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Grauenfels Cohen G, Cohen MJ, Dveyrin Z, Mor Z, Rorman E, Kaliner E. Serological follow-up after syphilis diagnosis in Israel. Epidemiol Infect 2024; 152:e63. [PMID: 38606644 DOI: 10.1017/s0950268824000566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
The global incidence of syphilis is increasing. Continuity of care challenges the control of sexually transmitted diseases. In this study, we assessed the follow-up and serological decline differences between community- and hospital-diagnosed patients in Israel. A historical cohort study was conducted using the Israel National Syphilis Center (NSC) repository. Patients with a positive non-specific Venereal Disease Research Laboratory (VDRL) test between 2011 and 2020 were included. Rates of serological follow-up and serological titre decreases were compared between hospital- and community-diagnosed patients. The study included 4,445 patients, 2,596 (58.4%) were diagnosed in community clinics and 1,849 (41.6%) in hospitals. Of community-diagnosed patients, 1,957 (75.4%) performed follow-up testing, compared with 834 (51.2%) hospital-diagnosed patients (p < 0.001). On multivariate analysis, the odds ratio of serology follow-up among community-diagnosed patients was 2.8 (95 per cent confidence interval (95% CI): 2.2-3.5) that of hospital-diagnosed patients. There were 1,397 (71.4%) community-diagnosed patients with serological titre decrease, compared with 626 (74.9%) hospital-diagnosed patients (p = 0.03). On multivariate analysis, this difference diminished. Serological follow-up testing is suboptimal and was performed more often among patients initially diagnosed in the community compared to hospitals. Continuity of care should be improved to promote successful patient care and prevent disease spread.
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Affiliation(s)
| | - Matan J Cohen
- Faculty of Medicine, Hebrew University, Clalit Health Services, Jerusalem district, Israel
| | - Ze'ev Dveyrin
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel-Aviv Jaffa, Israel
| | - Zohar Mor
- Central Department of Health, Ministry of Health, Ramla, Israel
- School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Efrat Rorman
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel-Aviv Jaffa, Israel
| | - Ehud Kaliner
- Central Department of Health, Ministry of Health, Ramla, Israel
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Armon-Omer A, Mansor T, Edelstein M, Bukovetzky E, Groisman L, Rorman E, Nov AS, Shahien R. Association between multiple sclerosis and urinary levels of toxic metals and organophosphates: A cross-sectional study in Israel. Mult Scler Relat Disord 2024; 83:105445. [PMID: 38242049 DOI: 10.1016/j.msard.2024.105445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/13/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a multifactorial disease of uncertain etiology damaging myelin sheaths around axons of the central nervous system. Myelin protects the axon from potentially harmful exogenous factors. The aetiological role of environmental exposure metals and organophosphates is unclear. OBJECTIVE Identify whether urinary levels of metals and organophosphates differed in MS patients and controls. METHODS We recruited MS patients from Ziv Medical Centre and healthy controls. MS patients were evaluated according to Expanded Disability Status Scale into mild and moderate-severe conditions. Each participant provided a urine sample and completed epidemiological questionnaires. The levels of six metal (Aluminum, Cadmium, Chromium, Lead, Mercury, Nickel) and one metalloid (Arsenic) and common organophosphates pesticide metabolites (6 dialkylphosphates, DAP) were measured in urine using inductively coupled plasma-mass spectrometry and gas-chromatography mass-spectrometry. We compared cases with controls in terms of urinary levels of these compounds using Mann-Whitney and Kruskall-Wallis tests. RESULTS Urinary cadmium and mercury levels were higher in the 49 MS patients than the 37 controls (p < 0.01). Cadmium levels were higher in moderate-severe MS patients (n = 24) than mild MS patients (n = 25) (p = 0.003). CONCLUSION Urinary cadmium and mercury levels were higher among MS patients than controls. Cadmium levels correlated with disease severity. Further studies are needed to explore potential causal pathways between these compounds and MS pathogenesis.
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Affiliation(s)
| | - Tarek Mansor
- Department of Neurology, Ziv Medical Center, Zefat, Israel
| | - Michael Edelstein
- Ziv Medical Center, Research Institute, Zefat, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Zefat, Israel
| | | | - Luda Groisman
- National Public Health Laboratories, Tel Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratories, Tel Aviv, Israel
| | | | - Radi Shahien
- Department of Neurology, Ziv Medical Center, Zefat, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Zefat, Israel.
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Berman T, Rorman E, Groisman L, Keinan-Boker L, Shimony T, Barnett-Itzhaki Z. Association between parental smoking and child exposure to environmental tobacco smoke in Israel. Isr J Health Policy Res 2023; 12:37. [PMID: 38115120 PMCID: PMC10731699 DOI: 10.1186/s13584-023-00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure in children can cause delayed lung development and lifelong cardiovascular damage. The aim of this study was to measure ETS exposure in children in Israel in 2020-2021 using urinary cotinine (UC) measurements and to assess correlates of ETS exposure, including parental smoking. METHODS In the framework of the National Human Biomonitoring Program, spot urine samples and questionnaire data were collected from 166 children aged 4-12 years, during the years 2020-2021. We collected urine samples in 233 adults, 69 of whom were parents of children included in the study. Parents of participating children were asked about parental smoking, child's exposure to ETS and smoking policy at home. Cotinine and creatinine were measured in urine. Creatinine-adjusted and unadjusted urine cotinine (UC) geometric means were calculated. Associations between potential correlates and UC concentrations were analyzed in univariate and multivariate analyses. For 69 child-parent pairs, correlation between child and parental UC was analyzed. RESULTS Based on urinary cotinine measurement, 65.2% of children of smokers are exposed to ETS, compared to 20.7% of children in non-smoking families. Greater numbers of smokers living in the home (beta = 1.27, p < 0.01), and low maternal education (beta = - 2.32, p < 0.01) were associated with higher levels of UC in a multivariate analysis. Spearman correlations showed a positive moderate correlation between UC in 69 child-parent pairs (r = 0.52, p < 0.01). CONCLUSIONS In order to reduce child exposure to ETS, smoking parents should be urgently targeted for smoking cessation and smoke-free home interventions. Further interventions are needed to protect all children from ETS.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Efrat Rorman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Luda Groisman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel.
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
- Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel.
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Rubinstein M, Makhon A, Losev Y, Valenci GZ, Gatt YE, Margalit H, Fass E, Kutikov I, Murik O, Zeevi DA, Savyon M, Tau L, Kaidar Shwartz H, Dveyrin Z, Rorman E, Nissan I. Prolonged survival of a patient with active MDR-TB HIV co-morbidity: insights from a Mycobacterium tuberculosis strain with a unique genomic deletion. Front Med (Lausanne) 2023; 10:1292665. [PMID: 38020140 PMCID: PMC10657812 DOI: 10.3389/fmed.2023.1292665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Coinfection of HIV and multidrug-resistant tuberculosis (MDR-TB) presents significant challenges in terms of the treatment and prognosis of tuberculosis, leading to complexities in managing the disease and impacting the overall outcome for TB patients. This study presents a remarkable case of a patient with MDR-TB and HIV coinfection who survived for over 8 years, despite poor treatment adherence and comorbidities. Whole genome sequencing (WGS) of the infecting Mycobacterium tuberculosis (Mtb) strain revealed a unique genomic deletion, spanning 18 genes, including key genes involved in hypoxia response, intracellular survival, immunodominant antigens, and dormancy. This deletion, that we have called "Del-X," potentially exerts a profound influence on the bacterial physiology and its virulence. Only few similar deletions were detected in other non-related Mtb genomes worldwide. In vivo evolution analysis identified drug resistance and metabolic adaptation mutations and their temporal dynamics during the patient's treatment course.
