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Rufino de Sousa N, Steponaviciute L, Margerie L, Nissen K, Kjellin M, Reinius B, Salaneck E, Udekwu KI, Rothfuchs AG. Plaque-forming units from air samples: Letter to Editor. Re: Jefferson et al., Indoor Air, 2022. Indoor Air 2022; 32:e13169. [PMID: 36437649 DOI: 10.1111/ina.13169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Nuno Rufino de Sousa
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Laura Steponaviciute
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Lucille Margerie
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Karolina Nissen
- Department of Medical Sciences, Infectious Diseases, Uppsala University, University Hospital Uppsala, Uppsala, Sweden
| | - Midori Kjellin
- Department of Medical Sciences, Infectious Diseases, Uppsala University, University Hospital Uppsala, Uppsala, Sweden
| | - Björn Reinius
- Department of Medical Biochemistry and Biophysics (MBB), Karolinska Institutet, Stockholm, Sweden
| | - Erik Salaneck
- Department of Medical Sciences, Infectious Diseases, Uppsala University, University Hospital Uppsala, Uppsala, Sweden
| | - Klas I Udekwu
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Rufino de Sousa N, Steponaviciute L, Margerie L, Nissen K, Kjellin M, Reinius B, Salaneck E, Udekwu KI, Rothfuchs AG. Corrigendum. Re: de Sousa, N.R., et al., 2022. Detection and isolation of airborne SARS-CoV-2 in a hospital setting. Indoor air, 32(3), e13023. Indoor Air 2022; 32:e13085. [PMID: 36040276 PMCID: PMC10117284 DOI: 10.1111/ina.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Nuno Rufino de Sousa
- Department of Microbiology, Tumor
and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Laura Steponaviciute
- Department of Microbiology, Tumor
and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Lucille Margerie
- Department of Microbiology, Tumor
and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Karolina Nissen
- Department of Medical Sciences,
Infectious DiseasesUppsala University, University Hospital UppsalaSweden
| | - Midori Kjellin
- Department of Medical Sciences,
Infectious DiseasesUppsala University, University Hospital UppsalaSweden
| | - Björn Reinius
- Department of Medical Biochemistry
and Biophysics (MBB)Karolinska InstitutetStockholmSweden
| | - Erik Salaneck
- Department of Medical Sciences,
Infectious DiseasesUppsala University, University Hospital UppsalaSweden
| | - Klas I. Udekwu
- Department of Aquatic Sciences and
AssessmentSwedish University of Agricultural SciencesUppsalaSweden
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Rufino de Sousa N, Steponaviciute L, Margerie L, Nissen K, Kjellin M, Reinius B, Salaneck E, Udekwu KI, Rothfuchs AG. Detection and isolation of airborne SARS-CoV-2 in a hospital setting. Indoor Air 2022; 32:e13023. [PMID: 35347788 PMCID: PMC9111425 DOI: 10.1111/ina.13023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/21/2022] [Accepted: 03/10/2022] [Indexed: 05/15/2023]
Abstract
Transmission mechanisms for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are incompletely understood. In particular, aerosol transmission remains unclear, with viral detection in air and demonstration of its infection potential being actively investigated. To this end, we employed a novel electrostatic collector to sample air from rooms occupied by COVID-19 patients in a major Swedish hospital. Electrostatic air sampling in conjunction with extraction-free, reverse-transcriptase polymerase chain reaction (hid-RT-PCR) enabled detection of SARS-CoV-2 in air from patient rooms (9/22; 41%) and adjoining anterooms (10/22; 45%). Detection with hid-RT-PCR was concomitant with viral RNA presence on the surface of exhaust ventilation channels in patients and anterooms more than 2 m from the COVID-19 patient. Importantly, it was possible to detect active SARS-CoV-2 particles from room air, with a total of 496 plaque-forming units (PFUs) being isolated, establishing the presence of infectious, airborne SARS-CoV-2 in rooms occupied by COVID-19 patients. Our results support circulation of SARS-CoV-2 via aerosols and urge the revision of existing infection control frameworks to include airborne transmission.
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Affiliation(s)
- Nuno Rufino de Sousa
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Laura Steponaviciute
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Lucille Margerie
- Department of Microbiology, Tumor and Cell Biology (MTC)Karolinska InstitutetStockholmSweden
| | - Karolina Nissen
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Midori Kjellin
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Björn Reinius
- Department of Medical Biochemistry and Biophysics (MBB)Karolinska InstitutetStockholmSweden
| | - Erik Salaneck
- Department of Medical SciencesInfectious DiseasesUppsala UniversityUniversity Hospital UppsalaUppsalaSweden
| | - Klas I. Udekwu
- Department of Aquatic Sciences and AssessmentSwedish University of Agricultural SciencesUppsalaSweden
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Nissen K, Hagbom M, Krambrich J, Akaberi D, Sharma S, Ling J, Hoffman T, Lundkvist Å, Svensson L, Bondeson K, Salaneck E. Corrigendum to “Presymptomatic viral shedding and infective ability of SARS-CoV-2; a case report” <[Heliyon Volume 7, Issue 2, February 2021, Article e06328]>. Heliyon 2022; 8:e08906. [PMID: 35155841 PMCID: PMC8816836 DOI: 10.1016/j.heliyon.2022.e08906] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Karolina Nissen
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Marie Hagbom
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Janina Krambrich
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Dario Akaberi
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sumit Sharma
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jiaxin Ling
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tove Hoffman
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Åke Lundkvist
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Lennart Svensson
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Dept of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kåre Bondeson
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
- Corresponding author.
