Retrospective Evaluation of Clinical Bleeding in Dogs With Anticoagulant Rodenticide Toxicity—A Multi-Center Evaluation of 62 Cases (2010–2020)

Objective

To evaluate the most common locations of hemorrhage in dogs diagnosed with anticoagulant rodenticide intoxication.

Animals

Dogs presenting with hemorrhage secondary to anticoagulant rodenticide intoxication between at two university veterinary teaching hospitals.

Procedures

Medical records were searched from the years 2010 through 2020 and all records from dogs treated for hemorrhage secondary to anticoagulant rodenticide intoxication were reviewed. Dogs were diagnosed with anticoagulant rodenticide intoxication based on the combination of known exposure and prolonged coagulation testing, including prothrombin and activated thromboplastin time, or based on gas chromatography-mass spectrometry (GCMS). The diagnosis of hemorrhage was made based on physical exam findings, point-of-care ultrasound findings or radiography.

Results

Sixty-two dogs met the inclusion criteria and were included in the study. The most common sites of hemorrhage included: pleural space (hemothorax 37%), pulmonary parenchyma (24%), abdomen (24%), skin/subcutaneous (21%), gastrointestinal tract (18%), pericardium (13%), oral cavity (13%), nasal cavity (11%), ocular (8%), and urinary tract (7%). Overall, forty-five dogs (73%) had evidence of cutaneous or mucosal hemorrhage while thirty-three (53%) of dogs had evidence of cavitary hemorrhage. Forty-five percent of dogs had hemorrhage noted at only one site, while 55% experienced hemorrhage at more than one site. The location of hemorrhage and total number of hemorrhagic sites was not associated with survival or transfusion requirement.

Conclusions and Clinical Relevance

In conclusion, this study highlights that dogs with anticoagulant rodenticide intoxication present with diverse locations of hemorrhage and the majority of dogs had non-cavitary hemorrhage noted.

Pathology in Practice

In collaboration with the American College of Veterinary Pathologists.

A computational framework for ptychographic reconstructions

Ptychography is now a well-established X-ray microscopy tool for synchrotron end-stations equipped with a scanning stage and a pixelated detector. Ptychographic phasing algorithms use information from coherent diffraction to deliver quantitative images of the specimen at a resolution higher than the scanning resolution. These algorithms have traditionally been implemented in software on a per-instrument basis in various degrees of user-friendliness and sophistication. Here, we present Ptypy, a ptychography software written with the intention to serve as a framework across the diverse sets of available instruments and usage cases. A distinctive feature of the software is its formalism, which provides a convenient abstraction of the physical model, thus allowing for concise algorithmic implementations and portability across set-up geometries. We give an overview of the supported usage cases, explain the abstraction layer and design principles, and provide a step-by-step guide describing how an algorithm may be realized in a concise and readable manner. The software capabilities are illustrated with reconstructions from visible light and X-ray data.

Ptychographic X-ray nanotomography quantifies mineral distributions in human dentine

Bones are bio-composites with biologically tunable mechanical properties, where a polymer matrix of nanofibrillar collagen is reinforced by apatite mineral crystals. Some bones, such as antler, form and change rapidly, while other bone tissues, such as human tooth dentine, develop slowly and maintain constant composition and architecture for entire lifetimes. When studying apatite mineral microarchitecture, mineral distributions or mineralization activity of bone-forming cells, representative samples of tissue are best studied at submicrometre resolution while minimizing sample-preparation damage. Here, we demonstrate the power of ptychographic X-ray tomography to map variations in the mineral content distribution in three dimensions and at the nanometre scale. Using this non-destructive method, we observe nanostructures surrounding hollow tracts that exist in human dentine forming dentinal tubules. We reveal unprecedented quantitative details of the ultrastructure clearly revealing the spatially varying mineralization density. Such information is essential for understanding a variety of natural and therapeutic effects for example in bone tissue healing and ageing.

Immunization of Aotus monkeys with recombinant Plasmodium falciparum hybrid proteins does not reproducibly result in protection from malaria infection

Plasmodium falciparum antigens SERP, HRPII, MSAI, and 41-3 have shown promise as vaccine components. This study aimed at reproducing and extending previous results using three hybrid molecules. Antibody responses were reproduced in Aotus monkeys, but solid protection from a P. falciparum blood-stage challenge that showed an unintendedly enhanced pathogenicity was not observed.

