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Boemer F, Caberg JH, Dideberg V, Beckers P, Marie S, Marcelis L, Bours V, Dangouloff T, Servais L. [(S)un (M)ay (A)rise on SMA : the hope of a region without spinal muscular atrophy]. Rev Med Liege 2019; 74:461-464. [PMID: 31486315] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The treatment of spinal muscular atrophy (SMA) has considerably changed over the last 3 years. Several approaches that aim to increase the deficient SMN protein have demonstrated an efficacy that is inversely correlated with disease duration. In this context, newborn screening (NBS) is increasingly considered as the next step in several countries or regions. In 2018, we initiated a pilot study for NBS of SMA in French- and German-speaking Belgium. We aim to evaluate the feasibility, the efficacy, and the cost-effectiveness of such a program. Initially covering the region of Liege, the program was recently extended to the whole Southern Belgium and currently covers about 55.000 newborns per year. On June 1st 2019, 35.000 newborns had been screened and 5 affected babies were identified and referred to neuromuscular centers for early treatment. A full evaluation of the program will take place after three years to consider the inclusion of SMA screening in the publically-funded NBS program in Southern Belgium.
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Affiliation(s)
- F Boemer
- Service de Génétique Humaine, CHU Liège, Belgique
| | - J H Caberg
- Service de Génétique Humaine, CHU Liège, Belgique
| | - V Dideberg
- Service de Génétique Humaine, CHU Liège, Belgique
| | - P Beckers
- Service de Génétique Humaine, CHU Liège, Belgique
| | - S Marie
- Laboratoire de Maladies Métaboliques et Centre de Dépistage Néonatal, Cliniques Universitaires Saint-Luc, Bruxelles, Belgique
| | - L Marcelis
- Laboratoire de Pédiatrie, Centre de Dépistage Néonatal, Université Libre de Bruxelles, Bruxelles, Belgique
| | - V Bours
- Service de Génétique Humaine, CHU Liège, Belgique
| | - T Dangouloff
- Centre de Références des Maladies Neuromusculaires, Département de Pédiatrie, CHU Liège, Belgique
| | - L Servais
- Division de Neurologie pédiatrique, Centre de Références des Maladies Neuromusculaires, Département de Pédiatrie, CHU Liège, Belgique
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Delwaide C, De Leeuw P, François A, Beckers P, Hennaux V, Lefèvre P. Chronic meningococcemia presenting with recurrent painful rash and poly-arthralgia without fever. IDCases 2018; 14:e00416. [PMID: 30191127 PMCID: PMC6125768 DOI: 10.1016/j.idcr.2018.e00416] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/06/2018] [Accepted: 06/26/2018] [Indexed: 11/28/2022] Open
Abstract
Chronic meningococcemia is an uncommon disorder, representing a diagnostic challenge. Classically, this pathology would be considered in young adults with a history of episodes of fever, disseminated cutaneous vasculitis and arthralgia. Exact and rapid diagnosis is often further challenged by the fact that routine microbiological investigations frequently failed to identify incriminated micro-organism, Neisseria meningitidis. Here we present the case of a young man not presenting with the classical triad.
