Colonization of adrenal glands and ovaries of mice by HSV-2 variants. I. Virological studies

HSV-2 strain ER was shown to consist of variants with different pathogenic phenotype: Variant ER+ replicates to high titers in the adrenal glands and the ovaries but much less in the spleen; the testes were not colonized. ER+ migrates to the spinal ganglia and is highly neuroinvasive after i.p. inoculation. Variant ER- replicates 100-1,000 fold less in the adrenal glands and the ovaries, but proceeds to the spinal ganglia without invading the CNS. However, both variants are highly neuropathogenic after direct i.c. injection. We conclude that neuropathogenicity, neuroinvasiveness and the ability to replicate in the adrenal glands as well as ovaries are each determined by different sets of genes. Replication in mouse embryo fibroblasts--but not in Vero and adreno cortical carcinoma Y1 cells--is different for both strains. Also the adsorption capacity to cultured cells differs as shown by addition of D.S. 500. ER- is eliminated from the blood stream more quickly than ER+. Finally, C. parvum reduces the rate of replication of both variants in the adrenal and the ovaries. It is concluded that different adsorption and replications rates of variants ER+ and ER- in cell types critical for spread of HSV are responsible for the different pathobiological properties.

Diagnostic and therapeutic problems in a case of adrenal tuberculosis and acute Addison's disease

A case of adrenal tuberculosis with acute Addison's disease is presented. The case showed diagnostic and therapeutic problems, the latter concerning the untoward effects due to metabolic interferences and pharmacologic interactions among antitubercular drugs, substitutive corticosteroid therapy and hepatic metabolism. The side-effects, interactions and metabolism of drugs used during the course of disease are discussed.

Detection of cytomegalovirus-infected cells in autopsy material by in situ hybridization

A non-radioactive in situ hybridization (ISH) method was elaborated to detect cytomegalovirus (CMV)-infected cells in tissue specimens processed for diagnostic routine histopathology. A biotinylated CMV-DNA probe was hybridized following a) four different enzymatic predigestions, b) progressively increasing denaturation periods, and then detected by c) streptavidin-biotin, d) a monoclonal antibody against biotin using a three-stage alkaline phosphatase anti-alkaline phosphatase (APAAP)-technique, and e) combining c + d. Autopsy specimens obtained from an infant with acquired CMV-infection, six patients with AIDS, five patients clinically and serologically without CMV-infection, and preoperative needle core biopsies from six renal allografts served as material. ISH was specific and more sensitive when compared to immunohistochemical (IMH) detection of CMV-antigens by a monoclonal antibody. ISH was concluded to be a rapid, practical, and sensitive tool in daily diagnostic histopathology.

Intracellular parasitism of parenchymal cells by Mycobacterium leprae

The liver, skeletal muscle, and adrenal gland obtained from two nine-banded armadillos infected with Mycobacterium leprae were studied using an electron microscope. M. leprae were found in varying numbers inside hepatocytes, Kupffer's cells, striated muscle cells, adrenal cortical and adrenal medullary cells, endothelial cells, and macrophages. There was evidence to suggest that M. leprae were actively phagocytosed by the liver and skeletal muscle cells. The inert nature of M. leprae and its behavior as an almost ideal parasite of parenchymal cells are emphasized. The question of whether this unique parasitism of parenchymal cells and the possible processing and presentation of M. leprae antigens by these cells could be responsible for aberrant immune responses is raised.

Receptor-mediated adherence of Campylobacter pylori to mouse Y-1 adrenal cell monolayers

An in vitro adherence assay was developed to study the adherence of Campylobacter pylori to mammalian cells. Strains of C. pylori were isolated from individuals with gastritis. These strains possessed the fibrillar N-acetylneuraminyllactose(neuraminlactose)-binding hemagglutinin (NLBH) and were found to adhere to monolayers of mouse Y-1 adrenal cells. Adherence was rapid, prevented by pretreatment of the Y-1 cells with Clostridium perfringens neuraminidase, and blocked by the neuraminlactose-containing protein fetuin. Electron microscopy by the immunogold technique and with anti-NLBH antibody showed that NLBH was present at the sites of interaction between C. pylori and the Y-1 cells. These results indicate that the Y-1 monolayer is a valid model for receptor-specific adherence of C. pylori.