Role of diprotonated phosphate in evoking muscle reflex responses in cats and humans

Lactic acid and H+ evoke muscle reflexes that raise sympathetic nerve activity. Whether these substances are direct afferent stimulants or markers for the acidification of other substances is unknown. Diprotonated phosphate (H2PO4-), a possible mediator of fatigue, increases as the cell acidifies and phosphate is produced. Its role in evoking muscle reflexes is unknown. We used 31P-nuclear magnetic resonance to measure forearm muscle H+ and H2PO4- and microneurography to measure muscle sympathetic nerve activity (MSNA, peroneal nerve) during a handgrip protocol designed to dissociate H+ from H2PO4-. Ischemic handgrip (50% maximal voluntary contraction x 2 min) was followed by a 1-min rest period during which the muscle was freely perfused. This was followed by a second bout of ischemic handgrip and a 5-min recovery. In seven of eight subjects, MSNA correlated with H2PO4-, whereas it correlated with pH in only one subject. To determine whether muscle reflex responses are evoked by H+, lactic acid, monoprotonated phosphate (HPO4(2-), or H2PO4-, we injected H+, lactate, H2PO4- [all 50 mM in 10 mM N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES) buffered to pH 6], and HPO4(2-) (50 mM, pH 7.5 in 10 mM HEPES) into the arterial supply of the triceps surae of the cat (n = 9) as we measured mean arterial blood pressure (MAP). H2PO4- increased MAP more than HPO4(2-), H+, or lactate (27.1 +/- 3.7 vs. 5.0 +/- 1.3, 4.6 +/- 3.1, and 7.7 +/- 3.2 rise in mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)

Limb congestion and sympathoexcitation during exercise. Implications for congestive heart failure

During static exercise, heart failure (HF) subjects activate the sympathetic nervous system differently than normal controls. HF causes metaboreceptor desensitization with either enhanced mechanoreceptor activity or central command. In this report, we examined whether increased muscle interstitial pressure, as seen in HF, augments other neural systems. We measured muscle sympathetic nerve activity (MSNA; peroneal nerve) in 10 normals during static exercise (40% maximal voluntary grip) and posthandgrip circulatory arrest (PHG-CA). This was repeated after venous congestion (VC; cuff inflation to 90 mmHg). VC increased forearm volume (plethysmography) by 4.7%. MSNA responses to exercise were greater after VC (150.5 +/- 41.8 vs. 317.3 +/- 69.9 arbitrary units; P < 0.01). However, MSNA responses during PHG-CA were not affected by VC, and 31P nuclear magnetic resonance (n = 5) demonstrated no effect of VC on pH or H2PO4-. Similar effects of VC on MSNA were noted after ischemic exercise (n = 7), excluding flow alterations as the explantation. VC probably sensitized mechanically sensitive afferents since MSNA during involuntary biceps contractions increased after VC (n = 6), and skin sympathetic nerve responses during handgrip, an index of central command, were not increased by VC (n = 6).

Acute and chronic antiarrhythmic efficacy of d-sotalol in patients with sustained ventricular tachyarrhythmias

To evaluate the clinical efficacy of d-sotalol, 84 patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF), who had inducible sustained VT/VT at baseline electrophysiologic study (EPS), were investigated after intravenous (IV) d-sotalol (1.5-2.5 mg.kg-1). A total of 29 additional patients received only oral d-sotalol, (400-600 mg.day-1). Acute success of antiarrhythmic therapy was defined as suppression of inducible sustained VT/VF. The overall success rate of IV d-sotalol was 38% (32/84) after a mean of 4.3 drugs failed to suppress inducibility. A 78% success rate (31/40) was demonstrated in patients who were also assessed after oral d-sotalol. Torsade de pointes type VT was seen in one patient. After 1 year, only 16% of patients with a positive EPS had a recurrence compared to 43% of patients with a negative EPS (P < 0.05). Estimated survival rates were 95 and 88% after 1 and 2 years of follow-up, respectively. Only five of 56 patients discontinued d-sotalol therapy because of adverse effects. IV d-sotalol appears to be an effective antiarrhythmic agent. Its long-term efficacy is predictable on the basis of therapy guided by electrophysiologic testing in patients with refractory ventricular tachyarrhythmias. The efficacy of d-sotalol seems comparable to that reported for d,l-sotalol.