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Affiliation(s)
- Mor Rubinstein
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Andrei Makhon
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Yelena Losev
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Gal Zizelski Valenci
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Yair E. Gatt
- Department of Microbiology and Molecular Genetics, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hanah Margalit
- Department of Microbiology and Molecular Genetics, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ephraim Fass
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Ina Kutikov
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Omer Murik
- Translational Genomics Laboratory, Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - David A. Zeevi
- Translational Genomics Laboratory, Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Michal Savyon
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Luba Tau
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hasia Kaidar Shwartz
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Israel Nissan
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
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Losev Y, Rubinstein M, Nissan I, Haviv P, Barsky Y, Volinsky M, Bar-Giora G, Zouher T, Hamawi M, Valenci GZ, Kutikov I, Shwartz HK, Dveyrin Z, Chemtob D, Rorman E. Genomic, phenotypic and demographic characterization of Mycobacterium tuberculosis in Israel in 2021. Front Cell Infect Microbiol 2023; 13:1196904. [PMID: 37928179 PMCID: PMC10622789 DOI: 10.3389/fcimb.2023.1196904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
According to World Health Organization WHO, Tuberculosis (TB) is the second cause of death from infectious disease worldwide. During 2021, 10.6 million people were infected with TB, and 1.6 million people died. TB is caused by pathogens belonging to the Mycobacterium tuberculosis complex (MTBC), mainly by Mycobacterium tuberculosis (M.tb). Members of this complex are acid-fast bacilli, which can cause intrapulmonary and extra pulmonary TB, and can be divided into various lineages, based on genomic markers. The main public health threat comes from drug resistant M.tb strains, which are responsible for about 25% of TB death and treatment failure worldwide. Treating drug resistant TB patients significantly raises the costs of TB treatment. This study provides an overview of the demographic and drug susceptibility characteristics of newly diagnosed TB patients in Israel in 2021. The State of Israel has a very low level of TB endemicity and is at a pre-elimination phase. Notably, only 11.7% of the newly diagnosed TB patients were born in Israel. In this report, of the 154 new laboratory-confirmed TB patients, 66.7% had pulmonary TB, while 16% had extrapulmonary TB. Males accounted for 52% of the patients, with the most prevalent age group being 21-40. Most patients were citizens of Israel (53.9%), while 37.7% had no Israeli citizenship. Among non-citizens, there was a predominance of males and patients aged 21-40. The susceptibility profile showed a high resistance rate to streptomycin (18.2%) and to a lower extent to isoniazid (13.6%), pyrazinamide (8.4%), rifampicin (7.8%), and ethambutol (3.2%). Only 2 cases of XDR-TB and 10 MDR-TB strains were detected in Israel in 2021, with both XDR strains and 5 out of 10 MDR strains belonging to the Beijing lineage. Most of Beijing isolates were resistant to at least one tested drug. Genomic sequencing of 134 out of 156 strains and bioinformatics analysis using the MTBseq program and WHO mutation catalogue shows a good match with only 9 discrepancies between phenotypic and genotypic susceptibility profiles in first line drugs. The most common lineage is Delhi-Cas (23%) followed by the Beijing lineage (17%). Most patients from the Delhi-Cas lineage were born in Africa, while patients with Beijing isolates were born in different countries. Minimum spanning tree analysis identified 15 clusters. The study highlights the need for ongoing surveillance of TB using molecular and phenotypic tools to further decreasing the spreading level of the disease and develop effective treatment strategies.
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Affiliation(s)
- Yelena Losev
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Mor Rubinstein
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Israel Nissan
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Paz Haviv
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Yohi Barsky
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Martha Volinsky
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Gefen Bar-Giora
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Tamara Zouher
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Mazal Hamawi
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Gal Zizelski Valenci
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Ina Kutikov
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Hasia Kaidar Shwartz
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Daniel Chemtob
- Department of Tuberculosis (TB) and AIDS and National TB Program Manager, Ministry of Health, Jerusalem, Israel
- Hebrew University-Hadassah Faculty of Medicine, School of Public Health and Community Medicine, Jerusalem, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
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Hassan L, Shinar E, Groisman L, Rorman E, Kloog I, Jaffe E, Stoyanov E, Moser A, Novack V, Gat R, Grant-Sasson K, Novack L. National blood bank services as a platform for national human biomonitoring - A proof-of-concept study. Chemosphere 2023; 328:138569. [PMID: 37023902 DOI: 10.1016/j.chemosphere.2023.138569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Human biomonitoring (HBM) is crucial for identifying potential risks to human health from exposure to environmental hazards. However, it is an expensive and labor-intensive endeavor. To save on samples' collection process we suggested using a national blood banking system as a platform for a national HBM program. For the case study, we used a comparison of blood donors from heavily industrialized Haifa Bay region, northern Israel, with donors from the rest of the country. METHODS The study population comprised a random sample of blood donors donating blood all over Israel. Samples of whole blood were tested for arsenic (As), cadmium (Cd), chromium (Cr) and lead (Pb). Donors' donations sites and residential locations were geocoded. Smoking status was verified based on Cd levels, after calibrating their concentrations vs Cotinine in a sub-sample of 45 subjects. Metal concentrations were compared between regions using a lognormal regression, while controlling for age, gender, and predicted probability of smoking. RESULTS During Mar 2020-Feb 2022, we collected 6230 and tested 911 samples. Concentrations of most of the metals were modified by age, gender, and smoking. Cr and Pb appeared to be 1.08-1.10 times higher among Haifa Bay residents than in the rest of the country (although with borderline significance of 0.069 for Cr). Cr and Pb were 1.13-1.15 times higher for those who donated blood in the Haifa Bay region, but not necessarily resided in the area. Donors from Haifa Bay had lower levels of As and Cd as compared to other donors in Israel. CONCLUSIONS Using a national blood banking system for HBM proved to be feasible and efficient. Blood donors from Haifa Bay area were characterized by elevated levels of Cr and Pb and lower levels of As and Cd. An extensive investigation of industries in the area is warranted.
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Affiliation(s)
- Lior Hassan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Eilat Shinar
- National Blood Services Center, Magen David Adom, Israel
| | | | | | - Itai Kloog
- Department of Environmental, Geoinformatics and Urban Planning Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eli Jaffe
- National Blood Services Center, Magen David Adom, Israel
| | | | - Asher Moser
- National Blood Services Center, Magen David Adom, Israel
| | - Victor Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel; Soroka Clinical Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Roni Gat
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Kineret Grant-Sasson
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel.
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Ovadia YS, Gefel D, Toledano Y, Rosen SR, Avrahami-Benyounes Y, Groisman L, Rorman E, Hen L, Fytlovich S, Katz LS, Anteby EY, Shenhav S. Does Iodine Intake Modify the Effect of Maternal Dysglycemia on Birth Weight in Mild-to-Moderate Iodine-Deficient Populations? A Mother-Newborn Prospective Cohort Study. Nutrients 2023; 15:2914. [PMID: 37447240 PMCID: PMC10343728 DOI: 10.3390/nu15132914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
It is unclear how maternal glycemic status and maternal iodine status influence birth weight among individuals with mild-to-moderate iodine deficiency (ID). We studied the association between birth weight and both maternal glucose levels and iodine intake among pregnant women with mild-to-moderate ID. Glucose values were assessed using a glucose challenge test (GCT) and non-fasting glucose levels that were determined before delivery; individuals' iodine statuses were assessed using an iodine food frequency questionnaire; and serum thyroglobulin (Tg) and urinary iodine concentrations (UIC) were used to assess each group's iodine status. Thyroid antibodies and free thyroxine (FT4) levels were measured. Obstetric and anthropometric data were also collected. Large-for-gestational age (LGA) status was predicted using a Cox proportional hazards model with multiple confounders. Tg > 13 g/L was independently associated with LGA (adjusted hazard ratio = 3.4, 95% CI: 1.4-10.2, p = 0.001). Estimated iodine intake correlated with FT4 among participants who reported consuming iodine-containing supplements (ICS) after adjusting for confounders (β = 0.4, 95% CI: 0.0002-0.0008, p = 0.001). Newborn weight percentiles were inversely correlated with maternal FT4 values (β = -0.2 95% CI:-0.08--56.49, p = 0.049). We conclude that in mild-to-moderate ID regions, insufficient maternal iodine status may increase LGA risk. Iodine status and ICS intake may modify the effect that maternal dysglycemia has on offspring weight.
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Affiliation(s)
- Yaniv S. Ovadia
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
- Foreign Studies Department, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100001, Israel
| | - Dov Gefel
- School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100001, Israel; (D.G.); (S.R.R.)
| | - Yoel Toledano
- Endocrinology Clinic, Division of Maternal Fetal Medicine, Helen Schneider Women’s Hospital, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Shani R. Rosen
- School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100001, Israel; (D.G.); (S.R.R.)
