A comparison of two mathematical models of the impact of mass drug administration on the transmission and control of schistosomiasis

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This paper compares two mathematical models describing the transmission dynamics of schistosome infection and the impact of mass drug administration.

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The models differ structurally in a number of ways, including the dynamics of the intermediate snail host and the treatment of adult worms within the human host.

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The models are validated against data taken from a mass-drug administration trial in Mozambique.

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The differences between the model predictions and the data are discussed in the context of the structural differences between the models.

The predictions of two mathematical models describing the transmission dynamics of schistosome infection and the impact of mass drug administration are compared. The models differ in their description of the dynamics of the parasites within the host population and in their representation of the stages of the parasite lifecycle outside of the host. Key parameters are estimated from data collected in northern Mozambique from 2011 to 2015. This type of data set is valuable for model validation as treatment prior to the study was minimal. Predictions from both models are compared with each other and with epidemiological observations. Both models have difficulty matching both the intensity and prevalence of disease in the datasets and are only partially successful at predicting the impact of treatment. The models also differ from each other in their predictions, both quantitatively and qualitatively, of the long-term impact of 10 years’ school-based mass drug administration. We trace the dynamical differences back to basic assumptions about worm aggregation, force of infection and the dynamics of the parasite in the snail population in the two models and suggest data which could discriminate between them. We also discuss limitations with the datasets used and ways in which data collection could be improved.

THE DECADE OF THE RABiT (2005-15)

The RABiT (Rapid Automated Biodosimetry Tool) is a dedicated Robotic platform for the automation of cytogenetics-based biodosimetry assays. The RABiT was developed to fulfill the critical requirement for triage following a mass radiological or nuclear event. Starting from well-characterized and accepted assays we developed a custom robotic platform to automate them. We present here a brief historical overview of the RABiT program at Columbia University from its inception in 2005 until the RABiT was dismantled at the end of 2015. The main focus of this paper is to demonstrate how the biological assays drove development of the custom robotic systems and in turn new advances in commercial robotic platforms inspired small modifications in the assays to allow replacing customized robotics with 'off the shelf' systems. Currently, a second-generation, RABiT II, system at Columbia University, consisting of a PerkinElmer cell::explorer, was programmed to perform the RABiT assays and is undergoing testing and optimization studies.

Soil-Transmitted Helminths: Mathematical Models of Transmission, the Impact of Mass Drug Administration and Transmission Elimination Criteria

Infections caused by soil-transmitted helminthias (STHs) affect over a billion people worldwide, causing anaemia and having a large social and economic impact through poor educational outcomes. They are identified in the World Health Organization (WHO) 2020 goals for neglected tropical diseases as a target for renewed effort to ameliorate their global public health burden through mass drug administration (MDA) and water and hygiene improvement. In this chapter, we review the underlying biology and epidemiology of the three causative intestinal nematode species that are mostly considered under the STH umbrella term. We review efforts to model the transmission cycle of these helminths in populations and the effects of preventative chemotherapy on their control and elimination. Recent modelling shows that the different epidemiological characteristics of the parasitic nematode species that make up the STH group can lead to quite distinct responses to any given form of MDA. When connected with models of treatment cost-effectiveness, these models are potentially a powerful tool for informing public policy. A number of shortcomings are identified; lack of critical types of data and poor understanding of diagnostic sensitivities hamper efforts to test and hence improve models.

The Role of More Sensitive Helminth Diagnostics in Mass Drug Administration Campaigns: Elimination and Health Impacts

