A Case of Dyke-Davidoff-Masson Syndrome with Hypoplasia of the Kidney: An Unusual Association

Dyke-Davidoff-Masson syndrome (DDMS) is a rare neuro-osteal syndrome of childhood and a constellation of cerebral hemiatrophy, facial asymmetry, seizures, osseous changes, and hemiplegia. It commonly presents with seizures and hemiplegia. The involvement of the kidney in DDMS is not known in the available literature, except in a case report that described ectopic kidney in DDMS. We present the case of a 15-year-old boy who presented with recurrent seizures, right facial palsy, left hemiparesis, and advanced renal failure. The neuroimaging revealed diffuse right cerebral atrophy, dilatation of the ipsilateral lateral ventricle, and ipsilateral thickening of the calvaria. The nephrological evaluation suggested the diagnosis of chronic kidney disease stage VD, probably secondary to congenital hypoplasia of the kidney.

Clinical Profile and Outcomes of Nephrotic Syndrome With Acute Kidney Injury in Adults: A Prospective Cohort Study

BACKGROUND

Nephrotic syndrome (NS) is characterized by various clinicopathological conditions like proteinuria, hypoalbuminemia, and anasarca. Patients with NS are prone to experience associated problems like acute kidney injury (AKI). The present study aimed to investigate the clinical profile and outcomes of NS with AKI in adults.

MATERIALS AND METHODS

This prospective, observational study was conducted over a period of one year. Adult patients with NS diagnosed with AKI were enrolled in the study. Data were collected at baseline and patients were followed up for at least three months.

RESULTS

A total of 60 patients were enrolled. The majority of the patients (78.3%) were aged between 18 and 30 years. Anemia was observed among 96.7% of the patients. A significant improvement was observed in the mean levels of proteinuria (5.80 vs. 1.70 gm/dL; P < 0.001), total cholesterol (270.00 mg/dL vs. 160.00 mg/dL), serum creatinine (2.18 mg/dL vs. 1.68 mg/dL; P < 0.001), and serum albumin (1.86 gm/dL vs. 3.29 gm/dL; P < 0.001) at baseline to three months. Pre-renal AKI was diagnosed in 95% of patients. According to histological classification, 19 patients had minimal change disease, whereas focal segmental glomerulosclerosis was observed in 23 patients. It was observed that 96.7% of the patients did not necessitate the need for renal replacement therapy.

CONCLUSION

The present study successfully examined the clinical profile and outcomes of adults with NS and AKI. The findings provide valuable insights into the characteristics and prognosis of this patient population, contributing to a better understanding of NS with AKI in adults.

Understanding the hydrochemical functioning of glacierized catchments of the Upper Indus Basin in Ladakh, Indian Himalayas

Recent studies have endorsed that surface water chemical composition in the Himalayas is impacted by climate change-induced accelerated melting of glaciers. Chemical weathering dynamics in the Ladakh region is poorly understood, due to unavailability of in situ dataset. The aim of the present study is to investigate how the two distinct catchments (Lato and Stok) drive the meltwater chemistry of the Indus River and its tributary, in the Western Himalayas. Water samples were collected from two glaciated catchments (Lato and Stok), Chabe Nama (tributary) and the Indus River in Ladakh. The mildly alkaline pH (range 7.3-8.5) and fluctuating ionic trend of the meltwater samples reflected the distinct geology and weathering patterns of the Upper Indus Basin (UIB). Gibbs plot and mixing diagram revealed rock weathering outweighed evaporation and precipitation. The strong associations between Ca²⁺-HCO₃^-, Mg²⁺-HCO₃^-, Ca²⁺-Mg²⁺, Na⁺-HCO₃^-, and Mg²⁺-Na⁺ demonstrated carbonate rock weathering contributed to the major ion influx. Principal component analysis (PCA) marked carbonate and silicates as the most abundant minerals respectively. Chemical weathering patterns were predominantly controlled by percentage of glacierized area and basin runoff. Thus, Lato with the larger glacierized area (~ 25%) and higher runoff contributed low TDS, HCO₃^-, Ca²⁺, and Na⁺ and exhibited higher chemical weathering, whereas lower chemical weathering was evinced at Stok with the smaller glacierized area (~ 5%). In contrast, the carbonate weathering rate (CWR) of larger glacierized catchments (Lato) exhibits higher average value of 15.7 t/km²/year as compared to smaller glacierized catchment (Stok) with lower average value 6.69 t/km²/year. However, CWR is high in both the catchments compared to silicate weathering rate (SWR). For the first time, in situ datasets for stream water chemical characteristics have been generated for Lato and Stok glaciated catchments in Ladakh, to facilitate healthy ecosystems and livelihoods in the UIB.

