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PubMed2007

The reinfection threshold regulates pathogen diversity: the case of influenza.

The awareness that pathogens can adapt and evolve over relatively short time-scales is changing our view of infectious disease epidemiology and control. Research on the transmission dynamics of antigenically diverse pathogens is progressing and there is increasing recognition for the need of new concepts and theories. Mathematical models have been developed considering the modelling unit in two extreme scales: either diversity is not explicitly represented or diversity is represented at the finest scale of single variants. Here, we use an intermediate approach and construct a model at the scale of clusters of variants. The model captures essential properties of more detailed systems and is much more amenable to mathematical treatment. Specificities of pathogen clusters and the overall potential for transmission determine the reinfection rates. These are, in turn, important regulators of cluster dynamics. Ultimately, we detect a reinfection threshold (RT) that separates different behaviours along the transmissibility axis: below RT, levels of infection are low and cluster substitutions are probable; while above RT, levels of infection are high and multiple cluster coexistence is the most probable outcome.

Animals↗
PubMed1996

Monoclonal antibody recognition of members of the meningococcal P1.10 variable region family: implications for serological typing and vaccine design.

Identification of antigenic variants of the PorA protein of Neisseria meningitidis with specific mAbs (serosubtyping) is used in meningococcal strain characterization and the resultant data has been exploited in the design of novel multivalent vaccines against this important pathogen. The reactivity of the P1.10 serosubtyping mAb MN20F4.17 with eight members of the meningococcal P1.10 variable region (VR) family (prototype P1.10 and variants P1.10a-P1.10g), identified by nucleotide sequence analysis of porA genes, was investigated. Analysis of overlapping synthetic octapeptides by ELISA demonstrated that the peptide sequence, QNQRPTL, present only in the prototype P1.10, was sufficient for binding of the mAb. A linear peptide of 14 amino acids, containing the minimum epitope, inhibited binding of mAb MN20F4.17 to whole cells in a competitive ELISA. This binding was weak compared with a tethered peptide or the native protein. In whole-cell ELISA or dot-blot assays using low concentrations of mAb MN20F4.17 only the prototype P1.10 was detected. However, when higher concentrations of antibody were used the prototype P1.10 was detected, together with variants P1.10a, P1.10c and P1.10e by whole-cell ELISA and P1.10a and P1.10c by the immunoblot technique. The variants P1.10b, P1.10d, P1.10f and P1.10g showed no reactivity with mAb under any of the conditions tested. A survey of the porA genes in serogroup B and C strains revealed that the P1.10a variant, rather than the prototype P1.10, was the most common member of the P1.10 VR family in England and Wales. These data illustrate: (i) the problems associated with epidemiological analyses that rely solely on monoclonal antibodies; (ii) the importance of using defined assay conditions for serosubtyping; and (iii) that genetical analyses provide more reliable information than serological data based on murine reagents for the design of candidate vaccines that include PorA.

Amino Acid Sequence↗
PubMed1997

Infectivity and pathogenicity in chimpanzees of a surface gene mutant of hepatitis B virus that emerged in a vaccinated infant.

Hepatitis B virus (HBV) variants with amino acid mutations in the a epitope of the major surface protein have been identified, and questions have been raised regarding their biologic properties. Dilutions of serum that contained the first such described HBV mutant, with an Arg-for-Gly substitution at codon 145 of the S gene, were inoculated into 6 seronegative chimpanzees. Five of the animals developed serologic and/or biochemical evidence of hepatitis B. A polymerase chain reaction-based assay that discriminated between the wild type and mutant viral genomes revealed that a pure population of the mutant genome was present in the 10(-6) and 10(-7) dilutions of the index serum, resulting in infection of the chimpanzees receiving these dilutions only with the mutant virus. A clone of the mutant virus replicated normally following transfection in vitro. Thus, this HBV surface gene mutant is viable, infectious, and pathogenic in chimpanzees.

Animals↗
PubMed2001

Biofilm formation in a hydrodynamic environment by novel fimh variants and ramifications for virulence.

