Porotic hyperostosis and cribra orbitalia in samples from the Late Hillfort Period sites at Detkovice - Za zahradama (district Prostejov) and Vídenská street (district Brno), Czech Republic.

Porotic hyperostosis and cribra orbitalia are pathological changes occurring on the human skull. These changes were observed and evaluated on skeletal remains from Detkovice - Za zahradama and Vídenská Street in Brno; both sites are dated back to the 10th to 12th centuries AD. A total of 605 subjects were assessed for age, sex, and the above-stated pathologies using standard methods. The influence of age and sex on the occurrence of these pathologies was examined statistically. Results indicated that at the site of Detkovice - Za zahradama, porotic hyperostosis, and cribra orbitalia do not depend on sex or age. However, at Vídenská Street in Brno, these pathologies do not depend on sex, but they depend on age so a higher incidence of pathologies in juveniles is observed. Differences between both sites could be caused by different numbers of evaluated individuals or different state of preservation of skeletal remains. The aetiology of the origin of these pathologies could not be determined by the methodology used here, but with the prevailing lower age of pathological subjects, a lack of nutrition with consequent absence of iron and developing anaemia might be the cause. Based on our statistical data, we can observe that the pathologies we studied occur more frequently in children older than newborns and younger infants. This may indicate that these studied pathologies arise only during the lifetime of the individual and do not have a prenatal occurrence.

COVID-19-free workplace: Measuring the level of antibodies against coronavirus as a basis for testing strategy in companies.

The Czech Republic is one of the countries most affected by the coronavirus pandemic - approximately 16% of the population had a positive PCR test, 2-3 times more people underwent infection without undergoing this examination. It is particularly useful for employers to know how many employees have already contracted the infection and for how many people are still at risk of the coronavirus infection. For this purpose, it is appropriate to examine IgG antibodies. However, the testing strategy is different at present - antigen testing is mandatory to look for infectious individuals, regardless of human immunity. The aim of the pilot study was to determine the number of immune individuals after infection at three clinics of GENNET s.r.o. At the same time, unvaccinated individuals who had not had COVID-19 or had undergone it more than three months ago were tested with antigen tests. The cohort included 297 subjects, of whom 182 were not vaccinated (61.3 %) and 115 subjects (38.7 %) were after the vaccination. Of the unvaccinated, 71 people had in the past a positive PCR test (39 %), another 18 people had positive IgG antibodies without infection (9.9 %) and 38 people (20.9 %) had negative IgG antibodies. So far, 55 persons (30.2 %) have not been examined. If we add people vaccinated and people with antibodies, then 74.3 % of employees of the GENNET Archa clinic, 68 % of employees from the GENNET Kostelní clinic and 58.1 % from the GENNET Liberec clinic were immune to infection. 153 individuals on average (60 of whom had antibodies) were tested for the antigen test in four rounds. The infection was detected in two people. Both belonged to the group without tested antibodies. No person with antibodies was tested positive for antigen. People who have antibodies after vaccination or infection are substantially less prone to infection and have a low risk of continuing to spread the virus. By examining antibodies, employers will gain a better overview of the situation in the workplace. Based on our study, we recommend including antibody testing into antiepidemic measures and limit antigen testing to seronegative individuals.

Calibration of silicone for passive sampling of semivolatile organic contaminants in indoor air.

Semivolatile organic compounds (SVOCs) are mostly man-made chemicals that distribute between the gas and solid phase in the environment. Many of them could pose harm to people and therefore it is important to know their concentrations in the indoor environment to evaluate the related risks. Inhalation exposure can be assessed using passive sampling. In this study, we employed silicone elastomer as a passive sampler for monitoring gaseous polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs) in indoor air. We performed a sampler calibration study in which samplers consisting of 0.5 mm thick silicone sheets with a total surface area of 300 cm2 were exposed to indoor air in a university lecture theatre for up to 56 days. Uptake kinetics of SVOCs was studied by collecting 2 samplers every week. The results were used to develop a model based on mass transfer theory that can be used to estimate the air sampling rate RS as a function of compound's molecular volume. We examined release kinetics of performance reference compounds that covered a broad range of silicone-air partition coefficient (log KSA 5.95-9.49) and investigated a hypothesis of isotropic exchange kinetics, i.e. equality of rate constants for uptake and release, of SVOCs. PCBs and OCPs concentration in air calculated from contaminant amounts accumulated in passive samplers were in good agreement with those determined by active sampling running simultaneously during the entire study. The use of performance reference compounds is suitable for in situ passive sampler calibration.

Current possibilities of diagnostics and treatment of immunological causes of female infertility.

