[Renaissance of mouse favus : Retrospective analysis of Trichophyton quinckeanum infections at Jena University Hospital in the period 2015-2020]

The number of Trichophyton quinckeanum infections has increased significantly in recent years. In 2020 in particular, the number of cases increased fivefold compared to 2015. Infections multiplied, especially in the second half of the year, which correlated with the upsurge in field mouse populations. Typical vectors are mice and rats as well as dogs and cats, which hunt the rodents. The animals are usually asymptomatic. In humans, on the other hand, the course is usually more inflammatory corresponding to other zoophilic mycoses. Typical clinical manifestations of the infections are tinea corporis and tinea capitis. Treatment of T. quinckeanum infections is similar to other dermatophyte infections, depending on the severity, location and age of the patient as well as the immune status, previous illnesses and medication. The duration of local therapy should be at least 4 weeks and continued for up to 14 days after the normalization of the skin presentation. Systemic treatment should take place with terbinafine 250 mg once a day orally (in adults). Alternatives are itraconazole, fluconazole and griseofulvin. Only the preparation griseofulvin, which is no longer available in Germany, is approved for children. Alternatively, terbinafine, itraconazole or fluconazole can also be used in children as an "off-label" treatment in an individual healing attempt.

TROPHY registry - status report

INTRODUCTION

The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration.

METHODS

On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported.

RESULTS

According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers.

CONCLUSIONS

Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.

95 Jahre Universitäts-Hautklinik Jena: Geschichte und Gegenwart

Anlässlich des 95-jährigen Jubiläums der Universitäts-Hautklinik Jena beleuchtet dieser Beitrag die historische Entwicklung des Hauses in den verschiedenen politischen Systemen des letzten Jahrhunderts sowie die aktuelle Situation der Klinik als Teil des Universitätsklinikums Jena. Verschiedene Klinikleitungen in der Vergangenheit prägten die Ausrichtung des Hauses in Bezug auf Therapie und Forschung und setzten Schwerpunkte auf Themen wie Phototherapie, Autoimmunerkrankungen, Dermatoonkologie, Andrologie und Biomaterialforschung. Die Universitäts-Hautklinik vereint neben hochqualitativer Patientenversorgung und Lehre umfangreiche Forschungsaktivitäten.

Mating analyses of Trichophyton benhamiae offspring reveals linkage of genetic markers used in taxonomy

Mating experiments were conducted with four clinical Trichophyton benhamiae isolates, genetically similar to the Trichophyton benhamiae CBS 112371, featuring the plus mating type and with two minus type strains. One minus type strain belonged to the white subgroup, and the other minus type strain, DSM 6916, showed genetic kinship to the yellow subgroup. Only two plus type strains were able to form mature, pigmented gymnothecia with DSM 6916. These two plus type strains demonstrated dark pigmentation and powdery mycelium on Takashio agar, whereas the other three strains exhibited a low degree of pigmentation on the same medium. All five plus strains were able to mate with the minus type strain of their own white subgroup. Cultures from single ascospore isolates showed highly variable morphology and pigmentation. Three genetic markers (ITS, mating type, EF1 alpha) were analyzed in polymerase chain reaction (PCR) experiments with optimized primers and PCR conditions to discriminate between subgroups. Furthermore, RAPD-PCR was used to generate a DSM 6916-specific DNA-fragment which served as an additional genetic marker. Assessing the isolates with recombinant genotypes, it was found that three genetic markers behave like linked genes. The recombination of plus mating type went together with ITS, EF1 alpha and RAPD marker of the DSM 6916 parental strain and was most frequently isolated, whereas plus types recombinants in this case were completely missing. This shows a high imbalance in mating type distribution of recombinants.

[Dermatophytosis caused by rare anthropophilic and zoophilic agents]

The basis for effective treatment of any dermatomycosis is the correct and timely identification of the pathogen, which allows the targeted choice of the most suitable antimycotic and is important for the prevention of repeated infections. In recent years, infections with dermatophytes seem to have increased. In fact, from 2007 to 2018, there was an increase in the number of samples processed in the Mycology Laboratory of the Department of Dermatology at the University Hospital Jena. The most common isolated dermatophytes between 2007 and 2018 were Trichophyton (T.) rubrum, T. interdigitale, Microsporum (M.) canis and T. benhamiae. However, dermatophytoses may also be caused by rare anthropophilic agents such as Epidermophyton floccosum, zoophiles such as T. verrucosum, T. quinckeanum or Nannizzia (N.) persicolor as well as by geophiles such as N. gypsea. Therefore, these dermatophytes should at least be known, so that in case of unusual observations investigations can be performed accordingly. Changes in the pathogen spectrum of dermatophytoses have taken place over time and it is expected that the occurrence of dermatophytes will be subject of continuous fluctuations, which may mean that the incidence of some of these "rare" dermatophytes, as described here in five clinical examples, may be changing.

Cold atmospheric pressure plasmas exhibit antimicrobial properties against critical bacteria and yeast species

OBJECTIVE

Cold atmospheric pressure plasmas (CAPPs) have been used to sterilise implant materials and other thermally unstable medical products and to modify chemical surfaces. This study investigates the antimicrobial effect of the gas and input power used to generate CAPPs on microorganisms causing skin infections, such as Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans and Malassezia pachydermatis.

METHOD

Microorganisms were cultivated on Mueller Hinton 2 (MH2) agar plates. CAPP treatment was performed using the Plasma BLASTER MEF. To investigate the antimicrobial effects the following CAPP parameters were varied: the gas used, input power, as well as number of treatments and treatment time.

RESULTS

The antimicrobial efficacy of the CAPPs was found to increase with increasing input power and treatment time (or cycles). Furthermore the plasma generated from nitrogen is more effective than from air.

CONCLUSION

The study showed that CAPPs demonstrate strong bactericidal and fungicidal properties in vitro. The selective application of CAPPs for the treatment of wound infections may offer a promising supplementary tool alongside current therapies.

