Immunoglobulin G1 Antibodies Against Phosphorylcholine Are Associated With Protection in Systemic Lupus Erythematosus and Atherosclerosis: Potential Underlying Mechanisms.

OBJECTIVE: Immunoglobulin M antibodies against phosphorylcholine (anti-PCs) may be protective in atherosclerosis, cardiovascular disease (CVD), and systemic lupus erythematosus (SLE). We study immunoglobulin G1 (IgG1) and immunoglobulin G2 (IgG2) anti-PCs, with a focus on atherosclerosis and SLE. METHODS: We determined anti-PCs by using the enzyme-linked immunosorbent assay in 116 patients with SLE and 110 age- and sex-matched controls. For functional studies, we used three in-house-generated, fully human monoclonal IgG1 anti-PCs (A01, D05, and E01). Apoptosis was induced in Jurkat T cells and preincubated with A01, D05, E01, or IgG1 isotype control, and effects on efferocytosis by human macrophages were studied. Anti-PC peptide/protein characterization was determined using a proteomics de novo sequencing approach. RESULTS: IgG1, but not IgG2, anti-PC levels were higher among patients with SLE (P = 0.02). IgG1 anti-PCs were negatively associated with Systemic Lupus International Collaborating Clinics (SLICC) damage index and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores (odds ratio [OR]: 2.978 [confidence interval (CI): 0.876-10.098] and OR: 5.108 [CI 1.3-20.067], respectively) and negatively associated with CVD, atherosclerotic plaques, and echolucent plaques (potentially vulnerable plaques), but the association for the two former was not significant after controlling for confounders. D05 had a maximum effect on macrophage efferocytosis efficiency, followed by A01 and E01. The monoclonal antibodies showed differential binding specificity to PC and PC-associated neoepitopes. A peptide analysis showed a difference in the complementarity-determining region 3 of the three IgG1 anti-PC clones that are crucial for recognition of PC on apoptotic cell surfaces and other neoepitopes. CONCLUSION: IgG1 anti-PCs are negatively associated with disease activity and disease damage in SLE, but the negative association with CVD is also dependent on confounding risk factors. One potential underlying mechanism could be increased clearance of dead cells.

Phenotypic features of vascular calcification in chronic kidney disease.

BACKGROUND: Patients with chronic kidney disease stage 5 (CKD5) are predisposed to vascular calcification (VC), but the combined effect of factors associated with VC was sparsely investigated. We applied the relaxed linear separability (RLS) feature selection model to identify features that concomitantly associate with VC in CKD5 patients. METHODS: Epigastric arteries collected during surgery from living donor kidney transplant recipients were examined to score the histological extent of medial VC. Sixty-two phenotypic features in 152 patients were entered into RLS model to differentiate between no-minimal VC (n = 93; score 0-1) and moderate-extensive VC (n = 59; score 2-3). The subset of features associated with VC was selected on the basis of cross-validation procedure. The strength of association of the selected features with VC was expressed by the absolute value of 'RLS factor'. RESULTS: Among 62 features, a subset of 17 features provided optimal prediction of VC with 89% of patients correctly classified into their groups. The 17 features included traditional risk factors (diabetes, age, cholesterol, BMI and male sex) and markers of bone metabolism, endothelial function, metabolites, serum antibodies and mitochondrial-derived peptide. Positive RLS factors range from 1.26 to 4.05 indicating features associated with increased risk of VC, and negative RLS factors range from -0.95 to -1.83 indicating features associated with reduced risk of VC. CONCLUSION: The RLS model identified 17 features including novel biomarkers and traditional risk factors that together concomitantly associated with medial VC. These results may inform further investigations of factors promoting VC in CKD5 patients.

The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis.

