Complete nucleotide sequence, genome organization, and biological properties of human immunodeficiency virus type 1 in vivo: evidence for limited defectiveness and complementation

Previous studies of the genetic and biologic characteristics of human immunodeficiency virus type 1 (HIV-1) have by necessity used tissue culture-derived virus. We recently reported the molecular cloning of four full-length HIV-1 genomes directly from uncultured human brain tissue (Y. Li, J. C. Kappes, J. A. Conway, R. W. Price, G. M. Shaw, and B. H. Hahn, J. Virol. 65:3973-3985, 1991). In this report, we describe the biologic properties of these four clones and the complete nucleotide sequences and genome organization of two of them. Clones HIV-1YU-2 and HIV-1YU-10 were 9,174 and 9,176 nucleotides in length, differed by 0.26% in nucleotide sequence, and except for a frameshift mutation in the pol gene in HIV-1YU-10, contained open reading frames corresponding to 5'-gag-pol-vif-vpr-tat-rev-vpu-env-nef-3' flanked by long terminal repeats. HIV-1YU-2 was fully replication competent, while HIV-1YU-10 and two other clones, HIV-1YU-21 and HIV-1YU-32, were defective. All three defective clones, however, when transfected into Cos-1 cells in any pairwise combination, yielded virions that were replication competent and transmissible by cell-free passage. The cellular host range of HIV-1YU-2 was strictly limited to primary T lymphocytes and monocyte-macrophages, a property conferred by its external envelope glycoprotein. Phylogenetic analyses of HIV-1YU-2 gene sequences revealed this virus to be a member of the North American/European HIV-1 subgroup, with specific similarity to other monocyte-tropic viruses in its V3 envelope amino acid sequence. These results indicate that HIV-1 infection of brain is characterized by the persistence of mixtures of fully competent, minimally defective, and more substantially altered viral forms and that complementation among them is readily attainable. In addition, the limited degree of genotypic heterogeneity observed among HIV-1YU and other brain-derived viruses and their preferential tropism for monocyte-macrophages suggest that viral replication within the central nervous system may differ from that within the peripheral lymphoid compartment in significant and clinically important ways. The availability of genetically and biologically well characterized HIV-1 clones from uncultured human tissue should facilitate future studies of virus-cell interactions relevant to viral pathogenesis and drug and vaccine development.

Evolution of the serum amyloid A (SAA) protein superfamily

The serum amyloid A (SAA) superfamily comprises a number of genes and proteins characterized from a range of mammalian species. The majority of members described to date are dramatically induced during the acute-phase response, suggesting an important short-term beneficial role in the response to tissue injury and inflammation. However, important disease associations have also been proposed for certain SAAs during chronic inflammation. The nomenclature of many of the superfamily members has been the result of comparisons with previously reported sequences implying disease association and/or functional relatedness between such members. The evolutionary relationships of the SAA superfamily members have been investigated by comparisons at both the amino acid and the nucleotide level. The results indicate that all members of the superfamily within a species have been undergoing concerted evolution. This has important implications in ascribing functions and disease associations to individual SAA superfamily members and indicates that designations should not be based on the extent of amino acid identity alone but should be made only following direct experimental observation of the proteins themselves.

Decreased Performance and Return to Play Following Anterior Cruciate Ligament Reconstruction in National Football League Wide Receivers

Purpose

To identify the time to return to play (RTP) and evaluate the performance level in wide receivers in the National Football League following anterior cruciate ligament (ACL) reconstruction.

Methods

A total of 29 wide receivers in the National Football League who underwent ACL reconstruction between 2013 and 2017 who met inclusion criteria were retrospectively identified and reviewed. For each player, a matched control with similar demographics was identified to compare various in-game performance measurements and seasons played.

