A prospective study of real-time panfungal PCR for the early diagnosis of invasive fungal infection in haemato-oncology patients.

A blinded prospective study was performed to determine whether screening of whole blood using a real-time, panfungal polymerase chain reaction (PCR) technique could predict the development of invasive fungal infection (IFI) in immunocompromised haemato-oncology patients. In all, 78 patients (125 treatment episodes) were screened twice weekly by real-time panfungal PCR using LightCyclertrade mark technology. IFI was documented in 19 treatment episodes (five proven, three probable and 11 possible), and in 12, PCR was sequentially positive. PCR positivity occurred in: 4/5 proven; 2/3 probable; 6/11 possible; and 29/106 with no IFI. In 8/12 with IFI and sequentially positive PCR results, PCR positivity occurred before (median 19.5 days) and in 4/12 (median 10.5 days) after the initiation of empirical antifungal therapy. Based on sequential positive results for proven/probable IFI sensitivity, specificity, positive predictive value and negative predictive value were 75, 70, 15 and 98%, respectively. Real-time panfungal PCR is a sensitive tool for the early diagnosis of IFI in immunocompromised haemato-oncology patients. It may be most useful as a screening method in high-risk patients, either to direct early pre-emptive antifungal therapy or to determine when empirical antifungal therapy can be withheld in patients with antibiotic--resistant neutropenic fever. However, these strategies require further assessment in comparative clinical trials.

Protein purification with vapor-phase carbon dioxide.

Gaseous CO2 was used as an antisolvent to induce the fractional precipitation of alkaline phosphatase, insulin, lysozyme, ribonuclease, trypsin, and their mixtures from dimethylsulfoxide (DMSO). Compressed CO2 was added continuously and isothermally to stationary DMSO solutions (gaseous antisolvent, GAS). Dissolution of CO2 was accompanied by a pronounced, pressure-dependent volumetric expansion of DMSO and a consequent reduction in solvent strength of DMSO towards dissolved proteins. View cell experiments were conducted to determine the pressures at which various proteins precipitate from DMSO. The solubility of each protein in CO2-expanded DMSO was different, illustrating the potential to separate and purify proteins using gaseous antisolvents. Polyacrylamide gel electrophoresis in sodium dodecyl sulfate (SDS-PAGE) was used to quantify the separation of lysozyme from ribonuclease, alkaline phosphatase from insulin, and trypsin from catalase. Lysozyme biological activity assays were also performed to determine the composition of precipitates from DMSO initially containing lysozyme and ribonuclease. SDS-PAGE characterizations suggest that the composition and purity of solid-phase precipitated from a solution containing multiple proteins may be accurately controlled through the antisolvent's pressure. Insulin, lysozyme, ribonuclease, and trypsin precipitates recovered substantial amounts of biological activity upon redissolution in aqueous media. Alkaline phosphatase, however, was irreversibly denaturated. Vapor-phase antisolvents, which are easily separated and recovered from proteins and liquid solvents upon depressurization, appear to be a reliable and effective means of selectively precipitating proteins.

Leader protein of foot-and-mouth disease virus is required for cleavage of the p220 component of the cap-binding protein complex.

Suppression of host protein synthesis in cells infected by poliovirus and certain other picornaviruses involves inactivation of the cap-binding protein complex. Inactivation of this complex has been correlated with the proteolytic cleavage of p220, a component of the cap-binding protein complex. Since picornaviral RNA is not capped, it continues to be translated as the cap-binding protein complex is inactivated. The cleavage of p220 can be induced to occur in vitro, catalyzed by extracts from infected cells or by reticulocyte lysates translating viral RNA. Expression of polioviral protease 2A is sufficient to induce p220 cleavage, and the presence in 2A of an 18-amino-acid sequence representing a putative cysteine protease active site correlates with the ability of different picornaviruses to induce p220 cleavage. Foot-and-mouth disease virus (FMDV) infection induces complete cleavage of p220, yet the FMDV genome codes for a 2A protein of only 16 amino acids, which does not include the putative cysteine protease active site. Using cDNA plasmids encoding various regions of the FMDV genome, we have determined that the leader protein is required to initiate p220 cleavage. This is the first report of a function for the leader protein, other than that of autocatalytic cleavage from the FMDV polyprotein.

Characterization of a nonstructural phosphoprotein of two orbiviruses.

A phosphorylated nonstructural protein, NS2, was detected in bluetongue and African horsesickness virus (BTV and AHSV) infected-radiolabeled-cell lysates by electrophoresis on SDS-polyacrylamide gels (SDS-PAGE). The NS2 proteins of both viruses have similar migration on one-dimensional (1D) 10% SDS-PAGE. Examination of infected cell lysates on two-dimensional (2D) gels (isoelectric focusing followed by SDS-PAGE) separated two phosphorylated isoelectric forms of BTV NS2 and four phosphorylated forms of AHSV NS2. The isoelectric points of both species of BTV NS2 were acidic relative to all forms of AHSV NS2. Nonphosphorylated NS2 polypeptides were not detected by 2D gels. A nonphosphorylated host protein, which comigrated with NS2 on 1D gels, could be distinguished from viral proteins by isoelectric focusing on 2D gels. High performance liquid chromatography (HPLC) elution profiles of NS2 tryptic peptides from the two orbiviruses were compared. Three 32P-labeled tryptic peptides were generated from both AHSV and BTV NS2 proteins, which had been isolated and eluted from SDS-polyacrylamide gels. The elution profile from reverse phase HPLC was very similar for the tryptic phosphopeptides; in contrast, 35S-labeled tryptic peptides displayed considerable differences in elution profiles for the two NS2 proteins. Phosphoamino acid analysis revealed only phosphoserine in hydrolysates of BTV and AHSV NS2.

