[THE ROLE OF CYTOKINES AND CHEMOKINES IN LABORATORY DIAGNOSTIC OF CHRONIC VIRAL HEPATITIS C]

The chronic viral hepatitis C is widely prevalent disease with prolonged persistence of virus and obliterated clinical picture. The present techniques of diagnostic of degree of fibrosis of liver and prognosis of course of disease have particular shortcomings. Hence, search of safe low invasive methods based on blood biomarkers is an actual task. The cytokines/chemokines (mediators of chronic inflammation) directly involved into immunopathogenesis of chronic viral hepatitis C can act in the capacity of biomarkers. The study was carried out to comprehensively analyze content of cytokines/chemokines in peripheral blood of patients with chronic viral hepatitis C at various stages of disease and infected by different genotypes of virus of hepatitis C. The concentration of cytokines/chemokines was identified in blood plasma of patients with chronic viral hepatitis C (n = 73) and conditionally healthy donors (n =3 7): IFNα, IFNγ, IFNλ/IL28α, TNFα, CCL2/MCP-1, CCL3/MIP-lα, CCL4/MIP-lβ, CCL5/RANTES, CCL8/MCP-2, CCL20/AIP-3α, CXCL9/MIG, CXCL10/P-10, CXCLII/ITAC. The multiplex analysis using technology xMAP was applied. The increasing of level of TNFα, CCL2/MCP-1, CCL4/ MIP-l, CCL8/ACP-2, CCL20/MIP-3α, CXCL9/MIG, CXCL10/IP-10, CXCL11/ITA C was established in blood plasma of patients with chronic viral hepatitis C as compared with control group. The levels of analyzed interferons IFNα, IFNγ, IFNλ/IL28α had no difference in studied groups. As far as chronic viral hepatitis C progresses and fibrosis of hepatic tissue develops the concentrations of TNFα, CCL2/MCP-1, CCL20/MIP-3α, CXCL9/MIG, CXCL10/IP-l0, CXCL11/ITAC increased significantly. The concentrations of chemokine CXCL11/IT4 C can be used as informative indicator for differentiating diagnostic of early stages of liver fibrosis. Depending on genotype of virus of hepatitis C, in patients with chronic viral hepatitis C change in content of CCL8/MCP-2 was established. Hence, detection in blood plasma of patients with chronic viral hepatitis C concentration of particular cytokines/chemokines using multiplex analysis technique permit analyzing additional information concerning degree of liver fibrosis, activity of process of damage of hepatic tissue under chronic viral hepatitis C that indicates indirectly on genotype of virus of hepatitis C.

[REPRODUCTIVE FUNCTION IN MEN WITH CHRONIC PROSTATITIS: CLINICAL, DISEASE HISTORY AND MICROBIOLOGICAL RISK ASPECTS]

Association between chronic prostatitis (HP) and fertility disorders remains a controversial issue. The aim of this retrospective multicenter cross-sectional study was to examine clinical, disease history and microbiological risk factors for fertility deterioration in men with HP. Case records of 3174 men aged 20-45 years living in a heterosexual marriage and having a regular sexual life were analyzed. Examination of couples and sperm analysis was conducted in accordance with the requirements of the WHO. Leukocytospermia was present in 19% of infertile cases. In 54% of those cases chronic prostatitis was associated with aerobic bacterial infection, in 9% - with chlamydial and in 12% with urea- and mycoplasma. It was found that concentrations ofleukocytes in semen and clinical symptoms (pain and dysuria) were not independent risk factors for infertility. Infertile patients had higher incident rates of E. coli (OR=4,1) and bacterial associations (OR=6,9) with reduced antimicrobial resistance of seminal plasma(for E. coli OR=9,9; for Ps. aeruginosa OR=6,0). Other risk factors for fertility reduction in patients with HP are the duration of the disease (OR=2,7), frequency of exacerbations (OR=2,6), presence of fibrosis and prostatolites (OR=1,8) and functional prostate-vesicular obstruction (OR=1,4). Further studies are needed to understand HP pathogenesis and explain the negative impact of HP on male fertility.

