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Strategy for producing new foot-and-mouth disease vaccines that display complex epitopes.

Widely used inactivated vaccines for foot-and-mouth disease (FMD) induce protective immunity, but vaccine production plants and residual virus in the vaccine itself have been implicated in disease outbreaks. The structure of the FMD virion has been determined, and although much of the surface of the viral particle is produced by complex folding of the three surface-exposed capsid proteins (VP1-3), some surface regions representing important linear epitopes can be mimicked by recombinant proteins or synthetic peptides. Vaccine candidates based on these products stimulate immune responses to foot-and-mouth virus (FMDV), but do not always protect livestock from disease. The basis of protective immunity to FMDV has been explored using genetic engineering to produce antigenic chimeras of the virus. Studies with these chimeras have shown that a strong and protective immune response can be generated in livestock to epitopes outside the sequential epitopes incorporated into previous subunit vaccine candidates. Genetic engineering of the virus has also been used to demonstrate that changes within the sequence encoding an arginine-glycine-aspartic acid (RGD) sequence in VP1 abrogate virus binding to cells in culture, confirming the role of RGD as the receptor binding site. Based on this information, genetically stable viruses which cannot bind to cells have been created by deleting the nucleotides coding the RGD sequence. The receptor binding site-deleted viruses have been shown to be non-infectious in tissue culture, mice, and swine. Cattle vaccinated with these viruses are protected from disease when challenged with virulent FMDV, demonstrating that they could serve as the basis for safer FMD vaccines.

Amino Acid Sequence↗

Rapid correlation between field isolates and vaccine strains of foot-and-mouth disease virus.

Antigenic relationships between field isolates of foot-and-mouth disease virus and available vaccine strains can be rapidly determined by ELISA. The most suitable vaccine strain to control an outbreak caused by the field isolate can then be quickly identified. The classical method of subtyping strains of foot-and-mouth disease virus should be replaced with a nomenclature which describes the relationship between a strain and the most antigenically closely related vaccine strain.

Animals↗

Novel low-molecular-weight synthetic vaccine against foot-and-mouth disease containing a potent B-cell and macrophage activator.

Most synthetic peptide vaccines described to date are effective only in combination with proteins and Freund's adjuvant. The work describes a novel completely synthetic virus peptide vaccine, which consists of a synthetic activator of B cells and macrophages, covalently linked to an amphiphilic alpha-helical T-cell epitope. The low-molecular-weight vaccine of 3.4 kDa developed against foot-and-mouth disease virus (FMDV) is composed of a synthetic VP1 (135-154) with a sequence homologous to an FMDV protein and the adjuvant tripalmitoyl-S-glyceryl-cysteinylserylserine (P3CSS). P3CSS is the synthetic analogue of the N-terminal part of the lipoprotein from Gram-negative bacteria. The antigenic determinant VP1 (135-154) is an alpha-helix as shown by circular dichroism. The resulting novel type of vaccine tripalmitoyl-S-glyceryl-cysteinylserylseryl-FMDV-VP1 (135-154) induces a long-lasting high protection against foot-and-mouth disease and serotype-specific virus-neutralizing antibodies in guinea-pigs after a single administration without any additional adjuvant or carrier. In contrast to other simple fatty acid conjugates this new type of vaccine contains a built-in adjuvant with high affinity to both B and T lymphocytes.

Adjuvants, Immunologic↗

Enhancement of the immune response elicited with foot-and-mouth disease virus vaccines by an extract of the Mycobacterium sp. wall.

The immunomodulating effect of an extract of the cell wall of Mycobacterium sp. (WSF, Vetrepharm Inc., London, Canada) in foot-and-mouth disease virus inactivated vaccines was tested in a murine model. The duration of immunity, protection, stimulation of immunocompetent cells acting on the long-lasting secondary response and possible tissue damage were examined. The incorporation of 10 micrograms WSF into aqueous and oil vaccines induced a high and long-lasting specific antibody response. The neutralizing titres of these antibodies were significantly higher than those observed in animals immunized with vaccines lacking WSF and conferred protection for at least 7 months. The data collected in repopulation assays indicate that WSF participates in the activation of immune cell populations involved in long-lasting memory. This results in an efficient B-cell secondary response even in the absence of T cells, lasting at least 5 months. No adverse reactions were detected. The enhancement effect of WSF on the immune response to foot and mouth disease vaccines observed in the murine model indicates the possibility of its inclusion in aqueous vaccines to be tested in cattle.