INTRODUCTION: Uterine scar dehiscence can complicate caesarean section with complications like post partum hemorrhage, endomyometritis, localized/generalized peritonitis, and sepsis. PRESENTATION OF CASE: Our patient had abdominal wound infection after LSCS surgery and features of sepsis. The wound infection was actually the presentation of a uterine scar dehiscence and localized peritonitis. DISCUSSION: Incidence of uterine scar dehiscence is around 0.6%. Presentation can be post partum hemorrhage, endomyometritis, and generalized/localized peritonitis. Peritonitis caused by uterine incisional necrosis must be dealt surgically. A high index of suspicion with appropriate investigations can highlight such problems for early treatment and cure with least morbidity especially related to further pregnancies. CONCLUSION: Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy.

Health-related quality of life in children with cerebral palsy and their families.

OBJECTIVE: To determine the health-related quality of life in children with cerebral palsy and their families. METHODS: One hundred children (3-10 years of age) receiving regular rehabilitation therapy for cerebral palsy for last 1 year at a Child Development Centrer were enrolled and the Lifestyle assessment questionnaire - cerebral palsy was administered to the parents. RESULTS: 9% had good, 24% had mildly-affected, 37% had moderately-affected and 30% had severely-affected health-related quality of life. The physical independence, mobility and social integration dimensions were much more severely affected than the clinical burden, economic burden and schooling dimensions. CONCLUSION: Health-related quality of child is affected in most children with cerebral palsy.

Difference in the level of interferon gamma mRNA transcripts on stimulation of cattle and buffalo mononuclear cells with foot and mouth disease virus-antigen: a possible role of sequence variation in promoter region.

In an attempt to resolve the claim that buffaloes differ from cattle in disease progression, this study was undertaken to compare the mitogen (conA) or antigen (foot and mouth disease virus) induced expression levels of interferon gamma (IFN-γ mRNA in peripheral blood mononuclear cells (PBMCs) by real-time quantitative PCR. In general, the levels of IFN-γ mRNA were lower in buffaloes than in crossbred cattle. Significantly higher levels of IFN-γ mRNA were also observed in crossbred cattle when induced with FMD virus (1 µg). Analysis of the partial promoter sequences of the IFN-γ gene from the respective species revealed a conserved 4 base (GTCT) deletion in all the buffalo promoter sequences. In-silico analysis indicated the binding of glucocorticoid receptor (GR) and erythroid nuclear factor (NF-E) to this region in cattle. GR has been shown to be a transcription factor by itself and also regulates other major transcription factors like NF-κB and AP-1. The differential expression levels of IFN-γ mRNA between these species could be due to this deletion in the promoter region of buffalo. Further studies involving mobility shift and promoter assays would throw more light on the differential expression levels.

Immune Response in Goats to Different Payloads of FMDV Monovalent Vaccine: Protection Against Virulent Challenge and Development of Carrier Status.

The relationship of Foot-and-Mouth Disease virus antigen payload and number of dose of vaccine conferring protection against virus challenge in goats was studied. Goats vaccinated with oil adjuvant Foot-and-Mouth Disease vaccines containing different antigen payloads with or without booster resisted virulent challenge at 21 days post-vaccination or 7 days after booster respectively. However, localized sub-clinical infection was observed in two vaccinated goats on 35 days post-challenge. RNA could be detected from 31.8% of vaccinated goats (10(2.69)-10(4.99) viral RNA copies per cotton swab of nasal secretions) on day 35 post-challenge. Since no live virus could be isolated after 5 days post-challenge, the risk of these animals transmitting the disease was probably very low. The finding showed that oil adjuvant Foot-and-Mouth Disease vaccines containing antigen payload of 1.88 µg may prevent or reduce the local virus replication at the oropharynx and shedding of virus from nasal secretions and thereby reduce the amount of virus released into the environment subsequent to exposure to live virus. This study also showed that goats with poor sero conversion to vaccination can be infected without overt clinical signs and became carriers like sheep.

Genetic characterization of Indian type O FMD virus 3A region in context with host cell preference.