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Affiliation(s)
- C Delwaide
- Neurology Service, IFAC-VIVALIA, 6900 Marche en Famenne, Belgium
| | - P De Leeuw
- Internal Medicine service, IFAC-VIVALIA, 6900 Marche en Famenne, Belgium
| | - A François
- Clinical Biology Service, IFAC-VIVALIA, 6900 Marche en Famenne, Belgium
| | - P Beckers
- Clinical Biology Service, IFAC-VIVALIA, 6900 Marche en Famenne, Belgium
| | - V Hennaux
- Clinical Biology Service, IFAC-VIVALIA, 6900 Marche en Famenne, Belgium
| | - Ph Lefèvre
- Clinical Biology Service, IFAC-VIVALIA, 6900 Marche en Famenne, Belgium.,Microbiology and Hygiene Unit of Pharmacological Faculty, Université Libre de Bruxelles (ULB), Belgium
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De La Porte S, Demeulenaere M, Ectors B, Stoop T, Possemiers N, Al Hatawe T, Wuyts K, Beckers P, Vorlat A, Heidbuchel H, Shivalkar B. P2552Cardiac rehabilitation revisited: time to change standard practices? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - B Ectors
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - T Stoop
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - N Possemiers
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - T Al Hatawe
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - K Wuyts
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - P Beckers
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - A Vorlat
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - H Heidbuchel
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
| | - B Shivalkar
- University of Antwerp Hospital (Edegem), Cardiology, Antwerp, Belgium
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Beckers P, Vanhees L, Pattyn N, De Maeyer C, Coeckelberghs E, Frederix G, Goetschalckx K, Van Craenenbroeck E, Cornelissen V, Conraads V. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: the saintex-cad study. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.278] [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: 11/24/2022]
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van der Giessen J, Franssen F, Fonville M, Kortbeek T, Beckers P, Tolsma P, Stenvers O, Teunis P, Takumi K. How safe is the meat inspection based on artificial digestion of pooled samples for Trichinella in pork? A scenario from wildlife to a human patient in a non-endemic region of Europe. Vet Parasitol 2013; 194:110-2. [PMID: 23433990 DOI: 10.1016/j.vetpar.2013.01.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The occurrence of trichinellosis in a resident of the Netherlands prompted us to examine the likelihood of this originating from infected rats in spite of prevailing biosecurity and testing procedures. In so doing, we sought to calculate the possible risks for trichinellosis in countries deemed non-endemic. The infection risk was determined by simulating a scenario from a reservoir of minimally contaminated wildlife to pigs to humans. Results indicate that humans might become infected even in the event that artificial digestion had been performed on individually tested pig carcasses. Our conclusions justify reconsidering Trichinella control strategies based on the current testing protocol, and emphasize the importance of proper cooking as further insurance against human infection.
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Affiliation(s)
- Joke van der Giessen
- National Institute for Public Health and The Environment (RIVM), Bilthoven, The Netherlands.
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Roestenberg M, Teirlinck AC, McCall MBB, Teelen K, Makamdop KN, Wiersma J, Arens T, Beckers P, van Gemert G, van de Vegte-Bolmer M, van der Ven AJAM, Luty AJF, Hermsen CC, Sauerwein RW. Long-term protection against malaria after experimental sporozoite inoculation: an open-label follow-up study. Lancet 2011; 377:1770-6. [PMID: 21514658 DOI: 10.1016/s0140-6736(11)60360-7] [Citation(s) in RCA: 217] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We have shown that immunity to infection with Plasmodium falciparum can be induced experimentally in malaria-naive volunteers through immunisation by bites of infected mosquitoes while simultaneously preventing disease with chloroquine prophylaxis. This immunity was associated with parasite-specific production of interferon γ and interleukin 2 by pluripotent effector memory cells in vitro. We aim to explore the persistence of protection and immune responses in the same volunteers. METHODS In an open-label study at the Radboud University Nijmegen Medical Centre (Nijmegen, Netherlands), from November to December, 2009, we rechallenged previously immune volunteers (28 months after immunisation) with the bites of five mosquitoes infected with P falciparum. Newly recruited malaria-naive volunteers served as infection controls. Our primary outcome was the detection of blood-stage parasitaemia by microscopy. We assessed the kinetics of parasitaemia with real-time quantitative PCR (rtPCR) and recorded clinical signs and symptoms. In-vitro production of interferon γ and interleukin 2 by effector memory T cells was studied after stimulation with sporozoites and red blood cells infected with P falciparum. Differences in cellular immune responses between the study groups were assessed with the Mann-Whitney test. This study is registered with ClinicalTrials.gov, number NCT00757887. FINDINGS Four of six immune volunteers were microscopically negative after rechallenge. rtPCR-based detection of blood-stage parasites in these individuals was negative throughout follow-up. Patent parasitaemia was delayed in the remaining two immunised volunteers. In-vitro assays showed the long-term persistence of parasite-specific pluripotent effector memory T-cell responses in protected volunteers. The four protected volunteers reported several mild to moderate adverse events, of which the most commonly reported symptom was headache (one to three episodes per volunteer). The two patients with delayed patency had adverse events similar to those in the control group. INTERPRETATION Artificially induced immunity lasts longer than generally recorded after natural exposure; providing a new avenue of research into the mechanisms of malaria immunity. FUNDING Dioraphte Foundation.
