Document management and scanning in the physician's office.

A popular PC magazine recently conducted a survey asking readers whether a paperless office or Santa Claus was more believable. Santa Claus won. Health care professionals would make that same choice. They come from an educational process that teaches, if it is not on paper, it never happened. However, the necessity for fast and easy access to medical documents, particularly in managed care networks, is causing the paperless office to rush forward at breakneck speed.

Immunosuppression and intracellular calcium signaling in splenocytes from chicks infected with chicken anemia virus, CL-1 isolate.

Hematocrits, histopathology, concanavalin A-induced lymphocyte proliferation, intracellular calcium signaling, and lymphocyte subpopulations were analyzed over a 6-week period in individual chicks inoculated with the CL-1 isolate of chicken anemia virus. Lymphoid depletion/atrophy was present in the thymus and bone marrow by 11 days post-infection (PI). Anemia was present at 14 days PI. The mean lymphocyte proliferation stimulation index (SI) of the inoculated group was significantly lower than that of the control group at 11 days PI. This response was reversed at 18 days PI, when the SI of the inoculated group was significantly higher than that of the controls; values subsequently returned to baseline. The increase in intracellular calcium levels in CAV-infected chicks and controls paralleled the proliferative response. Percentages of CD3-, CD4-, CD8-, and natural-killer-positive-staining cells decreased significantly at 18 and 25 days PI. The most dramatic decrease occurred in the CD8-positive-staining cell population at 18 and 25 days PI.

Active cross-protection induced by a recombinant baculovirus expressing chimeric infectious bursal disease virus structural proteins.

The VP2 structural gene encoded in the large genomic segment A of the variant GLS strain of infectious bursal disease virus (IBDV) was modified to encode a neutralization epitope (B69), found only on classic strains of IBDV. A chimeric cDNA clone of the large segment A, encoding VP3, VP4, and the modified variant IBDV VP2 structural proteins, was expressed in a recombinant baculovirus. The chimeric protein expressed was assessed with a panel of neutralizing monoclonal antibodies (MAbs), and it contained not only all previously MAb-defined GLS variant strain epitopes but also the B69 neutralization epitope found on classic IBDV strains. Complete active protection was afforded to specific-pathogen-free chickens by a subunit chimeric vaccine against virulent challenge with the classic IM and STC strains, as well as against the variant E/Del and GLS IBDV strains. Compared with a previously tested recombinant subunit vaccine, which incorporated unmodified baculovirus-expressed large-segment A GLS proteins, the recombinant chimeric subunit vaccine resulted in markedly improved active cross-protection against classic IBDV challenge.

Active and passive protection against variant and classic infectious bursal disease virus strains induced by baculovirus-expressed structural proteins.

Infectious bursal disease virus (IBDV) is responsible for a highly immunosuppressive disease in young chickens which causes significant economic losses to the poultry industry worldwide. The structural protein genes (VP2, VP3 and VP4) of a variant IBDV strain (GLS) were expressed in insect cells using a baculovirus expression system. Susceptible chickens vaccinated with a single dose of the recombinant IBDV antigens were completely protected against challenge with two variant strains of IBDV (GLS and Delaware), and partially protected against the standard challenge strain (STC). A booster dose of the recombinant antigens induced higher levels of neutralizing antibodies and afforded complete protection against both variant and standard virus challenges. Specific-pathogen-free hens vaccinated with a single dose of the same subunit vaccine produced virus-neutralizing antibodies that were capable of passively protecting the progeny from infection with variant IBDV.

Molecular basis of antigenic variation in infectious bursal disease virus.

Four antigenically different strains of infectious bursal disease virus (IBDV), characterized by their reactivities with a panel of neutralizing monoclonal antibodies (MAbs), were selected to determine the molecular basis of antigenic variation. The large genome segment A, encoding the structural proteins of the U.S. variants GLS, DS326, E/Del and the vaccine strain D78, was cloned and sequenced. Comparison of the deduced amino acid sequences of the U.S. variants with other IBDV strains showed that most of the amino acid substitutions occur in the central region between residues 212 to 332, especially in the two hydrophilic regions between residues 212 to 223 and residues 314 to 324 of VP2 protein. By comparing the amino acid sequences of these variant viruses and their reactivities with IBDV specific MAbs, the putative amino acids involved in the formation of virus-neutralizing epitopes were identified. Comparison of the D78 versus PBG98 sequence showed that Gln at position 249 (Gln249) appears to be critical in binding with MAb B69. Similarly, comparison of the U.S. variant sequences with other serotype 1 sequences showed unique substitution(s) at residue Glu321 in GLS, residues Ile286, Asp318, Glu323 in E/Del, and residues Glu311 and Gln320 in DS326, which could be potential residue(s) involved in the recognition of MAb57, MAb67, and MAb179 epitopes, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Presence of lesions without virus replication in the thymus of chickens exposed to infectious bursal disease virus.