The 3A region of foot-and-mouth disease virus has been implicated in host range and virulence. For example, amino acid deletions in the porcinophilic strain (O/TAW/97) at 93-102aa of the 153 codons long 3A protein have been recognized as the determinant of species specificity. In the present study, 18 type O FMDV isolates from India were adapted in different cell culture systems and the 3A sequence was analyzed. These isolates had complete 3A coding sequence (153aa) and did not exhibit growth restriction in cells based on species of origin. The 3A region was found to be highly conserved at N-terminal half (1-75aa) but exhibited variability or substitutions towards C-terminal region (80-153). Moreover the amino acid substitutions were more frequent in recent Indian buffalo isolates but none of the Indian isolates showed deletion in 3A protein, which may be the reason for the absence of host specificity in vitro. Further inclusive analysis of 3A region will reveal interesting facts about the variability of FMD virus 3A region in an endemic environment.

Phylogenetic analysis of nucleoprotein gene of dog rabies virus isolates from Southern India.

India like several other South East Asian and African countries continues to face the public health and economic problems associated with the disease. Our objective was to perform a limited sequence analysis of a portion of nucleoprotein gene of 22 rabies virus isolates obtained from domestic animals in Southern India during 2004-2005. These isolates were compared with rabies virus isolates originating from Asia, Europe, Africa and North America. The phylogenetic analysis showed that RV isolates in Southern India belong to genotype 1. They were similar to one another forming a single major genetic cluster not ordered by geography or species of origin. However, they were dissimilar to RV isolates in Northern India and in other parts of the world. The data indicated that dog rabies virus variants are the major circulating viruses and control of dog rabies would result in overall reduction in the burden and incidence of rabies in India.

Identification of cross-contaminated animal cells by PCR and isoenzyme analysis.

Animal cell lines have become very popular substrates for the production of vaccines and biopharmaceuticals. Characterization of candidate production cell lines is central to ensure product safety and maintenance of consistency in the manufacture of biologicals. Nested PCR and isoenzyme analysis have been used widely to prove the identity and purity of various cell lines and primary cells individually and also after deliberate cross-contamination. The nested PCR based on the Cytochrome b (Cyt b) gene of mitochondrial DNA (Mt DNA) was found to be more sensitive than isoenzyme analysis in detecting low levels of contaminants (as low as 1%). Interestingly, competition between different co-cultured cell lines has shown in one case that cross-contamination need not always results in a mixed cell population. The nested PCR technique for the Cyt b gene described in this study appears to be a potential replacement for isoenzyme analysis and here we demonstrate the PCR method used is sensitive and reliable for cell line authentication in a simple, rapid and reliable format to help assure the authenticity of cell substrates for the production of safe vaccines and biopharmaceuticals.

Experimental transmission of foot-and-mouth disease among Indian buffalo (Bubalus bubalis) and from buffalo to cattle.

Indian buffalo and cattle were infected experimentally with a serotype O strain of foot-and-mouth disease virus of buffalo origin. Whereas intradermolingual inoculation of buffalo produced largely sub-clinical infection, inoculation in the dental pad produced vesicles in the mouth and on the feet. A buffalo infected via the dental pad transmitted infection to cattle and buffalo by direct contact with them for 24h. The contact-exposed buffalo developed (1) delayed-onset clinical signs, and (2) shedding of virus from the nose, commencing before the appearance of vesicles and continuing until the experiment was terminated 10 weeks after exposure. The covert nature of the disease in Indian buffalo, coupled with the prolonged shedding of virus, suggests that this species represents a host of epidemiological importance.

Cloning, expression and evaluation of the efficacy of a recombinant Eimeria tenella sporozoite antigen in birds.