Type 1 fimbriae are surface-located adhesion organelles of Escherichia coli that are directly associated with virulence of the urinary tract. They mediate D-mannose-sensitive binding to different host surfaces by way of the minor fimbrial component FimH. Naturally occurring variants of FimH that bind strongly to terminally exposed monomannose residues have been associated with a pathogenicity-adaptive phenotype that enhances E. coli colonization of extraintestinal locations such as the urinary tract. The FimH adhesin also promotes biofilm formation in a mannose-inhibitable manner on abiotic surfaces under static growth conditions. In this study, we used random mutagenesis combined with a novel selection-enrichment technique to specifically identify mutations in the FimH adhesin that confer on E. coli the ability to form biofilms under hydrodynamic flow (HDF) conditions. We identified three FimH variants from our mutant library that could mediate an HDF biofilm formation phenotype to various degrees. This phenotype was induced by the cumulative effect of multiple changes throughout the receptor-binding region of the protein. Two of the HDF biofilm-forming FimH variants were insensitive to mannose inhibition and represent novel phenotypes not previously identified in naturally occurring isolates. Characterization of our enriched clones revealed some similarities to amino acid alterations that occur in urinary tract infection (UTI) strains. Subsequent screening of a selection of UTI FimH variants demonstrated that they too could promote biofilm formation on abiotic surfaces under HDF conditions. Interestingly, the same correlation was not observed for commensal FimH variants. FimH is a multifaceted protein prone to rapid microevolution. In addition to its previously documented roles in adherence and invasion, we have now demonstrated its function in biofilm formation on abiotic surfaces subjected to HDF conditions. The study indicates that UTI FimH variants possess adaptations that enhance biofilm formation and suggests a novel role for FimH in UTIs associated with medical implants such as catheters.

Adhesins, Bacterial↗
PubMed2006

Rigidity and spasms from autoimmune encephalomyelopathies: stiff-person syndrome.

Stiff-person syndrome (SPS) is a disorder characterized by progressive muscle rigidity with superimposed painful muscle spasms and gait impairment due to continuous motor activity. Evidence has accumulated in favor of SPS representing an autoimmune, predominantly encephalomyelopathic disorder resulting from B-cell-mediated clonal production of autoantibodies against presynaptic inhibitory epitopes on the enzyme glutamic acid decarboxylase (GAD) and the synaptic membrane protein amphiphysin. Recognition of the clinical spectrum of SPS is important, particularly the upper-limb, cervical, and cranial nerve involvement that occurs in paraneoplastic variants. The correlation between antibody levels and severity of disease offers evidence for a pathogenic role for the anti-GAD and anti-amphiphysin autoantibodies. The scarcity of neuropathological correlates stand in sharp contrast with the severity of the disability in affected individuals and suggests that functional impairment of inhibitory circuits without structural damage is sufficient to develop the full clinical spectrum of SPS. The rarity of this condition limits the feasibility of controlled clinical trials in the treatment of SPS, but the available evidence suggest that drugs that increase cortical and spinal inhibition such as benzodiazepines and drugs that provide immune modulation such as intravenous immunoglobulin, plasmapheresis, and prednisone are effective treatments.

Autoantibodies↗
PubMed1975

Vaccinia virus variants as presumable cause of vaccinial complications.

Two vaccinia viruses isolated from patients with vaccinial complications (vaccinial ulcer, postvaccinial seizures) showed qualitative differences from the original parental strain. After intradermal injection of the viruses into the rabbit marked necroses developed, which the original strains did not produce. While the parental virus did not grow on the chorioallantoic membrane at 41 degrees C after 2 days incubation, the vaccinia variant produced typical lesions at that temperature. Also the yield of infectious virus on various cell systems was 1--2.5 logs higher for the virus than for the original vaccine strain. With the plaque technique differences were seen in the appearance and size of plaques between the variant and the parental vaccinia strain. These results indicate that virus of an increased pathogenicity could be isolated from the patients and this might be causally connected with the postvaccinial complications from which they were suffering.