Innate immune response of human epidermal keratinocytes and dermal fibroblasts to in vitro incubation of Trichophyton benhamiae DSM 6916

BACKGROUND

Superficial cutaneous infection caused by the zoophilic dermatophyte Trichophyton benhamiae is often associated with a highly inflammatory immune response. As non-professional immune cells, epidermal keratinocytes and dermal fibroblasts contribute to the first line of defence by producing pro-inflammatory cytokines and antimicrobial peptides (AMP).

OBJECTIVE

Purpose of this study was to gain a deeper understanding of the pathogenesis and the fungal-host interaction as not much is known about the innate immune response of these cutaneous cells against T. benhamiae.

METHODS

Using a dermatophytosis model of fibroblasts and keratinocytes incubated with T. benhamiae DSM 6916, analyses included determination of cell viability and cytotoxicity, effects on the innate immune response including expression and secretion of pro-inflammatory cytokines/chemokines and expression of AMP, as well as alterations of genes involved in cell adhesion.

RESULTS

Trichophyton benhamiae DSM 6916 infection led to severe cell damage and direct induction of a broad spectrum of pro-inflammatory cytokines and chemokines in both cutaneous cells. Only keratinocytes differentially up-regulated AMP genes expression after T. benhamiae DSM 6916 infection. Expression of AMPs in fibroblasts was not inducible by fungal infection, whereas their absences potentially contributed to a continuous increase in the fungal biomass on fibroblasts, which in turn was reduced in keratinocytes possibly due to the antimicrobial actions of induced AMPs. On mRNA level, T. benhamiae DSM 6916 infection altered cell-cell contact proteins in keratinocytes, indicating that targeting specific cell-cell adhesion proteins might be part of dermatophytes' virulence strategy.

CONCLUSION

This study showed that in addition to immune cells, keratinocytes and fibroblasts could participate in antimicrobial defence against an exemplary infection with T. benhamiae DSM 6916.

CALCIUM HYDROXYLAPATITE MICROSPHERES - BIOCOMPATIBILITY AND CLINICAL EFFECTS

Soft tissue fillers are used in aesthetic medicine for volumizing and for contouring. Calcium hydroxylapatite (CaHA) is a fully biodegradable biostimulatory filler. The study presents results of in vitro biocompatibility and cytotoxicity investigations performed on CaHA and illustrates its clinical effects. We used a human cell culture model for in vitro studies with HaCaT keratinocytes and human dermal fibroblasts, known to be a sensitive cell type for biocompatibility and cytotoxicity. Cells were exposed to different concentrations of CaHA (Radiesse®). Cell proliferation was calculated by luminometric adenosine triphosphate (ATP) measurement using the ATPLiteTM-M Assay. Possible cytotoxic effects were detected by the calorimetric Cytotoxicity Detection Kit. Clinical data were obtained from our own treatment files. CaHA did neither inhibit cell proliferation nor cause cytotoxicity. Clinical data suggest an excellent tolerability and long-term efficacy superior to hyaluronic acid-based fillers. CaHA is a versatile and well-tolerated biodegradable and biostimulatory filler.

Plasmamedizin – Kaltes Plasma zur Behandlung von Hautinfektionen

Plasma, der vierte Aggregatzustand der Materie, ist ein ionisiertes Gas und kann technisch aus Gasen wie Argon, Helium, Stickstoff, Sauerstoff oder Luft bei Normaldruck und niedrigen Temperaturen hergestellt werden. Dieses „kalte atmosphärische Plasma“ (KAP) besteht dann aus einer Mischung von reaktiven Spezies wie angeregten Molekülen, geladenen Partikeln, reaktiven Sauerstoff- und Stickstoffspezies sowie UV-Strahlung. Diese Komponenten tragen zur antimikrobiellen Wirkung des Plasmas bei, vermitteln aber auch Effekte gegen Parasiten, Phagen und Viren sowie gegen Malignomzellen. KAPs können daher zur Sterilisation von Oberflächen, zur Dekontamination von Lebensmitteln, in der Dermatologie und der Zahnheilkunde eingesetzt werden. KAPs haben darüber hinaus als alternative antiseptische Therapie zur Anwendung von lokalen Antibiotika bei nicht-systemischen Infektionen rapide an Bedeutung gewonnen. Aufgrund des vielseitigen Wirkprinzips ist die Entwicklung bakterieller Resistenzen gegen KAP unwahrscheinlich.

A novel native collagen dressing with advantageous properties to promote physiological wound healing

OBJECTIVE

Chronic hard-to-heal wounds generate high costs and resource use in western health systems and are the focus of intense efforts to improve healing outcomes. Here, we introduce a novel native collagen (90 %):alginate (10 %) wound dressing and compare it with the established oxidised dressings Method: Matrices were analysed by atomic force microscopy (AMF), scanning electron microscopy (SEM), and immunoelectron microscopy for collagen types I, III and V. Viability assays were performed with NIH-3T3 fibroblasts. Matrix metalloproteinase (MMP) binding was analysed, and the effect of the wound dressings on platelet-derived growth factor B homodimer (PDGF-BB) was investigated.

RESULTS

Unlike oxidised regenerated cellulose (ORC)/collagen matrix and ovine forestomach matrix (OFM), the three-dimensional structure of the native collagen matrix (NCM) was found to be analogous to intact, native, dermal collagen. Fibroblasts seeded on the NCM showed exponential growth whereas in ORC/collagen matrix or OFM, very low rates of proliferation were observed after 7 days. MMP sequestration was effective and significant in the NCM. In addition, the NCM was able to significantly stabilise PDGF-BB in vitro.

CONCLUSION

We hypothesise that the observed microstructure of the NCM allows for an effective binding of MMPs and a stabilisation and protection of growth factors and also promotes the ingrowth of dermal fibroblasts, potentially supporting the re commencement of healing in previously recalcitrant wounds.

DECLARATION OF INTEREST

This work was supported by BSN Medical, Hamburg, Germany.

