Involvement of vulnibactin and exocellular protease in utilization of transferrin- and lactoferrin-bound iron by Vibrio vulnificus

In vitro growth experiments were conducted to evaluate the ability of vulnibactin, a siderophore produced by Vibrio vulnificus, to sequester transferrin- or lactoferrin bound iron for growth. Comparative studies with the strain producing vulnibactin and its exocellular protease-deficient mutant revealed the involvement of the protease in addition to vulnibactin in effective utilization of iron ion (Fe3+) bound to transferrin and lactoferrin. It appears that the protease causes cleavage of these proteins, thereby making bound iron more accessible to vulnibactin.

[A case of alveolar soft-part sarcoma with cerebral metastases]

A case of alveolar soft-part sarcoma with multiple cerebral metastases in addition to multiple lung and bone metastases is reported. This is a rare tumor which thus far has only been recognized as a malignant soft tissue tumor with great uncertainty. A 24-year-old man with a chief complaint of left frontal headache was admitted to our unit on September 26, 1994. A tumor of the right forearm had been surgically removed 9 years previously, and surgery had been followed by two courses of chemotherapy with vincristine, cyclophosphamide and actinomycin-D and subsequent irradiation for bone metastasis. The chemotherapy, however, did not have any clear effect. Neurological examination at the time revealed only bilateral papilledema, but CT and MRI scan of the brain showed a round mass in the left occipital lobe with homogeneous enhancement and another small mass was detected in the right occipital lobe. A cerebral angiogram showed a vascular tumor. The preoperative diagnosis was multiple cerebral metastases of alveolar soft part sarcoma. Left occipital craniotomy was performed on October 12, 1994, and the tumor was completely removed by lobectomy. Specimens of the tumor showed typical histological features of alveolar soft-part sarcoma. Whole-brain radiotherapy was administered postoperatively, and the patient is well neurologically without right homonymous hemianopsia. The clinical features of alveolar soft-part sarcoma are discussed. Only a few cases have been reported in the literature, but the most frequent site of the primary lesion has been the lower extremities, and cerebral metastasis has not been rare. All efforts should be focused on discovering this tumor in the early stage because surgical removal can yield good results, and radiotherapy is thought to be effective in terms of patient "quality of life".

Actions of Vibrio vulnificus metalloprotease on human plasma proteinase-proteinase inhibitor systems: a comparative study of native protease with its derivative modified by polyethylene glycol

Vibrio vulnificus, an opportunistic human pathogen causing wound infection and septicemia, produces a metalloprotease (VVP) which is suspected to be a virulent determinant. The interactions of VVP, as well as its derivative (PEG1-VVP) modified with polyethylene glycol, with a variety of human plasma proteins were investigated. We found that native VVP and its derivative were able to act directly on many biologically important human plasma proteins even in the presence of alpha-macroglobulin, the sole plasma inhibitor of native VVP. The activities of both classical and alternative pathways of the complement cascade system were drastically abolished by incubation with either VVP. Furthermore, these proteases rapidly digested the A alpha-chain of human fibrinogen into fragment(s) with no clotting ability. Therefore both VVPs are thought to function as a fibrinogenolytic enzyme, causing delay of the coagulation reaction. VVP and PEG1-VVP were also shown to destroy plasma proteinase inhibitors including alpha 1-proteinase inhibitor, a major inhibitor in human plasma. Because endogenous proteolytic enzymes and their inhibitors are indispensable in maintaining physiological homeostasis, these findings suggest that VVP (and PEG1-VVP) may cause an imbalance of human plasma proteinase-proteinase inhibitor systems, thus eliciting an immunocompromised state in the host and facilitating the development of a systemic V. vulnificus infection such as septicemia.