Adjuvants, Immunologic↗

Avridine and LPS from Brucella ovis: effect on the memory induced by foot-and-mouth disease virus vaccination in mice.

Foot-and-mouth disease is one of the more economically important diseases among meat-producing biungulate species. In contrast to natural infection, current foot-and-mouth disease virus (FMDV) vaccines, prepared with inactivated virus and adjuvants, elicit short-lived protection. The immunomodulating effect on FMDV vaccines of avridine and lipopolysaccharide of Brucella ovis (LPS) was tested in a murine model. The duration of immunity, protection, stimulation of immunocompetent cells producing a long-lasting secondary response and immunoglobulin (Ig) isotypes were examined. The incorporation of either immunomodulator into aqueous and oil vaccines induced a long-lasting specific antibody response. The neutralizing titres and protection were significantly higher than those observed in animals immunized with control vaccines. Data collected from repopulation assays indicated that the immunomodulators used participate in the activation of immune cell populations involved in long-lasting memory. This resulted in an efficient B-cell secondary response even in the absence of T cells, which were necessary for the stimulatory effect of the immunomodulators in donor mice. Avridine and LPS stimulated IgG1, IgG2a and IgG2b production, which was correlated with the improvement of the protection induced by these vaccines.

Adjuvants, Immunologic↗

Treatment of electrical burns of the mouth.

A study is made of 58 cases of burns produced in the mouth by electricity in which the authors assess the possible advantages and disadvantages of three kinds of treatment: conservative, surgical after debridement and early of primary surgical. The different kinds of treatment are considered to be suitable, depending upon the type of lesion. In the slight cases, good results are obtained with conservative treatment. In serious cases, with important destruction of the lips or the tongue, our experience favours surgery which should be performed very early whenever possible. The results obtained enable us to reach the conclusion that surgery allows the problem of burns produced in the mouth by electricity to be resolved in less time, with a shorter stay in hospital fewer surgical operations and better final results than conservative treatment.

Adolescent↗

Electrical burns of the mouth: still searching for an answer.

This report is a review of the literature and the clinical experience of electrical burns of the mouth in the West Midlands Regional Burns Unit at the Birmingham Accident Hospital, UK, over the past 10 years. There were five patients, four were children, 9 months to 5 years of age, and one adult. All patients had electrical conduction injuries involving the lips and perioral structures with involvement of the oral commissure. Electrical arc and flash burns were not included in this study. One child had a severe electrical injury and posed a difficult management problem. Although a variety of reconstructive procedures are available, the dilemma between conservative treatment and immediate reconstruction persists. Early intraoral splinting has been suggested in the literature. It was not used in any of the patients in this series and, though it may be beneficial, the patient compliance of a paediatric population may be questionable. The incidence of electrical burns has been on the decline, but those affecting the mouth still continue to be a major problem in management.

Adult↗

Variation in foot-and-mouth disease virus isolates in Kenya: an examination of field isolates by T1 oligonucleotide fingerprinting.

Ribonuclease T1 oligonucleotide maps of strains of 4 of the endemic serotypes of foot-and-mouth disease virus isolated in Kenya between 1964 and 1982 have been compared with data obtained in complement-fixation and neutralization tests. There was a continual change in the oligonucleotide maps obtained for all the serotypes examined. This genetic heterogeneity was generally associated with antigenic variation. Viruses isolated during the 12-month course of an epidemic of the SAT 1 serotype showed few changes in their oligonucleotide fingerprints, and were serologically related. These maps form a data base that will be useful in future epidemiological studies on the maintenance and spread of foot-and-mouth disease virus in this region.

Animals↗

Foot-and-mouth disease: detection of antibodies in cattle sera by blocking ELISA.