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Bacchus P, Nissen K, Berg J, Bråve A, Gyll J, Larsson C, Muradrasoli S, Tellström A, Salaneck E. Civil-Military Collaboration to Facilitate Rapid Deployment of a Mobile Laboratory in Early Response to COVID-19: A High-Readiness Exercise. Health Secur 2021; 19:488-497. [PMID: 34542343 DOI: 10.1089/hs.2021.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Rapid and adaptable diagnostic capabilities are of great importance in the face of emerging infectious diseases. In an outbreak, timely establishment of diagnostic routines is crucial to identifying cases and preventing the spread of the disease, especially when faced with high-consequence pathogens. In this article, we describe a multiagency exercise including the rapid deployment and diagnostic adaptation of the Swedish Armed Forces mobile laboratory (biological field analysis laboratory) in the context of COVID-19. This deployment was initiated as a high-readiness exercise at the end of January 2020, when the global development of the outbreak was still uncertain. Through collaboration with the Public Health Agency of Sweden and a civilian hospital, a real-time reverse transcriptase polymerase chain reaction method specific to SARS-CoV-2 was made available and adapted to the mobile laboratory, and the team established and evaluated a functional and efficient diagnostic asset along with a logistical support chain. We also organized and evaluated mobile testing teams, and the method was later used in large-scale, national, cross-sectional COVID-19 surveys in several regions of Sweden. In this article, we focus on the challenges of overbridging the civil-military interface in this context and identifying lessons learned and added values to the response during the early pandemic. We propose that the experiences from this exercise and governmental agency collaboration are valuable in preparation for future outbreaks.
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Affiliation(s)
- Philip Bacchus
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Karolina Nissen
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Johanna Berg
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Andreas Bråve
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Jenny Gyll
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Christer Larsson
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Shaman Muradrasoli
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Andreas Tellström
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
| | - Erik Salaneck
- Philip Bacchus, MSci, is a Commander, Swedish Navy; Johanna Berg is a Specialist, Infectious Diseases; Jenny Gyll, MSci, is a Biology Expert; and Christer Larsson, PhD, and Andreas Tellström, MSci, are Laboratory Engineers; all at the Swedish Armed Forces National CBRN Defence Centre, Umeå, Sweden. Karolina Nissen, MD, is a Specialist, Infectious Diseases, and Erik Salaneck, MD, PhD, is an Associate Professor; both in the Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Andreas Bråve, PhD, is Deputy Head of Department and Shaman Muradrasoli, PhD, is Head of Unit; both at the Public Health Agency of Sweden, Solna, Sweden. Erik Salaneck is also Associate Professor, Swedish Armed Forces Centre for Defence Medicine, Gothenburg, Sweden
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Nissen K, Hagbom M, Krambrich J, Akaberi D, Sharma S, Ling J, Hoffman T, Svensson L, Bondeson K, Salaneck E. Presymptomatic viral shedding and infective ability of SARS-CoV-2; a case report. Heliyon 2021; 7:e06328. [PMID: 33644482 PMCID: PMC7894094 DOI: 10.1016/j.heliyon.2021.e06328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/25/2021] [Accepted: 02/17/2021] [Indexed: 12/11/2022] Open
Abstract
Possible pre- or asymptomatic transmission has been reported, both from SARS-CoV and from MERS-CoV outbreaks, although this appears to be uncommon. In contrast, during the COVID-19 pandemic, an increasing number of studies and case reports indicate that pre- or asymptomatic transmission of SARS-CoV-2 is not only possible but also occurs frequently. We report repeated rRT-PCR detection of SARS-CoV-2 in a health care worker and demonstrate infective ability up to three days prior to mild COVID-19 symptoms. rRT-PCR indicated high viral levels approximately three days after exposure. Viral samples collected one and three days prior to symptoms exhibited infectivity on Vero E6 cells, confirmed by detection of double-stranded RNA by immunofluorescence, assessment of cytopathic effect (CPE) and rRT-PCR. SARS-CoV-2 specific IgM and IgG antibodies were detected by day 9 and 15, respectively, after symptom onset. We propose that this provides evidence for potential early presymptomatic transmission of SARS-CoV-2 and that infectivity may be manifest shortly after exposure.
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Affiliation(s)
- Karolina Nissen
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Marie Hagbom
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Janina Krambrich
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Dario Akaberi
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sumit Sharma
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jiaxin Ling
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tove Hoffman
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Lennart Svensson
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Dept of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kåre Bondeson
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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Nissen K, Hagbom M, Krambrich J, Akaberi D, Sharma S, Ling J, Hoffman T, Svensson L, Bondeson K, Salaneck E. Presymptomatic viral shedding and infective ability of SARS-CoV-2; a case report. Heliyon 2021. [PMID: 33644482 DOI: 10.21203/rs.3.rs-36269/v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
Possible pre- or asymptomatic transmission has been reported, both from SARS-CoV and from MERS-CoV outbreaks, although this appears to be uncommon. In contrast, during the COVID-19 pandemic, an increasing number of studies and case reports indicate that pre- or asymptomatic transmission of SARS-CoV-2 is not only possible but also occurs frequently. We report repeated rRT-PCR detection of SARS-CoV-2 in a health care worker and demonstrate infective ability up to three days prior to mild COVID-19 symptoms. rRT-PCR indicated high viral levels approximately three days after exposure. Viral samples collected one and three days prior to symptoms exhibited infectivity on Vero E6 cells, confirmed by detection of double-stranded RNA by immunofluorescence, assessment of cytopathic effect (CPE) and rRT-PCR. SARS-CoV-2 specific IgM and IgG antibodies were detected by day 9 and 15, respectively, after symptom onset. We propose that this provides evidence for potential early presymptomatic transmission of SARS-CoV-2 and that infectivity may be manifest shortly after exposure.
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Affiliation(s)
- Karolina Nissen
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Marie Hagbom
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Janina Krambrich
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Dario Akaberi
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sumit Sharma
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jiaxin Ling
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tove Hoffman
- Dept of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Lennart Svensson
- Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Dept of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kåre Bondeson
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
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Langenwalder DB, Schmidt S, Silaghi C, Skuballa J, Pantchev N, Matei IA, Mihalca AD, Gilli U, Zajkowska J, Ganter M, Hoffman T, Salaneck E, Petrovec M, von Loewenich FD. Correction to: The absence of the drhm gene is not a marker for human-pathogenicity in European Anaplasma phagocytophilum strains. Parasit Vectors 2020; 13:497. [PMID: 32998772 PMCID: PMC7526212 DOI: 10.1186/s13071-020-04350-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Nissen K, Krambrich J, Akaberi D, Hoffman T, Ling J, Lundkvist Å, Svensson L, Salaneck E. Long-distance airborne dispersal of SARS-CoV-2 in COVID-19 wards. Sci Rep 2020; 10:19589. [PMID: 33177563 DOI: 10.21203/rs.3.rs-34643/v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/03/2020] [Accepted: 10/28/2020] [Indexed: 05/23/2023] Open
Abstract
Evidence suggests that SARS-CoV-2, as well as other coronaviruses, can be dispersed and potentially transmitted by aerosols directly or via ventilation systems. We therefore investigated ventilation openings in one COVID-19 ward and central ducts that expel indoor air from three COVID-19 wards at Uppsala University Hospital, Sweden, during April and May 2020. Swab samples were taken from individual ceiling ventilation openings and surfaces in central ducts. Samples were subsequently subjected to rRT-PCR targeting the N and E genes of SARS-CoV-2. Central ventilation HEPA filters, located several stories above the wards, were removed and portions analyzed in the same manner. In two subsequent samplings, SARS-CoV-2 N and E genes were detected in seven and four out of 19 room vents, respectively. Central ventilation HEPA exhaust filters from the ward were found positive for both genes in three samples. Corresponding filters from two other, adjacent COVID-19 wards were also found positive. Infective ability of the samples was assessed by inoculation of susceptible cell cultures but could not be determined in these experiments. Detection of SARS-CoV-2 in central ventilation systems, distant from patient areas, indicate that virus can be transported long distances and that droplet transmission alone cannot reasonably explain this, especially considering the relatively low air change rates in these wards. Airborne transmission of SARS-CoV-2 must be taken into consideration for preventive measures.