In vitro studies on the beneficial effect of a hydrokinetic fiber dressing on wound healing by reduction of protease activity

OBJECTIVE

To test the binding capacity of a hydrokinetic fiber dressing for PMN elastase, MMP-2 and MMP-9 in vitro, and to determine whether testing of dressing material samples in vitro is sufficient to predict the performance of the whole dressing.

METHOD

In vitro protease binding assays for PMN elastase, MMP-2 and MMP-9 were used to evaluate the protease modulating capacity of sorbion sachet EXTRA, a superabsorbant dressing that consists of special hydrokinetic fibers, which are formed from cellulose and sodium polyacrylate in a mechanical process without any bonding agents or adhesives. The ability of the hydrokinetic fiber dressing to inhibit elastase and collagenase activity was also tested at 0%, 50% and 100% saturation volume.

RESULTS

The hydrokinetic fiber wound dressing was able to bind considerable amounts of elastase, reducing elastase activity by approximately 84%. Moreover, it significantly decreased MMP-2 and MMP-9 concentrations in vitro and was able to completely inhibit collagenase activity.

CONCLUSION

In summary, the hydrokinetic fiber dressing sorbion sachet EXTRA was able to significantly reduce the concentration and activity of proteolytic enzymes in vitro. These results suggest that sorbion sachet EXTRA should have a beneficial action by reducing the detrimental effects of proteolytic enzymes in vivo.

DECLARATION OF INTEREST

This work was supported by Sorbion GmbH & Co. KG, Senden, Germany.

Antimicrobial impact of cold atmospheric pressure plasma on medical critical yeasts and bacteria cultures

OBJECTIVES

Plasma medicine focuses on the application of cold atmospheric pressure plasmas (CAPs) in or on the human body. So far, plasmas have been used to sterilize implant materials or other thermally unstable medical products and have been applied for chemical surface modifications. This study investigates the antimicrobial effect of physical plasmas on microorganisms which cause skin infections, such as Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans, depending on the plasma source and the kind of plasma excitation used.

MATERIALS

Microorganisms were plated onto MH2 agar plates. Plasma treatment was performed using the plasma sources BLASTER MEF and kinpen 09. To investigate the antimicrobial effects, the following plasma parameters have been varied: working gas, distance from nozzle to surface, electrical power, grid spacing of treatment lines, number of treatments and work piece velocity.

RESULTS

The generated plasmas had an antimicrobial effect that depended on the chosen plasma parameters, in particular on the process gas used, the plasma power and the number of treatments performed. Thus, different reactive species were observed by optical emission spectroscopy measurement in the generated plasmas.

CONCLUSIONS

The study showed that CAPs exhibit profound bactericidal and fungicidal properties in vitro. However, an important factor for the antimicrobial efficacy is the composition of the 'chemical soup' supplied by the CAP system which can be regulated by the process gases used.

SAP-containing dressings exhibit sustained antimicrobial effects over 7 days in vitro

OBJECTIVE

To investigate the antimicrobial activity of SAP-containing wound dressings in vitro over a prolonged period of time (7 days) and to assess their ability to sustain the antimicrobial effect.

METHOD

SAP dressings were tested according to the JIS L 1902:2002 against the pathogens Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and Candida albicans.Additionally, effect on S. aureus and P. aeruginosa growth was investigated after a prolonged incubation period of 7 days. Furthermore, both SAP dressings were repeatedly inoculated with P. aeruginosa suspension and, after 7 days, microbial growth under the dressings was evaluated.

RESULTS

Both SAP-containing wound dressings tested exhibited a significant to strong antimicrobial activity against Staphylococcus aureus, MRSA, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Candida albicans in vitro. Moreover, it could be shown that they were able to sustain antibacterial efficacy over a prolonged period of time. Using a direct incubation method with repeated re-inoculation of the dressing samples, it could be shown that growth of P. aeruginosa was reduced after 4 days of treatment and completely inhibited after 7 days. No significant differences were observed between the two SAP-dressings tested.

CONCLUSION

These in vitro experiments impressively demonstrated the antimicrobial mechanism of SAP-containing wound dressings: rapid up-take of fluid, binding of microorganisms to the SAP-core, and retention of the bacteria inside the dressing. Moreover, it could be shown that they are able to exhibit their antimicrobial activity over a prolonged period of time unless the amount of fluid present exceeds their fluid-handling capacity.

Superabsorbent polymer-containing wound dressings have a beneficial effect on wound healing by reducing PMN elastase concentration and inhibiting microbial growth

A comprehensive in vitro approach was used to assess the effects of superabsorbent polymer (SAP) containing wound dressings in treatment of non-healing wounds. A slight negative effect on HaCaT cells was noted in vitro which is most likely due to the Ca(2+) deprivation of the medium by binding to the SAP. It could be shown that SAP wound dressings are able to bind considerable amounts of elastase reducing enzyme activity significantly. Furthermore, SAP's inhibit the formation of free radicals. The SAP-containing wound dressings tested also exhibited a significant to strong antimicrobial activity effectively impeding the growth of gram-negative and gram-positive bacteria as well as yeasts. In conclusion, in vitro data confirm the positive effect of SAP wound dressings observed in vivo and suggest that they should be specifically useful for wound cleansing.

Both copy number and sequence variations affect expression of human DEFB4

Copy number variations (CNVs) were found to contribute massively to the variability of genomes. One of the best studied CNV region is the beta-defensin cluster (DEFB) on 8p23.1. Individual DEFFB copy numbers (CNs) between 2 and 12 were found, whereas low CNs predispose for Crohn's disease. A further level of complexity is represented by sequence variations between copies (multisite variations, MSVs). To address the relation of DEFB CN and MSV to the expression of beta-defensin genes, we analyzed DEFB4 expression in B-lymphoblastoid cell lines (LCLs) and primary keratinocytes (normal human epidermal keratinocyte, NHEK) before and after stimulation with lipopolysaccharide, tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma). Moreover, we quantified one DEFB4 MSV in DNA and mRNA as a marker for variant-specific expression (VSE) and resequenced a region of approximately 2 kb upstream of DEFB4 in LCLs. We found a strong correlation of DEFB CN and DEFB4 expression in 16 LCLs, although several LCLs with very different CNs exhibit similar expression levels. Quantification of the MSV revealed VSE with consistently lower expression of one variant. Costimulation of NHEKs with TNF-alpha/IFN-gamma leads to a synergistic increase in total DEFB4 expression and suppresses VSE. Analysis of the DEFB4 promoter region showed remarkably high density of sequence variabilities (approximately 1 MSV/41 bp).

