RESUMEN
Feral populations of aoudad (Ammotragus lervia) occur in Texas bighorn sheep (Ovis canadensis) habitat and pose several conceptual ecological threats to bighorn sheep re-establishment efforts. The potential threat of disease transmission from aoudad to bighorn sheep may exacerbate these issues, but the host competency of aoudad and subsequent pathophysiology and transmissibility of pneumonic pathogens involved in the bighorn sheep respiratory disease complex is largely unknown. Because the largest population-limiting diseases of bighorn sheep involve pathogens causing bronchopneumonia, we evaluated the host competency of aoudad for Mycoplasma ovipneumoniae and leukotoxigenic Pasteurellaceae. Specifically, we described the shedding dynamics, pathogen carriage, seroconversion, clinical patterns, and pathological effects of experimental infection among wild aoudad held in captivity. We found that aoudad are competent hosts capable of maintaining and intraspecifically transmitting Mycoplasma ovipneumoniae and Pasteurellaceae and can shed the bacteria for 53 days after exposure. Aoudad developed limited clinical signs and pathological findings ranged from mild chronic lymphohistiocytic bronchointerstitial pneumonia to severe and acute suppurative pneumonia, similarly, observed in bighorn sheep infected with Mycoplasma spp. and Pasteurellaceae bacteria, respectively. Furthermore, as expected, clinical signs and lesions were often more severe in aoudad inoculated with a combination of Mycoplasma ovipneumoniae and Pasteurellaceae as compared to aoudad inoculated with only Mycoplasma ovipneumoniae. There may be evidence of interindividual susceptibility, pathogenicity, and/or transmissibility, indicated by individual aoudad maintaining varying severities of chronic infection who may be carriers continuously shedding pathogens. This is the first study to date to demonstrate that aoudad are a conceptual disease transmission threat to sympatric bighorn sheep populations due to their host competency and intraspecific transmission capabilities.
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Mycoplasma ovipneumoniae , Pasteurellaceae , Neumonía por Mycoplasma , Animales , Mycoplasma ovipneumoniae/patogenicidad , Pasteurellaceae/patogenicidad , Neumonía por Mycoplasma/transmisión , Neumonía por Mycoplasma/veterinaria , Neumonía por Mycoplasma/microbiología , Ovinos , Borrego Cimarrón/microbiología , Rumiantes/microbiología , Enfermedades de las Ovejas/transmisión , Enfermedades de las Ovejas/microbiología , Infecciones por Pasteurellaceae/transmisión , Infecciones por Pasteurellaceae/microbiología , Infecciones por Pasteurellaceae/veterinaria , FemeninoRESUMEN
Improved methods are needed to prevent wildlife deaths from anthrax. Caused by Bacillus anthracis, naturally occurring outbreaks of anthrax are frequent but unpredictable. The commercially available veterinary vaccine is labeled for subcutaneous injection and is impractical for large-scale wildlife vaccination programs; therefore, oral vaccination is the most realistic method to control and prevent these outbreaks. We reported the induction of an anthrax-specific lethal toxin (LeTx) neutralizing antibody response in mice following oral vaccination with alginate microcapsules containing B. anthracis Sterne strain 34F2 spores, coated with poly-L-lysine (PLL) and vitelline protein B (VpB). We continued evaluating our novel vaccine formulation through this proof-of-concept study in white-tailed deer (WTD; Odocoileus virginianus; n = 9). We orally vaccinated WTD via needle-free syringe with three formulations of the encapsulated vaccine: 1) PLL-VpB-coated microcapsules with 107-8 spores/ml (n = 5), 2) PLL-VpB-coated microcapsules with 109-10 spores/ml (n = 2), and 3) PLL-coated microcapsules with 109-10 spores/ml (n = 2). Although the limited sample sizes require continued experimentation, we observed an anthrax-specific antibody response in WTD serum following oral vaccination with PLL-coated microcapsules containing 109 spores/ ml. Furthermore, this antibody response neutralized anthrax LeTx in vitro, suggesting that continued development of this vaccine may allow for realistic wildlife anthrax vaccination programs.
