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Partial protection against genital reinfection by immunization of guinea-pigs with isolated outer-membrane proteins of the chlamydial agent of guinea-pig inclusion conjunctivitis.

Because partial protection against reinfection is induced by experimental infection in the guinea-pig model of genital chlamydial infection, we sought to induce immunity by immunization. Female guinea-pigs were immunized subcutaneously with the major outer-membrane protein (MOMP) and the 61 kDa cysteine-rich outer-membrane protein (61 kDa) of the agent of guinea-pig inclusion conjunctivitis (GPIC) eluted from SDS-polyacrylamide gels (SDS-MOMP, SDS-61 kDa). Post-immunization sera and secretions contained antibodies to the SDS-purified proteins at high titre as measured by immunoblotting, whereas enzyme immunoassays (EIA) using whole elementary bodies as antigen showed significantly lower titres (P < 0.001). Likewise, blastogenic responses of peripheral mononuclear cells to GPIC elementary bodies were weak. Animals immunized with SDS-MOMP and SDS-61 kDa were fully susceptible to intravaginal challenge, as were control animals immunized with buffer without protein. Another group of animals were immunized with material prepared by extraction of chlamydial outer-membrane complexes with octyl beta-D-glucopyranoside (OGP) and dithiothreitol, which consisted largely of MOMP (OGP-MOMP). In contrast to the SDS-MOMP group, sera and secretions in the OGP-MOMP group showed high titres in EIA, and high titre antibodies to MOMP by immunoblot; however, most animals also had antibodies to 61 kDa, 72 kDa and ca. 84 kDa outer-membrane proteins. OGP-MOMP animals were partially protected against genital challenge as evidenced by low inclusion scores compared to control animals, although duration of infection measured by culture isolation was similar to controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Microvirus of chlamydia psittaci strain guinea pig inclusion conjunctivitis: isolation and molecular characterization.

The authors report the isolation and molecular characterization of a bacteriophage, &phi;CPG1, which infects CHLAMYDIA: psittaci strain Guinea pig Inclusion Conjunctivitis. Purified virion preparations contained isometric particles of 25 nm diameter, superficially similar to spike-less members of the &phi;X174 family of bacteriophages. The single-stranded circular DNA genome of &phi;CPG1 included five large ORFs, which were similar to ORFs in the genome of a previously described CHLAMYDIA: bacteriophage (Chp1) that infects avian C. psittaci. Three of the ORFs encoded polypeptides that were similar to those in a phage infecting the mollicute Spiroplasma melliferum, a pathogen of honeybees. Lesser sequence similarities were seen between two ORF products and the major capsid protein of the &phi;X174 coliphage family and proteins mediating rolling circle replication initiation in phages, phagemids and plasmids. Phage &phi;CPG1 is the second member of the genus CHLAMYDIAMICROVIRUS:, the first to infect a member of a CHLAMYDIA: species infecting mammals. Similarity searches of the nucleotide sequence further revealed a highly conserved (75% identity) 375 base sequence integrated into the genome of the human pathogen Chlamydia pneumoniae. This genomic segment encodes a truncated 113 residue polypeptide, the sequence of which is 72% identical to the amino-terminal end of the putative replication initiation protein of &phi;CPG1. This finding suggests that C. pneumoniae has been infected by a phage related to &phi;CPG1 and that infection resulted in integration of some of the phage genome into the C. pneumoniae genome.

Amino Acid Sequence↗

Infectivity titration of guinea-pig inclusion conjunctivitis agent in irradiated McCoy cells.

Estimation of the infectivity of the agent of guinea-pig inclusion conjunctivitis for irradiated McCoy cells, assayed as inclusion-forming units, was influenced by the age of cells after irradiation, the maturation time of the inclusions, the centrifugal force and the centrifugation temperature. Agent passaged through irradiated McCoy cells or guinea-pig conjunctivae showed a greater capacity to infect irradiated McCoy cells without centrifuging than agent grown in a chick embryo. The nature of the change and the mechanism of infectivity enhancement by centrifuging are discussed.

