Biomedical subjects
Publications and source records attributed to K A Eaton.
This paper examines the problems encountered by general dental practitioners (GDPs) when they attempt to carry out research. It outlines the possible stages a GDP might use when planning to undertake research and possible areas of interest to investigate. Part 2 will appear in a subsequent issue of Primary Dental Care.
Gastric and non-gastric species of Helicobacter were examined for the presence of the adhesin-encoding gene, hpaA, from the human-associated gastric Helicobacter H. pylori (Hp), and for adhesin subunit protein HpaA. Amplification of a 375-bp internal DNA fragment of hpaA by PCR demonstrated the presence of the gene in Hp and in two closely related gastric Helicobacters, H. nemestrinae (Hn) and H. acinonyx (Hx), but not in the more distantly related H. felis (Hf) and H. mustelae (Hm). The non-gastric Helicobacters, H. canis (Hc), H. muridarum (Hr), H. fennelliae (He) and H. cinaedi (Hi), were all negative for hpaA. An immunoblot assay of water extracts with adhesin-specific antibody confirmed these results. The deduced amino acid (aa) sequences of Hp HpaA and Hn adhesin A (hereafter termed HnaA) are very similar, having identical receptor-binding motifs (rbm); also, the hemagglutination (HA) properties of Hn and Hp cells were indistinguishable. In contrast, the rbm of Hx adhesin A (hereafter termed HxaA), compared to that of Hp, contained a non-conservative aa substitution (Ile to Thr); also, there was variance in five consecutive aa from 10 to 14 residues upstream from the rbm. We conclude that these aa substitutions in HxaA are probably responsible for the difference in receptor recognition of this adhesin, as evidenced by the resistance of Hx HA to inhibition with N-acetylneuraminyl-alpha(2,3)-lactose. These results are consistent with the biological similarity between the natural host(s) of Hp and Hn; i.e., human and non-human primates, and the dissimilarity between these hosts and the feline host, the cheetah.
This study sought to determine if coccoid forms of Helicobacter pylori are virulent for gnotobiotic piglets. Coccoid forms were generated by maintaining broth cultures of H. pylori under microaerobic conditions for 16 days. The resulting cultures contained bacteria with a coccoid morphology that could not be cultured in vitro. Coccoid H. pylori did not colonize any of 6 gnotobiotic piglets that were inoculated, whereas bacillary H. pylori colonized 6 of 6 inoculated piglets. Piglets colonized by bacillary H. pylori developed lymphocytic gastritis, but no gastritis developed in piglets inoculated with coccoid H. pylori, and coccoid-inoculated piglets were sero-negative for H. pylori-specific antibody. Thus, coccoid H. pylori appears to be a degenerate nonviable morphologic phase.
Clinical isolates of Helicobacter pylori, the gastric pathogen implicated in gastritis, peptic ulcers, and gastric cancer in humans, are diverse in traits likely to be important for colonization and disease. Here we report studies using a gnotobiotic piglet-H. pylori infection model to test for host-specific adaptation and to detect cocolonization by different strains. First, an H. pylori strain that initially had grown only weakly in piglets was adapted to them by spontaneous mutation and selection during 12 serial passages; this resulted in an increase in yield from about 10(3) to > 10(7) bacteria per g of mucosa. Second, piglets were fed mixtures of two different well-adapted strains and the presence of one or both strains was monitored by restriction analysis of a PCR-amplified flagellar (flaA) gene segment. The restriction fragment patterns from pools of bacteria indicated that both strains had colonized most piglets and that both strains were present at more than half of the individual biopsy sites, although often at unequal ratios. This suggests a microcolonial mode of growth with limited migration of bacteria between neighboring sites in the gastric mucosa. We propose that the gnotobiotic piglet-H. pylori infection model will be useful for testing how spontaneous mutation, selection, and DNA transfer between strains during mixed infection may each contribute to adaptation to specific hosts and the evolution of virulence of this important pathogen.