[EBOLA HEMORRHAGIC FEVER; ETIOLOGY, EPIDEMIOLOGY, PATHOGENESIS, AND CLINICAL SYMPTOMS]

The data on the prevalence of disease caused by Ebola virus, biological features of its pathogen, character of the epidemiological process, pathogenesis and clinical symptoms are presented. The disease is characterized by suppression of protective immunological mechanisms and systemic inflammatory reaction accounting for the lesions of vascular endothelium, hemostatic and immune systems. It eventually leads to polyorgan insufficiency and severe shock. Lethality amounts to 50%.

[EBOLA HEMORRHAGIC FEVER: DIAGNOSTICS, ETIOTROPIC AND PATHOGENETIC THERAPY, PREVENTION]

The data on diagnostics, etiotropic and pathogenetic therapy, prevention of Ebola hemorrhagic fever are presented including diagnostic algorithms for different clinical situations. Fundamentals of pathogenetic therapy are described. Various groups of medications used for antiviral therapy of conditions caused by Ebola virus are characterized. Experimental drugs at different stages of clinical studies are considered along with candidate vaccines being developed for the prevention of the disease.

[Influence of exam stress on the development of endothelial dysfunction and the formation of platelet-leukocyte coagregates]

The aim of this work was to study the qualitative and quantitative composition of circulating endotheliocytes, P-selectin-associated leukocyte and platelet of coogregation blood levels of endothelin, interleukin-6 students on the background of exam stress. The research was made on the group conditionally healthy volunteers aged MT 18.3 ± 1 years that before participating in the study had a medical examination (n = 15). Blood sampling was made three times: 1--three months before the session (in a normal school day, two hours after training sessions), 2--for 25 ± 10 min before the exam, 3 - 15 ± 10 min after the exam. Approved the development of endothelial dysfunction in the background of exam stress, manifested by increased levels of circulating endothelial cells and endothelin. The total number of leukocyte and platelet of coogregation during the semester, before and after the exam has not changed, while there was an increase outlets, due to the expression of P-selectin on red blood cells before the exam and precipitous decline after the exam.

[Content of some pro- and anti-inflammatory cytokines in blood sera of leptospirosis patients]

AIM

Study the content of some pro- and anti-inflammatory cytokines in blood sera of leptospirosis patients in dynamics of infectious process and the role of these cytokines in the disease immunopathogenesis.

MATERIALS AND METHODS

The content of cytokines in blood sera was determined by a method based on xMAP technology with a standard panel consisting of 9 analytes: TNF-α, MCP-1, IL-8, IL-4, IL-6, IL-10, IL-1Ra, IL-12 (p70), IFN-γ.

RESULTS

A significantly increased level of IL-8, IL-10, TNF-α was confirmed and the increased content of MCP-1 in leptospirosis patients compared with practically healthy donors was established for the first time. Correlations between cytokines during leptospirosis were detected.

CONCLUSION

The data obtained show that cytokines play an important role in leptospirosis immunopathogenesis.

[Quantitative determination of HBsAg in blood sera and hepatitis B virus covalently closed circular DNA in liver tissue as markers of chronic viral hepatitis B activity]

AIM

Quantitative evaluation of HBV covalently closed circular DNA (cccDNA) content in liver tissue of patients with moderately active CHBV course compared with inactive HBsAg carriers as well as establishment of a possible link between HBV cccDNA in liver cells and HBsAg level in blood sera in these groups of patients.

MATERIALS AND METHODS

Patients (n = 34) with CHBV diagnosis were examined for levels ofALT, HBsAg (qualitatively and quantitatively), anti-HBcor IgG, anti-HBe IgG, anti-HCV IgG+IgM, anti-HDV IgG+IgM, HBV DNA in qualitative and quantitative variant. Liver biopsy was carried out in all the patients. HBV DNA was determined in liver tissue by Pollicino T. et al. (2004).

RESULTS

Based on HBV DNA PCR, the patients were allocated to a group of inactive HBsAg carriers (n = 16) and CHBV (n = 18) of moderate activity. Viral load in CHBV patients had a mean of 540 +/- 230 IU/ml. ALT level in carriers was comparatively lower than in patients with CHBV. HBsAg level in blood of inactive carriers was significantly lower, 940 +/- 259 IU/ml against 2559 +/- 982 IU/ml in patients with CHBV (p < 0.05). The quantity of cccDNA per 1 cell in inactive HBsAg carriers--0.15 +/- 0.14, and in patients group of CHBV with moderate activity--1.71 +/- 1.32 (p = 0.034).

