Assay of Escherichia coli heat-labile enterotoxin with vero cells

Primary Human Derived Blood Outgrowth Endothelial Cells: An Appropriate In Vitro Model to Study Shiga Toxin Mediated Damage of Endothelial Cells

Hemolytic uremic syndrome (HUS) is a rare disease primarily characterized by hemolytic anemia, thrombocytopenia, and acute renal failure. Endothelial damage is the hallmark of the pathogenesis of HUS with an infection with the Shiga toxin (Stx) producing Escherichia coli (STEC-HUS) as the main underlying cause in childhood. In this study, blood outgrowth endothelial cells (BOECs) were isolated from healthy donors serving as controls and patients recovered from STEC-HUS. We hypothesized that Stx is more cytotoxic for STEC-HUS BOECs compared to healthy donor control BOECs explained via a higher amount of Stx bound to the cell surface. Binding of Shiga toxin-2a (Stx2a) was investigated and the effect on cytotoxicity, protein synthesis, wound healing, and cell proliferation was studied in static conditions. Results show that BOECs are highly susceptible for Stx2a. Stx2a is able to bind to the cell surface of BOECs with cytotoxicity in a dose-dependent manner as a result. Pre-treatment with tumor necrosis factor alpha (TNF-α) results in enhanced Stx binding with 20–30% increased lactate dehydrogenase (LDH) release. Endothelial wound healing is delayed in a Stx2a-rich environment; however, this is not caused by an effect on the proliferation rate of BOECs. No significant differences were found between control BOECs and BOECs from recovered STEC-HUS patients in terms of Stx2a binding and inhibition of protein synthesis.

Heat-Labile Enterotoxins

Heat-labile enterotoxins (LTs) of Escherichia coli are closely related to cholera toxin (CT), which was originally discovered in 1959 in culture filtrates of the gram-negative bacterium Vibrio cholerae. Several other gram-negative bacteria also produce enterotoxins related to CT and LTs, and together these toxins form the V. cholerae-E. coli family of LTs. Strains of E. coli causing a cholera-like disease were designated enterotoxigenic E. coli (ETEC) strains. The majority of LTI genes (elt) are located on large, self-transmissible or mobilizable plasmids, although there are instances of LTI genes being located on chromosomes or carried by a lysogenic phage. The stoichiometry of A and B subunits in holotoxin requires the production of five B monomers for every A subunit. One proposed mechanism is a more efficient ribosome binding site for the B gene than for the A gene, increasing the rate of initiation of translation of the B gene independently from A gene translation. The three-dimensional crystal structures of representative members of the LT family (CT, LTpI, and LTIIb) have all been determined by X-ray crystallography and found to be highly similar. Site-directed mutagenesis has identified many residues in the CT and LT A subunits, including His44, Val53, Ser63, Val97, Glu110, and Glu112, that are critical for the structures and enzymatic activities of these enterotoxins. For the enzymatically active A1 fragment to reach its substrate, receptor-bound holotoxin must gain access to the cytosol of target cells.

The genome landscape of the african green monkey kidney-derived vero cell line

Continuous cell lines that originate from mammalian tissues serve as not only invaluable tools for life sciences, but also important animal cell substrates for the production of various types of biological pharmaceuticals. Vero cells are susceptible to various types of microbes and toxins and have widely contributed to not only microbiology, but also the production of vaccines for human use. We here showed the genome landscape of a Vero cell line, in which 25,877 putative protein-coding genes were identified in the 2.97-Gb genome sequence. A homozygous ∼9-Mb deletion on chromosome 12 caused the loss of the type I interferon gene cluster and cyclin-dependent kinase inhibitor genes in Vero cells. In addition, an ∼59-Mb loss of heterozygosity around this deleted region suggested that the homozygosity of the deletion was established by a large-scale conversion. Moreover, a genomic analysis of Vero cells revealed a female Chlorocebus sabaeus origin and proviral variations of the endogenous simian type D retrovirus. These results revealed the genomic basis for the non-tumourigenic permanent Vero cell lineage susceptible to various pathogens and will be useful for generating new sub-lines and developing new tools in the quality control of Vero cells.

E. coli heat labile toxin (LT) inactivation by specific polyphenols is aggregation dependent

Recently, polyphenol extracts were suggested to inhibit binding of Escherichia coli heat labile enterotoxin (LT) to its intestinal receptor GM1. Therefore, polyphenols are promising feed or food supplements to combat enterotoxigenic infections. Little is known of the precise mechanism, or the type of polyphenol required. Here, seven different polyphenols were tested in vitro (1) for inhibition of LT binding to GM1 (GM1-ELISA), (2) for LT inhibitory activity in the cAMP Vero-cell assay, and (3) by testing the aggregating properties of polyphenols with LT using molecular weight exclusion membrane filters, and by centrifugation techniques. Results showed only three out of seven polyphenols, pentagalloylglucose (PGG), epigallocatechingallate (EGCG) and gallocatechingallate (GCG), to effectively inhibit binding of LT to GM1, and to inhibit induction of cAMP in Vero cells, and that PGG is the most effective. Blocking of the GM1 receptor is unlikely as a mechanism because pre-incubation of GM1 with polyphenols had no effect. Co-incubation of polyphenols with forskolin did not interfere with cAMP production in Vero cells, showing that polyphenol activity is not directly related to cAMP. It is concluded that the inhibitory activities of these three polyphenols may coincide with the formation of large (>100 kDa) LT-polyphenol aggregates. Enterotoxin inactivation appears to require a minimum of two galloyl moieties in polyphenol structure and the pentagalloyl PGG is the most effective.

Escherichia coli O104:H4 outbreak from sprouted seeds

From May to July 2011, one of the largest reported outbreaks of haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by the Shiga toxin-producing Escherichia coli (STEC) O104:H4 occurred in Germany and France. The hypothetical origin of the outbreak strain was a combined enteroaggregative E. coli and an enterohaemorrhagic E. coli with the ability to resist multi-antibiotics and produce Shiga-toxin 2. The combination of aggregative ability, antibiotic resistance and the production of Shiga-toxin 2 significantly affected the severity of the symptoms presented. Since humans may be the primary reservoir, it is likely that contamination could have occurred through contact with infected individuals. Farm food safety management, and hand hygiene training programmes are crucial to primary production to prevent or reduce risks of contamination.

