Demonstration of Hepatitis B e Antigen in the Core of Dane Particles

Dane particles were isolated in a large scale from plasma of asymptomatic carriers of hepatitis B surface antigen. The core of Dane particles was exposed by treatment with NP-40 and 2-mercaptoethanol. The antigenicity of hepatitis B e antigen (HBeAg) was not detected on the surface of Dane particles or of their cores. However, when Dane particle cores were treated with Pronase, some activity of HBeAg was liberated from them as a small molecule. When the cores were further treated with SDS, they revealed a high activity of HBeAg, indicating that HBeAg existed in the core of Dane particles in a cryptic form, which can be exposed by treatment with proteolytic enzyme or SDS. Dane particles and their cores were subjected to polyacrylamide gel electrophoresis in SDS. After electrophoresis, the gel was cut into two halves, and each half was determined for polypeptide composition and for HBeAg activity. Both of Dane particles and their cores disclosed two peaks of HBeAg activity associated with molecules with a size of 19,000 and 45,000 daltons. These two polypeptides were the major constituents of the cores. Dane particles revealed several polypeptides in addition to the HBeAg polypeptides, which were identified as hepatitis B surface antigen components. On the basis of the results obtained, HBeAg is an integral component of Dane particles, the presently accepted hepatitis B virions. These results provide the basis for the close correlation between HBeAg and Dane particles in the serum of persons infected with hepatitis B virus.

Studies on the outbreak of hepatitis A in an institute for mentally retarded children

The authors encountered an outbreak of acute hepatitis in a public institute for mentally retarded children in Aomori Prefecture, Japan. Studies revealed that the probable vehicles of transmission of infection were contaminated water, contaminated meals, and close contact. From the clinical manifestations and epidemiological investigations of 41 affected children and staff members, an outbreak of hepatitis A was strongly suspected. Immune electron microscopy disclosed hepatitis A virus antigen particles in the stool specimens collected during the few days before and after peak transaminase elevation. Hepatitis A antigen was further extracted and purified. The antigen was the first reported recovery of the virus from a natural outbreak of hapatitis A in Asia. Subsequently, with the immune adherence hemagglutination test, using this extracted antigen, an increase in titer of antibody to hepatitis A antigen was demonstrated. Thus, this epidemic was serologically established as an outbreak of hepatitis A. Human immune serum globulin for the protection against hepatitis A was administrated to the 80 individuals concerned, and it was effective in preventing the clinical manifestation of hepatitis.

Incomplete inactivation of hepatitis B virus after heat treatment at 60 C for 10 hours

A 10(-3) dilution of pooled serum (positive for hepatitis B e antigen and DNA polymerase activity) containing hepatitis B virus (HBV) in a titer 10(5) times the chimpanzee-infectious dose, was heated under water maintained at 60 C for 10 hr. There was a twofold decrease in the titer of hepatitis B surface antigen (HBsAg) as measured by reverse passive hemagglutination after the heat treatment. The heated, diluted serum was still infectious and caused HBV infections in both seronegative chimpanzees given 1-ml iv inoculations of the diluted serum. However, the infectivity of the virus was decreased approximately 10(4)-fold by heat treatment as judged from the prolonged incubation period before appearance of HBsAg in blood. This figure was based on the inverse linear relation between the dose of HBV and the incubation period. The incomplete inactivation of HBV by heat treatment at 60 C for 10 hr should be emphasized because it is widely accepted that heat treatment destroys HBV.

Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection

Infantile papular acrodermatitis (IPA, Gianotti's disease) is a clinical manifestation of hepatitis B virus (HBV) infection in childhood. An epidemic of of IPA occurred in Matsuyama, Japan, where 153 patients in a pediatric clinic had IPA between October 1974 and March 1977. In this period 12 mothers and two fathers of patients contracted acute hepatitis B with overt jaundice three to 14 months after their offspring had IPA. Analysis of the subtype of hepatitis B surface antigen (HBsAg) in the infants and their jaundiced mothers and/or fathers disclosed that HBV was transmitted from the infants. All of the index cases were one year old or younger, although the age of patients with IPA ranged from three months to 10 years. In approximately 40% of patients with IPA who were one year old or younger, HBs antigenemia persisted for one year. These facts suggested that the contraction of IPA in children, especially those one year old or younger, was an important route toward establishment of the carrier state of HBV which maintains the reservoir of this virus in the community.