Demonstration of a ferric vibrioferrin-binding protein in the outer membrane of Vibrio parahaemolyticus

Under iron-restricted conditions, Vibrio parahaemolyticus produces a siderophore, vibrioferrin, accompanying expression of two major outer membrane proteins of 78 and 83 kDa. Autoradiographic analysis of nondenaturing polyacrylamide gel electrophoregrams of outer membrane preparations previously incubated with [35Fe]ferric vibrioferrin revealed a single radiolabeled band, in which the 78-kDa protein was detected predominantly by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The antiserum against the purified 78-kDa protein partially inhibited Fe-VF binding to isolated OMPs. The 78-kDa protein was cleaved by the treatment of whole cells with proteinase K, indicating that a portion of this protein is exposed on the surface of the outer membrane. The treated cells lost most of their iron uptake activity mediated by vibrioferrin. These results suggest that the ferric vibrioferrin-binding protein of 78 kDa may function as the receptor for ferric vibrioferrin involved in the initial step of vibrioferrin-mediated iron uptake. Immunoblot analysis using the antiserum against the 78-kDa protein demonstrated that the molecular mass and antigenic properties of the protein were highly conserved among V. parahaemolyticus strains examined. The antiserum also recognized an iron-repressible outer membrane protein of 78 kDa from iron-restricted V. alginolyticus strains, some of which appeared to produce vibrioferrin.

[A case of painful tic convulsif due to cerebellopontine angle epidermoid tumor which could not be clearly detected by MRI]

A case of painful tic convulsif (trigeminal neuralgia and ipsilateral hemifacial spasm) caused by cerebellopontine angle epidermoid tumor is presented. This tumor was compressed to the trigeminal nerve, and became attached to the facial and auditory nerves. The facial nerve exit-zone of brain stem was also compressed by the tumor along with a branch of the posterior inferior cerebellar artery. Total removal of the tumor was carried out and neuralgia and facial spasm disappeared. Painful tic convulsif caused by brain tumor is rare (eight cases in the literature plus our case), but epidermoid tumor is not rare as a cause of this complaint (seven in eight cases). In preoperative examination of this case, we could not detect this epidermoid in the cerebellopontine angle, because this tumor was the same intensity as CSF liquid on magnetic resonance imaging (T1 and T2 weighted image) and exerting hardly any mass effect on the brainstem. On encountering a case of painful tic convulsif of unknown origin despite the usual preoperative examinations, it may be useful that same kind of brain tumor, especially, epidermoid might be concealed in the cerebellopontine angle lesion.

Utilization of hemin and hemoglobin as iron sources by Vibrio parahaemolyticus and identification of an iron-repressible hemin-binding protein

Several clinical isolates of Vibrio parahaemolyticus were examined for their ability to utilize either hemin or hemoglobin as a sole source of iron. Both compounds appeared to be equally good iron sources. Maximum growth was obtained at 5 microM hemin or 1.25 microM hemoglobin under the conditions tested. Using a hemin-agarose batch affinity method, the hemin-binding protein was isolated from crude total membranes of a hemin-utilizing strain, WP1, grown under iron-deficient but not under iron-sufficient conditions. This protein was identical to the 83 kDa outer membrane protein which was expressed in response to iron limitation. The protein was susceptible to proteinase K cleavage in whole cells, indicating its exposure at the cell surface. Hemin and hemoglobin, but not protoporphyrin IX, inhibited binding of the protein to hemin-agarose.

Differences in lymphocyte proliferative responses to food antigens and specific IgE antibodies to foods with age among food-sensitive patients with atopic dermatitis

BACKGROUND

Clinical symptoms of patients with food-sensitive atopic dermatitis often improve with increasing age.

OBJECTIVE

To investigate this tendency and the underlying mechanism.

METHODS

We selected and divided 194 food-sensitive atopic dermatitis patients into three age groups. The proliferative responses of peripheral blood mononuclear cells (PBMCs) to food antigens and specific IgE antibodies to foods then were evaluated with respect to age. We also followed up 55 food-sensitive patients with atopic dermatitis and examined their improvement ratio after 1 year. Further, we investigated changes in lymphocyte proliferative responses to food antigens and specific IgE antibodies to foods in food-sensitive patients with atopic dermatitis during elimination diets.