Diagnosis of disseminated histoplasmosis by fine needle aspiration of the adrenal gland

The cytologic findings in a case of disseminated histoplasmosis diagnosed by fine needle aspiration (FNA) of the adrenal gland are presented. Bilateral adrenal enlargement was discovered on CT scan in a patient whose systemic symptoms had been attributed to tuberculosis, but were resistant to antituberculous chemotherapy. The aspirate contained numerous histiocytes containing intracytoplasmic organisms with the morphologic features of Histoplasma capsulatum. The case shows that radiographically directed FNA of the adrenal gland, which has been recognized as a valuable aid in the confirmation of primary and secondary neoplasia, may also be quite useful in the less common setting of infectious disease involving this organ.

Disseminated histoplasmosis diagnosed by fine needle aspiration biopsy of the adrenal gland. A case report

A case of disseminated histoplasmosis diagnosed by fine needle aspiration (FNA) biopsy of the adrenal gland is reported for a 60-year-old man who presented with a 40-pound weight loss and abdominal computed tomography showing bilateral adrenal enlargement. FNA biopsy of the adrenal gland revealed clusters of macrophages with abundant cytoplasm containing the yeast forms of Histoplasma capsulatum. This case emphasizes that FNA is effective in diagnosing infectious as well as neoplastic conditions of the adrenal glands.

Demonstration of infectious bovine rhinotracheitis virus antigen in paraffin sections

Nine pregnant heifers were inoculated intravenously with infectious bovine rhinotracheitis virus (IBRV) in the sixth month of pregnancy. Tissues were collected from the fetus of a heifer killed 13 days postinoculation (PI), from fetuses of 6 heifers that aborted 16-27 days PI, and from mummified fetuses of 2 heifers that aborted 53 and 85 days PI, respectively. Control tissues were obtained from the fetus of a non-inoculated heifer that was killed in the seventh month of gestation. Tissues were fixed in 10% formalin, embedded in paraffin, and examined for viral antigen by immunohistochemistry, using biotinylated second antibody and alkaline phosphatase-labeled avidin-biotin complex. Antigen was detected in at least 1 tissue from the fetus of each inoculated heifer. Positive tissues included lung, liver, spleen, kidney, adrenal, and placenta. In several fetuses, antigen was identified in tissues from which virus was not isolated in cell culture. This appeared to occur when tissues had only a few small foci of infection or when tissues were severely autolyzed. The observation of viral antigen in tissues from mummified fetuses indicates that this technique may be useful in diagnostic laboratories to detect IBRV infection in tissues that are not suitable for virus isolation or for examination by the cryostat tissue section-fluorescent antibody technique.

[The significance of corticosteroid insufficiency in the mechanisms of toxicosis in experimental listeriosis]

The infection of mice with Listeria led, in case of the development of an acute generalized form of the disease, to the sharp decrease of the content of ascorbic acid and to the nearly complete delipidization of the glomerular zone of the adrenal cortex, which was indicative of the development of relative adrenal insufficiency. The most pronounced histomorphological and histochemical changes occurred simultaneously with the maximum accumulation of Listeria in the adrenal glands. The administration of hydrocortisone at the period of the development of acute infection produced a temporary decrease in the manifestations of toxicosis. The maximum protective effect was achieved by combined glucocorticoid and antibiotic therapy.