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Vacunas contra el Carbunco , Carbunco , Bacillus anthracis , Ciervos , Enfermedades de los Roedores , Animales , Ratones , Carbunco/prevención & control , Carbunco/veterinaria , Anticuerpos Neutralizantes , Cápsulas , Espectroscopía de Resonancia por Spin del Electrón/veterinaria , Vacunación/veterinaria , Animales Salvajes , Anticuerpos AntibacterianosRESUMEN
Outbreaks of anthrax, caused by the soilborne bacterium Bacillus anthracis, are a continuous threat to free-ranging livestock and wildlife in enzootic regions of the United States, sometimes causing mass mortalities. Injectable anthrax vaccines are commercially available for use in livestock, and although hand injection is not a cost- or time-effective long-term management plan for prevention in wildlife, it may provide a tool for managers to target selectively animals of high conservation or economic value. Vaccine-induced anthrax-specific antibody responses have been reported previously in white-tailed deer (Odocoileus virginianus), but the protective nature was not determined. In this study, five white-tailed deer were subcutaneously vaccinated with one dose (1 mL) of the Anthrax Spore Vaccine. Eight blood collections by jugular venipuncture were conducted over 146 d to measure the anthrax-specific antibody response in each deer's serum over time. Antibodies were first detected by ELISA and later with toxin neutralization assays to estimate in vitro protection. Average peak absorbance by ELISA occurred at 14 d postvaccination, whereas average peak in vitro protection occurred at 28 d postvaccination. Observed in vitro protection on average for white-tailed deer after this single-dose vaccination protocol lasted 42-56 d postvaccination, although three individuals still maintained lethal toxin-neutralizing serum antibody titers out to 112 d postvaccination. Vaccination responses were variable but effective to some degree in all white-tailed deer.
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Vacunas contra el Carbunco , Carbunco , Bacillus anthracis , Ciervos , Humanos , Animales , Carbunco/prevención & control , Carbunco/veterinaria , Carbunco/epidemiología , Ciervos/microbiología , Esporas Bacterianas , Animales Salvajes/microbiología , Vacunación/veterinaria , Anticuerpos Neutralizantes , Anticuerpos Antibacterianos , Antígenos BacterianosRESUMEN
We unsuccessfully attempted to safely chemically immobilize a roan antelope (Hippotragus equinus) with a premixed combination of medetomidine (5 mg/mL) and ketamine (150 mg/mL) for injury treatment. This dose (0.066 mg/kg medetomidine and 1.96 mg/kg ketamine) produced poor quality of immobilization, probably exacerbated by stimulation before completing induction.
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Ketamina , Medetomidina , Animales , Medetomidina/farmacologíaRESUMEN
After identifying a captive herd of white-tailed deer in central Texas with >94% seroprevalence with SARS-CoV-2 neutralizing antibodies in September 2021, we worked retrospectively through archived serum samples of 21 deer and detected seroconversion of all animals between December 2020 and January 2021. We then collected prospective samples to conclude that the duration of persistence of neutralizing antibodies is at least 13 months for 19 (90.5%) of the animals, with two animals converting to seronegative after six and eight months. Antibody titres generally waned over this time frame, but three deer had a temporary 4- to 8-fold increases in plaque reduction neutralization test titres over a month after seroconversion; anamnestic response cannot be ruled out.
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COVID-19 , Ciervos , Animales , Anticuerpos Neutralizantes , COVID-19/veterinaria , Estudios Prospectivos , Estudios Retrospectivos , SARS-CoV-2 , Estudios Seroepidemiológicos , Texas/epidemiologíaRESUMEN
We evaluated the safety and efficacy of nalbuphine (40 mg/mL), plus medetomidine (10 mg/mL), plus azaperone (10 mg/mL) under the premixed label NalMed-A. From January to March 2020, 10 aoudad (Ammotragus lervia) were immobilized via dart-gun for seven separate sampling periods for a total of 45 recorded individual immobilization events. Induction and reversal times with NalMed-A were 5.53±2.61 min and (following atipamezole administration) 5.08±2.43 min while previous studies with alpha-2 agonist-ketamine combinations gave median and average induction times of 4.6 min and 11.2 min using medetomidine-ketamine and xylazine-ketamine, respectively. Overall, NalMed-A adequately immobilized aoudad, with 13% incidence of hyperthermia and 2.22% mortality when delivered via dart.
