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Browsing by Author "Lavadinovic, Lidija (22941135800)"

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    Association of Vitamin D, Zinc and Selenium Related Genetic Variants With COVID-19 Disease Severity
    (2021)
    Kotur, Nikola (54961068500)
    ;
    Skakic, Anita (57095918200)
    ;
    Klaassen, Kristel (54959837700)
    ;
    Gasic, Vladimir (57095898600)
    ;
    Zukic, Branka (26030757000)
    ;
    Skodric-Trifunovic, Vesna (23499690800)
    ;
    Stjepanovic, Mihailo (55052044500)
    ;
    Zivkovic, Zorica (57224757364)
    ;
    Ostojic, Olivera (57224676685)
    ;
    Stevanovic, Goran (15059280200)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Pavlovic, Sonja (7006514877)
    ;
    Stankovic, Biljana (35785023700)
    Background: COVID-19 pandemic has proved to be an unrelenting health threat for more than a year now. The emerging amount of data indicates that vitamin D, zinc and selenium could be important for clinical presentation of COVID-19. Here, we investigated association of genetic variants related to the altered level and bioavailability of vitamin D, zinc and selenium with clinical severity of COVID-19. Methods: We analyzed variants in genes significant for the status of vitamin D (DHCR7/NADSYN1 rs12785878, GC rs2282679, CYP2R1 rs10741657, and VDR rs2228570), zinc (PPCDC rs2120019) and selenium (DMGDH rs17823744) in 120 Serbian adult and pediatric COVID-19 patients using allelic discrimination. Furthermore, we carried out comparative population genetic analysis among European and other worldwide populations to investigate variation in allelic frequencies of selected variants. Results: Study showed that DHCR7/NADSYN rs12785878 and CYP2R1 rs10741657 variants were associated with severe COVID-19 in adults (p = 0.03, p = 0.017, respectively); carriers of DHCR7/NADSYN TG+GG and CYP2R1 GG genotypes had 0.21 and 5.9 the odds for developing severe disease, OR 0.21 (0.05–0.9) and OR 5.9 (1.4–25.2), respectively. There were no associations between selected genetic variants and disease severity in pediatric patients. Comparative population genetic analysis revealed that Serbian population had the lowest frequency of CYP2R1 rs10741657 G allele compared to other non-Finish Europeans (0.58 compared to 0.69 and 0.66 in Spanish and Italian population, respectively), suggesting that other populations should also investigate the relationship of CYP2R1 variant and the COVID-19 disease course. Conclusion: The results of the study indicated that vitamin D related genetic variants were implicated in severe COVID-19 in adults. This could direct prevention strategies based on population specific nutrigenetic profiles. © Copyright © 2021 Kotur, Skakic, Klaassen, Gasic, Zukic, Skodric-Trifunovic, Stjepanovic, Zivkovic, Ostojic, Stevanovic, Lavadinovic, Pavlovic and Stankovic.
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    Association of Vitamin D, Zinc and Selenium Related Genetic Variants With COVID-19 Disease Severity
    (2021)
    Kotur, Nikola (54961068500)
    ;
    Skakic, Anita (57095918200)
    ;
    Klaassen, Kristel (54959837700)
    ;
    Gasic, Vladimir (57095898600)
    ;
    Zukic, Branka (26030757000)
    ;
    Skodric-Trifunovic, Vesna (23499690800)
    ;
    Stjepanovic, Mihailo (55052044500)
    ;
    Zivkovic, Zorica (57224757364)
    ;
    Ostojic, Olivera (57224676685)
    ;
    Stevanovic, Goran (15059280200)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Pavlovic, Sonja (7006514877)
    ;
    Stankovic, Biljana (35785023700)
    Background: COVID-19 pandemic has proved to be an unrelenting health threat for more than a year now. The emerging amount of data indicates that vitamin D, zinc and selenium could be important for clinical presentation of COVID-19. Here, we investigated association of genetic variants related to the altered level and bioavailability of vitamin D, zinc and selenium with clinical severity of COVID-19. Methods: We analyzed variants in genes significant for the status of vitamin D (DHCR7/NADSYN1 rs12785878, GC rs2282679, CYP2R1 rs10741657, and VDR rs2228570), zinc (PPCDC rs2120019) and selenium (DMGDH rs17823744) in 120 Serbian adult and pediatric COVID-19 patients using allelic discrimination. Furthermore, we carried out comparative population genetic analysis among European and other worldwide populations to investigate variation in allelic frequencies of selected variants. Results: Study showed that DHCR7/NADSYN rs12785878 and CYP2R1 rs10741657 variants were associated with severe COVID-19 in adults (p = 0.03, p = 0.017, respectively); carriers of DHCR7/NADSYN TG+GG and CYP2R1 GG genotypes had 0.21 and 5.9 the odds for developing severe disease, OR 0.21 (0.05–0.9) and OR 5.9 (1.4–25.2), respectively. There were no associations between selected genetic variants and disease severity in pediatric patients. Comparative population genetic analysis revealed that Serbian population had the lowest frequency of CYP2R1 rs10741657 G allele compared to other non-Finish Europeans (0.58 compared to 0.69 and 0.66 in Spanish and Italian population, respectively), suggesting that other populations should also investigate the relationship of CYP2R1 variant and the COVID-19 disease course. Conclusion: The results of the study indicated that vitamin D related genetic variants were implicated in severe COVID-19 in adults. This could direct prevention strategies based on population specific nutrigenetic profiles. © Copyright © 2021 Kotur, Skakic, Klaassen, Gasic, Zukic, Skodric-Trifunovic, Stjepanovic, Zivkovic, Ostojic, Stevanovic, Lavadinovic, Pavlovic and Stankovic.