Duality of hepatitis B e antigen in serum of persons infected with hepatitis B virus: evidence for the nonidentity of e antigen with immunoglobulins

Hepatitis B e antigen (HBeAg) is detected in the serum of some persons infected with hepatitis B virus. Owing to a close correlation of HBeAg and hepatitis B virus in the serum, it has been used as a practical indicator of infectivity. Two entities of HBeAg activity physicochemically different from each other were demonstrated in the serum of persons infected with hepatitis B virus. One was associated with a molecule that precipitated in 1.33 M ammonium sulfate solution, was larger than IgG, and had an electrophoretic mobility in the beta- to gamma-globulin regions and an isoelectric point of approximately pH 5.7. In contrast, the other HBeAg activity was associated with a molecule that was soluble in 1.33 M ammonium sulfate solution, was smaller than IgG, and had an electrophoretic mobility in the alpha-globulin region and an isoelectric point at pH 4.8. In spite of their marked physicochemical differences, a line of antigenic identity was clearly observed for them when they were tested against antibody to HBeAg by a them when they were tested against antibody to HBeAg by a double immunodiffusion method. The HBeAg activity associated with the large molecule was completely removed by an affinity column of anti-IgG, whereas the activity of the small molecule was not. These results indicate that, in the serum, HBeAg exists as a molecule smaller than IgG and also in association with IgG.

Failure of antibody to e antigen to precipitate Dane particles containing DNA polymerase activity and hepatitis B core antigen

Serum samples of 67 asymptomatic carriers were tested for Dane particles by electron microscopy, and for e antigen by immunodiffusion, as well as for hepatitis B antigen-associated DNA polymerase activity, and four samples enriched with respect to Dane particles were selected. Hepatitis B antigen particles in them were separated from e antigen and concentrated by centrifugation, and the Dane-rich preparations were incubated with buffer, antibody to e antigen (anti-HBe) or antibody to hepatitis B surface antigen. After centrifugation, the supernatant was tested for DNA polymerase activity, and both supernatant and precipitate were tested for hepatitis B core antigen (HBcAg) by the immune adherence haemagglutination method after the coat of the Dane particles had been disrupted with NP-40 and 2-mercaptoethanol. It was found that anti-HBe did not precipitate Dane particles as measured by DNA polymerase activity and HBcAg. On the basis of the results obtained, it has been concluded that e antigen does not exist on the surface of hepatitis B virions.

Discovery of a lectin with affinity for the HBs antigen

An extract of marguerite leaves was found to contain an agglutinin which has affinity for HBs (adr type) antigen-sensitized sheep erythrocytes and for pure HBs antigen. This agglutinin activity was inhibited by the plasma of hepatitis patients who were known to have circulating HBs antigen. The agglutinin activity was also inhibited by 0.03M N-acetylneuraminic acid.

Clinical significance of e-antigen/anti-e, with special reference to HBc-antigen in the liver

e-antigen and anti-e were assayed in sera of asymptomatic HBs-Ag carriers and of patients with liver diseases. Thirteen out of 34 (38.2%) asymptomatic carriers were positive for e-antigen, which was in sharp contrast to the reports from USA and Europe. e-antigen was detected to a greater extent in patients with chronic active hepatitis, reversely anti-e in patients with chronic persistent hepatitis. However, e-antigen was found rarely in patients with cirrhosis and never in 23 cases with hepatoma positive for HBs-Ag. HBc-Ag in the liver was detected in 4 out of 8 e-antigen positive asymptomatic carriers and in 4 out of 5 patients with chronic liver diseases with e-antigen respectively, and moreover in 3 out of 14 anti-e positive cases, so that the presence of anti-e did not necessarily mean the negativity of HBc-Ag in the liver. Anti-HBc titer, however, was lower in anti-e positive sera than in e-antigen positive ones. This may implicate the decreased replication of HBV in cases with anti-e. These results emphasize that the investigation of e-antigen/anti-e is mandatory for the evaluation of the prognosis of asymptomatic carriers and of patients with chronic hepatitis.

Determination of e antigen and antibody to e by means of passive hemagglutination method

A simple and sensitive method was developed for the detection of e antigen and antibody to e (anti-e) by means of the passive hemagglutination (PHA) method. Sheep erythrocytes were fixed by glutraraldehyde and coated with either e antigen or anti-e which had been specifically purified from plasma of asymptomatic carriers of hepatitis B antigen by affinity column chromatography, and then by gel filtration on Sephadex G-200. A gain in specific activity of more than 2000-fold for e antigen and 100-fold for anti-e was achieved as compared with the original plasma pool which was used as the source for purification. The PHA method was at least 300 times more sensitive than the conventional immunodiffusion method both for e antigen and anti-e assays. When the PHA method was applied for neat serum samples of 80 asymptomatic carriers, e antigen was found in 21.3% and anti-e in 62.5%, at rates much higher than those determined by immunodiffusion for the identical serum samples at 3-fold concentration (16.3 and 30.0%, respectively).