CONCLUSION

The method of quantitative determination of HBV cccDNA in liver tissue of patients was worked out. Differences in quantitative content of HBsAg in blood sera of inactive carriers and CHBV patients with moderate activity reflect changes in the extent of hepatocyte infection by HBV.

[Genotyping of parvovirus B19 isolates circulating in Northwestern Federal District of Russia]

AIM

Genotyping and phylogenetic analysis of parvovirus B19 isolates isolated on the territories of Northwestern Federal District (NWFD) of Russia.

MATERIALS AND METHODS

61 blood sera and 30 oropharyngeal lavages obtained from patients with maculopapular rash from various territories of NWFD were studied for the presence of parvovirus B 19 DNA (PVB 19). DNA isolation and amplification was carried out by standard techniques. DNA segment including fragment of non-structural gene NS1 and region of structural gene VPI (NS1-VPlu, 994 nucleotides) was sequenced, original sequences ofoligonucleotide primers were selected for this purpose. Phylogenetic analysis was carried out online on the website http://www.phylogeny.fr. Data for tree construction was obtained from GenBank.

RESULTS

PVB 19 DNAwas detected in 45% ofsamples. PVB19 genome segment was sequenced in 8 samples. All the PVB 19 isolates belong to a single cluster of 1A genotype. Isolate 57.12 from Komi Republic is similar to ISR-G strain isolated from Israel.

CONCLUSION

Phylogenetic analysis showed a high degree of genetic similarity between PVB 19 isolates circulating on the territories of NWFD, their membership in the most widespread genotype in the world. Local and import cases ofparvovirus infection (PVI) were identified. The authors make a conclusion on the necessity to include PVI into the system of rubella and measles control.

[Features of population composition of peripheral blood CXCR3-positive lymphocytes in chronic viral hepatitis c patients]

AIM

Quantitative determination ofCXCR3+, CCR5+ and CCR6+ cells in major lymphocyte populations: T-helpers (Th), cytotoxic T-lymphocytes (CTL), natural killers (NK) and T-natural killer cells (TNK), B-lymphocytes in patients with chronic viral hepatitis C (CVHC).

MATERIALS AND METHODS

Content of lymphocyte populations carrying chemokine receptor CXCR3 was studied, chemokine receptors CCR5 and CCR6 were evaluated on T-lymphocytes, in peripheral blood of 19 CVHC patients and 32 conditionally healthy donors. Cell populations were determined by flow cytofluorometry by using various combinations of monoclonal antibodies: for evaluation of Th and CTL (CD3/CD4/CD8/CXCR3/CCR5/CCR6); NK and TNK (CDl6/CD56/CD3/ CXCR3); B-cells (CD 19/CD45/CXCR3).

RESULTS

In patients with CVHV compared with healthy donors a significant increase of quantity of CXCR3-positive Th was detected, however the content of CXCR3-positive CTL did not differ in the groups compared; CXCR3+ NK cell content was lower with equal content of CXCR3+ TNK. Analysis of quantity of CXCR3+ B-cells showed an increase of more than 3.5 times in CVHC patients. Significant differences in relative content of Th and CTL carrying CCR5 and CCR6 were not detected despite a non-significant increase of quantity of CCR5+ and CCR6+ Th.

CONCLUSION

Content of major lymphocyte populations carrying chemokine receptor CXCR3 changed significantly compared with conditionally healthy donors in peripheral blood of CVHC patients. The increase of quantity of CXCR3-positive B-cells may be associated with infection of these cells by HCV or development of extra-liver manifestations of HVHC.

[The ways of improvement of direct results of surgery of patients with rectal cancer]

The data of 1740 patients (during 20 years) with rectal cancer were analyzed. Planned operations were performed in 95.8% of patients. The adenocarcinoma was verified in all patients. Accompanying pathology was detected in 84.9% of patients and the pathology of cardiovascular system was more frequent (76.6%). Complicated course of tumourous process was revealed in 4.5% of patients (cases of bowel obstruction, the perifocal inflammation). The majority of patients had the II, III stage of the oncologic process. All operations were performed by conventional (open) way. The number of anterior resection of the rectum increased and the number of abdominoanal resection with bringing down reduced. The specific weight of sphincter preserving operations, which were completed by forming a colostomy decreased. The quantity of performed abdominoperineal extirpation was constant.