Eimeria infection in poultry is of significant economic interest worldwide. Development of a cost-effective sub-unit vaccine that provides cross-protection may help reduce loss in poultry industry. One approach explored by many investigators is to block the parasite invasion into gut epithelium. Use of microneme proteins to prevent parasite invasion is one of the most straightforward approaches in developing a preventive vaccine. Here we describe cloning and expression of microneme-1 protein of Eimeria tenella, obtained from an outbreak sample from India. We have evaluated the ability of the recombinant protein to elicit both cell mediated immune (CMI) and humoral immune responses. We also evaluated the efficacy of the recombinant protein in protecting against a homologous challenge. Our data indicate recombinant EtMIC1 is able to impart partial protection against homologous challenge in chicken. Inclusion of more invasion proteins may improve the efficacy of prophylactic vaccine against Coccidiosis.

Human monoclonal antibody and vaccine approaches to prevent human rabies.

Rabies, being a major zoonotic disease, significantly impacts global public health. It is invariably fatal once clinical signs are apparent. The majority of human rabies deaths occur in developing countries. India alone reports more than 50% of the global rabies deaths. Although it is a vaccine-preventable disease, effective rabies prevention in humans with category III bites requires the combined administration of rabies immunoglobulin (RIG) and vaccine. Cell culture rabies vaccines have become widely available in developing countries, virtually replacing the inferior and unsafe nerve tissue vaccines. Limitations inherent to the conventional RIG of either equine or human origin have prompted scientists to look for monoclonal antibody-based human RIG as an alternative. Fully human monoclonal antibodies have been found to be safer and equally efficacious than conventional RIG when tested in mice and hamsters. In this chapter, rabies epidemiology, reservoir control measures, post-exposure prophylaxis of human rabies, and combination therapy for rabies are discussed. Novel human monoclonal antibodies, their production, and the significance of plants as expression platforms are emphasized.

Molecular epidemiology of rabies virus isolates in India.

In India, rabies is enzootic and is a serious public health and economic problem. India has a large population of stray dogs which, together with a lack of effective control strategies, might have led to the persistence of rabies virus (RV) in the canine population. Our objective was to study the molecular epidemiology of RV isolates in India based on nucleotide sequence analysis of 29 RV isolates originating from different species of animals in four states. Here we have analyzed two sets of sequence data based upon a 132-nucleotide region of the cytoplasmic domain (CD) of the G gene (G-CD) and a 549-nucleotide region (Psi-L) that combines the noncoding G-L intergenic region (Psi) and a fragment of the polymerase gene (L). Phylogenetic analysis revealed that the RV isolates belong to genotype 1 and that they were related geographically but were not related according to host species. Five different genetic clusters distributed among three geographical regions were identified. Comparison of the deduced amino acid sequences of G-CD between RV isolates revealed three amino acid changes (amino acid 462G [aa462G], aa465H, and aa468K) that distinguished the Indian RVs from RV isolates in other parts of the world. Analysis of the data indicated that the dog rabies virus variants are the major circulating viruses in India that transmit the disease to other domestic animals and humans as well.

Analysis of VP2 gene sequences of canine parvovirus isolates in India.

The epidemiology of canine parvovirus (CPV) infections in dogs in India was examined using 27 isolates collected during a two-year period. The VP2 genes of 22 isolates were sequenced, and the deduced amino acid sequences were compared. The results indicated that the isolates belonged to CPV type 2a except four, which belonged to CPV type 2b. Comparison of the VP2 gene sequences revealed that the Indian isolates formed separate lineages distinct from the South East Asian isolates. The canine parvovirus isolates in India appear to evolve independently, and distinct geographical patterns of evolution could not be discerned in the isolates examined.

A simple immuno-capture ELISA to estimate rabies viral glycoprotein antigen in vaccine manufacture.