Hepatic and branchial glutathione S-transferases of two fish species: substrate specificity and biotransformation of microcystin-LR

Liver and gills of roach (Rutilus rutilus) and silver carp (Hypophthalmichthys molitrix) were examined for glutathione S-transferases (GSTs) contents and their substrate specificity and capacity to biotransform microcystin-LR (MC-LR). GSTs and other glutathione (GSH) affine proteins were purified using a GSH-agarose matrix and separated by anionic chromatography (AEC). Substrate specificities were determined photometrical for 1-chloro-2,4-dinitrobenzene (CDNB), 1,2-dichloro-4-nitrobenzene (DCNB), 4-nitrobenzyl chloride (pNBC) and ethacrynic acid (ETHA). Biotransformation rate of MC-LR was determined by high performance liquid chromatography (HPLC). Roach exhibited different hepatic and branchial GST activities for used substrates (DNB, pNBC and DCNB) compared to silver carp but not for ethacrynic acid. It suggests that, both fish species have similar amount of pi and/or alpha class, which were the dominant GST classes in liver and gills. Gills of both fish species contained a higher number of GST isoenzymes, but with lower activities and ability of MC-LR biotransformation than livers. GST isoenzymes from roach had higher activity to biotransform MC-LR (conversion rate ranging up to 268 ng MC-LR min(-1) mL(-1) hepatic enzyme) than that isolated from silver carp. Without any prior contact to MC-LR or another GST inducer, roach seems to be better equipped for microcystin biotransformation than silver carp.

Evaluation of biocompatibility and cytotoxicity using keratinocyte and fibroblast cultures

Determination of biocompatibility and cytotoxicity is part of the initial evaluation of medical devices stipulated by ISO standards on biological evaluation of medical devices. Cell culture systems for testing biological reactions to drugs, biomaterials or treatment techniques used in various disciplines have been gaining importance. A wide variety of cell lines are commonly used: cultured fibroblasts from human skin, buccal mucosa, periodontal membrane or embryonic lung; epithelial and HeLa cells; cultures of human keratinocytes and HaCaT cells; different murine cell lines (C3H-L, Balb/c 3T3, L929 and others) as well as murine cells cultured from liver and spleen; T lymphocytes from lymph nodes and macrophages obtained by lavage. All these cells are suitable for the use in biocompatibility tests. Nevertheless, the general opinion is that cytotoxicity tests in vitro will be more convincing when performed with cells that are homologous with the human tissue concerned. In accordance, appropriate cell lines for the use in cytotoxicity and tolerance tests concerning the skin would be human dermal fibroblasts and human epidermal keratinocytes, as they take an active part in the immune response, inflammatory processes and wound healing.

Humic substances modify accumulation but not biotransformation of pyrene in salmon yolk-sac fry

Humic substances may influence the bioavailability of polycyclic aromatic hydrocarbons (PAHs) in aquatic environment. Relatively little is known how humic substances affect the biotransformation of PAHs in aquatic animals. Here we report how two different types of humic substances affected the accumulation of pyrene, a four-ringed PAH, to yolk-sac fry of landlocked salmon (Salmo salar m. sebago). The accumulation of pyrene to yolk-sac fry tissues was inversely related to humic substance concentration in a short term (72h) exposure. However, the biotransformation of pyrene was not affected by humic substances. Pyrene or humic substances did not induce CYP1A activity in yolk-sac fry tissues contrasting to beta-naphthoflavone, which was used as a positive control. Yolk-sac fry were capable to biotransform pyrene to phase I (1-hydroxypyrene) and phase II (pyrene-1-sulphate) products. Interestingly, glucuronide conjugate (i.e. pyrene-1-glucuronide) was not present in yolk-sac fry tissues. The concentration of parent pyrene and 1-hydroxypyrene remained the same throughout the experiment but the concentration of pyrene-1-sulphate more than doubled from 24 to 72h. This finding suggests that salmon yolk-sac fry are not capable to excrete phase II biotransformation products or the excretion is very slow. Further, this could indicate that early life stage toxicity of many CYP1A inducing compounds is related to accumulation of phase II conjugates in fry tissues.

Measurement of intracranial pressure in children: a critical review of current methods

Assessment of intracranial pressure (ICP) is essential in the management of acute intracranial catastrophe to limit or actively reduce ICP. This article provides background information and reviews the current literature on methods of measuring ICP in children. Indications for ICP measurement are described for children with traumatic brain injury, shunt insertion or malfunction, arachnoid cyst, craniosynostosis, and prematurity. Various methods of ICP monitoring are detailed: non-invasive, indirect (lumbar puncture, visual-evoked potentials, fontanelle compression, and optic nerve sheath), and direct assessment (ventricular cannulation, and epidural, subdural, and intraparenchymal devices). Normal levels of ICP will depend on the age and position of the child during monitoring. This article provides clinical and research-based evidence in this area where there is currently limited guidance.

