Antibody and cytokine seerum levels in patients subjected to anti-rabies prophylaxis with serum-vaccination

Rabies is considered a fatal disease once clinical symptoms have developed. The aim of this study was to evaluate epidemiological aspects and immune response in patients attacked by domestic and wild animals and subjected to post-exposure rabies treatment with equine serum and associated vaccine. Thirty-three patients were evaluated; they were between 13 and 65 years old, 75.8% were male and 24.2% female, and from the Botucatu neighborhood. Twenty healthy control individuals with the same age range were also studied. Specific antibodies to equine immunoglobulins and IFN-g, IL-2, IL-4, and IL-10 production were evaluated by ELISA. IgM, IgE, IgG and subclasses, and rabies virus antibodies serum levels were determined by nephelometry and seroneutralization methods, respectively. No anaphylactic or serum sickness allergic reactions were observed in patients after treatment. Anti-equine IgG levels were significantly higher than those of IgM after 14 and 28 days of treatment. Protective antibodies to rabies virus > 0.5 UI/ml were detected in 84.6% and 75% of patients at days 14 and 28, respectively. IFN-g, IL-2 and IL-10 levels in patients before and 48h after treatment were significantly higher than in controls suggesting that both Th1 and Th2 cells were activated in the patients. Serum IgM levels were higher at day 14, and IgG2 and IgE levels were higher at day 28 of treatment. These results suggest that post-exposure rabies treatment in humans induces significant alterations in patient immune response characterized by increased levels of cytokines, serum levels of specific rabies virus antibodies, and the equine serum components employed in the treatment

Evolution and prophylaxis of human rabies

Rabies is a viral acute encephalitis of progressive and fatal outcome, particular of hot-blooded animals, and accidentally affecting men. Since it is a zoonosis with different animal species acting as a reservoir in the nature, this disease is a great public health problem in several countries in development. Prophylactic treatments for human rabies started in 1885 with Louis Pasteur, and developed in order to provide higher protection and lower incidence of side effects. Today, treatments of pre and post-exposure to the virus are well established, with excellent results of protection for individuals exposed to animals potentially contaminated by the rabies virus. These treatments consist of utilising the vaccine isolatedly or in combination with equine immunoglobulin, what contributes, in an important way, to the decrease in the number of cases of rabies.(AU)

Fibroblast growth factor signaling regulates Dach1 expression during skeletal development.

Dach1 is a mouse homologue of the Drosophila dachshund gene, which is a key regulator of cell fate determination during eye, leg, and brain development in the fly. We have investigated the expression and growth factor regulation of Dach1 during pre- and postnatal skeletal development in the mouse limb to understand better the function of Dach1. Dach1 was expressed in the distal mesenchyme of the early embryonic mouse limb bud and subsequently became restricted to the tips of digital cartilages. Dach1 protein was localized to postmitotic, prehypertrophic, and early hypertrophic chondrocytes during the initiation of ossification centers, but Dach1 was not expressed in growth plates that exhibited extensive ossification. Dach1 colocalized with Runx2/Cbfa1 in chondrocytes but not in the forming bone collar or primary spongiosa. Dach1 also colocalized with cyclin-dependent kinase inhibitors p27 (Kip1) and p57 (Kip2) in chondrocytes of the growth plate and in the epiphysis before the formation of the secondary ossification center. Because fibroblast growth factors (FGF), bone morphogenetic proteins (BMP), and hedgehog molecules (Hh) regulate skeletal patterning of the limb bud and chondrocyte maturation in developing endochondral bones, we investigated the regulation of Dach1 by these growth and differentiation factors. Expression of Dach1 in 11 days postcoitus mouse limb buds in organ culture was up-regulated by implanting beads soaked in FGF1, 2, 8, or 9 but not FGF10. BMP4-soaked beads down-regulated Dach1 expression, whereas Shh and bovine serum albumin had no effect. Furthermore, FGF4 or 8 could substitute for the apical ectodermal ridge in maintaining Dach1 expression in the limb buds. Immunolocalization of FGFR2 and FGFR3 revealed overlap with Dach1 expression during skeletal patterning and chondrocyte maturation. We conclude that Dach1 is a target gene of FGF signaling during limb skeletal development, and Dach1 may function as an intermediary in the FGF signaling pathway regulating cell proliferation or differentiation.

