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Biomedical subjects

J Verhoef

Publications and source records attributed to J Verhoef.

At least 343 records · Page 19Linked to original sources

Minimal oligosaccharide structures required for induction of immune responses against meningococcal immunotype L1, L2, and L3,7,9 lipopolysaccharides determined by using synthetic oligosaccharide-protein conjugates.

The 12 types of meningococcal lipopolysaccharide (LPS) (immunotypes) contain immunotype-specific and cross-reactive epitopes situated on the oligosaccharide part of the LPS molecules. To identify useful cross-reactive epitopes and to determine minimal oligosaccharide structures required for the induction of an immune response against the most prevalent immunotypes, L1, L2, and L3,7,9, synthetic as well as native LPS-derived oligosaccharides were conjugated with tetanus toxoid. L3,7,9 phosphoethanolamine (PEA) group-containing oligosaccharide-tetanus toxoid conjugates evoked high immunoglobulin G (IgG) antibody levels in rabbits which were detected by an L2-, L3,7,9-, and, depending on the antiserum, L1-specific enzyme-linked immunosorbent assay (ELISA). Inhibition studies revealed that an identical antibody population was detected by L1 and L3,7,9 ELISA, indicating a similar tertiary structure of the inner core oligosaccharide of these two immunotypes. These antibodies recognize PEA group-containing epitopes present on the L1 and L3,7,9 LPS. An L2 PEA group-containing oligosaccharide-tetanus toxoid conjugate elicited L2- and L3,7,9-specific IgG antibodies, but in contrast with the L3,7,9 conjugates, no L1-specific IgG antibodies were evoked. These results indicate that L1 and L2 LPS do not contain cross-reactive epitopes, whereas both L2 and L3,7,9 LPS and L1 and L3,7,9 LPS possess common determinants. Three linear oligosaccharides and one branched oligosaccharide, representing partial structures of the inner core oligosacchardes of meningococcal LPS, were synthesized. Only the branched synthetic oligosaccharide-containing conjugate was able to induce and L1- and L3,7,9-specific immune response, whereas the linear oligosaccharide-protein conjugates evoked L2-specific immune responses. The branched oligosaccharide (beta-D-Glcp(1----4)-[L-alpha-D-Hepp(1----3)]-L-alpha-D-Hepp ) is therefore considered a minimal structure required for the induction of an immune response against L1 and L3,7,9 LPS and part of a cross-reactive epitope between these two immunotypes. For L2-specific immune responses, oligosaccharide structures terminating in beta-D-Glcp(1----4), alpha-D-GlcNAcp(1----2), or L-alpha-D-Hepp(1----5) are needed. The results suggest that it is possible to prepare an oligosaccharide structure with the ability to evoke an immune response against L1, L2, and L3,7,9 LPS. A feasible structure for such a "hybrid" oligosaccharide is discussed.

Animals↗

Characterization of a proteinaceous adhesin of Staphylococcus epidermidis which mediates attachment to polystyrene.

Coagulase-negative staphylococci (CoNS) have evolved into important agents of foreign body-related infections. Adhesion of causative bacteria to biomaterials is considered to be an essential step in these infections. We and others have shown that adhesion of CoNS to biomaterials may be mediated by protease-sensitive surface constituents. In the present study we expanded on these investigations by characterizing a biomaterial adhesin of Staphylococcus epidermidis 354 by using a strain-specific monoclonal antibody (MAb 36.4). MAb 36.4 was strongly and exclusively reactive with strain 354 in an enzyme-linked immunosorbent assay in which whole bacteria were used as antigens. Immunoblotting of cell wall polypeptides of strain 354 revealed strong reactivity with a 200- to 220-kDa band and a weaker reaction in the 100- to 110-kDa range. Preincubation of strain 354 with MAb 36.4 resulted in a 54 to 91% (mean +/- standard deviation, 74% +/- 14%; n = 10) inhibition of adhesion to polystyrene spheres. Fab fragments prepared from MAb 36.4 also inhibited adhesion effectively, indicating specific blocking of an adhesion antigen rather than aspecific inhibition. Immunogold electron microscopy with MAb 36.4 revealed deposition of gold particles on the cell surface and possibly also on fimbrialike surface projections. It is concluded that a surface-located protein antigen of S. epidermidis 354 recognized by MAb 36.4 acts as an adhesin mediating attachment to uncoated foreign material. It is speculated that this type of adhesion to biomaterials may play an important role in the pathogenesis of foreign body-related infections caused by CoNS.

