Disassociation of Spa type and serovar of an Erysipelothrix rhusiopathiae serovar 6 strain isolated from a diseased pig

The surface protective antigen (Spa) protein of Erysipelothrix rhusiopathiae is an important component in protecting pigs against swine erysipelas. The Spa protein has been antigenically divided into 3 types: SpaA, SpaB, and SpaC. Swine erysipelas vaccines are formulated with strains of serovar 1 and/or 2, both of which are SpaA-possessing serovars. The association of Spa type with E. rhusiopathiae serovar has been reported, and therefore, the determination of the Spa type and the serovar of clinical isolates are important to assess vaccine efficacy. An E. rhusiopathiae strain, designated Ireland, was isolated from a diseased pig and identified as serovar 6 by a conventional agar gel precipitation test. Sequence analysis of the chromosomal locus presumably defining the serovar antigenicity of E. rhusiopathiae revealed that the gene content and organization of the chromosomal regions of the Ireland strain were identical to those of the serovar 6 reference strain (Tuzok). Sequence analysis of the spa gene and dot blots using a SpaA-specific monoclonal antibody confirmed that, unlike the Tuzok strain possessing SpaB, the Ireland strain expressed SpaA, indicating that the Spa type is not associated with the serovar in this strain. Thus, further investigation into the association between Spa type and serovar of clinical swine isolates is warranted.

A case of nivolumab-induced acute-onset type 1 diabetes mellitus in melanoma

Nivolumab, an anti-PD-1 antibody, is now considered an important therapeutic agent in several advanced malignancies. However, immune-related adverse events such as endocrinopathies have been reported with its use. Thyroid disorder and isolated adrenocorticotropic hormone deficiency have frequently been reported as nivolumab-induced immune-related adverse events. Another endocrinopathy is nivolumab-induced type 1 diabetes mellitus (t1dm), described as diabetes mellitus with rapid onset and complete insulin insufficiency, at times leading to fulminant t1dm. We report the case of a 68-year-old woman who developed pancreatic islet-related autoantibody-negative t1dm, possibly induced by nivolumab, under continuous glucocorticoid administration. She was treated with nivolumab for advanced malignant melanoma, concomitant with 10 mg prednisolone daily for thrombophlebitis tapered to 5 mg after 13 courses of nivolumab therapy. At approximately the 27th course of nivolumab therapy, she showed elevated plasma glucose levels despite preserved insulin secretion. A month later, she developed diabetic ketoacidosis. Her insulin secretion decreased and finally was exhausted. She was diagnosed with acute-onset rather than fulminant t1dm because of a rapidly progressive course to diabetic ketoacidosis during just more than 1 week. She is currently receiving insulin replacement. There has been no recurrence of the melanoma. Thus, nivolumab might induce autoimmune diabetes mellitus, with patients having t1dm-sensitive human leucocyte antigen being more susceptible even when receiving glucocorticoids. Physicians should be aware that nivolumab could potentially induce t1dm as a critical immune-related adverse event.

Identification of serovar 1a, 1b, 2, and 5 strains of Erysipelothrix rhusiopathiae by a conventional gel-based PCR

Among the four species of the genus Erysipelothrix, Erysipelothrix rhusiopathiae is the main species that causes disease in swine and poultry and has also been isolated from human patients. Recently, E. rhusiopathiae infections in domesticated animals have increased in many countries and are also the cause of emerging wildlife disease in arctic and boreal ecosystems. Historically, E. rhusiopathiae has been differentiated from other Erysipelothrix species by their serovars, which are determined based on cell wall antigens. Serotyping of Erysipelothrix is important, as specific E. rhusiopathiae serovars (1a, 1b, and 2) are associated with disease in pigs, poultry, and humans. However, serotyping is laborious and time-consuming and requires a full set of serovar reference strains and strain-specific antiserum. In this study, to develop a conventional gel-based PCR assay that can detect the main disease-associated serovars of E. rhusiopathiae, the draft genome sequences of E. rhusiopathiae strains of serovars 1a, 1b, 2, and 5, the last of which is often isolated from wild animals, were analyzed. Primers were designed based on the serovar-specific sequences of the strains and tested for field strains isolated from extensive origins. Among two hundred and ninety-seven isolates of various serovar strains of E. rhusiopathiae and other Erysipelothrix species, the PCR assay identified serovar 1a, 1b, 2, and 5 strains of E. rhusiopathiae. This conventional gel-based PCR assay should be useful for serovar surveillance of E. rhusiopathiae isolates in domesticated and wild animals as well as in humans.

The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study

Objectives

To compare the effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament (ACL) reconstruction animal model.

Methods

Anterior cruciate ligament reconstruction using the plantaris tendon as graft material was performed on both knees of 24 rabbits (48 knees) to mimic ACL reconstruction by two different suspensory fixation devices for graft fixation. For the adjustable fixation device model (Socket group; group S), a 5 mm deep socket was created in the lateral femoral condyle (LFC) of the right knee. For the fixed-loop model (Tunnel group; group T), a femoral tunnel penetrating the LFC was created in the left knee. Animals were sacrificed at four and eight weeks after surgery for histological evaluation and biomechanical testing.

Results

Histologically, both groups showed a mixture of direct and indirect healing patterns at four weeks, whereas only indirect healing patterns were observed in both groups at eight weeks. No significant histological differences were seen between the two groups at four and eight weeks in the roof zone (four weeks, S: mean 4.8 sd 1.7, T: mean 4.5 sd 0.5, p = 0.14; eight weeks, S: mean 5.8 sd 0.8, T: mean 4.8 sd 1.8, p = 0.88, Mann-Whitney U test) or side zone (four weeks, S: mean 5.0 sd 1.2, T: mean 4.8 sd 0.4, p = 0.43; eight weeks, S: mean 5.3 sd 0.8,T: mean 5.5 sd 0.8, p = 0.61, Mann-Whitney U test) . Similarly, no significant difference was seen in the maximum failure load between group S and group T at four (15.6 sd 9.0N and 13.1 sd 5.6N) or eight weeks (12.6 sd 3.6N and 17.1 sd 6.4N, respectively).

Conclusion

Regardless of bone tunnel configuration, tendon-bone healing after ACL reconstruction primarily occurred through indirect healing. No significant histological or mechanical differences were observed between adjustable and fixed-loop femoral cortical suspension methods.

Cite this article: Y. Sato, R. Akagi, Y. Akatsu, Y. Matsuura, S. Takahashi, S. Yamaguchi, T. Enomoto, R. Nakagawa, H. Hoshi, T. Sasaki, S. Kimura, Y. Ogawa, A. Sadamasu, S. Ohtori, T. Sasho. The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study. Bone Joint Res 2018;7:327–335. DOI: 10.1302/2046-3758.75.BJR-2017-0238.R2.

Multiplex PCR assay for the simultaneous detection and differentiation of clonal lineages of Erysipelothrix rhusiopathiae serovar 1a strains currently circulating in Japan

The species Erysipelothrix rhusiopathiae displays genetic heterogeneity; however, E. rhusiopathiae serovar 1a strains currently circulating in Japan exhibit remarkably low levels of genetic diversity and group into clonal sublineages of Lineage IVb (IVb-1 and IVb-2). In the present study, based on whole genome sequencing data, we designed primers for a multiplex PCR assay to simultaneously detect and differentiate the sublineages of E. rhusiopathiae strains. Among the one hundred and twenty-seven isolates of various serovar strains, including isolates from a wide range of hosts and geographic origins, the PCR assay could successfully detect and differentiate the serovar 1a strains belonging to the sublineages.