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Affiliation(s)
- Meta Roestenberg
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
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Kibiki GS, Beckers P, Mulder B, Arens T, Mueller A, Boeree MJ, Shao JF, Van der Ven AJAM, Diefenthal H, Dolmans WMV. Aetiology and presentation of HIV/AIDS-associated pulmonary infections in patients presenting for bronchoscopy at a referral hospital in northern Tanzania. ACTA ACUST UNITED AC 2008; 84:420-8. [PMID: 18074960 DOI: 10.4314/eamj.v84i9.9551] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the aetiological agents of pulmonary infections in HIV-infected Tanzanians and to correlate the causative agents with clinical, radiographic features, and mortality. DESIGN A prospective study. SETTING Kilimanjaro Christian Medical Centre (KCMC), Tanzania. SUBJECTS Bronchoalveolar lavage fluid (BAL) were obtained from 120 HIV infected patients with pulmonary infections. BAL for causative agents was analysed and correlated with clinical and radiographic features, and one-month outcome. RESULTS Causative agents were identified in 71 (59.2%) patients and in 16 of these patients, multiple agents were found. Common bacteria were identified in 35 (29.2%) patients, Mycobacterium tuberculosis in 28 (23.3%), Human Herpes Virus 8 (HHV8) in 12 (10%), Pneumocystis jiroveci in nine (7.5%) and fungi in five (4.2%) patients. Median CD4 T cell count of the patients with identified causes was 47 cells/microl (IQR 14-91) and in the 49 patients with undetermined aetiology was 100 cells/ microl (IQR 36-188; p = 0.01). Micronodular chest radiographic lesions were associated with presence of M. tuberculosis (p = 0.002). The one-month mortality was 20 (16.7%). The highest mortality was associated with HHV8 (41.7%) and M. tuberculosis (32.1%). Mortality in patients with undetermined aetiology was 11.3%. No death occurred in patients with PCP. CONCLUSION In this population of severely immunosuppressed HIV-infected patients with pulmonary infection a variety of causative agents was identified. Micronodular radiographic lesions were indicative of TB. High mortality was associated with M. tuberculosis or HHV8. No death occurred in patients with P. jiroveci infection.
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Affiliation(s)
- G S Kibiki
- Department of Internal Medicine, Endoscopy Unit, KCMC, Tumaini University, P.O. Box 3010, Moshi, Tanzania
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Affiliation(s)
- Astrid Oude Lashof
- Nijmegen University Centre for Infectious Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
| | - W Joost Lesterhuis
- Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Geert Wanten
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Pieter Beckers
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Monique Keuter
- Department of NUCI International Health, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
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Linssen CFM, Jacobs JA, Beckers P, Templeton KE, Bakkers J, Kuijper EJ, Melchers WJG, Drent M, Vink C. Inter-laboratory comparison of three different real-time PCR assays for the detection of Pneumocystis jiroveci in bronchoalveolar lavage fluid samples. J Med Microbiol 2006; 55:1229-1235. [PMID: 16914653 DOI: 10.1099/jmm.0.46552-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [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: 01/02/2023] Open
Abstract
Pneumocystis jirovecipneumonia (PCP) is an opportunistic infection affecting immunocompromised patients. While conventional diagnosis of PCP by microscopy is cumbersome, the use of PCR to diagnose PCP has great potential. Nevertheless, inter-laboratory validation and standardization of PCR assays is lacking. The aim of this study was to evaluate the inter-laboratory agreement of three independently developed real-time PCR assays for the detection ofP. jiroveciin bronchoalveolar lavage fluid samples. Therefore, 124 samples were collected in three tertiary care laboratories (Leiden University Medical Center, Maastricht Infection Center and Radboud University Nijmegen Medical Centre) and were tested by both microscopy and real-time PCR. Of 41 samples positive forP. jiroveciby microscopy, 40 were positive in all three PCR assays. The remaining sample was positive in a single assay only. Out of 83 microscopy-negative samples, 69 were negative in all three PCR assays. The other 14 samples were found positive, either in all three assays (n=5), in two (n=2) or in one of the assays (n=7). The data demonstrate high inter-laboratory agreement among real-time PCR assays for the detection ofP. jiroveci.