Animals↗
PubMed2006

Evidence of genetic heterogeneity in MRCS (microcornea, rod-cone dystrophy, cataract, and posterior staphyloma) syndrome.

PURPOSE: To present the detailed phenotype of a subject with MRCS (microcornea, retinal dystrophy, cataract, and posterior staphyloma) syndrome and to investigate the underlying molecular genetic basis. DESIGN: Interventional case report. METHODS: Clinical examination, electrophysiologic assessment, B-scan ultrasonography, and mutation screening of the gene VMD2. The protocol of the study was approved by the local ethics committee and informed consent was obtained. RESULTS: A 12-year-old boy was identified with bilateral microcornea, rod-cone dystrophy, congenital cataracts, and posterior staphylomata associated with high myopia (MRCS). Mutation screening failed to identify disease-causing sequence variants in VMD2, the gene associated with MRCS syndrome. All previous subjects have had pathogenic VMD2 sequence alterations. CONCLUSIONS: We present a further report of the MRCS syndrome and provide evidence in support of genetic heterogeneity in this phenotype.

Bestrophins↗
PubMed2004

Continuous-flow UVC irradiation: a new, effective, protein activity-preserving system for inactivating bacteria and viruses, including erythrovirus B19.

Despite the increasing number of screening tests being introduced, ensuring the inactivation of blood-borne pathogens in blood-derived therapeutic material is a major concern. Dynamic continuous-flow UVC irradiation is a new way to inactivate a large range of pathogens without adding any photosentizers. The efficacy of different methods was evaluated against the following viruses: murine parvovirus MVMp, human B19, the encephalomyocarditis virus (EMC, a picornavirus used as a model for model for hepatitis A virus), and bovine herpes virus type 1 (BHV, a model for enveloped viruses such as hepatitis B virus). We show that continuous-flow UVC irradiation is very effective, particularly against resistant pathogens (e.g. parvoviruses and bacteria) at UVC doses preserving protein activity. It may be applicable to newly emerging related viruses or variants.

Animals↗
PubMed2006

A simian immunodeficiency virus V3 loop mutant that does not efficiently use CCR5 or common alternative coreceptors is moderately attenuated in vivo.

Sexually transmitted HIV-1 strains utilize the chemokine receptor CCR5 for viral entry and inhibitors targeting this coreceptor offer great promise for antiretroviral therapy. They also raise the question, however, whether viral variants exhibiting altered coreceptor interactions and resistance against these antiviral agents might still be pathogenic. In the present study, we analyzed a SIVmac239 envelope (Env) mutant (239DL) containing two mutations in the V3 loop which reduced viral entry via CCR5 by 10- to 20-fold, disrupted utilization of common alternative SIV coreceptors and changed the way Env engaged CCR5. To evaluate its replicative capacity and pathogenic potential in vivo we infected six rhesus macaques with 239DL. We found that 239DL replication was only slightly attenuated early during infection. Thereafter, a D324V change, which restored efficient CCR5 usage and coincided with 239wt-like levels of viral replication, emerged in two animals. In contrast, the viral geno- and phenotype remained stable in the other four rhesus macaques. Although these animals had about 100-fold reduced viral RNA loads relative to 239wt-infected macaques, they showed pronounced CD4 T-cell depletion in the intestinal lamina propria, and one developed opportunistic infections and died with simian AIDS. Thus, changes in the V3 loop that diminished CCR5 usage and altered Env interactions with CCR5 reduced the pathogenic potential of SIVmac in rhesus macaques but did not abolish it entirely.

Animals↗
PubMed2003

Does the occurrence of certain rare cancers indicate an inherited cancer susceptibility?

