Irritant contact dermatitis induced by a mustard compress.
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Adult↗
Biomedical subjects
P K Kohl
Publications and source records attributed to P K Kohl.
[High-level tetracycline-resistance of Neisseria gonorrhoeae].
High level tetracycline resistance of Neisseria gonorrhoeae is mediated by a 25.2-MD plasmid and is characterized by a minimal inhibitory concentration of 16 micrograms/ml or more. The 25.2-MD plasmid originated through the insertion of the streptococcal tetM determinant into the 24.5-MD transfer plasmid of N. gonorrhoeae. In the present study the prevalence of N. gonorrhoeae with high-level tetracycline resistance in the Heidelberg gonococcal population between 1981 and 1989 was determined. Among 1765 N. gonorrhoeae isolates, one strain with high-level tetracycline resistance was identified. The presence of the 25.2-MD plasmid in this strain was demonstrated by plasmid-agarose gel electrophoresis. The auxotype/serovar class proline-/IB-1 indicates the importation of this strain from the USA. The 25.2-MD recombinant plasmid, in contrast to the 24.5 MD transfer plasmid, has a rather wide host range, which is favourable to the occurrence both of high-level tetracycline resistance and of beta-lactamase plasmids in N. meningitidis.
Bacterial Proteins↗
[The modern diagnosis of gonorrhea].
Modern identification of Neisseria gonorrhoeae may be either accomplished by direct detection of gonococcal antigen, i.e. without microbiological culturing, or, following culturing, by rapid culture confirmation. The direct detection of gonococcal antigen in an enzyme immuno-assay (Gonozyme) shows reduced specifity especially with mixed microbial flora, and decreased sensitivity with small numbers of organisms. Culture confirmation may be achieved by a rapid sugar degradation test (API----quadFERM+), by specific enzyme detection using chromogenic substrates (Gonochek II), or by demonstration of protein I specific for Neisseria gonorrhoeae by means of monoclonal antibodies (Mikrotrak, Phadebact monoclonal GC, Gonogen II). Detection of protein I is highly sensitive and specific in both the tests of immunofluorescence and coagglutination.
Antigens, Bacterial↗
[Immunobiologic aspects of Neisseria gonorrhoeae].
Surface structures of Neisseria gonorrhoeae (NG), which can mediate properties of virulence like adhesion and inflammation, try to escape the human immune response with the help of their highly variable antigenicity. In addition there are surface-exposed structures, like protein 1, which have relatively constant antigenetical powers and are likely to play an important part in both the uptake of nutrients and the infection process. Protein 1 shows no intrastrain and only limited interstrain variability. Anti-protein 1 monoclonal antibodies have gained practical significance with regard to serotyping and detection of NG in clinical specimens. Conserved epitopes of pilin and protein 1 may serve as the basis of a gonococcal vaccine.
Antibodies, Monoclonal↗
Monoclonal antibodies to protein I for serotyping of Neisseria gonorrhoeae: correlation of serotype with bactericidal activity.
Seven monoclonal antibodies have been used for the serotyping of one hundred Neisseria gonorrhoeae wild strains, randomly selected from nine U.S. cities, and seven serotype reference strains by the co-agglutination method. As determined by gel-immunoradioassay, the monoclonal antibodies recognized the protein I trimer of a single or a limited subset of serotype reference strains. All but three strains were typable by one or two of the antibodies. The most common serotypes were 1.3 (26%), 1 (20%), 5 (17%), 5.7 (11%) and 9 (10%). To correlate typing results with ability for killing of these antibodies, susceptibility of typed and non-typed strains to killing was studied. Susceptibility was significantly associated with typing by the serotype 7 (p = 0.011) and serotype 9 (p = 0.033) specific monoclonal antibodies. Reaction of antibodies recognizing epitopes on the protein IB molecule with a given strain predicted in an average of 43% of strains (49% of strains of serotype 5, 62% of serotype 7, 29% of serotype 8, and 33% of serotype 9) its susceptibility to killing by the typing antibodies. In contrast, only 15% of the strains (15% of strains of serotype 1 and 15% of serotype 3) were killed by their typing antibodies, recognizing epitopes on the protein IA molecule. These monoclonal antibodies might prove to be important for the isolation and structural characterization of epitopes responsible for susceptibility of the gonococcus to killing and thus for the development of a vaccine against invasive gonococcal disease.