Animals↗

Characterisation of Haemophilus spp. isolated from infant conjunctivitis.

Haemophilus strains isolated from children under the age of 11 months with conjunctivitis were characterised by biotype, sugar fermentation, plasmid pattern and outer-membrane-protein profiles. H. influenzae was the most common species identified and was separated into 14 groups based on sugar fermentation and biotype patterns and into more than 20 groups when plasmid and outer-membrane-protein profiles were included. Small (mol. wt less than 10 X 10(6)) plasmids were identified in 11 of 34 (32%) H. influenzae isolates, 1 of 2 H. haemolyticus and 4 of 6 (67%) H. parainfluenzae isolates. Examination of sugar-fermentation and plasmid patterns increased the ability to distinguish between strains isolated at different times from recurrent disease and may have general applications in the study of Haemophilus strains isolated from a single anatomical site.

Bacterial Outer Membrane Proteins↗

Mousepox conjunctivitis: the role of Fas/FasL-mediated apoptosis of epithelial cells in virus dissemination.

BALB/c mice infected with the Moscow strain of Ectromelia virus (ECTV-MOS) show a large number of apoptotic cells, and an influx of lymphoid cells in the epithelium and substantia propria of conjunctivae, respectively. The presence of ECTV-MOS antigens in the epithelium of conjunctivae significantly upregulates Fas in the epithelial layer and FasL in the suprabasal layer of conjunctiva. Inhibition of FasL with blocking antibodies in cultures of conjunctival cells isolated from ECTV-MOS-infected BALB/c mice showed that the Fas/FasL pathway is important in apoptosis of ECTV-MOS-infected cells. The results also showed that the presence of cytokines, in particular interferon (IFN)-gamma, upregulated expression of Fas. Interleukin (IL) 2, 4, 10 and IFN-gamma were produced at the peak of conjunctivitis (at day 15 of infection) with a predominance of IFN-gamma and a small, but significant, production of IL4 and IL10 compared with non-infected animals. These results suggest that not only is Fas/FasL expression in conjunctiva involved in elimination of migrating Fas+ cells but also plays an important role in the turnover of conjunctival epithelium and thus may be crucial for ECTV spreading to the surrounding environment.

Animals↗

Genomic comparison of adenovirus type 3 isolates from patients with acute conjunctivitis in Japan, Australia, and the Philippines.

A total of 53 Ad3 isolates obtained from patients with acute conjunctivitis in Japan, Australia, and the Philippines during 1973 to 1986 were analyzed for their genome types with 4 restriction endonucleases, BamHI, BglII, HindIII, and SmaI. Two new genome types designated tentatively as Ad3f and Ad3g were identified by combination of BamHI and BglII in the isolates. The changes of restriction sites and sizes of restriction fragments in newly recognized Ad3f and Ad3g were located at the similar regions reported in other Ad3 genome types by O'Donnell et al (1986) on physical maps of the Ad3 prototype strain GB genome. In Japan, 46 Ad3 isolates obtained from 1983 to 1986 were either Ad3f or Ad3g. Yearly alternation of predominance of both genome types were observed in the northern part of Japan during the period. In Australia, two genome types Ad3p and Ad3f were found in 6 isolates, and the former was observed in the 3 isolates obtained before 1981 and the remaining 3 isolates were obtained after 1983. In the Philippines, the only isolate obtained in 1984 was Ad3p.

Adenoviridae Infections↗

Genome typing of adenovirus strains isolated from conjunctivitis in Japan, Australia, and the Philippines.