Specific-pathogen-free (SPF) chickens were exposed to the IM and VA isolates of virulent infectious bursal disease virus (IBDV). Both viruses induced rapidly progressing lymphoid cell depletion in the bursa. The bursal lesions persisted through the observation period of 16 days. The virus-exposed birds also had histologic lesions in the thymus. Thymic lesions peaked at 3-4 days postinoculation (PI) and then subsided. Immunofluorescence (IF) and antigen-capture enzyme-linked immunosorbent assay (ELISA) detected abundant viral antigen in the bursa, but not in the thymus, of chickens during the first week after infection with IM-IBDV or VA-IBDV. This result indicated that the presence of histologic lesions in the thymus was not associated with active infection and replication of the virus in thymic cells. Inoculation of homogenates of bursal and thymic tissues from virus-exposed chickens into embryonated chicken eggs revealed the presence of infectious virus from both tissues. We speculated that the virus recovered from thymus may have been contributed by virus-infected cells that were circulating through the thymus at the time when this tissue was homogenized.

Infectious bursal disease virus structural proteins expressed in a baculovirus recombinant confer protection in chickens.

Plasmids were prepared that contained cDNA segments of the large genomic segment A of infectious bursal disease virus (IBDV) strain GLS-5. The genes encoding the IBDV structural proteins (VP2, VP3 and VP4) were introduced into the baculovirus transfer vector pBlueBacI to obtain a recombinant baculovirus vIBD-7. When insect cells were infected with recombinant viruses, the result was synthesis of IBDV precursor proteins which were processed by the viral protease. The recombinant IBDV antigens were characterized by immunoprecipitation with monoclonal antibodies (MAbs) and polyclonal antiserum to IBDV, and by antigen-capture ELISA using a panel of IBDV-specific MAbs. The recombinant IBDV antigens closely resembled the native IBDV proteins and reacted with all the GLS-5 strain-specific neutralizing MAbs that recognize only conformational epitopes of IBDV. When susceptible chickens were inoculated with the recombinant IBDV antigens, virus-neutralizing antibodies were induced that conferred up to 79% protection against IBDV challenge.

Relationship of the enzyme-linked immunosorbent assay to indirect immunofluorescent antibody test for the detection of so-called chicken anemia agent antibodies in serum from broiler breeders.

Serum samples collected from breeder chickens ranging in age from 1 day to 55 weeks were tested for CAA antibodies by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescent antibody (IFA) test. The relationship of ELISA to IFA test was determined. The sensitivity of the ELISA relative to the IFA test was 82.64%, and the specificity of the ELISA relative to the IFA test was 56.25%. Agreement between the ELISA and the IFA test was highly significant (Kappa = 0.74, Z = 5.78). We concluded that the ELISA is as good as the IFA test for detecting CAA antibody in sera from chickens.

Development and comparison of serologic methods for diagnosing chicken anemia virus infection.

This paper describes the development of an indirect immunoperoxidase assay (IIP) and an indirect enzyme-linked immunosorbent assay (ELISA) for detecting antibodies to chicken anemia virus (VAC). The IIP assay developed used CAV-infected MDCC-MSB1 cells for detecting antibody to CAV, whereas the ELISA utilized gradient-purified immunoadsorbed CAV as the target antigen. The IIP and ELISA were compared with the standard indirect immunofluorescent antibody (IFA) assay, which is more conventionally used to screen chicken serum for antibodies against CAV. Comparative test results of 185 field samples of chicken serum by these three methods were in agreement 84% of the time. Both IFA and IIP assays yielded fewer positive tests than did the ELISA. IFA and IIP assays were in agreement 93% of the time, as compared with 91% agreement of IIP and ELISA results, or 84% agreement for comparative IFA and ELISA results.

A monoclonal antibody-based agar gel precipitin test for antigenic assessment of infectious bursal disease viruses.

Five monoclonal antibodies (MAbs) directed at different neutralization epitopes of infectious bursal disease virus (IBDV) precipitated IBDV antigens in double immunodiffusion. Based on the positive or negative reaction of some of the MAbs in agar gel precipitin tests (AGPT), four different antigenic species of IBDV could be discerned. Although the antigen-capture enzyme-linked immunosorbent assays (AC-ELISA) were more sensitive than AGPTs for differentiating IBDV types, use of the MAbs in AGPT did offer a useful and accessible technique for differentiating wild type IBDV directly from infected tissues taken in the field.