Agglutination Tests↗
Evaluation of a non-radioactive DNA probe for confirmatory identification of Neisseria gonorrhoeae.
A biotinylated DNA probe combined with a streptavidin-peroxidase complex for the identification of culture isolates of N. gonorrhoeae (Ortho diagnostic systems, Neckargemünd, FRG) was compared with the conventional carbohydrate utilisation test as reference. All 118 strains identified by the reference method as N. gonorrhoeae also gave positive reactions with the DNA hybridisation assay. However, with this test 2 of 23 non-gonococcal Neisseria or Branhamella species were identified as N. gonorrhoeae as well. The study shows that the DNA hybridisation technique can principally be used for the confirmatory identification of N. gonorrhoeae, but since specificity is particularly essential for confirmatory identification, the DNA hybridisation assay evaluated cannot be recommended for routine diagnosis.
Carbohydrate Metabolism↗
[Complement-independent bulla formation in pemphigus vulgaris by IgG4].
In cryostat sections from lesional skin of a patient with pemphigus, a typical pattern of IgG deposits was detected at the epidermal intercellular space. However, there were no deposits of complement (C) components. By the highly sensitive APAAP technique using monoclonal antibodies, it was demonstrated that the IgG deposits consisted exclusively of IgG4. IgG subclass analysis of serum autoantibodies against epidermal intercellular substance antigen revealed an identical subclass restriction to IgG4. The IgG4 portion of the serum IgG fraction was significantly increased. Since IgG4 is known to be a an almost ineffective activator of complement, the lack of deposits of C components is not surprising. Our ex vivo observations suggest that complement is not essential for the induction of pemphigus acantholysis.
Antibodies, Monoclonal↗
[Classification of Gonococcus: auxanologic and serologic aspects using monoclonal antibodies].
500 N. gonorrhoeae strains from the area of Lübeck/West Germany, collected in 1976-84, were auxologically and serologically classified by means of monoclonal antibodies from the Genetic Systems Corporation, Seattle, Washington (USA), against gonococcal outer membrane protein I. During the first years, auxological classification showed high proportions of AHU-strains (40%), which amounted to 20% over the total observation period. PPNG and DGI strains have characteristic type patterns. Our synopsis of serovars corresponds with the results obtained in a recent world-wide study. Combined auxological and serological classification shows two N. gonorrhoeae pools, 18% each, which cannot be further distinguished: AHU/A1 and prototrophic/B3. The advantages of the system have been proved in answering plain epidemiological questions. For further discrimination, an additional independent classification method might be useful.
Antibodies, Monoclonal↗
[Serotyping Neisseria gonorrhoeae].
To control gonorrhea an understanding of pathogenesis and epidemiology is necessary. To achieve this goal a serologic typing system recognizing antigenic variants of the gonococcus is needed. The serotyping systems proposed in past years are described and their clinical relevance discussed. At the moment two typing systems based on protein I and monoclonal antibodies are available. Protein I serotypes are correlated with the killing of Neisseria gonorrhoeae by bactericidal antibodies and may play a role in the future development of a gonococcal vaccine. The serovar system permits precise analysis of gonococcal populations and can be used especially for epidemiologic studies. The possibility of discriminating between reinfection and therapy failure can be of importance in therapeutic studies. A microepidemiologic analysis for partner identification is possible by combined determination of serovar and auxotype. Both monoclonal typing systems represent standardized monospecific reagents which, besides serotyping, will be used for the diagnosis of gonococcal disease as well.
Antibodies, Monoclonal↗
[Current status of vaccine development in sexually transmissible diseases].