Hepatitis B e antigen and infectivity of hepatitis B virus

For confirmation of the difference in the infectivity of hepatitis B surface antigen (HBS Ag)-positive serum according to differences in the e antigen system, four chimpanzees were inoculated with serum positive for hepatitis B e antigen (HBe Ag), and three chimpanzees were inoculated with serum positive for antibody to HBe Ag (anti-HBe). Since the infectivity titrations are not yet completed, the end infectivity titer of each serum is not known. All four chimpanzees given injections of 10(-1), 10(-4), or 10(-8) dilutions of HBe Ag-positive serum developed hepatitis B virus infection, whereas the one chimpanzee injected with undiluted anti-HBe-positive serum became infected, and other chimpanzees injected with diluted anti-HBe-positive sera did not. As judged from the length of the incubation period before appearance of HBS Ag in blood, there seemed to be a remarkable difference in infectivity between the HBe Ag-positive serum and the anti-HBe-positive serum; the former serum was 10(8) times more infectious than the latter.

Correlation between titer of antibody to hepatitis B core antigen and presence of viral antigens in the liver

Liver specimens of 31 autopsied cases of liver cirrhosis who had had detectable levels of antibody to hepatitis B core antigen (anti-HBc) inthe serum were stained for hepatitis B core antigen (HBcAg) and hepatitis B surface antigen (HBSAg) by the direct immunofluorescence method. Their premortem serum samples were tested for HBSAg, antibody to HBSAg (anti-HBS) and anti-HBC. Persistent hepatitis B virus (HBV) infection as judged by circulating and/or liver HB antigens was identified in 18 patients, and all of them revealed a high titer of anti-HBC ranging from 2(11) to 2(16) by the immune adherence hemagglutination method. In contrast, anti-HBC titer of the remaining 13 patients without detectable HB antigens was less than 2(9), and the geometric mean titer of anti-HBC of the patients with persistent HBV infection was significantly higher than that of the patients without (13.9+/-1.55 versus 7.23+/-1.30; t test, P less than 0.001). A combination of circulating anti-HBS and hepatic HB antigens was found in one patient, whose serum revealed an anti-HBC titer of 2(12). On the basis of these results, a high titer of anti-HBC in the serum (immune adherence hemagglutination titer of 2(11) or more) seems to be a reliable indicator of persistent HBV infection in the liver.

A direct immunofluorescence method for the detection of hepatitis B core antigen in formalin-fixed and gelatin-embedded liver specimens

Images

High prevalence of e antigen among healthy blood donors carrying hepatitis B surface antigen in Japan

Hepatitis B surface antigen (HBsAg) was detected by an immune adherence haemagglutination method in the serum samples of 292 voluntary, apparently healthy blood donors at four regional blood centres in Japan. Their serum samples were concentrated 3-fold and tested for e antigen (e Ag) and antibody to e (anti-e) by immunodiffusion. The e Ag was found in 41 samples (14.0%) and anti-e in 57 (18.6%). When 100 randomly selected serum samples containing HBsAg were tested as they were (unconcentrated), and at 3- and 5-fold concentrations, e Ag was detected in 3, 16 and 27, respectively, and anti-e in 10, 21 and 26. Subtypes of HBsAg were similar in carriers with e Ag and with anti-e. There is a high prevalence of e Ag in healthy individuals in Japan. There are also high rates of vertical transmission of hepatitis B virus from mothers to children, as well as a high incidence in the past of post-transfusion hepatitis. This is further evidence that e antigen is a marker for the infectivity of hepatitis B virus in carriers.

