in wMel-infected and control mosquitoes following intrathoracic inoculations. In contrast, mosquitoes with the wMelPop strain of Wolbachia showed at least a 10⁴ times reduction in YFV RNA copies compared to controls. The extent of reduction in virus infection depended on Wolbachia strain, titer and strain of the virus, and mode of exposure. Although originally proposed for dengue biocontrol, our results indicate a Wolbachia-based strategy also holds considerable promise for YFV and CHIKV suppression. Mosquito-transmitted viruses such as dengue, yellow fever and chikungunya, are responsible for significant morbidity and mortality throughout tropical and sub-tropical regions of the world. These viruses are primarily transmitted by Aedes aegypti, a mosquito that due to its close association with humans has historically been difficult to control. An innovative control strategy involving the release of mosquitoes infected with the intracellular bacterium Wolbachia is currently being developed. This approach is based on the recent discovery that Wolbachia reduces infection of mosquitoes with dengue virus, malaria parasites and filarial nematodes. In the current study, we demonstrated that Wolbachia also blocks infection of chikungunya and yellow fever viruses in Ae. aegypti. The degree of virus inhibition depended on the strain of Wolbachia, the route of virus exposure, the virus strain and the titer of virus that the mosquitoes were exposed to. The implementation of Wolbachia-based control strategies has the capacity to transform the way that mosquitotransmitted diseases are controlled in the future.

Dengue is one of the most widespread mosquito-borne diseases in the world. The causative agent, dengue virus (DENV), is primarily transmitted by the mosquito Aedes aegypti, a species that has proved difficult to control using conventional methods. The discovery that A. aegypti transinfected with the wMel strain of Wolbachia showed limited DENV replication led to trial field releases of these mosquitoes in Cairns, Australia as a biocontrol strategy for the virus. Field collected wMel mosquitoes that were challenged with three DENV serotypes displayed limited rates of body infection, viral replication and dissemination to the head compared to uninfected controls. Rates of dengue infection, replication and dissemination in field wMel mosquitoes were similar to those observed in the original transinfected wMel line that had been maintained in the laboratory. We found that wMel was distributed in similar body tissues in field mosquitoes as in laboratory ones, but, at seven days following blood-feeding, wMel densities increased to a greater extent in field mosquitoes. Our results indicate that virus-blocking is likely to persist in Wolbachia-infected mosquitoes after their release and establishment in wild populations, suggesting that Wolbachia biocontrol may be a successful strategy for reducing dengue transmission in the field. Almost half of the world's population is at risk of contracting dengue virus, particularly in the tropics and sub-tropics. The virus is transmitted by the mosquito Aedes aegypti, a cosmopolitan species that has proved difficult to control using traditional methods. A new biocontrol strategy has been developed involving the release of mosquitoes infected with Wolbachia bacteria. Mosquitoes with the wMel strain of Wolbachia show dramatically reduced replication and transmission of dengue virus in laboratory trials. Although promising, the utility of Wolbachia biocontrol depends on field wMel-infected mosquitoes retaining the phenotype of reduced viral replication. Mosquitoes with wMel were released in the field in Cairns, Australia in early 2011. We provide evidence that, one year later, field collected wMel mosquitoes showed reduced dengue virus replication in the body and limited dissemination to the head compared to controls. Wolbachia numbers in mosquitoes increased following blood meals, which may further decrease viral replication if the insects feed frequently. Our results indicate that Wolbachia-mediated dengue interference is sustained in field populations and shows no sign of attenuation after one year of deployment.

The obligate endosymbiontWolbachia pipientisis found in a wide range of invertebrates where they are best known for manipulating host reproduction. Recent studies have shown thatWolbachiaalso can modulate the lifespan of host insects and interfere with the development of human pathogens in mosquito vectors. Despite considerable study, very little is known about the molecular interactions betweenWolbachiaand its hosts that might mediate these effects. Using microarrays, we show that the microRNA (miRNA) profile of the mosquito,Aedes aegypti, is significantly altered by thewMelPop-CLA strain ofW. pipientis. We found that a host miRNA (aae-miR-2940) is induced afterWolbachiainfection in both mosquitoes and cell lines. One target of aae-miR-2940 is theAe. aegyptimetalloprotease gene. Interestingly, expression of the target gene was induced afterWolbachiainfection, ectopic expression of the miRNA independent ofWolbachia, or transfection of an artificial mimic of the miRNA into mosquito cells. We also confirmed the interaction of aae-miR-2940 with the target sequences using GFP as a reporter gene. Silencing of the metalloprotease gene in bothWolbachia-infected cells and adult mosquitoes led to a significant reduction inWolbachiadensity, as did inhibition of the miRNA in cells. These results indicate that manipulation of the mosquito metalloprotease gene via aae-miR-2940 is crucial for efficient maintenance of the endosymbiont. This report shows howWolbachiaalters the host miRNA profile and provides insight into the mechanisms of host manipulation used by this widespread endosymbiont.

Chikungunya and dengue infections are spatio-temporally related. The current review aims to determine the geographic limits of chikungunya, dengue and the principal mosquito vectors for both viruses and to synthesise current epidemiological understanding of their co-distribution. Three biomedical databases (PubMed, Scopus and Web of Science) were searched from their inception until May 2015 for studies that reported concurrent detection of chikungunya and dengue viruses in the same patient. Additionally, data from WHO, CDC and Healthmap alerts were extracted to create up-to-date global distribution maps for both dengue and chikungunya. Evidence for chikungunya-dengue co-infection has been found in Angola, Gabon, India, Madagascar, Malaysia, Myanmar, Nigeria, Saint Martin, Singapore, Sri Lanka, Tanzania, Thailand and Yemen; these constitute only 13 out of the 98 countries/territories where both chikungunya and dengue epidemic/endemic transmission have been reported. Understanding the true extent of chikungunya-dengue co-infection is hampered by current diagnosis largely based on their similar symptoms. Heightened awareness of chikungunya among the public and public health practitioners in the advent of the ongoing outbreak in the Americas can be expected to improve diagnostic rigour. Maps generated from the newly compiled lists of the geographic distribution of both pathogens and vectors represent the current geographical limits of chikungunya and dengue, as well as the countries/territories at risk of future incursion by both viruses. These describe regions of co-endemicity in which lab-based diagnosis of suspected cases is of higher priority.