Antibodies, Monoclonal↗

Preparation, characterization, and immunogenicity of meningococcal immunotype L2 and L3,7,9 phosphoethanolamine group-containing oligosaccharide-protein conjugates.

A method was developed for the well-defined coupling of phosphoethanolamine group (PEA)- and carboxylic acid group-containing polysaccharides and oligosaccharides to proteins without the need for extensive modification of the carbohydrate antigens. The carboxylic acid group of the terminal 2-keto-3-deoxyoctulosonic acid moiety was utilized to introduce a thiol function in meningococcal immunotype L2 and L3,7,9 lipopolysaccharide-derived oligosaccharides. The thiol group-containing oligosaccharides were subsequently coupled to bromoacetylated proteins. Immunotype L2 and L3,7,9 PEA group-containing oligosaccharide-tetanus toxoid conjugates were prepared, and their immunogenicities were studied in rabbits. Both the immunotype L2 and immunotype L3,7,9 conjugates evoked high immunoglobulin G (IgG) antibody titers after the first booster injection. These conjugates also displayed an ability to induce long-lasting IgG antibody levels which could be detected until 9 months after one booster injection at week 3. The adjuvant Quil A enhanced the immune response to all the conjugates to a minor extent, which is in contrast with reported adjuvant effects of Quil A on these types of antigens in mice. A conjugate prepared from the dephosphorylated L3,7,9 oligosaccharides evoked a significantly lower IgG response than a similar PEA-containing conjugate, and enzyme-linked immunosorbent assay inhibition studies indicated a different epitope specificity. Furthermore, antisera elicited with the complete bacteria contained antibodies directed against PEA-containing epitopes, which stresses the importance of the presence of unmodified PEA groups in meningococcal lipopolysaccharide-derived oligosaccharide-protein conjugates. The procedure developed offers an elegant solution for the specific coupling of meningococcal PEA-containing oligosaccharides to proteins and may therefore be a very useful tool in the development of a vaccine against group B meningococci.

Animals↗

Nontoxigenic strains of Clostridium difficile lack the genes for both toxin A and toxin B.

A total of 39 toxigenic and 20 nontoxigenic strains of Clostridium difficile were tested for the presence of either toxin A or toxin B by the polymerase chain reaction (PCR). All toxigenic strains produced cytotoxin as assayed by using highly sensitive fetal lung fibroblasts and were positive for toxin A as well as toxin B in the PCR assay. All nontoxigenic strains failed to produce toxin and were negative in the PCR assay. This study shows that nontoxigenic strains of Clostridium difficile lack the toxin A as well as the toxin B gene.

Bacterial Proteins↗

Monoclonal antibodies specific for the phase-variant O-acetylated K1 capsule of Escherichia coli.

Two monoclonal antibodies, one each of the immunoglobulin M and G2b types, were produced from mouse spleen cells. These monoclonal antibodies only reacted with approximately 50% of the Escherichia coli K1 strains and not against group B meningococci. No reaction was observed after the strains were boiled. E. coli K1 strains that reacted with the monoclonal antibodies could become nonreactive after subculture. Based on these findings, we conclude that the monoclonal antibodies react with the O-acetylated K1 capsule.

Acetylation↗

Role of mesothelial cells in peritoneal antibacterial defence.

Whether phagocytosis of Staphylococcus aureus by polymorphonuclear neutrophils, monocytes, and peritoneal macrophages takes place when the staphylococci are adherent to monolayers of human mesothelial cells in the absence of opsonins was investigated. Adherence of S aureus to mesothelial monolayers increased significantly when the bacteria were opsonised with pooled human serum, but phagocytosis by polymorphonuclear neutrophils and monocytes occurred independently. Phagocytosis by peritoneal macrophages, however, was only marginal. Pretreatment of polymorphonuclear neutrophils with inhibitors of cellular metabolism and motility reduced their phagocytic capacity. These results indicate that the surface of mesothelial cells provides favourable conditions for the elimination of staphylococci in the peritoneal cavity. Phagocytic motility seems to be important in surface phagocytosis. The inability of peritoneal macrophages to phagocytise staphylococci adherent to the mesothelial cells suggests that they contribute little to the antibacterial defence of the peritoneal membrane of patients receiving peritoneal dialysis.