Diagnostics play a crucial role in determining treatment protocols and evaluating success of mass drug administration (MDA) programmes used to control soil-transmitted helminths (STHs). The current diagnostic, Kato-Katz, relies on inexpensive, reusable materials and can be used in the field, but only trained microscopists can read slides. This diagnostic always underestimates the true prevalence of infection, and the accuracy worsens as the true prevalence falls. We investigate how more sensitive diagnostics would impact on the management and life cycle of MDA programmes, including number of mass treatment rounds, health impact, number of unnecessary treatments and probability of elimination. We use an individual-based model of STH transmission within the current World Health Organization (WHO) treatment guidelines which records individual disability-adjusted life years (DALY) lost. We focus on Ascaris lumbricoides due to the availability of high-quality data on existing diagnostics. We show that the effect of improving the sensitivity of diagnostics is principally determined by the precontrol prevalence in the community. Communities at low true prevalence (<30%) and high true prevalence (>70%) do not benefit greatly from improved diagnostics. Communities with intermediate prevalence benefit greatly from increased chemotherapy application, both in terms of reduced DALY loss and increased probability of elimination. Our results suggest that programmes should be extended beyond school-age children, especially in high prevalence communities. Finally, we argue against using apparent or measured prevalence as an uncorrected proxy for true prevalence.

Studies of the Transmission Dynamics, Mathematical Model Development and the Control of Schistosome Parasites by Mass Drug Administration in Human Communities

Schistosomiasis is global in extent within developing countries, but more than 90% of the at-risk population lives in sub-Saharan Africa. In total, 261 million people are estimated to require preventive treatment. However, with increasing drug availability through donation, the World Health Organization has set a goal of increasing coverage to 75% of at-risk children in endemic countries and elimination in some regions. In this chapter, we discuss key biological and epidemiological processes involved in the schistosome transmission cycle and review the history of modelling schistosomiasis and the impact of mass drug administration, including both deterministic and stochastic approaches. In particular, we look at the potential impact of the WHO 2020 schistosomiasis treatment goals.

What impact will the achievement of the current World Health Organisation targets for anthelmintic treatment coverage in children have on the intensity of soil transmitted helminth infections?

BACKGROUND

It is the aim of the World Health Organisation to eliminate soil-transmitted helminths (STH) as a health problem in children. To this end, the goal is to increase anthelmintic treatment coverage for soil transmitted helminths to reach 75 % in pre-school aged and school aged children by 2020 in endemic countries. In this paper, we use mathematical models to investigate the impact of achieving this goal on the burdens of Ascaris lumbricoides, Trichuris trichuria and hookworm.

METHODS

We employ a deterministic fully age-structured model of STH transmission and mass drug administration to examine the changes in worm burden in response to the known and projected coverage trends in children up to 2020 and beyond. Parameters are estimated from worm expulsion data and age intensity profiles before treatment using maximum likelihood methods. Model validation is performed using reinfection studies for Ascaris and analyses are conducted to assess the sensitivity of the predicted outcomes to variation in parameter estimates including transmission intensity (R0), children's contributions to the pool of infective stages and drug coverage levels.

RESULTS

The impact of the required increase in coverage trends are quite different across the three species. Ascaris burdens are reduced dramatically by 2020 with elimination predicted within studied the setting a further 10 years. For Trichuris and hookworm, however, impact is more limited, due to issues of drug efficacy (Trichuris) and distribution of worms in the population (hookworm). Sensitivity analysis indicates that results are largely robust. However, validation against Ascaris data indicates that assumptions concerning re-infection among children may have to be revised.

CONCLUSIONS

The 2020 coverage target is predicted to have a major impact on Ascaris levels by 2020. However, there is evidence from model validation that Ascaris in children is more resilient to treatment than currently assumed in the model. Broader coverage across all age classes is required to break transmission for hookworm and alternative dual drug treatment approaches are needed for Trichuris.

What is required in terms of mass drug administration to interrupt the transmission of schistosome parasites in regions of endemic infection?

BACKGROUND

Schistosomiasis is endemic in 54 countries, but has one of the lowest coverages by mass drug administration of all helminth diseases. However, with increasing drug availability through donation, the World Health Organisation has set a goal of increasing coverage to 75 % of at-risk children in endemic countries and elimination in some regions. In this paper, we assess the impact on schistosomiasis of the WHO goals in terms of control and elimination.

METHODS

We use an age-structured deterministic model of schistosome transmission in a human community and the effect of mass drug administration. The model is fitted to baseline data from a longitudinal re-infection study in Kenya and validated against the subsequent re-infection data. We examine the impact on host worm burden of the current treatment trend, extrapolated to meet the WHO goals, and its sensitivity to uncertainty in important parameters. We assess the feasibility of achieving elimination.