DNA restriction endonuclease analysis for genome typing of adenovirus (Ad) DNA was carried out on a total of 65 Ad isolates including serotypes Ad4, Ad7, Ad8, Ad11, Ad19, and Ad37 from patients with epidemic keratoconjunctivitis and acute conjunctivitis obtained in Japan from 1982 to 1986, Australia from 1973 to 1986, and the Philippines in 1984. All 4 isolates of Ad7 in Australia were Ad7b. Four of 6 Ad11 isolates obtained in Japan were typed as Ad11 prototype (Ad11p), and the remaining were identified to be new genome types, designated tentatively as Ad11c and Ad11d. An isolate of Ad11 obtained in Australia was typed as Ad11c. Nine Ad8 isolates in Australia and in the Philippines were typed as Ad8p, but 11 Ad8 isolates in Japan were Ad8b. Thirteen Ad19 isolates were identified as Ad19a. All 3 isolates of Ad37 in Japan and three isolates in Australia before 1982 were typed as Ad37p, however, 5 isolates in Australia after 1983 were identified as a new genome type, designated as Ad37d. In Japan, 10 isolates of Ad4 were identified as Ad4a.

Adenoviridae Infections↗

CD8+ T cells play disparate roles in the induction and the effector phases of murine experimental allergic conjunctivitis.

Although CD4+ Th2 cells clearly play an essential role in the development of experimental allergic diseases, the functions CD8+ T cells may have in these diseases have been investigated less extensively and remain controversial. Here, we investigated the roles of CD8+ T cells in the development of experimental allergic conjunctivitis (EC). EC was induced in CD8alpha-deficient (CD8KO) mice and wild-type (WT) mice by active immunization with short ragweed pollen (RW) followed by challenge with RW-containing eye drops. Alternatively, EC was induced by transferring RW-primed splenocytes followed by RW challenge. With regard to actively immunized mice, CD8KO mice showed significantly less severe eosinophil infiltration of the conjunctiva and lower total IgE levels, although the levels of the other Igs were equivalent between the two strains. Cytokine production by cultured splenocytes also did not differ, but the WT conjunctivas showed upregulated IL-5 and IL-6 expression and greater upregulation of IL-4 expression than the conjunctivas of CD8KO mice. Thus, CD8+ T cells may play a significant role during the induction phase by aiding IgE production and the generation of Th2 cytokines in the conjunctiva, thus promoting the development of EC. In contrast, splenocytes from CD8KO mice induced significantly more severe EC in WT mice than cells from WT mice. In addition, transfer of RW-primed splenocytes induced significantly more severe eosinophil infiltration in CD8KO recipient mice. Thus, CD8+ T cells promote the development of EC during the induction phase, but suppress it during the effector phase.

Adoptive Transfer↗

Group comparative trial of 2% sodium cromoglycate (Opticrom) with placebo in the treatment of seasonal allergic conjunctivitis.

A double-blind group comparative trial comparing Opticrom with a matching placebo, over a four-week period, in seasonal allergic conjunctivitis is reported. Overall assessment of treatment benefit made at the end of the trial by the patients and the clinician showed a statistically significant difference in favour of Opticrom. Of the patients on Opticrom, eighteen (90%) said they improved while in the clinicians opinion, seventeen (85%) improved. Six patients using Opticrom and five using placebo complained of stinging of the eyes, while one patient using placebo complained of his eyes becoming bloodshot and watering.

Adolescent↗

Double-blind group comparative study of 2% nedocromil sodium eye drops with 2% sodium cromoglycate and placebo eye drops in the treatment of seasonal allergic conjunctivitis.

A 4 week, multicentre, double-blind, double dummy, placebo controlled group comparative study was carried out during the birch pollen season to compare the efficacy and tolerability of 2% nedocromil sodium eye drops (twice daily) and 2% sodium cromoglycate eye drops (four times daily). Participants with a history of seasonal allergic conjunctivitis (SAC) were randomized to receive nedocromil sodium (60), sodium cromoglycate (61) or placebo (64). Clinical assessment of SAC showed improvement with both active treatments compared to placebo but symptomatology was low and only changes in photophobia and grittiness reached significance (P < 0.05). Patient diaries showed significant control of itching by both active treatments, compared to placebo, with no differences between the active preparations. Patients' opinions indicated a marked placebo effect: 73% of this group reported full or moderate control of symptoms, compared with 75% in sodium cromoglycate and 80% in the nedocromil sodium group. Unusual symptoms were most common (27 patients) with nedocromil sodium eye drops: P < 0.05 vs. placebo (15 patients). There were no serious adverse events. Nedocromil sodium eye drops (b.d.) and sodium cromoglycate eye drops (q.i.d.) were both considered clinically more effective than placebo in controlling symptoms of SAC due to birch pollen.