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Ketamina , Nalbufina , Animales , Azaperona/farmacología , Combinación de Medicamentos , Hipnóticos y Sedantes/farmacología , Inmovilización/veterinaria , Ketamina/farmacología , Medetomidina/farmacología , Nalbufina/farmacología , RumiantesRESUMEN
Free-ranging white-tailed deer (Odocoileus virginianus) across the United States are increasingly recognized for infection and transmission of SARS-CoV-2. Through a cross-sectional study of 80 deer at three captive cervid facilities in central and southern Texas, we provide evidence of 34 of 36 (94.4%) white-tailed deer at a single captive cervid facility seropositive for SARS-CoV-2 by neutralization assay (PRNT90), with endpoint titers as high as 1,280. In contrast, all tested white-tailed deer and axis deer (Axis axis) at two other captive cervid facilities were seronegative, and SARS-CoV-2 RNA was not detected in respiratory swabs from deer at any of the three facilities. These data support transmission among captive deer that cannot be explained by human contact for each infected animal, as only a subset of the seropositive does had direct human contact. The facility seroprevalence was more than double of that reported from wild deer, suggesting that the confined environment may facilitate transmission. Further exploration of captive cervids and other managed animals for their role in the epizootiology of SARS-CoV-2 is critical for understanding impacts on animal health and the potential for spillback transmission to humans or other animal taxa. IMPORTANCE As SARS-CoV-2 vaccine coverage of the human population increases and variants of concern continue to emerge, identification of the epidemiologic importance of animal virus reservoirs is critical. We found that nearly all (94.4%) of the captive white-tailed deer at a cervid facility in central Texas had neutralizing antibodies for SARS-CoV-2. This seroprevalence is over double than that which has been reported from free-ranging deer from other regions of the United States. Horizontal transmission among deer may be facilitated in confinement. Tracking new infections among wild and confined deer is critical for understanding the importance of animal reservoirs for both veterinary and human health.
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COVID-19 , Ciervos , Animales , COVID-19/epidemiología , COVID-19/veterinaria , Vacunas contra la COVID-19 , Estudios Transversales , Humanos , SARS-CoV-2 , Estudios Seroepidemiológicos , Texas/epidemiologíaRESUMEN
OBJECTIVE: To evaluate the effects of different polyphenols and solvents on dentin collagen's crosslinking interactions and biostabilization against MMPs and collagenase degradation. METHODS: Two polyphenols [proanthocyanidin (PA) and quercetin (QC)] with different water solubility were prepared as treatment solutions using ethanol (EtOH) or dimethyl sulfoxide (DMSO) as solvents. 6-um-thick dentin films were microtomed from dentin slabs of third molars. Following demineralization, films or slabs were subject to 60-s treatment (PA or QC) or no treatment (control) with subsequent extended-rinse with original solvent (EtOH or DMSO) or distilled water (DW). Collagen crosslinking interactions were assessed by FTIR. Biostability was assessed through endogenous MMPs activity via confocal laser scanning microscopy, and exogenous collagenase degradation via weight loss, hydroxyproline release and SEM. Finally, direct collagenase inactivation was also evaluated. Data were analyzed by three-way ANOVA and post-hoc tests (α=0.05%). RESULTS: Distinct effects of two polyphenols and solvents on collagen crosslinking and biostabilization were observed. Higher crosslinking and biostability efficacy occurred with PA than QC (p<0.001) that demonstrated negligible collagen interactions. With DMSO solvent, efficacy results were significantly reduced with both polyphenols (p<0.05). DMSO-rinse further weakened interactions of PA with collagen, diminishing biostability (p<0.05). Low biostability was detected with QC and DW-rinse, suggesting direct enzymatic inhibition due to physical presence in collagen. SIGNIFICANCE: Collagen crosslinking interactions and biostability depend on polyphenol chemical characteristics. Treatment-solution solvents may affect interactions between polyphenols and collagen, specifically, DMSO showed detrimental effects on collagen crosslinking and biostability and should be used with caution.