Early Days of Food and Environmental Virology

In July 1962, the author joined the Food Research Institute (FRI), then at the University of Chicago, to become its food virologist. There was a limited record of waterborne viral disease outbreaks at the time; recorded data on foodborne outbreaks were fewer still. Laboratory environmental (water and wastewater) virology was in its infancy, and food virology was in gestation. Detection of viruses was most often attempted by inoculation of primary primate cell cultures, with observation for plaque formation or cytopathic effects. Focus was initially on enteroviruses and reoviruses. Environmental and food samples had to be liquefied if not already in liquid form; clarified to remove solids, bacteria, and fungi; and concentrated to a volume that could be tested in cell culture. Cytotoxicity was also a concern. Studies at the FRI and some other laboratories addressed all of these challenges. The FRI group was the World Health Organization's Collaborating Center for Food Virology for many years. Other topics studied were virus inactivation as functions of temperature, time, matrix, disinfectants, and microbial action; peroral and ex-vivo infectivity; and the suitability of various virus surrogates for environmental monitoring and inactivation experiments. Detection of noroviruses and hepatitis A virus required molecular methods, most often RT-PCR. When it was found that inactivated virus often gave the same RT-PCR signal as that of infectious virus, sample treatments were sought, which would prevent false-positive test results. Many laboratories around the world have taken up food and environmental virology since 1962, with the result that a dedicated journal has been launched.

Enhancement of toxin- and virus-neutralizing capacity of single-domain antibody fragments by N-glycosylation

Single-domain antibody fragments (VHHs) have several beneficial properties as compared to conventional antibody fragments. However, their small size complicates their toxin- and virus-neutralizing capacity. We isolated 27 VHHs binding Escherichia coli heat-labile toxin and expressed these in Saccharomyces cerevisiae. The most potent neutralizing VHH (LT109) was N-glycosylated, resulting in a large increase in molecular mass. This suggests that N-glycosylation of LT109 improves its neutralizing capacity. Indeed, deglycosylation of LT109 decreased its neutralizing capacity three- to fivefold. We also studied the effect of glycosylation of two previously isolated VHHs on their ability to neutralize foot-and-mouth disease virus. For this purpose, these VHHs that lacked potential N-glycosylation sites were genetically fused to another VHH that was known to be glycosylated. The resulting fusion proteins were also N-glycosylated. They neutralized the virus at at least fourfold-lower VHH concentrations as compared to the single, non-glycosylated VHHs and at at least 50-fold-lower VHH concentrations as compared to their deglycosylated counterparts. Thus, we have shown that N-glycosylation of VHHs contributes to toxin- and virus-neutralizing capacity.

Dietary specific antibodies in spray-dried immune plasma prevent enterotoxigenic Escherichia coli F4 (ETEC) post weaning diarrhoea in piglets

In order to establish the mechanism of spray dried plasma powder (SDPP) in improving pig health and performance, a diet containing either 8% SDPP, spray dried immune plasma powder (SDIPP), or control protein (soybean and whey) ration was fed to piglets in an experimental model of enterotoxigenic Escherichia coli F4 (ETEC) post-weaning diarrhoea (PWD). SDIPP was obtained from pigs immunized with a vaccine containing ETEC fimbrial subunit F4 and heat-labile toxin (LT), and SDPP from non-immunized controls. Average daily growth (ADG) was determined, and daily samples of rectal faeces were assessed for diarrhoea (as percentage of dry matter), and ETEC excretion (in CFU/g). SDPP and SDIPP significantly (p<0.05) reduced diarrhoea, and SDIPP significantly reduced ETEC excretion. ADG was not significantly (p>0.05) affected. After the experiment, 30% of piglets tested F4 receptor positive (F4R+). A significant correlation between F4R status and morbidity was found. In F4R+ animals, SDIPP significantly improved diarrhoea and ADG, and decreased ETEC excretion, and SDPP significantly improved diarrhoea and ADG. Surprisingly, SDPP reduced diarrhoea in F4R+ animals without significant reduction of ETEC excretion, which is most likely related to the presence of anti-LT antibodies in SDPP. The results show that oral protection against ETEC by SDPP is attributable to spontaneous antibodies, in this case anti-LT antibodies. Furthermore, the results indicate that the combination of anti-LT and anti-F4 antibodies as in SDIPP is most effective in ETEC prevention. Finally, the F4R distribution in the herd should be taken into account to correctly assess efficacy.

60Co irradiation of Shiga toxin (Stx)-producing Escherichia coli induces Stx phage

Shiga toxin (Stx)-producing Escherichia coli (STEC), an important cause of hemolytic uremic syndrome, was completely killed by (60)Co irradiation at 1 x l0(3) gray (1 kGy) or higher. However, a low dose of irradiation (0.1-0.3 kGy) markedly induced Stx phage from STEC. Stx production was observed in parallel to the phage induction. Inactivation of Stx phage required a higher irradiation dose than that for bacterial killing. Regarding Stx, cytotoxicity was susceptible to irradiation, but cytokine induction activity was more resistant than Stx phage. The findings suggest that (1). although (60)Co irradiation is an effective means to kill the bacteria, it does induce Stx phage at a lower irradiation dose, with a risk of Stx phage transfer and emergence of new Stx-producing strains, and (2). irradiation differentially inactivates some activities of Stx.

Enterobacter sakazakii: infectivity and enterotoxin production in vitro and in vivo

Enterobacter sakazakii has been implicated as the causal organism in a severe form of neonatal meningitis, with reported mortality rates of 40 to 80%. Dried infant formula has been identified as a potential source of the organism in both outbreaks and sporadic cases. In this study, clinical and foodborne isolates of E. sakazakii were evaluated for enterotoxin production by the suckling mouse assay. In addition, suckling mice were challenged both orally and by intraperitoneal injection. Of 18 E. sakazakii strains evaluated, four were found to test positive for enterotoxin production. All strains of E. sakazakii were lethal to suckling mice at 10(8) CFU per mouse by intraperitoneal injection, while two strains caused death by the peroral route. In in vitro assays, CHO, Vero, and Y-1 cells demonstrated both cell lysis and rounding when exposed to E. sakazakii strain LA filtrates. This is the first report describing any putative virulence factors of E. sakazakii.