DACH: genomic characterization, evaluation as a candidate for postaxial polydactyly type A2, and developmental expression pattern of the mouse homologue.

The gene DACH is a human homologue of Drosophila melanogaster dachshund (dac), which encodes a nuclear factor essential for determining cell fates in the eye, leg, and nervous system of the fly. To investigate possible connections between DACH and inherited developmental disorders, we have characterized the human DACH genomic structure and investigated the tissue and cellular distribution of the mouse DACH1 protein during development. DACH spans 400 kb and is encoded by 12 exons. The predominant DACH transcript is 5.2 kb and encodes a 706-amino-acid protein with an observed molecular weight of 97 kDa.DACH mRNA was detected in multiple adult human tissues including kidney and heart. The mouse DACH1 protein was immunolocalized to specific cell types within the developing kidneys, eyes, cochleae, and limb buds. Data suggest genetic linkage of the limb bud patterning defect postaxial polydactyly type A (designated PAP-A2, MIM 602085) to a 28-cM interval on chromosome 13 that includes DACH. However, mutation analysis of DACH in this PAP-A2 pedigree revealed no sequence differences in the coding region, splice sites, or proximal promoter region. The data presented will allow for the analysis of DACH as a candidate for other developmental disorders affecting the limbs, kidneys, eyes, ears, and other sites of DACH expression.

[Carcinoma of the penis. The basic principles of the diagnostic and therapeutic guidelines]. / Carcinoma do pénis. Princípios básicos de orientação diagnóstica e terapêutica.

Despite the low incidence of penile cancer nowadays, this tumor presents a difficult diagnosis and staging methodology as well as difficult therapeutic options. The author emphasises the clear destruction between superficial and invasive neoplasms. In the latter, the simultaneous treatment of the lymphatic territories is considered of extreme importance.

Evaluation of intradermal sensitivity test in patients submitted to heterologous serotherapy

This review deals with heterologous sera produced used in Brazil. The authors studied 64 patients. Of these, 35 had been attacked by domestic and wild animals and received antirabies serum; 20 had been bitten by venomous animals (snakes and scorpions) and were treated with specific antivenoms; and 9 had traumas and received antitetanic serum. All these patients were submitted to the intradermal sensitivity test before, and 30 days after receiving heterologous serotherapy. The following results obtained by the authors agree with those in literature: - The intradermal test using undiluted heterologous serum produced a more acute reaction than that using heterologous serum diluted 1:10; - The larger the volume of serum, the larger was the wheal directly after inoculation; - The antigenic concentration influenced the final local reaction; - The reading 30 minutes after inoculation was always higher than that 15 min after; - No systemic reaction was observed during the tests; - The use of promethazine as a prophylactic medication did not protect against the early reactions; - Tests performed 30 days after serotherapy showed a higher reactivity, probably due to sensitization; - The intradermal sensitivity test did not allow the authors to predict early reactions. After these observations, the authors do not recommend the intradermal sensitivity test for patients submitted to heterologous serotherapy. They, however, strongly recommend a careful observation during the infusion and clinical follow up in the first 24 hours.

The 5' ends of LINE1 repeats in rabbit DNA define subfamilies and reveal a short sequence conserved between rabbits and humans.