We sought to determine whether rare cancers indicate an increased risk of inherited cancer susceptibility. We ascertained 77 individuals with rare cancers which occur with increased relative risk in carriers of germline BRCA1/BRCA2 (fallopian, young-onset pancreatic) or HNPCC (biliary, small intestinal, urothelial, gallbladder, young-onset pancreatic) mutations. Individuals with two primary neoplasms (7), or with a first- or two second-degree relatives with breast/ovarian cancer were tested for BRCA1/BRCA2 mutations (18); those with two primary HNPCC cancers or one first degree relative with an HNPCC-related cancer were tested for mutations in MLH1/MSH2 (19). Of these 77 individuals with cancer (19 fallopian, 8 gallbladder, 17 biliary, 17 pancreatic, 11 urothelial, 5 small intestinal), 39 (50.6%) had at least one first degree relative with cancer (excluding lung and skin); two conformed to Bethesda HNPCC criteria. No definitely pathogenic germline MLH1 and MSH2 mutations were found in 19 individuals, although 2 MSH2 variants were detected. A family history of breast/ovarian, HNPCC or colon cancer in a first degree relative was found in 40% of fallopian, 20% of biliary, 35% of pancreatic, 27% of urothelial and 20% of small bowel cancer patients. A BRCA1 frameshift mutation was detected in a woman with fallopian (54 y) and breast (39 y) cancers, and a BRCA2 nonsense mutation in a woman with biliary (48 y) and breast (45 y) cancers. This study supports the premise that the occurrence of rare (especially double primary) cancers does indicate an increased cancer susceptibility, although the numbers of cases ascertained were too small to draw firm conclusions.

Adult↗
PubMed2000

Role of the Gly460Trp polymorphism of the alpha-adducin gene in primary hypertension in Scandinavians.

Previous studies have suggested that the Trp460 allele of the Gly460Trp polymorphism in the alpha-adducin gene is associated with salt sensitivity and primary hypertension. The present study was undertaken to evaluate if the Trp460 allele of this polymorphism is associated with primary hypertension in Scandinavians. To address this issue, 294 patients with primary hypertension and 265 normotensive control subjects from Sweden were examined and genotyped for the Gly460Trp polymorphism using polymerase chain reaction and restriction fragment length polymorphism methods. We then used a population of 80 patients with primary hypertension and 154 normotensive control subjects from Finland to replicate the findings. The frequency of the Trp460 allele was lower in hypertensive patients than in normotensive controls in the Swedish population (17.7% vs 23.0%; P = 0.03) and in the Finnish population (14.4% vs 19.5%; NS). Therefore we also performed a pooled analysis in which the frequency of the Trp460 allele was significantly lower in hypertensive patients than in normotensive controls (17.0% vs 21. 7%; P = 0.02). In subjects who did not receive antihypertensive medication (n = 447) there was no difference between carriers of the three different codon 460 genotypes (Trp-Trp; Trp-Gly and Gly-Gly) either for systolic (128 +/- 18; 127 +/- 15 and 129 +/- 17 mm Hg, NS) or for diastolic blood pressure (75.6 +/- 12.1; 74.7 +/- 9.3 and 75.0 +/- 10.4 mm Hg, NS). In conclusion, the lower frequency of the Trp460 allele in hypertensive patients than in normotensive controls strongly argues against a pathogenic role of this allele in primary hypertension. The results rather suggest that another variant in linkage disequilibrium with the Gly460Trp polymorphism increases susceptibility for hypertension. Journal of Human Hypertension (2000) 14, 43-46.

Alleles↗
PubMed2003

Phenotypic switching of Cryptococcus neoformans can influence the outcome of the human immune response.

The human pathogenic fungus Cryptococcus neoformans exhibits the phenomenon of phenotypic switching, a process that generates variant colonies that can differ in morphology, virulence and other characteristics such as capsular glucuronoxylomannan (GXM) size and structure. A previous study established that mucoid colony (MC) variants of C. neoformans were more virulent and elicited a different inflammatory response than smooth colony (SM) variants. In this study, we investigated the interaction of cells from MC and SM variants and their respective GXMs with human T cells and monocytes. Specifically, we measured CD40, CD80 and CD86 expression, lymphoproliferation and interleukin (IL)-4, IL-10, interferon (IFN)-gamma and IL-12Rbeta2 expression in the presence and absence of variant cells and their GXMs. For some immune parameters, both MC and SM strains produced similar results, in particular no differences were observed in IL-4 induction. However, for other critical parameters, including CD86 expression, lymphoproliferation and IL-10 production, the MC variant had effects that can be expected to impair the immune response. Hence, a single C. neoformans strain can elicit several different immune responses depending on the colony type expressed, and this is unlikely to be accounted for by differences in phagocytosis only. The results provide a potential explanation for the higher virulence of the MC variant based on the concept that these cells inhibit the development of a vigorous immune response. Furthermore, the results suggest a mechanism by which phenotypic switching can generate variants able to evade the immune response.

