[Accelerated culture diagnosis of tuberculosis by using automatic Bactec MGIT 960 and MB/BACT systems].
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Biomedical subjects
Publications and source records attributed to A M Moroz.
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RCR-heteroduplex (GDA) and chip methods were used to detect rifampricin-resistant (RR) and rifampicin-sensitive (RS) Mycobacterium tuberculosis (MTB) in the samples from patients (sputum) and in the clinical isolates of MTB from these patients (MB/BacT liquid medium and Lowenstein Jensen's (LJ) solid medium. The efficiency of detecting RR and RS of MTB (from the sputum) is 100 and 92.3% in the chip and GDA tests, respectively. Correlations between GDA (sputum) and drug test (LJ) were 91.7%, that of chip (sputum) and drug test LJ, 88.5%, chip (sputum) and chip clinical isolates (LJ), 100%. The efficacy of GDA and chip in the detection of RR of MTB strains is under discussion.
Two alternative methods for identification of rifampicin-resistant strains of Mycobacterium tuberculosis on biological microchips are developed. The methods are based on detection of point mutations and other rearrangements in the rpoB gene region determining rifampicin resistance. Hybridization on TB-microchip detects 30 mutant variants of DNA in rifampicin-resistant strains (about 95% of all resistant forms). Allele-specific microchip PCR shortens the duration of analysis to 1.5 h. These methods can be used in clinical diagnostic laboratories for evaluating drug resistance/sensitivity of tuberculosis agent and for monitoring of the efficiency of antibiotic therapy.
A hundred and seventy respiratory samples from patients with different forms of tuberculosis were used to test the efficiency of the automatic liquid culture systems BACTEC MGIT 960 and MB/BacT with inoculation into the standard dense media. All these media provided 47 M. tuberculous isolates, of them 41 (87.2%), 38 (80.9%), and 76.6% on the BACTER 960, MB/BacT, and dense media, respectively. The average time of detection of mycobacterial growth by means of automatic systems was much shorter and equal to 10.7 days on the BACTEC 960 and 18.7 days on the MB/BacT versus 33.2 days on the standard dense medium. In terms of their sensitivity and detection rate, the automatic systems were superior to the dense media widely used in laboratory practice.
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A test-system based on amplification of IS 986 fragment (nested-PCR) was developed for the detection of Mycobacterium tuberculosis and M. bovis in different biological samples. We constructed external primers and selected appropriate amplifications parameters (annealing temperatures for states I and II, the number of cycles for each amplification stage, components of the amplification mixture, and pretreatment conditions for different biological samples). The developed parameters make the detection of mycobacteria more efficient and less expensive compared to commercial Cobas Amplicor system.
The paper outlines the high-priority trends in basic and applied investigations of antituberculous immunity. It presents the results obtained from studies of the genetic mechanisms responsible for the control of susceptibility in experimental tuberculosis, from analyses of novel chemical and recombinant tuberculosis vaccines, from examinations of the role of immunological memory in the disease. While describing the results of tuberculosis immunodiagnosis, particular emphasis is laid on its major aspects: on the differential diagnosis of tuberculosis and other lung diseases and on the screening of high-risk group populations for disease progression in order to made further in-depth studies. Current aspects of evaluating the immune status and nonspecific responsiveness in patients with tuberculosis are considered.
Results of operative treatment of patients with esophageal hernias of the diaphragm can be substantially improved in cases of differential approach to choice of the plasty method. Choice of the method of plasty depends on the hernia type, topographic-anatomical structure of the esophageal opening of the diaphragm, concomitant diseases and age of the patient. Preference should be given to methods of non-complete fundoplication performed from the transabdominal access.
The prophylactics of bronchopulmonary complications was performed by the authors original method of intrapulmonary electrophoresis. It was shown to be effective and allowed the amount of postoperative bronchitis and pneumonia to be reduced from 15-20% to 4.4%.
It is firmly established that the allelic composition of the H-2 complex has a prominent impact on the course of tuberculosis (TB) infection in mice, including granuloma formation, mycobacterial spread in the lungs, and the dynamics of mortality. Although intuitively obvious, the role of long-term specific T cell responses in the expression of corresponding phenotypes is poorly understood. In this study we have compared polyclonal lymph node cell response (cell yield, proliferation, surface markers, IL-4/interferon-gamma (IFN-gamma) production) to Mycobacterium tuberculosis H37Rv sonicate in repeated 10-day cycles of stimulation/rest between H-2 congenic IE-negative mouse strains, categorized on the basis of mortality following lethal challenge as TB-susceptible (C57B1/6), TB-resistant (4R) and BCG non-protected (B10.M). The capacity to retain specific responsiveness to repeated stimulation by mycobacterial antigens depended upon both the H-2 haplotype of the host and the immunizing dose of the antigen. 4R lymph node cells following either 50 microg/mouse or 100 microg/mouse immunization constantly responded to sonicate, increased in numbers, and after the third stimulation/rest cycle developed into a stable CD3+CD4+ cell line. B6 cells following either 50 microg/mouse or 100 microg/mouse immunization, and B10.M cells following 100 microg/mouse (but not 50 microg/mouse) immunization, lost the capacity to incorporate methyl-3H-thymidine during the second cycle, and died. Analogous results were obtained in the in vivo experiments, when the dynamics of the response over 12 weeks following a single immunization with the antigen was studied. In response to the antigen, cells from all three mouse strains produced significant amounts of IL-2 and IFN-gamma, but not IL-4, indicating that they belong predominantly to the Th1-like subset. Among noteworthy differences between the mouse strains was a clear deficiency of CD8+ T cells in B6 cultures, and an unusually high proportion of CD3+CD4-CD8- (double-negative) T cells in B10.M cultures following a high-dose immunization.
