Fluorescent Gram stain in the microbiologic diagnosis of infectious keratitis and endophthalmitis

PURPOSE

To verify the sensitivity of a recently described technique of fluorescent Gram stain (FGS) and evaluate its role in direct microscopic examination of clinical ocular samples.

METHODS

In the first part of the study, culture suspensions of 10 bacterial isolates were stained, using FGS and conventional Gram stain (CGS), and were assessed for morphology, and Gram sign. In the second part, 39 corneal scrapings and 18 vitreous biopsy materials were stained and observed by both methods.

RESULTS

Gram reaction and morphology of the bacteria, using CGS and FGS, were compared against culture. In both parts of the study, the sensitivity of CGS was significantly higher than FGS in the detection of Gram positive reaction (p = 0.01, 0.02). The specificities and predictive values of CGS and FGS were comparable in the evaluation of clinical samples. The bacterial morphology was demonstrated better (p = 0.01) with CGS. Significant quenching of fluorescence and change in Gram reaction with time were noted in FGS.

CONCLUSIONS

The low sensitivity, quenching of fluorescence and change in Gram reaction presently preclude the usage of FGS as a diagnostic tool in ocular infections.

Role of cellular kinases in the gene expression of nonsegmented negative strand RNA viruses

Nonsegmented negative strand RNA viruses package an RNA-dependent RNA polymerase composed of two subunits, a large protein L and a phosphoprotein P, for transcription and replication of their genome RNAs. The RNA polymerase activity resides within the L protein, while the P protein acts as a transcription factor or transactivator of the polymerase. Since P protein is heavily phosphorylated and phosphorylation is known to regulate function of many viral as well as cellular proteins, the role of phosphorylation of P protein in the gene expression of this group of RNA viruses has recently been investigated. Through expression in bacteria the P protein was produced in large quantity in the nonphosphorylated form and involvement of cellular kinase(s) in its phosphorylation was studied. Casein kinase II and/or protein kinase C have been shown to play a critical role in the activation of P protein in transcription. These findings have opened up a new avenue for studying an important regulatory step in virus gene expression that may lead to the development of an effective antiviral agent.

Phosphorylation of canine distemper virus P protein by protein kinase C-zeta and casein kinase II

Transcription by nonsegmented negative-strand RNA viruses is mediated by the viral RNA-dependent RNA polymerase and transcriptional cofactor P. The P protein is activated by phosphorylation, an event initiated by cellular kinases. The kinase used differs among this group of RNA viruses; vesicular stomatitis virus and respiratory syncytial virus utilize casein kinase II (CKII), whereas human parainfluenza virus type 3 utilizes PKC isoform zeta (PKC-zeta) for activation of its P protein. To identify the cellular kinase(s) involved in the phosphorylation of the canine distemper virus (CDV) P protein, we used recombinant CDV P in phosphorylation assays with native kinase activities present in CV1 cell extracts or purified CKII and PKC isoforms. Here, we demonstrate that the CDV P protein is phosphorylated by two cellular kinases, where PKC-zeta has the major and CKII the minor activities. In contrast, the P protein of another member of the morbillivirus genus, measles virus, is phosphorylated predominantly by CKII, whereas PKC-zeta has only minor activity. Selective inhibition of PKC-zeta activity within CV1 cells eliminated permissiveness to CDV replication, indicating an in vivo role for PKC-zeta in the virus replication cycle. The broad tissue expression of PKC-zeta parallels the pantropic nature of CDV infections, suggesting that PKC-zeta activity is a determinant of cellular permissiveness to CDV replication.

Major goat sperm 105 kDa maturation antigen: purification, characterization, and effect of its antiserum on acrosin activity

A ConA binding membrane glycoantigen of 105 kDa molecular mass was purified from mature goat sperm by ion exchange and gel filtration chromatography. Of the detergents examined, the anionic deoxycholate was found to be highly effective in maximum solubilization of this sperm membrane antigen (SMA2). The analysis of the saccharide components by gas liquid chromatography revealed that the 105 kDa antigen (SMA2) contained the highest amount of mannose, followed by galactose and glucose in a ratio of 4:3:1. One amino sugar, N-acetylglucosamine, was also found to be present in the polysaccharide branching of the SMA2 antigen. The internal sulfydryl linkage is essential for the maintenance of the protein backbone of 105 kDa antigen. The antigen selectively resides on the anterior head of goat sperm. The binding of anti-SMA2 antibody to the integrated mature goat spermatozoa inhibited the release of acrosin after the induction of spermatozoa with Ca-ionophore.