Dynamics of glutathione-S-transferases in Mytilus galloprovincialis exposed to toxic Microcystis aeruginosa cells, extracts and pure toxins

Molluscs and especially bivalves are able to accumulate dinoflagelates, diatoms and cyanobacteria toxins, and, being vectors for these toxins, transfer them along food chains. The data obtained from laboratory experiments showed that bivalve molluscs are resistant to cyanobacteria toxins. In this work, we wanted to test if Mytilus galloprovincialis organs react to microcystins and other cyanobacteria compounds by inducing or decreasing its GST activity. Acclimated mussels M. galloprovincialis were exposed to the toxic Microcystis aeruginosa M13 strain. Exposure of mussels to toxins was done in three ways: living Microcystis cells, crude Microcystis extracts and pure toxins. The measurement of soluble and microsomal GST activity in the different mussel organs was done by using the substrates 1-chloro-2,4-dinitrobenzene (CDNB) and 2,4-dichloro-1-nitrobenzene (DCNB). Analysis of the GST activity of the control mussels using CDNB as a substrate showed that cytosolic activity is much more significant than microsomal. Intact M. aeruginosa cells did not induce any significant response from the mussels, showing that these animals are quite resistant to the cyanobacteria if they are intact. On the other hand, cell extracts caused an important effect in the gut, in the gills and in the labial palps, although in different ways. There was an increase in GST activity in the gut and gills of mussels exposed to Microcystis extracts, showing a response of this detoxication pathway, but in the labial palps a severe reduction in GST activity occurred. Pure MC LR+YR induced an increase in GST activity in all organs but the labial palps. The results showed that other substances apart from microcystins may cause stress to mussels and affect detoxication enzymes such as GST.

Ecotoxicological effects of selected cyanobacterial secondary metabolites: a short review

Cyanobacteria are one of the most diverse groups of gram-negative photosynthetic prokaryotes. Many of them are able to produce a wide range of toxic secondary metabolites. These cyanobacterial toxins can be classified in five different groups: hepatotoxins, neurotoxins, cytotoxins, dermatotoxins, and irritant toxins (lipopolysaccharides). Cyanobacterial blooms are hazardous due to this production of secondary metabolites and endotoxins, which could be toxic to animals and plants. Many of the freshwater cyanobacterial blooms include species of the toxigenic genera Microcystis, Anabaena, or Plankthotrix. These compounds differ in mechanisms of uptake, affected organs, and molecular mode of action. In this review, the main focus is the aquatic environment and the effects of these toxins to the organisms living there. Some basic toxic mechanisms will be discussed in comparison to the mammalian system.

Direct and interacting toxicological effects on the waterflea (Daphnia magna) by natural organic matter, synthetic humic substances and cypermethrin

Humic substances are the main component of dissolved organic matter in all aquatic ecosystems, comprising a variety of molecular structures and functional groups. They bind organic pollutants and metals, thereby decreasing the bioavailability and consequently the toxicity of these substances in most instances. Recent studies also describe direct interactions and effects on organisms. Current studies also show that in some cases mitigation effects are stronger at lower concentrations of natural organic matter (NOM) and that toxicity increases with increased NOM concentrations. We hypothetise that at higher concentrations the mitigating effects are overlayed by direct effects of NOM themselves, thus these aspects were investigated in combination. So, on the one hand, this study demonstrates direct effects on toxicological parameters and activities of transformation enzyme systems of Daphnia magna, provoked by two NOM and one synthetic humic-like substance, HS1500. On the other hand, capacities of NOM and synthetic HS1500 to mitigate effects of the insecticide cypermethrin were investigated. Taken together, mitigation effects were overlayed by direct own effects of the NOM and HS1500. The NOM used were isolates from Suwannee River (XAD, Spring 2000) and from streams of the Svartberget forest (reverse osmosis, Spring 2000). The HS1500 was synthetically produced by radicalic autoxidation of hydroquinones. Suwannee River NOM at concentrations between 50 and 100 mg/l, and HS1500 (10-50 mg/l), but not Svartberget NOM increased immobility and lethality of the daphnids. All elevated the activity of the soluble glutathione S-transferase from 0.5 mg/l (HS1500), 1.0 mg/l (Suwannee River NOM) and 10 mg/l (Svartberget NOM) onwards, the microsomal glutathione S-transferase did not react. The glutathione peroxidase tended to increase. In the single exposure, the insecticide cypermethrin increased all toxicological parameters, elevated soluble and tendentially microsomal glutathione S-transferase activity between 0.001 and 1.0 microg/l and tendentially increased glutathione peroxidase. In contrast to that, 50 mg/l of the NOM and HS1500 did not mitigate toxicological effects. HS1500 in combination with cypermethrin even increased immobility, compared to cypermethrin alone. Increase of the NOM or HS1500 concentrations in combination with cypermethrin did not increase mitigation as seen in the activity of soluble glutathione S-transferases, activities of microsomal glutathione S-transferase and glutathione peroxidase even decreased, relative to control, which can be a hint of enzyme disfunction or further damages in the cell. An increase of concentration did not increase mitigation. Mitigation was higher at lower NOM or HS1500 concentration, probably as a consequence of the direct effects caused by themselves. Consequently, direct effects are relevant for analysing the mitigation qualities.

Measurement of glomerular filtration rate by low-dose iopromide plasma clearance

PURPOSE

Glomerular filtration rate (GFR) can be measured by iopromide plasma clearance. As an injection of 120 ml nonionic contrast medium is expensive and especially in patients with nephropathy potentially nephrotoxic, we investigated whether iopromide plasma clearance could be measured using a tenth of that dose as 'low-dose' clearance.

MATERIAL AND METHODS

Fifty adult patients scheduled for CT were recruited. Iopromide 300 mg I/ml was used for GFR measurement. Prior to CT, low-dose clearance was measured by injecting 12 ml iopromide per 75 kg b.w. At 3, 4 and 5 h after injection, plasma samples were obtained and the iodine concentration was measured by X-ray fluorescence analysis. Immediately after the last blood sample, CT was again performed following injection of 120 ml iopromide per 75 kg b.w. A further 3 plasma samples were then obtained 3, 4, and 5 h after CT and used for the determination of high-dose clearance.

RESULTS

Low-dose clearance ranged from 20 ml/min to 141 ml/min (mean 78.3 ml/min). High-dose and low-dose clearance correlated excellently, with clearance (high-dose) = 1.4 + 0.994 clearance (low-dose); the correlation coefficient was r = 0.944, the standard deviation SDxy= 9.3 ml/min.

CONCLUSION

Plasma clearance of iopromide is dose-independent on use of iodine amounts of 3.6 g and 36 g I/75 kg b.w. The GFR can be determined by high-dose and low-dose iopromide plasma clearance with identical accuracy.