Antigen-Presenting Cells↗
PubMed1993

Role of the YadA protein in prevention of opsonization of Yersinia enterocolitica by C3b molecules.

When mixed with normal human serum, wild-type pathogenic Yersinia enterocolitica, previously incubated at 37 degrees C, fixed less C3b than its variant cured of the virulence plasmid pYV. Mutants unable to secrete the Yop proteins were still protected against C3b deposition. By contrast, mutants deficient in the production of outer membrane protein YadA fixed more C3b than their YadA+ parent. Gene yadA, cloned as a minimal polymerase chain reaction fragment and introduced in trans, complemented the mutations. Production of YadA by recombinant Escherichia coli LK111 also resulted in a reduction of the amount of C3b deposited on the bacterial surface. The reduction of C3b at the surface of Y. enterocolitica YadA+ compared with YadA- cells correlated with an increase of the amount of factor H fixed at the bacterial surface. The YadA monomer separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to a nitrocellulose membrane was able to bind factor H. We conclude that factor H bound to YadA reduces the C3b deposition on the bacterial surface, probably by a rapid inactivation of C3b.

Adhesins, Bacterial↗
PubMed2005

Bacterial characteristics in relation to clinical source of Escherichia coli isolates from women with acute cystitis or pyelonephritis and uninfected women.

Characteristics differentiating Escherichia coli strains that cause cystitis or pyelonephritis from fecal E. coli remain incompletely defined, particularly among adult women in the United States. Accordingly, phylogenetic group, O antigens, and virulence factors (VFs) were analyzed among 329 E. coli isolates from the mid-to-late 1990s from women in the United States with acute pyelonephritis (n = 170), cystitis (n = 83), or no infection (fecal; n = 76). Compared with fecal and cystitis isolates, pyelonephritis isolates exhibited a greater prevalence of phylogenetic group B2, most virulence-associated O antigens, and most VFs and had higher VF scores. In contrast, cystitis and fecal isolates differed minimally. By stepwise multivariable logistic regression, significant (P < or = 0.015) predictors of cystitis and/or pyelonephritis (versus fecal) included afa/dra (Dr-binding adhesins), ibeA (invasion of brain endothelium), iha (putative adhesin-siderophore), malX (pathogenicity island marker), the O75 antigen, papEF (P fimbriae), papG allele II (P adhesin variant), group B2, and sfa/foc (S and F1C fimbriae). However, virulence profiles overlapped considerably among source groups and varied greatly within each group. E. coli "clonal group A" (CGA) and the O2:K5/K7:H1 and O75:K+ clonal groups were significantly associated with cystitis and/or pyelonephritis. These findings identify potential vaccine targets, suggest that urovirulence is multiply determined, and confirm the urovirulence of specific E. coli clonal groups, including recently recognized CGA.

Acute Disease↗
PubMed2004

Genetically increasing Myoc expression supports a necessary pathologic role of abnormal proteins in glaucoma.