Phosphorylated states of vesicular stomatitis virus P protein in vitro and in vivo

We have previously shown that the phosphoprotein (P) of vesicular stomatitis virus (VSV), New Jersey serotype (PNJ) is phosphorylated by casein kinase II, within the N-terminal domain I (P1 form), whereas the C-terminal domain II is phosphorylated by a protein kinase activity associated with the L protein (P2 form) (D. J. Chattopadhyay and A.K. Banerjee, Cell 49, 407, 1987; A.M. Takacs et al., J. Virol. 66, 5842, 1992). In the present studies, we have mapped the corresponding P1 and P2 phosphorylation sites in the P protein of the well-studied Indiana serotype (PIND) and compared that with the two previously designated NS1 and NS2 forms present in vivo. The PIND expressed in Escherichia coli in an unphosphorylated form (P0) was used as substrate for recombinant casein kinase II (CKII). By site-directed mutagenesis, the CKII-mediated phosphorylation sites in the P protein were mapped at S60, T62, and S64 within the acidic domain I in vitro. In contrast, using BHK cell extract as the source of CKII or expressing P protein in COS cells labeled with 32PI, the phosphorylation sites were mapped at S60 and S64 with no phosphorylation at T62 residue. We used a peptide mapping technique by which the phosphorylation sites within domain I and domain II were determined. Using this method we demonstrated that the P1 and P2 forms are similar, if not identical, to the previously designated NS1 and NS2 forms, respectively. The domain II phosphorylating kinase activity, associated with the L protein, is shown to be present also in the N-RNA complex, indicating that this activity is of cellular origin. By site-directed mutagenesis, we have shown that S226 and S227 are involved in phosphorylation within domain II. We also demonstrate that the P1 and P2 forms are interconvertible and arise by phosphorylation/dephosphorylation of the phosphate groups in domain II, confirming the precursor-product relationship between the two phosphorylated forms of P protein.

Presumed noninfectious endophthalmitis after cataract surgery

PURPOSE

To study the clinical features and results of conservative management in cases of presumed noninfectious endophthalmitis after cataract surgery.

SETTING

L.V. Prasad Eye Institute, Hyderabad, India.

METHODS

This retrospective study evaluated cases of presumed noninfectious endophthalmitis occurring after cataract surgery in a hospital-based population. Patients with minimal hypopyon and decreased visual acuity unassociated with pain, lid edema, conjunctival chemosis, corneal abscess, and obvious vitreous involvement were treated conservatively. The mainstays of treatment were topical and systemic steroids. Four eyes with clinical evidence of worsening required surgical intervention. Main outcome measures were resolution of inflammation and final visual acuity.

RESULTS

In 23 of 27 patients, the inflammation resolved with medical therapy alone; 21 had a final visual acuity of 20/50 or better. In 3 of the 4 eyes that had surgery, the culture was positive for low virulent organisms; all had a satisfactory outcome. One eye with preoperative glaucoma developed absolute glaucoma with resolution of inflammation.

CONCLUSION

Noninfectious endophthalmitis invariably presents with hypopyon and decreased vision unassociated with pain and lid edema. A trial of medical therapy with corticosteroids as the mainstay of treatment is often rewarding. Frequent monitoring and preparation for surgical intervention if required are key.