Measurement of glomerular filtration rate by low-dose iopromide plasma clearance

PURPOSE

Glomerular filtration rate (GFR) can be measured by iopromide plasma clearance. As an injection of 120 ml nonionic contrast medium is expensive and especially in patients with nephropathy potentially nephrotoxic, we investigated whether iopromide plasma clearance could be measured using a tenth of that dose as 'low-dose' clearance.

MATERIAL AND METHODS

Fifty adult patients scheduled for CT were recruited. Iopromide 300 mg I/ml was used for GFR measurement. Prior to CT, low-dose clearance was measured by injecting 12 ml iopromide per 75 kg b.w. At 3, 4 and 5 h after injection, plasma samples were obtained and the iodine concentration was measured by X-ray fluorescence analysis. Immediately after the last blood sample, CT was again performed following injection of 120 ml iopromide per 75 kg b.w. A further 3 plasma samples were then obtained 3, 4, and 5 h after CT and used for the determination of high-dose clearance.

RESULTS

Low-dose clearance ranged from 20 ml/min to 141 ml/min (mean 78.3 ml/min). High-dose and low-dose clearance correlated excellently, with clearance (high-dose) = 1.4 + 0.994 clearance (low-dose); the correlation coefficient was r = 0.944, the standard deviation SDxy= 9.3 ml/min.

CONCLUSION

Plasma clearance of iopromide is dose-independent on use of iodine amounts of 3.6 g and 36 g I/75 kg b.w. The GFR can be determined by high-dose and low-dose iopromide plasma clearance with identical accuracy.

Effects of enteric bacterial and cyanobacterial lipopolysaccharides, and of microcystin-LR, on glutathione S-transferase activities in zebra fish (Danio rerio)

Cyanobacteria (blue-green algae) can produce a variety of toxins including hepatotoxins e.g. microcystins, and endotoxins such as lipopolysaccharides (LPS). The combined effects of such toxins on fish are little known. This study examines the activities of microsomal (m) and soluble (s) glutathione S-transferases (GST) from embryos of the zebra fish, Danio rerio at the prim six embryo stage, which had been exposed since fertilisation to LPS from different sources. A further aim was to see how activity was affected by co-exposure to LPS and microcystin-LR (MC-LR). LPS were obtained from Salmonella typhimurium, Escherichia coli, a laboratory culture of Microcystis CYA 43 and natural cyanobacterial blooms of Microcystis and Gloeotrichia. Following in vivo exposure of embryos to each of the LPS preparations, mGST activity was significantly reduced (from 0.50 to between 0.06 and 0.32 nanokatals per milligram (nkat mg(-1)) protein). sGST activity in vivo was significantly reduced (from 1.05 to between 0.19 and 0.22 nkat mg(-1) protein) after exposure of embryos to each of the cyanobacterial LPS preparations, but not in response to S. typhimurium or E. coli LPS. Activities of both m- and sGSTs were reduced after co-exposure to MC-LR and cyanobacterial LPS, but only mGST activity was reduced in the S. typhimurium and E. coli LPS-treated embryos. In vitro preparations of GST from adult and prim six embryo D. rerio showed no significant changes in enzyme activity in response to the LPS preparations with the exception of Gloeotrichia bloom LPS, where mGST was reduced in adult and embryo preparations. The present study represents the first investigations into the effects of cyanobacterial LPS on the phase-II microcystin detoxication mechanism. LPS preparations, whether from axenic cyanobacteria or cyanobacterial blooms, are potentially capable of significantly reducing activity of both the s- and mGSTs, so reducing the capacity of D. rerio to detoxicate microcystins. The results presented here have wide ranging implications for both animal and human health.

Toxicokinetics of atrazine in embryos of the zebrafish (Danio rerio)

Atrazine (2-chloro-4-ethylamino-6-isopropylamine-s-triazine) is a widely used selective herbicide. Due to its persistence, it is present in many surface waters, contaminating nontarget organisms such as fish. Teratogeny of atrazine was examined during the first 48 h of zebrafish development (embryo test) and correlated to effects on the microsomal and soluble glutathione S-transferases (m-/sGST; EC 2.5.1.18). Atrazine at 4 mg/L disturbed the normal development to long pec stage, at concentrations between 10 and 20 mg/L it caused retardations in organogenesis, a slowdown of movements, and functional disturbances of heart and circulatory system. m- and sGST activities were affected by atrazine in all investigated developmental stages. Atrazine elevated the mGST activity dose dependently up to a concentration of 5 mg/L, and the sGST up to 1 mg/L. Higher atrazine concentrations caused a decrease of GST activity, especially of the sGST of the younger stages, 32 cells and 75% epiboly. This might indicate that the detoxication system itself is affected, which then gives rise to morphological abnormalities during fish development. In vitro tests were performed to purify and characterize GST-formed atrazine metabolites by the use of ESI--HPLC--MS. mGST showed higher conversion rates compared to sGST.

Mutants of tobacco mosaic virus with temperature-sensitive coat proteins induce heat shock response in tobacco leaves

We analyzed, with respect to heat shock proteins (HSPs), systemically reacting tobacco leaves inoculated with Tobacco mosaic virus (TMV), wild-type vulgare, and temperature-sensitive coat protein (CP) mutants Ni 118 (P20L) and flavum (D19A), kept at 23 or 30 degrees C. HSP18 and HSP70 mRNAs and proteins were induced with temperature-sensitive CP mutants after 1 to 2 days at 30 degrees C. After 4 to 6 days, HSP70 was also induced at 23 degrees C. The induction of HSPs paralleled the amount of insoluble TMV CP in leaf extracts, indicating that denatured TMV CP by itself induces a heat-shock response.