The immune system plays an important role in many processes of human reproduction. During pregnancy, mother's body has to accept the semialogenic fetus, therefore the role of immune processes has a high importance. Tolerance of the fetus by the mother's immune system is ensured by a complex of immune mechanisms, the knowledge of which brings us to the new insights into human reproduction processes and in seeking of new ways to modulate immunity in repeated embryo implantation failures, miscarriages, premature births, preeclampsia, and other fertility disorders and pregnancy complications. The review article is a summary of current possibilities of immunological laboratory diagnostics in reproductive immunology, presents indications for these tests and their interpretation, and mentions possible methods of therapeutic immune intervention.

Circulating NK and NKT cells in the diagnosis and treatment of immunological causes of female infertility - retrospective data analysis from the tertiary clinical center.

Immune dysregulation can cause embryo implantation failure, possibly due to mechanisms of innate non-adaptive immunity, including natural killer (NK) and natural killer T (NKT) cells. Retrospective analysis of relative counts and functional properties of NK and NKT peripheral blood cells in women with cellular immunopathology before and after immunomodulatory treatment was realized to evaluate these values in a proportion of clinical post-treatment pregnancies. For retrospective analysis, data were collected from 184 infertile women treated for abnormal functional properties and/or numbers of NK and NKT cells after stimulation with sperm and trophoblast antigens. Flow cytometric analyses of peripheral blood both before and during/after immunomodulatory treatment were performed to determine whether clinical pregnancy was achieved. Of 184 cases, immunomodulatory treatment contributed to clinical pregnancy in 109 women (59 %), all but 25 of whom required assisted reproduction techniques to become pregnant. Clinical pregnancy was associated with significantly lower numbers of circulating NK cells (p = 0.03) and significantly less activation of NK cells by trophoblasts (p < 0.001). Increased numbers of peripheral blood NK cells and their pathological activation by trophoblast antigens are immunological factors of infertility in women. However, when appropriately chosen, immunomodulatory treatment can make clinical pregnancy more likely.

COVID-19 and immunomodulation treatment for women with reproductive failures.

COVID-19 pandemic is affecting various areas of health care, including reproductive medicine. Many women with infertility are treated by immunomodulation and immunosuppression in periimplantation period due to underlying autoimmune diseases or cellular immune dysfunction. Many questions have been raised in relation to COVID-19, including susceptibility to SARS-CoV-2 infection in women with immunotherapy, how to manage women with an increased risk of and active COVID-19 infection. International team of reproductive immunologists led by professor Joanne Kwak-Kim prepared a review of information and recommendations for using immunotherapy in women with reproductive disorder in COVID-19 pandemic. Everyday practice need led us to presentation of the synopsis of these interim guidelines for particular treatment modalities.

Role of biomarkers of cardiac remodeling, myofibrosis, and inflammation in assessment of disease severity in euvolemic patients with chronic stable heart failure.

OBJECTIVE: This study aimed to determine the importance of biomarkers of chronic heart failure (CHF) for assessing disease severity in euvolemic stable patients. PATIENTS AND METHODS: N-terminal pro-B-type natriuretic peptide (NT-proBNP), growth differentiation factor (GDF)-15, galectin-3, cystatin-C, soluble suppression of tumorigenicity 2 (sST2), tissue type inhibitor of matrix metalloproteinase (TIMP)-1, and ceruloplasmin levels were measured in euvolemic patients with stable CHF. Severity of CHF was defined by echocardiographic and biochemical parameters. RESULTS: In 160 patients (123 men and 37 women, mean age: 65.8±12.2 years), we found strong associations between NT-proBNP and bilirubin levels (r = 0.434) and the estimated glomerular filtration rate (r = -0.321). GDF-15 and cystatin-C levels were significantly correlated with parameters of kidney function. In multivariable regression analysis, NT-proBNP levels were associated with the left ventricular ejection fraction and left ventricular end-systolic volume (coefficient of determination R2 = 0.777). Additionally, GDF-15 levels were correlated with urea levels (R2 = 0.742), and cystatin C levels were correlated with urea and bilirubin levels (R2 = 0.732). CONCLUSION: Besides NT-proBNP, GDF-15 and cystatin C are promising biomarkers for establishing the severity of disease in euvolemic patients with stable CHF.

Evaluation of IFN-γ Enzyme-linked Immunospot Assay (ELISPOT) as a First-line Test in the Diagnosis of Non-Immediate Hypersensitivity to Amoxicillin and Penicillin.