Pneumatic retinopexy: principles and practice

Pneumatic retinopexy (PR) is an alternative to scleral buckling for the surgical repair of selected retinal detachments. A gas bubble is injected into the vitreous cavity, and the patient is positioned so that the bubble closes the retinal break (s), allowing absorption of the subretinal fluid. Cryotherapy or laser photocoagulation is applied around the retinal break(s) to form a permanent seal. The procedure can be done in an outpatient setting, and no incisions are required. A multicenter randomized controlled clinical trial has demonstrated that the anatomic success rate is comparable to scleral buckling, but the morbidity is significantly less with PR. If the macula was detached for less than two weeks, the visual results are significantly better with PR than with scleral buckling. Cataract surgery was required significantly more often following scleral buckling than following PR. Two independent reports have shown that an attempt with PR does not disadvantage the eye; such that the results of scleral buckling after failed PR are not significantly different than primary scleral buckling. A comprehensive review of the world literature on PR revealed 27 statistical series totaling 1,274 eyes. These combined series had a single-operation success rate of 80%, and 98% were cured with reoperations. Pneumatic retinopexy should be considered in cases without inferior or extensive retinal breaks and without significant proliferative vitreoretinopathy. The cost of buckling varies from 4 to 10 times that of PR.

Inhibition of human parainfluenza virus-3 replication by interferon and human MxA

We have investigated the IFN-mediated inhibition of human parainfluenza virus-3 (HPIV-3) replication in cultured human A549 cells. IFN-alpha inhibited the virus yield significantly with concomitant reduction of viral RNA accumulation by more than 90%. Further studies indicated that the inhibitory action of IFN was at the level of primary transcription of HPIV3 replication. Since the IFN-inducible protein, MxA, has been shown to inhibit virus replication in several RNA viruses, we examined the role of MxA in HPIV-3 replication using a stably transfected human glioblastoma cell line expressing MxA. In these cells HPIV-3 replication was decreased by more than 100-fold depending on the virus dosage used with concomitant inhibition of viral RNA synthesis by about 80%. However, the viral primary transcription was not affected in this MxA-producing cell line. In contrast, in the parental cell line IFN-mediated inhibition occurred at the primary transcription step of HPIV-3 replication. These data suggest that in addition to MxA, other IFN-inducible proteins are involved in the anti-HPIV-3 effect of IFN in both the cell lines used.

Expression of the human MxA protein is associated with hyperphosphorylation of VSV P protein in human neural Cells

Constitutive expression of the type I interferon-inducible human cytoplasmic MxA protein has been shown to interfere with primary transcription of vesicular stomatitis virus (VSV) in tissue culture cells. As phosphorylation of the VSV P protein has been linked to its ability to stimulate viral transcription, we analyzed the phosphorylation status of this protein in human brain cells (U-87) stably transfected with MxA. We observed a general increase in cellular kinase activity in the presence of MxA, affecting both cellular proteins and VSV P protein. Phosphorylation of the latter was up to threefold higher both in vivo and in vitro. In vitro phosphorylation of recombinant VSV P protein could be enhanced in MxA-negative cell extracts after exogenous addition of recombinant His-MxA. Biochemical evidence and phosphorylation of a mutant P protein lacking the recognized casein kinase II (CKII) sites suggested that hyperphosphorylation of VSV P protein was not due to a stimulation of CKII. We thus propose that expression of MxA in human brain cells is associated with the stimulation of a cellular kinase that is active in phosphorylating both cellular target proteins and VSV P protein.

Studies on the platelet alpha-adrenoceptor subtypes in diabetes mellitus

Studies on the platelet alpha-adrenoceptor subtypes were carried out in 19 subjects with treated diabetes mellitus and 15 normal age and sex-matched controls. By utilising selective antagonists, it was noted that all the normal human platelets exhibited the alpha-2 adrenoceptor. 7 diabetics (37%) expressed both the alpha-1 and alpha-2 adrenoceptors and diabetic complications along with hypertension were most common in this group. Another 7 diabetics (37%) expressed the alpha-2 receptor only and diabetic complications were minimum in this group. Interestingly, 5 diabetics (26%) did not express either the alpha-1 or alpha-2 receptor and these patients occupied an intermediate position with regard to diabetic complications. Thus, it was concluded that platelet alpha-1 adrenoceptors perhaps indicated a poor prognosis in diabetes mellitus, opening up future scope for work in this area.