Comparison of the effects of adjuvants and adjuvant doses on the quantitative and qualitative antibody response to selected antigens in New World squirrel monkeys Saimiri sciureus

The effect of several adjuvants and of adjuvant doses on the quantitative and qualitative antibody response to tetanus toxoid (TT) and a recombinant herpes simplex virus peptide (HSVgD) was evaluated in the New World monkey Saimiri sciureus. All adjuvant formulations were effective in inducing a strong antibody response to these antigens. The qualitative antibody response, as defined by monoclonal antibodies 3A2/G6 and 4G3/B5, was determined. Only 3A2/G6+ antibodies were induced after immunization with HSVgD irrespective of the adjuvant used and after immunization with TT alone. However, both types of antibodies were induced against TT in the presence of the adjuvants tested. These data suggest that both adjuvant and antigens can intervene in driving the quality of the antibody response induced after immunization. Strong antibody response to TT was induced at any adjuvant dose tested, suggesting that lower doses are as effective as higher doses. These findings can have implications on the design of future trials of vaccine candidate constructs in monkeys and eventually in human beings.

Protection of Aotus monkeys from malaria infection by immunization with recombinant hybrid proteins

On the basis of investigations of the malarial blood-stage antigens SERP, HRPII, and MSAI from Plasmodium falciparum, we chose two Escherichia coli-expressed hybrid proteins containing selected partial sequences of these antigens. Antibodies raised against both hybrid proteins in rabbits and Aotus monkeys recognize the corresponding P. falciparum polypeptides. In two independent trials with 13 animals, immunization of Aotus monkeys with either of the two hybrid proteins administered in a well-tolerated oil-based formulation protected the animals from an experimental P. falciparum infection.

Effect of pH and inorganic phosphate on creatine kinase inactivation: an in vitro 31P NMR saturation-transfer study

The pseudo-first-order rate constant of rabbit muscle creatine kinase (CK), in the direction of ATP synthesis (kf), was determined by saturation-transfer 31P NMR. When pH was varied between 6.0 and 7.4, kf increased linearly at both 20 degrees C and 37 degrees c. The corresponding flux is very small between pH 6.0 and 6.5, in contrast to previous studies. Up to 50 h exposure of the CK enzyme to high concentrations of inorganic phosphate (Pi), a known inhibitor in certain situations, had negligible effect on enzymatic flux in the physiological pH range. Thus under in vivo conditions, such as in stroke, where pH falls as low as 6.2 and Pi rises to high levels, the rate of the CK reaction may be severely reduced due to pH but not due to high Pi concentrations.

Strategies for the development of an antimalarial vaccine

Susceptible Aotus monkeys were immunized with Escherichia coli-derived fusion proteins containing partial sequences of the proteins MSAI, SERP, HRPII and with a group of three recombinant antigens isolated by screening with an antiserum raised against the protective 41 kDa protein band. HRPII, the combination of the fusion proteins of the 41 kDa group and a mixture of two sequences of SERP conferred significant protection against a challenge infection with Plasmodium falciparum blood stages. Based on the protective capacity of these recombinant antigens we have expressed two hybrid proteins (MS2/SERP/HRPII and SERP/MSAI/HRPII) in E. coli containing selected partial sequences. In two independent immunization trials it was shown that immunization of Aotus monkeys with either of the two hybrid proteins can protect the animals from an experimental P. falciparum infection.

Protection of aouts monkeys after immunization with recombinant antigens of Plasmodium falciparum

The genus Aotus spp. (owl monkey) is one of the WHO recommended experimental models for Plasmodium falciparum blood stage infection, especially relevant for vaccination studies with asexual blood stage antigens of this parasite. For several immunization trials with purified recombinant merozoite/schizont antigens, the susceptible Aotus karyotypes II, III, IV and VI were immunized with Escherichia coli derived fusion proteins containing partial sequences of the proteins MSAI (merozoite surface antigen I), SERP (serine-stretch protein) and HRPII (histidine alanine rich protein II) as well as with a group of recombinant antigens obtained by an antiserum raised against a protective 41 kD protein band. The subcutaneous application (3x) of the antigen preparations was carried out in intact animals followed by splenectomy prior to challenge, in order to increase the susceptibility of the experimental hosts to the parasite. A partial sequence of HRPII, the combination of three different fusion proteins of the 41 kD group and a mixture of two sequences of SERP in the presence of a modified Al(OH)3 adjuvant conferred significant protection against a challenge infection with P. falciparum blood stages (2-5 x 10(6)) i. RBC). Monkeys immunized with the MS2-fusion protein carrying the N-terminal part of the 195 kD precursor of the major merozoite surface antigens induced only marginal protection showing some correlation between antibody titer and degree of parasitaemia. Based on the protective capacity of these recombinant antigens we have expressed two hybrid proteins (MS2/SERP/HRPII and SERP/MSAI/HRPII) in E. coli containing selected partial sequences of SERP, HRPII and MSAI. Antibodies raised against both hybrid proteins in rabbits and Aotus monkeys recognize the corresponding schizont polypeptides. In two independent immunization trials using 13 animals (age 7 months to 3 years) we could show that immunization of Aotus monkeys with either of the two hybrid proteins administered in an oil-based well tolerated formulation protected the animals from a severe experimental P. falciparum (strain Palo Alto) infection.