[Prevalence of seronegative hepatitis D among patients with chronic viral hepatitis B]

AIM

Evaluate prevalence of hepatitis D virus replication markers among patients with chronic viral hepatitis B (CVHB) with active infection course and pronounced biochemical markers of liver damage (ALT level increase).

MATERIALS AND METHODS

ALT>2N served as a criteria of active CVHB course. The following parameters were determined: HBsAg, anti-HBcor IgG, anti-HBeAb, anti-HCV IgG, anti-HDV IgG+IgM, HBV DNA, HDV RNA. HCV IgG(+) patients were excluded from the analysis. In total 142 patients were examined.

RESULTS

Antibodies against HDV were detected in 16.2% (n=23) with CVHB, and HDV DNAwas detected in 21.8% of the examined individuals (n=31). The following variants of HDV infection marker combination were detected: HDV IgG(-) HDV RNA(-) - 75.3% (n=107), no HDV infection; HDV IgG(+) HDV RNA(-) - 2.8% (n=4), anamnestic antibodies against HDV; HDV IgG(+) HDV RNA (+) - 13.4% (n=19), active CVHB+D infection; HDV IgG(-) HDV RNA(+) - 8.4% (n=12), seronegative course of CVHB+B.

CONCLUSION

Examination of patients with pronounced cytolytic syndrome but PCR HBV DNA (-) must include not only determination of serologic markers of HDV infection but also HDV replication markers (PCR HDV RNA). Detection ofpatients with seronegative HDVcourse among patients with HVHB (8.4%) persuasively demonstrates the necessityto introduce molecular-biological examination for HDV RNA into CVHB laboratory diagnostics algorithm.

[Prevalence of latent (HBs negative) chronic hepatitis B among patients of infectious disease cabinets in St. Petersburg outpatients clinics]

AIM

Evaluation of prevalence of latent form (HBsAg negative) of chronic viral hepatitis B (HVHB) among patients being examined in cabinets of St. Petersburg infectious disease polyclinics with chronic viral hepatitis diagnosis.

MATERIALS AND METHODS

Laboratory investigation included HVHB markers determination: HBsAg, anti-HBs, anti-HBcor IgM, anti-HBcor, HBeAg, anti-HBe, hepatitis B virus (HBV) DNA in blood sera and plasma of patients. A total of 705 individuals were examined.

RESULTS

In 25.4% of patients laboratory markers of hepatitis B virus were not present, 20.1% of patients were reconvalescent with anti-HBs antibodies in titers greater than 10 IU/ml and HBV DNA not present. Laboratory HVHB diagnosis was confirmed only in 384 (54.5%) of examined patients, most of these had HBsAg positive form of infection (69.0%) with HBV DNA in blood sera (60%). Only anti-HBcor or anti-HBe antibodies were detected and HBsAg and anti-HBs were not detected in 119 (31.0%) of cases. 6 patients of this group had HBV DNA in blood plasma higher than 20 IU/ml (1.6% of total number of patients with laboratory confirmed HVHB).

CONCLUSION

Standard laboratory examination of patients from hepatitis B infection (including HVHB) high risk groups should include a full list of markers (serological and DNA), thus allowing latent HVHB diagnostics, that, based on our data, amounts to 1.6% of examined patients with HVHB.

[The age dynamics of spontaneous and induced in vitro chromosome aberrations in human lymphocytes under natural and radiation induced senescence]

The frequency of translocations, detected by FISH in lymphocytes of control donors increased with increasing age as quadratic function. This process is elevated in persons exposed to radiation at low-doses. It means that the level of translocations could be used as an indicator of biological age. Moreover the frequency of translocations should be taken into account when biological reconstruction of absorbed dose is carried out. The frequency of dicentrics, detected by FISH and FPG methods increased with age in both groups compared and in equal rate, the linear model being fit the data best. The rate of age-increase for translocations is much higher than for dicentrics. Chromosomal radiosensitivity of lymphocytes in vitro tends to increase with age in control group and significantly decrease--in exposed one, that is low-dose radiation exposure changes the character of age dependence of cytogenetic radiosensitivity.