- Center for Healthcare Technology and Innovation Policy Research, Gertner Institute of Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Yael Avrahami-Benyounes
- Women’s Health Center, Maccabi Healthcare Services, Southern Region, Beersheba 8489312, Israel;
| | - Ludmila Groisman
- National Public Health Laboratory, Ministry of Health, Tel Aviv 6108401, Israel; (L.G.); (E.R.)
| | - Efrat Rorman
- National Public Health Laboratory, Ministry of Health, Tel Aviv 6108401, Israel; (L.G.); (E.R.)
| | - Lihi Hen
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
| | - Shlomo Fytlovich
- Laboratory of Clinical Biochemistry, Barzilai University Medical Center, Ashkelon 7830604, Israel;
| | - Liora S. Katz
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Eyal Y. Anteby
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
- Faculty of Health Sciences, Ben-Gurion University of Negev, Beersheba 8410501, Israel
| | - Simon Shenhav
- Obstetrics and Gynecology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel; (L.H.); (E.Y.A.); (S.S.)
- Faculty of Health Sciences, Ben-Gurion University of Negev, Beersheba 8410501, Israel
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8
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Groisman L, Berman T, Quinn A, Pariente G, Rorman E, Karakis I, Gat R, Sarov B, Novack L. Levels of PFAS concentrations in the placenta and pregnancy complications. Ecotoxicol Environ Saf 2023; 262:115165. [PMID: 37348217 DOI: 10.1016/j.ecoenv.2023.115165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Recent research has raised concerns about the potential health effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) exposure, particularly during critical periods of development such as pregnancy. In this study, we sought to investigate the presence and potential impacts of PFAS in the placenta. METHODS We measured 13 PFAS compounds in placental tissue samples among 50 women who gave birth at a tertiary medical center in southern Israel. The sample comprised of 10 women with pregnancy-related complications (preterm birth, preeclampsia, gestational diabetes or small-for-gestational age) and 40 women without complications individually matched to cases by age. RESULTS For five (5) out of 13 PFAS compounds (Perfluorooctane Sulfonate (PFOS), perfluorooctanoic acid (PFOA), Perfluorohexanesulphonic acid (PFHxS), Perfluorononanoic acid (PFNA), Perfluorodecanoic acid (PFDA)) median concentrations were lower or comparable to placental measurements in different international populations. Geometric mean was estimated at 0.09 ng/g (90%CI:0.07;0.10) for PFOA, 0.05 ng/g for PFNA (90%CI:0.04;0.07), 0.03 ng/g for PFDA (90%CI:0.01;0.03), 0.06 ng/g for PFHxS (90%CI:0.05;0.07), 0.23 ng/g for PFOS linear measurement (90%CI:0.20;0.26) and 0.25 ng/g (90%CI:0.22;0.30) for PFOS summed concentrations that included non-linear isomers. Composite outcome of pregnancy-related complications was associated with elevated PFOA placental concentrations at an odds ratio (OR)= 1.82 (90%CI:1.06;3.13) for an increase of one quintile of PFOA value and adjusted to maternal gravidity in a conditional logistic regression. CONCLUSION This pilot study indicates a widespread exposure to multiple PFAS compounds in placental tissue of pregnant women in Israel. These findings warrant further validation through comprehensive national human biomonitoring initiatives.
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Affiliation(s)
- Luda Groisman
- National Public Health Laboratory, Israel Ministry of Health, Tel Aviv, Israel
| | - Tamar Berman
- Department of Health Promotion, Tel Aviv University, Israel; Department of Environmental Health, Israel Ministry of Health, Israel, Tel Aviv University, Israel
| | - Anna Quinn
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel
| | - Gali Pariente
- The Division of Obstetrics and Gynecology, Soroka University Medical Center, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Israel Ministry of Health, Tel Aviv, Israel
| | - Isabella Karakis
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel; Department of Environmental Epidemiology, Israel Ministry of Health, Israel
| | - Roni Gat
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel; Soroka University Medical Center, Negev Environmental Health Research Institute, Israel
| | - Batia Sarov
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel
| | - Lena Novack
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Israel; Soroka University Medical Center, Negev Environmental Health Research Institute, Israel.
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Hassan L, Shinar E, Groisman L, Rorman E, Kloog I, Jaffe E, Stoyanov E, Novack V, Moser A, Gat R, Grant-Sasson K, Novack L. Linking between ambient pollution and metals concentration in blood. Nationwide study based on the national blood banking system. Sci Total Environ 2023:164434. [PMID: 37245805 DOI: 10.1016/j.scitotenv.2023.164434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
This study was aimed to describe the chemical traces of air pollution in blood of residents and evaluate the association between ambient pollution and its dose absorbed internally by a human body. The national Magen David Adom Blood Services blood donation collection platform and the National Public Health Laboratory's testing services were utilized to conduct a human biomonitoring study among blood donors in Israel. The donors' residential addresses and donations sites' locations were geocoded and merged with the levels of pollutants recorded by the nearby monitoring stations. Pollutants included nitrogen dioxide (NO2), sulfate dioxide (SO2), ozone (O3), carbon monoxide (CO) and particulate matter of size <10 and 2.5 μm in diameter (PM10 & PM2.5). Metal concentrations were statistically analyzed by ratio t-test and a lognormal regression, and adjusted to age, gender and smoking (defined based on Cadmium values). The findings indicate an independent positive association between pollutants and metals' concentrations in blood. Specifically, an increase in interquartile range (IQR) of NO2 was associated with 9.5 % increase in As in blood. The increase in one IQR of PM10 and SO2 was associated with an increase in Pb, of 16.6 % and 12.4 %, respectively. SO2 was also adversely associated with Cd concentrations, by increasing its levels by 5.7 %. The donors' proximity to quarries was related to the Pb blood levels higher 1.47 times compared to donors without quarries close to their residence (p-value = 0.013). To conclude, ambient pollution levels are associated with internal metals' concentrations, reaffirming the link between the two in the pathological pathway from air pollution to morbidity.
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Affiliation(s)
- Lior Hassan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | | | | | | | - Itai Kloog
- Department of Geography, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eli Jaffe
- Blood Services Center, Magen David Adom, Israel
| | | | - Victor Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel; Clinical Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Asher Moser
- Blood Services Center, Magen David Adom, Israel
| | - Roni Gat
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Kineret Grant-Sasson
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel.
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10
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Michael T, Levy A, Kohn E, Daniel S, Hazan A, Berkovitch M, Brik A, Hochwald O, Borenstein L, Betser M, Moskovich M, Livne A, Keidar R, Rorman E, Groisman L, Weiner Z, Malkoff A, Solt I. Prenatal exposure to common heavy metals is associated with anogenital distance in newborns. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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11
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Mazuz ML, Weiss A, Beer O, Tirosh-Levy S, Riklis I, Dveyrin Z, Rorman E, Cohen NZ, Markovich MP, Baneth G. High infection rates of Toxoplasma gondii in cattle, sheep and pigs from Israel. Comp Immunol Microbiol Infect Dis 2023; 92:101928. [PMID: 36459723 DOI: 10.1016/j.cimid.2022.101928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
Toxoplasma gondii is an obligate intracellular parasite belonging to the phylum Apicomplexa, which causes the zoonotic disease toxoplasmosis. T. gondii infects almost all warm blood animals. Generally, infected animals are asymptomatic and remain infected for life. Infection of humans occurs by consumption of infected undercooked meat or contaminated vegetables, fruit and water. The aim of this study was to evaluate the prevalence and seroprevalence of T. gondii in livestock in Israel. For the serological screening we investigated the presence of antibodies against T. gondii in sera using the indirect fluorescent antibody test (IFAT). Molecular screening was preformed using conventional PCR and nested PCR for the detection of T. gondii DNA in tissue samples. Serum samples of 249 cattle and 138 sheep were collected from farms. This serological survey showed high seroprevalence with seropositivity of 29 % in cattle and 33 % in sheep. In addition, 526 paired sera and tissue samples from cattle, sheep and pigs were obtained in slaughterhouses. The serological prevalence of T. gondii in healthy animals intended for human consumption was 29.4 % in cattle, 26.1 % in sheep and 8.1 % in pigs. The molecular detection of T. gondii in the tissue samples was 7.5 % in cattle, 7.3 % in sheep and 6.3 % in pigs. Considering the combined positive results from both serological and molecular assays, exposure to or infection with the parasite was present in 26.2 % of the samples (33.8 % in cattle, 30.3 % in sheep, 12.5 % in pigs). The prevalence of T. gondii in pigs was significantly lower compared to that of cattle and sheep (P < 0.001). All PCR positive samples from animals and 12 human positive samples were genotyped using a restriction fragment length polymorphism (PCR-RFLP) method. The results showed the existence of atypical genotypes in the majority of the samples and no correlation between animals and human samples could be determined from this study. Widespread exposure to T. gondii in Israel with the presence of parasite DNA in meat from cattle, sheep and pigs meant for human consumption was found.