Cells, Cultured↗

Surfactant protein A is opsonin in phagocytosis of herpes simplex virus type 1 by rat alveolar macrophages.

In the present study we used flow cytometry to investigate the phagocytosis of fluorescein isothiocyanate-labeled herpes simplex virus type 1 (FITC-HSV-1) by rat alveolar macrophages and the effects of surfactant protein A (SP-A) on this process. The phagocytosis of FITC-HSV-1 by alveolar macrophages, which was studied as a model for virus phagocytosis in general, was strongly enhanced in the presence of SP-A. The SP-A-mediated phagocytosis was time and concentration dependent, reaching a maximal level after 15 min of incubation and at an SP-A concentration of 5 micrograms/ml. Using a fluorescence quenching technique, we could show that at least 65% of the viruses were indeed internalized by the macrophages. The addition of SP-A to the system was sufficient for the phagocytosis of FITC-HSV-1 by the alveolar macrophages, suggesting that SP-A acts as an opsonin. This hypothesis was further strengthened by the observation that F(ab')2 fragments of immunoglobulin G directed against SP-A could abolish FITC-HSV-1 phagocytosis by alveolar macrophages preincubated with SP-A. Comparing the opsonic capacity of serum and SP-A, SP-A proved to be twice as potent as serum in stimulating phagocytosis of FITC-HSV-1 by alveolar macrophages. Complement factor C1q, which is known to possess a similar collagen-like domain as SP-A, did not stimulate phagocytosis of FITC-HSV-1 by alveolar macrophages nor did it inhibit SP-A-mediated HSV-1 phagocytosis. This study demonstrates that SP-A may play an important role in the antiviral defenses of the lung.

Animals↗

Structural and functional changes of surfactant protein A induced by ozone.

The major surfactant protein SP-A is thought to play an important role in the regulation of the structure and the metabolism of pulmonary surfactant. We investigated whether this protein may be a target in ozone toxicity. Several properties were studied that are probably relevant to the physiological functions of SP-A. In vitro exposure of human and canine SP-A to ozone led to decreases in 1) self-association of SP-A, 2) SP-A-mediated lipid aggregation, and 3) binding of SP-A to immobilized mannose. SP-A was neither degraded nor cross-linked by ozone exposure. Exposure of canine SP-A to ozone led to an increase in the apparent molecular weight of monomeric SP-A. Human SP-A did not show this change. Oxidation of methionine and tryptophan residues in canine SP-A was detected following ozone exposure. Reactions of ozone with other amino acid residues were not observed. The impairments of structure and properties of SP-A may contribute to the toxic action of ozone in the lungs.

Animals↗

The phagocytic process and the role of complement in host defense.

Three lines of defense play an integral role in host defense. The mechanical barrier (skin and mucous membrane: first line), non-specific defense (phagocytic cells non-specific humoral factors) and the specific line of defense. Phagocytic cells act in phases: chemotaxis, attachment of the bacteria to the membrane of the phagocytic cells, ingestion, killing and digestion. Attachment of the particle to receptors is only optimal when the bacteria are loaded with antibodies (IgG) and/or activated complement factors (C3b, C3Bbi), because the phagocyte has receptors for these opsonins (Fc, and C receptors). The late complement factors are also able to kill and lyse certain bacteria without phagocytes. The killing mechanism of the phagocyte is complex. It is oxygen dependent and oxygen independent. Presumably toxic oxygen species are most important to kill bacteria by phagocytes.

Bacterial Infections↗

Tumour necrosis factor triggers granulocytes to internalize complement-coated virus particles.