The current diagnostic algorithm for beta-lactam allergy is based on skin and provocation tests, both of which carry a certain risk of inducing hypersensitivity reactions. Thus, non-invasive in vitro tests reliable enough to replace skin and provocation tests at least in a portion of patients are desirable. We aimed to verify the utility of IFN-γ ELISPOT as a first-line test in patients with suspected non-immediate hypersensitivity reaction to amoxicillin (AMX) and penicillin (PNC). The prospective observational study included 24 patients with recent, suspected non-immediate hypersensitivity reaction to AMX or PNC and 6 recently-exposed healthy subjects. In vitro tests were performed in all patients and healthy subjects: a) IFN-γ ELISPOT with PNC, AMX and amoxicillin plus clavulanic acid (AMX-CL); b) penicillin specific IgE; c) basophil activation test (BAT). Skin and provocation tests followed only in certain patients. IFN-γ ELISPOT results with PNC and AMX stimulation did not differ from the unstimulated condition. The highest IFN-γ responses to AMX-CL were close to previously published criteria in three patients; one of which had true hypersensitivity according to drug provocation tests. Five patients with confirmed hypersensitivity by skin tests showed no response to the culprit antibiotic on IFN-γ ELISPOT assay. Our results did not support the utility of IFN-γ ELISPOT in the diagnosis of mild, non-immediate hypersensitivity to amoxicillin and penicillin.

IgG4-related Disease - A Patient with Multiple Organ Involvement.

IgG4-related diseases represent a heterogeneous group of conditions characterised by elevated serum IgG4 levels and fibrotic or sclerosing changes in the affected organs or systems accompanied by IgG4-positive plasma cells. A disease associated with IgG4 may affect virtually any organ - salivary glands, periorbital tissue, kidneys, lungs, meninges, aorta, prostate, pericardium or skin. Histopathological findings are uniform, characterised by a major lymphoplasmocytic infiltrate and the presence of IgG4-producing plasma cells, irrespective of the affected site. It can be difficult to establish a correct diagnosis due to the lack of clinical symptoms. Treatment with immunosuppressive drugs provides good results and requires interdisciplinary cooperation.

Mercury in canned fish from local markets in the Czech Republic.

The aim of this survey was to compare total mercury (THg) in canned fish in terms of species and fishing area. A number of 110 samples of canned fish, which were divided by fish species and fishing area, were analysed. The highest THg content in muscle tissue was found in the escolar. In other fish species, the highest level was detected in tuna. Mercury content in tuna differed significantly from mackerel, sardine, and sprat. Mercury content in herring differed significantly from sprat. The order of the fish according to their THg content corresponds to their status in the aquatic food chain. A significant difference was also found between fish caught from the closed Mediterranean and Black Sea and fish caught in the open oceans. In terms of THg content, the results of this study indicate good quality of various species of canned fish caught in worldwide locations.

Evaluation of mercury contamination in dogs using hair analysis.

OBJECTIVES: The present work is aimed at assessing the mercury contamination of dogs through the analysis of hair. For the determination of the total mercury in dogs, we chose skin derivatives--hair. The content of total mercury was also measured in the pelleted feed. METHODS: Dogs were divided into two groups. The first group (group A) was fed granular feed containing fish and the second group (group B) granular feed free of fish. A total of 131 hair and granular feed samples were collected. The total mercury in hair and granular feed samples was measured using atomic absorption spectrophotometry on AMA 254. RESULTS: The values of the total mercury content in the hair of dogs had a median value of 0.0375 mg.kg(-1) in group A and of 0.0336 mg.kg(-1) in group B. No statistically significant difference was found between the groups (p>0.05). The median values of the total mercury were 0.0048 mg.kg(-1) in group A and 0.0017 mg.kg(-1) in group B, respectively. A highly statistically significant difference between the groups was found (p<0.01). CONCLUSIONS: No correlation was obtained between the total mercury content in the hair of dogs and granulated feed (rs=0.2069, p>0.05). The reason may be a content of various mercury species in feed samples or a human failure (nonobservance of the prescribed diet).

Mercury speciation in fish muscles from major Czech rivers and assessment of health risks.

The aim of this work was to determine the mercury and methylmercury content in muscle tissue of chub (Leuciscus cephalus L.), to assess the health risks of eating the fish and to determine the number of fish meat servings that are suitable for weekly consumption. Total mercury concentrations were determined using a single-purpose atomic absorption spectrophotometer AMA 254. Methylmercury concentrations were determined by gas chromatography. The location where the highest total mercury concentrations in fish muscle tissues were found was the Vltava - Vranany (0.236±0.1001mg/kg(-1)), and the highest methylmercury concentration was found at the Labe - Obríství (0.231±0.1056mg/kg(-1)). The conclusion based on the data ascertained is that the locations from which the lowest number of fish meat servings can be eaten are the Vltava - Vranany and the Labe - Obríství. The results of this study helped evaluate contamination levels of rivers that flow out of the Czech Republic.