RESULTS

Model results show that the current treatment trend, extrapolated to the WHO goals, is able to greatly reduce host worm burdens. If coverage is continued at the same level beyond 2020, elimination is possible for low to moderate transmission settings, where transmission intensity is defined by the basic reproduction number, R0. Low levels of adult coverage have a significant impact on worm burden in all settings. Model validation against the re-infection survey demonstrates that the age-structured model is able to match post-treatment data well in terms of egg output, but that some details of re-infection among school children and young adults are not currently well represented.

CONCLUSIONS

Our work suggests that the current WHO treatment goals should be successful in bringing about a major reduction in schistosome infection in treated communities. If continued over a 15 year period, they are likely to result in elimination, at least in areas with lower transmission.

Effect of dose rate on residual γ-H2AX levels and frequency of micronuclei in X-irradiated mouse lymphocytes

The biological risks associated with low-dose-rate (LDR) radiation exposures are not yet well defined. To assess the risk related to DNA damage, we compared the yields of two established biodosimetry end points, γ-H2AX and micronuclei (MNi), in peripheral mouse blood lymphocytes after prolonged in vivo exposure to LDR X rays (0.31 cGy/min) vs. acute high-dose-rate (HDR) exposure (1.03 Gy/min). C57BL/6 mice were total-body irradiated with 320 kVP X rays with doses of 0, 1.1, 2.2 and 4.45 Gy. Residual levels of total γ-H2AX fluorescence in lymphocytes isolated 24 h after the start of irradiation were assessed using indirect immunofluorescence methods. The terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was used to determine apoptotic cell frequency in lymphocytes sampled at 24 h. Curve fitting analysis suggested that the dose response for γ-H2AX yields after acute exposures could be described by a linear dependence. In contrast, a linear-quadratic dose-response shape was more appropriate for LDR exposure (perhaps reflecting differences in repair time after different LDR doses). Dose-rate sparing effects (P < 0.05) were observed at doses ≤2.2 Gy, such that the acute dose γ-H2AX and TUNEL-positive cell yields were significantly larger than the equivalent LDR yields. At the 4.45 Gy dose there was no difference in γ-H2AX expression between the two dose rates, whereas there was a two- to threefold increase in apoptosis in the LDR samples compared to the equivalent 4.45 Gy acute dose. Micronuclei yields were measured at 24 h and 7 days using the in vitro cytokinesis-blocked micronucleus (CBMN) assay. The results showed that MNi yields increased up to 2.2 Gy with no further increase at 4.45 Gy and with no detectable dose-rate effect across the dose range 24 h or 7 days post exposure. In conclusion, the γ-H2AX biomarker showed higher sensitivity to measure dose-rate effects after low-dose LDR X rays compared to MNi formation; however, confounding factors such as variable repair times post exposure, increased cell killing and cell cycle block likely contributed to the yields of MNi with accumulating doses of ionizing radiation.

A method for measuring vertical forces applied to the upper limb during sit-to-stand

The aim of this study was to develop a basic measurement system to estimate the vertical loading of the upper limb during the sit-to-stand activity, with a view to increasing the understanding of the loading of the wrist in daily living activities. A chair was adapted and instrumented with strain gauges and position sensors so that the force applied through the upper limbs to the arms of the chair could be calculated. Four aspects of the chair's geometry could be varied. A force plate was positioned on the floor between the legs of the chair to record the corresponding foot loading. Twenty normal subjects (22-56 years, mean 32.7 years) participated in a pilot study in which loading through the upper and lower limbs was recorded for a range of chair geometries. The vertical force transmitted through each upper limb was typically 20-30 per cent of bodyweight. The vertical upper limb load averaged across all subjects showed a small reduction when either the seat height or the height of the chair arms was increased.