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Affiliation(s)
- Catharina F M Linssen
- Department of Medical Microbiology, Maastricht Infection Center (MINC), University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Jan A Jacobs
- Department of Medical Microbiology, Maastricht Infection Center (MINC), University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Pieter Beckers
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre (RUNMC), PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Kate E Templeton
- Department of Medical Microbiology, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Judith Bakkers
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre (RUNMC), PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Ed J Kuijper
- Department of Medical Microbiology, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Willem J G Melchers
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre (RUNMC), PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Marjolein Drent
- Department of Respiratory Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Cornelis Vink
- Department of Medical Microbiology, Maastricht Infection Center (MINC), University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands
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Conraads VM, Beckers P, Bosmans J, De Clerck LS, Stevens WJ, Vrints CJ, Brutsaert DL. Combined endurance/resistance training reduces plasma TNF-alpha receptor levels in patients with chronic heart failure and coronary artery disease. Eur Heart J 2002; 23:1854-60. [PMID: 12445534 DOI: 10.1053/euhj.2002.3239] [Citation(s) in RCA: 125] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Physical reconditioning of patients with chronic heart failure (CHF) improves exercise capacity and restores endothelial function and skeletal muscle changes. The effects of 4 months combined endurance/resistance exercise training on cytokines and cytokine receptors in patients with CHF were studied. In addition, changes in submaximal and maximal exercise performance were addressed. METHODS AND RESULTS Twenty-three patients with stable CHF due to coronary artery disease (CAD, n=12) or idiopathic dilated cardiomyopathy (IDCM, n=11) were trained for 4 months. Blood sampling for measurement of plasma concentrations (ELISA) of interleukin (IL)-6, tumour necrosis factor (TNF)-alpha, soluble TNF receptor 1 (sTNFR1) and 2 (sTNFR2), as well as cardiopulmonary exercise testing were performed at baseline and after 4 months. Training induced a significant decrease in sTNFR1 (P=0.02) for the total population, and in both sTNFR1 (P=0.01) and sTNFR2 (P=0.02) concentrations for the CAD group only. IL-6 and TNF-alpha levels were not altered. Cytokine concentrations remained unchanged in an untrained age- and sex-matched control group. NYHA functional class, submaximal and maximal workrate were significantly improved in both patient groups. Oxygen uptake at the anaerobic threshold (P=0.002) and at peak exercise increased in the CAD patients only (P=0.008). CONCLUSION Besides an overall beneficial effect on exercise capacity, combined endurance/resistance exercise training has an anti-inflammatory effect in patients with CHD and CAD.
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Affiliation(s)
- V M Conraads
- Department of Cardiology, University Hospital Antwerp (UIA), Wilrijkstraat 10, 2650 Edegem, Belgium
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Ma L, Kutty G, Jia Q, Imamichi H, Huang L, Atzori C, Beckers P, Groner G, Beard CB, Kovacs JA. Analysis of variation in tandem repeats in the intron of the major surface glycoprotein expression site of the human form of Pneumocystis carinii. J Infect Dis 2002; 186:1647-54. [PMID: 12447742 DOI: 10.1086/345721] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2002] [Revised: 08/21/2002] [Indexed: 11/03/2022] Open
Abstract
Variation in the tandem repeats in the expression site of the human-derived Pneumocystis carinii major surface glycoprotein gene was characterized by denaturing gel electrophoresis. The number of repeats in 147 isolates ranged from 2 to 6, with 2, 3, and 4 repeats being the most common. Sequence analysis identified 3 types of repeat units that differed by 1 nucleotide, which suggests a hierarchy of evolution of human-derived P. carinii. Examination of sequential samples obtained from 6 patients at an interval of 10-90 days showed an identical repeat pattern in each patient. However, in 2 of 4 patients with 2-3 different samples obtained within 4 days, different repeat patterns were observed among the samples. Quantifying the number of repeats by denaturing gel electrophoresis is a simple and rapid-typing method that can be used alone or in combination with other methods to study the epidemiology of P. carinii.
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Affiliation(s)
- Liang Ma
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA
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Conraads V, Beckers P, Bosmans J, De Clerck L, Stevens W, Vrints C, Brutsaert D. Combined endurance/resistance training reduces plasma TNF-alpha receptor levels in patients with chronic heart failure and coronary artery disease. J Heart Lung Transplant 2002. [DOI: 10.1016/s1053-2498(01)00568-x] [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: 10/18/2022] Open
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Tsolaki AG, Beckers P, Wakefield AE. Pre-AIDS era isolates of Pneumocystis carinii f. sp. hominis: high genotype similarity with contemporary isolates. J Clin Microbiol 1998; 36:90-3. [PMID: 9431927 PMCID: PMC124814 DOI: 10.1128/jcm.36.1.90-93.1998] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [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: 07/30/1997] [Accepted: 10/08/1997] [Indexed: 02/05/2023] Open
Abstract
Isolates of Pneumocystis carinii f. sp. hominis were examined from six individuals who died of P. carinii pneumonia between 1968 and 1981 and who had underlying immunodeficiencies which were not due to human immunodeficiency virus infection. DNA sequence variation was analyzed in the genes encoding the mitochondrial large subunit rRNA (mt LSU rRNA), the internal transcribed spacer (ITS) regions of the nuclear rRNA, the arom locus, and the mitochondrial small subunit rRNA. No major variations were observed when these isolates were compared to isolates from HIV-infected individuals. A small number of minor differences were detected. A new position at which variation occurred in the mt LSU rRNA was observed in one sample. Three new ITS sequence types were identified. A total of nine different ITS sequence types were found in the six samples. Mixed infection with different ITS sequence types of P. carinii f. sp. hominis was observed in four of the six samples. The ITS locus was the most informative of the four loci for distinguishing among the isolates of P. carinii f. sp. hominis. The data suggest that isolates of P. carinii f. sp. hominis from before the AIDS pandemic are genetically very similar to those currently found in HIV-infected individuals.