Coagulation disorders in experimentally induced acute mouse malaria

The development of coagulation disorders was studied in murine malaria. Plasmodium vinckei was chosen following an initial experiment because onset and duration of parasitemia were more suitable for hemostasiological studies than in the short-lasting infection, caused by P. berghei. Evaluation of the time courses of hematocrit, platelets, antithrombin (AT) III activity, Factor V activity and parasitemia showed a significant decrease in platelets, hematocrit, Factor V and AT III activity during the course of infection. The obtained data strongly suggest the development of a disseminated intravascular coagulation in mice during the terminal phase of murine malaria.

A recombinant hybrid protein as antigen for an anti-blood stage malaria vaccine

Based on investigations on several blood stage antigens from Plasmodium falciparum we have expressed a hybrid protein in E. coli containing 262 amino acids of the serine-stretch protein SERP and 189 amino acids of the histidine alanine rich protein HRPII. Antibodies raised against the hybrid protein by immunization of rabbits and Aotus monkeys react with both corresponding schizont polypeptides. Two Aotus monkeys immunized with the SERP/HRPII hybrid protein showed only low parasitemias after challenge infection with P. falciparum, compared to the control group. The result suggests that hybrid proteins of this type may be the basis for the development of a malaria vaccine.

Antithrombin III substitution affects survival rate in a murine malaria model

The effect of AT III substitution on survival time was studied in P. vinkei infected mice. One hundred mice were infected, randomly selected and allocated to two groups of 40 animals each on day 13 after infection. One group was placebo treated, the other group received 3 IU AT III daily on days 13 to 19. Comparison of the survival time in the log rank test showed a prolongation of the median survival time (5 versus 9 days, P less than 0.01). It is concluded that AT III might be beneficial in the treatment of severe malaria cases.

Antimalarial activity of new floxacrine-related acridinedione derivatives: studies on blood schizontocidal action of potential candidates against P. berghei in mice and P. falciparum in vivo and in vitro

Deoxyfloxacrine derivatives (1-hydrazone: S 83 0083; 1-imine: S 84 7277) and floxacrine derivatives (10-methoxy-floxacrine: L 84 7667; 1-imine: L 84 7693) selected from a series of newly synthesized 3-aryl-7-chloro-3,4-dihydro-1,9(2H,10H)-acridinediones were evaluated for blood schizontocidal activities in mice infected with asexual stages of various drug-resistant lines of P. berghei and in New World monkeys infected with blood schizonts of different chloroquine-resistant strains of P. falciparum. All compounds tested showed high activity against drug-resistant lines of P. berghei (ED50: 1.0-4.4 mg/kg x 5, per os) and were distinctly superior in their antimalarial potency to floxacrine. Compounds L 84 7667 and L 84 7693 proved to be highly active against the FCBR strain of P. falciparum in vitro (IC50: 0.73-1.78 nmol); they effected temporary clearance of parasitemias due to the Palo Alto strain of P. falciparum in squirrel monkeys at oral doses of 15 mg/kg given daily for 5 consecutive days. Compounds S 83 0083 and S 84 7277, showing moderate in vitro effects (12.9-24.8 nmol), cleared parasitemias of the FCBR strain of P. falciparum in owl monkeys at oral doses of 20 mg/kg (S 84 7277) given daily for 5 or 7 consecutive days (follow-up period, 17 and 30 days, respectively) or at doses of 20 mg/kg (x 4) (S 83 0083) followed by doses of 40 mg/kg (x 3) within a follow-up period of 30 days. These observations suggest that the range of doses required for the cure of established P. falciparum infections is probably too large to cover infections with strains of the least susceptibility and might evoke toxic reactions by the potential candidates tested.