New approaches to animal vaccines utilizing genetic engineering.

Control of infectious diseases in livestock is an important determinant in the success of a nation's effort to efficiently meet its need for animal products. Genetic engineering offers many new options in the design of animal vaccines. Monoclonal antibodies, DNA cloning, recombination, and transfection are examples of techniques that facilitate innovative strategies in antigen identification, production, and delivery. This article reviews the use of genetic engineering in the production of vaccines directed against foot-and-mouth disease virus and other important pathogens of animals. The advantages and disadvantages of vaccines produced through the use of genetic engineering are discussed.

Proteolytic processing of foot-and-mouth disease virus polyproteins expressed in a cell-free system from clone-derived transcripts.

All picornaviral genes are expressed as a single, large polyprotein, which is proteolytically processed into the system produces functional proteins, including viral protease 3C, which plays a major role in processing the precursor proteins. To study the function of the two putative proteases 3C and leader (L) in processing, we constructed several cDNA plasmids encoding various regions of the FMDV type A12 genome. These plasmids, containing FMDV cDNA segments under the control of the T7 promoter, were transcribed in vitro by using T7 RNA polymerase and then translated in rabbit reticulocyte lysates. The expressed FMDV gene products were identified by immunoprecipitation with specific antisera and analyzed by gel electrophoresis. The results demonstrate the following: (i) the leader protein, L, is processed from the structural protein precursor, P1, in the absence of any P2 or P3 region proteins; (ii) protein 2A remains associated with the structural protein precursor, P1, rather than the precursor, P2; (iii) the processing of the P1-2A/P2 junction is not catalyzed by 3C or L; (iv) the proteolytic processing of polyproteins from the structural P1 region (except VP4/VP2) and the nonstructural P2 and P3 region is catalyzed by 3C.

Immunological cross-reactivity between carbamyl phosphate synthetases I, II, and III.

Four types of carbamyl phosphate synthetase have been previously distinguished on the basis of catalytic properties and metabolic role. Immunoblot assay has now demonstrated cross-reactivity between rat liver carbamyl phosphate synthetase I and the following other three types of synthetases: carbamyl phosphate synthetase II from SV40-transformed baby hamster kidney cells, carbamyl phosphate synthetase III from spiny dogfish liver and from largemouth bass liver, and Escherichia coli carbamyl phosphate synthetase. The strongest cross-reactivity was observed between carbamyl phosphate synthetases I and III. These findings indicate at least partial structural homology among the various synthetases and constitute the first demonstration of such a relationship among the enzymes.

Postdate pregnancy: utilization of contraction stress testing for primary fetal surveillance.

Six hundred seventy-nine postdate study patients surveyed with a contraction stress test (CST) protocol had no perinatal deaths and no greater morbidity than that found in a 500-patient normal term control population. However, the postdate study did have a significantly increased risk of intrapartum fetal distress, meconium-stained amniotic fluid, macrosomia, and cesarean section for both failed progress of labor and fetal distress. Among the postdate study group there was a high incidence of patients with abnormal CST results (39%); these patients with abnormal CST results were at increased risk for subsequent intrapartum fetal distress. Seventy-five percent of the postdate study patients entered labor spontaneously and delivery was elected because of abnormal CST results in only 5.4%. The data presented here support the use of contraction stress testing for primary surveillance of the prolonged pregnancy and they suggest that only one in 20 patients past 42 weeks' gestation will require intervention for fetal indications with this approach.

Continuous measurement of vascular diameters via television microscopy.

In the past 10 years, microcirculation studies have emphasized quantitative measurements of microvascular diameters to characterize in vivo small vessel responses to experimental forcings such as hemorrhage, anesthesia, and hypoxia. We have developed an instrument to obtain continuous diameter measurements of a small artery and vein (40-200 mu) via closed-circuit television microscopy. The outputs are analog voltages proportional to the vessel diameters. Video processing is limited to two image areas termed "windows," which are defined by markers on the monitor and positioned over separate vertically aligned vessels. Each vessel, which appears darker than the surrounding tissue, is located by comparing the video signal to a reference voltage that adapts to changes in the relative contrast within the window. In the presence of a vessel, a ramp voltage is generated, the peak value of which is proportional to the vessel diameter. These peaks are averaged over the 15-video lines of the window and over several video frames to reduce noise sensitivity. In order to accommodate preparation movement such as skeletal muscle contraction, window position and width automatically adapt to changes in vessel position and width. Visual verification of system performance is provided by clamping the video signal to white on that portion of the image which the instrument identifies as vessel.