A blocking ELISA was developed for the detection of antibodies to foot-and-mouth disease virus SAT1, SAT2 and SAT3 and for the quantification of antibodies on a single dilution of serum. The avidin-biotin system was used. The test was compared with the liquid-phase ELISA executed at the World Reference Laboratory for foot-and-mouth disease. It was found to have favourable logistics and combined high specificity with high sensitivity. The quantitative test using a single dilution of serum was resource saving and proved to be a reliable and precise method for the assessment of antibody levels.

Animals↗

Race and gender influences on the survival of patients with mouth cancer.

Previous studies have shown that race and gender are important correlates of survival among patients with cancer of certain sites. Since race and gender influence the stage of disease at diagnosis and the choice of therapy it has been argued that survival differentials may not be real but instead, they represent secondary associations with clinical variables. Therefore, verification of the true prognostic effects of race and gender requires proper controlling for potential confounders, such as stage and treatment. We have studied the 15-year survival experience of a hospital-based cohort of 4527 patients diagnosed with cancer of the mouth over a 28-year period in Brazil. Race and gender were strong predictors of stage and treatment. The odds ratios for no treatment were 1.35 (95% confidence limits [CL]: 1.09, 1.66) for females and 1.63 (CL: 1.29, 2.06) for non-white patients even after adjustment by stage, presumably a key criterion to define treatment. Survival differentials were found for lip cancer, with respect to race, and for cancers of the gum, floor of mouth, and other oral subsites, with respect to gender. Non-whites experienced 2.1 times the risk of lip cancer recurrence (CL: 1.20, 3.61) and 2.3 times the risk of dying from it (CL: 1.29, 4.09) as compared to whites. However, controlling for stage and treatment modality variables by proportional hazards regression reduced the same risk ratios to 1.01 (CL: 0.57, 1.78) and 1.17 (CL: 0.65, 2.13), respectively. The survival advantage experienced by females (17% lower risk of recurrences and 29% lower risk of cancer deaths) regarding other oral sites was independent from the effect of clinical factors.

Adult↗

Biochemical analysis of saliva and taste acuity evaluation in patients with burning mouth syndrome, xerostomia and/or gustatory disturbances.

OBJECTIVE: In the current study, we performed taste and salivary analysis on patients suffering from burning mouth syndrome and xerostomia or taste disturbances. STUDY DESIGN: A total of 180 patients who complained of idiopathic burning mouth syndrome (BMS) and taste aberrations and/or xerostomia that may accompany BMS were evaluated. These patients were compared with 90 healthy, age- and sex-matched controls. Salivary flow rate, biochemical and immunological analysis and taste acuity by the forced-choice drop technique were performed for all subjects. These analyses were found to be conclusive in distinguishing controls from patients with complaints. RESULTS: The great similarity of both salivary and taste analysis in the BMS, taste aberration and xerostomia groups, which were significantly different from the results obtained in the control group, was found to be the most striking result. Higher salivary concentrations in the experimental group were consistent with a lower saliva (water) flow rate. CONCLUSION: An oral neuropathy and/or neurological transduction interruption induced by salivary compositional alterations is suggested as the possible aetiology for the complaints. This report may add an important objective diagnostic tool to the clinician treating these patients.

Adolescent↗

Evaluation of in vitro inhibitory potential of small interfering RNAs directed against various regions of foot-and-mouth disease virus genome.

India is endemic for foot-and-mouth disease and it continues to be a major threat to the livestock industry despite vaccination programmes. In the present study, the ability of specific small interfering (si)RNAs directed against different genomic regions of foot-and-mouth disease virus (FMDV) to inhibit virus replication in BHK-21 cells was examined. For preliminary evaluation of possible siRNA-mediated FMDV inhibition, a cocktail of several unique populations of 12-30bp siRNAs were successfully produced corresponding to three target regions located at structural (VP3-VP1), non-structural (2A-2C), and non-structural-untranslated (3D-3'UTR) region of serotype Asia1. Once the populations of siRNAs generated were found to reduce the virus titre significantly, two highly conserved 21bp siRNA duplexes were designed by analysing all FMDV sequence entries available in public-domain databases. In virus titration assay, more than 99% inhibition of virus yield for all the four serotypes (type Asia1, O, A, and C) could be demonstrated in cells transfected with each of the FMDV-specific siRNAs at 24h post-infection, compared to control cells transfected with scrambled siRNA. This was well supported by reduction in OD values in FMDV-specific sandwich ELISA. Although 100-fold reduction in virus titre with siRNA1 is substantial considering the transfection efficiency and fixed level of input siRNA, siRNA2 emerged to be a better choice as target where more than 300-fold reduction was observed and its inhibitory effect extended up to 48 h post-infection against all the serotypes. Interestingly, in the present study type A virus (IND 17/77) had a single mismatch at position 2 in the siRNA2 target region but it did not abrogate the inhibitory effect.

