A new method to measure air-borne pyrogens based on human whole blood cytokine response

Measurement of dust-borne MRSA in pig farms using different approaches

AIMS

To obtain knowledge about (i) how to sample airborne methicillin-resistant Staphylococcus aureus (MRSA) and dust in the pig farm environment including effects of sampler on (a) measured exposure, (b) MRSA survival and (c) spatial and temporal variation in exposure, and (ii) the association between exposure to MRSA, dust and optical density OD.

METHODS AND RESULTS

Airborne dust was sampled on five pig farms using five active and one passive samplers. Staphylococcus aureus and MRSA (as a subset of S. aureus) were quantified using selective agar media and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The Andersen sampler, electrostatic dust collectors (EDC), and Gesamtstaubprobenahme (GSP) and Institute of Occupational Medicine samplers with polycarbonate or Teflon filters were applicable for sampling airborne MRSA. The half-life of MRSA was not reduced by active sampling. A significant correlation was found between dust and S. aureus exposure within, but not between, farm section and farms. A significant spatial and temporal variation in dust and MRSA exposure was found within a stable. The dust sampling rate and the concentration of MRSA in the sampled dust decreased after 5 days of sampling.

CONCLUSION

Sampling using the GSP can be performed for 1 h without affecting the following half-life of MRSA. Sampling for MRSA using the EDC should not exceed 3 days due to overloading and the die-off of MRSA. The measurement of OD may be used as a proxy measure for dust exposure. To obtain knowledge about potential exposure, samples should be taken repeatedly and in different areas within a stable section.

SIGNIFICANCE AND IMPACT OF THE STUDY

Sampling method, sampling time and number of samples taken, but not force of airflow on the filter, influence the measured potential exposure to MRSA and dust.

Whole Blood Cytokine Response to Local Traffic-Related Particulate Matter in Peruvian Children With and Without Asthma

This study sought to investigate if acute phase immune responses of whole blood from Peruvian children with controlled and uncontrolled asthma differed from children without asthma, following exposure to traffic-related particulate matter (TRPM). TRPM, including particulate matter from diesel combustion, has been shown to stimulate acute airway inflammation in individuals with and without asthma. For this study, a whole blood assay (WBA) was used to test peripheral whole blood samples from 27 children with asthma, and 12 without asthma. Participant blood samples were stimulated, ex vivo, for 24-h with an aqueous extract of TRPM that was collected near study area highways in Lima, Peru. All participant blood samples were tested against the same TRPM extract, in addition to purified bacterial endotoxin and pyrogen-free water, which served as positive and negative WBA controls, respectively. The innate and adaptive cytokine responses were evaluated in cell-free supernatants of the whole blood incubations. Comparatively similar levels were recorded for nine out of the 10 cytokines measured [e.g., – Interleukin (IL)-1β, IL-6, IL-10], regardless of study participant asthma status. However, IL-8 levels in TRPM-stimulated blood from children with uncontrolled asthma were diminished, compared to subjects without asthma (633 pg/ml vs. 1,023 pg/ml, respectively; p < 0.01); IL-8 responses for subjects with controlled asthma were also reduced, but to a lesser degree (799 pg/ml vs. 1,023 pg/ml, respectively; p = 0.10). These relationships were present before, and after, adjusting for age, sex, obesity/overweight status, C-reactive protein levels, and residential proximity to the study area’s major roadway. For tests conducted with endotoxin, there were no discernible differences in cytokine response between groups, for all cytokines measured. The WBA testing conducted for this study highlighted the capacity of the TRPM extract to potently elicit the release of IL-8 from the human whole blood system. Although the small sample size of the study limits the capacity to draw definitive conclusions, the IL-8 responses suggest that that asthma control may be associated with the regulation of a key mediator in neutrophil chemotaxis, at a systemic level, following exposure to PM derived from traffic-related sources.

Comparison of the interleukin-1β-inducing potency of allergenic spores from higher fungi (basidiomycetes) in a cryopreserved human whole blood system

BACKGROUND

Spores from basidiomycete fungi (basidiospores) are highly prevalent in the atmosphere of urban and rural settings. Studies have confirmed their potential to affect human health as allergens. Less is known about their potential to serve as stimuli of the innate immune system and induce proinflammatory reactions.

METHODS

In this study, we evaluated the proinflammatory potential of spores from 11 allergenic basidiomycete species (gilled: Pleurotus ostreatus,Oudemansiella radicata,Armillaria tabescens,Coprinus micaceus,Pluteus cervinus, and Chlorophyllum molybdites, and nongilled: Pisolithus arhizus,Merulius tremellosus,Calvatia cyathiformis,Lycoperdon pyriforme, andBoletus bicolor) based on their potency to induce the release of the proinflammatory cytokine interleukin (IL)-1β in a cryopreserved human whole blood system. In addition, the roles of morphological features of the spores (surface area, shape, and pigmentation) were examined for their role in the IL-1β-including potency of spores. Peripheral blood from healthy volunteers was collected, pooled, and cryopreserved. After stimulating the cryopreserved pooled blood with 10(6) to 10(3) basidiospores/ml, the concentration of IL-1β in culture supernatants was determined with ELISA.

