Optimización de un método de PCR en tiempo real para el diagnóstico de infecciones por Mycoplasma pneumoniae / Optimization of a real-time PCR method for the diagnosis of Mycoplasma pneumoniae infections

A Mycoplasma pneumoniae se lo ha descrito como causante de diversas patologías, pero la más frecuente es la neumonía de la comunidad, en la que puede asociarse a otros patógenos. Afecta pincipalmente a niños de edad escolar y adultos jóvenes, aunque en las últimas décadas es frecuente hallarlo también en niños menores de 5 años. El daño celular ocurre sobre el epitelio de bronquios y bronquiolos por acumulación de peróxido de hidrógeno y radicales superóxido producidos durante su metabolismo celular. Recientemente se ha reportado que en estos eventos patogénicos también participa una citotoxina conocida como CARDS toxin (community-acquired respiratory distress syndrome) que la bacteria expresa como factor de virulencia, ya que induce una importante respuesta inflamatoria celular. Los métodos moleculares son más sensibles y rápidos que los métodos de diagnóstico tradicionales y se consideran de elección. No obstante, para lograr un diagnóstico óptimo, se aconseja la combinación de estos métodos junto con los serológicos. En el presente estudio se optimiza un método de PCR en tiempo real con iniciadores dirigidos a la región del gen que codifica la CARDS toxin. El método demostró ser muy sensible y rápido para el diagnóstico clínico de M. pneumoniae, con una concordancia қ: 0,95 con el método convencional de PCR anidada que emplea como target al gen que codifica para la citoadhesina P1. A su vez es mucho menos laborioso e implica un menor riesgo de contaminación, lo que permite el manejo de un alto número de muestras clínicas (AU)

Mycoplasma pneumoniae has been described as the cause of different infections, the most common of which is communityacquired pneumonia, possibly associated with other pathogens. Community-acquired pneumonia mainly affects school-age children and young adults, although over the past decades the disease has also been found in children under 5 years of age. Cell damage occurs on the epithelium of the bronchi and bronchioles due to accumulation of hydrogenous peroxide and superoxide radicals produced during cell metabolism. Recently, it has been reported that in these pathogenic events a cytotoxin known as CARDS toxin (community-acquired respiratory distress syndrome) participates, expressed by the bacteria as a factor of virulence, as it induces an important inflammatory cell response. The molecular methods are more sensitive and faster than the traditional diagnostic methods, and are considered the methods of choice; however, for an optimal diagnosis, a combination of these methods together with serological studies is recommended. In the current study, a real-time PCR method with markers targeted to the region of the gene encoding the CARDS toxin was optimized. The method showed to be very sensitive and fast for the clinical diagnosis of M. pneumoniae, with a қ agreement of 0.95 with the conventional nested PCR method that uses the gene encoding cytoadhesin P1 as a target. Additionally, the new method is much easier with a lower risk of contamination, which allows management of a large number of clinical samples (AU)

Surveillance of adamantane resistance among influenza A H3 viruses isolated in Argentina between 2001 and 2007.

A dramatic rise in the frequency of resistance to adamantane drugs by influenza A H3 viruses, associated with a single amino acid replacement in the viral matrix M2 protein, has occurred in multiple countries worldwide in recent years. We investigated the frequency of adamantane-resistant influenza A H3 viruses in Argentina during the period 2001-2007. We used reverse transcription followed by polymerase chain reaction. The obtained products were sequenced for the detection of mutations of the M2 gere relevant to the resistance phenotypes. The HA1 sequences of the sensitive and resistant strains were also analyzed to clarify whether they had any relevance to the resistant mutations. Twenty out of 55 (36%) strains were identified with the resistance-conferring substitution at amino acid 31 (Serine 31 Asparagine). No resistant viruses were detected between 2001 and 2005. All strains isolated in 2006 and four out of five isolates from 2007 were resistant. None of the patients had received previous treatment with amantadine and/or rimantadine. The HA1 analysis showed that there were only two changes (Serine193 Phenylalanine and Aspartic acid 225 Asparagine) present in the strains with the M2 substitution at position 31. Our data indicate that since 2006 there has been a significant increase of adamantane-resistant influenza A H3 viruses, which raises concern over the spread of these viruses in Argentina.