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Affiliation(s)
- A G Tsolaki
- Department of Paediatrics, Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom
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Hautvast JL, Tolboom JJ, Derks TJ, Beckers P, Sauerwein RW. Asymptomatic intestinal microsporidiosis in a human immunodeficiency virus-seronegative, immunocompetent Zambian child. Pediatr Infect Dis J 1997; 16:415-6. [PMID: 9109148 DOI: 10.1097/00006454-199704000-00017] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- J L Hautvast
- Department of Paediatrics, University Hospital Nijmegen St. Radboud, The Netherlands
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Perenboom RM, Sauerwein RW, Beckers P, van Schijndel AC, van Steenwijk RP, Borleffs JC, van Leusen R, van der Meer JW. Cytokine profiles in bronchoalveolar lavage fluid and blood in HIV-seropositive patients with Pneumocystis carinii pneumonia. Eur J Clin Invest 1997; 27:333-9. [PMID: 9134383 DOI: 10.1046/j.1365-2362.1997.1170661.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Concentrations and ex vivo production of interleukin 1 beta (IL-1), tumour necrosis alpha (TNF), interleukin 6 (IL-6), interleukin-1 receptor antagonist (IL-1RA) and TNF soluble receptors (sTNF-receptors, P55 and P75) were measured in bronchoalveolar lavage (BAL) fluid and blood in 23 HIV-seropositive (HIV+) patients with Pneumocystis carinii pneumonia (PCP) and compared with values found in healthy HIV-seronegative (HIV-) controls and asymptomatic HIV+ subjects. Concentrations of the proinflammatory cytokine IL-1 beta were increased in BAL fluid of HIV+ patients with PCP (184 +/- 47 pg mL-1) compared with undetectable levels in healthy control subjects (P = 0.0001). In plasma of these patients higher concentrations of the anti-inflammatory cytokine IL-1RA were found during acute PCP than after recovery (2.1 +/- 0.7 vs. 0.5 +/- 0.2 ng mL-1, P = 0.01). No correlations could be found between cytokine concentrations and clinical severity of the infection. Corticosteroid treatment did not influence cytokine concentrations in BAL or blood, nor did it suppress the production in alveolar cells. In whole-blood cultures, however, lipopolysaccharide (LPS)-stimulated production was significantly suppressed for IL-1 (1.3 vs. 5.5 ng mL-1, P = 0.009) and for IL-6 (0.6 vs. 2.5 ng mL-1, P = 0.01). The overall data show that in HIV+ patients with PCP (similar to what we had found previously in HIV-patients with PCP) proinflammatory cytokines are more prominently present in BAL, whereas anti-inflammatory reaction is predominant in the circulation.