Dietary garlic extract in modifying clastogenic effects of inorganic arsenic in mice: two-generation studies

Mice are fed by gavage crude garlic extract (100 mg/kg b.wt.) for 30 consecutive days. One set was administered sodium arsenite (0.1 mg/kg b.wt.) simultaneously. Another set was treated with sodium arsenite only. Mice given distilled water were kept as negative control. Exposed mice from each set were sacrificed and bone marrow preparations examined for chromosomal aberrations and damaged cells. Sodium arsenite is a strong clastogen and the effects were reduced to a significant level by prolonged administration of garlic extract. For F1 studies, exposed male mice were mated with exposed female mice, and the progeny examined. In the progeny, clastogenic effects of sodium arsenite persisted in a lower degree, indicating that the metal is able to cross the transplacental barrier. There was no statistically significant difference between the effect in progeny of parents only given sodium arsenite when given simultaneously for prolonged periods in the parents; however, the effect is meagre in the next generation.

Expression of L protein of vesicular stomatitis virus Indiana serotype from recombinant baculovirus in insect cells: requirement of a host factor(s) for its biological activity in vitro

The 241-kDa large (L) protein of vesicular stomatitis virus (VSV) Indiana serotype, a multifunctional catalytic subunit of the viral RNA polymerase, has been expressed in Spodoptera frugiperda cells infected with recombinant baculovirus BacPAK6-L containing the L gene under the control of a polyhedrin promoter. The recombinant L protein was biologically active and supported viral mRNA synthesis in vitro. When the expressed L protein was purified by phosphocellulose column chromatography, it eluted in two peaks, one at 0.4 M NaCl (peak I) and the second at 0.75 M NaCl (peak II). The L protein in peak I showed significant transcriptional activity in an in vitro transcription reconstitution experiment, whereas the L protein in peak II was inactive. Interestingly, the addition of cytoplasmic extract from uninfected Sf21 cells to peak II completely restored transcription in vitro, indicating the requirement of a host factor(s) for the activity of the L protein. This factor is relatively heat stable and is dissociable from the recombinant L protein. It is also present in BHK, COS, and HeLa cells in detectable levels. The role of the putative host protein(s) in the activation of the L protein is discussed.

A 50 KDa protein modulates guanine nucleotide binding of transglutaminase II

Regulation of cellular response is an important mechanism for controlling cellular functions. The transmembrane signaling of the hormone receptors is regulated by GTP-binding proteins (GTPases) and their associated proteins. Our previous studies demonstrated that the bifunctional GTP-binding protein, G alpha h (transglutaminase II), consistently copurified with an approximately 50 kDa protein (G Beta h) which is dissociated from G alpha h upon activation with GTP gamma S or AlF4-. Present immunological and biochemical studies on the regulation of the GTPase cycle of G alpha h, which involves the alpha 1-adrenoceptor and 50 KDa G beta h, reveal that the 50 kDa protein is indeed a G alpha h-associated protein and down regulates functions of G alpha h. Thus, polyclonal antibody against G Beta h coimmunoprecipitates GDP-bound G alpha h but not the GDP-AlF4--bound form. The GTP gamma S binding and GTPase activity of G alpha h are inhibited in a G beta h concentration dependent manner. Supporting this notion, G beta h accelerated GTP gamma S release from G alpha h and changes the affinity of G alpha h from GTP to GDP. Moreover, the ternary complex preparation exhibits TGase activity that is inhibited in the presence of the alpha 1-agonist and GTP. The GTP gamma S binding by the ternary complex, consisting of the alpha 1-agonist, the receptor, and Gh, is also inhibited by G beta h. The inhibition of GTP gamma S binding with the ternary complex requires a > or = 2.7-fold higher concentration of G beta h than the G alpha h alone, indicating that the receptor enhances the affinity of G alpha h for GTP. In addition, G beta h copurifies with an alpha 1-agonist, adrenoceptor, and G alpha h ternary complex, showing that the complex is a heterotetramer. Our data also suggest that G beta h does not directly interact with alpha 1-adrenoceptor. These findings clearly demonstrate that G alpha h associates with a novel protein which modulates the affinity of G alpha h for guanine nucleotides and that the GDP-bound Gh is the ground state for the counterpart activator, the alpha 1-adrenoceptor, in this signaling system.