RESULTS

Proliferative responses of PBMCs to ovalbumin of patients in the over 6-years-old group were significantly (P < .05) lower than those of the less than 1-year-old group. Proliferative responses of PBMCs to bovine serum albumin of patients in the over 6-years-old group were significantly (P < .05) lower than those in the 1 to 5-year-old group and in the less than 1-year-old group. RAST values for hen egg in the over 6-years-old group were significantly (P < .05) lower than those for the less than 1-year-old group. Improvement was shown by 13 of the 33 hen egg-sensitive patients with atopic dermatitis, an improvement ratio of 39%, and by 9 of the 22 cow milk-sensitive patients with atopic dermatitis, an improvement ratio of 41%. Proliferative responses of PBMCs to food antigens in food-sensitive patients with atopic dermatitis decreased rapidly after patients were placed on elimination diets.

CONCLUSION

The PBMC proliferative responses to food antigens and RAST values were higher for young children and lower for older ones who suffered from food-sensitive atopic dermatitis. Oral tolerance, in addition to the development of digestive and absorptive functions, may be responsible for these immunologic changes.

Frequent loss of the cyclin-dependent kinase-4 inhibitor gene in human gliomas

Studies have shown that homozygous deletion of the cyclin-dependent kinase-4 inhibitor (CDK4I) gene, which is mapped to chromosome 9p21, is frequently observed in various types of human cancers. Here we report that the CDK4I gene was deleted in gliomas. Eight cell lines derived from glioblastomas and samples from 14 patients with various grades of gliomas were examined by Southern blot analysis. We found that the CDK4I gene was deleted in 7 of 8 (87.5%) cell lines and 7 of 9 (78%) samples from high-grade glioma patients, whereas it was deleted in 1 of 5 (20%) low-grade glioma samples. These results suggested that inactivation of the CDK4I gene may play an important role in the progression of human glioma.

Evaluation of lymphocyte proliferative responses to casein hydrolysate formula in cow's milk-sensitive children: response of peripheral blood mononuclear cells to hydrolysate formula

The proliferative responses of peripheral blood mononuclear cells (PBMCs) to cow's milk proteins and a casein hydrolysate formula were investigated in 10 cow's milk-sensitive patients. The casein hydrolysate formula reduced the symptoms in seven children but not in three. The proliferative responses of PBMCs to cow's milk proteins and the formula were higher in the three patients whose symptoms were not reduced by casein hydrolysate formula. However, the proliferative responses of PBMCs to hydrolysate formula were lower than those to cow's milk proteins in patients whose symptoms were reduced by casein hydrolysate formula. These results suggest that an elimination diet with casein hydrolysate formula may not be as effective in some patients with cow's milk allergy whose PBMCs proliferate to casein hydrolysate formula.

Production of antigenically related exocellular elastolytic proteases mediating hemagglutination by vibrios

Exocellular proteases produced by Vibrio fluvialis, V. furnissii, V. metschnikovii and V. campbellii were characterized and compared to those of V. mimicus protease (VMP) and V. vulnificus protease (VVP). These proteases possessed both elastolytic and hemagglutinating abilities and were identified, except that of V. metschnikovii, as metalloprotease. Conversely, V. metschnikovii protease failed to exhibit some of the salient features for metalloproteases suggesting the existence of protease(s) other than metalloprotease. However, antibodies against VVP cross-reacted to these proteases and to VMP indicating antigenic relatedness amongst vibrio proteases. This study, thus, demonstrated the prevalent distributions of antigenically related proteases both in pathogenic and non-pathogenic vibrios, bringing their status as a virulence determinant into question.

Genetic analysis of IgE and the IGHE, IGHEP1 and IGHEP2 genes in atopic families

The familial occurrence of allergic diseases was studied in 478 individuals and their family members. The results showed that there was pronounced familial clustering. Total serum IgE concentrations of atopic patients and their parents were well correlated. Moreover, the concentration of specific IgE of the patients and their parents was also well correlated, suggesting that IgE production was genetically determined. To determine if major structural abnormalities of IGHE, IGHEP1 and IGHEP2 genes might lead to aberrant control and subsequent increase in IgE concentration, genomic DNAs from 55 individuals, i.e., 31 atopic patients and their family members, were examined. We detected the IGHE, IGHEP1 and IGHEP2 genes in all 55 leukocyte DNAs. We could not find any large deletions or duplications in the IGHE, IGHEP1 and IGHEP2 genes of atopic patients with high serum IgE concentrations.