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Affiliation(s)
| | - Adi Weiss
- Division of Parasitology, Kimron Veterinary Institute, Beit Dagan, Israel; Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment. The Hebrew University of Jerusalem, Israel
| | - Oren Beer
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment. The Hebrew University of Jerusalem, Israel
| | - Sharon Tirosh-Levy
- Division of Parasitology, Kimron Veterinary Institute, Beit Dagan, Israel; Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment. The Hebrew University of Jerusalem, Israel
| | - Irena Riklis
- Israeli National Toxoplasmosis Reference Centre, Ministry of Health, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory, Tel Aviv, Public Health Services, Ministry of Health, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Tel Aviv, Public Health Services, Ministry of Health, Israel
| | | | | | - Gad Baneth
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment. The Hebrew University of Jerusalem, Israel
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12
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Michael T, Kohn E, Daniel S, Hazan A, Berkovitch M, Brik A, Hochwald O, Borenstein-Levin L, Betser M, Moskovich M, Livne A, Keidar R, Rorman E, Groisman L, Weiner Z, Rabin AM, Solt I, Levy A. Prenatal exposure to heavy metal mixtures and anthropometric birth outcomes: a cross-sectional study. Environ Health 2022; 21:139. [PMID: 36581953 PMCID: PMC9798586 DOI: 10.1186/s12940-022-00950-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Numerous studies have suggested significant associations between prenatal exposure to heavy metals and newborn anthropometric measures. However, little is known about the effect of various heavy metal mixtures at relatively low concentrations. Hence, this study aimed to investigate associations between prenatal exposures to a wide range of individual heavy metals and heavy metal mixtures with anthropometric measures of newborns. METHODS We recruited 975 mother-term infant pairs from two major hospitals in Israel. Associations between eight heavy metals (arsenic, cadmium, chromium, mercury, nickel, lead, selenium, and thallium) detected in maternal urine samples on the day of delivery with weight, length, and head circumference at birth were estimated using linear and Bayesian kernel machine regression (BKMR) models. RESULTS Most heavy metals examined in our study were observed in lower concentrations than in other studies, except for selenium. In the linear as well as the BKMR models, birth weight and length were negatively associated with levels of chromium. Birth weight was found to be negatively associated with thallium and positively associated with nickel. CONCLUSION By using a large sample size and advanced statistical models, we could examine the association between prenatal exposure to metals in relatively low concentrations and anthropometric measures of newborns. Chromium was suggested to be the most influential metal in the mixture, and its associations with birth weight and length were found negative. Head circumference was neither associated with any of the metals, yet the levels of metals detected in our sample were relatively low. The suggested associations should be further investigated and could shed light on complex biochemical processes involved in intrauterine fetal development.
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Affiliation(s)
- Tal Michael
- Department of Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev Beer-Sheva, Beersheba, Israel
| | - Elkana Kohn
- Clinical Pharmacology and Toxicology Unit, Pediatric Division, Shamir (Assaf Harofeh) Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sharon Daniel
- Department of Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev Beer-Sheva, Beersheba, Israel
- Clalit Health Services, Southern District, Beer-Sheva, Israel
| | - Ariela Hazan
- Clinical Pharmacology and Toxicology Unit, Pediatric Division, Shamir (Assaf Harofeh) Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Matitiahu Berkovitch
- Clinical Pharmacology and Toxicology Unit, Pediatric Division, Shamir (Assaf Harofeh) Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Anna Brik
- Clinical Pharmacology and Toxicology Unit, Pediatric Division, Shamir (Assaf Harofeh) Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ori Hochwald
- Neonatal Intensive Care Unit, Rambam Health Care Campus, and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Liron Borenstein-Levin
- Neonatal Intensive Care Unit, Rambam Health Care Campus, and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Moshe Betser
- Delivery Rooms and Maternity Ward, Shamir (Assaf Harofeh) Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Miki Moskovich
- Delivery Rooms and Maternity Ward, Shamir (Assaf Harofeh) Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ayelet Livne
- Neonatal Intensive Care Unit, Shamir (Assaf Harofeh) Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rimona Keidar
- Neonatal Intensive Care Unit, Shamir (Assaf Harofeh) Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Ministry of Health, Tel-Aviv, Israel
| | - Luda Groisman
- National Public Health Laboratory, Ministry of Health, Tel-Aviv, Israel
| | - Zeev Weiner
- Department of Obstetrics and Gynecology, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, POB 9602, 31096, Haifa, Israel
| | - Adi Malkoff Rabin
- Department of Obstetrics and Gynecology, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, POB 9602, 31096, Haifa, Israel
| | - Ido Solt
- Department of Obstetrics and Gynecology, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, POB 9602, 31096, Haifa, Israel.
| | - Amalia Levy
- Department of Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev Beer-Sheva, Beersheba, Israel
- Environment and Health Epidemiology Research Center, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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13
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Barnett-Itzhaki Z, Ehrlich D, Troen AM, Rorman E, Groismann L, Blaychfeld-Magnazi M, Endevelt R, Berman T. Results of the national biomonitoring program show persistent iodine deficiency in Israel. Isr J Health Policy Res 2022; 11:18. [PMID: 35346362 PMCID: PMC8960077 DOI: 10.1186/s13584-022-00526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Adequate iodine intake is essential for human health, for normal thyroid function, and for attainment of full intellectual potential in children. In light of Israel's lack of a mandatory salt fortification policy, heavy reliance on desalination and low iodine intake from dairy products and seafood, there is concern in Israel that the population is iodine deficient. Indeed, the first Israeli National Iodine Survey in 2016 found a median urinary iodine concentration (UIC) of 83 µg/L among school age children, falling below the WHO’s adequacy range of 100–299 µg/L for children.
Methods
In the framework of the National Human Biomonitoring Program in Israel, spot urine samples and questionnaire data were collected from 166 healthy children aged 4–12 years in 2020–2021. Urinary iodine concentrations were measured at the Ministry of Health National Biomonitoring Laboratory, using mass spectrometry. An international comparison of median urinary iodine concentrations (UIC) was performed taking into consideration the levels of desalinated water per capita, and fortification policies.
Results
The overall median (interquartile range [IQR]) UIC was 80.1 µg/L (44.7–130.8 µg/L) indicating that the population’s iodine status has not improved in the five years that have passed since inadequacy was first identified. When comparing 13 countries with population size above 150,000, whose desalinated water per capita was at least 1 m3, Israel and Lebanon were the only countries with median UIC below the WHO adequacy range.
Conclusions
There is an urgent need for mandatory salt fortification in Israel. Based on our international comparison, we conclude that the potential impact of desalination on iodine intake can be compensated for using the implementation of salt fortification policy. This study highlights the critical need for public health surveillance of nutritional and environmental exposures using human biomonitoring, with emphasis on vulnerable populations such as pregnant women and children.