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    Clinical characteristics and functional outcome of patients with West Nile neuroinvasive disease in Serbia
    (2014)
    Popovic, Natasa (57214680239)
    ;
    Milosevic, Branko (57204639427)
    ;
    Urosevic, Aleksandar (58075718100)
    ;
    Poluga, Jasmina (6507116358)
    ;
    Popovic, Nada (35462343700)
    ;
    Stevanovic, Goran (15059280200)
    ;
    Milosevic, Ivana (58456808200)
    ;
    Korac, Milos (10040016700)
    ;
    Mitrovic, Nikola (55110096400)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Nikolic, Jelena (57207516168)
    ;
    Dulovic, Olga (6602485522)
    Neurologic manifestations are prominent characteristic of West Nile virus (WNV) infection. The aim of this article was to describe neurological manifestations in patients with WNV neuroinvasive disease and their functional outcome at discharge in the first human outbreak of WNV infection in Serbia. The study enrolled patients treated in the Clinic for Infectious and Tropical Diseases, Clinical Center Serbia in Belgrade, with serological evidence of acute WNV infection who presented with meningitis, encephalitis and/or acute flaccid paralyses (AFP). Functional outcome at discharge was assessed using modified Rankin Scale (mRS) and Barthel index. Fifty-two patients were analysed. Forty-four (84.6 %) patients had encephalitis, eight (15.4 %) had meningitis, and 13 (25 %) had AFP. Among patients with AFP, 12 resembled poliomyelitis and one had clinical and electrodiagnostic findings consistent with polyradiculoneuritis. Among patients with encephalitis, 17 (32.7 %) had clinical signs of rhombencephalitis, and eight (15.4 %) presented with cerebellitis. Respiratory failure with subsequent mechanical ventilation developed in 13 patients with WNE (29.5 %). Nine (17.3 %) patients died, five (9.6 %) were functionally dependent (mRS 3-5), and 38 (73.1 %) were functionally independent at discharge (mRS 0-2). In univariate analysis, the presence of AFP, respiratory failure and consciousness impairment were found to be predictors of fatal outcome in patients with WNV neuroinvasive disease (p < 0.001, p < 0.001, p = 0.018, respectively). The outbreak of human WNV infection in Serbia caused a notable case fatality ratio, especially in patients with AFP, respiratory failure and consciousness impairment. Rhombencephalitis and cerebellitis could be underestimated presentations of WNV neuroinvasive disease. © 2014 Springer-Verlag Berlin Heidelberg.