Sensitivity and predictability of vitreous cytology, biopsy, and membrane filter culture in endophthalmitis

PURPOSE

Forty-seven consecutive patients with endophthalmitis were prospectively studied to: 1) compare the undiluted vitreous biopsy culture and membrane filter culture of vitrectomy cassette fluid; 2) determine the sensitivity and specificity of initial smear examinations in relation to final culture; and 3) characterize vitreous cytology in culture positive and negative endophthalmitis.

METHODS

Examinations included smears (Gram stains, Diff Quik [Bacto Laboratories Pvt. Ltd., Liverpool, Australia] and unstained) and aerobic/anaerobic culture of undiluted vitreous biopsy specimens and diluted vitreous collected in the cassette. The cassette fluid was passed through 5-microns polycarbonate filter for cytology and a 0.22-microns polyvinylidene difluoride millipore filter for culture.

RESULTS

By either method culture results were positive in 27 (57.4%) patients. Culture positive of the vitreous biopsy alone was 44.6% and cassette fluid alone was 49% (P > 0.05). In the initial smear examination the sensitivity and specificity of the Gram stain were 66.6% and 84.2%, respectively. comparatively, Diff Quik provided lower sensitivity and specificity at 40.7% and 80.9% respectively. Examination of wet film of vitreous samples did not provide any useful information. Although polymorphs were seen in large numbers in all cultures that yielded positive results on examination, they also were seen in 80% of the sterile samples. There was no significant difference in the quantity of macrophages observed in infected and noninfected samples.

CONCLUSIONS

Initial smear examination and cytology have limited roles in the diagnosis of infectious endophthalmitis. Obtaining cultures of both an undiluted vitreous biopsy sample and the vitrectomy cassette fluid has a significant advantage compared with culture of only one sample.

Effects of crude garlic extract on mouse chromosomes in vivo

Three concentrations (25, 50 and 100 mg/kg body weight) of fresh garlic (Allium sativum L.) were administered daily by gavage to Swiss albino mice for different durations up to 60 days. These concentrations had been observed to protect significantly against effects of known clastogens. The endpoints scored were frequencies of chromosomal aberrations and damaged cells induced in bone marrow preparations. These parameters were found to be directly dose dependent and after an initial enhancement at 7 days, were reduced following prolonged exposure for 30 and 60 days to the low level observed at 24 hr. Therefore, administration of a low concentration of garlic extract daily is suggested for at least 30 days to obtain the maximum benefit of the extract in protecting against the clastogenic effects of known genotoxicants.

Role of cellular casein kinase II in the function of the phosphoprotein (P) subunit of RNA polymerase of vesicular stomatitis virus

The phosphorylation of the P protein of vesicular stomatitis virus by cellular casein kinase II (CKII) is essential for its activity in viral transcription. Recent in vitro studies have demonstrated that CKII converts the inactive unphosphorylated form of P (P0) to an active phosphorylated form P1, after phosphorylation at two serine residues, Ser-59 and Ser-61. To gain insight into the role of CKII-mediated phosphorylation in the structure and function of the P protein, we have carried out circular dichroism (CD) and biochemical analyses of both P0 and P1. The results of CD analyses reveal that phosphorylation of P0 to P1 significantly increases the predicted alpha-helical structure of the P1 protein from 27 to 48%. The phosphorylation defective double serine mutant (P59/61), which is transcriptionally inactive, possesses a secondary structure similar to that of P0. P1, at a protein concentration of 50 micrograms/ml, elutes from a gel filtration column apparently as a dimer, whereas both P0 and the double serine mutant elute as a monomer at the same concentration. Interestingly, unlike wild-type P1 protein, the P mutants in which either Ser-59 or Ser-61 is altered to alanine required a high concentration of CKII for optimal phosphorylation. We demonstrate here that phosphorylation of either Ser-59 or Ser-61 is necessary and sufficient to transactivate L polymerase although alteration of one serine residue significantly decreases its affinity for CKII. We have also shown that P1 binds to the N-RNA template more efficiently than P0 and the formation of P1 is a prerequisite for the subsequent phosphorylation by L protein-associated kinase. In addition, mutant P59/61 acts as a transdominant negative mutant when used in a transcription reconstitution assay in the presence of wild-type P protein.