Localization of a Na(+)-K(+)-2Cl(-) cotransporter in the rabbit lens

Earlier work from this laboratory demonstrated a bumetanide-inhibitable K(+) uptake activity in cultured bovine lens epithelial cells, but not at the anterior surfaces of intact bovine lenses isolated in an Ussing-type chamber. Presently the distribution of the bumetanide-sensitive Na(+)-K(+)-2Cl(-) cotransporter within the lens was re-examined. To complement previous results, (86)Rb(+) uptake experiments were done in a chamber design that limited exposure of the radiolabel to specific surfaces of rabbit lenses under short-circuit conditions. In addition, the cotransporter protein (NKCC1, but not NKCC2) was immune-detected in Western blots. For the latter, membrane preparations were obtained from capsule-plus-epithelial specimens, and from three cortical fractions, i.e. the anterior, equatorial, and posterior regions, as well as a fifth, nuclear fraction. K(+) influxes across the anterior-polar, equatorial, and posterior-polar surfaces were 0.375, 0.348 and 0.056 microEq (hr cm(2))(-1) respectively, rates that were not significantly reduced by the presence of 0.1 mM bumetanide (P > 0.15, as unpaired data). In contrast, bumetanide-sensitive K(+) influx rates were measured across the anterior and equatorial surfaces under hypertonic, but not under hypo-osmotic conditions. In culture, bumetanide and ouabain were equipotent in reducing by approximately half the K(+) uptake of quiescent, rabbit lens epithelial cells under control, iso-osmotic conditions, indicating a cell-culture induced up-regulation of the cotransport activity by an undetermined mechanism. The immunoblotting of lens membrane proteins elicited approximately 170-180 kDa bands accordant with the identity of the NKCC1 isoform in the epithelial and cortical equatorial fractions. Thus, NKCC1 was readily demonstrated using membrane specimens taken from within the lens. Its activity in the intact organ may be activated by conditions fostering cell shrinkage, and perhaps, agents stimulating epithelial cell elongation, given its distribution within the lens.

Identification and localization of acid-base transporters in the conjunctival epithelium

Acid-base transporters of rabbit and porcine conjunctival epithelia were identified and localized with immunoblotting and immunohistochemical techniques using specific antibodies against carriers commonly found in epithelia, i.e. the Cl(-)/HCO3(-)exchanger (AE2), Na(+)/H(+) exchanger (NHE-1, -2, -3) and the electrogenic Na(+)-(n)HCO3(-) cotransporter (NBC). Western blot analysis demonstrated that anti-AE2 reacted with an approximate 170 kDa protein in both rabbit and pig cell membranes prepared from separately isolated bulbar and palpebral conjunctivae. NHE1 was similarly identified in these distinct conjunctival regions but results with anti-NBC were ambiguous. Histochemical examinations indicated that the AE2 and NHE1 proteins reside on the basolateral surfaces of the plasma membrane throughout the multilayered tissue. The immunostaining of porcine cryosections for AE2 and rabbit sections for NHE1 was specific, because of its abolishment following either pre-absorption with the corresponding peptide or omission of the primary antibody. Screening with anti-NBC produced weak staining of the sections that appeared to be non-specific. For confirmation of these results, the acid-base transporters present in rabbit cell cultures of conjunctival epithelia were ascertained from the changes in intracellular pH (pH(i)) evoked upon sequential superfusion with media of altered composition. This approach readily obtained Na(+)- and Cl(-)-dependent pH(i)effects consistent with the existence of Cl(-)/HCO3(-) and Na(+)/H(+)exchange activities. Evidence for the presence of NBC could not be acquired, thereby substantiating the observations from the immunodetection techniques. The identity and location of the antiporters that were found suggested that these elements could contribute to transcellular Cl(-)transport in the basolateral-to-apical direction. To test this possibility, the effects of AE and/or NHE inhibition were determined on the bumetanide-insensitive Cl(-)-dependent short-circuit current across rabbit conjunctivae freshly isolated in Ussing-type chambers. These experiments revealed that such current is indeed sustained by the antiporters. Results with acetazolamide further suggested that the contribution of the acid-base transporters towards transepithelial Cl(-)secretion is variable and dependent upon individual rates of metabolic CO(2)production. Overall, the present study provides an initial identification of the acid-base transporters present in the conjunctiva. Besides their likely role in intracellular pH regulation, the parallel, basolateral expression of AE2 and NHE1 indicates that these elements do not directly contribute to the pH of the tear film but may complement the Na(+)-2Cl(-)-K(+)cotransporter in effectuating Cl(-)secretion.