Total mercury content in canine hair before and after administration of vaccines containing thiomersal.

OBJECTIVES: Thiomersal is ethylmercury containing compound. It has been used as a preservative in vaccines since the 1930s because it is very effective in preventing bacterial contamination. Ethylmercury penetrates into growing hair in a similar manner as methylmercury. DESIGN: A total of 48 hair samples were collected from vaccinated dogs. Each sample was accompanied with a questionnaire including data on age, gender, vaccinations. Total mercury content in hair, granules and vaccines was determined by the direct method of cold vapours using an AMA 254 (advance mercury analyser; Altec Ltd., Czech Republic). RESULTS: At first we performed two pre-experiments. In first pre-experiment, the highest value of total mercury content was 0.732 mg.kg-1. The content of total mercury ranged from 0.022 to 0.092 mg.kg-1 in the second pre-experiment. The results were not statistically significant in the pre-experiments. In the main experiment the lowest concentration of total mercury in dog's hair was 0.002 mg.kg-1 and the highest value was 0.560 mg.kg-1. The median value of total mercury ranged from 0.023 to 0.033 mg.kg-1. The results were not statistically significant in the main experiment. Total mercury content in vaccines corresponded with the declared quantity. Rather, results showed mercury content to be correlated with the consumption of feed containing fish. CONCLUSIONS: Thiomersal preservative, contained in vaccine, does not increase content of total mercury in canine hair. Our results have shown that content of mercury in hair depends on fish consumption (fish granules, fish treats and fresh fish).

Valganciclovir prophylaxis against cytomegalovirus impairs lymphocyte proliferation and activation in renal transplant recipients.

BACKGROUND: Antiviral prophylaxis against cytomegalovirus has been associated with reduced risk of allograft rejection and improved allograft survival after renal transplantation. This phenomenon might not be fully explained by preventing the indirect effects of cytomegalovirus. The effect of antiviral agents on lymphocyte function in patients treated with modern immunosuppression has not been studied to date. METHODS: Adult renal transplant recipients were assigned to 3-month prophylaxis with either valganciclovir (900 mg once daily; n=19) or valacyclovir (2 g four times daily; n=17) as part of an ongoing randomized trial. Subsets of lymphocytes, lymphocyte proliferation and/or cytokine production after in vitro mitogen stimulation were evaluated at the end of prophylaxis and 1 month after withdrawal of antiviral drugs. RESULTS: Lymphocyte proliferation was significantly decreased both after phytohemagglutinine (25% ±15% versus 32% ±18%; P=0.025) and concanavalin A stimulation (17% ±9% versus 25% ±16%; P=0.011) during valganciclovir, but not valacyclovir therapy. Moreover, a lower activated T-cell count (CD3(+)HLA-DR(+) cells) was noted in valganciclovir-treated patients (13% ±10% versus 17% ±12% of total CD3(+) T-cells; P=0.005). CONCLUSIONS: Valganciclovir suppresses lymphocyte proliferation and activation in patients after renal transplantation.

[Diagnostics of sepsis]. / Diagnostika sepse.

Sepsis is a serious high mortality disease. As regards pathophysiology, it is a systemic inflammatory response to infection. Its timely diagnosis strongly influences mortality. The identification of biomarkers is used for diagnosing, monitoring, and prognosis in septic patients. The methods for their measurement cover a range of disciplines such as clinical biochemistry, haematology, immunology, and clinical microbiology. The most frequently used sepsis markers in routine clinical diagnostics are C-reactive protein and procalcitonin. The detection of selected cytokines, mediators, and surface markers in immunocompetent cells gives us further chance for improvement of this diagnostics. The methods of calculating gene expression represent a technology with a potential for the discovery of new biomarkers which would improve both diagnostics and therapy in the sense of personalized medicine.

Identification of an ICP27-responsive element in the coding region of a herpes simplex virus type 1 late gene.