Sensitization to sugar cane pollen in Okinawan allergic children

Specific IgE antibodies to sugar cane pollen were investigated in seventy-four Okinawan children who suffered from allergic disorders. Only two (2.7%) with asthma of the 74 patients had specific IgE antibodies to sugar cane pollen as well as house dust and Dermatophagoides farinae. However, they have no histories of their symptoms being aggravated when sugar cane flowers bloom. From these results, the sensitization to sugar cane pollen exists in a small number of Okinawan allergic children, however, the low incidence of positivity could reflect lack of exposure to sensitizing doses of sugar cane pollen in these children.

Predictive values of cord blood IgE and cord blood lymphocyte responses to food antigens in allergic disorders during infancy

Proliferative response of cord blood lymphocytes stimulated twice by food antigens and cord blood IgE concentration were measured in 131 full-term newborn infants for the prediction of allergic disorders. Through the follow-up study for 2 1/2 years, the value of stimulation index in proliferative response of cord blood lymphocytes to ovalbumin or bovine serum albumin was greater than 1.5 in 17 (sensitivity 53.1%) of 32 infants in whom allergic disorders developed and less than 1.5 in 81 (specificity 81.8%) of 99 infants who had no allergic disorders (cutoff limit of stimulation index 1.5). The sensitivity was increased (71.9%) by the combination of the cord blood IgE concentration (cutoff limit 1.0 IU/ml) and proliferative response of cord blood lymphocytes to food antigens (cutoff limit of stimulation index 1.5). The combination of the cord blood IgE concentration and proliferative response of cord blood lymphocytes to food antigens is useful for the prediction of allergic disorders. Interleukin-2 production of cord blood lymphocytes stimulated with food antigens was also measured in 24 newborn infants. Interleukin-2 activity in culture supernatants of ovalbumin- or bovine serum albumin-stimulated cord blood lymphocytes correlated well with proliferative response of cord blood lymphocytes to ovalbumin or bovine serum albumin.

Cloning and nucleotide sequence of the carboxynorspermidine decarboxylase gene from Vibrio alginolyticus

The gene (nspC) encoding carboxynorspermidine decarboxylase (CANS DC), the last enzyme in norspermidine biosynthesis, in Vibrio alginolyticus was isolated by immuno-screening and its complete nucleotide sequence was determined. Sequence analysis of the subcloned fragment (2.0 kb) revealed an ORF of 1131 bp encoding a protein of 377 amino acids with a calculated molecular mass of 42,008 Da. The sequence of 20 N-terminal amino acids of purified CANS DC was found to be identical to that predicted from the nspC gene. A putative ribosome binding sequence was observed 8 bp upstream from the translation start site (ATG), and promoter- and terminator-like sequences were detected upstream and downstream of the ORF, respectively. Database searches identified no similar proteins, but the deduced amino acid sequence contained a putative pyridoxal 5'-phosphate binding region similar to those of the bacterial meso-2,6-diaminopimelate decarboxylases and eukaryotic ornithine decarboxylases. Another full ORF was found on the opposite strand downstream from the nspC gene. It encoded a protein of 69 amino acids with a calculated molecular mass of 7441 Da, which exhibited some weak similarity to ScrR, a repressor protein of V. alginolyticus, in the helix-turn-helix DNA binding domain, but did not appear to be expressed in the host cells.