Comparative efficacy of various toxoids against salmonellosis in poultry

An attempt was made to develop a vaccine against salmonellosis in poultry by formalizing the Salmonella toxins (enterotoxin plus cytotoxins) that have been found to be the main virulent products of the organisms. Formalized (FT) and carbonated (CT) toxoids were prepared from partially purified toxins of Salomella enteric subspecies enterica ser. Weltevreden (BM-1643) and S. enterica ser. Gallinarum (L-19/a). There was no mortality in birds vaccinated with formalized toxoid of serovar Weltevredenplus Freund's complete adjuvant (FCA) following homologous or heterologous (S. enterica ser. Gallinarum and S. enterica ser. Typhimurium) challenges. Protection ranged from 50% to 83.3% in thegroups immunized with other preparations of S. enterica ser. Weltevreden, i.e. with FT without FCA or with CT with or without FCA. Formalized toxoid prepared from S. entrica ser. Gallinarum (FTSG) toxins given with FCA afforded 100% protection against homologous challenge, but not against heterologous serovars. In the control group. only 16.7% of the birds survived in a subgroup challenged with S. enterica ser. Gallinarum. and none withstood challenge with S enterica ser. Weltevreden or S. enterica ser. Typhimurium. No untoward reactions were observed in any of the immunized groups. Thus, the vaccine was considered to be potent and safe.

Pathogenic characteristics of Escherichia coli strains isolated from newborn piglets with diarrhea in Brazil

Ninety-one Escherichia coli isolates obtained from diarrheic and normal feces of newborn piglets (0-11 days of age) from three states of Brazil were assessed for phenotypic and genotypic characteristics associated with pathogenic processes. These isolates expressed fimbriae F18ac and type 1, but not fimbriae K88, K99, 987P or F41. Genes for toxins (LT-I, STa, SLT-I, SLT-II, SLT-IIv) either individually or combined were found to be present in most of the diarrheic strains (65.7%) and in 42.8% of the non-diarrheic ones. The eaeA gene was present in 25.7% of the diarrheic isolates and in 9.5% of the non-diarrheic ones. Colicin, hemolysin and aerobactin were also found to be produced by some strains from both sources. Because of the great variety of biological characteristics associated with different illness processes, we suggest that, in Brazil, pigs may act as a reservoir for transmission of Escherichia coli strains to other animals.

Effect of pH on survival, thermotolerance, and verotoxin production of Escherichia coli O157:H7 during simulated fermentation and storage

Heat treatment is increasingly being introduced to fermented meat processing, since the acid tolerance properties of Escherichia coli O157:H7 can permit this organism to survive traditional processing procedures. This study investigated the effect of growth pH and fermentation on the thermotolerance at 55 degrees C of E. coli O157:H7 in a model fermented meat system. E. coli O157:H7 (strain 380-94) was grown at pH 5.6 or 7.4 (18 h at 37 degrees C), fermented to pH 4.8 or 4.4 in brain heart infusion broth, and stored for 96 h. Cells grown at pH 5.6 had higher D values at 55 degrees C (D55 degrees C) than cells grown at pH 7.4 (P < 0.001). Cells fermented to pH 4.8 had higher D55 degrees C than those fermented to pH 4.4 (P < 0.001). Cells fermented to pH 4.8 demonstrated an increase in D55 degrees C during storage (P < 0.001), whereas cells fermented to pH 4.4 showed a decrease in D55 degrees C during the same period (P < 0.001). The effect of growth pH on verotoxin production by E. coli O157:H7 was assessed using the verotoxin assay. Cells grown at pH 5.6 had lower verotoxin production then cells grown at pH 7.4. This effect was not sustained over storage. These results indicate that a lower growth pH can confer cross-protection against heat. This has implications for the production of acidic foods, such as fermented meat, during which a heating step may be used to improve product safety.

Isolation and characterisation of four distinct cytotoxic factors of Salmonella Weltevreden

Four distinct cytotoxins with different biological, physico-chemical and antigenic characteristics were isolated from a single Salmonella Weltevreden strain recovered from buffalo meat. The toxins were purified by means of salt precipitation, dialysis, gel filtration and ion-exchange chromatographic methods. Cytotoxin I was dermonecrotic, verocytotoxic and lethal for the mouse (LD50 120 micrograms). It induced accumulation of serosanguinous fluid in the rabbit ligated ileal loop (RLIL) and mucinous fluid in the stomach. It was active within a narrow pH range (5.0-8.0) and lost its activity on autoclaving for 1 min. Cytotoxin II was verocytotoxic, enterotoxic and lethal to for the mouse (LD50, 1 mg). It induced delayed vasopermeability in rabbit skin, was active at between pH 5.6 and 8.4 only and heat-sensitive (100 degrees C, 30 min). Cytotoxin III was neither dermatotoxic nor enterotoxic. It induced vacuolation, multinucleation and formation of syncytia in Vero cells. It was pH-sensitive beyond the range of 4.8 to 8.2. It was completely inactivated on boiling for 30 min. Cytotoxin IV was intensely necrotizing to rabbit skin within 6 h of inoculation and lysed Vero cells. It also possessed haemolytic and lecithinase/phospholipase-C activities. The cytotoxin lost its activity on heating at 90 degrees C (30 min) but remained active between pH 2.5 and 7.5. The PIs of the cytotoxins were estimated to be 9.0, 7.0, 5.6 and 3.0, respectively. All the four cytotoxins were immunogenic in rabbits but antigenically unrelated as the anticytotoxin neutralized only the homologous cytotoxin and did not cross-react with heterologous cytotoxins.

Cytotoxin produced by Escherichia coli isolated from chickens with swollen head syndrome (SHS)

This study was conducted to determine the presence of selected virulence factors in Escherichia coli recovered from swollen head syndrome (SHS) in chickens. Thirty-six (72%) of 50 isolates of E. coli from SHS were shown to produce a cytotoxin that was active on Vero and HeLa but not on Y-1 cells. The toxin was called VT2y because the cytotoxic effect on Vero cells was morphologically similar to that produced by E. coli verotoxins (VTs), and this effect was neutralized by antiserum against VT2 but not by antiserum against VT1. Interestingly, DNA probes for VT1 and VT2 failed to hybridize the VT2y-positive isolates with total DNA. Although the role of this toxin in SHS has yet to be demonstrated, the marked edema which characterizes affected chickens is consistent with the action of a toxin such as verotoxin which targets vascular endothelium.