During productive herpes simplex virus type 1 (HSV-1) infection, a subset of viral delayed-early (DE) and late (L) genes require the immediate-early (IE) protein ICP27 for their expression. However, the cis-acting regulatory sequences in DE and L genes that mediate their specific induction by ICP27 are unknown. One viral L gene that is highly dependent on ICP27 is that encoding glycoprotein C (gC). We previously demonstrated that this gene is posttranscriptionally transactivated by ICP27 in a plasmid cotransfection assay. Based on our past results, we hypothesized that the gC gene possesses a cis-acting inhibitory sequence and that ICP27 overcomes the effects of this sequence to enable efficient gC expression. To test this model, we systematically deleted sequences from the body of the gC gene and tested the resulting constructs for expression. In so doing, we identified a 258-bp "silencing element" (SE) in the 5' portion of the gC coding region. When present, the SE inhibits gC mRNA accumulation from a transiently transfected gC gene, unless ICP27 is present. Moreover, the SE can be transferred to another HSV-1 gene, where it inhibits mRNA accumulation in the absence of ICP27 and confers high-level expression in the presence of ICP27. Thus, for the first time, an ICP27-responsive sequence has been identified in a physiologically relevant ICP27 target gene. To see if the SE functions during viral infection, we engineered HSV-1 recombinants that lack the SE, either in a wild-type (WT) or ICP27-null genetic background. In an ICP27-null background, deletion of the SE led to ICP27-independent expression of the gC gene, demonstrating that the SE functions during viral infection. Surprisingly, the ICP27-independent gC expression seen with the mutant occurred even in the absence of viral DNA synthesis, indicating that the SE helps to regulate the tight DNA replication-dependent expression of gC.

Herpes simplex virus type 1 ICP27 regulates expression of a variant, secreted form of glycoprotein C by an intron retention mechanism.

We previously showed that herpes simplex virus type 1 (HSV-1) immediate-early (IE) protein ICP27 can posttranscriptionally stimulate mRNA accumulation from a transfected viral late gene encoding glycoprotein C (gC) (K. D. Perkins, J. Gregonis, S. Borge, and S. A. Rice, J. Virol. 77:9872-9884, 2003). We began this study by asking whether ICP27 homologs from other herpesviruses can also mediate this activity. Although the homologs from varicella-zoster virus (VZV) and human cytomegalovirus (HCMV) were inactive, the homolog from bovine herpesvirus 4 (BHV-4), termed HORF1/2, was a very efficient transactivator. Surprisingly, most of the mRNA produced via HORF1/2 transactivation was 225 nucleotides shorter than expected due to the removal of a previously undescribed intron from the gC transcript. We found that the gC mRNA produced in the absence of transactivation was also mostly spliced. In contrast, gC mRNA produced by ICP27 transactivation was predominantly unspliced. Based on these results, we conclude that ICP27 has two distinct effects on the transfected gC gene: it (i) stimulates mRNA accumulation and (ii) promotes the retention of an intron. Interestingly, the spliced transcript encodes a variant of gC that lacks its transmembrane domain and is secreted from transfected cells. As the gC splicing signals are conserved among several HSV-1 strains, we investigated whether the variant gC is expressed during viral infection. We report here that both the spliced transcript and its encoded protein are readily detected in Vero cells infected with three different laboratory strains of wild-type HSV-1. Moreover, the variant gC is efficiently secreted from infected cells. We have designated this alternate form of the protein as gCsec. As the extracellular domain of gC is known to bind heparan sulfate-containing proteoglycans and to inhibit the complement cascade via an interaction with complement component C3b, we speculate that gCsec could function as a secreted virulence factor.

Herpes simplex virus type 1 immediate-early protein ICP27 is required for efficient incorporation of ICP0 and ICP4 into virions.

Early in infection, herpes simplex virus type 1 (HSV-1) immediate-early (IE) proteins ICP0 and ICP4 localize to the nucleus, where they stimulate viral transcription. Later in infection, ICP0 and to a lesser extent ICP4 accumulate in the cytoplasm, but their biological role there is unknown. Previously, it was shown that the cytoplasmic localization of ICP0/4 requires the multifunctional IE protein ICP27, which is itself an activator of viral gene expression. Here, we identify a viral ICP27 mutant, d3-4, which is unable to efficiently localize ICP0 and ICP4 to the cytoplasm but which otherwise resembles wild-type HSV-1 in its growth and viral gene expression phenotypes. These results genetically separate the function of ICP27 that affects ICP0/4 localization from its other functions, which affect viral growth and gene expression. As both ICP0 and ICP4 are known to be minor virion components, we used d3-4 to test the hypothesis that the cytoplasmic localization of these proteins is required for their incorporation into viral particles. Consistent with this conjecture, d3-4 virions were found to lack ICP0 in their tegument and to have greatly reduced levels of ICP4. Thus, the cytoplasmic localization of ICP0 and ICP4 appears to be a prerequisite for the assembly of these important transcriptional regulatory proteins into viral particles. Furthermore, our results show that ICP27 plays a previously unrecognized role in determining the composition of HSV-1 virions.