Two intestinal spirochete isolates obtained from chickens with diarrhea were examined by electron microscopy, biochemical tests, rRNA gene restriction pattern analysis, and multilocus enzyme electrophoresis. One isolate (strain 91-1207/C1) was pathogenicity tested in vivo in chickens. The chicken spirochetes were morphologically indistinguishable from Serpulina innocens and Serpulina hyodysenteriae and phenotypically similar to S. innocens. However, the chicken spirochetes could be distinguished from S. innocens, S. hyodysenteriae, and other swine intestinal spirochetes by rRNA gene restriction pattern analysis and multilocus enzyme electrophoresis. In pathogenicity tests in 1-day-old chicks and 14-month-old hens, chicken spirochete 91-1207/C1 produced pale-yellow, watery cecal contents and mild lymphocytic typhlitis. These findings support the conclusion that avian intestinal spirochetes can be pathogenic to commercial poultry and that the microorganisms are different from intestinal spirochetes that infect pigs.
Archival gastric tissues from 10 of 39 gnotobiotic piglets colonized with Helicobacter pylori 26695 contained stromal leukocytic inflammation along with ulcers and erosions. In contrast, gastric tissues from 54 archival control piglets were devoid of both inflammation and ulcers. These data confirm the hypothesis that H. pylori infection alone is ulcerogenic.
Conventional female BalbC mice were inoculated with Gastrospirillum-like bacteria in mouse gastric homogenate or in 5.0-microns filtrate of gastric homogenate. The bacteria were originally isolated from cheetahs with gastritis. The mice were killed 6 months, 7 months, or 1 year after inoculation. All mice became infected with Gastrospirillum-like bacteria that were confined to the gastric mucosa. Control mice, given either sterile Brucella broth, 0.22-microns filtrate of infected gastric homogenate, or uninfected gastric homogenate did not become infected with bacteria. Lesions in infected mice included severe lymphoplasmacytic gastritis (26/26 infected mice), gastric epithelial hyperplasia (25/26 infected mice), and gastric ulceration (11/26 infected mice). Neutrophilic inflammatory cell infiltrates were inconsistent. None of the uninfected control mice had Gastrospirillum-like bacteria, gastritis, gastric epithelial hyperplasia, or gastric ulceration. These results implicate Gastrospirillum-like bacteria from cheetahs in the pathogenesis of gastric ulceration. This model will be useful in investigating the mechanisms of gastric ulceration associated with bacterial gastritis.
BACKGROUND: Urease-negative Helicobacter pylori generated by insertional mutagenesis fails to colonize gnotobiotic piglets, and this effect is largely independent of gastric pH. The purpose of this study was to determine whether urease-negative H. pylori colonized gastric explants ex vivo. METHODS: Gastric mucosal explants derived from neonatal germ-free piglets were inoculated with either wild-type H. pylori or one of two mutants derived by insertional mutagenesis. RESULTS: All three bacterial strains colonized explants. The level of colonization increased over the duration of the experiment, reaching 10(8)-10(9) cfu/g gastric mucosa by 72 h after inoculation. Morphologic evidence of colonization was similar to that observed in gnotobiotic piglets. CONCLUSIONS: Colonization of explants was not affected by lack of urease. These results contrast with previous findings showing that urease activity is essential for colonization of piglets by H. pylori. Thus, urease-dependent colonization is dependent on an intact gastric microenvironment.
This evaluation was based on replies from a random sample of general dental practitioners who were asked to complete questionnaires before and after being sent a video and accompanying booklet on partial denture design. Forty per cent (257) of the original sample (636) completed and returned both questionnaires. A total of 212 respondents (82%) felt the video had been of value and 175 (68%) said they would be more likely to provide metal partial dentures after having watched it. The positive effects of the video were greatest amongst the most recently qualified. Despite some improvement after watching the video, there remained 105 (40%) who indicated that they would leave all partial denture design decisions to the technician on at least some occasions. Comparison of data from first and second questionnaires showed little evidence of substantial shifts in choice of denture design for a series of specific situations. It was concluded that whilst the programme had been well received and had produced changes in intention, there was less objective evidence of change.