Results

Of the wide receivers that met the inclusion criteria, 9 of 29 (31%) did not RTP in a regular season game following ACL reconstruction. For players who did RTP, 20 of 29 (69%), the average time was 10.9 months (331.4 ± 41.6 days). When we compared the tear group with the matched control cohort, players with ACL tears ended their careers on an average of 1.9 seasons earlier (2.2 vs 4.1 seasons, P < .001) and also played less than half the number of games (25.5 vs 56.6 games, P = .001), respectively. Those that RTP also saw decreased performance statistics in targets (353.6 vs 125.2 P < .001), receptions (208.0 vs 74.4, P = .001), receiving yards (2691.0 vs 987.9, P = .001), and touchdowns (17.4 vs 6.2, P = .002).

Conclusions

Sixty-nine percent of wide receivers who underwent ACL reconstruction were able to RTP at an average of 10.9 months, or 331.4 days. Despite the majority of players being able to RTP, there was a significant decrease in both statistical performance and career duration.

Level of Evidence

Level III, case-control study.

Effects of Fellowship Training on Pediatric Anterior Cruciate Ligament Reconstruction Techniques and Outcomes

The purpose of this study is to examine differences in pediatric anterior cruciate ligament reconstruction (ACLR) between surgeons with either pediatric or sports medicine fellowship training. Patients were divided into two groups, those performed by either a pediatric or sports medicine fellowship-trained surgeon. One hundred and forty-one patients were identified: 91 (64.5%) by pediatric trained surgeons and 50 (35.4%) by sports medicine trained surgeons. Patients that had ACLR by a pediatric trained surgeon were younger (p = 0.02), had larger body mass index (BMI) (p = 0.027), and more likely to have government assisted insurance (p = 0.006). Pediatric trained surgeons had longer procedure time (p < 0.001), used smaller graft sizes (p = 0.016), used soft tissue grafts (p < 0.001) and used button fixation at both the femur and tibia (p < 0.001). There were no differences regarding meniscus surgery, surgical technique (transphyseal versus physeal sparing), arthrofibrosis, graft failure, and intraoperative complications (p > 0.05). This study shows favorable and comparable results after ACLRs with either pediatric or sports medicine fellowship training. (Journal of Surgical Orthopaedic Advances 30(3):161-165, 2021).

National Football League Wide Receivers and Running Backs Have Decreased Production Following ACL Reconstruction: An Evaluation of Fantasy Football Performance as an Outcome Measure

Purpose

To use fantasy football points as a simple measure alongside on-field statistics to compare performance in National Football League (NFL) offensive skill position players before and after anterior cruciate ligament (ACL) reconstruction.

Methods

A retrospective review of all NFL quarterbacks (QB), running backs (RB), wide receivers (WR), and tight ends (TE) who sustained an isolated, unilateral ACL injury from 1988 to 2017 was conducted. Data were collected from public data sources, team releases, NFL injury reports, press releases, and other Internet resources. For each player, a matched control with similar demographics was identified. Their in-game performance post-ACL reconstruction was analyzed using fantasy football points as an outcome measure.

Results

A total of 13 QBs, 30 RBs, and 29 WRs who underwent ACL reconstruction from 1988 to 2017 and who met inclusion criteria were retrospectively identified and reviewed. Of the 13 quarterbacks included in the study, there was no statistically significant difference in fantasy football points between the pre- and post-ACL reconstruction groups, as well as post-ACL and matched control groups. There was a statistically significant decrease in career fantasy football performance of running backs post-ACL reconstruction compared with matched control groups (129.6 vs 553.6; P < .0001). There was also a statistically significant decrease in per game fantasy football points post-ACL reconstruction (4.4 vs 11.2; P < .0001). Lastly, WRs also demonstrated a decrease in career fantasy football performance post-ACL reconstruction compared with matched controls (145.3 vs 460.9; P = .002). In addition, they also had a decrease in per game fantasy football performance (5.0 vs 7.7; P = .042).

Conclusions

Quarterbacks did not have a statistically significant decrease in performance following ACL reconstruction based on fantasy football performance. Conversely, both running backs and wide receivers had decreased per game and career performance post-ACL reconstruction based on their fantasy football statistics. Furthermore, RBs had the largest decline in production each season over a 3-year period following ACLR compared to QBs and WRs, respectively.

Level of Evidence

Level III, case-control study.