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14
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Fass E, Zizelski Valenci G, Rubinstein M, Freidlin PJ, Rosencwaig S, Kutikov I, Werner R, Ben-Tovim N, Bucris E, Erster O, Zuckerman NS, Mor O, Mendelson E, Dveyrin Z, Rorman E, Nissan I. HiSpike Method for High-Throughput Cost Effective Sequencing of the SARS-CoV-2 Spike Gene. Front Med (Lausanne) 2022; 8:798130. [PMID: 35087848 PMCID: PMC8787038 DOI: 10.3389/fmed.2021.798130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022] Open
Abstract
The changing nature of the SARS-CoV-2 pandemic poses unprecedented challenges to the world's health systems. Emerging spike gene variants jeopardize global efforts to produce immunity and reduce morbidity and mortality. These challenges require effective real-time genomic surveillance solutions that the medical community can quickly adopt. The SARS-CoV-2 spike protein mediates host receptor recognition and entry into the cell and is susceptible to generation of variants with increased transmissibility and pathogenicity. The spike protein is the primary target of neutralizing antibodies in COVID-19 patients and the most common antigen for induction of effective vaccine immunity. Tight monitoring of spike protein gene variants is key to mitigating COVID-19 spread and generation of vaccine escape mutants. Currently, SARS-CoV-2 sequencing methods are labor intensive and expensive. When sequence demands are high sequencing resources are quickly exhausted. Consequently, most SARS-CoV-2 strains are sequenced in only a few developed countries and rarely in developing regions. This poses the risk that undetected, dangerous variants will emerge. In this work, we present HiSpike, a method for high-throughput cost effective targeted next generation sequencing of the spike gene. This simple three-step method can be completed in < 30 h, can sequence 10-fold more samples compared to conventional methods and at a fraction of their cost. HiSpike has been validated in Israel, and has identified multiple spike variants from real-time field samples including Alpha, Beta, Delta and the emerging Omicron variants. HiSpike provides affordable sequencing options to help laboratories conserve resources for widespread high-throughput, near real-time monitoring of spike gene variants.
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Affiliation(s)
- Ephraim Fass
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Gal Zizelski Valenci
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Mor Rubinstein
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Paul J. Freidlin
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Shira Rosencwaig
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Inna Kutikov
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Robert Werner
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Nofar Ben-Tovim
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Efrat Bucris
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Oran Erster
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Neta S. Zuckerman
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Orna Mor
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
| | - Israel Nissan
- National Public Health Laboratory, Public Health Services, Ministry of Health, Tel Aviv, Israel
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15
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Grossman R, Adler A, Rubinstein M, Nissan I, Kaidar-Shwartz H, Dveyrin Z, Leshem E, Maor Y, Tau L, Rorman E. Emergence of Mycobacterium canariasense infections in central Israel. Eur J Clin Microbiol Infect Dis 2022; 41:501-504. [PMID: 34997389 DOI: 10.1007/s10096-021-04356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/29/2021] [Indexed: 11/03/2022]
Abstract
In 2018, Mycobacterium canariasense bloodstream infection was diagnosed in Israel. Further investigation had identified additional five cases in three medical centers, including isolates from blood (1), cornea (1), and sputum (3). Isolates were susceptible to all the antimicrobial tested. All but one isolate was related by whole-genome phylogeny.
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Affiliation(s)
- Rona Grossman
- National Mycobacterium Reference Centre, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel.
| | - Amos Adler
- Microbiology Laboratory, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mor Rubinstein
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | - Israel Nissan
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | - Hasia Kaidar-Shwartz
- National Mycobacterium Reference Centre, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | - Eyal Leshem
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute for Travel and Tropical Medicine, Sheba Medical Center, Ramat Gan, Israel
| | - Yasmin Maor
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Disease Unit, Edith Wolfson Medical Centre, Holon, Israel
| | - Luba Tau
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Disease Unit, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
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16
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Borges V, Isidro J, Correia C, Cordeiro D, Vieira L, Lodhia Z, Fernandes C, Rodrigues AM, Azevedo J, Alves J, Roxo J, Rocha M, Côrte-Real R, Toscano C, Pessanha MA, Nissan I, Pilo S, Rorman E, Dveyrin Z, Paitan Y, Paran H, Wagner-Kolasko G, Beirnes J, Gibbons S, Severini A, Borrego MJ, Gomes JP. Transcontinental Dissemination of the L2b/D-Da Recombinant Chlamydia trachomatis Lymphogranuloma venereum (LGV) Strain: Need of Broad Multi-Country Molecular Surveillance. Clin Infect Dis 2021; 73:e1004-e1007. [PMID: 33512482 DOI: 10.1093/cid/ciab067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
Previously, we identified a Chlamydia trachomatis lymphogranuloma venereum (LGV) recombinant strain possessing a non-LGV ompA genotype. Here, culture-independent genome sequencing confirms its circulation in Europe, Middle East, and North America, and unveils emergence of antibiotic resistance. Broad surveillance is needed.
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Affiliation(s)
- Vítor Borges
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Joana Isidro
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cristina Correia
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Dora Cordeiro
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Luís Vieira
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Zohra Lodhia
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cândida Fernandes
- Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
| | | | | | | | - João Roxo
- CheckpointLX, Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | - Miguel Rocha
- CheckpointLX, Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | - Rita Côrte-Real
- Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
| | | | | | - Israel Nissan
- National Public Health Laboratories, Tel Aviv, Israel
| | - Shlomo Pilo
- National Public Health Laboratories, Tel Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratories, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratories, Tel Aviv, Israel
| | - Yossi Paitan
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine & Tel Aviv University, Tel Aviv, Israel.,Clinical Microbiology Lab, Meir Medical Center, Kfar Saba, Israel
| | - Haim Paran
- Department of General Surgery A, Meir Medical Center, Kfar Saba, Israel
| | - Gal Wagner-Kolasko
- Department of Family Medicine, Clalit Gan-Meir LGBT Clinic, Tel Aviv, Israel
| | | | | | - Alberto Severini
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - João Paulo Gomes
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
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17
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Pilo S, Zizelski Valenci G, Rubinstein M, Pichadze L, Scharf Y, Dveyrin Z, Rorman E, Nissan I. High-resolution multilocus sequence typing for Chlamydia trachomatis: improved results for clinical samples with low amounts of C. trachomatis DNA. BMC Microbiol 2021; 21:28. [PMID: 33461496 PMCID: PMC7814548 DOI: 10.1186/s12866-020-02077-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Several Multilocus Sequence Typing (MLST) schemes have been developed for Chlamydia trachomatis. Bom’s MLST scheme for MLST is based on nested PCR amplification and sequencing of five hypervariable genes and ompA. In contrast to other Chlamydia MLST schemes, Bom’s MLST scheme gives higher resolution and phylogenetic trees that are comparable to those from whole genome sequencing. However, poor results have been obtained with Bom’s MLST scheme in clinical samples with low concentrations of Chlamydia DNA. Results In this work, we present an improved version of the scheme that is based on the same genes and MLST database as Bom’s MLST scheme, but with newly designed primers for nested-1 and nested-2 steps under stringent conditions. Furthermore, we introduce a third primer set for the sequencing step, which considerably improves the performance of the assay. The improved primers were tested in-silico using a dataset of 141 Whole Genome Sequences (WGS) and in a comparative analysis of 32 clinical samples. Based on cycle threshold and melting curve analysis values obtained during Real-Time PCR of nested-1 & 2 steps, we developed a simple scoring scheme and flow chart that allow identification of reaction inhibitors as well as to predict with high accuracy amplification success. The improved MLST version was used to obtain a genovars distribution in patients attending an STI clinic in Tel Aviv. Conclusions The newly developed MLST version showed great improvement of assay results for samples with very low concentrations of Chlamydia DNA. A similar concept could be applicable to other MLST schemes. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-020-02077-y.
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Affiliation(s)
- Shlomo Pilo
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | | | - Mor Rubinstein
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | - Lea Pichadze
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | - Yael Scharf
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | - Zeev Dveyrin
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | - Efrat Rorman
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel
| | - Israel Nissan
- Ministry of Health, National Public Health Laboratory, Tel Aviv, Israel.