Adrenal involvement in scrapie-induced obesity

In previous studies we found an increase in body weight during the preclinical phase of disease in certain scrapie strain-mouse strain combinations. The effect was augmented by injection into the hypothalamus. In the present study, we found an increase in food consumption (compared to the normal mouse brain injection group) for both the 139A and ME7 scrapie groups, although only the ME7 group showed an increase in body weight. In a scrapie strain-mouse strain combination that showed an increase in body weight, the adrenal gland was the only organ that showed a significant increase in weight. The titer of scrapie in the adrenals was comparatively low. Adrenalectomy prevented the increase in body weight in two strains of mice injected with the ME7 scrapie strain. The results suggest that scrapie-induced obesity depends on an effect of scrapie on the hypothalamic-pituitary-adrenal axis.

Analysis and isolation of cytomegalovirus DNA by field inversion gel electrophoresis

High molecular weight human cytomegalovirus (CMV) DNA was isolated from agarose-embedded infected human diploid cells by employing field inversion gel electrophoresis. A high yield of CMV DNA molecules was obtained within 1 week of infecting the cell culture. Labelling of the viral DNA with biotin by nick translation enabled the detection of CMV-infected cells in sections of paraffin-embedded human adrenal gland by in situ hybridization.

The influence of androgens on paralysis in mice following intravenous inoculation of herpes simplex virus

In mice, intravenous inoculation of relatively avirulent strains of herpes simplex virus [e.g. P2C6, a mutant of strain CL(101), deficient in thymidine kinase] produced infection in the adrenal gland and mid-spinal cord followed by hind limb paralysis without death. Male mice were less susceptible to paralysis than female mice. Castration of male mice before inoculation increased their susceptibility to that of female animals; treatment with testosterone reversed this change. The differences in susceptibility to paralysis in the various categories of animal were not reflected in differences in growth of virus in the adrenal gland or spinal cord.

Growth advantage and enhanced toxicity of Escherichia coli adherent to tissue culture cells due to restricted diffusion of products secreted by the cells

This study was undertaken to examine whether Escherichia coli adherent to tissue cells gain advantages over nonadherent bacteria due to their proximity to the cells. We used tissue culture cells and isogenic derivatives of a proline auxotrophic strain of E. coli that were fimbriated (Fim+) or nonfimbriated (Fim-), and were heat-labile enterotoxin producing (Tox+) or toxin nonproducing (Tox-). We found that the Fim+ bacteria; which were capable of adhering to tissue culture cells, initiated growth much sooner than did nonadherent Fim- bacteria; the adherent bacteria used tissue cell-derived proline, which was available at high concentrations only in the zone of bacterial adherence. Likewise, cyclic AMP secreted by adherent (Fim+) bacteria was maintained at high concentration on the tissue cell surfaces. As few as 2 X 10(5) adherent Fim+ Tox+ bacteria exert toxic activity upon Y1 adrenal cells, whereas toxin secreted in the medium by 6 X 10(6) Fim- Tox+ bacteria was undetectable. The results suggest that the growth advantage and enhanced toxicity of adherent E. coli is due to restricted diffusion of products secreted by the tissue culture and bacterial cells, respectively.

Septicemic listeriosis in a reindeer calf

Septicemic listeriosis is described in a 2-day-old reindeer calf (Rangifer tarandus tarandus) from a local zoo. The gross and microscopic lesions were typical of disease caused by bacterial septicemia. Major lesions included necrosis of the liver, lung, adrenal gland, spleen, and lymph node. The diagnosis was suspected by special histopathological stains and confirmed by isolation of Listeria monocytogenes from multiple organs. This is the first report of listeriosis in a reindeer.