A histidin alanine rich recombinant antigen protects Aotus monkeys from P. falciparum infection

We have isolated a cDNA clone coding for 165 amino acids of a histidine alanine rich protein. An extended repeat region of this clone codes for the tripeptide Ala-His-His, which is extremely conserved, and for the tripeptide Ala-Ala-Asp, which shows only slight variability among the repeat units. This antigen exhibits high homology to the HRPII antigen described by Wellems and Howard (1986). The coding region was expressed in E. coli as a MS2-polymerase fusion protein, which was purified and used for immunization of Aotus monkeys. The animals immunized with this fusion protein showed only low parasitemias (less than 2%) after infection with P. falciparum, while animals from the control group or animals immunized with a MS2-fusion protein carrying other malaria specific sequences were not protected. The result suggests that this antigen is a good candidate for a malaria vaccine.

Trypanothione reductase from Trypanosoma cruzi. Purification and characterization of the crystalline enzyme

The structural differences between trypanothione reductase of Trypanosoma cruzi and human glutathione reductase, an enzyme of known three-dimensional structure, offer an opportunity for rational drug design against Chagas' disease. As a first step in the analysis of the parasite enzyme we report its purification and characterization. 2.2 mg trypanothione reductase was extracted from 33 g wet weight of cultured epimastigotes or from 4 g lyophilized cells. The flavoenzyme was purified 2400-fold to homogeneity in three steps with an overall yield of 45%. The enzyme is a dimer with a subunit Mr of 50,000. Using NADPH (Km = 5 microM) and trypanothione disulfide (Km = 45 microM) as substrates, a turnover number of 14,200 min-1 was estimated. Trypanothione reductase, the parasite enzyme, and glutathione reductase, the host enzyme, exhibit mutually exclusive specificities for their respective disulfide substrates. When screening cell cultures or column eluates for the presence of trypanothione reductase, a microassay based on Ellman's reagent as indicator was used. A mixture of regioisomeric glutathionylspermidine disulfides isolated from Escherichia coli served as substrate in this microassay. Experimentally, the catalytic cycle of the enzyme can be subdivided into the half-reactions Eox + NADPH + H+----EH2 + NADP+, and EH2 + trypanothione disulfide----Eox + dihydrotrypanothione. This is also true for the crystallized enzyme in the presence of 2 M (NH4)2SO4. The spectral properties of trypanothione reductase both in the oxidized form (Eox) and in the two-electron-reduced form (EH2) closely resemble those of human glutathione reductase. Both proteins contain a flavin and a redox-active disulfide at the catalytic site. After reduction of Eox to EH2, trypanothione reductase can be inactivated by specifically alkylating one of the nascent active-site thiols.

Toxic effect of isolated glycophorin A on the in vitro growth of Plasmodium falciparum

We have examined the inhibitory potencies of glycophorin A, a mixture of glycophorins B and C, chymotryptic fragments of GpA, desialylated GpA, alkaliborohydride treated GpA, and the O-linked tetrasaccharide isolated from GpA on the invasion of human red blood cells by synchronous Plasmodium falciparum (strain FCB). 50% inhibition of invasion, as measured by 3H-hypoxanthine incorporation into parasites, was achieved at 14 and 155 microM for GpA and GpA-CH1, respectively. We have noticed, however, that isolated GpA exhibits a toxic effect on the intraerythrocytic growth of the parasite whereas the chymotryptic fragment (amino acid residues 1-64 of GpA) does not. Thus the inhibitory potency of isolated GpA during erythrocyte invasion by the merozoite should be regarded as the result of both an inhibitory and a toxic effect. The inhibitory effect should be attributed to the carbohydrate-rich outer portion of GpA carrying clusters of neuraminic acid. The toxic effect should be attributed to the hydrophobic region of GpA which might be capable of inserting into the membrane of free merozoites and/or erythrocytes. Our data suggest that results previously obtained with glycoprotein inhibitors carrying hydrophobic portions may have to be questioned.

Intermediate host (Biomphalaria alexandrina) antigens partly protect against subcutaneous infections with cercariae of Schistosoma mansoni but are ineffective in infections by percutaneous invasion

Mice were immunized against hepatopancreas homogenate of Biomphalaria alexandrina, using Al(OH)3 as adjuvant, and challenged by subcutaneous (s.c.) injection of Schistosoma mansoni cercariae, percutaneous invasion of cercariae and intravenous (i.v.) injection of mechanically prepared schistosomula of different ages. Significantly reduced (about 50%) numbers of adult S. mansoni were found 42 days after challenge in immunized animals infected by s.c. injection of cercariae. Protective effects were detectable as early as 4 days after infection when the numbers of schistosomules in the lungs were reduced in immunized animals. However, immunized animals lacked protective immunity against S. mansoni when infected via the percutaneous route with cercariae or by i.v. injection of schistosomules of different ages. Experiments show that immunization of hosts against intermediate host antigens does not protect against S. mansoni infection via the natural route.