Isolation and characterization of enteroaggregative Escherichia coli (EAggEC) by genotypic and phenotypic markers, isolated from diarrheal children in Congo

OBJECTIVE: To determine the prevalence of enteroaggregative Escherichia coli (EAggEC) in African diarrheal children in Lwiro, Congo, to characterize EAggEC isolates by possible genotypic and phenotypic markers, and to evaluate the EAggEC probe pCVD432 in identifying EAggEC. METHODS: The Hep-2 cell adhesion assay and colony-blot hybridization assays were carried out for the identification of EAggEC. O:H serotyping, biotyping, antibiogram and plasmid-profile analysis were done. To detect the E. coli LT and ST, ELISA tests were used and, for VT, a vero cell assay was used. RESULTS: EAggEC strains were isolated from 56 out of 115 diarrheal children (48.7%): the organism was present alone and presumed to cause diarrhea in 22 (19.1%) cases. The rest of the cases were associated with two or more diarrheagenic E. coli strains. EAggEC strains were isolated from 25% of total diarrheal children (first day of isolation) and 8.86% of age-matched healthy individuals (p<0.03). This isolation rate was significantly higher than the one found for other diarrheagenic E. coli strains. In parallel, we evaluated the sensitivity and specificity of EAggEC probe pCVD432, and found that it had 56% sensitivity with 100% specificity compared with the Hep-2 cell test. EAggEC isolates were characterized by serotyping, biotyping, antibiotic resistance pattern, plasmid profiling and toxin production analysis. They did not produce any one of these classical toxins and nor did they relate to any particular serotypes. Plasmid analysis of the 79 EAggEC isolates (n=315) showed seven different profiles. Ten resistance patterns were identified and 34 strains were sensitive to all drugs. There was no association between plasmid profiles and antibiotic resistance patterns. All 16 classical E. coli biotypes were found in this small EAggEC population. CONCLUSIONS: EAggEC has been emerging as a cause of childhood diarrhea in African children in Congo. From the accumulated data it was found that there is a great heterogeneity in EAggEC populations.

SEROTYPING AND ENTEROTOXIGENICITY OF ESCHERICHIA COLI ISOLATED FROM URINARY TRACT INFECTIONS

One hundred and forty patients with symptomatic urinary tract infection were investigated for serotyping and enterotoxin production. Escherichia coli constituted 63 per cent of the 119 culture positive cases followed by Klebsiella spp and Proteus spp. E. coli serotype O5 was the most prevalent (29.3%) of the typable strains followed by O17 and O25. Out of the 75 E. coli strains, 30 (40%) were enterotoxin producers. Four per cent produced both heat-stable enterotoxin and heat-labile enterotoxin, 21.3 per cent produced only heat stable, whereas 13.3 per cent produced only heat labile toxin. E. coli serotype O5 was the commonest enterotoxin producer (45.5%), followed by rough strains (52.9%) and untypable strains (30.7%). Other ET producing strains were O1, O25, O55, O57 and O60. The enterotoxin production of the most prevalent serotype O5 possibly contributes as a virulence marker in UTI cases.

Enterotoxin and cytotoxin production by Salmonella enteritidis strains isolated from gastroenteritis outbreaks

Seventy-six Salmonella enteritidis, three Salmonella virchow and one Salmonella bradenrup strains were screened for enterotoxigenicity by using the Chinese hamster ovary (CHO), Y1 adrenal, Vero and HeLa cell tests. All the strains gave positive reactions for enterotoxin production, except one, and the relative sensitivity to the toxin exhibited by the different cell lines was evaluated. An enterotoxic activity has been identified in sonicated extracts of Salm. enteritidis. This enterotoxin was purified on Agarose A-5m (Bio-Rad) and Superose 12 HR 10/30 column. The enterotoxic activity was eluted from the Superose column in the first peak. Like Vibrio cholerae toxin CT and Escherichia coli enterotoxin LT, it was blocked by GM1 ganglioside, but at a higher concentration. In addition, a cytotoxic factor has been partially identified. The procedure for isolating the cytotoxin included ammonium sulphate precipitation, size-exclusion chromatography and anion exchange chromatography. This cytotoxin factor caused inhibition of protein synthesis in cultured cells, as determined by flow cytometry and [3H]-leucine incorporation. Flow cytometry analysis also showed an activation of CHO cells when exposed to this cytotoxic factor resulting in a state of active growth. Cytotoxic activity was not blocked by gangliosides.

Enteropathogens associated with childhood diarrhea in Italy. The Italian Study Group on Gastrointestinal Infections

BACKGROUND

Infectious diarrheal diseases remain an important cause of childhood morbidity in industrialized countries. The knowledge of the etiology and epidemiology of childhood diarrhea in a given area is needed to plan any measure designed to prevent or ameliorate diarrheal illness and to develop practice guidelines for the most appropriate stool examination procedures.

METHODS

We evaluated 618 children with diarrhea and 135 controls prospectively for viral, bacterial and parasitic enteric pathogens. Diarrheagenic Escherichia coli was identified by gene probes specific to different virulence factors. Stool filtrates were examined for the presence of free bacterial toxins by a cell culture cytotoxicity assay. Clinical and epidemiologic data were recorded and analyzed in relation to microbiologic findings.

RESULTS

Enteropathogens were identified in 59% of children with diarrhea and in 10.4% of asymptomatic controls. The agents mainly associated with disease were rotavirus (23.6%), Salmonella (19.2%) and Campylobacter (7.9%). Rotavirus was significantly more frequent among children observed as inpatients whereas Campylobacter was significantly more common in outpatients. Infections with diarrheagenic E. coli, Shigella flexneri, yersinia enterocolitica, Cryptosporidium and Giardia were observed in a limited number of patients. The clinical presentation of children was not sufficiently characteristic to permit presumptive diagnosis of a specific pathogen. conversely the presence of blood and/or leukocytes in stools had a high positive predictive value for Salmonella or Campylobacter infection.