Outcome of COVID-19 in Kidney Transplant Patients from Eastern India: A Single Center Study

Introduction

COVID-19 in kidney transplant recipients (KTR) had been associated with high incidence of acute kidney injury and higher mortality. Management of these patients is still evolving.

Methods

A retrospective observational study was done that included all KTR aged ≥18 years and ≤65 years who had COVID-19 diagnosis via RTPCR test between 1 June 2020 and 30 May 2021. Severity of COVID-19 was determined as per the guidelines given by Government of India. Acute kidney injury was defined according to KDIGO guideline. Data was collected and analyzed using SPSS version 16.0 (Chicago, SPSS Inc.).

Results

Out of 34 patients, 29 were men. Median age of patients was 39.9 years and median time since transplantation was 34 months. Presenting symptoms were fever (100%), cough (79.4%), gastrointestinal symptoms (23.5%), and dysgeusia/anosmia (23.5%). COVID-19 was severe in 17.6%, moderately severe in 32.4%, and mild in 50% of patients. Time since transplantation, duration of symptoms, hospital stay and inflammatory markers like CRP, LDH, ferritin and d-dimer were significantly associated with disease severity (P < 0.05). Steroids were increased in 55%, antiproliferative agents stopped in 97%, and calcineurin inhibitors stopped in 26% of patients. 70.6% of the patients were managed in home isolation. Acute kidney injury occurred in 58.8% cases. 75% of the AKI patients recovered by 28 days after discharge.

Conclusion

Our study showed that outcome of COVID-19 in kidney transplant patients was reasonably good.

Deciphering the role of meteorological parameters controlling the sediment load and water discharge in the Sutlej basin, Western Himalaya

The Sutlej River basin of the western Himalaya (study area), owing to its unique geographical disposition, receives precipitation from both the Indian summer monsoon (ISM) and the Westerlies. The characteristic timing and intensity of the ISM and Westerlies, leaves a distinct footprint on the sediment load of the River. Analysis with the last forty years data, shows an increasing trend for temperature. While for precipitation during the same period, the Spiti watershed on the west has highest monthly accumulated precipitation with long term declining trend, in contrast to the other areas where an increasing trend has been observed. Thus, to probe the hydrological variability and the seasonal attributes, governed by the Westerlies and ISM in the study area, we analyzed precipitation, temperature, snow cover area (in %), discharge, suspended sediment concentration (SSC) and suspended sediment load (SSL) for the period 2004 - 2008. To accomplish the task, we used the available data of five hydrological stations located in the study area. Inter-annual shift in peak discharge during the monsoon period is controlled by the variation in precipitation, snow melt, glacier melt and temperature. Besides seasonal variability has been observed in generation of the sediments and its delivery to the river. Our analysis indicates, dominance of the Westerlies footprints in the hydrological parameters of the Spiti region, towards western part of the study area. While, it is observed that the hydrology of the Khab towards eastern part of the study area shows dominance of ISM. Further downstream, the hydrology of Nathpa station also shows dominance of ISM. It also emerged out that the snowmelt contribution to the River flow is mostly during the initial part, at the onset of the monsoon, while for rest and major part of the summer monsoon season, the River flow is augmented by the precipitation, glacial melt and some snow melt. We observed, that the SSC increases exponentially in response to increase in temperature and correlates positively with River discharge. The average daily SSL in the summer monsoon is many times more than that in the winter monsoon. The downstream decrease in steepness of the sediment rating curve is attributed to either a change in the River-sediment dynamics or on account of the anthropogenic forcing. The top 1% of the extreme summer monsoon events (only 4 events) in our study area contribute up to 45% of SSL to the total sediment load budget. It has also been observed that the River-sediment dynamics in the upstream catchments are more vulnerable and sensitive to the extreme events in comparison to the downstream catchments. The present study for the first time gives a holistic insight in to the complex dynamics of the hydrological processes operational in the study area. The research findings would be crucial for managing the water resources of the region and the linked water and food security.