Adult↗

Topical sodium cromoglycate (Opticrom) relieves ongoing symptoms of allergic conjunctivitis within 2 minutes.

Twelve patients with seasonal allergic conjunctivitis caused by either birch or timothy grass pollen were challenged out of season in both eyes, with the relevant allergen. Itching, redness, swelling, and tearing were assessed on a 0-3 scale. When a positive reaction, i.e., at least 4 points, had occurred in both eyes, one drop of 2% sodium cromoglycate was administered to one eye and one drop of placebo to the other eye in each patient, in a double-blind, randomized fashion. Symptoms were then assessed after 2, 10, 30, and 60 min. Sodium cromoglycate was statistically better than placebo in reducing the symptoms at 2, 10, and 30 min after the treatment had been administered, showing that topical application of 2% sodium cromoglycate can quickly relieve ongoing symptoms of allergic inflammation in the eye.

Administration, Topical↗

A placebo-controlled trial of cetirizine in seasonal allergic rhino-conjunctivitis in children aged 6 to 12 years.

A total of 124 children of both sexes aged between 6 and 12 years with pollen-associated rhino-conjunctivitis were included in a multicentre double-blind study of parallel group design to compare the effects of cetirizine 10 mg daily, given as 5 mg morning and evening for 2 weeks, with those of placebo of identical appearance. Rhinorrhea, sneezing, nasal obstruction and nasal and ocular pruritus were evaluated using symptom scores by patients on daily self-evaluation cards and by investigators who, in addition, made a global evaluation at the end of treatment. Appropriate wash-out periods for previous medicines were observed. Unchanged treatment of asthma was allowed and inhaled corticosteroids were continued in 3 placebo patients. Compliance was checked and found to be less than 80% of the prescribed dosage in 2 cetirizine patients. The mean percentage of study days when symptoms were absent or at the most mild (i.e. present but not disturbing), as reported daily by the patients, was significantly greater with cetirizine (56.2%) than placebo (29.7%). This 26.5% difference was considered clinically significant. The value of this method of expressing treatment effects in allergic rhinitis is discussed. Improvement in maximum symptom scores (severest symptoms) assessed by investigators was better for cetirizine than placebo after treatment for 1 week and 2 weeks. Improvement in individual daily symptoms was greater for cetirizine than placebo after a few days.(ABSTRACT TRUNCATED AT 250 WORDS)

Cetirizine↗

Household hygiene practices in relation to dampness at home and current wheezing and rhino-conjunctivitis among school age children.

Good household hygiene practices may improve indoor air quality in the domestic environment. Conversely, a 'hygiene hypothesis' is challenging the importance of hygiene and sanitation at home. This study aims to investigate the relationship between household hygiene practices and dampness at home and current wheezing, asthma and other allergic conditions among Australian children. Nine hundred and ninety-six children from four primary schools in Perth, Western Australia, were recruited for a domestic environmental and health survey during March and April of 2002. The results showed that high cleanliness scores were negatively associated with moulds at home before and after adjustment for age of dwelling (p < 0.001). High ventilation scores were inversely related with damp patches, condensation and moulds at home (p < 0.05). However, households with high cleanliness scores appeared to have significantly higher prevalence of current wheezing (p < 0.05) and current rhino-conjunctivitis (p < 0.05) in children. The association remained even after controlling for confounders such as age and gender of children, asthma history of parents, passive smoking and dampness at home.

Adolescent↗

Non-Hodgkin's lymphoma and auricular hypoplasia: associated with juvenile colloid milium or ligneous conjunctivitis?

The exact nature of amyloid-like hyaline material deposits in the skin is not well understood in some disorders. Three of those--ligneous conjunctivitis, ligneous periodontitis and colloid milium--have been rarely reported in a same patient. We report a case of mucosal and skin deposits of an amyloid-like homogeneous material associated with non-Hodgkin's lymphoma and congenital auricular hypoplasia. We discussed and reviewed the literature on these unique associations to determine whether these are the same pathological process. We also noted whether this case represents a new syndrome or a coincidental association.