Uptake, effects, and metabolism of cyanobacterial toxins in the emergent reed plant Phragmites australis (cav.) trin. ex steud

The commonly occurring cyanobacterial toxin microcystin-LR (MC-LR) was rapidly taken up by the emergent reed plant Phragmites australis with clear distribution in the different cormus parts of the plant. Highest uptake was detected in the stem, followed by the rhizome. Enzyme extracts of the rhizome system, the stem, and the leaf revealed the presence of soluble glutathione S-transferases (sGST) measured with the model substrate 1-chloro-2,4-dinitrobenzene. A significant elevation of sGST activity in the rhizome and stem parts of P. australis was detected after a 24-h exposure to 0.5 microg/L MC-LR. Rhizome, stem, and leaf tissues were also able to conjugate several microcystin toxins. However, no conjugation, either chemical nor enzymatic, was detected using the related cyanobacterial toxin nodularin as substrate. Highest glutathione S-transferase activity for the toxin substrates was detected in the pkat/mg range in the stem of P. australis. For MC-LR, a complete metabolism from the formation of a glutathione conjugate to the degradation of a cysteine conjugate in all cormus parts of the plant is reported. The stepwise degradation of the MC-LR-glutathione conjugate to a gamma-glutamylcysteine and a cysteine conjugate was demonstrated by comparison with chemically formed reference compounds and by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. This is the first evidence for the uptake and metabolism of cyanobacterial toxins by an emergent aquatic macrophyte.

The human dopamine transporter gene: the 5'-flanking region reveals five diallelic polymorphic sites in a Caucasian population sample

The 5'-flanking region of the human dopamine transporter (hDAT) was systematically screened for variants by single strand conformation analysis (SSCA) between -1586 and +97 basepair (bp) relative to the transcription start site. Five diallelic polymorphisms were found, which were shown to be due to single base substitutions: T-67A, G-660C, C-839T, C-1169G, T-1476G. In a population sample of 119 unrelated Caucasians, allele frequencies of the rarer allele were 47% for -67T, 3% for -660C, 45% for -839T, 50% for -1169G, and 8% for -1476G, respectively. Among 15 observed haplotypes, seven haplotypes collected a frequency of about 96% in our sample. T-67A, C-839T, C-1169G, T-1476G were related to potential transcriptional recognition sites. These findings and the occurrence of distinct haplotypes at the hDAT promoter locus in a Caucasian population sample make this region a promising target in the context of linkage and association studies in certain diseases.

The effects of a cyanobacterial crude extract on different aquatic organisms: evidence for cyanobacterial toxin modulating factors

In an aquatic ecosystem, during cyanobacterial bloom lysis, a mixture of toxins and other cyanobacterial and bacterial components will be present in the water, acting on aquatic organisms. Most of the research into toxic effects of cyanobacteria has involved the use of purified toxins. In this study, the "real-life" situation of a cyanobacterial lysis event was investigated. For this purpose, intact cells from a natural cyanobacterial bloom from Lake Müggelsee, Berlin, were taken and the cells were broken by repeated freeze/thaw cycles. This crude extract was used to expose several aquatic organisms ranging from microalgae (Scenedesmus armatus), macrophyte (Ceratophyllum demersum), invertebrate (Chaoborus crystallinus) up to fish eggs (Danio rerio) to look at several physiological parameters such as detoxication enzyme activity and, in the case of the microalgae and the macrophyte, also the effect on activity of photosynthesis. In all the tests, the cyanobacterial crude extract caused stronger effects than the pure cyanobacterial toxins used in equivalent concentrations.

Monoclonal antibody MS13 identifies a plasmatocyte membrane protein and inhibits encapsulation and spreading reactions of Manduca sexta hemocytes

Lepidopterans generally can successfully defend themselves against a variety of parasites or parasitoids. One mechanism they use is to encapsulate the invader in many layers of hemocytes. For encapsulation to occur, the hemocytes must attach to the foreign material, spread, and adhere to each other. The molecules that mediate these processes are not known. One method to identify proteins potentially necessary for adhesion, spreading, and, thus, encapsulation is to use monoclonal antibodies that interfere with these functions. In this paper, we report that a monoclonal antibody against Manduca sexta plasmatocytes effectively inhibited encapsulation of synthetic beads in vitro and in vivo. Furthermore, it inhibited plasmatocyte spreading in vitro. Other anti-hemocyte antibodies did not have these effects. The plasmatocyte-specific monoclonal antibody, mAb MS13, recognized a protein of approximately 90,000 daltons as indicated by Western blot analysis of hemocyte lysate proteins. The epitope recognized by mAb MS13 was present on the exterior surface of plasmatocytes. Using indirect immunohistochemistry with hemocyte-specific antibodies, we also determined that during encapsulation plasmatocytes were the first cells bound to latex beads and later layers consisted of both plasmatocytes and granular cells. Arch.

Uptake, toxicity, and effects on detoxication enzymes of atrazine and trifluoroacetate in embryos of zebrafish

The uptake, toxicity, and elimination of atrazine and trifluoroacetate (TFA) were studied in early life stages of the zebrafish (Danio rerio). Furthermore, the effects of these xenobiotics on soluble (s) and microsomal (m) glutathione S-transferases (GST) of zebrafish embryos were investigated using 1-chloro-2,4-dinitrobenzene (CDNB), 1,2-dichloro-4-nitrobenzene (DCNB), and [(14)C]atrazine. [(14)C]Atrazine was taken up by the embryos within seconds, unhindered by the chorions. It accumulated in the embryos by a factor of 19 after 24 h of exposure time. LC(50) (48 h) was determined at 36.8 mg/L. At a level of 5 mg/L atrazine, activities of s and m GSTs were elevated in most stages, especially in prim 6 and long pec stage (24, 48 h after fertilization, respectively). GST activity toward atrazine was detectable only in untreated D. rerio eggs, increasing with developmental time. [(14)C]Atrazine was eliminated from the embryos between 24 and 48 h, indicating a possible metabolism to a more hydrophilic GSH conjugate. [(14)C]TFA was taken up by embryos, reaching at maximum fivefold the concentration of the incubation medium after 10 h. The chorions served no physiological protection. TFA (1 g/L) caused low elevation of the GST activity. No acute toxic effects (48 h) were observed up to 4 g/L TFA.

