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PubMed1992

Encephalocraniocutaneous lipomatosis and the Proteus syndrome: distinct entities with overlapping manifestations.

We have studied three children with cutaneous (epidermal nevi), subcutaneous (lipomas, plantar skin thickening), vascular (hemangioma, lymphangioma), skeletal (osteoma, exostosis, localized hypertrophy), and neurological (hydrocephaly, lissencephaly, partial agenesis of the corpus callosum) developmental defects associated with the Proteus syndrome and related hamartoneoplastic conditions. We compared our findings in these three patients with those of 50 others with Proteus syndrome and nine with encephalocraniocutaneous lipomatosis (ECCL) reported in the literature. We found that Proteus syndrome and ECCL have distinct identities even though some clinical manifestations are shared by both and a few patients have manifestations of both conditions.

Bone Neoplasms↗
PubMed1994

Regional Proteus syndrome and somatic mosaicism.

We report on a patient with regional manifestations of Proteus syndrome. Major findings included multiple hyperostoses of the calvaria, facial bones, and mandible. Additionally, the patient had a scleral tumor. This lends further support to the hypothesis of somatic mosaicism as a cause of Proteus syndrome. Because mosaic distribution of lesions is variable in extent, criteria for the diagnosis of Proteus syndrome should be loose rather than overly rigid even though patients with limited regional involvement may be particularly difficult to diagnose.

Child↗
PubMed2005

Proteus syndrome: an update.

Proteus syndrome is a complex disorder consisting variably of disproportionate, asymmetric overgrowth of body parts; cerebriform connective tissue nevi; epidermal nevi; vascular malformations of the capillary, venous, and lymphatic types; and dysregulated adipose tissue. Serious complications may ensue, such as pulmonary embolism, cystic lung disease, and various neoplasms. Somatic mosaicism, lethal in the nonmosaic state, is the best working hypothesis. Although Proteus syndrome data are consistent with this hypothesis, it has not been proven. The etiology is unknown to date. Diagnostic criteria are emphasized because misdiagnosis of Proteus syndrome is common. Finally, evaluation and management are discussed.

Diagnosis, Differential↗
PubMed1997

The simultaneous production of both Hly- and Hpm-like hemolysins is characteristic of the Proteus penneri species.

Clinical isolates of Proteus penneri were tested for the presence of genes encoding hemolytic activity. Strains possessing DNA sequences similar to the hlyCABD genes in Escherichia coli were found. Each secreted a 110 kDa protein which reacted with a specific anti-HlyA antiserum. Southern blotting analysis revealed that the HindIII restriction fragment pattern for the hlyCABD genes of these strains was conserved. Similarly, the chromosomal location of these genes is relatively conserved based on the pattern of NotI digested DNA fragments separated by pulsed field gel electrophoresis. One strain carried an additional copy of the hlyCABD determinant which was mapped on a second NotI genomic fragment. All strains contained also chromosomally encoded sequences related to the hpmBA genes originally cloned from Proteus mirabilis. All strains produced a 166 kDa exoprotein detected in immunoblots with a specific antiserum raised against HpmA hemolysin. The hpmBA genes were located on other NotI fragments than hlyCABD genes. In contrast to the other Proteae, the simultaneous production of both hemolysins seems to be a common characteristics of Proteus penneri isolates.

Blotting, Southern↗
PubMed1991

Effect of Staphylococcus epidermidis on adherence of Pseudomonas aeruginosa and Proteus mirabilis to polymethyl methacrylate (PMMA) and gentamicin-containing PMMA.

The goals of this study were to determine 1) effect of Staphylococcus epidermidis adherence and biofilm production on adherence of the opportunistic pathogens Proteus mirabilis and Pseudomonas aeruginosa to polymethyl methacrylate (PMMA); 2) if the biofilm killed by autoclaving altered adherence of other organisms; 3) if adherence of S. epidermidis to gentamicin-containing PMMA altered adherence of the opportunistic pathogens P. mirabilis and P. aeruginosa to gentamicin-containing PMMA. Results show that biofilms formed by S. epidermidis, whether alive or dead, significantly increased adherence of Pseudomonas. Adherence of Proteus was significantly increased on dead biofilms and increased, but not significantly (p = less than 0.1), on live ones. Greatest adherence seen in the study was to autoclaved biofilms. Significant adherence of Proteus and Pseudomonas was found on gentamicin-containing PMMA specimens, which were preincubated with S. epidermidis for formation on the biofilm. These results indicate that a biofilm is formed on PMMA-gentamicin specimens and this may impair the ability of gentamicin to kill other organisms.