Mega festivals like MahaKumbh, a largest mass congregation, facilitated the transmission of SARS-CoV-2 to humans and endangered animals via contaminated water

Our surrounding environment has been influenced by the COVID-19 pandemic situation. The second wave of COVID-19 in India has proven to be more devastating and aggressive than the first wave of the pandemic, which led to recognizing India as one of the world's topmost worst-hit nations considering >4000 fatalities reported in a single day in May 2021. Such “resurgence and acceleration” of COVID-19 transmission has been fuelled by the MahaKumbh festival and political mass gathering (elections rallies) events, where the COVID-19 protocols have been ignored by millions of pilgrims/followers. The present review discusses only the consequences of this year's MahaKumbh festivals, the largest religious mass gathering on earth, which was held during the COVID-19 pandemic in India, and its impact on both the spread of SARS-CoV-2 among participants and their families and its influence on the quality of the river Ganga. This article tries to give readers outside of India an overview of how much impact of any such single large gathering of any relgion in any part of the world can drive coronavirus infections and effectively commence the second/third wave outbreak with this case study. Furthermore, the religious large scale celebration are widely accepted through out the world that have played a significant role in the spread of the pandemic into remote villages and towns all over the subcontinent/world, thus affecting many areas with insufficient healthcare facilities that have been relatively spared. This review also highlights the potential risk of transmission from infected humans into the aquatic environment of the river Ganga. Besides the obvious relevance of SARS-CoV-2, a large variety of other water-related disease vectors (bacteria, viruses, and protozoa) stemming from visitors to the religious congregation were introduced into the upstream regions of the Ganga river. Their sheer number is assumed to have had a severe influence on its delicate ecosystem, including endangered mammals such as the river Dolphins. The detailed epidemiological and clinical study on transmission routes of SARS-CoV-2 is the need of the hour to understand the pathogenesis of RNA virus infection and prevent the massive spreading of such infectious respiratory diseases. An interdisciplinary approach, rooted in evidence-based efficient learning, contextual strategies, and a streamlined unified approach should be adopted to help in the development of a proactive prevention model during future MahaKumbh festival (and similar religious gatherings) instead of just “picking up the pieces” in a conventional post-event model.

Fibrillary glomerulonephritis presenting as crescentic glomerulonephritis in a young female: a case study

Fibrillary glomerulonephritis (FGN) is a rare disorder accounting for up to 1% of all glomerulonephritis (GN). FGN usually manifests as nephrotic or subnephrotic proteinuria, hematuria, and hypertension in patients after the sixth decade. The overall prognosis of FGN is very poor. Crescentic presentation of FGN is uncommon which may be diagnosed as rapidly progressive glomerulonephritis (RPGN) unless electron microscopy and/or special stains are done. We report a case of a young female who presented as RPGN but diagnosis was revised to crescentic FGN after electron microscopy and immunohistochemical staining with DNAJB9 stain. Patient remained dialysis-dependent after treatment with steroid and cyclophosphamide for 2 months and progressed to end-stage renal disease (ESRD). Crescentic FGN usually does not respond to treatment and invariably progresses to ESRD over few months. This case emphasizes the defining role of electron microscopy and special stains in diagnosing uncommon glomerular diseases.