[The dose-response of unstable chromosome exchanges in lymphocytes of cancer patients undergone whole-body fractionated gamma-rays exposure at the total dose 1.15 Gy]

The dose-response of unstable chromosome exchanges (UCE) in lymphocytes of 4 cancer patients undergone whole-body fractionated gamma-rays exposure (at the daily dose of 0.115 Gy up to the total dose 1.15 Gy) was compared with corresponding dose-response for lymphocytes of the same patients, irradiated in vitro at the same dose range. In vivo irradiation yielded lower frequency of UCE on the dose unit than in vitro irradiation. It was shown that the in vivo dose-response curve gives more adequate dose estimation than in vitro one. This curve could be used for reconstruction of absorbed dose in the cases of analogous character of in-controlled irradiation of people.

The effect of the native bacterial community structure on the predictability of E. coli O157:H7 survival in manure-amended soil

AIMS

The survival capability of pathogens like Escherichia coli O157:H7 in manure-amended soil is considered to be an important factor for the likelihood of crop contamination. The aim of this study was to reveal the effects of the diversity and composition of soil bacterial community structure on the survival time (ttd) and stability (irregularity, defined as the intensity of irregular dynamic changes in a population over time) of an introduced E. coli O157:H7 gfp-strain were investigated for 36 different soils by means of bacterial PCR-DGGE fingerprints.

METHODS AND RESULTS

Bacterial PCR-DGGE fingerprints made with DNA extracts from the different soils using bacterial 16S-rRNA-gene-based primers were grouped by cluster analysis into two clusters consisting of six and 29 soils and one single soil at a cross-correlation level of 16% among samples per cluster. Average irregularity values for E. coli O157:H7 survival in the same soils differed significantly between clusters (P = 0.05), whereas no significant difference was found for the corresponding average ttd values (P = 0.20). The irregularity was higher for cluster 1, which consisted primarily of soils that had received liquid manure and artificial fertilizer and had a significant higher bacterial diversity and evenness values (P < 0.001).

CONCLUSIONS

Bacterial PCR-DGGE fingerprints of 36 manure-amended soils revealed two clusters which differed significantly in the stability (irregularity) of E. coli O157 decline. The cluster with the higher irregularity was characterized by higher bacterial diversity and evenness.

SIGNIFICANCE AND IMPACT OF THE STUDY

The consequence of a high temporal irregularity is a lower accuracy of predictions of population behaviour, which results in higher levels of uncertainty associated with the estimates of model parameters when modelling the behaviour of E. coli O157:H7 in the framework of risk assessments. Soil community structure parameters like species diversity and evenness can be indicative for the reliability of predictive models describing the fate of pathogens in (agricultural) soil ecosystems.

Bacterial regulation of antagonistic activity of bacteria

The phenomenon of microbial regulation of bacterial antagonism was studied using metabolites and cell walls of indicator microorganism culture as inductors. The algorithm of selection of stimulators of bacterial antagonistic activity is determined, experimental conditions are described, and methodological approach to stimulation of bacterial antagonistic activity is developed, which can be used for stimulation of probiotic antagonistic activity and for improving colonization resistance of the host organism during infection.

Modelling the contamination of lettuce with Escherichia coli O157:H7 from manure-amended soil and the effect of intervention strategies

AIMS

A growing number of foodborne illnesses has been associated with the consumption of fresh produce. In this study, the probability of lettuce contamination with Escherichia coli O157:H7 from manure-amended soil and the effect of intervention strategies was determined.

METHODS AND RESULTS

Pathogen prevalence and densities were modelled probabilistically through the primary production chain of lettuce (manure, manure-amended soil and lettuce). The model estimated an average of 0.34 contaminated heads per hectare. A minimum manure storage time of 30 days and a minimum fertilization-to-planting interval of 60 days was most successful in reducing the risk. Some specific organic farming practices concerning manure and soil management were found to be risk reducing.

CONCLUSIONS

Certain specific organic farming practices reduced the likelihood of contamination. This cannot be generalized to organic production as a whole. However, the conclusion is relevant for areas like the Netherlands where there is high use of manure in both organic and conventional vegetable production.

SIGNIFICANCE AND IMPACT OF THE STUDY

Recent vegetable-associated disease outbreaks stress the importance of a safe vegetable production chain. The present study contributed to this by providing a first estimate of the likelihood of lettuce contamination with E. coli O157:H7 and the effectiveness of risk mitigation strategies.