Serotonin-elicited inhibition of Cl(-) secretion in the rabbit conjunctival epithelium

The effects of serotonin [5-hydroxytryptamine (5-HT)] on the transepithelial electrical properties of the short-circuited rabbit conjunctiva were examined. With this epithelium, the short-circuit current (I(sc)) measures Cl(-) secretion plus an amiloride-resistant Na(+) absorptive process. Apical addition of 5-HT (10 microM) elicited a prompt I(sc) reduction from 14.2 +/- 1.2 to 10.9 +/- 1.2 microA/cm(2) and increased transepithelial resistance from 0.89 +/- 0.05 to 1.03 +/- 0.06 kOmega. cm(2) (means +/- SE, n = 21, P<0.05). Similar changes were obtained with conjunctivae bathed without Na(+) in the apical bath, as well as with conjunctivae preexposed to bumetanide with the Cl(-)-dependent I(sc) sustained by the parallel activities of basolateral Na(+)/H(+) and Cl(-)/HCO(3)(-) exchangers. In contrast, the 5-HT-evoked effects were attenuated by the absence of Cl(-) (DeltaI(sc) = -0.5 +/- 0.2, n = 5), suggesting that reduced Cl(-) conductance(s) is an effect of 5-HT exposure. In amphotericin B-treated conjunctiva and in the presence of a transepithelial K(+) gradient, 5-HT addition reduced K(+) diffusion across the preparation by 13% and increased transepithelial resistance by 4% (n = 6, P < 0.05), indicating that an inhibition in K(+) conductance(s) was also detectable. Significant electrical responses also occurred under physiological conditions when 5-HT was introduced to epithelia pretreated with adrenergic agonists or protein kinase C, phospholipase C, phosphodiesterase, or adenylyl cyclase inhibitors or after perturbation of Ca(2+) homeostasis. Briefly, the conjunctiva harbors the only known Cl(-)-secreting epithelium in which 5-HT evokes Cl(-) transport inhibition; receptor subtype and signal transduction mechanism were not determined.

Immunolocalization of Na-K-ATPase, Na-K-Cl and Na-glucose cotransporters in the conjunctival epithelium

PURPOSE

To investigate possible regional expression of transport systems in the conjunctival epithelium given distinct differences in morphological appearance between the bulbar and palpebral epithelia as well as variations found in the proportions of Na absorptive versus Cl secretory activities in electrophysiological studies.

METHODS

Mouse monoclonal antibodies against the alpha1-subunit of Na-K-ATPase and Na-K-Cl cotransporter (NKCC1) and a rabbit polyclonal antibody against the Na-glucose cotransporter (SGLT1) were used in immunoblotting and immunofluorescent labeling of frozen fixed sections isolated from either the bulbar and palpebral regions of the conjunctiva.

RESULTS

Western blot analysis clearly demonstrated the presence of Na-K-ATPase, NKCC1 and SGLT1 proteins in both bulbar and palpebral conjunctiva. Indirect immunofluorescence studies on bulbar and palpebral conjunctival portions revealed intense staining by the anti-NKCC1 and anti-alpha1-Na-K-ATPase antibodies exclusively at the basolateral surfaces, whereas the anti-SGLT1 antibody was used with porcine conjunctiva to elicit strong and unambiguous staining along the apical plasma membrane.

CONCLUSIONS

Proteins that mediate the transport activities of the Na-K-ATPase and Na-K-Cl cotransporter are uniformly distributed throughout the palpebral and bulbar regions of the rabbit conjunctival epithelium. Although the Na-glucose cotransporter could be detected in immunoblots of the rabbit, this cotransporter appears to be uniformly distributed as well, based upon immunohistochemical sections of the pig conjunctiva. Thus, it appears likely that mechanisms for Cl secretion and Na absorption reside in both bulbar and palpebral segments of the conjunctival epithelium.