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Affiliation(s)
- Karolina Nissen
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Janina Krambrich
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Dario Akaberi
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tove Hoffman
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Jiaxin Ling
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Åke Lundkvist
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Lennart Svensson
- Department of Molecular Medicine and Virology, Linköping University, Linköping, Sweden
- Division of Infectious Diseases, Department of Medicine, Karolinska Institute, Solna, Sweden
| | - Erik Salaneck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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Langenwalder DB, Schmidt S, Silaghi C, Skuballa J, Pantchev N, Matei IA, Mihalca AD, Gilli U, Zajkowska J, Ganter M, Hoffman T, Salaneck E, Petrovec M, von Loewenich FD. The absence of the drhm gene is not a marker for human-pathogenicity in European Anaplasma phagocytophilum strains. Parasit Vectors 2020; 13:238. [PMID: 32381072 PMCID: PMC7206706 DOI: 10.1186/s13071-020-04116-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/29/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Anaplasma phagocytophilum is a Gram-negative obligate intracellular bacterium that replicates in neutrophil granulocytes. It is transmitted by ticks of the Ixodes ricinus complex and causes febrile illness in humans and animals. The geographical distribution of A. phagocytophilum spans the Americas, Europe, Africa and Asia. However, human disease predominantly occurs in North America but is infrequently reported from Europe and Asia. In North American strains, the absence of the drhm gene has been proposed as marker for pathogenicity in humans whereas no information on the presence or absence of the drhm gene was available for A. phagocytophilum strains circulating in Europe. Therefore, we tested 511 European and 21 North American strains for the presence of drhm and compared the results to two other typing methods: multilocus sequence typing (MLST) and ankA-based typing. RESULTS Altogether, 99% (478/484) of the analyzable European and 19% (4/21) of the North American samples from different hosts were drhm-positive. Regarding the strains from human granulocytic anaplasmosis cases, 100% (35/35) of European origin were drhm-positive and 100% (14/14) of North American origin were drhm-negative. Human strains from North America and Europe were both part of MLST cluster 1. North American strains from humans belonged to ankA gene clusters 11 and 12 whereas European strains from humans were found in ankA gene cluster 1. However, the North American ankA gene clusters 11 and 12 were highly identical at the nucleotide level to the European cluster 1 with 97.4% and 95.2% of identity, respectively. CONCLUSIONS The absence of the drhm gene in A. phagocytophilum does not seem to be associated with pathogenicity for humans per se, because all 35 European strains of human origin were drhm-positive. The epidemiological differences between North America and Europe concerning the incidence of human A. phagocytophilum infection are not explained by strain divergence based on MLST and ankA gene-based typing.
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Affiliation(s)
- Denis B Langenwalder
- Department of Medical Microbiology and Hygiene, Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacherstrasse 67, 55131, Mainz, Germany
| | - Sabine Schmidt
- Department of Medical Microbiology and Hygiene, Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacherstrasse 67, 55131, Mainz, Germany
| | - Cornelia Silaghi
- Institute of Infectology, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Jasmin Skuballa
- Chemical and Veterinary Investigations Office Karlsruhe (CVUA Karlsruhe), Weissenburgerstrasse 3, 76187, Karlsruhe, Germany
| | - Nikola Pantchev
- IDEXX Laboratories, Mörikestrasse 28/3, 71636, Ludwigsburg, Germany
| | - Ioana A Matei
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Andrei D Mihalca
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Urs Gilli
- IDEXX Diavet AG, Schlyffistrasse 10, 8806, Bäch, Switzerland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, ul.Żurawia 14, 15-345, Białystok, Poland
| | - Martin Ganter
- Clinic for Swine and Small Ruminants, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Tove Hoffman
- Department of Medical Biochemistry and Microbiology (IMBIM), Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
| | - Friederike D von Loewenich
- Department of Medical Microbiology and Hygiene, Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacherstrasse 67, 55131, Mainz, Germany.
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11
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Hoffman T, Nissen K, Krambrich J, Rönnberg B, Akaberi D, Esmaeilzadeh M, Salaneck E, Lindahl J, Lundkvist Å. Evaluation of a COVID-19 IgM and IgG rapid test; an efficient tool for assessment of past exposure to SARS-CoV-2. Infect Ecol Epidemiol 2020; 10:1754538. [PMID: 32363011 PMCID: PMC7178815 DOI: 10.1080/20008686.2020.1754538] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/25/2022] Open
Abstract
COVID-19 is the most rapidly growing pandemic in modern time, and the need for serological testing is most urgent. Although the diagnostics of acute patients by RT-PCR is both efficient and specific, we are also crucially in need of serological tools for investigating antibody responses and assessing individual and potential herd immunity. We evaluated a commercially available test developed for rapid (within 15 minutes) detection of SARS-CoV-2-specific IgM and IgG by 29 PCR-confirmed COVID-19 cases and 124 negative controls. The results revealed a sensitivity of 69% and 93.1% for IgM and IgG, respectively, based solely on PCR-positivity due to the absence of a serological gold standard. The assay specificities were shown to be 100% for IgM and 99.2% for IgG. This indicates that the test is suitable for assessing previous virus exposure, although negative results may be unreliable during the first weeks after infection. More detailed studies on antibody responses during and post infection are urgently needed.