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We have studied the role of three mouse distinct non-H-2 genes (Bcg, Tbc-1, xid) in several phenomena of antituberculosis immunity and resistance. On the basis of median survival time (MST) of mice following infection with virulent Mycobacterium tuberculosis H37Rv, Bcg gene did not control resistance to the lethal dose of H37Rv infection in non-vaccinated and Myco. bovis (BCG)-vaccinated mice. However, Bcgr allele, in comparison with Bcgs allele, determined more effective suppression of an early multiplication in spleens of H37Rv mycobacteria after a low dose (5x10(4) colony-forming units (CFU)) injection. CBA/N mice, which are not protected efficiently against tuberculous challenge by BCG vaccination, were characterized by a decreased in vitro proliferation of immune lymph node cells, both spontaneous and stimulated with mycobacterial antigens. The decreased proliferation was due to immunosuppression caused by interactions between responding T cells and CBA/N antigen-presenting cells (APC). We have confirmed that the defective response to BCG-vaccination in CBA/N mice is linked with the X-chromosome and thus is presumably determined by the xid gene itself. I/St mice (Tbc-1s), supersusceptible to H37Rv infection, were not able to restrict the growth of H37Rv mycobacteria in spleens, even following infection with a low dose (5x10(4)), but restricted the growth of Myco.bovis BCG more effectively than Bcgs mice.
CBA mice served as experimental tuberculosis model to study protective, immunomodulating and toxico-allergic properties of two drugs including cytoplasma and cell walls of BCG mycobacteria as well as of synthetic adjuvant polyoxidonium. Doses and schemes are presented developed for experimental tuberculosis treatment with cytoplasm and not causing toxico-allergic reactions in mice. The specific immunomodulator of cytoplasm, polyoxidonium, proved effective therapeutic modality in experimental mouse tuberculosis.
Reviews the recent progress in immunopathogenesis, immunogenetics, immunodiagnosis, immunotherapy, and immunoprophylaxis of tuberculosis. The findings of Russian scientists (primarily at the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences) are compatible to the results of medical centers abroad.
The paper discusses the genetic control of and the mechanisms of protective antituberculous immunity following BCG vaccination in inbred mice. The following genetic systems H-2 (B10.M)(H-2f) and B10.SM (H-2v) congenics were not protected with a high dose of BCG vaccine); Xid (X-linked immunodeficiency) CBA/N mice were not protected with regularly protective doses of BCG vaccine; Tbc-1 (I/St mice (Tbc-1s) were hypersensitive to tuberculosis. In two genetic systems (H-2 and xid), a distinct genetic control of susceptibility to primary tuberculosis and efficacy of BCG vaccination was demonstrated.
The impact of the in vivo administration of monoclonal antibodies against cytokines on the development of a pathological process in mice infected with Mycobacterium tuberculosis H37Rv-infected mice. The susceptibility to fatal experimental tuberculosis, the level of DTH to mycobacterial antigens, the production of specific antimycobacterial IgG and IgM, T-cell proliferative responses to M. tuberculosis H37Rv antigens. Anti-gamma-interferon and anti-IL-2 treatment was found to provide virtually no effects on the course of experimental tuberculosis, the intravenous administration of anti-IL-4-monoclonal antibodies on days 2, 4, and 6 after inoculation with a lethal dose of M. tuberculosis significantly increases the median survival time (MST). This increase in MST is accompanied by a more prominent DTH response and lymphocytic proliferative reaction on the one hand, and by lower concentrations of specific IgG on the other. The therapeutical prospects of anti-IL-4 treatment in tuberculosis are discussed.
We have studied the impact of distinct haplotypes and of different alleles at specific H-2 loci on: (i) the susceptibility to lethal form of experimental tuberculosis; (ii) the level of DTH to mycobacterial antigens; (iii) the efficacy of vaccination with bacille Calmette-Guérin (BCG); and (iv) the IgG production and T cell proliferative response to H37Rv antigens. On the basis of median survival time (MST) following primary inoculation with lethal dose of Mycobacterium tuberculosis, susceptibility to infection associated with I-Ab and Db alleles, host resistance associated with I-Ak and Dd alleles. Mice bearing a disease-resistant phenotype also developed a vigorous DTH response. Vaccination with BCG before H37Rv infection significantly prolonged the survival time of both resistant and susceptible animals, except in B10.M (H-2f) mice. The latter exhibited intermediate resistance to infection before but slight decrease in the MST following a high-dose BCG vaccination. Distinct H-2 regulation of susceptibility to lethal infection and of BCG vaccination efficacy was confirmed in another relatively resistant H-2f-bearing strain A.CA, in which mortality occurred more rapidly in vaccinated compared with primarily infected animals. The expression of the H-2f haplotype was associated with a low DTH response to tuberculin following vaccination and subsequent lethal infection. The lack of BCG protection against Myco, tuberculosis challenge in B10.M mice associated with the high titre of specific IgG. In addition, these mice exhibited a unique ability to respond to 65-kD antigen by both IgG synthesis and T cell proliferation.
The serum content of interferon (IF) and its correlation with diverse immunologic parameters were studied in tuberculosis-resistant mice. In primary contamination the IF level was much higher in B10 mice highly sensitive to tuberculosis infection in all periods of the study than that in highly resistant A/Sn mice. In the vaccinated mice which were later infected this tendency remained but IF levels were 1.5--2 times higher than in primary contamination. Comparison of the IF level and the studied resistance parameters in the resistant mice revealed an inverse correlation. If the immunologic parameters in resistant A/Sn mice are higher than those in B10 mice the latter have significantly higher serum IF levels.