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    Publication
    Clinical characteristics and functional outcome of patients with West Nile neuroinvasive disease in Serbia
    (2014)
    Popovic, Natasa (57214680239)
    ;
    Milosevic, Branko (57204639427)
    ;
    Urosevic, Aleksandar (58075718100)
    ;
    Poluga, Jasmina (6507116358)
    ;
    Popovic, Nada (35462343700)
    ;
    Stevanovic, Goran (15059280200)
    ;
    Milosevic, Ivana (58456808200)
    ;
    Korac, Milos (10040016700)
    ;
    Mitrovic, Nikola (55110096400)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Nikolic, Jelena (57207516168)
    ;
    Dulovic, Olga (6602485522)
    Neurologic manifestations are prominent characteristic of West Nile virus (WNV) infection. The aim of this article was to describe neurological manifestations in patients with WNV neuroinvasive disease and their functional outcome at discharge in the first human outbreak of WNV infection in Serbia. The study enrolled patients treated in the Clinic for Infectious and Tropical Diseases, Clinical Center Serbia in Belgrade, with serological evidence of acute WNV infection who presented with meningitis, encephalitis and/or acute flaccid paralyses (AFP). Functional outcome at discharge was assessed using modified Rankin Scale (mRS) and Barthel index. Fifty-two patients were analysed. Forty-four (84.6 %) patients had encephalitis, eight (15.4 %) had meningitis, and 13 (25 %) had AFP. Among patients with AFP, 12 resembled poliomyelitis and one had clinical and electrodiagnostic findings consistent with polyradiculoneuritis. Among patients with encephalitis, 17 (32.7 %) had clinical signs of rhombencephalitis, and eight (15.4 %) presented with cerebellitis. Respiratory failure with subsequent mechanical ventilation developed in 13 patients with WNE (29.5 %). Nine (17.3 %) patients died, five (9.6 %) were functionally dependent (mRS 3-5), and 38 (73.1 %) were functionally independent at discharge (mRS 0-2). In univariate analysis, the presence of AFP, respiratory failure and consciousness impairment were found to be predictors of fatal outcome in patients with WNV neuroinvasive disease (p < 0.001, p < 0.001, p = 0.018, respectively). The outbreak of human WNV infection in Serbia caused a notable case fatality ratio, especially in patients with AFP, respiratory failure and consciousness impairment. Rhombencephalitis and cerebellitis could be underestimated presentations of WNV neuroinvasive disease. © 2014 Springer-Verlag Berlin Heidelberg.
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    Genome-Wide Association Study of COVID-19 Outcomes Reveals Novel Host Genetic Risk Loci in the Serbian Population
    (2022)
    Zecevic, Marko (23480744700)
    ;
    Kotur, Nikola (54961068500)
    ;
    Ristivojevic, Bojan (57216549129)
    ;
    Gasic, Vladimir (57095898600)
    ;
    Skodric-Trifunovic, Vesna (23499690800)
    ;
    Stjepanovic, Mihailo (55052044500)
    ;
    Stevanovic, Goran (15059280200)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Zukic, Branka (26030757000)
    ;
    Pavlovic, Sonja (7006514877)
    ;
    Stankovic, Biljana (35785023700)
    Host genetics, an important contributor to the COVID-19 clinical susceptibility and severity, currently is the focus of multiple genome-wide association studies (GWAS) in populations affected by the pandemic. This is the first study from Serbia that performed a GWAS of COVID-19 outcomes to identify genetic risk markers of disease severity. A group of 128 hospitalized COVID-19 patients from the Serbian population was enrolled in the study. We conducted a GWAS comparing (1) patients with pneumonia (n = 80) against patients without pneumonia (n = 48), and (2) severe (n = 34) against mild disease (n = 48) patients, using a genotyping array followed by imputation of missing genotypes. We have detected a significant signal associated with COVID-19 related pneumonia at locus 13q21.33, with a peak residing upstream of the gene KLHL1 (p = 1.91 × 10−8). Our study also replicated a previously reported COVID-19 risk locus at 3p21.31, identifying lead variants in SACM1L and LZTFL1 genes suggestively associated with pneumonia (p = 7.54 × 10−6) and severe COVID-19 (p = 6.88 × 10−7), respectively. Suggestive association with COVID-19 pneumonia has also been observed at chromosomes 5p15.33 (IRX, NDUFS6, MRPL36, p = 2.81 × 10−6), 5q11.2 (ESM1, p = 6.59 × 10−6), and 9p23 (TYRP1, LURAP1L, p = 8.69 × 10−6). The genes located in or near the risk loci are expressed in neural or lung tissues, and have been previously associated with respiratory diseases such as asthma and COVID-19 or reported as differentially expressed in COVID-19 gene expression profiling studies. Our results revealed novel risk loci for pneumonia and severe COVID-19 disease which could contribute to a better understanding of the COVID-19 host genetics in different populations. Copyright © 2022 Zecevic, Kotur, Ristivojevic, Gasic, Skodric-Trifunovic, Stjepanovic, Stevanovic, Lavadinovic, Zukic, Pavlovic and Stankovic.