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Affiliation(s)
- Tove Hoffman
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden
| | - Karolina Nissen
- Department of Medical Sciences, Infectious Diseases Uppsala University, Uppsala, Sweden
| | - Janina Krambrich
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden
| | - Bengt Rönnberg
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden.,Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
| | - Dario Akaberi
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden
| | - Mouna Esmaeilzadeh
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Infectious Diseases Uppsala University, Uppsala, Sweden
| | - Johanna Lindahl
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden.,Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Department of Biosciences, International Livestock Research Institute, Hanoi, Vietnam
| | - Åke Lundkvist
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC), Uppsala University, Uppsala, Sweden
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12
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Hoffman T, Wilhelmsson P, Barboutis C, Fransson T, Jaenson TGT, Lindgren PE, Von Loewenich FD, Lundkvist Å, Olsen B, Salaneck E. A divergent Anaplasma phagocytophilum variant in an Ixodes tick from a migratory bird; Mediterranean basin. Infect Ecol Epidemiol 2020; 10:1729653. [PMID: 32284823 PMCID: PMC7144310 DOI: 10.1080/20008686.2020.1729653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023] Open
Abstract
Anaplasma phagocytophilum (AP) has vast geographical and host ranges and causes disease in humans and domesticated animals. We investigated the role of northward migratory birds in the dispersal of tick-borne AP in the African-Western Palearctic. Ticks were collected from northward migratory birds trapped during spring migration of 2010 at two localities in the central Mediterranean Sea. AP DNA was detected by PCR (gltA and 16S rRNA) and variant determination was performed using ankA sequences. In total, 358 ticks were collected. One of 19 ticks determined as Ixodes was confirmed positive for AP DNA. The tick was collected from a woodchat shrike (Lanius senator senator) trapped in Greece, and molecularly determined to belong to the I. ricinus complex and sharing highest (95%) 16S RNA sequence identity to I. gibbosus. The ankA AP sequence exhibited highest similarity to sequences from rodents and shrews (82%) and ruminants (80%). Phylogenetic analyses placed it convincingly outside other clades, suggesting that it represents a novel AP variant. The divergent Ixodes species harboring a novel AP variant could either indicate an enzootic cycle involving co-evolution with birds, or dissemination from other regions by avian migration. None of the 331 Hyalomma marginatum sensu lato ticks, all immature stages, were positive for AP DNA, lending no evidence for the involvement of Hyalomma ticks transported by birds in the ecology of AP.
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Affiliation(s)
- Tove Hoffman
- Department of Medical Biochemistry and Microbiology (IMBIM), Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Peter Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Microbiology, County Hospital Ryhov, Jönköping, Sweden.,Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Christos Barboutis
- Antikythira Bird Observatory, Hellenic Ornithological Society/Birdlife Greece, Athens, Greece
| | - Thord Fransson
- Department of Environmental Research and Monitoring, Swedish Museum of Natural History, Stockholm, Sweden
| | | | - Per-Eric Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Microbiology, County Hospital Ryhov, Jönköping, Sweden.,Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Åke Lundkvist
- Department of Medical Biochemistry and Microbiology (IMBIM), Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Björn Olsen
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
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13
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Hoffman T, Lindeborg M, Barboutis C, Erciyas-Yavuz K, Evander M, Fransson T, Figuerola J, Jaenson TGT, Kiat Y, Lindgren PE, Lundkvist Å, Mohamed N, Moutailler S, Nyström F, Olsen B, Salaneck E. Alkhurma Hemorrhagic Fever Virus RNA in Hyalomma rufipes Ticks Infesting Migratory Birds, Europe and Asia Minor. Emerg Infect Dis 2019; 24:879-882. [PMID: 29664386 PMCID: PMC5938767 DOI: 10.3201/eid2405.171369] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Alkhurma hemorrhagic fever virus RNA was detected in immature Hyalomma rufipes ticks infesting northward migratory birds caught in the North Mediterranean Basin. This finding suggests a role for birds in the ecology of the Alkhurma hemorrhagic fever virus and a potential mechanism for dissemination to novel regions. Increased surveillance is warranted.
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14
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Järhult JD, Wahlgren J, Hasan B, Salaneck E, Lundkvist Å. Mallard or chicken? Comparing the isolation of avian influenza A viruses in embryonated Mallard and chicken eggs. Infect Ecol Epidemiol 2015; 5:28458. [PMID: 26356095 PMCID: PMC4565061 DOI: 10.3402/iee.v5.28458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/19/2015] [Accepted: 08/16/2015] [Indexed: 11/14/2022] Open
Abstract
Background To date, the most efficient and robust method for isolating avian influenza A viruses (IAVs) is using embryonated chicken eggs (ECEs). It is known that low-pathogenic avian IAVs undergo rapid genetic changes when introduced to poultry holdings, but the factors driving mutagenesis are not well understood. Despite this, there is limited data on the effects of the standard method of virus isolation of avian-derived viruses, that is, whether isolation in ECEs causes adaptive changes in avian IAVs. Eggs from a homologous species could potentially offer an isolation vessel less prone to induce adaptive changes. Methods We performed eight serial passages of two avian IAVs isolated from fecal samples of wild Mallards in both ECEs and embryonated Mallard eggs, and hemagglutination assay titers and hemagglutinin sequences were compared. Results There was no obvious difference in titers between ECEs and embryonated Mallard eggs. Sequence analyses of the isolates showed no apparent difference in the rate of introduction of amino acid substitutions in the hemagglutinin gene (three substitutions in total in embryonated Mallard eggs and two substitutions in ECEs). Conclusion Embryonated Mallard eggs seem to be good isolation vessels for avian IAVs but carry some practical problems such as limited availability and short egg-laying season of Mallards. Our study finds isolation of Mallard-derived avian IAVs in ECEs non-inferior to isolation in embryonated Mallard eggs, but more research in the area may be warranted as this is a small-scale study.