Surveillance of adamantane resistance among influenza A H3 viruses isolated in Argentina between 2001 and 2007 / Vigilancia de la resistencia a los adamantanos entre los virus influenza A H3 aislados en Argentina entre 2001 y 2007

A dramatic rise in the frequency of resistance to adamantane drugs by influenza A H3 viruses, associated with a single amino acid replacement in the viral matrix M2 protein, has occurred in multiple countries worldwide in recent years. We investigated the frequency of adamantane-resistant influenza A H3 viruses in Argentina during the period 2001- 2007. We used reverse transcription followed by polymerase chain reaction. The obtained products were sequenced for the detection of mutations of the M2 gene relevant to the resistance phenotypes. The HA1 sequences of the sensitive and resistant strains were also analyzed to clarify whether they had any relevance to the resistant mutations. Twenty out of 55 (36%) strains were identified with the resistance-conferring substitution at amino acid 31 (Serine 31 Asparagine). No resistant viruses were detected between 2001 and 2005. All strains isolated in 2006 and four out of five isolates from 2007 were resistant. None of the patients had received previous treatment with amantadine and/or rimantadine. The HA1 analysis showed that there were only two changes (Serine193 Phenylalanine and Aspartic acid 225 Asparagine) present in the strains with the M2 substitution at position 31. Our data indicate that since 2006 there has been a significant increase of adamantane-resistant influenza A H3 viruses, which raises concern over the spread of these viruses in Argentina.

En los últimos años, se ha detectado un aumento de virus influenza A H3 resistentes a los adamantanos en distintos países, asociados mayoritariamente con el reemplazo de un único aminoácido de la proteína matriz M2. Se investigó la frecuencia de virus influenza A H3 resistentes a los adamantanos en Argentina entre 2001 y 2007. Se utilizó la transcripción reversa seguida de la reacción en cadena de la polimerasa y de la técnica de secuencia directa para la detección de mutaciones en el gen que codifica para la proteína M2, relevantes para los fenotipos de resistencia. También se analizó la secuencia de la porción HA1 de cepas resistentes y sensibles, para intentar establecer alguna relación con las mutaciones de M2. De un total de 55 cepas, 20 (36%) fueron resistentes debido a un cambio aminoacídico en la posición 31 (serina 31 asparagina). No se detectaron cepas resistentes entre 2001 y 2005. Las cepas aisladas en el 2006 y 4 de 5 cepas obtenidas en el 2007 fueron resistentes. Ninguno de los pacientes de los que se habían aislado esas cepas había recibido tratamiento antiviral con anterioridad. En la porción secuenciada de HA1 se encontraron dos cambios (serina 193 fenilalanina y ácido aspártico 225 asparagina), presentes sólo en las cepas que tuvieron la mutación en la posición 31 de M2. Desde el año 2006 se ha registrado en Argentina un aumento significativo de la circulación de virus influenza A H3 con genotipo resistente, lo que genera expectativa con respecto a su diseminación en nuestro país.

Influenza circulating strains in Argentina exhibit differential induction of cytotoxicity and caspase-3 in vitro.

BACKGROUND: Human influenza infections are a significant cause of morbidity worldwide. Though damage to the respiratory epithelium and has been related to apoptosis, which occurs subsequent to influenza virus infection, little information is available regarding cell cytotoxicity of human strains. OBJECTIVE: To study cytotoxicity performed in vitro by various circulating strains in Argentina. The study sample consisted of three vaccine strains (H1N1, H3N2, and B) administered during 1999-2000 in South America and three strains isolated from clinical samples, one, NAC (H1N1) obtained from an adult inpatient with human pneumonia; and the other two (T) and (T2) (H3N2) with influenza syndrome. Viral antigen was detected by an immunofluorescence test, conducted prior to viral isolation in MDCK cells. Strains were subtyped by the hemmaglutination inhibition test. Cytotoxic properties were determined by lactate dehydrogenase reaction (LDH), crystal violet staining and Hoechst staining. Caspase-3 activity, morphological changes of apoptosis, and viral yields were measured in MDCK infected cells. RESULTS AND CONCLUSIONS: Cells infected by each of the strains exhibited apoptosis morphology by Hoechst staining and caspase-3 activity was high for both H1N1 strains. Further, high levels of LDH activity were detected for NAC and H3N2 strains tested, indicating the possible role of different viral proteins or functions on cell cytotoxicity. The NAC strain, isolated from human pneumonia and antigenically related to A/New Caledonia /20/99 (H1N1), was the highest cytotoxic strain and an excellent inducer of caspase-3 activity. In turn, no parameter was related to different viral yields. We conclude that human strains studied in this paper may be useful tools in the characterization of molecular determinants involved in viral cytopathogenicity.