Rabies is an endemic, fatal zoonotic disease in the developing countries. Prevention and post-exposure therapy require safe and efficacious vaccines. The vaccine potency depends on the amount of immunogenic rabies viral glycoprotein antigen in the vaccine preparation. In order to estimate the rabies viral glycoprotein antigen, a specific monoclonal antibody was developed and used in an immuno-capture ELISA (IC-ELISA). The monoclonal antibody binds a conformational epitope on the natively folded rabies viral glycoprotein as indicated by specific, membrane fluorescence on unfixed, rabies virus infected murine neuroblastoma (MNA) cells and glycoprotein gene encoding plasmid transfected COS cells. In addition, the monoclonal antibody competes with and blocks a glycoprotein antigen site III binding monoclonal antibody (mAb-D1, Institut Pasteur, Paris, France). The monoclonal antibody was used in an IC-ELISA using an in-house standard to quantify the rabies viral glycoprotein antigen in 12 vaccine preparations with potency values ranging from 4 to 18 IU. The results indicated a good correlation with the NIH mouse potency assay (r=0.83). The immuno-capture ELISA described in this study can be used to quantify the immunogenic rabies viral glycoprotein antigen in the inactivated rabies viral antigen preparation in a simple and rapid format, which enables better vaccine formulation.

Ascorbic acid supplementation improved antibody response to infectious bursal disease vaccination in chickens.

The purpose of the present study was to determine if supplementation of ascorbic acid (AA) to the diet would have a beneficial effect on infectious bursal disease (IBD) vaccination of chickens for protection against infectious bursal disease virus (IBDV) infection. Two hundred forty specific pathogen-free (SPF) chickens were divided into eight experimental groups. A 2 x 2 x 2 factorial arrangement in a completely randomized design was used; AA supplementation at 1,000 ppm in the diet, vaccination, and challenge were the main effects. Prior to challenge and 10 d after challenge, serum AA concentration, serum corticosterone concentration, ELISA antibody titer to IBDV, body weight, bursa-to-body weight (B:B) ratio, and bursal histological score (BHS) were determined. Nonvaccinated chickens fed a diet supplemented with AA did not exhibit clinical signs or mortality following challenge, whereas AA-unsupplemented counterparts had 100% cumulative morbidity and 30% cumulative mortality. Serum AA levels of AA-supplemented and vaccinated chickens were significantly (P < 0.05) higher than AA-unsupplemented and vaccinated chickens. Fourteen days following vaccination, significantly (P < 0.05) higher ELISA titers to IBDV were observed in vaccinated chickens supplemented with AA as compared to AA-unsupplemented counterparts. Ascorbic acid-supplemented chickens, especially those also vaccinated, had higher body weight gains as compared to the AA-unsupplemented chickens. Ascorbic acid-supplemented chickens challenged with IBDV did not show any clinical signs or mortality. The results suggest that supplementation of AA at 1,000 ppm in the diet has beneficial effects on antibody response to IBD vaccination and body weight gain.

Optimum conditions for in vitro chicken IL-2 production and its in vivo role in Newcastle disease vaccinated chickens.

Optimum conditions for in vitro chicken interleukin-2 (IL-2) production were studied. IL-2 containing culture supernatants were generated by mitogen stimulation of splenic mononuclear cells (SMC) and the samples were tested on 72 h Concanavalin A (ConA) blasts for their proliferative ability. 3H-thymidine incorporation was used as a measurement of proliferation. Higher stimulation indices and thus maximal IL-2 production were obtained with the following culture conditions: 5 x 10(6) cells ml(-1) cultured for 24 h in the presence of 10 microg ml(-1) ConA in serum free Iscove's modified Dulbecco medium. The molecule responsible for IL-2 activity was found to have a molecular weight of 14000 as estimated by size exclusion chromatography. SMC obtained from chickens inoculated with Newcastle disease virus were used to study the immunomodulatory role of IL-2. The lymphocyte transformation test was used as an in vitro correlate of cell mediated immunity in these chickens. The mitogen responses of cells obtained from virus inoculated and control chickens were similar on the basis of stimulation indices. Antigen specific lymphocyte proliferation was demonstrated using SMC obtained from virus inoculated chickens. Uptake of exogenous IL-2 by 72 h ConA blasts was of similar magnitude in both virus inoculated and control chickens indicating that uptake of IL-2 by T lymphocytes was normal in Newcastle disease virus inoculated chickens.