Bacterial Adhesion↗
PubMed1983

Adhesion of Proteus species to various cell types.

Pathogenic and saprophytic Proteus strains from the urine of patients with urinary tract infections and healthy adults respectively were evaluated with regard to their ability to adhere in vitro to homologous cells (uroepithelial cells from urinary sediment and cultured WISH cells) and heterologous cells (RK-13 and MDCK cells). The effect on attachment of pretreating bacteria with subinhibitory concentrations of piperacillin and sagamicin was also determined for one sensitive and one resistant strain. Fifty percent of the pathogenic Proteus strains demonstrated good adherence to human urinary epithelial cells, whereas saprophytic strains did not adhere. There was a lower rate of attachment to culture cells. Piperacillin and sagamicin in subinhibitory concentrations caused a decrease in the attachment of the sensitive Proteus strain.

Adhesiveness↗
PubMed2005

Identification and functional characterisation of genes and corresponding enzymes involved in carnitine metabolism of Proteus sp.

Enzymes involved in carnitine metabolism of Proteus sp. are encoded by the cai genes organised as the caiTABCDEF operon. The complete operon could be sequenced from the genomic DNA of Proteus sp. Amino acid sequence similarities and/or enzymatic analysis confirmed the function assigned to each protein involved in carnitine metabolism. CaiT was suggested to be an integral membrane protein responsible for the transport of betaines. The caiA gene product was shown to be a crotonobetainyl-CoA reductase catalysing the irreversible reduction of crotonobetainyl-CoA to gamma-butyrobetainyl-CoA. CaiB and CaiD were identified to be the two components of the crotonobetaine hydrating system, already described. CaiB and caiD were cloned and expressed in Escherichia coli. After purification of both proteins, their individual enzymatic functions were solved. CaiB acts as betainyl-CoA transferase specific for carnitine, crotonobetaine, gamma-butyrobetaine and its CoA derivatives. Transferase reaction proceeds, following a sequential bisubstrate mechanism. CaiD was identified to be a crotonobetainyl-CoA hydratase belonging to the crotononase superfamily. Because of amino acid sequence similarities, CaiC was suggested to be a betainyl-CoA ligase. Taken together, these results show that the metabolism of carnitine and crotonobetaine in Proteus sp. proceeds at the CoA level.

Acyl Coenzyme A↗
PubMed2001

Biotransformation of crotonobetaine to L(-)-carnitine in Proteus sp.

Two proteins, component I (CI) and component II (CII), catalyze the biotransformation of crotonobetaine to L(-)-carnitine in Proteus sp. CI was purified to electrophoretic homogeneity from cell-free extracts of Proteus sp. The N-terminal amino acid sequence of CI showed high similarity (80%) to the caiB gene product from Escherichia coli O44K74, which encodes the L(-)-carnitine dehydratase. CI alone was unable to convert crotonobetaine into L(-)-carnitine even in the presence of the cosubstrates crotonobetainyl-CoA or gamma-butyrobetainyl-CoA, which are essential for this biotransformation. The relative molecular mass of CI was determined to be 91.1 kDa. CI is composed of two identical subunits of molecular mass 43.6 kDa. The isoelectric point is 5.0. CII was purified to electrophoretic homogeneity from cell-free extracts of Proteus sp. and its N-terminal amino acid sequence showed high similarity (75%) to the caiD gene product of E. coli O44K74. The relative molecular mass of CII was shown to be 88.0 kDa, and CII is composed of three identical subunits of molecular mass 30.1 kDa. The isoelectric point of CII is 4.9. For the biotransformation of crotonobetaine to L(-)-carnitine, the presence of CI, CII, and a cosubstrate (crotonobetainyl-CoA or gamma-butyrobetainyl-CoA) were shown to be essential.

Acyl Coenzyme A↗
PubMed2005

A structured-population model of Proteus mirabilis swarm-colony development.

In this paper we present continuous age- and space-structured models and numerical computations of Proteus mirabilis swarm-colony development. We base the mathematical representation of the cell-cycle dynamics of Proteus mirabilis on those developed by Esipov and Shapiro, which are the best understood aspects of the system, and we make minimum assumptions about less-understood mechanisms, such as precise forms of the spatial diffusion. The models in this paper have explicit age-structure and, when solved numerically, display both the temporal and spatial regularity seen in experiments, whereas the Esipov and Shapiro model, when solved accurately, shows only the temporal regularity. The composite hyperbolic-parabolic partial differential equations used to model Proteus mirabilis swarm-colony development are relevant to other biological systems where the spatial dynamics depend on local physiological structure. We use computational methods designed for such systems, with known convergence properties, to obtain the numerical results presented in this paper.