Insulin-like growth factor-I and insulin-like growth factor binding protein-2 and -5 in equine seminal plasma: association with sperm characteristics and fertility.

The objectives of this study were 1) to determine whether insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding proteins (IGFBPs) were present in seminal plasma of stallions; 2) to compare semen parameters (IGF proteins, sperm numbers, morphology, and motility) from stallions at sexual rest (SR) and when sexually active (SA); 3) to compare semen parameters between stallions with high and low seminal plasma IGF-I concentrations; and 4) to examine the relationship between seminal plasma IGF-I concentrations and fertility parameters of stallions. Ejaculates were collected from stallions at SR (n = 51) and SA (n = 46). Concentrations of IGF-I and IGFBP-2 in seminal plasma samples were determined by radioimmunoassay. Presence of IGFBPs in equine seminal plasma was verified using immunoprecipitation and Western ligand blot procedures. IGF-I, IGFBP-2, and IGFBP-5 were present in equine seminal plasma. Concentrations of IGF-I, IGF-I/protein, total IGF-I, IGFBP-2, IGFBP-2/protein, and total IGFBP-2 were not significantly different (P > or = 0.13) in seminal plasma between stallions at either SR or SA. At SR, stallions with higher seminal plasma IGF-I had more total IGFBP-2 per ejaculate (P < 0.01), more morphologically normal sperm (P = 0.05), and higher first-cycle pregnancy rates (P = 0.02). At SA, stallions with higher seminal plasma IGF-I had fewer cycles per pregnancy (P = 0.02). An association of seminal plasma IGF-I concentration with sperm motility, sperm morphology, and pregnancy rates in bred mares suggests that IGF-I may play a role in sperm function.

Interactions of xylazine and acepromazine with oxytocin and the effects of these interactions on intrauterine pressure in normal mares and mares with delayed uterine clearance.

The effects of the sedatives xylazine (predominantly alpha2 agonist) and acepromazine (predominantly alpha1 antagonist) and their influence on intrauterine pressure were measured in four reproductively normal mares and four mares with delayed uterine clearance. Intrauterine pressure was measured in each mare during oestrus for three 100 min periods using an 8-F catheter with three discrete pressure sensors. After 10 min of baseline recording, xylazine, acepromazine or saline was administered i.v. Oxytocin was administered i.v. after a further 30 min, and pressure recordings were continued for 60 min. The pressure changes analysed were: number of uterine contractions; time of onset and duration of the first contraction; and the time at which intrauterine pressure changed from baseline. Data were analysed using the mixed procedure of the Statistical Analysis System. ANOVA detected an effect of treatment (P < 0.0001) and a treatment by group interaction (P < 0.001). Xylazine administration caused a tetanic contraction in all mares. When mares with delayed uterine clearance were sedated with xylazine before administration of oxytocin, the duration of increased intrauterine pressure was longer than that of normal mares (24.87 +/- 2.52 and 15.81 +/- 2.46, respectively; P < 0.0001). Acepromazine administration had no effect on the oxytocin-induced contraction pattern in normal mares, but there was a decrease in the number of contractions in mares with delayed uterine clearance. The enhanced response to alpha-agonists and -antagonists observed in mares with delayed uterine clearance when the drugs were administered before oxytocin may be due to denervation supersensitivity. After mating, sedation of mares with xylazine is preferred to sedation with acepromazine, as xylazine increases uterine contraction time.

Dynamics of prostaglandin secretion, intrauterine fluid and uterine clearance in reproductively normal mares and mares with delayed uterine clearance.