Adult↗

Giant papillary conjunctivitis--a review.

First described in 1974 by an Australian ophthalmologist Dr. Spring, Giant Papillary Conjunctivitis (GPC) is one of the external ocular allergic conditions. It is most often associated with contact lens wear, but has also been described in patients with ocular prostheses and corneal sutures following surgery. Diagnosis is usually straightforward. Patients complain of decreasing lens tolerance, mucus production, often severe enough to cause blurred vision, and some itch. Inspection will reveal conjunctival hyperaemia and enlarged tarsal papillae. Management centres around patient education regarding careful lens hygiene but in severe cases may require a change to disposable lenses or a cessation of lens wear. In some cases, pharmacological agents may be required. The histopathology of GPC is very similar to Vernal Keratoconjunctivitis (VKC). It is caused by a complex immunological reaction and is not solely IgE-mediated. Trauma and foreign body reactions also play a role. The incidence of GPC has decreased with the advent of disposable lenses.

Animals↗

Comparison of the topical ocular antiallergic efficacy of emedastine 0.05% ophthalmic solution to ketorolac 0.5% ophthalmic solution in a clinical model of allergic conjunctivitis.

PURPOSE: To compare the clinical efficacy of emedastine ophthalmic solution to that of ketorolac ophthalmic solution using a conjunctival allergen challenge model. METHODS: The conjunctival allergen challenge model was used in this randomized, double-masked, single center, crossover study. The titer of allergen that elicited a positive allergic reaction was selected. After at least 14 days, 36 subjects were randomized into two groups of 18 to receive either emedastine in one eye and placebo in the contralateral eye, or ketorolac in one eye and placebo in the contralateral eye. Ten minutes after drug instillation, subjects were challenged with antigen. At 3, 10 and 20 minutes following challenge subjects graded ocular itching and were assessed for hyperemia in conjunctival, ciliary, and episcleral vessel beds. Approximately 14 days later, subjects received the alternate treatment in one eye and placebo in the contralateral eye. They were again challenged with allergen and their responses were rated in the same manner. Ocular discomfort was assessed by the subjects after administration of each study drug. RESULTS: Emedastine significantly (p < 0.05) inhibited ocular itching and redness in vascular beds following topical ocular administration. In contrast, ketorolac failed to significantly inhibit ocular itching or redness in this study. Patient assessment of comfort indicated emedastine was significantly (p < 0.05) more comfortable than ketorolac upon topical ocular administration. CONCLUSION: Emedastine is superior to ketorolac in controlling itching and redness, the cardinal symptom and sign of allergic conjunctivitis.

Anti-Inflammatory Agents, Non-Steroidal↗

Allergic contact dermatits and conjunctivitis from epinephrine.

A patient with chronic open-angle glaucoma was suspected of having allergic dermatitis and conjunctivitis to epinephrine. He was tested with epinephrine and other active substances, the preservatives and antioxidants usually used in the preparation of eye drops. He was also tested with other possible contactants with which he had had contact. The patient showed positive allergic patch test reactions to the chloride solution of epinephrine. The patient showed an unexpected positive reaction when tested with di-isopropyl fluorophosphate (DFP). The importance of routine patch testing in ophthalmic practice to detect sensitizers in cases of contact allergy is stressed.

Aged↗

Allergic contact dermatitis and conjunctivitis to corticosteroids.

This is a report of two patients suspected of having allergic dermato-conjunctivitis due to corticosteroids. Both were tested with the constituents of the ointments they were using, that is, corticosteroids, antibacterial agents, preservatives, and other active ingredients of the ointment bases. Both patients showed positive allergic patch test reactions to the respective corticosteroid betamethasone valerate, and one to hydrocortisone, neomycin, and a rubber additive. The importance of routine patch testing in ophthalmic practice to detect sensitizers in cases of allergy is mentioned. Hydrocortisone (25%) in petrolatum is recommended for patch testing.

Administration, Topical↗