Agar↗
PubMedDate not supplied

Pathology of lipomatous lesions in Proteus syndrome.

Proteus syndrome is an extremely rare, complex hamartomatous disorder with markedly variable clinical expression. We present a case of Proteus syndrome with multiple disfiguring soft tissue masses that were present since early childhood. The lesions involved predominantly the right side of the body and included scoliosis, macrodactyly, and limited hyperostosis in the right foot. There was no evidence of cranial or skin lesions. The patient underwent multiple resections of soft tissue masses, including an amputation of the right foot because of severe gait disturbance. All specimens exhibited lipomatous lesions that were probably hamartomatous rather than neoplastic. She carried a diagnosis of neurofibromatosis for more than a decade, but a re-evaluation of clinical features and pathological findings prompted the diagnosis of Proteus syndrome. We believe that a more informed evaluation of the pathology material may help to identify this rare entity.

Adult↗
PubMed1996

Structural and immunochemical studies on the lipopolysaccharide of the 'T-antigen'-containing mutant Proteus mirabilis R14/1959.

In DOC-PAGE, lipopolysaccharide (LPS) of Proteus mirabilis R14/1959 (Rb-type) mutant showed a ladder-like migration pattern indicating the presence of a high molecular weight polysaccharide chain. The isolated polysaccharide, called T-antigen because of similarity with the T1 chain of Salmonella friedenau LPS, contained D-glucose, D-galacturonic acid (D-GalA), and D-GlcNAc in molar ratios 2:1:1 and was structurally different from the O-antigen of the parental S-strain P. mirabilis S1959 but identical to the O-antigen of another S-strain Proteus penneri 42. The importance of a D-GalA(L-Lys)-containing epitope, most likely present in the core region of LPS, and of GalA present in the T-antigen chain in manifesting the serological specificity of P. mirabilis R14/1959 were revealed using rabbit polyclonal homologous and heterologous R- and O-specific antisera and the appropriate antigens, including synthetic antigens which represent partial structures of various Proteus LPS.

Animals↗
PubMed2004

Structure of the O-polysaccharide of Proteus serogroup O34 containing 2-acetamido-2-deoxy-alpha-D-galactosyl phosphate.

On mild acid degradation of the lipopolysaccharide of Proteus vulgaris O34, strain CCUG 4669, the O-polysaccharide was cleaved at a glycosyl-phosphate linkage that is present in the main chain. The resultant phosphorylated oligosaccharides and an alkali-treated lipopolysaccharide were studied by sugar and methylation analyses along with 1H and 13C NMR spectroscopy, and the following structure of the branched tetrasaccharide phosphate repeating unit of the O-polysaccharide was established: [carbohydrate structure: see text]The O-polysaccharide of Proteus mirabilis strain TG 276 was found to have the same structure and, based on the structural and serological data, this strain was proposed to be classified into the same Proteus serogroup O34.

Carbohydrate Conformation↗
PubMed2005

Structure of a lactic acid ether-containing and glycerol phosphate-containing O-polysaccharide from Proteus mirabilis O40.

An O-polysaccharide was isolated by mild acid hydrolysis from the lipopolysaccharide of Proteus mirabilis O40 and studied by NMR spectroscopy, including 2D 1H, 1H COSY, TOCSY, ROESY, and 1H, 13C HMQC experiments, along with chemical methods. The polysaccharide was found to contain an ether of GlcNAc with lactic acid and glycerol phosphate in the main chain and to have the following structure: --> 3)-beta-D-GlcpNAc4(R-Lac)-(1 --> 3)-alpha-D-Galp-(1 --> 3)-D-Gro-1-P-(O --> 3)-beta-D-GlcpNAc-(1 --> where D-GlcpNAc4(R-Lac) stands for 2-acetamido-4-O-[(R)-1-carboxyethyl]-2-deoxy-D-glucose. This structure is unique among the known structures of the Proteus O-polysaccharides, which is in agreement with the classification of the strain studied into a separate O-serogroup. A serological relatedness of P. mirabilis O40 with some other Proteus strains was revealed and discussed in view of the O-polysaccharide structures.

Carbohydrate Sequence↗
PubMed2005

Evolution of skin lesions in Proteus syndrome.