Modulation of corneal endothelial hydration control mechanisms by Rolipram

Corneal stromal hydration is maintained by an active HCO3- transport mechanism located in the corneal endothelium. Whilst modulation of transport activity by changes in intracellular cAMP concentration have been noted, the site of effect is undefined. To resolve this question, the effects of Rolipram, a cAMP phosphodiesterase inhibitor, on endothelial physiology were determined. Addition of 0.1 mM Rolipram caused a threefold increase in intracellular cAMP with no change in cGMP. Associated with the increase in cAMP was a transient whole corneal thinning and a similarly transient increase in trans-endothelial potential difference, short-circuit current and resistance. The membrane potential hyperpolarized and the intracellular Na+ concentration decreased. The decreased intracellular Na+ was associated with an increased rate of Na+ extrusion between the endothelial cell and extracellular space. It is concluded that Rolipram increases the concentration of cAMP which activates the basolateral membrane Na+/K+-ATPase activity and increases net HCO3- transport. In addition there is a reduction in endothelial permeability which combined with the increase in pump activity may jointly explain the observed stromal thinning. The duplicity of responses indicates that if cAMP has a physiological role in regulating corneal hydration then it may operate on both the endothelial pump and the endothelial permeability.

Cyclic AMP-dependent stimulation of basolateral K(+)conductance in the rabbit conjunctival epithelium

The regulation of Na(+)transport by cAMP in freshly isolated rabbit conjunctival epithelium, a tissue exhibiting both Cl(-)secretion and Na(+)absorption, was examined. Bulbar-palpebral segments of conjunctiva were mounted between Ussing-type hemichambers under short-circuit conditions in Cl(-)free media. In this situation, the short-circuit current (I(sc)) measures an amiloride-resistant Na(+)absorptive process in the apical-to-basolateral direction. Apical additions (each at 10 microm) of cAMP-elevating compounds, forskolin, rolipram, IBMX and epinephrine all stimulated the Na(+)-dependent I(sc)by approximately 3.5-4.5 microA cm(-2)(minimal 40% increase) and reduced transepithelial resistance (R(t)) by at least 7% (P<0.05). Pre-exposure (1 hr) to the protein kinase A (PKA) inhibitor H-89 (10 microm), which in itself inhibited the I(sc)by 0. 5 microA cm(-2), attenuated the I(sc)responses of the cAMP-elevating agents (P< 0.05, unpaired data). In reverse, H-89 promptly decreased the I(sc)by 1.5-2.5 microA cm(-2)and increased R(t)by 5% (P<0.05) in tissues pre-stimulated with either forskolin or an epinephrine plus IBMX combination. Additions of epinephrine or rolipram to apically permeabilized preparations using amphotericin B, increased the I(sc)by 12 and 22% respectively over baseline and reduced R(t)by 6% (P<0.05). Similarly, in the presence of a transepithelial K(+)gradient (apical to basolateral) and amphotericin B, cAMP elevation stimulated K diffusion across the preparation by at least 1.8 microA cm(-2)and decreased the R(t)by 4% (P<0.05), changes that were reversed by subsequent H-89 addition. Under Cl(-)rich conditions, pretreatment with 5 m m Ba(2+)reduced the basal I(sc)by 59% and blocked the cAMP-induced I(sc)stimulations typically seen in the presence of the anion. The results provide evidence for a PKA-regulated, Ba(2+)-inhibitable (voltage insensitive) basolateral K(+)conductance in rabbit conjunctival epithelial cells. The action of Cl(-)secretogogues acting via cAMP on basolateral K(+)channel activity indicates that endogenous levels of cAMP may play a role in the regulation of Cl(-)secretion and Na(+)absorption in the conjunctiva.