The design of oral sustained-release theophylline dosing after conversion from intravenous to oral therapy

We studied the design of oral sustained-release theophylline dosing after conversion from constant aminophylline infusion. Twelve children with bronchial asthma (9 boys and 3 girls) were evaluated in this study. Each patient received a constant intravenous administration of aminophylline for 4-10 days. Three hours after conversion from constant aminophylline infusion, they received oral sustained-release theophylline twice daily at 12-hour intervals. Blood samples were obtained at least once during the aminophylline infusion, just before conversion from the aminophylline infusion, and 0, 3 and 6 hours, and 4-5 days after administering oral theophylline. Pharmacokinetic parameters were estimated using the serum theophylline concentrations that were obtained during constant aminophylline infusion. These estimates of pharmacokinetic parameters were used to predict the serum theophylline concentrations during oral theophylline therapy. Predicted serum theophylline concentrations using individual pharmacokinetic parameters were fitted with actual measured values in this study. When switching a patient from intravenous aminophylline to sustained-release oral theophylline, the use of Bayesian analysis of serum theophylline concentration values obtained during intravenous therapy works well in predicting serum theophylline concentrations and in determining oral dosages that maximize the drug's effectiveness.

[Rhinogenous retrobulbar optic neuritis: a case report]

Rhinogenous retrobulbar optic neuritis is characterized by neuritis secondary to paranasal sinusitis. A case of rhinogenous retrobulbar optic neuritis that was successfully treated by surgery is reported. A 40-year-old man complained of progressive right visual disturbance. The clinical course and neurological examination suggested right retrobulbar optic neuritis. CT and MRI scans demonstrated a massive tumor-like lesion near the right optic canal. Fifteen days after the onset, decompression of the right optic nerve was performed using a right pterional approach. After surgery, visual disturbance improved, and after about 1 month, the symptom had disappeared. Operative findings, histological examination and the postoperative course were consistent with the characteristics of rhinogenous retrobulbar optic neuritis. We consider decompression of the optic nerve to be effective for the treatment of rhinogenous retrobulbar optic neuritis.

Vibrio vulnificus may produce a metalloprotease causing an edematous skin lesion in vivo

Vibrio vulnificus, an opportunistic human pathogen, secretes a metalloprotease which has been suspected of being the causative factor for edematous skin lesions. The antibody against alpha-macroglobulin, the sole plasma inactivator of V. vulnificus metalloprotease, delayed clearance of the protease administered into dorsal skin, and increased the edema-forming ability of living bacterial cells. The derivative of the protease, which is resistant to the inactivating action of alpha-macroglobulin, was not excluded from the dorsal skin. Furthermore, the vibrio inoculated into the mammalian serum was found to produce the protease in adequate amounts. These results suggest that V. vulnificus secretes a metalloprotease into the interstitial-tissue space, resulting in the development of an edematous skin lesion, and that the protease is immediately inactivated by alpha-macroglobulin and subsequently excluded.

Siderophore-mediated utilization of iron bound to transferrin by Vibrio parahaemolyticus

Vibrio parahaemolyticus produces a structurally novel type of siderophore, termed vibrioferrin, in response to iron-limitation. This study was performed to examine whether vibrioferrin can assimilate iron from human iron-binding proteins for growth. Comparison of the growth rates between V. parahaemolyticus AQ 3354 and its spontaneously arising, vibrioferrin-deficient mutant revealed that vibrioferrin was able to sequester iron from 30% iron-saturated human transferrin for growth, but not from human lactoferrin even if fully saturated with iron. In both strains, iron limitation induced two high-molecular-weight outer membrane proteins with apparent molecular masses of approximately 78 and 83 kDa. Since only the outer membrane fraction including these proteins showed a binding capacity to ferric vibrioferrin complex, either of them may function as its cell surface receptor. These results suggested that the organism might utilize such a source of host iron through the action of vibrioferrin during in vivo survival and proliferation, although its importance in pathogenesis is unknown.