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    Genome-Wide Association Study of COVID-19 Outcomes Reveals Novel Host Genetic Risk Loci in the Serbian Population
    (2022)
    Zecevic, Marko (23480744700)
    ;
    Kotur, Nikola (54961068500)
    ;
    Ristivojevic, Bojan (57216549129)
    ;
    Gasic, Vladimir (57095898600)
    ;
    Skodric-Trifunovic, Vesna (23499690800)
    ;
    Stjepanovic, Mihailo (55052044500)
    ;
    Stevanovic, Goran (15059280200)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Zukic, Branka (26030757000)
    ;
    Pavlovic, Sonja (7006514877)
    ;
    Stankovic, Biljana (35785023700)
    Host genetics, an important contributor to the COVID-19 clinical susceptibility and severity, currently is the focus of multiple genome-wide association studies (GWAS) in populations affected by the pandemic. This is the first study from Serbia that performed a GWAS of COVID-19 outcomes to identify genetic risk markers of disease severity. A group of 128 hospitalized COVID-19 patients from the Serbian population was enrolled in the study. We conducted a GWAS comparing (1) patients with pneumonia (n = 80) against patients without pneumonia (n = 48), and (2) severe (n = 34) against mild disease (n = 48) patients, using a genotyping array followed by imputation of missing genotypes. We have detected a significant signal associated with COVID-19 related pneumonia at locus 13q21.33, with a peak residing upstream of the gene KLHL1 (p = 1.91 × 10−8). Our study also replicated a previously reported COVID-19 risk locus at 3p21.31, identifying lead variants in SACM1L and LZTFL1 genes suggestively associated with pneumonia (p = 7.54 × 10−6) and severe COVID-19 (p = 6.88 × 10−7), respectively. Suggestive association with COVID-19 pneumonia has also been observed at chromosomes 5p15.33 (IRX, NDUFS6, MRPL36, p = 2.81 × 10−6), 5q11.2 (ESM1, p = 6.59 × 10−6), and 9p23 (TYRP1, LURAP1L, p = 8.69 × 10−6). The genes located in or near the risk loci are expressed in neural or lung tissues, and have been previously associated with respiratory diseases such as asthma and COVID-19 or reported as differentially expressed in COVID-19 gene expression profiling studies. Our results revealed novel risk loci for pneumonia and severe COVID-19 disease which could contribute to a better understanding of the COVID-19 host genetics in different populations. Copyright © 2022 Zecevic, Kotur, Ristivojevic, Gasic, Skodric-Trifunovic, Stjepanovic, Stevanovic, Lavadinovic, Zukic, Pavlovic and Stankovic.
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    Influenza a H1N1 virus infection among pregnant women in a tertiary hospital in Belgrade, Serbia
    (2018)
    Milosevic, Ivana (58456808200)
    ;
    Korac, Milos (10040016700)
    ;
    Popovic, Natasa (57214680239)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Urosevic, Aleksandar (58075718100)
    ;
    Milosevic, Branko (57204639427)
    ;
    Jevtovic, Djordje (55410443900)
    ;
    Pelemis, Mijomir (6507978433)
    ;
    Stevanovic, Goran (15059280200)
    Introduction: Pregnant women are at higher risk of developing severe influenza. Our aim was to analyze clinical course and risk factors for fatal outcome in pregnant women with influenza (H1N1) infection. Methodology: This retrospective study enrolled eleven pregnant women with confirmed Influenza A (H1N1) infection treated in the Clinic for Infectious and Tropical Diseases, Belgrade, Serbia in a 6-years period. Results: The mean age of pregnant women was 28.9 ± 5.2 years, and mean gestational age was 23.1 ± 7.0 weeks. Nine (81.8%) pregnant women had pneumonia (six had interstitial and three had bacterial pneumonia). Pregnant women developed pneumonia more often than other women in the reproductive period, but without statistical significance (81.8% vs. 65.7%, p = 0.330, OR (95% CI) 2.35 (0.47-11.80)). Nine (81.8%) pregnant women recovered. None of them experienced preterm delivery or abortion. Two women (18.2%) died due to acute respiratory distress syndrome. In one of them fetal death occurred one day before she died. The other one was performed caesarean section three days before death. Her newborn and children of all recovered women were healthy at birth. Prolonged time to initiation of oseltamivir and higher body mass index were statistically significantly associated with fatal outcome (p = 0.002, and p = 0.007, respectively). Gestational week of pregnancy, the etiology of pneumonia and comorbidity were not found to be risk factors for death (p = 0.128, p = 0.499 and p = 1.000, respectively). Conclusion: Pregnant women with H1N1 infection are at higher risk of pneumonia and death than other women in the reproductive period. Early antiviral therapy reduces the risk of unfavorable outcome. © 2018 Milosevic et al.