Analysis of native kidney biopsy: Data from a single center from Bihar, India

This is a retrospective study of all native kidney biopsies performed at our center between October 1, 2012 and March 31, 2015. Relevant clinical and laboratory variables were recorded. Biopsy samples were processed for light microscopy and immunofluorescence in all cases. Histological classification was adapted from the World Health Organization recommendations. The indications for kidney biopsy were nephrotic syndrome in adults in 190 cases, rapidly progressive renal failure in 43, unexplained renal failure in 25, and steroid-resistant nephrotic syndrome in children in 12. The mean age of the patients was 31.48 ± 13.46 years. Male-to-female ratio was 1.87:1. Mean serum creatinine (SCr) of the patients was 2.36 ± 2.07 mg/dL. Primary glomerulonephritis accounted for 88.89% of cases (240) while secondary glomerulonephritis accounted for 7.40% of total cases (20). Interstitial disease accounted for 1.5% and vascular disease for 2.2%. The most common lesion among primary glomerulonephritis was focal segmental glomerulosclerosis (FSGS) (31.11%) followed by diffuse proliferative glomerulonephritis (DPGN) (13.33%) and membranous glomerulonephritis (MGN) (12.59%). Among secondary glomerulonephritis, lupus nephritis was the most common (5.56%). In patients with SCr 1.4 mg/dL or less (n = 131), FSGS was the most common histology (17.26%) followed by MGN (23.66%) and minimal change disease (7.63%). Whereas, in patients with SCr more than 1.4 mg/dL (n = 139), DPGN was the most common diagnosis (23.74%) followed by FSGS (17.26%) and IgAN (12.23%). Fourteen patients (5.2%) had one or more episode of gross hematuria, three of whom required blood transfusion. The overall FSGS was the most common lesion seen. When we consider only patients with deranged renal function, DPGN was the most common histopathological lesion. The reason for disproportionate high incidence for DPGN is not clear and requires further research.

Acute kidney injury with consumption of raw gall bladder of Indian carp fish (Labeo rohita): A single center study from India

AIM

This retrospective study examined the clinical presentation and outcome of all patients who presented with acute kidney injury (AKI) following consumption of uncooked fish gallbladder as folk medicine.

METHODS

We reviewed all cases admitted at our institute between 1 January 1997 and 31 December 2016 following ingestion of fish gallbladder (Indian carp/Labeo rohita).

RESULTS

A total 32 of patients were included, with a male: female ratio of 3:1 and mean age 44.34 ± 13.33 years. The mean number of gall bladder consumed was 4.59 ± 4.75. All 32 patients presented with hepatic and renal failure. The mean duration of onset of symptoms following ingestion was 6.47 ± 2.84 h. At the time of admission, urine output was 187.9 ± 141 mL/24 h, serum creatinine 11.66 ± 2.50 mg/dL, serum bilirubin 6.14 ± 3.91 mg/dL, serum glutamate-pyruvate transaminase (SGPT) 687 ± 458 IU/L and serum glutamic oxaloacetic transaminase (SGOT) 188 ± 181 IU/L. All but one patient required haemodialysis. Twenty-seven patients were discharged with recovering acute kidney injury while five patients died. Mean duration of hospital stay was 12.94 ± 8.31 days. Mean number of haemodialysis sessions received by patients was 4.59 ± 3.12. Interval between consumption and onset of symptoms, serum bilirubin and SGPT were found to be significantly different between those who survived and died.

CONCLUSION

Acute kidney injury associated with ingestion of raw fish gallbladder is associated with significant morbidity and mortality.

Methane production, oxidation and mitigation: A mechanistic understanding and comprehensive evaluation of influencing factors

Methane is one of the critical greenhouse gases, which absorb long wavelength radiation, affects the chemistry of atmosphere and contributes to global climate change. Rice ecosystem is one of the major anthropogenic sources of methane. The anaerobic waterlogged soil in rice field provides an ideal environment to methanogens for methanogenesis. However, the rate of methanogenesis differs according to rice cultivation regions due to a number of biological, environmental and physical factors like carbon sources, pH, Eh, temperature etc. The interplay between the different conditions and factors may also convert the rice fields into sink from source temporarily. Mechanistic understanding and comprehensive evaluation of these variations and responsible factors are urgently required for designing new mitigation options and evaluation of reported option in different climatic conditions. The objective of this review paper is to develop conclusive understanding on the methane production, oxidation, and emission and methane measurement techniques from rice field along with its mitigation/abatement mechanism to explore the possible reduction techniques from rice ecosystem.