In situ hybridization analysis of cytomegalovirus lytic infection in Kaposi's sarcoma associated with AIDS. A study of 14 autopsy cases

Cytomegalovirus (CMV) was assayed by in situ hybridization with commercially available biotin-labeled CMV-DNA probes in 45 formalin-fixed paraffin-embedded autopsy specimens with Kaposi's sarcoma from 14 cases of the acquired immune deficiency syndrome (AIDS). In seven of the 14 cases, a few scattered hybridizing cells were detected in Kaposi's sarcoma, but not all specimens from the same case showed such cells. Most of the positive cells were peculiarly swollen and not typical of Kaposi's sarcoma cells. All positive cases had at least some CMV-infected organs with typical cytomegalic cells containing nuclear inclusions while five of the 7 negative cases revealed no CMV-infected tissue by conventional light microscopy. Our results suggest that this in situ hybridization procedure using biotin-labeled DNA probes only reveals generalized CMV infection that is a consequence of impairment of immune mechanisms in AIDS patients.

Herpes simplex virus type 1 and 2 in the adrenal glands: replication and histopathology

The adrenal glands were shown to be the most severely infected organs in the early phase of HSV-1 infections (up to 10 days p.i.) after i.p. infections in mice. Virus could be isolated from the adrenal glands as early as one hour after infection with pathogenic and apathogenic strains. Infection of the adrenal glands is a result of viremia. The content of HSV-1 (5 strains) was much higher in the adrenals than in spleen and liver. It peaked at 3-4 days p.i. compared to 1-2 days in spleen and liver. Only strain 17 syn+ produced low tissue titres in the adrenal glands. Morphologic alterations by HSV-1 infections commenced with distinct foci 2 days after infection in the zona fasciculata, detected immunohistochemically by HSV-specific peroxidase-staining. Necrotic cells could be observed. The foci became confluent until day 4 and remained in this status up to day 7 p.i. During infection immunocompetent cells (macrophages, granulocytes, many T-helper--but only few T-cytotoxic/suppressor lymphocytes) could be observed. On day 10 p.i. the viral antigen had been completely eliminated. In contrast, intraperitoneal infections with 5 strains of HSV-2 resulted in infection of the adrenal glands only to a low degree. The titer of virus was low (exception: strain HG 52). This correlates well with the type of disease produced by either HSV-1 or 2. By comparing the replication of different strains of HSV-1 and 2, three types of "tropism" after i.p. infection of mice can be distinguished.

Murine cytomegalovirus adrenalitis in athymic nude mice

During studies of the pathogenesis of murine cytomegalovirus (MCMV) infection in athymic nude mice, we noted striking virus involvement of the adrenal glands. Because patients with the acquired immunodeficiency syndrome (AIDS) have recently been reported to have adrenal necrosis and evidence of infection of the adrenal gland with human cytomegalovirus (HCMV), we have further evaluated adrenal gland involvement during MCMV infection. Following virus inoculation, MCMV replicated to high titer in the adrenal glands of T-cell deficient, homozygous nude mice, but not heterozygous littermates with intact T-cell function. Concomitant with the high titers of virus, there appeared overt histological evidence of herpes-virus virus infection accompanied by patchy necrosis of adrenal cortical and medullary tissues. Acyclovir, which inhibits growth of MCMV, reduced virus replication in the adrenal gland. Similarly, virus replication was diminished in homozygous nude mice immunologically reconstituted by infusion of normal spleen cells three weeks prior to infection. Thus, in the absence of functioning T lymphocytes, MCMV can infect and replicate in adrenal tissues causing a progressive destructive adrenalitis.

Adrenal pathology in the acquired immune deficiency syndrome

Adrenal pathology was examined in 41 autopsied patients with the acquired immune deficiency syndrome. This represents the largest series and the first study with quantitation of adrenal cortical necrosis. In 32 cases clinical data were analyzed for features of adrenal insufficiency. Common clinical findings included vomiting, diarrhea, fever, hypotension, and hyponatremia. None of the 32 patients showed characteristic skin hyperpigmentation. Two patients were suspected premortem to have adrenal insufficiency. In one of these patients, adrenocorticotrophic hormone (ACTH) stimulation resulted in an adequate rise in plasma cortisol values. In the other patient, the baseline plasma cortisol value was elevated and failed to rise significantly after ACTH stimulation. Pathologic findings included widespread lipid depletion, infection by cryptococcus, and acid-fast organisms consistent with Mycobacterium avium-intracellulare, involvement by Kaposi's sarcoma, and necrotizing adrenalitis due to cytomegalovirus (CMV). A point-counting method was used to quantitate adrenal cortical and medullary necrosis. Necrosis due to CMV was greater in the medulla than the cortex. The maximum amount of adrenal cortical necrosis in any case was 70%. The degree of cortical necrosis was less than that usually associated with adrenal insufficiency.