Monocytes produced tumour necrosis factor-alpha (TNF-alpha) upon interaction with infective herpes simplex virus (HSV). Therefore, TNF-alpha and its action were examined in the regulation of anti-viral functions of human polymorphonuclear leucocytes (PMN). The uptake of fluorescein-labelled HSV by human PMN was monitored using flow cytometric analysis. As shown in earlier work, complement-coated herpes virions were bound to PMN but were not internalized. However, after priming with recombinant human TNF-alpha, complement-coated virions were taken up by human PMN. This complement receptor-mediated internalization is a new observation, both because it affects PMN and it is induced by a recombinant cytokine. Recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF), another priming factor of PMN, was unable to induce this phenomenon. By contrast, other parameters of PMN anti-viral defence were enhanced to the same extent by both TNF-alpha and GM-CSF. PMN primed by either TNF-alpha or GM-CSF showed both an enhanced respiratory burst and an increased membrane potential depolarization when triggered by immune complexes containing HSV, antibody and complement. Both primers rendered an enhanced uptake of HSV in the presence of specific antibody and in the presence of both antibody and complement, but they caused no effect on the rate or quantity of processing of phagocytosed HSV particles by PMN. We propose that TNF-alpha and GM-CSF act as effective modulators of PMH to enhance virus removal, especially in inflammatory sites. We tentatively conclude that TNF-alpha together with PMN and complement represent a novel non-specific defence mechanism against HSV.

Complement System Proteins↗

Amoxicillin-clavulanate prophylaxis against wound infections after clean-contaminated surgery. A controlled, randomized, prospective study.

In a single-blind, prospective randomized and controlled trial, amoxicillin-clavulanate was compared with gentamicin plus clindamycin as perioperative prophylaxis for 24 hours in clean-contaminated abdominal surgery. Proven infections of the abdominal incision occurred in one of 59 evaluable patients given amoxicillin-clavulanate and one of 43 with gentamicin/clindamycin. In the latter group there was also one incisional perineal wound infection. At follow-up enquiry by telephone around postoperative day 30, four patients in the amoxicillin-clavulanate group reported minor wound discharge for which they had not sought medical attention. Intraperitoneal infection occurred in one patient of that group, and in three of the gentamicin/clindamycin group. Both regimens thus were effective and safe as prophylaxis in clean-contaminated abdominal surgery.

Adult↗

Another reason to restrict the use of a hypertonic, glucose-based peritoneal dialysis fluid: its impact on peritoneal macrophage function in vivo.

Previous in vitro studies have revealed that the currently used peritoneal dialysis fluids (PDFs) inhibit several functions of phagocytic cells. Glucose-mediated hypertonicity was demonstrated to be one of the major detrimental factors. To investigate the clinical relevance of these in vitro findings, we compared the in vivo effect of a PDF with 3.86% glucose (D386) and a PDF containing 1.36% of glucose (D136) on peritoneal macrophage (PMO) function in eight CCPD patients. In a randomized cross-over setting, each patient used exclusively D136 or D386 on day one. The next day the patients who used D136 were switched to D386 and vice versa. PMO were isolated from the effluents and studied for their phagocytic capacity and chemiluminescence response. PMOs obtained from D386 effluents were significantly less phagocytic as compared to PMOs obtained after the in vivo use of D136 (38 +/- 7.1 vs 63 +/- 8.3%, p less than 0.02). In addition PMOs exposed to D386 were less able to mount a respiratory burst (peak response 4 +/- 1.0 vs 15 +/- 1.4% of control cells, p less than 0.05). Thus, the in vivo use of D386 was accompanied by significantly decreased PMO functions. These findings further stress the need to search for alternative solutions that do not rely on glucose-mediated hypertonicity for ultrafiltration.

Adult↗

The effect of glycerol-containing peritoneal dialysis fluid on peritoneal macrophage function in vivo.

Though glucose is universally applied as osmotic agent in CAPD, there is great interest in the use of alternative osmotic agents. Glycerol-containing peritoneal dialysis fluids (G-PDF) have been used in an attempt to minimize the metabolic effects of long-term exposure to glucose, especially in patients with diabetes. Since data were lacking, we studied the effect of G-PDF on peritoneal macrophage (PMO) function. In a randomized cross-over setting eight stable diabetic CAPD patients performed the third and fourth exchange of the day with either G-PDF or with glucose-containing PDF (D-PDF) of comparable osmolality. The next day the patients who had used G-PDF were switched to D-PDF and vice versa. PMO were isolated from the effluents and tested for their phagocytic capacity and chemiluminescence response. No differences were encountered in total and differential white cell counts between G-PDF and D-PDF effluents. PMO phagocytic capacity for both S. epidermidis (SE) and E. coli (EC) was significantly depressed after the instillation of G-PDF as compared to D-PDF (SE: 52 +/- 2.7 vs 69 +/- 5.0%, p less than 0.02, and EC: 44 +/- 5.7 vs 63 +/- 6.7%, p less than 0.02). The same held true for peak chemiluminescence response (5.3 +/- 1.36 vs 7.2 +/- 1.43% of control cells, p less than 0.005). Thus, G-PDF may compromise PMO function in vivo more than D-PDF despite its more favourable metabolic profile as compared to D-PDF for diabetic patients.