Identification of an enzymatically formed glutathione conjugate of the cyanobacterial hepatotoxin microcystin-LR: the first step of detoxication

Cyanobacterial toxins have adverse effects on mammals, birds and fish and are being increasingly recognised as a potent stress factor and health hazard factor in aquatic ecosystems. Microcystins, cyclic heptapeptides and a main group of the cyanotoxins are mainly retained within the producer cells during cyanobacterial bloom development. However, these toxins are released into the surrounding medium by senescence and lysis of the blooms. Any toxin present could then come into contact with a wide range of aquatic organisms including phytoplankton grazers, invertebrates, fish and aquatic plants. Recent studies showed the conversion of microcystin in animal liver to a more polar compound in correlation with a depletion of the glutathione pool of the cell. The present study shows the existence of a microcystin-LR glutathione conjugate formed enzymatically via soluble glutathione S-transferase in various aquatic organisms ranging from plants (Ceratophyllum demersum), invertebrates (Dreissena polymorpha, Daphnia magna) up to fish eggs and fish (Danio rerio). The main derived conjugate was characterized by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry yielding a mass of m/z 1302, which is equivalent to the mass assumed for a glutathione microcystin-LR conjugate. This conjugate appears to be the first step in the detoxication of a cyanobacterial toxin in aquatic organisms.

The 46/50 kDa phosphoprotein VASP purified from human platelets is a novel protein associated with actin filaments and focal contacts

Vasoactive agents which elevate either cGMP or cAMP inhibit platelet activation by pathways sharing at least one component, the 46/50 kDa vasodilator-stimulated phosphoprotein (VASP). VASP is stoichiometrically phosphorylated by both cGMP-dependent and cAMP-dependent protein kinases in intact human platelets, and its phosphorylation correlates very well with platelet inhibition caused by cGMP- and cAMP-elevating agents. Here we report that in human platelets spread on glass, VASP is associated predominantly with the distal parts of radial microfilament bundles and with microfilaments outlining the periphery, whereas less VASP is associated with a central microfilamentous ring. VASP is also detectable in a variety of different cell types including fibroblasts and epithelial cells. In fibroblasts, VASP is concentrated at focal contact areas, along microfilament bundles (stress fibres) in a punctate pattern, in the periphery of protruding lamellae, and is phosphorylated by cGMP- and cAMP-dependent protein kinases in response to appropriate stimuli. Evidence for the direct binding of VASP to F-actin is also presented. The data demonstrate that VASP is a novel phosphoprotein associated with actin filaments and focal contact areas, i.e. transmembrane junctions between microfilaments and the extracellular matrix.

The upright position of brush border-type microvilli depends on myosin filaments

We have studied the correlation between the actomyosin organization and microvillar position in an epithelial cell line derived from the proximal pig kidney tubule (LLC-PK1). When grown on glass, these cells are approximately 5–6 microns in height and develop numerous microvilli that project from the dorsal membrane. A fairly homogeneous distribution of microvilli was achieved by synchronization of the cell cycle. These microvilli are of the brush border type, as defined by their content of villin and their anchorage in a myosin-rich terminal web-like structure. When LLC-PK1 cells were injected with two monoclonal antibodies against pig brain nonmuscle myosin, in concentrations yielding a 1:1 ratio of antibody to myosin, neither microvillar number nor length was affected. However, when we examined the cells by scanning electron microscopy 1–3 h after microinjection, we found that one of the antibodies (a-PBM 4) had a profound effect on microvillar position: more than 50% were seen tilted or lying prone on the plasma membrane. The microvilli of cells injected with the other antibody (a-PBM 9) were not significantly different from those of cells injected with control antibodies. This difference correlates with in vitro properties of the antibodies: a-PBM 4 decreases the actin-activated Mg(2+)-ATPase of pig brain nonmuscle myosin quite substantially, while a-PBM 9 affects it only moderately. These differential effects are probably a consequence of the different epitope location as determined for both antibodies, not of differences in antibody affinity. Our data are compatible with the hypothesis that a-PBM 4 also interferes with the actomyosin interaction in situ, thus decreasing the effective cross-linking of microvillar rootlets by myosin filaments in the terminal web. On the basis of this model, we suggest that myosin filaments are essential for the upright position of brush-border type microvilli.

[Fulminant malignant hyperthermia during the 6th general anesthesia using volatile anesthetics]

We report on the fulminant crisis of malignant hyperthermia occurring in a 30-year-old female during kidney transplantation. In the past, she had been anaesthetised repeatedly without complications. Anaesthesia was induced with thiopental and vecuronium and continued with isoflurane/N2O/O2. After an initially normal course of anaesthesia, the patient developed symptoms of a fulminant malignant hyperthermia (MH) including excessive increase in end expiratory CO2, hyperkalaemia, tachycardia and hyperpyrexia. The patient was saved by the timely administration of dantrolene. A surgical revision required the next day because of bleeding was done under dantrolene cover and took an uncomplicated course. The patient was extubated 7.5 hours after the second intervention and transferred to a normal ward after 4 days. A subsequently performed in vitro contracture test clearly revealed susceptibility to malignant hyperthermia.

Characterization of the coated vesicle uncoating ATPase: tissue distribution, association with and activity on intact coated vesicles

We have analyzed the uncoating process of clathrin-coated vesicles (CV) performed by an ATPase (UA; apparent molecular mass 70 kDa) prepared from various mammalian tissues. Our data show that this enzyme removes the clathrin coat from isolated, intact coated vesicles, as seen by sedimentation analysis on gels and also by electron microscopy. The isolated UA does not discriminate between CV from homologous or heterologous tissues. This finding implies that the brain-specific insertion in clathrin light chains cannot be essential for the binding of brain UA to target vesicles. Polyclonal antibodies were raised against UA and were found to inhibit UA activity. Immunoblotting of purified CV and immunoblotting of CV in situ indicate that a subpopulation of CV contains bound UA. However, most of the uncoating enzyme is not associated with coated structures in mammalian tissue culture cells. Our data support the hypothesis that the 70 kDa uncoating ATPase is responsible for the in vivo uncoating of coated vesicles.