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Recubrimiento Dental Adhesivo , Recubrimientos Dentinarios , Colágeno , Dentina , Polifenoles , Solventes , Resistencia a la TracciónRESUMEN
OBJECTIVES: Error simulation models have been used to understand the relationship between analytical performance and clinical outcomes. We developed an error simulation model to understand the effects of method bias and precision on misclassification rate for neonatal hyperbilirubinemia using an age-adjusted risk assessment tool. METHODS: For each of 176 measured total bilirubin (TSBM) values, 10,000 simulated total bilirubin (TBS) values were generated at each combination of bias and precision conditions for coefficient of variation (CV) between 1 and 15%, and for biases between -51.3 µmol/L and 51.3 µmol/L (-3 and 3 mg/dL) fixed bias. TBS values were analyzed to determine if they were in the same risk zone as the TSBM value. We then calculated sensitivity and specificity for prediction of ≥75th percentile for postnatal age values as a function of assay bias and precision, and determined the rate of critical errors (≥95th percentile for age TSBM with <75th percentile TBS). RESULTS: A sensitivity >95% for predicting ≥75th percentile bilirubin values was observed when there is a positive fixed bias of greater than 17.1 µmol/L (1.0 mg/dL) and CV is maintained ≤10%. A specificity >70% for predicting <75th percentile bilirubin values was observed when positive systematic bias was 17.1 µmol/L (1 mg/dL) or less at CV ≤ 10%. Critical errors did not occur with a frequency >0.2% until negative bias was -17.1 µmol/L (-1 mg/dL) or lower. CONCLUSIONS: A positive systematic bias of 17.1 µmol/L (1 mg/dL) may be optimal for balancing sensitivity and specificity for predicting ≥75th percentile TSB values. Negative systematic bias should be avoided to allow detection of high risk infants and avoid critical classification errors.
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Hiperbilirrubinemia Neonatal , Sesgo , Bilirrubina , Humanos , Hiperbilirrubinemia Neonatal/diagnóstico , Lactante , Recién Nacido , Tamizaje Neonatal , Valor Predictivo de las Pruebas , Medición de Riesgo , Sensibilidad y EspecificidadRESUMEN
An oral vaccine against anthrax (Bacillus anthracis) is urgently needed to prevent annual anthrax outbreaks that are causing catastrophic losses in free-ranging livestock and wildlife worldwide. The Sterne vaccine, the current injectable livestock vaccine, is a suspension of live attenuated B. anthracis Sterne strain 34F2 spores (Sterne spores) in saponin. It is not effective when administered orally and individual subcutaneous injections are not a practical method of vaccination for wildlife. In this study, we report the development of a microencapsulated oral vaccine against anthrax. Evaluating Sterne spore stability at varying pH's in vitro revealed that spore exposure to pH 2 results in spore death, confirming that protection from the gastric environment is of main concern when producing an oral vaccine. Therefore, Sterne spores were encapsulated in alginate and coated with a protein shell containing poly-L-lysine (PLL) and vitelline protein B (VpB), a non-immunogenic, proteolysis resistant protein isolated from Fasciola hepatica. Capsule exposure to pH 2 demonstrated enhanced acid gel character suggesting that alginate microcapsules provided the necessary protection for spores to survive the gastric environment. Post vaccination IgG levels in BALBc/J mouse serum samples indicated that encapsulated spores induced anti-anthrax specific responses in both the subcutaneous and the oral vaccination groups. Furthermore, the antibody responses from both vaccination routes were protective against anthrax lethal toxin in vitro, suggesting that further optimization of this vaccine formulation may result in a reliable oral vaccine that will conveniently and effectively prevent anthrax in wildlife populations.