Purification and dose-dependent toxicity study of abrin in swiss albino male mice

Abrin, a phytotoxin obtained from the seeds of the Abrus precatorius plant, is highly toxic with an estimated human fatal dose of 0.1—1 μg/kg. In this study, abrin was purified and characterized through SDS PAGE and mass spectrometry analysis; further study on toxicity was carried out to investigate the alteration in biochemical, and hematological variables through histopathological observations in mice. The intraperitoneal LD50 value of purified abrin for mice was found to be 0.91μg/kg of body weight. Mice were exposed to 0.4 and 1.0 LD50 abrin doses intraperitoneally and observed on days 1, 3, and 7. Plasma GOT and GPT levels increased significantly at both doses. At 1.0 LD50 dose, alkaline phosphatase, bilirubin, urea, uric acid, and creatinine levels increased, whereas albumin, total protein, glucose and cholesterol levels decreased significantly. Abrin intoxication also altered the hemoglobin, WBC, and RBC counts significantly at 1.0 LD50 dose. Liver GSH levels decreased while lipid peroxidation increased significantly in a dose—dependent manner. Biochemical changes were supported by the histological investigation, which also showed the degenerative changes in organs. In conclusion, abrin intoxication caused toxic effects and severe damages on studied organs mediated through alteration in biochemical and hematological variables, lipid peroxidation, and degeneration.

Comparative analysis of extractable proteins from Clostridium perfringens type A and type C strains showing varying degree of virulence

The prevailing scenario of bioterrorism warrants development of medical countermeasures with expanded coverage of select agents. Clostridium perfringens is a pathogen of medical, veterinary and military importance, and has been listed as Validated Biological Agent. We employed 2DE-MS approach to identify a total of 134 unique proteins (529 protein spot features) from the extractable proteome of four type A and type C strains. Proteins showing altered expression under host-simulated conditions from virulent type A strain (ATCC13124) were also elucidated. Significant among the differentially expressed proteins were elongation factor, molecular chaperones, ribosomal proteins, carbamoyl phosphate synthase, clpB protein, choloylglycine hydrolase, phosphopyruvate hydratase, and trigger factor. Predictive elucidation, of putative virulence associated proteins and sequence conservation pattern of selected candidates, was carried out using homologous proteins from other bacterial select agents to screen for the commonality of putative antigenic determinants. Pathogens (17 select agents) were observed to form three discrete clusters; composition of I and II being consistent in most of the phylogenetic reconstructions. This work provides a basis for further validation of putative candidate proteins as prophylactic agents and for their ability to provide protection against clusters of pathogenic select bacterial agents; aimed at mitigating the shadows of biothreat.

The Fas/Fas ligand apoptotic pathway is involved in abrin-induced apoptosis

Abrin is a plant glycoprotein toxin from the seeds of Abrus precatorius, sharing similarity in structure and properties with ricin. Abrin is highly toxic, with an estimated human fatal dose of 0.1-1 µg/kg, causing death after accidental or intentional poisoning. It is a potent biological toxin warfare agent. There is no chemical antidote available against the abrin. The elucidation of molecular mechanism of abrin-induced cell death is important for development of therapy. Intrinsic pathway-mediated apoptosis has been well established in abrin-induced cell death. However, the detailed mechanism especially extrinsic receptor-mediated pathway remains uncharacterized. To assess whether some of the apoptosis known to occur after abrin exposure might be mediated by Fas/Fas ligand (Fas L) interactions, we analyzed effect of abrin on Fas pathway in Jurkat cells. Here, we report that activation of the Fas pathway is involved in abrin-induced apoptosis. Following treatment of abrin, Fas L was induced, which stimulated the Fas pathway by cross-linking Fas receptor (Fas R). Apoptosis was mediated by cleavage of the Fas R proximal caspase-8 and the downstream caspase-3, resulting in activation of the prototype caspase substrate poly-(ADP-ribose) polymerase and caspase-activated DNase. Blocking Fas L/Fas R interaction by using Fas inhibitor reduced abrin-induced apoptosis, further confirms involvement of Fas pathway. Activation of components of Fas pathway and caspases upon abrin treatment was also found in splenocytes in mice. Our findings offer new perspective for understanding the fundamental mechanism in abrin-induced apoptotic mechanism and may have implication in developing novel therapeutic strategies in the management for abrin-induced complications.

Development of ELISA based detection system for lethal toxin of Clostridium sordellii

BACKGROUND & OBJECTIVES

Clostridium sordellii and its toxins are associated with diseases in animals as well as human. C. sordellii produces two protein toxins (lethal toxin and haemorrhagic toxin). Lethal toxin has gained more importance due its high toxicity. The present study was carried out to develop a sandwich ELISA for detection of lethal toxin of C. sordellii.