Two experiments were performed to investigate relationships between oxytocin, prostaglandin release, uterine emptying and fluid accumulation in the uterus. In Experiment 1, the effect of oxytocin on the pattern of prostaglandin release during uterine clearance of radiocolloid was measured in 5 normal mares and 5 mares with delayed uterine clearance. Uterine clearance was measured during estrus by scintigraphy at 0, 60 and 120 min after colloid infusion. After the 120-min reading, 20 IU, i.v., oxytocin were given, and the amount of colloid cleared was measured at 135, 150 and 180 min. Plasma was obtained prior to and during scintigraphy at 5- and 15-min intervals to measure concentrations of 15-keto-13,14-dihydro-PGF2 alpha metabolite (PGFM) by RIA. In Experiment 2, plasma PGFM levels were compared after administration of oxytocin in 8 normal mares and 6 mares with delayed uterine clearance to determine if intrauterine fluid stimulated prostaglandin release. Mares received 2 treatments in a cross-over design. Treatment 1 consisted of 20 IU, i.v., oxytocin during estrus. Treatment 2 consisted of an infusion of 10 mL, i.u., saline 15 min prior to oxytocin administration. Treatments were performed 4 to 6 h apart. Blood was collected and PGFM was measured as in experiment 1. Data were analyzed by least squares analysis of variance. In Experiment 1, regression analysis of scintigraphy and PGFM profiles indicated that time response curves differed between groups (P < 0.01). At 120 min, normal mares retained 40.4 +/- 4.9% (mean +/- SEM) of the radiocolloid while mares with delayed clearance retained 88 +/- 5%. Fifteen minutes after oxytocin administration (135 min), all normal mares and 4 of 5 mares with delayed clearance retained only < 6% of the colloid. During the first 120 min, plasma PGFM concentrations did not differ between the 2 groups. After oxytocin was given, plasma PGFM concentrations increased in 4 of 5 mares with delayed uterine clearance (80 to 3,096 pg/mL) but not in normal mares (13 to 46 pg/mL). In Experiment 2, plasma PGFM concentrations did not rise in normal mares but rose in 3 of 6 mares with delayed clearance (135 to 483 pg/mL) independent of treatment or period. The results suggest that intrauterine clearance of radiocolloid after oxytocin administration appears to be independent of PGF2 alpha release in normal mares during estrus. The difference in prostaglandin release response after oxytocin administration between the 2 groups was unrelated to the presence of intrauterine fluid.

Changes in intrauterine pressure after oxytocin administration in reproductively normal mares and in those with a delay in uterine clearance.

Intrauterine pressure was measured in 4 reproductively normal mares and 4 mares with delay in uterine clearance after administration of oxytocin to determine if intrauterine pressure varied between dosage and group. Changes in intrauterine pressure were measured during estrus, when a follicle was > or =35 mm, using a Millar "Mikro-tip" catheter that had 3 discrete pressure sensors/channels. Mares received 4 different treatments of 10, 5, 2.5 or 0 IU (vehicle) of oxytocin. The protocol for each treatment consisted of a 10-min baseline recording, administration of treatment and measurement of changes in intrauterine pressure for 65 min. After administration of the first two treatments, mares were rested for 2 h and the protocol repeated for the remaining 2 treatments. Changes in intrauterine pressure were measured on a physiograph and stored in a computer. The results were analyzed by 4x4 Latin Square Design analysis of variance (ANOVA) using the GLM procedure of the Statistical Analysis System. The ANOVA detected a main effect of treatment (P<0.01) and mare (nested within group; P<0.01) but no effect of channels, group or treatment-by-group interaction. There was a dose-dependent increase in uterine activity in both normal mares and those with delayed uterine clearance. A dose of 10 IU of oxytocin induced a larger number of uterine contractions (5.67+/-0.06) for a longer time (24.09+/-1.18 min) than the 5 IU (4.16+/-0.06 contractions and 16.31+/-1.18; P<0.01 min) or 2.5 IU dose (4.08+/-0.06 contractions and 17.61+/-1.18 min). The first intrauterine wave occurred most often near the tip of the horn in 10 of 12 recordings in normal mares and in 8 of 12 recordings in mares with delayed uterine clearance. It was then propagated from the middle of the horn to the uterine body just cranial to the cervix. There was no pattern of propagation for subsequent intrauterine pressure waves. We conclude that the difference in spontaneous clearance of the uterus between the 2 groups is not reflected in their response to exogenous oxytocin as determined by changes in intrauterine pressure.