Toxicity of "hydrophobic groupings" and the role of carbohydrates in Plasmodium falciparum infection

We have tested various carbohydrate structures and neoglycoproteins (carbohydrate haptens attached to BSA) as inhibitors of the invasion of human red blood cells by Plasmodium falciparum merozoites (strain FCB) in synchronous in vitro cultures, using 3H-hypoxanthine incorporation into intraerythrocytic parasites as analytical tool, and have got the following results: The inhibition rate of N-acetyl-D-glucosamine glycosides is increased with increasing lipophilicity of the aglycon or spacer: CH3 less than (CH2)2NHCO(CH2)2COOCH3 less than (CH2)8COOCH3; p-Nitrophenyl glycosides proved to exhibit a toxic effect; The inhibition rate of synthetic disaccharide glycosides increased in the order beta DGal(1----4) beta DGlcNAcOCH3 less than beta DGlcNAc(1----4) beta DGlcNAcOCH3 less than beta DGlcNAc(1----4) alpha DManOCH3 less than beta DGlcNAc(1----4) beta DManO(CH2)8COOCH3; The O-linked tetrasaccharide alpha NeuAc(2----3) beta DGal(1----3) [alpha NeuAc(2----6)] alpha DGalNAcol, isolated from glycophorin A, was the best carbohydrate inhibitor tested so far; The inhibition rate of carbohydrates attached to BSA by an aliphatic spacer [-(CH2)8COOCH3] was not enhanced compared to the haptens; [DNP]33-BSA proved to be an extraordinary inhibitor of invasion which, however, most likely has to be attributed to a toxic effect; Observed toxicities appear to be attributable to hydrophobic interactions between the inhibitors and the RBC and merozoite membranes, which hampers both, intraerythrocytic growth of the parasite and its capability of RBC invasion.

Plasmodium falciparum: carbohydrates as receptor sites of invasion

Monosaccharides, disaccharides, and trisaccharides were tested as inhibitors of the in vitro growth of Plasmodium falciparum (strain FCB). While certain monosaccharides (N-acetyl-D-glucosamine, D-mannose, and 3-O-methyl-D-glucose) proved to exhibit a toxic or reversibly retarding effect on the intraerythrocytic development of the parasite, the corresponding alpha- or beta-methylglycosides did not. Several methylglycosides, synthetic di- and tri-saccharides, and artificial blood group antigens were further tested for inhibitory effects on invasion of host red blood cells in vitro. The synthetic disaccharides beta DGlcNAc(1----4) alpha DManOMe and beta DGlcNAc(1----4) DGlcNAc (chitobiose) were good inhibitors of invasion at 10 mM concentration, whereas beta DGal(1----4)beta DGlcNAcOMe was negligibly inhibitory. The inhibition rate of N-acetyl-D-glucosamine, beta-glycosidically linked to bovine serum albumin (BSA) by an alipathic spacer, -(CH2)8CO-, was not enhanced, compared to the corresponding hapten, beta DGlcNAcO(CH2)8COOCH3. The inhibition rates of blood group A- and B-trisaccharide haptens, which were inhibitors of invasion, were also not significantly enhanced when coupled to BSA by way of the corresponding amide spacer, -(CH2)2NHCO(CH2)7CO-. A remarkable enhancement of the inhibition rate was, however, observed when beta DGal(1----3) alpha DGalNAcO(CH2)2NHCO(CH2)7COOCH3 (T-hapten) was coupled to BSA. A clear-cut decrease in the inhibition rates of different beta-glycosides of N-acetyl-D-glucosamine, beta DGlcNAcOR, was observed, depending on the nature of the aglycon R(p-nitrophenyl greater than -(CH2)8COOCH3 greater than -(CH2)2NHCO(CH2)2COOCH3 greater than -CH3). Also, p-nitrophenyl-alpha-D-glucopyranoside was a much better inhibitor of invasion than the corresponding methyl glycoside, alpha DGlcOMe, which was not inhibitory. The properties of the aglycon spacer, used for the covalent attachment of the carbohydrate to the carrier protein, may thus be crucial for the outcome of the inhibition rate.