Timing of onset of allergic symptoms as a response to a double-blind, placebo-controlled food challenge in patients with food allergy combined with a radioallergosorbent test and the evaluation of proliferative lymphocyte responses

The timing of onset of allergic symptoms in a double-blind, placebo-controlled food challenge (DBPCFC) was combined with a radioallergosorbent test (RAST) and evaluation of proliferative responses of peripheral blood mononuclear cells (PBMCs) in 27 atopic dermatitis patients with hen's egg allergy. Of the 27 patients, 11 showed reactions within 2 h (immediate group), and 16 showed reactions after more than 2 h (nonimmediate group) after ingestion of hen's egg. The RAST scores for hen's egg in the immediate group were significantly (p < 0.01) higher than those in the nonimmediate group, while the proliferative responses of PBMCs to ovalbumin in the nonimmediate group were significantly (p < 0.01) higher than those in the immediate group. These results suggest that the RAST values are related to immediate allergic symptoms in DBPCFC and the proliferative responses of PBMCs are related to nonimmediate allergic symptoms in DBPCFC. The timing of onset of allergic symptoms in DBPCFC will render DBPCFC more useful in the diagnosis of food allergy, including the late-onset reactions to foods.

Existence of a novel hemagglutinin having no protease activity in Vibrio mimicus

The protease elaborated by Vibrio mimicus is known to possess hemagglutinating ability to chicken erythrocytes, the well-known HA/protease. A non-protease hemagglutinin (HA) with strong agglutinating ability towards rabbit erythrocytes was obtained from 32 hr culture supernatant of a pathogenic environmental strain of V. mimicus. This HA (V. mimicus HA: VMHA) appeared stable at relatively higher temperature and agglutinated the erythrocytes from rabbit, guinea pig and mouse but not the erythrocytes from chicken, bovine, horse and sheep. Simple sugars, metal ions and chelating agents failed to inhibit the activity of VMHA. The activity of VMHA was found to be sensitive to digestion by proteolytic enzymes including HA/protease. These results provide evidence for the existence of novel HA other than HA/protease in V. mimicus.

Structure and iron transport activity of vibrioferrin, a new siderophore of Vibrio parahaemolyticus

The structure of vibrioferrin, a siderophore from Vibrio parahaemolyticus, was elucidated based on a combination of partial hydrolysis and spectroscopic techniques. HPLC of purified vibrioferrin showed two peaks with an area ratio of approximately 2:1. However, upon reinjection of each of those isolated compounds, the original chromatographic pattern was obtained, indicating an equilibrium between two compounds in aqueous solution. Consistent with this finding, most of the NMR signals of vibrioferrin were duplicated. The structure was determined as 1-(2-[2-(5-carboxy-5-hydroxy-2-oxo-1-pyrrolidinyl)propionamide]ethyl) citrate, which exists in two epimeric forms resulting from cyclization between an amidic nitrogen of the alanine residue and a keto group of the 2-ketoglutaric acid residue. Transport experiments with 55Fe-labeled vibrioferrin demonstrated the function of vibrioferrin as a siderophore in V. parahaemolyticus. Kinetic studies with mid-log phase cells revealed that the iron uptake system was receptor-mediated, with Km and Vmax values of 67 nM and 54 pmol Fe/mg cell protein/min, respectively. Moreover, iron uptake mediated by vibrioferrin was blocked both by uncouplers and by ATPase inhibitors.

Comparison of allergic diseases and specific IgE antibodies in different parts of Japan

We investigated the differences of allergic diseases and specific IgE antibodies to inhaled or ingested allergens between two cities in a Japanese pediatric population. One of the two cities is Itoman, which is a subtropical city in Okinawa prefecture; the other is Gifu, which is a Temperate Zone city in Gifu prefecture. The prevalence of asthma or wheezy bronchitis was significantly higher in Itoman; however, the prevalence of atopic dermatitis was significantly higher in Gifu. Furthermore, the positive percentages of specific IgE antibodies to inhaled allergens such as house dust, and Dermatophagoides farinae were higher in Itoman. The positive percentages of specific IgE antibodies to ingested allergens such as egg white, cow milk, and soybean were higher in Gifu. These results suggest that the differences in prevalence of allergic diseases and allergens may depend on differences in the triggering environmental factors between different parts of Japan.