Thirty-seven gnotobiotic piglets from seven litters were infected with either Helicobacter pylori N6 or urease-negative H. pylori N6ureG::Km which contains an insertion in the ureG gene and produces inactive urease. To produce achlorhydria, piglets were treated throughout the experiment with omeprazole (5 mg intravenously every 12 h) and ranitidine (75 mg orally every 6 h). Treatment resulted in elevation of gastric pH to 7.0 +/- 1.1 throughout the experiment. Control piglets were not treated and remained normochlorhydric. Strain N6 colonized well in both normal and achlorhydric piglets. All 10 piglets were colonized, and colonization ranged from 4.4 +/- 1.5 log10 CFU/g of gastric mucosa in normochlorhydric piglets sacrificed after 2 days to 6.9 +/- 0.5 log10 CFU/g in normochlorhydric piglets sacrificed after 5 days. Strain N6ureG::Km did not colonize any of seven normochlorhydric piglets and was recovered only in low numbers (< 100 CFU/g) from four of nine achlorhydric piglets. In the second experiment, piglets were coinoculated with both strains N6 and N6ureG::Km. Coinoculation did not affect colonization by urease-positive N6. Urease-deficient N6ureG::Km was unable to colonize even in the presence of urease-positive bacteria. These results confirm that urease enzymatic activity (and not urease protein) is essential for colonization, that this effect is independent of diffusible products of urea metabolism, and that gastric pH protection is not a major role of urease in promoting colonization by H. pylori.
Gastric bacteria from cheetahs with gastritis were used to inoculate specific-pathogen free kittens and conventional mice. Helicobacter sp. and Gastrospirillum sp. colonized kittens, while only Gastrospirillum sp. colonized mice. In kittens, both bacterial species induced mild lymphofolliclar gastritis which did not change over the course of the 11 months observation period. In mice, Gastrospirillum sp. induced lymphoplasmacytic and follicular gastritis which increased in severity over 6 months and persisted for the 12 month observation period. Gastric ulcers and gastric mucosal hypertrophy were present in chronically infected mice. These results indicate that host but not bacterial factors influence the severity of gastritis, and that in mice, bacterial gastritis increases in severity with time and may lead to gastric ulceration in some individuals.
Four strains of a novel Helicobacter species were isolated from the stomachs of cheetahs (Acinonyx jubilatus) with gastritis. These isolates were phenotypically similar to Helicobacter pylori. The isolates were gram-negative, spiral bacteria which grew under microaerophilic conditions at 37 degrees C, but not at 25 or 42 degrees C, and produced urease, catalase, oxidase, alkaline phosphatase, and gamma-glutamyl transpeptidase. The isolates did not ferment glucose, mannitol, inositol, sorbitol, rhamnose, sucrose, melibiose, amygdalin, or arabinose; hydrolyze hippurate or indoxyl acetate; or reduce nitrate. They did not produce H2S from triple sugar iron agar, and they did not grow in the presence of 1.0% glycine or 1.5% NaCl. They were resistant to nalidixic acid and sensitive to cephalothin and metronidazole. Cells were typically 0.3 by 2.0 microns and possessed tufts of two to five sheathed, monopolar flagella. The G+C content of strain 90-119 was 30 mol%. Cluster analysis of densitometry scans of polyacrylamide protein gels revealed more than 70% similarity of the cheetah isolates to H. pylori, less than 60% similarity to Helicobacter felis, and less than 50% similarity to Helicobacter mustelae. Complete 16S rRNA sequences were determined for two of the cheetah isolates. Phylogenetic analysis was performed by comparing the cheetah sequences to those of 19 reference strains, including H. pylori, H. felis (two strains), H. mustelae, Helicobacter muridarum, "Flexispira rappini," Wolinella succinogenes, Campylobacter coli, Campylobacter concisus, Campylobacter curvus, Campylobacter fetus, Campylobacter hyointestinalis, Campylobacter jejuni, Campylobacter lari, Campylobacter rectus, Campylobacter sputorum subsp. bubulus, a Campylobacter sp. (pig isolate), [Bacteroides] gracilis, and [Bacteroides] ureolyticus.(ABSTRACT TRUNCATED AT 250 WORDS)
An outbreak of vomiting in a group of captive cheetahs (Acinonyx jubatus) was investigated, and histologic examination revealed chronic gastritis characterized by infiltration of lymphocytes and numerous plasma cells and epithelial erosions. Lymphoid follicles, globule leukocytes, scattered neutrophils, and (in one animal) abscessed gastric glands were inconsistent findings. In addition, necropsy of three cheetahs revealed gastric mucosal hyperplasia. Two kinds of bacteria were identified in the stomachs of infected cheetahs. Numerous long, tightly coiled motile Gastrospirillum-like organisms were seen in gastric mucus and in Warthin-Starry-stained sections of mucosa. These bacteria could not be cultured but were transmitted to conventional mice in homogenates of gastric mucosa from infected cheetahs. Ultrastructural examination revealed helical filaments on some of these bacteria. In addition, a smaller Helicobacter sp. was isolated. This organism could be cultured in vitro under microaerophilic conditions. One or both of these bacterial species was probably responsible for the gastritis in these cheetahs.