The 5' ends of five full-length LINE1 (L1) repeats from the rabbit genome (L1Oc) were mapped and their nucleotide sequences determined. Computer-generated alignments showed that these five L1Oc repeats can be divided into subfamilies, each of which has a characteristic sequence upstream of the first open reading frame (ORF1). These five L1Ocs range in size from 6.5 to 7.3 kb, with 5' ends located 76 to 1125 bp upstream of ORF1. Two of these subfamilies appear to have diverged from a common ancestor at least 66 million years ago. Comparisons of the 5' ends of L1s from rabbit, human, mouse, and rat show no common sequence 5' to ORF1, except for a 22-bp sequence that is found near the beginning of all characterized full-length L1s from rabbit and human. A statistical analysis indicates that this 22-bp aligned block is highly significant. Part of this 22-bp sequence matches the microE1 binding site in immunoglobulin gene enhancers. This strong conservation suggests that the microE1 binding site may be part of a transcriptional regulatory element at the 5' ends of rabbit and human L1 repeats.

Chronic toxicity and oncogenicity bioassay of inhaled ethyl acrylate in Fischer 344 rats and B6C3F1 mice.

Male and female Fischer 344 rats and B6C3F1 mice were exposed to 0, 25 or 75 ppm (0, 0.10 or 0.31 mg/l) ethyl acrylate vapors, 6 hours per day, 5 days per week, for a total of 27 months. Additional rats and mice were exposed to 225 ppm (0.92 mg/l) for 6 months and then held for 21 additional months post-exposure. Histopathologic changes in olfactory portions of the nasal mucosa were present in animals in all of these three exposure groups. These microscopic exposure-related changes were concentration-dependent, primarily in terms of distribution of the lesions within the nasal cavity. Generally those areas of the nasal mucosa normally lined by olfactory epithelium were altered, while the regions lined by respiratory epithelium were relatively unaffected. There was no indication of an oncogenic response in any organ or tissue in either rats or mice. A follow-up study in which Fischer 344 rats and B6C3F1 mice were exposed to 5 ppm (0.02 mg/l) for 24-months revealed no treatment-related changes in the nasal mucosa.

Teratologic evaluation of inhaled epichlorohydrin and allyl chloride in rats and rabbits.

Pregnant Sprague-Dawley rats and New Zealand white rabbits were exposed to vapors of epichlorohydrin (ECH) at concentrations of 0, 2.5 or 25 ppm or to allyl chloride (AC) at concentrations of 0, 30, or 300 ppm. Exposures were for 7 hr/day on days 6 through 15 (rats) or 6 through 18 (rabbits) of gestation. Maternal effects including decreased body weight and food consumption were observed among rats inhaling 25 ppm of ECH. No evidence of an adverse effect to the embryo or fetus was observed among rats or rabbits following exposure to ECH. In the AC study maternal toxicity occurred in both rats and rabbits treated at 300 ppm. These consisted of depressed weight gain during gestation and increases in liver weight (both species) and kidney weights (rats only). Fetuses from rats exposed to 300 ppm of AC had a slight delay in skeletal development but there were no other signs of embryotoxicity. Thus, ECH and AC were not teratogenic or embryolethal in rats or rabbits following inhalation exposure to concentrations which induced effects in the maternal animals.

Ethylene glycol monomethyl ether. I. Subchronic vapor inhalation study with rats and rabbits.

Male and female Sprague-Dawley rats and New Zealand White rabbits were exposed to 0, 30, 100 or 300 ppm ethylene glycol monomethyl ether (EGME) vapors 6 hours per day, 5 days per week, for a total of 13 weeks. No rats died prior to scheduled sacrifice, but some rabbits in the 100 and 300 ppm exposure groups died or were sacrificed when moribund during the study. Body weights as well as thymus and testicular weights of rats and rabbits in the 300 ppm group were reduced as a result of the exposures. Hematologic changes occurred in rats and rabbits exposed to 300 ppm. Concentrations of total protein, albumin and globulins in serum of rats (but not rabbits) in the 300 ppm group were lower than for controls. Gross lesions in rats and rabbits exposed to 300 ppm EGME included decreased size of thymus in both sexes, decreased abdominal fat, and small flaccid testes in males. In addition there was decreased lymphoid tissue in some rabbits, as well as a slight-to-moderate decrease in size of testes in 4 of 5 rabbits in the 100 ppm group and in 2 of 5 rabbits exposed to 30 ppm. Treatment-related microscopic lesions included degenerative changes in germinal epithelium of testes in all male rats and rabbits in the 300 ppm group, as well as in 3 of 5 rabbits in the 100 ppm group and 1 of 5 male rabbits in the 30 ppm group. The only effects attributed to exposure to 30 ppm EGME in this study were slight microscopic changes in testes of 1 of 5 male rabbits.