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    Influenza a H1N1 virus infection among pregnant women in a tertiary hospital in Belgrade, Serbia
    (2018)
    Milosevic, Ivana (58456808200)
    ;
    Korac, Milos (10040016700)
    ;
    Popovic, Natasa (57214680239)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Urosevic, Aleksandar (58075718100)
    ;
    Milosevic, Branko (57204639427)
    ;
    Jevtovic, Djordje (55410443900)
    ;
    Pelemis, Mijomir (6507978433)
    ;
    Stevanovic, Goran (15059280200)
    Introduction: Pregnant women are at higher risk of developing severe influenza. Our aim was to analyze clinical course and risk factors for fatal outcome in pregnant women with influenza (H1N1) infection. Methodology: This retrospective study enrolled eleven pregnant women with confirmed Influenza A (H1N1) infection treated in the Clinic for Infectious and Tropical Diseases, Belgrade, Serbia in a 6-years period. Results: The mean age of pregnant women was 28.9 ± 5.2 years, and mean gestational age was 23.1 ± 7.0 weeks. Nine (81.8%) pregnant women had pneumonia (six had interstitial and three had bacterial pneumonia). Pregnant women developed pneumonia more often than other women in the reproductive period, but without statistical significance (81.8% vs. 65.7%, p = 0.330, OR (95% CI) 2.35 (0.47-11.80)). Nine (81.8%) pregnant women recovered. None of them experienced preterm delivery or abortion. Two women (18.2%) died due to acute respiratory distress syndrome. In one of them fetal death occurred one day before she died. The other one was performed caesarean section three days before death. Her newborn and children of all recovered women were healthy at birth. Prolonged time to initiation of oseltamivir and higher body mass index were statistically significantly associated with fatal outcome (p = 0.002, and p = 0.007, respectively). Gestational week of pregnancy, the etiology of pneumonia and comorbidity were not found to be risk factors for death (p = 0.128, p = 0.499 and p = 1.000, respectively). Conclusion: Pregnant women with H1N1 infection are at higher risk of pneumonia and death than other women in the reproductive period. Early antiviral therapy reduces the risk of unfavorable outcome. © 2018 Milosevic et al.
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    Safety and immunogenicity of a seasonal trivalent inactivated split influenza vaccine: a phase I randomized clinical trial in healthy Serbian adults
    (2018)
    Stevanovic, Goran (15059280200)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Filipovic Vignjevic, Svetlana (57200791633)
    ;
    Holt, Renée (56513208500)
    ;
    Ilic, Katarina (58450436800)
    ;
    Berlanda Scorza, Francesco (35602819700)
    ;
    Sparrow, Erin (56999977300)
    ;
    Stoiljkovic, Vera (57200788316)
    ;
    Torelli, Guido (53464210100)
    ;
    Madenwald, Tamra (6506488677)
    ;
    Socquet, Muriel (56968221000)
    ;
    Barac, Aleksandra (55550748700)
    ;
    Ilieva-Borisova, Yordanka (57200798962)
    ;
    Pelemis, Mijomir (6507978433)
    ;
    Flores, Jorge (57214543059)
    This study was a phase I double-blind, randomized, placebo-controlled trial to evaluate the safety and immunogenicity of a Serbian-produced seasonal trivalent split, inactivated influenza vaccine in healthy adults. The vaccine was manufactured in eggs by the Torlak Institute of Virology, Vaccines and Sera, Belgrade, Serbia and contained A/H1N1, A/H3N2 and B viruses. The clinical trial took place at the Clinical Center of Serbia in Belgrade. Sixty healthy volunteers, aged 18–45 years, were enrolled in the trial. On the day of immunization, volunteers were randomly assigned to receive either a single dose of the trivalent seasonal influenza vaccine (15 μg of hemagglutinin per strain) or placebo (phosphate-buffered saline). Subjects were monitored for adverse events through a clinical history and physical examination, and blood was taken for testing at screening and on day 8 to assess vaccine safety. Serum samples obtained before and 21 days after immunization were tested for influenza antibody titers using hemagglutination-inhibition (HAI) and microneutralization (MN) tests. No serious adverse events were reported. Pain and tenderness at the injection site were the most commonly reported symptoms in both vaccine and placebo groups. Overall, serum HAI responses of fourfold or greater magnitude were observed to H1, H3, and B antigen in 80%, 75%, and 70% of subjects, respectively. Seroprotection rates as measured by HAI were also high (100%, 100% and 86.67%, respectively, for H1, H3 and B). Thus, Torlak's seasonal trivalent influenza vaccine was not associated with adverse events, was well-tolerated and immunogenic. It should be further evaluated in clinical trials to provide sufficient safety and immunogenicity data for licensing in Serbia. © 2018 The Author(s). Published with license by Taylor & Francis Group, LLC © 2018, © Goran Stevanovic, Lidija Lavadinovic, Svetlana Filipovic Vignjevic, Renée Holt, Katarina Ilic, Francesco Berlanda Scorza, Erin Sparrow, Vera Stoiljkovic, Guido Torelli, Tamra Madenwald, Muriel Socquet, Aleksandra Barac, Yordanka Ilieva-Borisova, Mijomir Pelemis, and Jorge Flores.