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Affiliation(s)
- Josef D Järhult
- Section for Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden;
| | - John Wahlgren
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden.,The Public Health Agency of Sweden, Solna, Sweden
| | - Badrul Hasan
- Section for Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Section for Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Åke Lundkvist
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.,The Public Health Agency of Sweden, Solna, Sweden
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15
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Olsen B, Salaneck E. ["Zaire" behind the largest Ebola epidemic ever. Highest mortality of the four human pathogenic Ebola viruses]. Lakartidningen 2014; 111:1960-1962. [PMID: 25349996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Björn Olsen
- Institutionen för medicinska vetenskaper, infektionssjukdomar - Uppsala universitet Uppsala, Sweden Institutionen för medicinska vetenskaper - Uppsala universitet Uppsala, Sweden
| | - Erik Salaneck
- Institutionen för medicinska vetenskaper, infektionssjukdomar - Uppsala universitet Uppsala, Sweden Institutionen för medicinska vetenskaper, infektionssjukdomar - Uppsala universitet Uppsala, Sweden
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16
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Wallménius K, Barboutis C, Fransson T, Jaenson TGT, Lindgren PE, Nyström F, Olsen B, Salaneck E, Nilsson K. Spotted fever Rickettsia species in Hyalomma and Ixodes ticks infesting migratory birds in the European Mediterranean area. Parasit Vectors 2014; 7:318. [PMID: 25011617 PMCID: PMC4230250 DOI: 10.1186/1756-3305-7-318] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 06/18/2014] [Indexed: 11/23/2022] Open
Abstract
Background A few billion birds migrate annually between their breeding grounds in Europe and their wintering grounds in Africa. Many bird species are tick-infested, and as a result of their innate migratory behavior, they contribute significantly to the geographic distribution of pathogens, including spotted fever rickettsiae. The aim of the present study was to characterize, in samples from two consecutive years, the potential role of migrant birds captured in Europe as disseminators of Rickettsia-infected ticks. Methods Ticks were collected from a total of 14,789 birds during their seasonal migration northwards in spring 2009 and 2010 at bird observatories on two Mediterranean islands: Capri and Antikythira. All ticks were subjected to RNA extraction followed by cDNA synthesis and individually assayed with a real-time PCR targeting the citrate synthase (gltA) gene. For species identification of Rickettsia, multiple genes were sequenced. Results Three hundred and ninety-eight (2.7%) of all captured birds were tick-infested; some birds carried more than one tick. A total number of 734 ticks were analysed of which 353 ± 1 (48%) were Rickettsia-positive; 96% were infected with Rickettsia aeschlimannii and 4% with Rickettsia africae or unidentified Rickettsia species. The predominant tick taxon, Hyalomma marginatum sensu lato constituted 90% (n = 658) of the ticks collected. The remaining ticks were Ixodes frontalis, Amblyomma sp., Haemaphysalis sp., Rhipicephalus sp. and unidentified ixodids. Most ticks were nymphs (66%) followed by larvae (27%) and adult female ticks (0.5%). The majority (65%) of ticks was engorged and nearly all ticks contained visible blood. Conclusions Migratory birds appear to have a great impact on the dissemination of Rickettsia-infected ticks, some of which may originate from distant locations. The potential ecological, medical and veterinary implications of such Rickettsia infections need further examination.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kenneth Nilsson
- Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, Uppsala, Sweden.
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17
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Hagman K, Barboutis C, Ehrenborg C, Fransson T, Jaenson TGT, Lindgren PE, Lundkvist A, Nyström F, Waldenström J, Salaneck E. On the potential roles of ticks and migrating birds in the ecology of West Nile virus. Infect Ecol Epidemiol 2014; 4:20943. [PMID: 24455105 PMCID: PMC3895205 DOI: 10.3402/iee.v4.20943] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 03/25/2013] [Revised: 12/03/2013] [Accepted: 12/13/2013] [Indexed: 11/14/2022] Open
Abstract
Background Mosquitoes are the primary vectors of West Nile virus (WNV). Ticks have, however, been suggested to be potential reservoirs of WNV. In order to investigate their role in the spread of the virus, ticks, which had been collected from birds migrating northwards from Africa to Europe, were analyzed for the potential presence of WNV-RNA. Methods On the Mediterranean islands Capri and Antikythira a total of 14,824 birds were captured and investigated from which 747 ticks were collected. Results and conclusion Most of the identified ticks (93%) were nymphs and larvae of Hyalomma marginatum sensu lato, most of which were or appear to be Hyalomma rufipes. Of these ticks 729 were individually screened for WNV-RNA. None of the ticks was found to be WNV positive. Thus, there was no evidence that Hyalomma marginatum s.l. ticks play a role in the spread of WNV from Africa to Europe.
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Affiliation(s)
- Karl Hagman
- Section for Infectious Diseases, Department of Medical Science, Uppsala University, Uppsala, Sweden
| | - Christos Barboutis
- Hellenic Ornithological Society and Natural History Museum of Crete, Crete, Greece
| | - Christian Ehrenborg
- Section for Infectious Diseases, Department of Medical Science, Uppsala University, Uppsala, Sweden
| | | | - Thomas G T Jaenson
- Department of Systematic Biology, Medical Entomology Unit, Uppsala University, Uppsala, Sweden
| | - Per-Eric Lindgren
- Department of Clinical and Experimental Medicine, Microbiology, Linköping University, Linköping, Sweden
| | - Ake Lundkvist
- Department of Medical Microbiology and Biochemistry, Uppsala University, Uppsala, Sweden ; Swedish Institute for Communicable Diseases and Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Fredrik Nyström
- Department of Clinical and Experimental Medicine, Microbiology, Linköping University, Linköping, Sweden
| | - Jonas Waldenström
- Center for Ecology and Evolution, Microbial Model Systems, Linneaus University, Kalmar, Sweden
| | - Erik Salaneck
- Section for Infectious Diseases, Department of Medical Science, Uppsala University, Uppsala, Sweden
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18
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Neiderud CJ, Vidh AL, Salaneck E. Soft tissue infection caused by Legionella bozemanii in a patient with ongoing immunosuppressive treatment. Infect Ecol Epidemiol 2013; 3:20739. [PMID: 24023988 PMCID: PMC3767882 DOI: 10.3402/iee.v3i0.20739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 03/01/2013] [Revised: 06/20/2013] [Accepted: 07/22/2013] [Indexed: 11/14/2022] Open
Abstract
The Legionellaceae family consists of approximately 50 species, of which the most commonly identified species is L. pneumophila, the causative agent of Legionnaires’ disease. Other Legionella ssp. most often cause clinical infections in the immune-compromised patients, in which L. bozemanii has been known to cause both pneumonia and lung abscesses. In the presented case, a soft tissue infection in a patient with ongoing immunosuppression was determined to be due to L. bozemanii. Hence, in immune-deficient patients, L. bozemanii could be considered a possible agent in soft tissue infections when other common pathogens have been ruled out.