The guinea pig model for Argentine hemorrhagic fever

Guinea pigs infected by the peripheral route with the XJ pathogenic strain of Junin virus showed viscerotropism mainly in reticulo-phagocytic rich organs. By immunofluorescence, heavy infection of reticular-phagocytic cells was demonstrated, supporting the leading role of these cell types. Absence of neurotropism was demonstrated by the inability to recover infectious virus, as well as the absence of antigens, immunoglobulins, or 3rd component of complement deposits, in cells, vessels, or meninges. The correlation between infectivity and antigen expression observed in organs, and the absence of evidence of immunopathologic mechanisms, strongly suggest a direct viral effect in these experimental conditions. The results show that infection of guinea pigs by the peripheral route is an adequate model for human Argentine hemorrhagic fever with the exception of central nervous system involvement. Comparisons are made with infections produced in guinea pigs by attenuated strains, as well as with the disease in primates and humans.

Lassa virus infection of rhesus monkeys: pathogenesis and treatment with ribavirin

Rhesus monkeys were experimentally infected with Lassa virus to establish their suitability as a nonhuman primate model for the human disease and to test the protective efficacy of ribavirin, an antiviral drug. Six of 10 untreated control monkeys died after subcutaneous inoculation of 10(6.1) plaque-forming units of Lassa virus (strain Josiah). Infectivity titrations of tissue homogenates from the six dead monkeys indicated significant replication in all tissues tested except the central nervous system. This distribution of virus was confirmed by direct immunofluorescence examination of cryostat-sectioned tissues. Ribavirin was beneficial in the treatment of two groups of infected monkeys. Four monkeys first treated on the day of viral inoculation experienced only mild clinical disease; four monkeys first treated five days later experienced a more severe illness. None of the eight monkeys treated with ribavirin died. Viremia titers and elevations of levels of serum transaminases in treated monkeys were significantly lower than in controls. Ribavirin may be beneficial in the treatment of humans exposed to this life-threatening virus.

Evaluation of the rabbit as a laboratory model for infectious bovine rhinotracheitis virus infection

Experimental infection of rabbits with infectious bovine rhinotracheitis virus (IBRV) produced diverse manifestations of disease which included abortion, conjunctivitis, dermatitis, vulvovaginitis, systemic infection, neonatal death and respiratory tract infection. Each disease syndrome was studied using virus isolation, fluorescent antibody examination and histologic examination. Conjunctivitis, dermatitis and vulvovaginitis lesions were characterized by edema, infiltration of mucosa and submucosa with inflammatory cells and ulceration of epithelium. Systemic infection resulted in severe necrosis of liver and adrenal glands with large numbers of cells containing intranuclear inculsions. Pregnant rabbits aborted within 48 hours following inoculation of IBRV. Virus infection and viral lesions were not demonstrated in aborted fetuses.

Acute murine adrenalitis induced by reovirus 3. An ultrastructural study

Reovirus 3 infection of neonatal mice, although characterized primarily by encephalitis, hepatitis, and pancreatitis, also induces an adrenalitis. Histologically, the latter is characterized initially by foci of coagulative necrosis which later enlarge and become surrounded by leukocytic infiltration. Ultrastructurally, the virus was shown to replicate in the paranuclear region of mainly adrenocortical cells but also medullary and endothelial cells. Apoptosis is the most common form of necrosis exhibited and is quickly followed by an infiltration of mononuclear phagocytes which eventually ingest the virus and the cellular debris.