METHODS

The catalytic domain (1.6 kb) of lethal toxin of C. sordellii was PCR amplified, cloned into pQE30 UA vector and transformed into Escherichia coli SG 13009. Expression conditions were optimized and the recombinant protein was purified under native condition using Ni-NTA affinity chromatography, confirmed by SDS-PAGE and Western blot. Antibody was generated against the purified recombinant protein using Freund's complete and incomplete adjuvants (FCA and FIA) in BALB/c mice and rabbit. A sandwich ELISA was optimized for the detection of lethal toxin.

RESULTS

The maximum recombinant protein expression was achieved at 0.5 mM IPTG (isopropylthiogalactoside) induction 4.0 h of post-induction. The polyclonal antibody raised in mice and rabbit showed a titre up to 1:512000. The produced antibody was highly sensitive with the detection limit of 0.3 ng/ml of lethal toxin at 1:4000 dilutions of mice (capturing) and rabbit (revealing) antibody.

INTERPRETATION & CONCLUSIONS

An ELISA based detection system was developed for the detection of lethal toxin of C. sordellii. The developed detection system was found to be specific as there was no cross-reactivity with any other clostridial toxins. It will be useful for the detection of lethal toxin of C. sordellii in clinical and environmental samples.

Expression, purification and development of neutralizing antibodies from synthetic BoNT/B LC and its application in detection of botulinum toxin serotype B

Botulism is a neuroparalytic disease caused by Clostridium botulinum, which produces seven (A-G) neurotoxins (BoNTs). The mouse bioassay is the gold standard for the detection of botulinum neurotoxins, however it requires at least 3-4 days for completion. Most of the studies were carried out in botulinum toxin A and less on type B. Attempts have been made to develop an ELISA based detection system, which is potentially an easier and more rapid method of botulinum neurotoxin detection. In the present study, the synthetic BoNT/B LC gene was constructed using PCR overlapping primers, cloned in a pET28a+ vector and expressed in E. coli BL21DE3. The maximum yield of recombinant proteins was optimized after 16 hrs of post induction at 21°C and purified the recombinant protein in soluble form. Antibodies were raised in Mice and Rabbit. The IgG antibody titer in the case of Mice was 1: 1,024,000 and Rabbit was 1: 512,000 with alum as adjuvant via intramascular route. The biological activity of the recombinant protein was confirmed by in-vitro studies using PC12 cells by the synaptobrevin cleavage, the rBoNT/B LC protein showed the maximum blockage of acetylcholine release at a concentration of 150nM rBoNT/B LC in comparison to the control cells. When the cells were incubated with rBoNT/B LC neutralized by the antisera raised against it, the acetylcholine release was equivalent to the control. IgG specific to rBoNT/B LC was purified from raised antibodies. The results showed that the developed antibody against rBoNT/B LC protein were able to detect botulinum toxin type B approximately up to 1 ng/ml. These developed high titer antibodies may prove useful for the detection of botulinum neurotoxins in food and clinical samples.

Recombinant Shiga toxin B subunit elicits protection against Shiga toxin via mixed Th type immune response in mice

Shigella dysenteriae is the causative agent of the third commonest bacterial disease for childhood diarrhoea and responsible for millions of deaths per year. It produces potent toxin termed Shiga toxin which is listed in category B biological warfare agent of CDC, USA. Earlier we have reported production of recombinant Shiga toxin B subunit that produced antibodies which neutralized Shiga toxin toxicity in HeLa cells. In the present study, we have evaluated the immunomodulatory potential of rStxB protein in Balb/c mice using Freunds adjuvants. Animal protection with recombinant StxB was conferred through both humoral and cellular immune responses as indicated by an increased antibody titre with predominance of IgG2a and IgG2b isotypes along with elevated levels of IgG1 subtype. Cytokine profile of the mice antiserum and splenocyte also indicates Th2 and Th1 type of immune responses where former dominates in early stage of immunization. Histopathology study of kidneys of vaccinated mice showed remarkable differences when compared to the animals infected with Shigella dysenteriae type1. The present study indicates that recombinant StxB is a promising vaccine candidate and can be used for production of therapeutic antibodies to counter Shiga intoxication.

