Structure of the insulin receptor ectodomain reveals a folded-over conformation.

The insulin receptor is a phylogenetically ancient tyrosine kinase receptor found in organisms as primitive as cnidarians and insects. In higher organisms it is essential for glucose homeostasis, whereas the closely related insulin-like growth factor receptor (IGF-1R) is involved in normal growth and development. The insulin receptor is expressed in two isoforms, IR-A and IR-B; the former also functions as a high-affinity receptor for IGF-II and is implicated, along with IGF-1R, in malignant transformation. Here we present the crystal structure at 3.8 A resolution of the IR-A ectodomain dimer, complexed with four Fabs from the monoclonal antibodies 83-7 and 83-14 (ref. 4), grown in the presence of a fragment of an insulin mimetic peptide. The structure reveals the domain arrangement in the disulphide-linked ectodomain dimer, showing that the insulin receptor adopts a folded-over conformation that places the ligand-binding regions in juxtaposition. This arrangement is very different from previous models. It shows that the two L1 domains are on opposite sides of the dimer, too far apart to allow insulin to bind both L1 domains simultaneously as previously proposed. Instead, the structure implicates the carboxy-terminal surface of the first fibronectin type III domain as the second binding site involved in high-affinity binding.

Commercial enzyme immunoassay adapted for the detection of antibodies to hepatitis C virus in dried blood spots.

BACKGROUND: Dried blood spots (DBS) provide a convenient method for blood sample collection in many settings where the prevalence of infection with hepatitis C virus (HCV) is increasing. Consequently, HCV assays are required that produce reliable results using samples derived from DBS. OBJECTIVES AND STUDY DESIGN: The optimum buffer for the elution of samples from DBS was selected and the performance of a commercial enzyme immunoassay (EIA) was evaluated using these DBS eluates and paired plasma samples. RESULTS: DBS with paired plasma samples were compared using this modified commercial EIA, which was found to have an estimated sensitivity and specificity of approximately 100% for detecting anti-HCV antibodies in DBS. CONCLUSION: A DBS-based assay for the detection of antibodies to HCV will prove valuable for collecting epidemiological data in the field or in under resourced settings.

Incidence immunoassay for distinguishing recent from established HIV-1 infection in therapy-naive populations.

OBJECTIVE: To identify a specific marker of recent HIV-1 infection. DESIGN: The humoral immune response in individuals recently infected with HIV-1 was followed by analysing the antibody isotype-specific response generated to HIV-1 antigens in sequential samples collected during and following seroconversion. METHODS: Antibody isotype-specific HIV-1 Western blots were analysed to identify interactions indicative of recent HIV-1 infection. These responses were further quantified using an antibody isotype-specific enzyme-linked immunoabsorbent assay based on recombinant HIV-1 antigens. RESULTS: During maturation of the immune response to HIV-1 infection, a rapid and enduring IgG1 isotype response was seen to all the major proteins transcribed by env, gag and pol. An early transient peak of IgG3 reactivity to p24 was observed over an interval of approximately 1-4 months following HIV-1 infection. The presence of IgG3 reactivity to p24 permitted established infection to be distinguished from recently infected individuals during this time period. CONCLUSION: An assay for anti-p24 IgG3 reactivity would provide an estimate of the incidence of HIV infection that may be applicable for epidemiological surveys as well as for monitoring new infections during vaccine trials and for managing treatment programmes.