Ethyl chloride: a two-week inhalation toxicity study and effects on liver non-protein sulfhydryl concentrations.

Male and female Fischer 344 rats (6/sex/exposure concentration) and male beagle dogs (2/exposure concentration) exposed to 0, 1600, 4000 or 10 000 ppm ethyl chloride (EtCl) for 6 hr/da, 5 da/wk for 2 weeks showed no toxicologically significant treatment-related effects on body weights; clinical chemistry, hematology, or urinalysis parameters; neurology (dogs only were examined); gross pathology or histopathology. The only treatment-related differences in organ or relative organ weights (in rats or dogs) were slight, but statistically significant increases in liver to body weight ratios of male rats exposed to 4000 or 10,000 ppm EtCl (4.9 and 7.5% respectively). Liver non-protein sulfhydryl (NPSH) concentration was measured in male Fischer rats and male B6C3F1 mice that were exposed for 6 hours to 0, 1600, 4000 or 10,000 ppm EtCl (mice were exposed to 0 or 4000 ppm EtCl only). Liver NPSH, measured 1/2 hr post exposure, was less than control values in 4000 ppm exposed rats (88% of control value), 4000 ppm exposed mice (64%), and 10,000 ppm exposed rats (89%). The slight decreases in rat liver NPSH seem consistent with the increased liver to body weight ratios. The toxicity data indicate that 2-week repeated exposures to EtCl concentrations that were up to 10 times the current A.C.G.I.H. T.L.V. (1000 ppm) caused minimal treatment-related effects in dogs and rats.

Metabolism of acrylate esters in rat tissue homogenates.

Methyl, ethyl and butyl acrylate were hydrolyzed to acrylic acid in rat liver, kidney and lung homogenates. The rates of hydrolysis of the various esters in these in vitro studies were comparable; hydrolysis rates were approximately 20 times higher in liver homogenates than in kidney or lung homogenates. The esters also disappeared rapidly when added to blood in vitro. However, the disappearance in blood was not associated with the appearance of acrylic acid. Ethyl acrylate was found to react spontaneously with GSH in vitro and this reaction was catalyzed greatly by enzymes in 100 000 x g liver supernatant. Acrylic acid did not react with GSH in vitro. Ethyl acrylate, but not acrylic acid, depletes non-protein sulfhydryls when added to blood in vitro. Thus, the disappearance of acrylate esters in blood in vitro could be due at least in part to binding with non-protein sulfhydryls in red blood cells rather than to hydrolysis.

Inhalation toxicity of acrylic acid.

Male and female Fischer 344 rats and B6C3F1 mice were exposed to 0, 5, 25 or 75 ppm acrylic acid vapors 6 hours per day, 5 days per week, for 13 weeks. These exposure levels were selected after conducting a 2-week probe study in which 225 ppm caused pronounced growth retardation and nasal lesions in both rats and mice. The 13-week exposures had no adverse effect on the growth of male and female rats and male mice. However, mean body weight gains of female mice in the 25 and 75 ppm exposure groups were statistically significantly lower than for controls after 12 weeks of exposure. There were no pronounced treatment related effects on organ weights, hematologic parameters, clinical chemistry parameters or urinary parameters. Histopathologic examinations revealed lesions of the nasal mucosa in rats in the 75 ppm exposure group, and in some or all mice at each treatment level. The nasal lesions were primarily localized to the olfactory epithelium; the respiratory epithelium was relatively unaffected. The histopathologic observations in both rats and mice included degeneration, and inflammatory cell infiltration in the olfactory mucosa. In mice there were also instances of hyperplasia of the submucosal glands and, replacement of olfactory epithelium by respiratory epithelium. These effects were attributed to the irritant properties of acrylic acid vapors.