Phorbol ester modulation of active ion transport across the rabbit conjunctival epithelium

Protein kinase C (PKC) activation elicits diverse cell-type specific effects on key epithelial transporters. The present work examined the influence of phorbol esters, which are known activators of PKC isoenzymes, on the short-circuit current (Isc), a direct measure of net transcellular electrolyte transport, of the rabbit conjunctiva. In this preparation, the Iscmeasures a Na+-dependent, bumetanide-inhibitable Cl-transport in the basolateral-to-apical direction plus an amiloride-resistant Na+absorptive process in the opposite direction. Additions of phorbol 12-myristate-13-acetate (PMA) to the basolateral bathing media did not affect the transepithelial electrical parameters; but its introduction to the apical bath at 1 and 10 micrometers elicited a transient ( approximately 2 min duration) Iscspike followed by a sustained reduction relative to the control level. Such PMA-elicited Iscreductions were from 14. 0+/-2.0 to 3.1+/-0.8 microA cm-2(+/-s.e.m.'s, n =3) at 1 micrometer and from 16.5+/-1.9 to 4.6+/-0.7 microA cm-2(n =22) at 10 micrometers. The former concentration failed to produce extensive Iscreductions in 3 other experiments. Similar results were obtained with phorbol 12, 13-dibutyrate (PDBu). Its apical administration at 0.1 micrometer reduced the Iscfrom 18.5+/-4.1 to 7.8+/-2.0 (n =3), and from 16. 5+/-2.9 to 6.9+/-1.2 (n =7) when introduced at 1 micrometer. The phorbol-evoked Iscreductions occurred without a simultaneous change in transepithelial resistance (Rt). However, after about 15-20 min, Rtgradually declined by about 25%. In contrast to these results, treatment with a phorbol ester known not to activate PKC (4-alpha-PMA) did not affect the electrical parameters when added at 10 micrometers. PMA- and PDBu-evoked Iscreductions could be obtained with conjunctiva that were (1) pretreated with bumetanide, (2) bathed in Cl--free media, and (3) pretreated with amphotericin B, changes consistent with a likely inhibition of the basolateral Na+/K+pump. Such Iscinhibitions were attenuated with conjunctiva pre-exposed to 1 micrometer staurosporine, a nonselective kinase inhibitor known to suppress PKC activity. Staurosporine, in itself, produced a rapid 26% Iscinhibition (n =15) along with a 17% Rtincrease upon its apical introduction. These electrical responses were less extensive in Cl--free media and absent in amphotericin B-treated conjunctiva, suggesting the presence of a kinase-mediated regulation of apical channels for both Na+and Cl-. Overall, these results imply that in addition to previously demonstrated epinephrine-elicited, up-regulation of Cl-secretion, mechanisms may also exist, via PKC activation, to suppress Na+/K+pumping and consequently reduce transepithelial transport rates.

A PCR-based method to distinguish fungi of the rice sheath-blight complex, Rhizoctonia solani, R. oryzae and R. oryzae-sativae

Identification of Rhizoctonia solani, R. oryzae and R. oryzae-sativae, components of the rice sheath disease complex, is extremely difficult and often inaccurate and as a result may hinder the success of extensive breeding programmes throughout Asia. In this study, primers designed from unique regions within the rDNA internal transcribed spacers have been used to develop a rapid PCR-based diagnostic test to provide an accurate identification of the species on rice. Tests on the specificity of the primers concerned showed that they provide the means for accurate identification of the Rhizoctonia species responsible for sheath diseases in rice.

Two pathways for electrogenic bicarbonate ion movement across the rabbit corneal endothelium

Amiloride (0.5 mM) inhibited the rate of entry of Na+ into corneal endothelial cells by more than half ((0.76 +/- 0.10) to (0.21 +/- 0.10) microEq cm(-2)h(-1)). The same concentration of amiloride caused only minimal disturbance to corneal hydration control by the endothelium (range 0-12%). Amiloride (0.5 mM) and acetazolamide (1 mM) reversibly inhibited trans-endothelial short circuit current by about a half. Their combined effect was not additive. Acetazolamide (1 mM) reduced net HCO3- flux across the short-circuited endothelium by about the same amount ((0.50 +/- 0.11) microEq cm(-2)h(-1)) that amiloride (0.5 mM) reduced Na+ entry into the cells ((0.55 +/- 0.14) microEq cm(-2)h(-1)). Low concentrations of amiloride (10 microM) had little effect on the transport characteristics of the endothelium, indicating that Na+ entry into the endothelial cells under physiological conditions is not primarily through Na+ channels. The data are consistent with an Na+/H+ exchanger acting in tandem with carbonic anhydrase through a pathway which could have a regulatory role on endothelial transport via its effect on Na+ re-entry. Residual trans-endothelial HCO3- transport, apparently unaffected by amiloride or acetazolamide inhibition, is calculated to be of sufficient magnitude to maintain corneal hydration.