CONCLUSION

The results of this study will be useful for planning strategies to prevent and control diarrheal diseases in our country.

An agar-overlay method for detection of toxins produced by Escherichia coli

An agar overlay method, with Vero and HeLa cells, was used for detection of heat-labile enterotoxin and verotoxin from Escherichia coli. The method is more sensitive than the conventional cell culture assay, is rapid, easy to perform, and is suitable for epidemiological studies.

Evidence that the A2 fragment of Shiga-like toxin type I is required for holotoxin integrity

Escherichia coli Shiga-like toxin type I (SLT-I) is a potent cytotoxin consisting of an enzymatically active A subunit and a pentameric B subunit that mediates toxin binding to susceptible eukaryotic cells. Evidence that the carboxy-terminal 38 amino acids of the A subunit are involved in holotoxin 1A:5B association is presented. We compared the ability of purified recombinant SLT-I B subunit (Slt-IB) to combine in vitro with purified recombinant SLT-I A subunit (Slt-IA; full-length subunit A includes amino acids 1 to 293) and its ability to combine with purified recombinant SLT-I A1 subunit (Slt-IA1; truncated subunit A includes amino acids 1 to 255). Each mixture was analyzed for biological and physical evidence of toxin assembly. Although Slt-IA successfully combined with Slt-IB to form a molecular species similar to holotoxin that was detectable by nondenaturing polyacrylamide gel electrophoresis and immunoblotting and yielded a molecule which was cytotoxic to cultured Vero cells, Slt-IA1 did not have this ability. Slt-IA1 was 36-fold more active than Slt-IA in an in vitro protein synthesis inhibition assay. These findings suggest that the Slt-IA2 fragment is crucial for formation of SLT holotoxin and stabilizes the interaction between the A and B subunits.

Empirical evaluation of conditions influencing the polymerase chain reaction: enterotoxigenic Escherichia coli as a test case

False polymerase chain reaction (PCR) results may be obtained under unfavourable reaction conditions. Therefore optimal conditions for the different factors influencing a specific PCR method should be determined before introduction to a clinical diagnostic laboratory. This study has concentrated on the detection of heat-labile enterotoxin-producing E. coli by PCR, with empirical evaluation of various factors. Template was prepared by heat-lysis of E. coli, and this was shown to be adequate for PCR detection. The results showed that deviation from the optimal conditions of any of the following conditions may lead to false results: lysis of bacterial cells, denaturation temperature during cycling, annealing temperature, primer concentration, enzyme concentration, magnesium concentration and ion concentration. Three different detection methods for PCR product were also evaluated. As little as one bacterium can be detected after 35 cycles of PCR amplification with 32P-labelled oligonucleotide probe. An alkaline phosphatase-labelled probe was 10-fold less sensitive, whereas 100 bacteria in 10 microliters of the original sample suspension were necessary to give a positive signal after gel electrophoresis. The information in this study may be useful to those who wish to introduce PCR tests to diagnostic laboratories.

Toxin production by Bacillus pumilus

Two strains of Bacillus pumilus (M11 and M38) and one strain each of Bacillus cereus (M27), Bacillus subtilis (M67), and Enterobacter agglomerans (M14) were identified from the air of Lancashire cotton mills. These strains were tested for cytopathic effects in Vero cells; B pumilus and B cereus strains were also examined for haemolytic activity, lecithinase production, and proteolytic action on casein. Rounding and clumping of the Vero cells occurred after the addition of supernatants prepared from B pumilus and B cereus strains; finger-like projections developed in the cells treated with B pumilus supernatants. Minimal effects occurred with B subtilis and E agglomerans. After two hours of exposure B pumilus (M11) produced the greatest effect, but treatment with trypan blue showed that most cells exposed to the M11 strain were still alive after 96 hours of exposure; those exposed to the supernatant prepared from the M38 strain of B pumilus were dead. Sheep erythrocytes were lysed more rapidly by B cereus than by B pumilus, B cereus (strongly positive) had a greater effect on lecithin than either of the B pumilus strains (M38 weakly positive, M11 negative). All hydrolised casein but the effect was more rapid with one of the B pumilus (M11) strains. It is concluded that not only do the toxins of B pumilus differ from those of B cereus, but there are also differences between the toxins produced by the two strains of B pumilus (M11 and M38).

Amplification of nucleic acids by polymerase chain reaction (PCR) and other methods and their applications

The in vitro replication of DNA, principally using the polymerase chain reaction (PCR), permits the amplification of defined sequences of DNA. By exponentially amplifying a target sequence, PCR significantly enhances the probability of detecting target gene sequences in complex mixtures of DNA. It also facilitates the cloning and sequencing of genes. Amplification of DNA by PCR and other newly developed methods has been applied in many areas of biological research, including molecular biology, biotechnology, and medicine, permitting studies that were not possible before. Nucleic acid amplification has added a new and revolutionary dimension to molecular biology. This review examines PCR and other in vitro nucleic acid amplification methodologies--examining the critical parameters and variations and their widespread applications--giving the strengths and limitations of these methodologies.

Improved method for the routine identification of toxigenic Escherichia coli by DNA amplification of a conserved region of the heat-labile toxin A subunit

This report describes a DNA amplification procedure for routine identification of heat-labile-toxin-producing Escherichia coli. Two oligonucleotide primers were used in a polymerase chain reaction procedure to amplify a highly conserved region of the A subunit of the heat-labile enterotoxin gene. Amplifications were done directly on E. coli colonies from plates when Salmonella, Shigella, or parasite infections were excluded as agents of the severe diarrhea in the patients. The conditions for the polymerase chain reaction method were empirically determined, and the procedure is inexpensive, sensitive, and specific. Positive results can be obtained over a wide variation in bacterial numbers, with no inhibition of Thermus aquaticus DNA polymerase. Detection of the amplified product can be done by agarose gel electrophoresis, which is specific and sensitive enough for routine diagnosis of this pathogen in clinical isolates. If greater sensitivity and specificity are required, hybridization with 32P- or alkaline phosphatase-labeled oligonucleotide probes can be used. Our results suggest that heat-labile-toxin-producing E. coli is responsible for about 9% of nondiagnosed diarrhea cases in Tygerberg Hospital, Tygerberg, Republic of South Africa.