Prevention of precancerous colonic lesions in rats by soy flakes, soy flour, genistein, and calcium.

The main purpose of this research was to determine whether diets containing soy products would inhibit the early stages of azoxymethane-induced colon cancer in F344 rats. Additional objectives were to determine whether feeding starch instead of sucrose, feeding additional calcium (0.5% compared with 0.1%), or feeding a low-fiber powdered enteral formula would influence early colon carcinogenesis. Colon cancer was initiated with 2 injections of azoxymethane (15 mg/kg body wt) and a 12-wk dietary treatment period was started 1 wk after the second injection. Precancerous colon lesions were assessed as foci with aberrant crypts (FAC). The mean numbers of FAC were 133 [soy concentrate (low concentration of phytochemicals)], 111 (starch substituted for sucrose), 98 [full-fat soy flakes (whole soybeans)], 87 (defatted soy flour), 77 (0.015% genistein), and 70 (0.5% Ca). The soy flour and full-fat soy flake diets contained 0.049% genistein derivatives (primarily glycosides), but were less effective in inhibiting the formation of FAC than the diet containing 0.015% genistein (as the aglycone). Eating soybeans and soy flour may reduce the early stages of colon cancer.

Research notes: ELISPOT assay for detection of antibody secreting cells to infectious bursal disease virus in chickens.

The ELISPOT assay was used to enumerate antibody secreting cells (ASC) in spleens of chickens infected with infectious bursal disease virus (IBDV). In the first experiment, chickens were orally challenged with IBDV. Spleens were collected 14 d later and used for ELISPOT assay. The assay detected 16 to 28 IgG ASC per 10(6) splenocytes and 3 to 6 IgM ASC per 10(6) splenocytes. In the second experiment, chickens were vaccinated against IBDV and orally challenged with IBDV 14 d after vaccination. Spleens were collected 7 d postchallenge. The ELISPOT assay detected 18 to 128 IgG ASC per 10(6) splenocytes and 4 to 6 IgM ASC per 10(6) splenocytes. The results indicated that the ELISPOT assay can be used to measure isotype-specific antibody responses to IBDV or other avian pathogens.

In vitro attachment and invasion of chicken ovarian granulosa cells by Salmonella enteritidis phage type 8.

The attachment and invasion of chicken ovarian granulosa cells by Salmonella enteritidis was examined in vitro. The attachment was inhibited by preincubation of granulosa cells with anti-chicken fibronectin antibody (approximately 70% reduction in attachment) or preincubation with a 14-kDa fimbrial protein isolated from S. enteritidis (68% reduction in attachment). Treatment of bacterial cells with the tetrapeptide RGDS before addition to granulosa cells resulted in inhibition of attachment (60% inhibition when 2 x 10(7) CFU of bacteria was treated with 500 microg of peptide). Treatment with the peptide GRGD resulted in similar magnitude of inhibition, indicating that extracellular matrix proteins play significant roles in the interaction of S. enteritidis with granulosa cells. In contrast, treatment of the bacterial cells with the peptide GRAD did not result in significant inhibition of attachment to the granulosa cells. S. enteritidis was found to attach specifically to fibronectin, collagen IV, and laminin-coated microtiter plate wells, with the rank order of attachment as follows: fibronectin > laminin > collagen IV. Light and transmission electron micrographs of S. enteritidis invasion of granulosa cells showed organisms with or without a surrounding membrane in the cytoplasm of granulosa cells. In some instances, dividing bacterial cells were observed in the cytoplasm. Results of this study demonstrated that S. enteritidis interacts with granulosa cells in a specific manner and can invade and multiply in these cells. The granulosa cell layer of the preovulatory follicles may be a preferred site for the colonization of the chicken ovaries by invasive strains of S. enteritidis.