Animals↗

Use of the Arndt wire-guided endobronchial blocker via nasal for one-lung ventilation in patient with anticipated restricted mouth opening for esophagectomy.

Functional separation of the lungs may be accomplished by several methods. Patient with restricted mouth opening has limited options for one-lung ventilation. We report the use of wire-guided endobronchial blockade, a new tool for achieving one-lung ventilation in a patient with restricted mouth opening requiring nasotracheal, fiberoptic intubation for esophagectomy and reconstruction with gastric tube substitution.

Aged↗

Evidence of adipocere in a burial pit from the foot and mouth epidemic of 1967 using gas chromatography-mass spectrometry.

Gas-chromatography-mass spectrometry was used to characterise the fatty acids from soils and associated tissues excavated from a 1967 Foot and Mouth burial pit. Subcutaneous fats were mainly comprised of 55-75% palmitic acid, 17-22% stearic acid and 3-16% oleic acid as well as 5-7% myristic acid. The distribution of fatty acids confirmed that the tissues were decayed to adipocere. The loss of oleic acid to <3% in two of the decayed fats suggested advanced stages of adipocere. However, adipocere formation was limited in a third tissue sample recovered from greater depth. Inductively coupled plasma atomic emission spectrometry of the pore waters revealed a decrease in Ca concentration and concurrent increase in Na concentrations this suggested that insoluble calcium salt had formed through displacement of sodium. The use of fatty acid profiles from soils and soil interstitial pore waters provide complementary evidence of adipocere formation in foot and mouth burial pits.

Adipose Tissue↗

Different public health geographies of the 2001 foot and mouth disease epidemic: 'citizen' versus 'professional' epidemiology.

Recently, there have been calls for health geographers to add critical and theoretical debate to 'post-medical' geographies, whilst at the same time informing 'new' public health strategies (Soc. Sci. Med. 50(9)1273; Area 33(4) (2002) 361). In this paper we reflect on how, alongside 'professional epidemiologies', 'citizen epidemiologies' can have credibility in informing public health policy and practice. We do this by drawing on mixed method and participatory research that used a citizens' panel to articulate the health and social outcomes of the 2001 foot and mouth disease disaster. We consider the difficulties of creating dialogue between on the one hand, time-limited, discrete, theoretical, visible and by implication legitimate, 'professional' knowledge and on the other, ongoing, holistic, experiential and often hidden 'citizen' knowledge of the foot and mouth disease epidemic. Despite significant evidence that in disaster and crisis situations, people need to be actively involved in key 'recovery' decisions (see for example At Risk Natural Hazards, People's Vulnerability, and Disasters, Routledge, London; A New Species of Trouble, Norton, New York), lay accounts, which may in themselves provide valuable evidence about the impact of the disaster, are often ignored. If health geographers are to critically inform 'new' public health policy then we need to consider research approaches that give voice to citizens' understanding of health outcomes as well as those of professionals. If 'new' public health is concerned with the material character of health inequalities, with fostering 'healthy' living and working environments, the promotion of community participation and individual empowerment (Area 33(4) (2002) 361), then we argue that situated, negotiated, everyday geographies of lay epidemiologies can and should inform public health policy.

Animal Husbandry↗

Factors affecting the characteristics of rapidly disintegrating tablets in the mouth prepared by the crystalline transition of amorphous sucrose.