Rapid and specific detection of verotoxin genes in Escherichia coli by the polymerase chain reaction

A set of four synthetic oligonucleotide probes derived from sequences of the VT1 (Shiga-like toxin I [SLT-I]) and VT2 (SLT-II) genes were used in a polymerase chain reaction (PCR) amplification procedure to detect these genes in some enteric pathogens. A total of 40 verotoxin-producing Escherichia coli strains and 43 isolates of other recognized enteric pathogens were studied. PCR amplification products identifying the VT1 and VT2 gene sequences were observed only in nucleic acid extracted from strains found to be VT positive in traditional tissue culture assays. Template nucleic acid extracted from other gram-negative bacteria was found to be negative with the exception of five isolates of Shigella dysenteriae type 1 in which good amplification with the VT1 probe was observed. The oligonucleotide probes clearly distinguished VT1 and VT2 strains of E. coli and did not give specific amplification with nucleic acid from VTe (a SLT-II variant)-producing E. coli. VT1 or VT2 genes or both were not detected in E. coli K-12 strain C600 or HB101 or in strains known to express other virulence factors, such as enterotoxins, adhesins, hemolysins, or unrelated cytotoxins. The sensitivity of the PCR procedure for detection of both VT1 and VT2 genes was determined to be 1 ng of total nucleic acid. Furthermore, the VT1 gene was easily detected when only 100 pg of nucleic acid was used as the template in the PCR procedure.

The virulence characteristics of strains of Escherichia coli isolated from cases of bovine mastitis in England and Wales

Of 470 Gram-negative facultative anaerobes isolated from cases of bovine mastitis in England and Wales, 422 were identified as Escherichia coli. The characteristics of 237 of these were investigated. Guinea-pig red cell haemagglutinins were possessed by 86% of strains and 12% were resistant to D-mannose. None of the strains tested invaded Vero cells. Haemolysin, Vero toxin and enterotoxin were produced by 5, 0.5 and 1% of strains, respectively. Twenty-two percent were resistant to one or more antibiotics and 4% to sodium arsenate. Transfer ability was possessed by 41% and lysogenic phage by 27% of strains; 62% possessed either one or the other and 12% possessed both. Colicin production was detected in 18% of strains; 5% produced Colicin V. Ninety-nine percent of strains were serum-resistant, while only 6% were able to grow well in bovine serum. A microscopically visible capsule was seen in 75% of strains. All strains possessed at least one of the potential virulence factors or markers studied. Several strains which possessed one characteristic only (mannose-sensitive haemagglutination or serum resistance), possessed one or more large molecular weight plasmids. None of the strains was particularly virulent for chickens following intramuscular inoculation. Of the strains which possessed one virulence characteristic, only those which were serum-resistant were re-isolated from expressed milk following intramammary inoculation of lactating cows.

Characteristics of verotoxigenic Escherichia coli from pigs

Porcine verotoxigenic Escherichia coli were characterized with respect to frequency of occurrence, serogroup, and association with disease, weaning, and selected properties of the bacterium. Of 668 strains of E. coli from southern Ontario pigs with enteric disease, 32 (4.8%) produced verotoxin at 10(3)-10(7) cytotoxic doses per mL of culture supernatant. Of 22 isolates which belonged to O serogroups 138, 139 and 141, 15 produced verotoxin. Among other enterotoxigenic types of E. coli, two of 57 isolates of O157:K"V17" and two of 96 isolates of O149:K91 were verotoxigenic. The remaining 13 verotoxigenic E. coli belonged to O groups 2, 107, 120, 121 and 130. An additional 21 verotoxigenic E. coli belonging to O groups 138, 139 and 141 and three to O157:K"V17" were identified in a collection of 47 E. coli recovered from weaned pigs with enteric disease. Verotoxigenic E. coli were associated with postweaning diarrhea, bloody stools, sudden death and edema disease. They were isolated at similar frequencies (14%) from healthy weaned pigs, and from weaned pigs with enteric disease. Isolation rates from neonates were low and significantly different from rates in weaned pigs. Neutralizing antibody to verotoxin was not detected in the sera of 45 pigs, which included pigs from herds with a history of edema disease. Verotoxin was not associated with production of colicin, hemolysin, or enterotoxins or with any of 23 biochemical properties of the organisms. The serological data indicate that porcine verotoxigenic E. coli are not a common source of verotoxigenic E. coli for humans. Porcine verotoxin may play a role in postweaning diarrhea and absence of detectable neutralizing antibody in serum may be an important aspect of pathogenesis.

A new heat-labile cytolethal distending toxin (CLDT) produced by Escherichia coli isolates from clinical material

A new heat-labile Escherichia coli toxin cytolethal to Vero, HeLa, HEp-2 and CHO cells and negative in Y-1 cells has been demonstrated in culture filtrates of 43 E. coli strains associated with diarrheal disease. This new toxin was termed a cytolethal distending toxin (CLDT) to reflect the progressive cell distention and cytotoxicity evidenced in all sensitive tissue cells. CLDT was distinct from the classic heat-labile (LT) and heat-stable enterotoxins, Verotoxins and hemolysins and was produced by some strains of the following E. coli serogroups (02, 07, 08, 018, 022, 039, 044, 055, 083, 086, 091, 0113, 0119, 0128 and 0167). Moderate cyclic AMP accumulation (75-fold) was observed in CHO cells exposed to E. coli CLDT for 24 h. In contrast to E. coli LT, cyclic AMP levels were optimal at 24 h and were observed to decrease over the following 72 h period in CHO cells exposed to E. coli CLDT. In addition to heat-lability at 70 degrees C for 15 min, E. coli CLDT demonstrated a molecular weight over 30,000, was nondialyzable and trypsin-sensitive. E. coli CLDT was negative in adult rabbit ligated ileal loop and suckling mouse assays and provoked only an erythematous response in rabbit skin. All CLDT-positive E. coli strains identified to date were non-hemolytic and non-invasive. Verotoxin and heat-labile enterotoxin were found in combination with CLDT in a few E. coli strains.