Despite the importance of MYOC for glaucoma, the protein's normal function(s) and the pathogenic mechanism(s) of MYOC mutations are not clear. Elevated intraocular pressure (IOP) and glaucoma are sometimes induced by corticosteroids, and corticosteroid use can result in substantially increased MYOC expression. It has been suggested, therefore, that steroid-induced MYOC protein levels cause steroid-induced glaucoma and that protein level-increasing mutations in MYOC contribute to glaucoma not associated with steroid use. A causative role of elevated MYOC levels in steroid-induced glaucoma is controversial, however, and it is not clear if elevated MYOC levels can result in IOP elevation. To directly test if increased levels of MYOC can cause IOP elevation and glaucoma, we generated bacterial artificial chromosome transgenic mice that overexpress Myoc at a level similar to that induced by corticosteroid use. These mice do not develop elevated IOP or glaucoma. Our present findings, along with the absence of glaucoma in mice completely lacking MYOC, show that changing the level of MYOC is not pathogenic (from absent to approximately 15 times normal). These findings suggest that noncoding sequence variants are unlikely to influence glaucoma and that disease pathogenesis in primary open-angle glaucoma patients is dependent upon the expression of abnormal mutant proteins. This work does not support a causative role for increased MYOC levels or the MYOC gene in steroid-induced glaucoma.

Adrenal Cortex Hormones↗
PubMed2003

Phenotypic and molecular characteristics of typical and atypical Escherichia coli O157, clinical and food isolates.

Enrichment, colony isolation and confirmation are three general phases of a standard diagnostic method. E. coli O 157 (the main member of EHEC group) differs metabolically from other strains of E. coli in a number of ways. Most isolates are slow- or non-fermenters of sorbitol and lack the enzyme beta-glucuronidase (GUD). But, a variety of atypical strains of E. coli O157 (sorbitol-fermenting variants, nonmotile and GUD-positive) have been reported. The discovery of these atypical pathogenic strains brings into question the validity of testing for the pathogen only by biotyping. Using classical cultivation and immunomagnetic separation, we have isolated from food a few atypical E. coli O157 (sorbitol-fermenting strains, GUD positive, nonmotile O157 strain which does not agglutinate with O157 latex and does not produce Shiga toxin). On the other hand, non-O157 VTEC (O26 serotype) producing Shiga toxin was isolated from meat. Molecular markers of E. coli O157 and virulence-associated factors of strains with aberrant biochemical properties were studied by PCR. This method helped us in the final identification of isolates. Since it was suggested that the production of verotoxins (VT) is accompanied by the production of enterohemolysin (Ehly) such correlation has also been evaluated in respect to the collection of VTEC of human, animal and food origin.

Animals↗
PubMed2005

[DNA-analysis in hereditary cancer: the importance of a reliable family history].

Three patients, a 45-year-old man, a 51-year-old woman and a 43-year-old woman, wanted to know whether they had a hereditary predisposition for cancer. The family of patient A fulfilled the clinical diagnostic criteria for hereditary non-polyposis colorectal carcinoma (HNPCC). The family of patient B fulfilled the clinical diagnostic criteria for hereditary breast/ovarian cancer (HBOC). The family of patient C did not completely fulfil the criteria for HBOC since only two family members had a confirmed diagnosis of breast cancer. In all three families, DNA-mutation analysis was performed. In families A and B no mutation was found. However, based on the family history, the diagnosis of hereditary cancer was made and recommendations for surveillance were given. After extensive counselling, one member of family B eventually decided to have prophylactic surgery performed. A few years later, a pathogenic mutation in BRCA2 was found in family B. In family C, an unclassified variant was found in BRCA1. Further investigations in the family were not possible, due to a lack of co-operation from family members. It is important to obtain a thorough and complete family history. When DNA-analysis remains inconclusive or if an unclassified variant is found, recommendations for surveillance will be based on this family history.

Adult↗
PubMed1994

[Experimental vaccination of SPF chickens against Newcastle disease using the method of coated-millet vaccine from a thermotolerant variant of the LaSota virus].

The thermotolerant variant A300 of LaSota virus was used to vaccinate 4 week old specified pathogen-free (SPF) chickens by feeding them with virus coated-millet. With vaccine doses above 10(6)EID50/bird, HI antibodies developed and protection to challenge was seen 2 months after vaccination, while 100% mortality occurred in the control groups. The PD50 was estimated to 10(6.85) EID50. This lyophilized vaccine intended for African village chickens can be kept at ambient temperature for at last 1 week up to 35 degrees C. Other trials on a large scale are still needed to determine the potential of this vaccine in the field conditions of rural Africa.

Animals↗