A prophylactic vaccine represents a major hope for the control of sexually transmitted diseases. The current general vaccine strategies and the status of vaccine development against infections with Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis and Herpes simplex virus are described. Vaccines consisting of whole infectious agents are replaced by protective subunits. A subunit vaccine has the advantage to be free from other components, which are not relevant for protection and which may confer unwanted side effects. At the present time vaccine development against infections with Neisseria gonorrhoeae and Herpes simplex virus seems to be the most progressed. With monoclonal antibodies several surface components could be identified, which are of importance for the pathomechanism. With Treponema pallidum and Chlamydia trachomatis the development is delayed by unsolved problems of immunity. For the production of vaccines molecular-biologic methods, like protein synthesis or gene-cloning will be used. Genetically modified live vaccines or polytope hybrid vaccines will gain importance in the future.
Humans↗
Epidemiological analysis of Neisseria gonorrhoeae in the Federal Republic of Germany by auxotyping and serological classification using monoclonal antibodies.
We evaluated a new serological classification system for Neisseria gonorrhoeae based on monoclonal antibodies directed against epitopes on the outer membrane protein I, in conjunction with auxotyping, to analyse gonococci from two cities in the Federal Republic of Germany. Isolates of N gonorrhoeae were collected during 1976-8 and 1980-2 in Lübeck, and during 1980-2 in Heidelberg. Between the two study periods in Lübeck, we observed an appreciable decrease in strains of the auxotype that requires arginine, hypoxanthine, and uracil (AHU-) and with serovar class PrIA-1 and the emergence of strains with the proline requiring auxotype and PrIB-1 serovar class. Serovar PrIA-1 accounted for 89 (97%) of 92 strains with the AHU- auxotype as opposed to 12 (4%) of 297 strains with other auxotypes (p less than 0.0001). Disseminated gonococcal infection was associated with AHU-/PrIA-1 strains. Penicillinase producing N gonorrhoeae (PPNG) strains belonged to eight different auxotype and serovar classes, which indicated that different strains had been imported. Classification of strains of N gonorrhoeae by auxotype and serovar class permits analysis of temporal changes in gonococcal populations, and of migrations of gonococci between different geographical areas. Typing N gonorrhoeae, together with assessing antibiotic susceptibilities, may prove useful for further studies of the epidemiology and control of gonorrhoea.
Antibodies, Monoclonal↗
[Gonococcal surface antigens and their significance for serotyping and vaccines].
Outer membrane components of Neisseria gonorrhoeae play an important role in the initial steps of infection. Precise knowledge about the surface antigens is needed for the development of a serotyping system and of a vaccine against local and systemic gonorrhea. Structure, antigenicity, and function of the best-known membrane components, i.e., lipopolysaccharide, protein I, protein II, protein III, and pili, are discussed. Lipopolysaccharide is a strong immunogen and induces bactericidal antibodies, but is unsuitable for use as a vaccine because of its toxicity. Protein I and protein III are stable proteins, not subject to antigenic variation. Antibodies against protein I, which are able to kill N. gonorrhoeae, are detectable in the serum of patients with disseminated gonococcal infection. Protein II and pili are highly variable antigens with constant, very slightly immunogenic regions. To interrupt the pathomechanism of gonococcal infection at different stages, future vaccines should contain more than one surface antigen.
Antibodies, Bacterial↗
Prevalence of Adamantiades-Behçet's disease in Germany and the municipality of Berlin: results of a nationwide survey.
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Behcet Syndrome↗
Epidemiology of sexually transmitted diseases. What does it tell us?
Incidence numbers of Neisseria gonorrhoeae, Treponema pallidum and Chlamydia trachomatis differ substantially in different countries at different times. In European countries, the incidence of gonorrhea and of primary and secondary syphilis currently is extremely low. In North American countries gonorrhea incidence declined at a very slow annual rate and syphilis incidence increased. Chlamydial infections show a profile that seems to be delayed by two decades from infections with Neisseria gonorrhoeae. Our efforts in the future should be directed to prevent the resurgence of gonorrhea and syphilis and to achieve the same success with chlamydial infections. Poor populations in developed and developing countries, which have similar demographic, social and economic characteristics, represent one important target group for control programs. Education of young and poor people represent the challenge of the future for sexually transmitted diseases control strategies. Combined strategies also will have an effect on incurable viral STD.
Europe↗