RESULTS

Basidiospores manifested concentration-dependent IL-1β-inducing potency, which was more marked among basidiospores from gilled basidiomycetes. At higher concentrations of basidiospores, the IL-1β-inducing potency could be differentiated in the cryopreserved human whole blood system. Morphological features did not correlate with the IL-1β-inducing potency of the basidiospores, suggesting that nonmorphological properties modulate the IL-1β-inducing potency.

CONCLUSION

Our data provide evidence of the proinflammatory potential of basidiospores, and the utility of cryopreserved human whole blood as a human-based in vitro system to study the immune reactivity of allergenic basidiospores.

Indoor exposure to airborne endotoxin: a review of the literature on sampling and analysis methods

Assessment of exposure to airborne endotoxins has been studied for several years, especially in occupational environments, but a large number of procedures are used for sampling and analysis. This lack of standardization makes it very difficult to compare results and set internationally accepted threshold limit values (TLVs) or occupational exposure limits (OELs) for endotoxin exposure. This paper reviews the methods reported, using advanced bibliographical search techniques: 82 papers published from 2004 to the present were selected to analyze methods for the assessment of human exposure to airborne endotoxins, with particular reference to occupational settings, and to examine their performance and critical points. Only few studies have focused on the standardization of sampling and analysis methods. The European Committee for Standardization Guidelines coincide with the procedures most frequently applied, but this does not guarantee the best results in terms of recovery and reproducibility. The factor that mainly affects endotoxin measurements is the extraction method, the main concern being the presence in the samples of a fraction insoluble in aqueous media. If substantial differences in the proportions of this fraction in different environments are confirmed in the future, the contribution of insoluble endotoxins cannot be neglected.

Assessment of airborne exposure to endotoxin and pyrogenic active dust using electrostatic dustfall collectors (EDCs)

Passive airborne dust sampling using electrostatic dustfall collectors (EDCs) is one possibility especially for long sampling periods. In this study, EDCs were deposited in living rooms of private households and in social rooms of composting plants. The aim of the study was to determine whether endotoxin and pyrogenic activity are measurable using EDCs. In all extracts, endotoxin (via Limulus amebocyte lysate [LAL] assay) and pyrogenic activity (interleukin [IL]-1β release via whole blood assay) were detectable. In addition, the monocyte chemotactic protein (MCP-1; CCL-2) as a secondary proinflammatory marker was measured with whole blood assay. Endotoxin activity and proinflammatory/pyrogenic activity of EDC extracts from social rooms in composting plants were higher compared to extracts obtained from EDCs in private household rooms. A significant correlation between LAL assay and whole blood assay was detectable. In conclusion, EDC sampling is an applicable method to evaluate settled dust from airborne bioaerosols displaying a longer period of exposure. The extraction of EDC without Tween enables one to measure endotoxin as well as proinflammatory/pyrogenic activity using the same sample for parallel detection and more reliable characterization of the airborne bioaerosol contamination.

Pyrogenic activity of air to characterize bioaerosol exposure in public buildings: a pilot study

AIMS

The aim of our study was to investigate indoor air quality (IAQ) by comparing pyrogen concentration and microbiological contamination in offices in public buildings.

METHODS AND RESULTS

Air samples were collected during cold and warm seasons in 39 offices in four European cities. Pyrogens were measured by the in vitro pyrogen test (IPT), moulds and bacteria by classical microbiology. In 92% of the investigated offices, pyrogen and microbial contaminations were below 150 EEU m(-3) and 10(3) CFU m(-3), respectively, whilst in 75%, moulds did not exceed 10(2) CFU m(-3).

CONCLUSIONS

The IPT is a rapid, reliable tool for measuring pyrogens that could be used as an 'early warning' indicator of IAQ.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first study on pyrogenic compound detection in offices using IPT, which could serve for developing future indoor air guidelines.

Standardization of whole blood assay for determination of pyrogenic activity in organic dust samples