Naturally occurring-neutralizing monoclonal antibody escape variants define the epidemiology of infectious bursal disease viruses in the United States.

A panel of two non-neutralizing and six neutralizing monoclonal antibodies (Mabs) were used in antigen-capture enzyme immunoassays (AC-ELISA) to examine the antigenicity of 1301 wild type infectious bursal disease viruses (IBDV) isolated from different poultry flocks throughout the United States over a three year period. Analysis of these isolates with protective, neutralizing Mabs directed against the VP2 structural protein of IBDV showed that four antigenically distinct groups of serotype 1 IBDV could be separated on the basis of the presence or absence of one or more Mab defined, conformation-dependent, multivalent neutralization site. AC-ELISA reactivity patterns of the Mabs with isolates demonstrated that IBDV field populations were relatively antigenically homogeneous per premise isolation. Geographically, various antigenic species were more or less prevalent, or nearly absent. Competition analysis with neutralizing Mabs coupled with AC-ELISA results suggested that neutralization epitopes for IBDV are distinct, spatially arranged, yet closely linked. Of 5 Mab defined neutralization epitopes, shown to be related to protection from virulent challenge by Classic IBDV strains isolated prior to 1985, only two of the epitopes remain unaltered on the most recent emergent variant field strain of IBDV isolated.

Pathogenicity of CL-1 chicken anemia agent.

Twelve-day-old broiler-type chickens had hemorrhagic necrotic wing tips. After 10 blind subcultures in an MDCC-MSB1 cell line, a virus (so-called chick anemia agent [CAA]) was isolated and designated CL-1 CAA. Five-day-old specific-pathogen-free chicken embryos from a commercial breeder flock that were found not to possess antibody against CAA were infected with CL-1 virus via yolk-sac injection. Many (49%) infected embryos were small and apparently had died from severe systemic hemorrhage. Hatched chicks were small and had pale feathers, skin, skeletal muscles, bone marrow, and viscera. All infected chicks had small thymuses. These thymuses often were so small that they could not be found grossly (P = 0.002). Anemia occurred within 4 days post-hatch. Microscopically, all hematopoietic organs were markedly atrophic. Septic necrotizing lesions were seen only in organs from CL-1-injected chicks. Physicochemical and pathological characteristics of this virus indicate that it is similar to other isolates of CAA found in Europe and Japan.

Group and strain-specific neutralization sites of infectious bursal disease virus defined with monoclonal antibodies.

Two somatic cell hybridizations were performed utilizing splenocytes from mice immunized with one or more strains of infectious bursal disease virus (IBDV). Supernatants from hybridoma cell lines were initially screened by the enzyme-linked immunosorbent assay (ELISA) against multiple strains of IBDV. Cell lines that secreted antibodies with ELISA reactivity patterns of interest were cloned, and their monoclonal antibodies (MCAs) were subsequently tested in cross-virus-neutralization tests. Two of the nine MCAs selected exhibited strong neutralizing activity and precipitated IBDV antigens in agar gel precipitin tests as well. MCA B69 significantly neutralized only the cloned D78 strain of IBDV, whereas MCA R63 neutralized all IBDV strains (representing both serotype I and II viruses) against which it was tested. Results of competitive ELISAs that used the R63 and B69 MCAs showed that the two neutralization sites on the D78 strain were not overlapping.

Differentiation of infectious bursal disease viruses directly from infected tissues with neutralizing monoclonal antibodies: evidence of a major antigenic shift in recent field isolates.

Two neutralizing monoclonal antibodies (MCAs), R63 and B69, were used in antigen-capture enzyme immunoassays to verify the presence of infectious bursal disease virus (IBDV) in infected bursal tissues. The intra-serotype-common neutralization site defined by the R63 MCA was present on all IBDV isolates and laboratory strains tested. However, the neutralization site defined by the B69 MCA was found on only classic or older IBDV strains; it was not found on recently isolated variants of IBDV or on a majority of recent field viruses examined. The data suggest that a major antigenic shift in IBDV has occurred in the field and that this shift involves, at a minimum, the deletion or alteration of one of two neutralization sites previously found on classic IBDV strains.

Development of and serologic evaluation of acquired immunity to Cryptosporidium baileyi by broiler chickens.