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Affiliation(s)
- Carl-Johan Neiderud
- Section of Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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19
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Lindeborg M, Barboutis C, Ehrenborg C, Fransson T, Jaenson TGT, Lindgren PE, Lundkvist A, Nyström F, Salaneck E, Waldenström J, Olsen B. Migratory birds, ticks, and crimean-congo hemorrhagic fever virus. Emerg Infect Dis 2013; 18:2095-7. [PMID: 23171591 PMCID: PMC3557898 DOI: 10.3201/eid1812.120718] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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20
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Salaneck E, Larsson T, Larson E, Larhammar D. Birth and death of neuropeptide Y receptor genes in relation to the teleost fish tetraploidization. Gene 2008; 409:61-71. [DOI: 10.1016/j.gene.2007.11.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 11/11/2007] [Accepted: 11/15/2007] [Indexed: 11/26/2022]
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21
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Bromée T, Sjödin P, Fredriksson R, Boswell T, Larsson TA, Salaneck E, Zoorob R, Mohell N, Larhammar D. Neuropeptide Y-family receptors Y6 and Y7 in chicken. Cloning, pharmacological characterization, tissue distribution and conserved synteny with human chromosome region. FEBS J 2006; 273:2048-63. [PMID: 16640567 DOI: 10.1111/j.1742-4658.2006.05221.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [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: 11/28/2022]
Abstract
The peptides of the neuropeptide Y (NPY) family exert their functions, including regulation of appetite and circadian rhythm, by binding to G-protein coupled receptors. Mammals have five subtypes, named Y1, Y2, Y4, Y5 and Y6, and recently Y7 has been discovered in fish and amphibians. In chicken we have previously characterized the first four subtypes and here we describe Y6 and Y7. The genes for Y6 and Y7 are located 1 megabase apart on chromosome 13, which displays conserved synteny with human chromosome 5 that harbours the Y6 gene. The porcine PYY radioligand bound the chicken Y6 receptor with a K(d) of 0.80 +/- 0.36 nm. No functional coupling was demonstrated. The Y6 mRNA is expressed in hypothalamus, gastrointestinal tract and adipose tissue. Porcine PYY bound chicken Y7 with a K(d) of 0.14 +/- 0.01 nm (mean +/- SEM), whereas chicken PYY surprisingly had a much lower affinity, with a Ki of 41 nm, perhaps as a result of its additional amino acid at the N terminus. Truncated peptide fragments had greatly reduced affinity for Y7, in agreement with its closest relative, Y2, in chicken and fish, but in contrast to Y2 in mammals. This suggests that in mammals Y2 has only recently acquired the ability to bind truncated PYY. Chicken Y7 has a much more restricted tissue distribution than other subtypes and was only detected in adrenal gland. Y7 seems to have been lost in mammals. The physiological roles of Y6 and Y7 remain to be identified, but our phylogenetic and chromosomal analyses support the ancient origin of these Y receptor genes by chromosome duplications in an early (pregnathostome) vertebrate ancestor.
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Affiliation(s)
- Torun Bromée
- Department of Neuroscience, Unit of Pharmacology, Uppsala University, Sweden
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22
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Salaneck E, Larson ET, Larsson TA, Larhammar D. Effects of a Teleost Tetraploidization on Neuropeptide Y Receptor Gene Repertoire in Ray-Finned Fishes. Ann N Y Acad Sci 2006; 1040:457-9. [PMID: 15891088 DOI: 10.1196/annals.1327.089] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The ancestral vertebrate repertoire for neuropeptide Y receptor genes of the Y1 subfamily probably included four subtypes: Y1, Y4, Y6, and Y8. There was probably a single gene in the Y5 category. Both Y1 and Y5 stimulate food intake in mammals. As the genome seems to have duplicated during the evolution of ray-finned fishes, we have investigated the gene repertoire in species that diverged prior to the appearance of teleosts, as well as a basal teleost and a shark. Our results show that the genes Y1, Y5, and Y6, which are missing in many teleosts, are present in basal actinopterygians. These dramatic alterations of the teleost receptor repertoire may be related to the tetraploidization in a teleost ancestor.
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Affiliation(s)
- Erik Salaneck
- Department of Neuroscience, Uppsala University, Sweden
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Abstract
The neuropeptide Y (NPY) system consists in mammals of three peptides and 4-5 G-protein-coupled receptors called Y receptors that are involved in a variety of physiological functions such as appetite regulation, circadian rhythm and anxiety. Both the receptor family and the peptide family display unexpected evolutionary complexity and flexibility as shown by information from different classes of vertebrates. The vertebrate ancestor most likely had a single peptide gene and three Y receptor genes, the progenitors of the Y1, Y2 and Y5 subfamilies. The receptor genes were probably located in the same chromosomal segment. Additional gene copies arose through the chromosome quadruplication that took place before the emergence of jawed vertebrates (gnathostomes) whereupon differential losses of the gene copies ensued. The inferred ancestral gnathostome gene repertoire most likely consisted of two peptide genes, NPY and PYY, and no less than seven Y receptor genes: four Y1-like (Y1, Y4/a, Y6, and Yb), two Y2-like (Y2 and Y7), and a single Y5 gene. Whereas additional peptide genes have arisen in various lineages, the most common trend among the Y receptor genes has been further losses. Mammals have lost Yb and Y7 (the latter still exists in frogs) and Y6 is a pseudogene in several mammalian species but appears to be still functional in some. One challenge is to find out if mammals have been deprived of any functions through these gene losses. Teleost fishes like zebrafish and pufferfish, on the other hand, have lost the two major appetite-stimulating receptors Y1 and Y5. Nevertheless, teleost fishes seem to respond to NPY with increased feeding why some other subtype probably mediates this effect. Another challenge is to deduce how Y2 and Y4 came to evolve an inhibitory effect on appetite. Changes in anatomical distribution of receptor expression may have played an important part in such functional switching along with changes in receptor structures and ligand preferences.