A new heat-labile cytolethal distending toxin (CLDT) produced by Campylobacter spp

A new heat-labile toxin cytolethal to CHO, Vero, HeLa, and HEp-2 cells and negative in Y-1 cells has been demonstrated in culture filtrates of many strains of Campylobacter spp. This new toxin was termed a cytolethal distending toxin (CLDT) to reflect the progressive cell distention and eventual cytotoxicity observed in all sensitive tissue cells. CLDT was distinct from previously reported cytotoxins and cholera-like enterotoxin produced by some Campylobacter spp. Since CHO elongation induced by either the Campylobacter enterotoxin or CLDT could not be differentiated after 24 h incubation, continuation of the assay for 96 h was essential for observation of CLDT-associated progressive morphological changes and cytolethal events. Specific assay conditions were required for demonstration of CLDT in Vero, HeLa, and HEp-2 cells. A 31-fold increase in cyclic AMP levels was observed in CHO cells exposed for 24 h to CLDT of catalase negative or weak positive Campylobacter. CLDT was detected in culture filtrates from strains of Campylobacter jejuni, C. coli, C. fetus subsp. fetus, C. laridis and catalase negative or weak positive Campylobacter. Of 718 strains investigated from both human and animal isolations, 295 (41%) were found to produce this toxin. Campylobacter CLDT was negative in adult rabbit ligated ileal loops, suckling mouse and rabbit skin tests. Hemorrhagic responses were observed in rat ligated ileal loop tests of CLDT-positive cultures. The new CLDT toxin could only be neutralized by homologous rabbit antitoxin, was trypsin-sensitive, nondialyzable and over 30,000 in molecular weight. CLDT-producing strains were observed in many serogroups and biotypes of Campylobacter spp. The strains tested originated from many countries and no clear association of toxigenicity with serotype or biotype could be established.

Evaluation of the Biken test to detect heat-labile (LT) enterotoxin produced by porcine and human Escherichia coli strains

Fifty-seven strains of enterotoxigenic Escherichia coli isolated from humans and pigs and producing thermolabile (LT) enterotoxin were used to ascertain the efficiency of the Biken test compared to the passive immune haemolysis test (PIH), considered as very sensitive for detecting that enterotoxin. The two assays were carried out using anti-porcine (anti-LTp), anti-human (anti-LTh), anti-cholera toxin (anti-CT) and anti-choleragenoid (anti-Cg) antisera. Our results showed that the Biken test was very irregular, with many false-negative results. Positive results (ranging from 78.9 to 22.8) were dependent upon the antiserum used. Conversely, the PIH test was much more efficient in the detection of LT, since 100% of the LT+ strains were positive in this test whatever the antiserum used.

Salmonella typhimurium aroA mutants as carriers of the Escherichia coli heat-labile enterotoxin B subunit to the murine secretory and systemic immune systems

We investigated the ability of Salmonella typhimurium vaccines to deliver heterologous antigens to the systemic and secretory immune systems of the mouse, while retaining their immunogenicity against salmonellosis. S. typhimurium SL3261, an avirulent aroA mutant, or SL3261 carrying plasmid pBRD026, a pBR322 derivative encoding the gene for Escherichia coli LT-B were used to immunize BALB/c mice orally. Both immunizing strains invaded the mononuclear phagocyte system of the mice, grew slowly until approximately day 14 post-infection, and then were rapidly cleared. No salmonellae were detected in livers, spleens, mesenteric lymph nodes or Peyer's patches by day 42. Mice immunized with either strain and challenged orally with the virulent parent strain, SL1344, several weeks after clearing the immunizing organism, were protected against the lethal S. typhimurium infection. Mice infected with SL3261 (pBRD026) developed substantial levels of IgG and IgA anti-LT-B antibodies 14 days post-infection in both serum and gut samples. The sera neutralized the effects of LT in an in vitro Vero cell assay. Thus, aroA mutants of S. typhimurium can deliver a heterologous antigen from a different enteric pathogen to the murine systemic and secretory immune systems without altering their efficacy against salmonellosis.

[Assay of thermolabile enterotoxins of Escherichia coli and Vibrio cholerae by inhibition of erythroadsorption on the GM1 ganglioside]

A GM1 erythroassay (GERYDO) for heat-labile Escherichia coli enterotoxin (LT) and cholera toxin (CT) is described. This assay was developed for use in poorly equipped laboratories in developing countries. It uses GM1-coated polystyrene plates and is based on the competition between the toxin to be assayed and CT covalently bound to sheep red blood cells. GERYDO can detect 0.9 or 0.5 ng of CT per ml depending on the method of sensitization of erythrocytes. Good quantitative and qualitative correlation with the enzyme-linked immunosorbent assay and the Vero cell test was observed.

Assay for heat-labile Escherichia coli enterotoxin using sandwich erythroimmunoassay

We investigated the possibility of using a sheep erythrocyte-antibody conjugate as reagent in a sandwich erythroimmunoassay (SERIA) procedure to detect and titrate Escherichia coli heat-labile enterotoxin (LT) with the naked eye. In this assay, which is based on the immunological similarity between Vibrio cholerae toxin (CT) and LT, rabbit anti-CT IgG was used as immunosorbent, and sheep erythrocytes, sensitized with the rabbit anti-CT antibodies, were used as indicator. The sensitivity of the test was demonstrated by a comparative study using an enzyme-linked immunosorbent assay (ELISA). The results obtained by SERIA with 130 samples correlated well with those of a Vero cell assay and a GM1-ELISA. The test is easy, relatively cheap and as sensitive as other standard techniques; it is particularly suited for field laboratories, especially in tropical countries, and a large number of strains may be examined daily.