Eighteen 2-wk-old broiler chickens that were inoculated orally with oocysts of Cryptosporidium baileyi (Group B) became infected, shed large numbers of oocysts in their feces on Days 6 to 12 post inoculation (PI), and suddenly cleared the parasites from the mucosal epithelium of the bursa of Fabricius (BF), cloaca, or both BF and cloaca on Days 14 to 16 PI. Eighteen uninoculated birds (Group A) did not shed oocysts during this time period. Five days after all birds in Group B stopped shedding oocysts, the 36 chickens comprising both groups were challenged orally with C. baileyi oocysts. At the time of necropsy, 10 days after oral challenge, all Group A birds (previously uninfected, challenged) had heavy C. baileyi infections in the mucosal epithelium of the BF or cloaca. No parasites were found in the BF or cloaca of the Group B birds (previously infected, recovered, challenged) at the time of necropsy. These data demonstrate that a single intestinal infection with C. baileyi can elicit an immune response of sufficient magnitude to clear the parasite from the intestinal (BF and cloaca) mucosa and to make broiler chickens resistant to subsequent oral challenge with oocysts of the same species. Development of resistance to reinfection was accompanied by the appearance of serum antibodies to C. baileyi that were detectable by two Cryptosporidium-specific assays; an indirect immunofluorescent antibody assay and an enzyme-linked immunosorbent antibody assay (ELISA). The ELISA described herein can now be incorporated into serologically based health monitoring programs.

Serologic incidence of Cryptosporidium in Delmarva broiler flocks.

Banked serum samples collected from an industry-wide serologic survey of eighteen Delmarva broiler flocks conducted in 1985 were evaluated for the presence of Cryptosporidium- specific antibodies in an indirect enzyme-linked immunosorbent assay (ELISA). Evaluation of sera collected at 49-days posthatch showed that 38% of the broiler flocks were serologically positive, whereas 50% of samples obtained from flocks at 63-days during an extended growout were positive. From a performance standpoint, the top nine flocks in the study were essentially negative at the 49-day sampling. In order to more firmly establish the serologic prevalence of Cryptosporidium in Delmarva broiler flocks, a second serologic survey was conducted early in 1987. In this study, an estimated 22% of the 454 broiler flocks sampled at approximately 49 days of age were positive for Cryptosporidium. The negative Cryptosporidium serology in the top 25% of these flocks was associated with better performance, but positive Cryptosporidium serology was not clearly correlated with poor performance. Remarkable differences between Cryptosporidium serologic exposure rates of the growout companies were observed, with some companies having exposure rates as high as 40%, and others rates of less than 3%.

Identification of species-specific and interspecies-specific polypeptides of Mycoplasma gallisepticum and Mycoplasma synoviae.

Temporal antisera (TA) prepared in susceptible Leg-horn-type chickens against Mycoplasma gallisepticum and M synoviae were evaluated to determine the extent of cross-reactivity in ELISA and hemagglutination inhibition tests. Species-specific and interspecies-specific polypeptides were identified after electrophoretic separation and protein immunoblotting with reference antisera, TA, and a monoclonal antibody specific for M gallisepticum. Mycoplasma gallisepticum antiserum cross-reacted with M synoviae polypeptides in ELISA and TA immunoblots. Two major M synoviae polypeptides (88 and 53 kilodaltons [kD]) cross-reacted with M gallisepticum antisera in TA immunoblots. An M gallisepticum polypeptide of 70 kD cross-reacted with M synoviae in TA immunoblots. In contrast, M gallisepticum and M synoviae reference antisera cross-reacted when immunoblotted with heterologous antigens. A monoclonal antibody specific for M gallisepticum bound to a 69-kD polypeptide in lectin-purified and whole-cell M gallisepticum protein fractions in immunoblot assays. The lectin-purified fraction hemagglutinated chicken RBC. Seemingly, the 69-kD polypeptide may constitute all or part of the M gallisepticum hemagglutinin.

Characterization of a battery of monoclonal antibodies for differentiation of Newcastle disease virus and pigeon paramyxovirus-1 strains.

Twenty monoclonal antibodies (MCAs) prepared against the velogenic GB-Texas strain of Newcastle disease virus (NDV) and the type 1 pigeon paramyxovirus (PPMV-1) were characterized and examined as potential immunodiagnostic reagents. All MCAs generated were found to bind specifically, but with varying reactivity, to various NDV strains in direct binding assays. In addition, MCA 15C4 neutralized and inhibited hemagglutination (HA) of all lentogenic, mesogenic, and velogenic NDV strains tested but not the PPMV-1 strain. Antibody 10D11 also inhibited HA activity, but inhibition was more selective and limited to the mesogenic and domestic or indigenous velogenic strains of NDV. MCA 79 reacted in all serologic assays with an antigenic site common to all serotype 1 avian paramyxoviruses. Passive immunization studies involving three different neutralizing MCAs (35, 79, and 15C4) showed that enhanced, but not complete, protection against virulent NDV challenge was provided when the three MCAs were administered in combination.