Anti-HBc titer in relation to the etiological role of hepatitis B virus in primary hepatocellular carcinoma

The antibody to hepatitis B core antigen (anti-HBc) is belived to be a marker for natural infection with hepatitis B virus (HBV). In order to study the etiological role of HBV in relation to primary hepatocellular carcinoma (PHC), the anti-HBc in sera of 31 PHC patients was surveyed by the immune adherence hemagglutination method which was about 10 times more sensitive than the complement fixation method. Twenty two out of 31 PHC cases were positive for anti-HBc (71.0%). The is a higher rate of incidence than that of HBs-Ag (51.6%). However, high anti-HBc titer above 2(10) which might reflect current infection with HBV was observed in 15 of these 22 cases. The remaining 7 cases had a titer lower than 2(8); 5 of these patients had neither HBs-Ag nor anti-HBs in their sera. As control, 37 anti-HBs positive blood donors with no definite liver disease were surveyed for anti-HBc titer. Thirty-four of them were positive, but in the majority of cases, the serum titer was less than 2(9), which might only reflect previous infection with HBV. These findings indicate that not only the prevalence of anti-HBc, but also the determination of its real titer is quite important for studying the relationship of HBV to PHC.

Hepatitis B antigen-associated deoxyribonucleic acid polymerase activity and e antigen/anti-e system

Serum samples of 403 asymptomatic blood donors carrying hepatitis B surface antigen (HB5Ag) were concentrated threefold and tested for e antigen and antibody to e antigen (anti-e) by immunodiffusion. Hepatitis B antigen (HBAg)-associated deoxyribonucleic acid (DNA) polymerase activity was specifically determined by the difference in incorporation of [methyl-3H]thymidine 5' -triphosphate into DNA by an aliquot of centrifuged serum samples after it had been treated either with normal rabbit serum or with rabbit antibody to HBSAg. All of 58 serum samples containing e antigen revealed HBAg-associated DNA polymerase activity, whereas none of 96 samples containing anti-e did. In the remaining 249 samples in which neither e antigen nor anti-e was found, 62 showed specific DNA polymerase activity, although at lower levels than the samples containing e antigen.

An epidemic of infantile papular acrodermatitis (Gianotti's disease) in Japan associated with hepatitis-B surface antigen subtype ayw

An epidemic of infantile papular acrodermatitis (I.P.A.) (Gianotti's disease) occurred in Matsuyama City, in south-east Japan in 1974-75. Patients ages ranged from less than one year to eight years. Hepatitis-B surface antigen (HBsAg) was detected by an immune adherence haemagglutination method in the serum samples of 48 of the 54 patients tested. HBsAg subtypes were determined by a haemagglutination-inhibition method. ayw antigens were identified in 42 patients and adr antigens in 3; it was not possible to determine subtypes in the remaining 3 patients because antigen titres were too low. Since subtype ayw and I.P.A. are extremely rare in Japan, the association of the disease with HBsAg subtype ayw is regarded as being most significant.

Studies on the role of proteases in the biochemical mechanisms of tissue injury

A complex of inflammatory protease with an inhibitor was found to be present in the early phase of Arthus skin lesions in guinea pig. From the extract of inflamed lesions a complex was partially purified by chromatography on DEAE-Sephadex A-50 and GE-cellulose, in that order. The inhibitor was finally dissociated rom the protease complex by treating them with cysteine followed by Sephadex G-50 chromatography. Active protease was recovered as a single peak which also contained some inhibitor activity. The isolated inhibitor was capable of inactivating inflammatory protease as well as papain. It was electrophoretically homogenous and was identified as protein or polypeptide in the serum alpha-1-globulin fraction. The significant role of the inhibitor in regulating the acute phase of inflammatory process is emphasized.

Determination of antibody to hepatitis B core antigen by means of immune adherence hemagglutination

A simple and rapid method utilizing immune adherence hemagglutination has been developed for the detection of antibodies to hepatitis B core antigen (anti-HBc). Hepatitis B core antigen (HBcAG) was prepared from Dane particles that had been isolated from plasma of asymptomatic antigen carriers. The method was specific and about 10 times more sensitive than the conventional complement-fixation method. A total of 215 serum samples obtained from healthy blood donors were surveyed for HBsAG and anti-HEc, as well as for hepatitis B surface antigen (HBsAg) and antibody to HBsAG (anti-HBs). Anti-HBc was found in 36 serum samples, at a prevalence rate higher than that of anti-HBs (31/215)...

Hepatitis B surface antigen in the serum of infants after deliver from asymptomatic carrier mothers

A survey of sera of 5,993 pregnant women for hepatitis B surface antigen in Tokyo revealed 139 asymptomatic carriers (2.3%), essentially the same as that of a control population of comparable age group (2.2%). None of 59 specimens of cord blood of their newborn infants was positive for HBsAg according to an immune adherence hemagglutination assay. In 11 mother-child pairs in whom follow-up was possible for more than seven months, HBsAg was detected in the sera of eight infants within the first six months, after birth, with antigenemia persisting throughout the observation period, while antigenemia was not detected in the remaining three. The subtype of HBsAg was identical for each mother-child pair. The antigen was detected in sera of two of the infants after appropriate incubation periods of 123 and 133 days, respectively, whereas in others it was detected as early as 5 and 13 days after delivery.