Erythrocyte invasion by malaria (Plasmodium falciparum) merozoites: recent advances in the evaluation of receptor sites

Recent advances in the understanding of the cellular, biochemical and molecular aspects of the highly specific interactions between P. falciparum merozoites and human red blood cells are summarized. Special attention is given to glycophorins A, B and C as receptors of invasion and to the role of carbohydrates and internal domains of glycophorin A, such as the Wrb antigen, as receptor site. Video pictures displaying the liberation of merozoites from schizont-infected red blood cells and the invasion of human erythrocytes by P. falciparum merozoites are also provided.

Further evidence for T cell abnormalities in chronic lymphocytic leukaemia of the B cell type

Functional properties were studied in the purified T cell fraction of patients with chronic lymphocytic leukaemia of the B cell type (B-CLL). This analysis included the evaluation of T suppressor activity when investigated patients' T cells were co-cultured together with allogenic normal B and OKT4 enriched T cells in the presence of pokeweed mitogen (PWM). The Ig secreting cells (ISC) were assessed in a reverse haemolytic plaque assay (RHPA). Antibody-dependent cytotoxicity (ADCC) and natural killer activity (NK) were determined in a 51Cr release assay. Furthermore, purified T cells reactive with the monoclonal antibody HNK1, known to recognize most effector cells in ADCC and NK, were enumerated using an indirect immunofluorescence. Our results revealed increased T suppressor cell activity and markedly deficient NK activity in peripheral blood lymphocytes (PBL), T cell and T gamma cell fractions from B-CLL patients, whereas ADCC potential was only increased in T cells and T gamma cells. Accordingly, T cells were recognized by HNK1 in greater numbers in B-CLL patients than in healthy subjects. Our data suggest that there may be a link between our findings and the hypogammaglobulinaemia as well as the increased incidence of second neoplasias reported in CLL.

Dual expression of T and B cell markers in human B cell neoplasias

Macrophage- and T-cell-depleted mononuclear cells from 36 patients with B cell lymphoma and 12 healthy individuals were investigated by indirect immunofluorescence with the monoclonal antibodies NEI-011 (7.2) and NEI-015 (10.2). The monoclonal antibody NEI-011 (7.2) recognized the Ia antigen and identified almost all B cells in the peripheral blood of healthy individuals. Furthermore, neoplastic B cells from all patients except those with plasma cell proliferation were found to react with this antibody. NEI-015 (10.2), a monoclonal antibody known to react with both T cells and B-CLL cells, did not react with normal circulating B cells. However, this antibody did identify neoplastic B cells except in cases of plasma cell proliferation and lymphoblastic lymphoma.

B-cell function in patients with chronic lymphocytic leukemia

Using a reverse hemolytic protein A plaque assay, spontaneous and pokeweed mitogen (PWM)-induced immunoglobulin (Ig) secretion was determined in peripheral blood from 22 patients with B1-chronic lymphocytic leukemia (CLL), one patient with B2-CLL, and one patient with suppressor T-CLL. Diagnoses were established by cytological and histological criteria as well as several marker analyses. Lymphocytes from B1- and B2-CLL patients were unable to secrete Ig either spontaneously or after PWM stimulation. In T-CLL lymphocytes, spontaneous Ig secretion was suppressed very probably by the OKT-8-positive leukemic population, since, after cultivation with PWM, a normal Ig secretion could be demonstrated which was paralleled by a decrease in the OKT-8-positive cells. Cocultivation experiments with freshly isolated, unseparated lymphocytes from normal subjects and lymphocytes from patients were of no informational value, since isolated normal B-cells alone already showed a high rate of Ig secretion. However, coculture experiments with separated subpopulations after PWM stimulation revealed an intrinsic B-cell defect in lymphocytes from B1-CLL patients, whereas their T-lymphocytes were found to be normal helper cells.

PWM-induced generation of immunoglobulin-secreting cells in patients with multiple myeloma

The pokeweed-mitogen-induced transformation of B-lymphocytes into immunoglobulin-secreting cells was studied in vitro in 25 patients with multiple myeloma using a reverse hemolytic plaque assay. Fifteen patients showed a good response in generating immunoglobulin-secreting cells, whereas 10 patients showed a decreased B cell reactivity which was not due to intermittent melphalan/steroid therapy administered to 15 patients. Experiments with lymphocyte subpopulations demonstrated that the inability of some multiple-myeloma patients to generate immunoglobulin-secreting cells was always based on a defect in the B-cell subset. Co-culture experiments with lymphocytes from normal individuals and patients revealed a cell-mediated suppression in one case, whereas humoral suppressive factors in the patients' serum could not be observed using the reverse hemolytic plaque assay. Patients were classified into three groups: (a) patients with a normal B-cell function, (b) patients with a reversible, tumor-dependent suppression of B-cell reactivity and (c) patients in whom the normal B-cell population was replaced by non-reactive cells.