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18
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Hassan L, Moser A, Rorman E, Groisman L, Naor Y, Shinar E, Gat R, Jaffe E, Novack V, Kloog I, Novack L. Human biologic monitoring based on blood donations to the National Blood Services. BMC Public Health 2020; 20:469. [PMID: 32268895 PMCID: PMC7140578 DOI: 10.1186/s12889-020-08588-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 12/28/2022] Open
Abstract
Background The ambient exposure does not always reflect the internal levels of pollution absorbed in the body. While human biomonitoring (HBM) could provide a valid estimate of exposure extent, it is usually an expensive and a heavily manpowered enterprise. Using samples collected during blood donations for HMB may provide a more efficient platform for a routine biomonitoring. Methods The current study is aimed to explore the feasibility of using the national blood banking system for the purposes of HBM, to compare between residents of a suspected polluted area in northern Israel (Haifa Bay) to the rest of the country. Specifically, we will assemble a geographically representative sample of blood donors residing in the study area and of the general population, to test for four industry and traffic-related metals: lead (Pb), cadmium (Cd), arsenic (As) and chromium (Cr). Samples of whole blood from donors will be tested in the Laboratory of Public Health Services managed by the Ministry of Health. The information on donors’ biomarkers levels will be further linked with the air pollution and meteorological data assessed at the location of the blood collection sites (short-term exposure) and donors’ permanent address (long-term exposure), as recorded by the monitoring stations spread throughout Israel and the satellite-based exposure models. The association between biomarkers and ambient environmental exposures will be assessed. The samples’ collection is planned for 2 years of 2020–2021. Discussion The information collected in this study could lead to environmental regulations within Haifa Bay area aimed to prevent exposure to high levels of hazardous chemicals.
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Affiliation(s)
- Lior Hassan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Sderot Rager 151, 84101, Beer-Sheva, Israel.,Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Asher Moser
- Blood Services Center, Magen David Adom, Tel Aviv-Yafo, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Luda Groisman
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Yamit Naor
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Eilat Shinar
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Roni Gat
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Sderot Rager 151, 84101, Beer-Sheva, Israel.,Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Eli Jaffe
- Blood Services Center, Magen David Adom, Tel Aviv-Yafo, Israel
| | - Victor Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel.,Soroka University Medical Center, Beer-Sheva, Israel
| | - Itai Kloog
- Department of Geography, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Sderot Rager 151, 84101, Beer-Sheva, Israel. .,Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel.
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Davidovich N, Pretto T, Blum SE, Baider Z, Grossman R, Kaidar-Shwartz H, Dveyrin Z, Rorman E. Mycobacterium gordonae infecting redclaw crayfish Cherax quadricarinatus. Dis Aquat Organ 2019; 135:169-174. [PMID: 31392969 DOI: 10.3354/dao03392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The redclaw crayfish Cherax quadricarinatus (von Martens, 1868) is one of the most commonly exploited freshwater crayfish species worldwide. Redclaw crayfish are susceptible to a number of pathogens but none have been linked to widespread epizootics. Mycobacterial infections have been sporadically reported in crayfish. In the case described, histopathology and bacterial identification confirmed an opportunistic infection caused by Mycobacterium gordonae in a hatchery of C. quadricarinatus in Israel. Intranuclear inclusion bodies, recorded in cells of the tubular epithelium of the hepatopancreas by histopathology, indicate a co-infection with a viral agent, referable to C. quadricarinatus bacilliform virus (CqBV). To the best of our knowledge this is the first description of mycobacteriosis in redclaw crayfish.
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20
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Mor Z, Nuss N, Savion M, Nissan I, Lidji M, Maneshcu S, Kaidar-Shwartz H, Amitai Z, Rorman E, Sheffer R. Tuberculosis outbreak in a nursing home involving undocumented migrants and Israeli citizens. Isr J Health Policy Res 2018; 7:36. [PMID: 30007410 PMCID: PMC6046096 DOI: 10.1186/s13584-018-0219-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/25/2018] [Indexed: 11/10/2022] Open
Abstract
ABSTRACK OBJECTIVES: Israel has absorbed > 60,000 migrant from the horn of Africa (MHOA) since 2006. No cross-transmission of Mycobacterium tuberculosis from MOHA to Israeli citizens has yet been reported. This study describes the results of contact investigation and laboratory work-out of a unique mixed cluster which included both MOHA and Israeli citizens. METHODS Description of the results of epidemiological investigation including laboratory confirmation. RESULTS This unique Mycobacterium tuberculosis strain included 29 patients: 26 were MOHA and three citizens who immigrated to Israel from the former Soviet Union. This is the first mixed cluster described in Israel, which has not been represented in the SITVIT international database of genotyping markers. The transmission from non-citizens to citizens occurred in a nursing institution, when MOHA infected three other contacts- two of whom were retarded residents, one of them died. The index case was screened before employment, and was permitted to return to wok although his chest X-ray demonstrated radiological findings compatible with tuberculosis. Epidemiological links were found in other 12 MOHA members of the cluster. CONCLUSION This report describes cross-transmission of Mycobacterium tuberculosis from non-citizens MOHA to Israeli citizens who were residents of a nursing home, which may be the first sign for an epidemiological shift. Although cross-ethnical transmission is still rare in Israel, medical settings should employ efficient infection control measures to protect both patients and staff from Mycobacterium tuberculosis.
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Affiliation(s)
- Z Mor
- Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - N Nuss
- Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel.
| | - M Savion
- Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel
| | - I Nissan
- National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - M Lidji
- Tel Aviv Tuberculosis clinic, Tel Aviv, Israel
| | - S Maneshcu
- Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel
| | - H Kaidar-Shwartz
- National Tuberculosis Reference Laboratory, Ministry of Health, Tel Aviv, Israel
| | - Z Amitai
- Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel
| | - E Rorman
- National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - R Sheffer
- Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel
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21
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Freidlin PJ, Nissan I, Luria A, Goldblatt D, Schaffer L, Kaidar-Shwartz H, Chemtob D, Dveyrin Z, Head SR, Rorman E. Structure and variation of CRISPR and CRISPR-flanking regions in deleted-direct repeat region Mycobacterium tuberculosis complex strains. BMC Genomics 2017; 18:168. [PMID: 28201993 PMCID: PMC5310062 DOI: 10.1186/s12864-017-3560-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/07/2017] [Indexed: 12/16/2022] Open
Abstract
Background CRISPR and CRISPR-flanking genomic regions are important for molecular epidemiology of Mycobacterium tuberculosis complex (MTBC) strains, and potentially for adaptive immunity to phage and plasmid DNA, and endogenous roles in the bacterium. Genotyping in the Israel National Mycobacterium Reference Center Tel-Aviv of over 1500 MTBC strains from 2008–2013 showed three strains with validated negative 43-spacer spoligotypes, that is, with putatively deleted direct repeat regions (deleted-DR/CRISPR regions). Two isolates of each of three negative spoligotype MTBC (a total of 6 isolates) were subjected to Next Generation Sequencing (NGS). As positive controls, NGS was performed for three intact-DR isolates belonging to T3_Eth, the largest multiple-drug-resistant (MDR)-containing African-origin cluster in Israel. Other controls consisted of NGS reads and complete whole genome sequences from GenBank for 20 intact-DR MTBC and for 1 deleted-DR MTBC strain recognized as CAS by its defining RD deletion. Results NGS reads from negative spoligotype MTBC mapped to reference H37Rv NC_000962.3 suggested that the DR/CRISPR regions were completely deleted except for retention of the middle IS6110 mobile element. Clonally specific deletion of CRISPR-flanking genes also was observed, including deletion of at least cas2 and cas1 genes. Genomic RD deletions defined lineages corresponding to the major spoligotype families Beijing, EAI, and Haarlem, consistent with 24 loci MIRU-VNTR profiles. Analysis of NGS reads, and analysis of contigs obtained by manual PCR confirmed that all 43 gold standard DR/CRISPR spacers were missing in the deleted-DR genomes. Conclusions Although many negative spoligotype strains are recorded as spoligotype-international-type (SIT) 2669 in the SITVIT international database, this is the first time to our knowledge that it has been shown that negative spoligotype strains are found in at least 4 different 24 loci MIRU-VNTR and RD deletion families. We report for the first time negative spoligotype-associated total loss of CRISPR region spacers and repeats, with accompanying clonally specific loss of flanking genes, including at least CRISPR-associated genes cas2 and cas1. Since cas1 deleted E.coli shows increased sensitivity to DNA damage and impaired chromosomal segregation, we discussed the possibility of a similar phenotype in the deleted-DR strains and Beijing family strains as both lack the cas1 gene. Electronic supplementary material The online version of this article (doi:10.1186/s12864-017-3560-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul Jeffrey Freidlin
- National Mycobacterium Reference Center, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel.