The aim of this study is to investigate the factors affecting the characteristics of rapidly disintegrating tablets containing an amorphous ingredient prepared by crystalline transition method (CTM) under various storage conditions. Effect of storage conditions and formulating ratio of amorphous sucrose on the characteristic changes (tensile strength, porosity, and disintegration time) of the rapidly disintegrating tablets was studied. The storage conditions of different temperature and humidity affected the rate of crystalline transition and the increase in the tablet tensile strength. The faster crystalline transition resulted in a faster rate of increase in the tablet tensile strength. Regarding the effect of the formulating ratio of amorphous sucrose, in the case of 20-100%, the tensile strength after storage as a function of the porosity could be plotted on the same curve. For tablets containing 100% amorphous sucrose, the tablets with different porosity changed to almost the same structure due to the crystalline transition. Hence, the higher formulating ratio of amorphous sucrose provided the longer disintegration time in the mouth. Therefore, we concluded that the formulating ratio of 10-20% of the amorphous sucrose in the tablet is suitable for the rapidly disintegrating tablet in the mouth when prepared by CTM.

Crystallization↗

Rescue treatment and prevention of asthma using magnesium throat lozenges: Hypothesis for a mouth-lung biologically closed electric circuit.

In the rescue treatment of acute asthma, injected and inhalant magnesium are relatively weak having demonstrated value only in severe illness, although theoretical and laboratory considerations suggest that magnesium should be strongly effective as an asthma rescue agent. It was hypothesized that a mouth-lung biologically closed electric circuit (BCEC) exists capable of nearly instantly transporting positively charged magnesium ions from the mouth and throat into the lungs. One hundred milligram magnesium (magnesium chloride) 4-g throat lozenges producing 100+ mM magnesium ion concentration in saliva were tested to determine if they had beneficial effects in asthma rescue and prevention. Subjects were selected based solely on need for asthma rescue, and lozenges were used as needed. Case histories are presented showing the nearly immediate effect of magnesium chloride throat lozenges in terminating and preventing asthma attacks. Throat lozenges containing magnesium chloride produced much more rapid and stronger benefits than has been reported for inhaled and injected magnesium. An added benefit from magnesium chloride lozenge treatment of asthma was relaxation. In this first report of its kind, magnesium chloride throat lozenges appeared to provide rescue benefits in the treatment of asthma equivalent to pharmaceutical asthma drugs. Countering these benefits, strong ionic magnesium solutions greatly increase rhinovirus, herpesvirus and Candida albicans in vitro, and appear to worsen these infections in humans. Magnesium lozenges releasing concentrated magnesium ions appear contraindicated during common colds, oral herpes infections, chronic rhinosinusitis, oral and respiratory infections in general, and their use must immediately be terminated if respiratory or oral symptoms worsen. Double-blind, placebo-controlled, clinical trials in people without respiratory or oral infections are needed to determine magnesium lozenge safety, and the extent by which drug treatment of asthma can be reduced.

Asthma↗

Complications encountered in a prospective series of 182 patients treated surgically for mouth cancer.

Outcomes of surgical treatment for patients with mouth cancer can be limited by the risk of perioperative complications. This study identifies factors that predict for complications in such patients. Between 1992 and 2000, 182 patients had surgery for mouth cancer. The patient, their medical and surgical characteristics as well as perioperative complications were identified. Univariate analysis was carried out to determine which characteristics were associated with complications. Complications occurred in 85 patients (47%). Fifty-three percent of the complications were of intermediate severity and 15.6% were major. The operative death rate was 3.2%. Factors predicting complications included pre-existing cardiovascular (p<0.01) and respiratory disease (p=0.02), alcohol consumption (p<0.01), stage of disease, nature and scale of surgery, duration of surgery (p<0.01). Tracheostomies (p<0.01, OR 3.05), poor differentiation of tumour (p<0.05) and presence of extracapsular spread were predictive of complications. Patients with more complications are at increase risk of operative death or dying with head and neck cancer (p=0.04). Complications were also analysed into those that may be related to surgical technique and medical management. 113 (37%) complications were in this category. Factors influencing complications are multifactorial. Identification of risk factors allows individualised approach should improve outcome of treatment.

Female↗