Adult↗

Life-saving immunotherapy with cross-reactive monoclonal antibodies against endotoxin: a critical evaluation of experimental and clinical studies.

In this paper clinical and experimental studies are reviewed for evidence that monoclonal antibodies (MoAbs), directed against common epitopes in the core glycolipid region of lipopolysaccharide (LPS) of gram-negative bacteria, protect against the lethal effect of bacteremia of serologically unrelated gram-negative bacteria. Only those experimental studies that included control MoAbs and excluded the possibility of survival due to endotoxin tolerance, provided evidence for the protective efficacy of cross-reactive MoAbs. Two recently performed clinical trials evaluating the protective value of the MoAbs HA-1A and E5 showed beneficial effects (enhanced survival) by each MoAb in different subgroups of patients with proven gram-negative bacterial infections. It is concluded that immunotherapy by MoAbs is a promising new tool in the treatment of gram-negative bacterial septic shock. However, the pathophysiological mechanism of protection remains to be elucidated and the group of patients which may benefit most remains to be defined more clearly. Therefore, further experimental and clinical studies are warranted.

Animals↗

Binding of rough lipopolysaccharides (LPS) to human leukocytes. Inhibition by anti-LPS monoclonal antibody.

The binding of rough LPS (ReLPS from Salmonella minnesota R595) to human peripheral blood polymorphonuclear leukocytes (PMN), monocytes, and lymphocytes was examined by using fluorescein-labeled LPS and flow cytometry. At 4 degrees C, FITC-ReLPS bound rapidly in a concentration- and time-dependent way to PMN, monocytes, and lymphocytes. Because mononuclear cells showed both binding and nonbinding cell populations, FITC-ReLPS was used in conjunction with specific phycoerythrin-labeled mAb to identify these cell subpopulations. In contrast to T lymphocytes and NK cells, all monocytes and B lymphocytes efficiently bound FITC-ReLPS. PMN and monocytes showed two to three times more cell-associated FITC-ReLPS when cells were incubated at 37 degrees C compared with incubation at 4 degrees C. Binding of FITC-ReLPS to lymphocytes was similar for both 4 degrees C and 37 degrees C incubation conditions. In contrast to 4 degrees C, at 37 degrees C cell-associated LPS reflects surface-bound as well as internalized LPS, as demonstrated with fluorescence quenching of extracellular FITC-ReLPS by trypan blue. At 4 degrees C, binding of FITC-ReLPS was inhibited by polymyxin B. In addition, purified IgM mAb directed against hydrophobic acyl residues of ReLPS showed more than 95% inhibition of ReLPS binding to leukocytes, indicating the ability of specific mAb to prevent LPS-cell interactions necessary to exert biologic effects. The use of mAb, directed against different parts of the LPS molecule, provides an alternative method for LPS binding-inhibition studies.

Antibodies, Monoclonal↗

[Spread and control of a methicillin-resistant Staphylococcus aureus in an academic hospital].

Between December 1988 and March 1989 twelve patients in the Utrecht University Hospital developed an infection with a methicillin-resistant Staphylococcus aureus (MRSA). Twenty other patients and 39 personnel members became colonized with the same MRSA strain. In spite of early isolation measures, progression of this epidemic was probably caused by the extreme degree of contagiousness of the first patient, who had a drug-induced allergic skin eruption. It seems likely that spread occurred via personnel and via a computer tomographic scanner. To contain the epidemic it was necessary to institute a special isolation ward with dedicated personnel. Although several MRSA strains have been introduced in the University Hospital since 1986, the strain we describe here is the only one which spread epidemically.

Academic Medical Centers↗