South-to-north gradient in distribution of the r determinant of hepatitis B surface antigen in Japan

A total of 2.305 sera positive for hepatitis B surface antigen were obtained from asymptomatic carriers throughout Japan and subtyped for the d, y, w, and r specificities by the hemagglutination inhibition method. Determinant d prevailed in Japan (d, 99.1%; y, 0.9%), and there was no regional variation in its occurrence. In sharp contrast, there was a marked variation in the distribution of the w and r determinants, forming an apparent south-to-north gradient of r. The percentage of r determinant was highest in Kyushu (92%-94%); it decreased gradually along the axis of Japan to the north and was lowest in Akita (46%), which is located at the north end of Honshu.

Application of the paired label radioantibody technique to detection and subtyping of hepatitis B surface antigen

A sensitive radioimmunoassay has been developed for the detection and subtyping, in regard to w and r specificities, of hepatitis B surface antigens (HBsAg). The binding of monospecific rabbit antibodies directed to either w or r determinant, labeled with 131I and 125I, respectively, by HBsAg was determined in the same experiment, taking advantage of the fact that these specificities are in general, expressed mutually exclusively. HBsAg in the test sample were bound to solid phase guinea pig anti-HBsAg antibody tube before the test. The ratio of percentage uptake of 125I anti-r to that of 131I anti-w for 28 normal sera without antigen was 0.69 0.18. The ratio for seven sera containing HBsAg with w determinant was less than 0.1, and that for 34 with r determinant was more than 10; 100-fold difference was noted between values of w and r antigens.

Haemagglutination inhibition assay of the common determinants and subspecificities of Australia antigen

Antigenic determinants of Australia antigen (AuAg) may be determined by haemagglutination inhibition with ease and high sensitivity. The reaction depends on the inhibitory effect of the test antigen-positive sample on the agglutination by specific antibody of glutaraldehyde-fixed sheep erythrocytes which have been tanned and coated with AuAg of different specificities. The standard monospecific antibody reactants are directed against one or other of the common antigens, a and Re, or against the subtypic determinants, d, y, w and r. Because it is more sensitive than conventional immunodiffusion or electrosyneresis, and more convenient than radio-immunoassay, haemagglutination inhibition is most suited to large-scale determinations of AuAg subtypes in samples of relatively low antigenic activity.

Antigenicity of Reduced and Alkylated Australia Antigen

The association of Australia antigen (AuAg)2 with human type B hepatitis has been fully established. It has been reported that AuAg, which contains 6.5 M% of cysteine (1), completely lost the ability to react with humoral anti-Au antibodies after reduction and alkylation (2). Recently, Vyas et al. (3) have further reported that the reduced and alkylated AuAg could induce a delayed-type hypersensitivity response in guinea pigs but did not raise humoral antibody, suggesting the significance of the disulfide-bond dependent conformation in stimulating the humoral antibody response.

We have found, however, that a part of the antigenic reactivity of AuAg was relatively resistant to reduction and alkylation, although most of it was sensitive to this procedure. This unexpected finding prompted us to study in detail the hitherto recognized antigenic determinants of AuAg—a, d, y, w and r3—with respect to their susceptibility to the conformational changes induced by this chemical modification.

Electrophoresis of guinea-pig complement components (C3, C5, C6, C7, C8 and C9) on polyacrylamide gel

The electrophoretic mobilities of C3, C5, C6, C7, C8 and C9 of guinea-pig complement were studied using polyacrylamide (PAA) gel as a supporting medium. The haemolytic activity of each complement component was readily revealed as a discrete haemolytic band in blood agar containing intermediate red blood cells and appropriate reagents which was overlayed on the PAA gel plate after electrophoresis. By this method, the relative mobilities of C3, C5, C6, C7, C8 and C9 were determined as 0.19, 0.40, 0.17, 0.27, 0.31 and 0.57 respectively. An additional, distinct, haemolytic C5 band was detected when native guinea-pig serum was run. The relative mobility of the haemolytic activity which was not detected when purified C5 was electrophoresed, was 0.25.