GM1 erythroimmunoassay for detection and titration of Escherichia coli heat-labile enterotoxin

A GM1 ganglioside erythroimmunoassay for the detection of heat-labile Escherichia coli enterotoxin (LT) was developed for use in poorly equipped laboratories in developing countries. This assay is based on the immunological similarity between Vibrio cholerae toxin and LT and uses cholera toxin antiserum and sheep anti-rabbit immunoglobulin covalently coupled to sheep erythrocytes as conjugate. This assay has the following advantages over other currently available techniques: the reagents it uses are stable, in particular, tanned and sensitized sheep erythrocytes; GM1 ganglioside is commercially available; erythro-adsorption can be read with the naked eye; the test can be completed in 1 day; and as little as 4 ng of V. cholerae toxin or LT per ml can be detected accurately. The GM1 ganglioside erythroimmunoassay showed good quantitative and qualitative correlation with the Vero cell assay and the conventional GM1 enzyme-linked immunosorbent assay. The GM1 ganglioside erythroimmunoassay was somewhat less sensitive than the GM1 enzyme-linked immunosorbent assay but more sensitive than the Vero cell assay. Results obtained for 12 LT-positive and 138 LT-negative E. coli strains correlated with results obtained with GM1 enzyme-linked immunosorbent and Vero cell assays.

Indirect haemagglutination test for the detection of thermolabile (LT) enterotoxin from Escherichia coli

An indirect haemagglutination test (IH) for the detection of enterotoxigenic E. coli (LT) was developed. Twenty-five enterotoxigenic E. coli (ETEC) from human and porcine diarrhoea and from river water were examined. The described IH test was more specific and sensitive than the passive immune haemolysis test (PIH).

Improvements in the microtitre GM1 ganglioside enzyme-linked immunosorbent assay for Escherichia coli heat-labile enterotoxin

A variant of the microtitre GM1-ELISA for Escherichia coli heat-labile enterotoxin was studied. The test was improved by both reducing the assay time from 2 1/2 d to 8 h and by determining the most appropriate GM1 coating concentration. Coating the plates with greater than or equal to 3 micrograms of GM1/ml yielded a maximal sensitivity and ensured a linear relationship between the enterotoxin concentration and the extinction observed when using the final assay-procedure. Thus an optimal accuracy was obtained. This ELISA was 4- to 8-times more sensitive than the Vero cell monolayer assay. The sensitivity of this ELISA and of the chinese hamster ovary cell monolayer assay were identical.

Toxin production and haemagglutination in strains of Escherichia coli from diarrhoea in Brescia, Italy

Two hundred and ninety-nine different strains of Escherichia coli, isolated from 172 patients with diarrhoea and 113 healthy subjects, were examined for enterotoxin, cytotoxin and haemolysin (Hly) production and for mannose-resistant haemagglutination (MRHA) and invasive properties. Three strains proved enterotoxigenic, none enteroinvasive; cytotoxin and Hly production was shown in 25 strains from patients and in 3 from controls. Ten strains produced the cytotoxic necrotizing factor (CNF), 6 released other factors which kill cell cultures. Hly production was shown in 21 strains, 9 of which were also positive for CNF. MRHA was detected in 26% of strains from diarrhoea compared with 14% of strains from healthy people. A strong association between toxin production and MRHA was demonstrated. Serotyping results showed that the strains exhibiting virulence traits mostly belonged to serogroups commonly involved in extra-intestinal infections. The possible role of strains of E. coli showing one or more virulence factors as opportunistic pathogens in diarrhoeal diseases is discussed.

Composite IS1 elements encoding hydroxamate-mediated iron uptake in FIme plasmids from epidemic Salmonella spp

Eleven FIme plasmids representative of those identified in epidemic strains of Salmonella wien and Salmonella typhimurium isolated in North Africa, Europe, and the Middle East have been examined for the presence of determinants of toxigenicity, adherence, and iron-sequestering mechanisms. Chemical and genetic data indicated that all plasmids code for a hydroxamate-mediated iron assimilation system. Detailed analysis of derivative plasmids and cloned fragments of FIme plasmid pZM61 demonstrated that the general genetic and structural organization of the DNA region containing the genes for hydroxamate biosynthesis and cloacin DF13 receptor was virtually identical to that described for the aerobactin-mediated iron uptake system of pColV-K30. This DNA region is part of a composite element that is 16.7 kilobases long and carries its IS1 modules as inverted repeats. A very similar element is present in either orientation in all nine FIme plasmids analyzed.

Vibrio cholerae infection and acquired immunity in an adult rabbit model

We modified the rabbit model for enteric infection by Vibrio cholerae developed by Spira et al. and designated the RITARD (for removable intestinal tie-adult rabbit diarrhea) model (20). Our modification DISC comprises a permanent ligation of the cecum (C) to prevent resorption of the fluid secreted by the small intestine, a temporary ligation of the small intestine (S) to enable the bacteria to colonize, and duodenal inoculation (DI) of the challenge material. The main difference between RITARD and DISC is that in the latter model the challenge material is injected into the duodenum approximately 10 cm distal to the stomach instead of into the jejunum. Four out of 5 V. cholerae strains tested, including 2 serotypes and 2 biotypes, were able to elicit a massive and usually fatal cholera-like diarrhea. The virulence depended strongly on the culturing conditions. One strain, C5, caused fatal diarrhea in a dose of about 1000 organisms, even if the temporary ligation was omitted (DIC model). Other modifications were the DIS and the DI model in which the permanent ligature of the cecum or both ligatures were omitted. Duodenal inoculation of organisms in a dose of 100 X the minimum infective dose (MID) in the DIS or DI model did not cause any disease symptom. However, such inoculations were found to cause protection against subsequent challenges with 100 X MID of homologous and heterologous organisms up to 52 weeks after duodenal inoculation. Subcutaneous injection with classical, whole cell cholera vaccine gave only partial protection of short duration. This model might contribute to the understanding of the pathogenesis of cholera as well as to the improvement of efficacy testing of cholera vaccines.

Epidemiological survey on bacterial, viral and parasitic agents in patients affected by acute enteritis

During the period June 1983-May 1984, faecal specimens from 797 patients with acute enteritis were examined for the presence of bacterial, viral and parasitic agents; 209 (26.2%) enteritic pathogens were identified, of whom 118 (35.4%) in 333 samples from the pediatrics wards. Bacterial agents were detected in 122 (15.3%), viruses in 63 (7.9%) and parasites in 25 (3.1%) of the 797 specimens. LT-producing E. coli, Salmonella and Rotavirus were the most frequent pathogens. Bacterial agents occurred most frequently in the summer and autumnal months, whereas viruses showed two peaks, the first one in summer due to cultivable agents, the second in winter to Rotavirus mainly.