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Affiliation(s)
- R M Perenboom
- Department of General Internal Medicine, University Hospital Nijmegen, The Netherlands
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Perenboom RM, Beckers P, Van Der Meer JW, Van Schijndel AC, Oyen WJ, Corstens FH, Sauerwein RW. Pro-inflammatory cytokines in lung and blood during steroid-induced Pneumocystis carinii pneumonia in rats. J Leukoc Biol 1996; 60:710-5. [PMID: 8975872 DOI: 10.1002/jlb.60.6.710] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [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: 02/03/2023] Open
Abstract
To gain more insight into the role of cytokines in Pneumocystis carinii pneumonia (PCP) we followed pro-inflammatory cytokine profiles in rats with steroid-induced PCP at 2-week intervals. The cytokines measured were immunoreactive interleukin-1beta (IL-1beta), bioactive interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-alpha). In vivo cytokine concentrations were determined in three compartments, i.e., bronchoalveolar lavage (BAL) fluid, lung homogenates, and plasma. Lipopolysaccharide (LPS) -stimulated cytokine production by alveolar cells and in whole-blood cultures was measured ex vivo. P carinii load and host inflammatory response, as determined by lung/body weight ratio and 111indium-IgG biodistribution were monitored throughout developing PCP. IL-1beta was elevated in lung homogenates (600, range <20-1260 pg/mL) and IL-6 in BAL fluid (48, range <20-115 pg/mL), whereas the pro-inflammatory cytokine concentrations were not increased in plasma. Thus in rats with PCP elevated pro-inflammatory cytokine concentrations were found to be restricted to the lung compartments. Corticosteroids did not significantly influence cytokine concentrations, but showed profound inhibitory effects on ex vivo cytokine production. The LPS-stimulated cytokine production by alveolar cells gradually decreased during the 6 weeks after the start of the steroid injections, whereas the production in whole blood cultures was immediately and completely suppressed.
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Affiliation(s)
- R M Perenboom
- Department of General Internal Medicine, University Hospital Nijmegen, The Netherlands
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Abstract
P.carinii molecular epidemiology appears a new interesting investigational field to understand distribution and incidence of isolates from different geographical locations. Recently a typing system, the Type Specific Oligoblotting (TSO) based on 6 different sequences of the Internal Transcribed Spacers (ITSs) of P.carinii rRNA has been developed [1]. By using P.carinii ITSs nested PCR followed by TSO hybridization we have typed 55 lung derived specimens collected in Italy, The Netherlands and sub-Saharian Africa from pts with microscopically detected P.carinii pneumonia.
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Affiliation(s)
- C Atzori
- II Div. Inf. Dis., L.Sacco Hosp. Milan, Italy
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20
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Perenboom RM, van Schijndel AC, Beckers P, Sauerwein R, Van Hamersvelt HW, Festen J, Gallati H, van der Meer JW. Cytokine profiles in bronchoalveolar lavage fluid and blood in HIV-seronegative patients with Pneumocystis carinii pneumonia. Eur J Clin Invest 1996; 26:159-66. [PMID: 8904526 DOI: 10.1046/j.1365-2362.1996.118253.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Concentrations and ex vivo production of interleukin-1beta (IL-1beta), tumour necrosis factor-alpha (TNF), interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1RA) and TNF soluble receptors were followed in bronchoalveolar lavage (BAL) fluid and blood from 10 HIV-seronegative patients with Pneumocystis carinii pneumonia (PCP) and compared with values found in healthy volunteers. During the acute phase of PCP, TNF but not IL-6 or IL-1beta was detectable in BAL fluid. At that time, plasma concentrations of the proinflammatory cytokines were low, whereas plasma concentrations of the anti-inflammatory cytokines were high. The ex vivo production capacity of proinflammatory cytokines was suppressed in the acute phase, in the blood as well as at the site of infection. During convalescence the production capacity of the blood cells normalized. The IL-1RA production capacity of the alveolar cells was also suppressed in the acute phase, but preserved in blood cells.
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Affiliation(s)
- R M Perenboom
- Department of General Internal Medicine, University Hospital Nijmegen, The Netherlands
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21
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Perenboom RM, Oyen WJ, van Schijndel AC, Beckers P, Corstens FH, van der Meer JW. Serial indium-111-labelled IgG biodistribution in rat Pneumocystis carinii pneumonia: a tool to monitor the course and severity of the infection. Eur J Nucl Med 1995; 22:1129-32. [PMID: 8542896 DOI: 10.1007/bf00800594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To study the effect of new therapeutic strategies, we developed an animal model to monitor the course and severity of experimental Pneumocystis carinii pneumonia (PCP) in rats. P. carinii density scores in Giemsa-stained impression smears were used to follow P. carinii load. Indium-111 labelled IgG scintigraphy and biodistribution, histology of paraffin-embedded tissue sections, lung/body weight (L/B wt) ratio and cell count and differentiation of broncho-alveolar lavage (BAL) fluid were used as parameters of host inflammatory response. Statistically significant differences in L/B wt ratio, number of neutrophils in BAL fluid, P. carinii density score, histological extent of inflammation and 111In-IgG accumulation in the lung were seen between the rats sacrificed at various time points. 111In-IgG accumulation in the lung correlated well with L/B wt ratio and P. carinii density score and correlated moderately with number of neutrophils in BAL fluid and with the histological extent of inflammation.