Impaired B-lymphocyte reactivity in patients with Hodgkin's disease and non-Hodgkin-lymphomas

The generation of immunoglobulin-secreting cells upon stimulation with pokeweed mitogen was studied in patients with Hodgkin's Disease (HD) and non-Hodgkin lymphomas (NHL) using a reverse hemolytic plaque assay. The experiments revealed that the majority of the patients in both groups had greatly diminished responses of their peripheral B-lymphocytes. Whereas in NHL patients an intrinsic B-cell defect is the most likely explanation for the impaired B-cell reactivity, the situation in HD appears to be more complex. In some patients with an active stage of the disease, suppressor cells were found to cause the unresponsiveness: in other patients, an intrinsic B-cell defect as well as a defect of the T helper cells were responsible for the diminished responses. The results further suggest that the immune defect in patients with HD is reversible and can be corrected by therapy.

Characteristics of immunoglobulin secretion in man evaluated by a reverse hemolytic plaque assay

The kinetics of Pokeweed mitogen-induced transformation of human B-lymphocytes into immunoglobulin-secreting cells were examined in a reverse hemolytic plaque assay using protein A-coated sheep red blood cells as indicator cells. Peak responses occurred consistently after 6-8 days of incubation. After determination of the optimal experimental conditions the RHPA was found to be a reliable tool to estimate ISC in vitro; the technique was also found to be applicable for experiments surveying the B-cell response of an individual over a period of months. The PWM-induced transformation of B cells was absolutely T-cell-dependent. Other substances known as typical T-cell mitogens were also tested for polyclonal B-cell activation and some of them showed significant responses. Further experiments have shown that co-cultivation of non-HLA identical cells did not increase the number of plaques in unstimulated cultures whereas the addition of PWM leads to the generation of ISC within the expected range. These findings open a wide field of application of the RHPA in experimental and clinical immunology.

Biochemical and technical considerations regarding the mass production of certain parasitic protozoa

This article summarizes the most relevant biochemical knowledge about growth factors as specific essential components of culture media, and calls attention to their significance with respect to the mass cultivation of some parasitic protozoa-e.g., Trypanosoma and Leishmania spp. and amoebae. Details of recent developments and techniques of parasite fermentation are reviewed.

Use of indirect microhemagglutination test with stable sensitized red cells in the detection of horse protein allergy

Sheep red blood cells were stabilized with sulfosalicylic acid and sensitized with purified horse-IgG by the action of glutardialdehyde. The cells were used in an indirect microhemmagglutination test with serum samples from 12 rabbits immunized with horse-IgG and complete Freund's adjuvant as well as from 10 control animals. 32 human serum samples were examined, 6 of them from patients with established horse protein allergy. The results were compared to those of a standard method of indirect hemagglutination using fresh human erythrocytes (group O Rh-), an active hemagglutination test against horse erythrocytes, Ouchterlony's immunodiffusion and skin tests with horse-IgG. The method proved to be very sensitive. The results correlated well with those of the other immunological techniques. The stable sensitized cells did not lose sensitivity after 1 year of storage at 4 degrees C.

Survey on experiences with latex-Chagas-test in various countries

The principle of the latex agglutination technique was applied on the serodiagnosis of Chagas' disease. The latex particles coated with antigen from Trypanosoma cruzi are agglutinated by antibodies against T. cruzi in the serum of patients suffering thereof. In 11600 comparative determinations worked out mainly in a number of South American laboratories, the sensitivity of this test was compared with xenodiagnosis, CF, IFT and IHA. The latex Chagas test shows a mean coincidence of 90% with xenodiagnosis, 88% with CF, 75% with IFT, and 83% with IHA. The results indicate that the test is a useful new tool for the serodiagnosis of Chagas' disease. Also the data from CF, IFT and IHA were compared with each other. The latex Chagas test is sensitive even in the early stage of the disease. Also the specificity of the test was evaluated in other parasitic, bacterial and general diseases.