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    Safety and immunogenicity of a seasonal trivalent inactivated split influenza vaccine: a phase I randomized clinical trial in healthy Serbian adults
    (2018)
    Stevanovic, Goran (15059280200)
    ;
    Lavadinovic, Lidija (22941135800)
    ;
    Filipovic Vignjevic, Svetlana (57200791633)
    ;
    Holt, Renée (56513208500)
    ;
    Ilic, Katarina (58450436800)
    ;
    Berlanda Scorza, Francesco (35602819700)
    ;
    Sparrow, Erin (56999977300)
    ;
    Stoiljkovic, Vera (57200788316)
    ;
    Torelli, Guido (53464210100)
    ;
    Madenwald, Tamra (6506488677)
    ;
    Socquet, Muriel (56968221000)
    ;
    Barac, Aleksandra (55550748700)
    ;
    Ilieva-Borisova, Yordanka (57200798962)
    ;
    Pelemis, Mijomir (6507978433)
    ;
    Flores, Jorge (57214543059)
    This study was a phase I double-blind, randomized, placebo-controlled trial to evaluate the safety and immunogenicity of a Serbian-produced seasonal trivalent split, inactivated influenza vaccine in healthy adults. The vaccine was manufactured in eggs by the Torlak Institute of Virology, Vaccines and Sera, Belgrade, Serbia and contained A/H1N1, A/H3N2 and B viruses. The clinical trial took place at the Clinical Center of Serbia in Belgrade. Sixty healthy volunteers, aged 18–45 years, were enrolled in the trial. On the day of immunization, volunteers were randomly assigned to receive either a single dose of the trivalent seasonal influenza vaccine (15 μg of hemagglutinin per strain) or placebo (phosphate-buffered saline). Subjects were monitored for adverse events through a clinical history and physical examination, and blood was taken for testing at screening and on day 8 to assess vaccine safety. Serum samples obtained before and 21 days after immunization were tested for influenza antibody titers using hemagglutination-inhibition (HAI) and microneutralization (MN) tests. No serious adverse events were reported. Pain and tenderness at the injection site were the most commonly reported symptoms in both vaccine and placebo groups. Overall, serum HAI responses of fourfold or greater magnitude were observed to H1, H3, and B antigen in 80%, 75%, and 70% of subjects, respectively. Seroprotection rates as measured by HAI were also high (100%, 100% and 86.67%, respectively, for H1, H3 and B). Thus, Torlak's seasonal trivalent influenza vaccine was not associated with adverse events, was well-tolerated and immunogenic. It should be further evaluated in clinical trials to provide sufficient safety and immunogenicity data for licensing in Serbia. © 2018 The Author(s). Published with license by Taylor & Francis Group, LLC © 2018, © Goran Stevanovic, Lidija Lavadinovic, Svetlana Filipovic Vignjevic, Renée Holt, Katarina Ilic, Francesco Berlanda Scorza, Erin Sparrow, Vera Stoiljkovic, Guido Torelli, Tamra Madenwald, Muriel Socquet, Aleksandra Barac, Yordanka Ilieva-Borisova, Mijomir Pelemis, and Jorge Flores.

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