| | - Israel Nissan
- National Mycobacterium Reference Center, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | - Anna Luria
- National Mycobacterium Reference Center, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel.,current address: Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Drora Goldblatt
- National Mycobacterium Reference Center, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | | | - Hasia Kaidar-Shwartz
- National Mycobacterium Reference Center, National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | - Daniel Chemtob
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
| | | | - Efrat Rorman
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
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22
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Goldblatt D, Rorman E, Chemtob D, Freidlin PJ, Cedar N, Kaidar-Shwartz H, Dveyrin Z, Mor Z. Molecular epidemiology and mapping of tuberculosis in Israel: do migrants transmit the disease to locals? Int J Tuberc Lung Dis 2016; 18:1085-91. [PMID: 25189557 DOI: 10.5588/ijtld.14.0186] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Israel receives migrants from various countries, some of which have high tuberculosis (TB) prevalence. OBJECTIVE To assess the predominant Mycobacterium tuberculosis strains in Israel isolated during 2008-2010 among Israeli-born and migrant patients, and to investigate possible transmission of TB from migrants to the local population. METHODS Molecular characterisation employed 43-spacer spoligotyping and 16-loci mycobacterial interspersed repetitive units-variable number of tandem repeats typing. All patients were classified according to those who were members of a cluster and those who were not. RESULTS Among 684 M. tuberculosis strains isolated from new patients genotyped and assigned to their specific cohort populations during the study period, major spoligotype families were Central Asian (CAS) (n = 140, 20%), Beijing (n = 101, 15%) and T (n = 160, 23%). Most Beijing strains (66%) were isolated from patients from the former Soviet Union (FSU), while CAS strains were mainly (74%) from Ethiopia, Eritrea and Sudan (EES). For the heterogeneous T-clade, patient countries of origin were 38% EES and 33% FSU. CONCLUSIONS Predominant M. tuberculosis genotypes in Israel in 2008-2010 were similar to genotypes endemic to the migrants' countries of origin. Epidemiological investigations did not demonstrate transmission between migrants and Israeli-born patients sharing the same cluster.
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Affiliation(s)
- D Goldblatt
- National Mycobacterium Reference Laboratory, National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - E Rorman
- National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - D Chemtob
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
| | - P J Freidlin
- National Mycobacterium Reference Laboratory, National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - N Cedar
- National Mycobacterium Reference Laboratory, National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - H Kaidar-Shwartz
- National Mycobacterium Reference Laboratory, National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - Z Dveyrin
- National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel
| | - Z Mor
- Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel
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23
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Ohad S, Ben-Dor S, Prilusky J, Kravitz V, Dassa B, Chalifa-Caspi V, Kashi Y, Rorman E. The Development of a Novel qPCR Assay-Set for Identifying Fecal Contamination Originating from Domestic Fowls and Waterfowl in Israel. Front Microbiol 2016; 7:145. [PMID: 26925034 PMCID: PMC4756122 DOI: 10.3389/fmicb.2016.00145] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 01/26/2016] [Indexed: 12/12/2022] Open
Abstract
The emerging microbial source tracking (MST) methodologies aim to identify fecal contamination originating from domestic and wild animals, and from humans. Avian MST is especially challenging, primarily because the Aves class includes both domesticated and wild species with highly diverse habitats and dietary characteristics. The quest for specific fecal bacterial MST markers can be difficult with respect to attaining sufficient assay sensitivity and specificity. The present study utilizes high throughput sequencing (HTS) to screen bacterial 16S rRNA genes from fecal samples collected from both domestic and wild avian species. Operational taxonomic unit (OTU) analysis was then performed, from which sequences were retained for downstream quantitative polymerase chain reaction (qPCR) marker development. Identification of unique avian host DNA sequences, absent in non-avian hosts, was then carried out using a dedicated database of bacterial 16S rRNA gene taken from the Ribosomal Database Project. Six qPCR assays were developed targeting the 16S rRNA gene of Lactobacillus, Gallibacterium, Firmicutes, Fusobacteriaceae, and other bacteria. Two assays (Av4143 and Av163) identified most of the avian fecal samples and demonstrated sensitivity values of 91 and 70%, respectively. The Av43 assay only identified droppings from battery hens and poultry, whereas each of the other three assays (Av24, Av13, and Av216) identified waterfowl species with lower sensitivities values. The development of an MST assay-panel, which includes both domestic and wild avian species, expands the currently known MST analysis capabilities for decoding fecal contamination.
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Affiliation(s)
- Shoshanit Ohad
- National Public Health Laboratory Tel Aviv, Ministry of Health Tel Aviv, Israel
| | - Shifra Ben-Dor
- Bioinformatics Unit, Department of Biological Services, Weizmann Institute of Science Rehovot, Israel
| | - Jaime Prilusky
- Bioinformatics Unit, Department of Biological Services, Weizmann Institute of Science Rehovot, Israel
| | - Valeria Kravitz
- National Public Health Laboratory Tel Aviv, Ministry of Health Tel Aviv, Israel
| | - Bareket Dassa
- Bioinformatics Core Facility, National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev Beer-Sheva, Israel
| | - Vered Chalifa-Caspi
- Bioinformatics Core Facility, National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev Beer-Sheva, Israel
| | - Yechezkel Kashi
- Faculty of Biotechnology and Food Engineering, Technion - Israel Institute of Technology Haifa, Israel
| | - Efrat Rorman
- National Public Health Laboratory Tel Aviv, Ministry of Health Tel Aviv, Israel
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24
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Bishara H, Rorman E, Mor Z, Shechter-Amram D, Weiler-Ravell D. Tuberculosis Beijing strain outbreak in an Israeli Arab rural community linked to an incarcerated immigrant. Int J Tuberc Lung Dis 2014; 18:1502-4. [DOI: 10.5588/ijtld.14.0429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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25
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Bishara H, Lidji M, Goldblatt D, Rorman E, Mor Z, Weiler-Ravell D. Tuberculosis outbreak in an immigrant reception center in Israel: a clinical and epidemiologic perspective. ACTA ACUST UNITED AC 2014; 46:906-10. [PMID: 25290583 DOI: 10.3109/00365548.2014.951684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Tuberculosis (TB) outbreaks in congregate settings pose a public health concern and a clinical challenge. We report a TB outbreak involving 6 cases of active TB among 28 recent Ethiopian immigrants (EIs) in an immigrant reception center in Israel. The outbreak erupted several weeks after a meticulous pre-immigration TB screening of this group. All five culture-positive TB patients were infected with the CAS1_DELHI family, SIT 25 strain. Pulmonary involvement manifested as only a persistent cough without systemic symptoms. This outbreak occurred because of miscommunication among healthcare staff and between healthcare staff and the EI index case. It was fuelled by the staff ignorance of the social bonds within the group, and the sluggish once-monthly schedule of the on-site TB clinic operated at the reception center, which further lacked radiography facilities. This outbreak highlights the challenges of screening for active TB among immigrants and hard to reach groups.
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Affiliation(s)
- Hashem Bishara
- Nazareth Tuberculosis Clinic, Nazareth Hospital, Nazareth, Faculty of Medicine in Galilee Bar-Ilan University
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26
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Mor Z, Goldblatt D, Kaidar-Shwartz H, Cedar N, Rorman E, Chemtob D. Drug-resistant tuberculosis in Israel: risk factors and treatment outcomes. Int J Tuberc Lung Dis 2014; 18:1195-201. [DOI: 10.5588/ijtld.14.0192] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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27
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Ohad S, Block C, Kravitz V, Farber A, Pilo S, Breuer R, Rorman E. Rapid identification of Enterobacter hormaechei and Enterobacter cloacae genetic cluster III. J Appl Microbiol 2014; 116:1315-21. [PMID: 24428402 DOI: 10.1111/jam.12439] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 12/23/2013] [Accepted: 01/02/2014] [Indexed: 11/29/2022]
Abstract
AIM Enterobacter cloacae complex bacteria are of both clinical and environmental importance. Phenotypic methods are unable to distinguish between some of the species in this complex, which often renders their identification incomplete. The goal of this study was to develop molecular assays to identify Enterobacter hormaechei and Ent. cloacae genetic cluster III which are relatively frequently encountered in clinical material. METHODS AND RESULTS The molecular assays developed in this study are qPCR technology based and served to identify both Ent. hormaechei and Ent. cloacae genetic cluster III. qPCR results were compared to hsp60 sequence analysis. Most clinical isolates were assigned to Ent. hormaechei subsp. steigerwaltii and Ent. cloacae genetic cluster III. The latter was proportionately more frequently isolated from bloodstream infections than from other material (P < 0·05). CONCLUSION The qPCR assays detecting Ent. hormaechei and Ent. cloacae genetic cluster III demonstrated high sensitivity and specificity. SIGNIFICANCE AND IMPACT OF THE STUDY The presented qPCR assays allow accurate and rapid identification of clinical isolates of the Ent. cloacae complex. The improved identifications obtained can specifically assist analysis of Ent. hormaechei and Ent. cloacae genetic cluster III in nosocomial outbreaks and can promote rapid environmental monitoring. An association was observed between Ent. cloacae cluster III and systemic infection that deserves further attention.