Development of immunodetection system for botulinum neurotoxin type B using synthetic gene based recombinant protein

BACKGROUND & OBJECTIVES

Botulinum neurotoxins (A-G) are among most poisonous substances in the world, produced by obligate anaerobic bacteria Clostridium botulinum. Among the seven serotypes A, B, E and F are of human importance. In India, the prevalence of C. botulinum as well as botulism outbreaks have been reported. Due to its extreme toxicity it has been classified in the Category A of biological warfare agent. So far, there is no commercial detection system available in India to detect botulism. The present study aims to develop an immuno detection system for botulinum neurotoxin serotype B using synthetic gene approach.

METHODS

The truncated fragment of the botulinum neurotoxin type B from amino acid 1-450 was synthesized using PCR overlap primers; the constructed gene was cloned in the pQE30UA vector and transformed to Escherichia coli SG 13009. The recombinant protein expression was optimized using various concentration of isopropylthiogalactoside (IPTG) induction, further the expression was confirmed by Western blot analysis using anti-His antibody. Recombinant protein was purified under denatured condition using Ni-NTA affinity chromatography. Antibody was generated against the recombinant protein using alum adjuvant in BALB/c mice and tested for cross reactivity with other serotypes of C. botulinum as well as closely related clostridia. An ELISA test was developed for the detection of botulinum neurotoxin and the minimum detection limit was also estimated.

RESULTS

The recombinant protein was expressed at maximum yield at 4.3 h of post-induction with 0.5 mM IPTG concentration. The recombinant protein was purified using Ni-NTA affinity chromatography up to the homogeneity level. The polyclonal antibodies were raised in mice with a titre of 1:2,048,000. The developed antibody was highly specific with a sensitivity of detecting approximately 15 ng/ml of recombinant protein and not showing any cross-reactivity with other serotypes.

INTERPRETATION & CONCLUSIONS

There is no commercial immunodetection system available in India to detect botulism. The developed detection system is highly specific. It will be useful for growing food industry to detect botulinum neurotoxin in food samples as well as in clinical samples.

Rapid multiplex PCR assay for the simultaneous detection of the Brucella Genus, B. abortus, B. melitensis, and B. suis

The routine identification and differentiation of Brucella species is a time-consuming and labor-intensive process, which frequently places personnel at risk of laboratoryacquired infection. Here, we describe the development of a rapid multiplex PCR assay for the confirmation of presumptive Brucella isolates. The assay was able to identify and differentiate major human pathogens, namely B. abortus, B. melitensis, and B. suis, in a single test of less than an hour and a half.

Differential toxicity profile of ricin isoforms correlates with their glycosylation levels

Ricin is one of the most potent and deadly plant toxins from the seeds of Ricinus communis. In view of its high toxicity, ricin is being used as an immunotoxin in cancer therapy. Ricin also has several isoforms with differential glycosylation depending on the seed variety. Our study shows three isoforms designated 1, 2 and 3, which differed in their surface charge, resulting in a different behavior on cation exchange chromatography, two dimensional (pI 5.5-8.7) and native PAGE. The molecular masses of isoform-1, 2 and 3 were measured as 63.55 kDa, 64.03 kDa and 62.8 kDa, respectively, by MALDI-TOF/MS. In vitro studies with monkey kidney (Vero) cells showed a time dependent increase in cytotoxicity of the isoforms evaluated by extracellular lactate dehydrogenase activity and mitochondrial dehydrogenase assay. These isoforms also induce oxidative stress and DNA damage. Among the isoforms, isoform-3 was quick to generate reactive oxygen species (ROS), (in 90 min) and exhibited maximum cytotoxicity. Morphological changes, catalase activity and DNA fragmentation were significantly higher with isoform-3 treatment compared to others. The glycosylation studies by MALDI-TOF/MS showed that isoform-3 is highly glycosylated with high sugar levels containing more of hybrid/complex type glycopeptides with mannose as hexose units. These experimental evidences clearly suggest that isoform-3 is superior in its early ROS generation, potency to induce oxidative stress and cytotoxicity, that could be due to it's higher glycosylation levels which make isoform-3 as an ideal candidate for immunotoxin studies.