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OBJECTIVE: Determine whether introduction of a reformulated bilirubin reagent, the Roche bilirubin Gen.3 assay, changed the relationship between BiliChek transcutaneous bilirubin (TcB) and total serum bilirubin (TSB). DESIGN AND METHODS: TcB results from term infants in the level 1 nursery obtained within one hour of a TSB were reviewed over two periods, six months before and after the conversion from the previous generation Roche bilirubin reagent to the new Roche Gen.3 bilirubin assay. TcB measurements were performed using BiliChek transcutaneous devices (Respironics, Marietta GA). Distribution of TSB results, and TcB minus TSB bias, were compared before and after introduction of the reformulated Roche bilirubin Gen.3 assay. Median and interquartile range (IQR) TSB values and bias were calculated. A statistical difference between median TSB values and bias were assessed using Man-Whitney test. RESULTS: A total of 301 paired TcB and TSB results were obtained, 172 before and 129 after implementation of the reformulated Roche bilirubin Gen.3 reagent. Median (IQR) TSB was 7.8 (6.8-8.7)mg/dL (133.3 (116.3-148.8) µmol/L) before and 7.6 (6.7-8.4)mg/dL (130 (114.6-143.6)µmol/L) after implementation of the reformulated reagent (pâ¯=â¯.1373). Median (IQR) bias between TcB and TSB was 2.9 (2.2-3.7) mg/dL (49.6 (37.6-63.3)µmol/L) before the reformulated reagent was implemented; and did not change at 2.9 (2.1-3.9) mg/dL (49.6 (35.9-66.7)µmol/L) after implementation (pâ¯=â¯.8242). CONCLUSION: Implementation of the reformulated Roche bilirubin Gen.3 reagent did not affect the relationship between BiliChek transcutaneous and total serum bilirubin; thus no changes were needed to the neonatal TcB screening protocol as a result of the new bilirubin reagent.
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Bilirrubina/sangre , Análisis Químico de la Sangre/instrumentación , Análisis Químico de la Sangre/métodos , Femenino , Humanos , Lactante , Recién Nacido , MasculinoRESUMEN
Models for the stabilization of an inverted pendulum figure prominently in studies of human balance control. Surprisingly, fluctuations in measures related to the vertical displacement angle for quietly standing adults with eyes closed exhibit chaos. Here we show that small-amplitude chaotic fluctuations ("microchaos") can be generated by the interplay between three essential components of human neural balance control, namely time-delayed feedback, a sensory dead zone, and frequency-dependent encoding of force. When the sampling frequency of the force encoding is decreased, the sensitivity of the balance control to changes in the initial conditions increases. The sampled, time-delayed nature of the balance control may provide insights into why falls are more common in the very young and the elderly.
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Retroalimentación Fisiológica/fisiología , Equilibrio Postural/fisiología , Adulto , Anciano , Humanos , Factores de TiempoRESUMEN
We introduce a method to produce continuous polydimethylsiloxane (PDMS) silicone filaments on the order of 0.5 m long and 100 µm in diameter. The approach overcomes traditional limitations in silicone drawing by partially precuring the polymer and drawing through a tube furnace. We characterize the filaments' mechanical properties, and their ability to switch hydrophobicity by UV-ozone and corona discharge patterning. The flexible filaments' dynamic properties were evaluated by way of athermal acoustic excitation at the air-water interface, revealing conformational reconfigurability consistent with a wormlike chain model. We envision applications in rapid prototyping and as a platform for model foldamer studies.