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Affiliation(s)
- S Ohad
- National Public Health Laboratory Tel Aviv, Ministry of Health, Tel Aviv, Israel
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28
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Attamna A, Chemtob D, Attamna S, Fraser A, Rorman E, Paul M, Leibovici L. Risk of tuberculosis in close contacts of patients with multidrug resistant tuberculosis: a nationwide cohort. Thorax 2009; 64:271. [PMID: 19252032 DOI: 10.1136/thx.2008.100974] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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29
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Rorman E, Zamir CS, Rilkis I, Ben-David H. Congenital toxoplasmosis—prenatal aspects of Toxoplasma gondii infection. Reprod Toxicol 2006; 21:458-72. [PMID: 16311017 DOI: 10.1016/j.reprotox.2005.10.006] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Revised: 10/11/2005] [Accepted: 10/24/2005] [Indexed: 11/25/2022]
Abstract
Toxoplasma gondii (T. gondii) is the cause of toxoplasmosis. Primary infection in an immunocompetent person is usually asymptomatic. Serological surveys demonstrate that world-wide exposure to T. gondii is high (30% in US and 50-80% in Europe). Vertical transmission from a recently infected pregnant woman to her fetus may lead to congenital toxoplasmosis. The risk of such transmission increases as primary maternal infection occurs later in pregnancy. However, consequences for the fetus are more severe with transmission closer to conception. The timing of maternal primary infection is, therefore, critically linked to the clinical manifestations of the infection. Fetal infection may result in natural abortion. Often, no apparent symptoms are observed at birth and complications develop only later in life. The laboratory methods of assessing fetal risk of T. gondii infection are serology and direct tests. Screening programs for women at childbearing age or of the newborn, as well as education of the public regarding infection prevention, proved to be cost-effective and reduce the rate of infection. The impact of antiparasytic therapy on vertical transmission from mother to fetus is still controversial. However, specific therapy is recommended to be initiated as soon as infection is diagnosed.
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Affiliation(s)
- Efrat Rorman
- National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel.
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30
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Braun E, Rorman E, Lueders KK, Bar-Sinai A, Hochman J. Differential expression of intracisternal A-particle transcripts in immunogenic versus tumorigenic S49 murine lymphoma cells. Virology 2000; 277:136-46. [PMID: 11062044 DOI: 10.1006/viro.2000.0568] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Tumorigenic S49 mouse lymphoma cells (T-25) were compared to their nontumorigenic (immunogenic) substrate-adherent descendants (T-25-Adh), using the differential display technique. A 784-bp fragment with 92% sequence homology to the intracisternal A-particle (IAP) element family was isolated from the latter cells. IAP sequences are endogenous, noninfectious retroviral elements that can undergo transpositions and act as mutagens. Expression of IAP transcripts (as detected by the isolated fragment) was 5- to 10-fold higher in T-25-Adh cells than in T-25 cells. IAP RT-PCR cDNA clones derived from the immunogenic T-25-Adh cells, but not from T-25 cells, contain two distinctive motifs: (i) a motif characteristic of IAP elements expressed in lymphoid cells (lymphocyte specific, LS); (ii) a nonapeptide sequence known to stimulate cytotoxic T lymphocytes in a leukemia cell line expressing IAP sequences. In addition, expression of transcripts containing these motifs is enhanced in the immunogenic cells as opposed to the tumorigenic cells. Furthermore, one of the IAP elements (belonging to the LS1 subfamily) is specifically hypomethylated in the DNA of the immunogenic cells. The above-mentioned relationship was strengthened when tumorigenic revertants derived from T-25-Adh cells, as well as independently selected tumorigenic and immunogenic S49 sublines, were studied. In all cases, enhanced immunogenicity was linked to the up-regulation of specific IAP elements. No transpositions of LS1 elements were observed among the different sublines studied. These findings suggest that, in the S49 lymphoma, selectively expressed IAP retroviral elements may function in a tumor suppressive capacity by affecting the immunogenic potential of these cells.
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MESH Headings
- Amino Acid Sequence
- Animals
- Base Sequence
- Cell Adhesion
- DNA, Complementary
- Gene Products, gag/chemistry
- Gene Products, gag/genetics
- Genes, Intracisternal A-Particle
- Genes, gag
- Lymphoma/genetics
- Lymphoma/virology
- Mice
- Molecular Sequence Data
- RNA, Messenger/genetics
- Sequence Alignment
- Sequence Homology, Amino Acid
- Sequence Homology, Nucleic Acid
- Transcription, Genetic
- Tumor Cells, Cultured
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Affiliation(s)
- E Braun
- Department of Cell and Animal Biology, The Hebrew University of Jerusalem, Jerusalem, 91904, Israel
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31
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Abstract
To characterize novel proteins expressed in lymphoma cells, monoclonal antibodies (MAbs) were raised against variant S49 mouse lymphoma cells. Immunoperoxidase analysis with a specific MAb, named M-66, revealed nuclear localization with prominent staining in the nucleoli of both tumorigenic (T-63) cells and nontumorigenic, immunogenic (T-25-Adh) cells. Weak signals were also observed in the cytoplasm and plasma membrane of both cells. Western blot analysis with M-66 antibody revealed a 14-kDa protein in nuclear extracts of both T-25-Adh and T-63 cells. An additional nuclear 21-kDa protein was evident only in T-63 cells. M-66 identified several clones from a T-25-Adh cDNA expression library. These clones demonstrated extensive homology (approximately 95% identity throughout their length) to the mouse mammary tumor virus (MMTV) env and LTR regions. Extensive amino acid sequence homology (approximately 90% identity) between the clones and the env protein was observed. M-66 identified the 14-kDa protein in another MMTV bearing T-cell lymphoma, EL-4. Immunoperoxidase analysis of EL-4 cells with M-66 also revealed prominent nucleolar staining. MMTV-negative cells and MMTV-positive cells of nonlymphocytic origin were devoid of both 14- and 21-kDa proteins. Moreover, an anti-MMTV gp52 (env) antibody precipitated the 21-kDa protein in T-63 cells. We thus suggest that MMTV bearing T-cell lymphomas express nucleolar proteins translated from the env region of MMTV.
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MESH Headings
- Amino Acid Sequence
- Animals
- Antibodies, Monoclonal
- Antigens, Viral, Tumor/metabolism
- Blotting, Western
- Cell Membrane/metabolism
- Cell Nucleolus/metabolism
- Cell Nucleolus/virology
- Cytoplasm/metabolism
- DNA, Neoplasm/analysis
- Gene Library
- Immunoenzyme Techniques
- Lymphoma, T-Cell/metabolism
- Lymphoma, T-Cell/ultrastructure
- Lymphoma, T-Cell/virology
- Mammary Tumor Virus, Mouse/metabolism
- Mice
- Mice, Inbred C57BL
- Microscopy, Immunoelectron
- Molecular Sequence Data
- Nuclear Proteins/metabolism
- Precipitin Tests
- Protein Biosynthesis
- Sequence Homology, Amino Acid
- Transcription, Genetic
- Tumor Cells, Cultured
- Viral Envelope Proteins/genetics
- Viral Envelope Proteins/metabolism
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Affiliation(s)
- H Hoch-Marchaim
- Department of Cell and Animal Biology, Hebrew University of Jerusalem, Israel
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