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Affiliation(s)
- D Larhammar
- Department of Neuroscience, Unit of Pharmacology, Box 593 Uppsala University, SE-75124 Uppsala, Sweden.
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Ruuskanen JO, Xhaard H, Marjamäki A, Salaneck E, Salminen T, Yan YL, Postlethwait JH, Johnson MS, Larhammar D, Scheinin M. Identification of duplicated fourth alpha2-adrenergic receptor subtype by cloning and mapping of five receptor genes in zebrafish. Mol Biol Evol 2004; 21:14-28. [PMID: 12949138 DOI: 10.1093/molbev/msg224] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [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] [Indexed: 11/14/2022] Open
Abstract
The alpha(2)-adrenergic receptors (alpha(2)-ARs) belong to the large family of rhodopsinlike G-protein-coupled receptors that share a common structure of seven transmembrane (TM) alpha-helices. The aims of this study were (1) to determine the number of alpha(2)-AR genes in a teleost fish, the zebrafish (Danio rerio), (2) to study the gene duplication events that generated the alpha(2)-AR subtypes, and (3) to study changes in receptor structure that have occurred since the divergence of the mammalian and fish lineages. Here, we report the cloning and chromosomal mapping of fish orthologs for all three mammalian alpha(2)-ARs. In addition, we identified a fourth alpha(2)-AR subtype with two duplicates in zebrafish. Chromosomal mapping showed that the zebrafish alpha(2)-AR genes are located within conserved chromosomal segments, consistent with the origin of the four alpha(2)-AR subtypes by two rounds of chromosome or block duplication before the divergence of the ray fin fish and tetrapod lineages. Thus, the fourth subtype has apparently been present in the common ancestor of vertebrates but has been deleted or is yet to be identified in mammals. The overall percentage identity between the fish and mammalian orthologs is 53% to 67%, and in the TM regions 80% to 87%. These values are clearly lower than what is observed between mammalian orthologs. Still, all of the residues thought to be important for alpha(2)-adrenergic ligand binding are conserved across species and subtypes, and even the most divergent regions of the fish receptors show clear "molecular fingerprints" typical for orthologs of a given subtype.
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Affiliation(s)
- Jori O Ruuskanen
- Department of Pharmacology and Clinical Pharmacology, Turku Graduate School of Biomedical Sciences, University of Turku, Finland
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Salaneck E, Ardell DH, Larson ET, Larhammar D. Three neuropeptide Y receptor genes in the spiny dogfish, Squalus acanthias, support en bloc duplications in early vertebrate evolution. Mol Biol Evol 2003; 20:1271-80. [PMID: 12777532 DOI: 10.1093/molbev/msg133] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It has been debated whether the increase in gene number during early vertebrate evolution was due to multiple independent gene duplications or synchronous duplications of many genes. We describe here the cloning of three neuropeptide Y (NPY) receptor genes belonging to the Y1 subfamily in the spiny dogfish, Squalus acanthias, a cartilaginous fish. The three genes are orthologs of the mammalian subtypes Y1, Y4, and Y6, which are located in paralogous gene regions on different chromosomes in mammals. Thus, these genes arose by duplications of a chromosome region before the radiation of gnathostomes (jawed vertebrates). Estimates of duplication times from linearized trees together with evidence from other gene families supports two rounds of chromosome duplications or tetraploidizations early in vertebrate evolution. The anatomical distribution of mRNA was determined by reverse-transcriptase PCR and was found to differ from mammals, suggesting differential functional diversification of the new gene copies during the radiation of the vertebrate classes.
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Affiliation(s)
- Erik Salaneck
- Department of Neuroscience, Unit of Pharmacology, Evolutionary Biology Center, Uppsala University, Uppsala, Sweden
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26
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Berglund MM, Fredriksson R, Salaneck E, Larhammar D. Reciprocal mutations of neuropeptide Y receptor Y2 in human and chicken identify amino acids important for antagonist binding. FEBS Lett 2002; 518:5-9. [PMID: 11997008 DOI: 10.1016/s0014-5793(02)02534-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The neuropeptide Y (NPY) receptor Y2 antagonist BIIE0246 has sub-nanomolar affinity for the human Y2 (hY2) receptor but binds very poorly to chicken Y2 (chY2) with micromolar affinity. Sequence comparisons identified several amino acids for investigation by mutagenesis. Reciprocal mutagenesis between hY2 and chY2 revealed that three of these, individually and in combination, are important for BIIE0246 binding, namely positions Gln(135) in transmembrane (TM) 3, Leu(227) in TM5, and Leu(284) in TM6. Mutagenesis of hY2 to the corresponding amino in chY2 (generating hY2[Q135H,L227Q,L284F]) made the affinity of BIIE0246 as low as for chY2. Introduction into chY2 of the three human residues resulted in antagonist affinity almost as high as for hY2. To distinguish between direct and indirect effects, each of the three residues in hY2 was replaced with alanine. BIIE0246 bound with 28-fold lower affinity to hY2[L227A], suggesting the Leu(227) interacts directly with the antagonist. The other two alanine mutants bound with unaltered affinity, suggesting that the corresponding chY2 residues abolish binding through steric hindrance or charge repulsion. Thus, three amino acid residues can in an additive manner completely account for the difference in antagonist binding between the hY2 and chY2 receptors. These results will be useful for construction of three-dimensional models of the widely divergent NPY receptor subtypes.