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Chronic wasting disease (CWD) is an invariably fatal transmissible spongiform encephalopathy of white-tailed deer, mule deer, elk, and moose. Despite a 100% fatality rate, areas of high prevalence, and increasingly expanding geographic endemic areas, little is known about the population-level effects of CWD in deer. To investigate these effects, we tested the null hypothesis that high prevalence CWD did not negatively impact white-tailed deer population sustainability. The specific objectives of the study were to monitor CWD-positive and CWD-negative white-tailed deer in a high-prevalence CWD area longitudinally via radio-telemetry and global positioning system (GPS) collars. For the two populations, we determined the following: a) demographic and disease indices, b) annual survival, and c) finite rate of population growth (λ). The CWD prevalence was higher in females (42%) than males (28.8%) and hunter harvest and clinical CWD were the most frequent causes of mortality, with CWD-positive deer over-represented in harvest and total mortalities. Survival was significantly lower for CWD-positive deer and separately by sex; CWD-positive deer were 4.5 times more likely to die annually than CWD-negative deer while bucks were 1.7 times more likely to die than does. Population λ was 0.896 (0.859-0.980), which indicated a 10.4% annual decline. We show that a chronic disease that becomes endemic in wildlife populations has the potential to be population-limiting and the strong population-level effects of CWD suggest affected populations are not sustainable at high disease prevalence under current harvest levels.
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Tecnología de Sensores Remotos/métodos , Enfermedad Debilitante Crónica/epidemiología , Animales , Animales Salvajes , Ciervos , Femenino , Masculino , Mortalidad , Densidad de Población , PrevalenciaRESUMEN
OBJECTIVE To compare the humoral response between sheep vaccinated with a killed-virus (KV) vaccine and those vaccinated with a modified-live virus (MLV) vaccine against bluetongue virus (BTV) serotype 17. DESIGN Randomized clinical trial followed by a field trial. ANIMALS 30 yearling crossbred ewes (phase 1) and 344 sheep from 7 Wyoming farms (phase 2). PROCEDURES In phase 1, ewes seronegative for anti-BTV antibodies received sterile diluent (control group; n = 10) or an MLV (10) or KV (10) vaccine against BTV-17 on day 0. Ewes in the KV group received a second dose of the vaccine on day 21. Ewes were bred 5 months after vaccination and allowed to lamb. Anti-BTV antibodies were measured in ewes at predetermined times after vaccination and in their lambs once at 5 to 10 days after birth. In phase 2, 248 commercial sheep were screened for anti-BTV antibodies and vaccinated with a KV vaccine against BTV-17 on day 0. Sheep seronegative for anti-BTV antibodies on day 0 (n = 90) underwent follow-up serologic testing on day 365 along with 96 unvaccinated cohorts (controls). RESULTS In phase 1, all vaccinated ewes developed anti-BTV antibodies by 14 days after vaccination and remained seropositive for 1 year; all of their lambs were also seropositive. All control ewes and lambs were seronegative. In phase 2, the prevalence of vaccinated sheep with anti-BTV antibodies 1 year after vaccination was 93% and 76% as determined by a serum neutralization assay and competitive ELISA, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Both vaccines induced antibodies against BTV-17 that persisted for at least 1 year and provided passive immunity for lambs and may be a viable option to protect sheep against disease.
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Virus de la Lengua Azul/inmunología , Lengua Azul/prevención & control , Ovinos/inmunología , Vacunas Atenuadas/inmunología , Vacunas de Productos Inactivados/inmunología , Vacunas Virales/inmunología , Animales , Anticuerpos Antivirales/biosíntesis , Anticuerpos Antivirales/sangre , Lengua Azul/inmunología , Femenino , Inmunidad Materno-Adquirida , Cinética , Masculino , Estudios Prospectivos , Vacunas Atenuadas/normas , Vacunas de Productos Inactivados/normas , Vacunas Virales/clasificación , Vacunas Virales/normasAsunto(s)
Bienestar del Animal , Animales Salvajes , Gatos , Animales , Castración/veterinaria , Salud Pública , Estados UnidosRESUMEN
OBJECTIVE. To evaluate the effectiveness of transcutaneous bilirubin (TcB) measurement in predicting risk for neonatal hyperbilirubinemia in outpatients. DESIGN. Subjects were infants ≤8 days old seen in an outpatient clinic. Infants discharged with high-risk (HR) or high-intermediate risk (HIR) total serum bilirubin (TSB) values and jaundiced infants were recruited. TSB and TcB (BiliChek) levels were plotted on an hour-specific nomogram to determine risk for hyperbilirubinemia. RESULTS. A total of 79 infants provided 87 sets of TcB and TsB values. Mean bias and standard deviation between TcB and TsB was 1.5 ± 2.1 mg/dL for outpatients, compared with 2.7 ± 1.3 mg/dL for inpatients. The sensitivity and specificity of HR or HIR TcB for predicting an HR or HIR TSB were 87% and 58%, respectively. Of 9 infants readmitted for phototherapy, 1 had a low-risk TcB and high-risk TSB. CONCLUSIONS. TcB screening in the outpatient environment may not be safe and efficient.