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Affiliation(s)
- R M Perenboom
- Department of General Internal Medicine, University Hospital Nijmegen, The Netherlands
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22
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Roeffen W, Geeraedts F, Eling W, Beckers P, Wizel B, Kumar N, Lensen T, Sauerwein R. Transmission blockade of Plasmodium falciparum malaria by anti-Pfs230-specific antibodies is isotype dependent. Infect Immun 1995; 63:467-71. [PMID: 7822011 PMCID: PMC173018 DOI: 10.1128/iai.63.2.467-471.1995] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [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: 01/27/2023] Open
Abstract
By use of the parental hybridoma cell line 63F2A2 that produces specific antibodies of immunoglobulin isotype G1 (IgG1; 63F2A2.1) against Pfs230, we attempted to enrich for the synthesis of the downstream switch variant IgG2b and IgG2a monoclonal antibodies (MAbs) of the hybridoma cell line (63F2A2.2b and 63F2A2.2a, respectively). The parental IgG1 did not reduce the Plasmodium falciparum transmission in a bioassay irrespective of the presence of complement. MAbs 63F2A2.2b and 63F2A2.2a were effective in reducing the infectivity of P. falciparum parasites to Anopheles gambiae mosquitoes in membrane-feeding experiments. A transmission reduction of 91% was accomplished by the 63F2A2.2b switch variant, and a reduction of greater than 99% was accomplished by the 63F2A2.2a switch variant, but only in the presence of active human complement. Subsequently, the transmission-reducing effect of MAb 63F2A2.2b or 63F2A2.2a was confirmed in vitro by the rapid lysis of newly formed macrogametes or zygotes in the presence of active complement. MAb 63F2A2.1 did not lyse the newly formed macrogametes or zygotes irrespective of the presence of complement.
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Affiliation(s)
- W Roeffen
- Department of Medical Microbiology, University of Nijmegen, The Netherlands
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23
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Roeffen W, Lensen T, Mulder B, Teelen K, Sauerwein R, Eling W, Meuwissen JH, Beckers P. Transmission blocking immunity as observed in a feeder system and serological reactivity to Pfs 48/45 and Pfs230 in field sera. Mem Inst Oswaldo Cruz 1994; 89 Suppl 2:13-5. [PMID: 7565122 DOI: 10.1590/s0074-02761994000600004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [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: 01/26/2023] Open
Abstract
Monoclonal antibodies (mAbs) and human sera from gametocyte carriers were applied in the bio-assay to test for their transmission-blocking capacity. Competition ELISA's have been developed for the detection of natural transmission blocking antibodies. Approximately 55% of the sera blocking in the bio-assay gave positive results in these competition ELISA's.
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Affiliation(s)
- W Roeffen
- University of Nijmegen, Department of Medical Microbiology, The Netherlands
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24
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Abstract
The incidence of brittle nails is higher in women than in men. Repeatedly a suspected cause for the higher incidence of brittle nails in women is the frequent exposure to water. This study was aimed at clarifying whether wet working conditions increase the incidence of brittle nails in women and men in a similar degree. We determined the incidence of brittle nails in 511 persons in professions that involve frequent hand contact with water. The data were compared to those of a large, non-selected control group. 50% of the female probands showed the sign of brittle nails (control group: 30.4%, p less than 0.05). Only 13.5% of the male test persons of this study had brittle nails; the difference to the control group (13.2%) was not significant. It is discussed that in women the bridges between nail corneocytes are possibly weaker than in males as a constitutional characteristic. Accordingly, frequent alternating periods of hydration and drying increase the incidence of brittle nails particularly in women.