To characterize bioaerosol exposure at workplaces standardized methods are necessary. Activity of endotoxin, one component of organic dust, can be quantified with the Limulus-Amoebocyte Lysat test (LAL test). Further information with respect to pyrogenic activity of the organic dust can be achieved by measuring cytokine release of human blood after stimulation with the dust or its extract (whole blood assay). The aim of our study was the standardization of the whole blood assay (WBA) while using cryo-preserved human blood (Qualis Laboratorium) and to compare the outcome of the different cytokines determined by incubation of the blood cells with extracts from dust samples collected at various workplaces. Cytokine release (IL-1 beta, IL-6, IL-8, TNF-alpha, MCP-1) was measured by ELISA after stimulation of fresh blood from ten donors as well as cryo-preserved human blood. In both cases blood was stimulated with E. coli endotoxin as well as with 30 dust filter extracts from various workplaces. All dust filter extracts were investigated in the WBA using cryo-preserved blood as well as with LAL test. E. coli endotoxin stimulated the release of IL-1 beta, IL-6, IL-8, TNF-alpha and MCP-1 in a dose-dependent manner in fresh as well as cryo-preserved human whole blood. 200 pg/ml E. coli endotoxin induced maximal cytokine release in cryo-preserved blood (mean value for IL-1 beta 2509+/-418 pg/ml; n=13 experiments) whereas fresh blood of single donors reached a maximum release when stimulated with 50 ng/ml endotoxin (mean value of ten donors 1125+/-553 pg/ml IL-1beta). Using cryo-preserved blood the coefficient of variation (CV) regarding the interassay variability was below 21% for all cytokines measured. Regarding 26 dust sample extracts correlation coefficient r2 for LAL test and WBA was between 0.90 and 0.93 (Pearson) for IL-1 beta, IL-6, IL-8 and TNF-alpha whereas correlation for MCP-1 was lower (r(2)=0.59). Two dust sample extracts which showed similar reactivity patterns in LAL test as well as in WBA with respect to IL-1 beta, IL-6, IL-8 and TNF-alpha could be differentiated by measuring MCP-1. In conclusion, cryo-preserved blood pools are suitable to standardize WBA. Combination of different outcome variables like IL-1 beta and MCP-1 improve the characterization from the inflammatory potency of workplace related dust samples.

Evaluation of quantification methods of occupational endotoxin exposure

Endotoxin has been identified as important component of organic-dust exposure and is suspected as main cause of work-related adverse health effects in dusty areas. Although the determination of endotoxin levels by using the Limulus amoebocyte lysate (LAL) assay is internationally accepted, reliability and variation of values measured with this test remain a point of discussion. Therefore, the purpose of the study was to determine the influence of different parameters on endotoxin activity measured in airborne samples. This study thus analyzed: (a) dust filter extraction procedures, (b) storage of samples, (c) usage of different commercially available LAL assays, and (d) results of the whole blood assay (WBA) compared to the LAL test. Using a parallel sampler, 120 filters were loaded with dust at 4 different occupational settings and extracted in 2 labs using a standardized protocol. Parameters like Tween in the extraction medium, extraction volume, centrifugation speed, and material of tubes used for extraction were tested. The LAL test and the WBA were able to determine the differences in dust load of filters obtained from the settings investigated. In addition, results varied significantly with modifications in extraction procedures. Using Tween for filter extraction mainly influenced the resulting endotoxin activity. In addition, LAL test differences according to manufacturer of LAL test, extraction volume, and whether the samples are freshly processed or frozen also resulted in significant variations in the endotoxin levels. In conclusion, a reliable assessment of exposure to endotoxin activity is only possible if standard operation procedures (SOPs) for sampling and determination are established.

Utilization of the human cell line HL-60 for chemiluminescence based detection of microorganisms and related substances

In this paper we describe a new pyrogen assay using the human leukemia cell line HL-60. The cell line is differentiated using all-trans retinoic acid (ATRA) to generate a cell population that resembles mature granulocytes. The differentiated HL-60 cell is capable of generating reactive oxygen species (ROS) when challenged with pyrogenic substances. In a luminol enhanced chemilumimetric assay the responsiveness of differentiated HL-60 cells is tested towards Salmonella typhimurium, Bacillus subtilis, Saccharomyces cerevisiae, Candida albicans, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). The results show a poor sensitivity to S. typhimurium but displays good sensitivity towards B. subtilis, LTA and LPS. Furthermore, the sensitivity towards the yeasts C. albicans and S. cerevisiae is considerably better than obtained in other in vitro cell systems. Overall these results indicate that the HL-60 cell assay possibly could be evolved to a supplementary assay for the known pyrogenic detection assays. Furthermore, the utilization of the assay for pyrogenic examination of recombinant drugs derived from yeast expression systems would be relevant to examine.

In vitro pyrogen test—A new test method for solid medical devices

Medical devices manufactured for implantation into humans must be free of any contamination with viable bacteria. However, remnants of dead bacteria and bacterial components alone may induce an inflammatory immune response. Pyrogen tests for such inflammatory contaminations are generally performed either by determining the content of lipopolysaccharide in rinsing solutions of batch samples by limulus amoebocyte lysate assay, by injecting the rinsing solutions into rabbits or by implanting batch samples into rabbits and measuring change of body temperature. In this study, we show that the in vitro pyrogen test (IPT), which measures the release of the inflammatory cytokine IL-1beta in fresh or cryopreserved human whole blood, can be used to assess the pyrogenic contamination of implantable medical devices. This test was used to check neurosurgical implants, namely aneurysm clips, as a proof of principle. Owing to the direct contact of the test material with the blood cells, this test does not require rinsing procedures, which have variable efficacy. The use of human blood ensures the detection of all substances that are pyrogenic for humans and reflects their relative potency. The safety of the products as delivered could be confirmed. The effects of sterilization and depyrogenization procedures on intentional pyrogenic contaminations of samples could be followed. This new application of the already internationally validated method promises to replace further rabbit pyrogen tests. It generates extremely sensitive results with an extended range of detectable pyrogenic contaminants.