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Affiliation(s)
- Magnus M Berglund
- Department of Neuroscience, Pharmacology, Uppsala University, Box 593, SE-75224, Uppsala, Sweden
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27
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Salaneck E, Fredriksson R, Larson ET, Conlon JM, Larhammar D. A neuropeptide Y receptor Y1-subfamily gene from an agnathan, the European river lamprey. A potential ancestral gene. Eur J Biochem 2001; 268:6146-54. [PMID: 11733009 DOI: 10.1046/j.0014-2956.2001.02561.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report here the isolation and functional expression of a neuropeptide Y (NPY) receptor from the river lamprey, Lampetra fluviatilis. The receptor displays approximately 50% amino-acid sequence identity to all previously cloned Y1-subfamily receptors including Y1, Y4, and y6 and the teleost subtypes Ya, Yb and Yc. Phylogenetic analyses point to a closer relationship with Y4 and Ya/b/c suggesting that the lamprey receptor could possibly represent a pro-orthologue of some or all of those gnathostome receptors. Our results support the notion that the Y1 subfamily increased in number by genome or large-scale chromosome duplications, one of which may have taken place prior to the divergence of lampreys and gnathostomes whereas the second duplication probably occurred in the gnathostome lineage after this split. Functional expression of the lamprey receptor in a cell line facilitated specific binding of the three endogenous lamprey peptides NPY, peptide YY and peptide MY with picomolar affinities. Binding studies with a large panel of NPY analogues revealed indiscriminate binding properties similar to those of another nonselective Y1-subfamily receptor, zebrafish Ya. RT-PCR detected receptor mRNA in the central nervous system as well as in several peripheral organs suggesting diverse functions. This lamprey receptor is evolutionarily the most distant NPY receptor that clearly belongs to the Y1 subfamily as defined in mammals, which shows that subtypes Y2 and Y5 arose even earlier in evolution.
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Affiliation(s)
- E Salaneck
- Unit of Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
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28
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Salaneck E, Holmberg SK, Berglund MM, Boswell T, Larhammar D. Chicken neuropeptide Y receptor Y2: structural and pharmacological differences to mammalian Y2(1). FEBS Lett 2000; 484:229-34. [PMID: 11078884 DOI: 10.1016/s0014-5793(00)02164-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [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: 10/17/2022]
Abstract
Here we report the molecular cloning of the chicken (Gallus gallus) neuropeptide Y (NPY) receptor Y2, the first non-mammalian Y2 receptor. It displays 75-80% identity to mammalian Y2 and has a surprisingly divergent cytoplasmic tail. Expression of the receptor protein in a cell line showed that the receptor did not bind the mammalian Y2 selective antagonist BIIE0246. Furthermore, porcine [Leu(31), Pro(34)]NPY, which binds poorly to mammalian Y2, exhibited an unexpectedly high affinity for chicken Y2. In situ hybridisation revealed expression in the hippocampus. Thus, the chicken Y2 receptor exhibits substantial differences with regard to sequence and pharmacological profile in comparison to mammalian Y2 receptors, while the expression pattern in the central nervous system resembles that observed in mammals.
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Affiliation(s)
- E Salaneck
- Department of Neuroscience, Unit of Pharmacology, Uppsala University, Sweden
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Risinger C, Salaneck E, Söderberg C, Gates M, Postlethwait JH, Larhammar D. Cloning of two loci for synapse protein Snap25 in zebrafish: comparison of paralogous linkage groups suggests loss of one locus in the mammalian lineage. J Neurosci Res 1998; 54:563-73. [PMID: 9843147 DOI: 10.1002/(sici)1097-4547(19981201)54:5<563::aid-jnr1>3.0.co;2-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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] [Indexed: 11/07/2022]
Abstract
Synaptosome-associated protein of 25 kDa (Snap25) is an intracellular protein that is defined as a target receptor for synapse vesicles prior to neurotransmitter release. Snap25 is highly conserved, with 61% identity between human and Drosophila melanogaster. Whereas mammals and chicken have a single locus for Snap25, the tetraploid goldfish has at least three loci. We report that the zebrafish has two loci with 91% amino acid identity to each other. The alternative splicing of exon 5 arose before the gene duplication. The expression patterns of the two loci are virtually identical in adult zebrafish. The two zebrafish snap25 loci are located in paralogous linkage groups that seem to correspond to human chromosome 20, which harbors the SNAP locus, and human chromosome 14. Because no additional Snap25 homologue has been reported for any mammal or chicken, snap25.2 may have been lost in the amniote or even tetrapod lineage.
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Affiliation(s)
- C Risinger
- Department of Neuroscience, Uppsala University, Sweden
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Lundell I, Berglund MM, Starbäck P, Salaneck E, Gehlert DR, Larhammar D. Cloning and characterization of a novel neuropeptide Y receptor subtype in the zebrafish. DNA Cell Biol 1997; 16:1357-63. [PMID: 9407007 DOI: 10.1089/dna.1997.16.1357] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.0] [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: 02/05/2023] Open
Abstract
Neuropeptide Y (NPY), peptide YY (PYY), and pancreatic polypeptide (PP) form a family of structurally related peptides. As we have previously isolated clones for NPY and PYY from the zebrafish (Danio rerio), we wished to clone the receptors for these peptides to allow correlation of ligand and receptor distribution. We describe here the cloning and functional expression of a receptor with equally high identity to the NPY-Y1 receptor as to the recently cloned Y4/PP1 and Y6 receptors with an overall amino acid sequence identity of approximately 50%. Furthermore, the zebrafish receptor gene lacks the intron present in the coding region in vertebrate Y1 genes. These features strongly suggest that the zebrafish receptor represents a separate subtype. Hence, we have named it zYb for zebrafish Y-receptor b. (We have also discovered a unique receptor called zYa.) The zYb receptor has a binding profile that is reminiscent of Y1 with affinities for NPY and PYY in the low picomolar range, whereas affinities for Y2-selective ligands are considerably lower. It couples to adenylyl cyclase by inhibiting cAMP synthesis. Receptor mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in brain, eye, and intestine. The binding profile and amino acid identity show that the zebrafish zYb receptor is related to Y1 but represents a distinct subtype that is likely to be present also in mammals.
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Affiliation(s)
- I Lundell
- Department of Medical Pharmacology, Uppsala University, Sweden
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Abstract
Zebrafish pax-6 (pax[zf-a]) and its murine homologue are structurally and functionally related to the Drosophila paired box gene eyeless, a master control gene for eye development. This report details the zebrafish pax-6 embryonic expression pattern both at the mRNA and protein level. Transcripts are first detected in the presumptive forebrain and hindbrain regions of the neural plate. After formation of the neural keel, Pax-6 protein accumulates within the same two domains. Expression is also observed in the optic vesicles and lens placodes, confirming that the Pax-6 protein is expressed in those areas of the eye where it is assumed to control differentiation. The relative DNA-binding affinity of the zebrafish Pax-6 protein to different categories of Pax recognition sites is shared with the murine homologue.
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Affiliation(s)
- K Amirthalingam
- Department of Biochemistry and Molecular Biology, University of Bergen, Norway
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