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Affiliation(s)
- D Lubach
- Department of Dermatology, Hautklinik Linden, Medizinische Hochschule Hannover, FRG
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25
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Graves PM, Doubrovsky A, Beckers P. Antibody responses to Plasmodium falciparum gametocyte antigens during and after malaria attacks in schoolchildren from Madang, Papua New Guinea. Parasite Immunol 1991; 13:291-9. [PMID: 1712931 DOI: 10.1111/j.1365-3024.1991.tb00283.x] [Citation(s) in RCA: 9] [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: 12/28/2022]
Abstract
Sera from 49 school children in Madang, Papua New Guinea with malaria and follow-up sera from 40 of these cases were tested by competitive ELISA for antibodies capable of inhibiting binding of eight monoclonal antibodies (MoAbs) to Plasmodium falciparum gametocytes. The proportion of sera inhibiting each MoAb ranged from 31.2% to 85.7%. At follow-up, the proportion of inhibitory sera decreased for 3 MoAbs, did not change significantly for 4 MoAbs and increased for one MoAb. When sera were grouped according to whether the follow-up blood slide was positive or negative, further trends emerged for MoAbs against the gamete surface antigen Pfs 48/45. Antibody levels to the IA3-B8 epitope decreased in follow-up positive cases, but remained unchanged for follow-up negative cases. The converse was observed for the IIC5-B10 epitope with an increase of antibody in follow-up positive cases and no change in the negative cases. Amount of antibody to the 3G12/58 epitope decreased when the follow-up was negative but not when it was positive. Increase in antibody to the 3E12/58 epitope occurred at the follow-up sample irrespective of the blood slide result. Thus four distinct patterns of longitudinal antibody response were observed against four epitopes on the same molecule.
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Affiliation(s)
- P M Graves
- Queensland Institute of Medical Research, Herston, Brisbane
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Graves PM, Doubrovsky A, Carter R, Eida S, Beckers P. High frequency of antibody response to Plasmodium falciparum gametocyte antigens during acute malaria infections in Papua New Guinea highlanders. Am J Trop Med Hyg 1990; 42:515-20. [PMID: 1695490 DOI: 10.4269/ajtmh.1990.42.515] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [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: 12/28/2022] Open
Abstract
Sera from 62 adult Papua New Guinea highlanders with suspected acute malaria were tested by competitive ELISA for the presence of antibodies capable of inhibiting binding of 8 monoclonal antibodies (Mabs) directed against epitopes on gametocytes of Plasmodium falciparum. Between 33% and 72% of the malaria cases were inhibitory, depending on the Mab. There was no difference between the proportion of persons with P. falciparum (asexuals or gametocytes) and P. vivax whose sera inhibited Mab binding, but all 3 categories had a significantly higher proportion of inhibitors than persons who were malaria negative. The amount of gametocyte antibody recognizing epitopes on Pfs 48/45 and Pfs 230 increased with increasing numbers of previous malaria episodes. The proportion of sera from these relatively nonimmune adults which had gamete antibodies was similar to the proportion seen in sera from a highly endemic area, suggesting that antibody responses to these epitopes are a part of the initial response observed after a limited number of malaria episodes.
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Affiliation(s)
- P M Graves
- Queensland Institute of Medical Research, Herston, Brisbane, Australia
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27
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Graves PM, Bhatia K, Burkot TR, Prasad M, Wirtz RA, Beckers P. Association between HLA type and antibody response to malaria sporozoite and gametocyte epitopes is not evident in immune Papua New Guineans. Clin Exp Immunol 1989; 78:418-23. [PMID: 2482146 PMCID: PMC1534822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
HLA-A,B,C and DR types were determined for 46 adults living in the Madang area of Papua New Guinea. Sera from these individuals were tested by ELISA for antibodies against: (i) sonicated schizont extract of Plasmodium falciparum; (ii) circumsporozoite repeat regions of P. falciparum and P. vivax; and (iii) epitopes on the 230 and 48/45 kD gametocyte antigens of P. falciparum. All sera were from highly immune individuals and reacted strongly to the schizont antigen. The proportions responding to circumsporozoite repeat regions were 60.7% and 23.9% for P. falciparum and P. vivax, respectively. Between 32.6 and 47.8% of adults responded to each gametocyte epitope as assessed by inhibition of monoclonal antibodies. The limited number of alleles present at each HLA locus which is characteristic of coastal Papua New Guinea was observed. Five HLA-DR alleles were detected, of which only three (HLA-DR2, 4 and w5) were present at frequencies over 0.12. All individuals possessed at least one DR2,4 or w5 allele, and 96% of individuals possessed DR2, or 4 or both. There was no evidence for association between HLA type and antibody response to circumsporozoite repeat regions or the gametocyte epitopes. Homozygotes for DR2 and 4 were able to respond to each antigen. These results imply that either there is no HLA restriction of the response to these antigens or that each DR type is responding to a different variant of the T-epitope. Even in the latter case the results are encouraging for the prospects of inclusion of an HLA-restricted T-epitope in a malaria vaccine for Papua New Guinea since a limited number of versions would be required to cover a population with an HLA profile similar to that in Madang.
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Affiliation(s)
- P M Graves
- Papua New Guinea Institute of Medical Research, Madang
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