Although Section 63 courses for general dental practitioners in the NHS have been running for many years, there seems to be poor understanding of what 'Section 63' means and how it operates. To some extent this is because of the changes which have taken place since it was introduced and the tremendous expansion in postgraduate dental education (and its objectives) in recent years. The introduction of other 'approved' courses and postgraduate education allowances have created further uncertainties. This paper gives an overview of Section 63, the source of the funds, how they are allocated, how they may be used and who is eligible, and outlines details of other 'approved' courses and the various allowances which GDPs can claim in relation to these different categories of courses.
In gnotobiotic piglets, parenteral vaccination with formalin-killed Helicobacter pylori and oral vaccination with live bacteria induced H. pylori-specific serum immunoglobulins G, M, and A. Vaccination reduced but did not prevent infection by subsequent challenge with viable H. pylori. Oral vaccination with killed bacteria was less effective in inducing serum antibody and had no effect on bacterial colonization. Immunization status influenced the histologic response of piglets to challenge by H. pylori. Lymphoplasmacytic gastritis was more severe in parenterally vaccinated piglets than in the other groups. In addition, neutrophilic infiltrates and neutrophilic gland abscesses in the gastric mucosa were present in 5 of 7 parenterally immunized piglets, none of the orally immunized piglets, and only 1 of 8 infected nonimmune control piglets. Furthermore, there was a positive correlation between immunoglobulin G, M, and A titer at challenge and severity of both neutrophilic and lymphocytic inflammation. These results suggest that although vaccination does not prevent infection by H. pylori, infection of an immune host leads to increased severity and activity of gastritis.
Non-motile variants of Helicobacter pylori (strain 26695) occurred with a frequency of 1.6 (SD 0.4) x 10(-4) variants/cell/division cycle, and reversion to the motile form occurred with a frequency of less than 10(-7) variants/cell/division cycle. The two forms remained greater than 90% pure for up to 50 cell divisions and differed only in the presence or absence of motility and flagella. Bacteria were recovered from nine of 10 gnotobiotic piglets inoculated orally with motile H. pylori, but from only two of eight inoculated with the non-motile variant. The motile form survived for 21 days in infected piglets, but the non-motile variant survived for only 6 days. Bacteria recovered from piglets inoculated with the non-motile variant were non-motile. These data support the hypothesis that motility is a colonisation factor for H. pylori.
Gingival crevicular fluid (GCF) sampling was performed on 2 occasions separated by 1 year, at 2 sites in the mouths of 102 male adolescents, mean age 17.85 years. Samples were collected onto 5 filter paper strips which were sequentially applied to the mouth of the crevice over a 9-min collection period. Volume and flow rates of GCF were determined for each site and were compared with clinical measurements of plaque, gingival colour, bleeding, gingival index (GI) and pocket depth, using a general linear models (GLM) procedure. While the initial volume of GCF showed no association with any clinical measurement, there was an association between flow rate of GCF and gingival colour. The volume of GCF collected in the final, 5th sample was associated with the GI. The sample site strongly influenced all measures of GCF volume. It is proposed that the flow rate of GCF may be a better indicator of gingival inflammation than the more imprecise clinical assessments of inflammation, since GCF flow rates more precisely reflect changes in tissue permeability. The association between the final sample, collected after 9 min, and clinical measurements, was probably a reflection of the association between clinically-detectable inflammation and the susceptibility of the site to mild irritation.
Ultrastructural examination of gastric mucosa from Helicobacter pylori-infected gnotobiotic piglets identified four general adherence patterns comparable to those observed in human patients. Intimate associations between the bacterial and mucosal cell membranes, including cuplike invaginations and adherence pedestals, were present and were accompanied by alterations to microvilli and cell membrane morphology.