Optometry and the military

This article comments on several of the major issues facing military optometry which were aired earlier this year at the AOA Federal Service Optometry Seminar. Among these issues, all of which influence recruitment and retention of optometry officers, are constructive credit, bonus and incentive pay, promotion policies, and optimum scope of care. Dr. Turner emphasizes that solutions to these problem areas depend not only upon AOA actions but also personal efforts and professionalism of military OD's.

Group-specific antigen expression during embryogenesis of the genome of the C-type RNA tumor virus: implications for ontogenesis and oncogenesis

Tests for the group-specific antigen of the C-type RNA tumor virus showed that mouse embryos of all strains tested, at some stage of development in utero, revealed detectable titers of group-specific antigen in one or more of their tissues; younger, rather than older, embryos were likely to be positive, particularly in those strains which normally reveal little or no expression of the RNA genome postnatally. The antigens were found in embryos of low-leukemia strains, free of infectious virus. These new findings support a previously stated hypothesis that the genome of RNA tumor viruses, mostly switched off for infectious virus expression, is vertically transmitted as part of the natural genetic apparatus of normal mouse cells. Since group-specific antigens have also been described in chick embryos and immunological tolerance to homologous group-specific antigens has been demonstrated in hamsters and cats as well as in mice and chickens, the hypothesis has been extended to include vertebrate cells in general. Finally, the high incidence and titers of the group-specific antigen suggest that the genes for RNA tumor virus, which later in life act as determinants of cancer, may be important also as gene determinants in the developing embryo.

Seroepidemiologic studies of coronavirus infection in adults and children

McIntosh, K. A. Z. Kapikian, H. C Turner, J. W. Hartley, R. H. Parrott and R. M. Chanock. (Lab. of Infectious Diseases, NIAID, NIH, Bethesda, Md. 20014) Sero-epidemiologic studies of coronavirus infection in adults and children. Amer. J. Epid., 1970, 97: 585–592-A seroepidemiologic study of infection by coronavirus strains 229E, OC38, OC43, and mouse hepatitis virus (MHV) strain A-59, is described. In adults with upper respiratory disease, two “outbreaks” of coronavirus infection occurred, one during the winter of 1965–1966 associated with complement fixing (CF) antibody responses to OC38, OC43 and MHV, and the other during the following winter associated with CF antibody responses to 229E. In hospitalized children, infection with 229E was rare; infection with OC38, OC43, and MHV occurred less often in hospitalized children with lower respiratory tract disease (3.5%) than in a control group with non-respiratory tract disease (8.2%). The limitations of the CF test using available coronavirus antigens are discussed.

Mouse leukemia virus activation by chemical carcinogens

The induction of lymphomas in C57BL mice by methylcholanthrene, urethan, or diethylnitrosamine was accompanied by the development of murine leukemia viral antigen in most of the lymphoid tumors. The cell-free transmission of lymphomas induced by methylcholanthrene and the development of antibody to murine leukemia virus prior to the detection of overt lymphoma in these mice suggest that unmasking of a latent leukemia virus is an indigenous actuating cause of the lymphomas.

Complement-fixing antigens in hamster tumors induced by the Bryan strain of Rous sarcoma virus

Hamster tumors transplanted subcutaneously from primary intracranial tumors which developed after inoculation of the Bryan strain of Rous sarcoma virus, contained virusspecific tumor antigens indistinguishable from those induced by the Schmidt-Ruppin strain.