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Atención Ambulatoria , Bilirrubina/análisis , Hiperbilirrubinemia Neonatal/diagnóstico , Tamizaje Neonatal/métodos , Bilirrubina/metabolismo , Humanos , Hiperbilirrubinemia Neonatal/sangre , Recién Nacido , Ictericia Neonatal/diagnóstico , Ictericia Neonatal/metabolismo , Estudios Prospectivos , Medición de Riesgo , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Fundamental to definitively identifying neonates at risk of developing significant hyperbilirubinemia is a better understanding of the genetic factors associated with early bilirubin rise. Previous genetic studies have focused on the UGT1A1 gene, associating common variation in the coding or promoter regions with qualitative assessments of bilirubin (i.e. significantly elevated or not). These studies have had conflicting results and limited success. We chose to approach the problem by focusing on the quantitative (absolute) change in bilirubin levels early in post-natal life. We apply this approach to the UGT1A1 gene--exploring the contribution of both rare and common variants to early bilirubin changes. METHODS: We sequenced the exons, PBREM, 5'-, and 3'- regions of the UGT1A1 gene in 80 otherwise healthy term neonates who had repeat bilirubin levels measured within the first five days of life. RESULTS: Three novel coding variants were observed, but there was no clear relationship between rare coding variants and bilirubin rise. Adjusted linear regression models fit to evaluate the relationship between changing bilirubin levels and common UGT1A1variants found that among 39 neonates whose bilirubin was resampled within 33 hours, individuals homozygous for the mutant allele of a 3'UTR SNP had significantly smaller changes in bilirubin (P=0.003) than individuals carrying the wild-type allele. CONCLUSIONS: Collectively, rare UGT1A1 coding variants do not appear to play a prominent role in determining early bilirubin levels; however common variants in the 3' UTR of UGT1A1 may modulate the early bilirubin rise. A quantitative approach to evaluating early bilirubin kinetics provides a more robust framework in which to better understand the genetics of neonatal hyperbilirubinemia.
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Bilirrubina/genética , Glucuronosiltransferasa/genética , Hiperbilirrubinemia Neonatal/genética , Bilirrubina/sangre , Femenino , Humanos , Hiperbilirrubinemia Neonatal/sangre , Recién Nacido , MasculinoRESUMEN
OBJECTIVES: To determine the relationship between BiliChek TcB (Respironics, Marietta GA) and Doumas reference serum or plasma total bilirubin (TSB). DESIGN AND METHODS: Pooled samples with values assigned by the Doumas reference method were used to establish the relationship between a local laboratory and reference Doumas TSB. We then established the relationship between TcB and TSB in the 3 months before and after reassignment of calibrator setpoints undertaken to match the local laboratory to Doumas reference bilirubin values. RESULTS: Before calibrator setpoint reassignment TSB as measured in our laboratory overestimated Doumas reference bilirubin. After calibrator adjustment laboratory TSB was within 1.7-6.8 micromol/L (0.1-0.4 mg/dL) of Doumas reference values. Mean bias between BiliChek TcB and TSB was 42.8+/-22.2 micromol/L (2.5+/-1.3mg/dL) (n=94) before and 49.6+/-22.2 micromol/L (2.9+/-1.3mg/dL) (n=115) after calibration adjustment. CONCLUSIONS: BiliChek TcB significantly overestimates TSB as measured by the Doumas reference method.