BACKGROUND: Proteus syndrome is a rare overgrowth disorder that is generally progressive, but the natural history of the skin lesions is not known. OBJECTIVE: Our purpose was to document the evolution of 4 common skin lesions in 16 patients with Proteus syndrome. RESULTS: Most epidermal nevi and vascular malformations were reported to appear in the first month of life and had little tendency for expansion or development of additional lesions. Subcutaneous lipomas and cerebriform connective tissue nevi were commonly noted in the first year of life, but not in the first month. Most patients reported that subcutaneous lipomas and cerebriform connective tissue nevi progressively increased in size, and in most patients additional lesions developed at new locations. Of the 4 types of skin lesions, plantar cerebriform connective tissue nevi were most frequently cited as a source of symptoms. CONCLUSION: Skin lesions of Proteus syndrome may not appear until later infancy or early childhood, making it difficult to diagnose in young children.

Adolescent↗
PubMed2001

Structure of the acidic O-specific polysaccharide from Proteus vulgaris O39 containing 5,7-diacetamido-3,5,7,9-tetradeoxy-L-glycero-L-manno-non-2-ulosonic acid.

The O-specific polysaccharide of Proteus vulgaris O39 was found to contain a new acidic component of Proteus lipopolysaccharides, 5,7-diacetamido-3,5,7,9-tetradeoxy-L-glycero-L-manno-non-2-ulosonic acid (di-N-acetylpseudaminic acid, Pse5Ac7Ac). The following structure of the polysaccharide was determined by NMR spectroscopy, including 2D 1H,(1)H COSY, TOCSY, ROESY, and 1H,(13)C HMQC experiments, along with selective cleavage of the polysaccharide by solvolysis with anhydrous trifluoromethanesulfonic (triflic) acid: -->8)-beta-Psep5Ac7Ac-(2-->3)-alpha-L-FucpNAc-(1-->3)-alpha-D-GlcpNAc-(1--> The structure established is unique among the O-specific polysaccharides, which is in accordance with classification of the strain studied into a separate Proteus serogroup.

Carbohydrate Sequence↗
PubMed2002

Structure of the O-specific polysaccharide of Proteus penneri 103 containing ribitol and 2-aminoethanol phosphates.

The O-specific polysaccharide of the lipopolysaccharide of Proteus penneri strain 103 was studied using 1H and 13C NMR spectroscopy, including 2D COSY, TOCSY, NOESY, H-detected 1H,(13)C HMQC, 1H, 31P HMQC, and HMBC experiments. It was found that the polysaccharide is built up of oligosaccharide-ribitol phosphate repeating units and thus resembles ribitol teichoic acids of Gram-positive bacteria. The following structure of the polysaccharide was established:where Etn and Rib-ol are ethanolamine and ribitol, respectively. This structure is unique among the known structures of Proteus O-antigens and, therefore, we propose classification of the strain studied into a new Proteus serogroup, O73. The molecular basis for cross-reactivity between O-antiserum against P. penneri 103 and O-antigens of P. mirabilis O33 and D52 is discussed.

Carbohydrate Sequence↗
PubMed2003

Structural and serological studies of the O-antigen of Proteus mirabilis O-9.

The following structure of the O-polysaccharide (O-antigen) of the lipopolysaccharide of Proteus mirabilis O-9 was determined by NMR spectroscopy, including 2D 1H,(1)H COSY, TOCSY, ROESY, and 1H,(13)C HMQC experiments, along with chemical methods: [chemical structure: see text] where the degree of O-acetylation is approximately 70%. Immunochemical studies using rabbit polyclonal anti-Proteus mirabilis O-9 serum showed the importance of the O-acetyl groups in manifesting the serological specificity of the O-9 antigen. Anti-P. mirabilis O-9 cross-reacted with the lipopolysaccharides (LPS) of P. vulgaris O-25 and Proteus penneri 14, which could be accounted for by a structural similarity of their O-polysaccharides.

Acetylation↗
PubMed1998

Structure of the O-specific polysaccharide of a serologically separate Proteus penneri strain 22.

The O-specific polysaccharide chain (O-antigen) of Proteus penneri strain 22 lipopolysaccharide was studied using chemical methods, including partial acid hydrolysis and Smith degradation, as well as one- and two-dimensional 1H and 13C NMR spectroscopy. The following structure of the pentasaccharide repeating unit was established: [sequence: see text] The O-specific polysaccharide contains a GalNAc residue in the furanose form which has not been hitherto found in bacterial polysaccharides. The O-antigen studied is serologically and structurally unique among Proteus strains and, therefore, a new Proteus serogroup O63 is proposed for P. penneri strain 22.

Carbohydrate Conformation↗