Purification, characterization and toxicity profile of ricin isoforms from castor beans

The castor seed contains the toxin ricin, one of the most poisonous naturally occurring toxins. The whole of the plant is poisonous, however the seeds are considered the major source of ricin. Ricin exists in different forms in beans of different origin. We investigated the presence of ricin in different isoforms and elucidate some of their structural and biological features isolated from the castor seeds. The isoforms were sub fractionated into ricin I, II and III by chromatography. Their molecular weights lie between 60-65 kDa with difference in their relative electrophoretic mobility. An acidic native PAGE of ricin isoforms at pH 2.9 was performed. Ricin I, II and III are highly cytotoxic against Vero cell line with IC(50) values of 60, 30 and 8 ng/ml respectively. Difference in cytotoxicity of isoforms was confirmed through hemagglutination assay, ricin III caused high degree of hemolysis. The preliminary in vivo toxicity studies showed that ricin III is highly toxic. Immunological studies revealed that anti-ricin I and II antibodies are cross reactive with all the ricin variants, whereas the anti-ricin III antibody is highly specific. The present study shows that anti-ricin I and II antibodies can be used for detection of entire ricin isoforms.

Characterization of native and denatured ricin using MALDI-TOF/MS

Ricin is a toxic protein present in the seeds of castor bean plant. It can be inactivated by heat; therefore characterization of denatured ricin is essential to differentiate it from native ricin and to avoid any ambiguity in its identification. In this study, potential of mass spectrometry using MALDI&mdash;TOF/MS has been exploited to investigate the effects of heat treatment on ricin and spiked food matrices. The molecular weights of ricin, ricin A (A1 and A2) and B chain were found to be 62.8 kDa, 31.2 kDa, 32.5 kDa and 32 kDa respectively. The mass spectrum revealed a polypeptide chain of 11.1 kDa for denatured ricin. The peptide mass fingerprinting showed 24 peptides, six were common both in native and denatured ricin. The differentiating peptide at position 294&mdash;318 (m/z 934.533) was observed only in denatured ricin. The three selected marker peptides m/z 1013.6, 1310.7, 1728.9 are chosen for identification of ricin inactivated by heat in spiked apple juice and milk samples by immunocapture analysis. There is always a probability of denatured non&mdash; toxic ricin being confused with native (toxic) ricin to create unnecessary panic. Keeping this probability in mind, our study will be of immense value in minimising such risk.

Denatured ricin can be detected as native ricin by immunological methods, but nontoxic in vivo

Ricin is a glycoprotein from Ricinus communis seeds. It is known to have diverse toxic effects on cells of different visceral organs. In the present study, we purified and denatured ricin in a boiling water bath for different time intervals. We further made an attempt to identify native and denatured ricin by immunobased detection systems. All the antigen/antibody-based assays identified native and denatured ricin. On SDS-PAGE, only native ricin was observed. In western blotting, ricin boiled for 3.75 min gave a strong band on X-ray film. On native polyacryl amide gel electrophoresis, native and denatured ricin gave ricin band in 60-kDa region. The denatured ricin did not [corrected] cause mortality up to 25 mg/kg, while 5 and 10 microg/kg of native ricin caused 50% and 100% mortality, respectively. Detection of native and denatured ricin is very difficult, and the investigating agencies, forensic scientists, and analysts should be very careful while interpreting the results.

Molecularly imprinted nanopatterns for the recognition of biological warfare agent ricin

Molecularly imprinted polymer (MIP) for biological warfare agent (BWA) ricin was synthesized using silanes in order to avoid harsh environments during the synthesis of MIP. The synthesized MIP was utilized for the recognition of ricin. The complete removal of ricin from polymer was confirmed by fluorescence spectrometer and SEM-EDAX. SEM and EDAX studies confirmed the attachment of silane polymer on the surface of silica gel matrix. SEM image of Ricin-MIP exhibited nanopatterns and it was found to be entirely different from the SEM image of non-imprinted polymer (NIP). BET surface area analysis revealed more surface area (227 m(2)/g) for Ricin-MIP than that of NIP (143 m(2)/g). In addition, surface area study also showed more pore volume (0.5010 cm(3)/g) for Ricin-MIP than that of NIP (0.2828 cm(3)/g) at 12 nm pore diameter confirming the presence of imprinted sites for ricin as the reported diameter of ricin is 12 nm. The recognition and rebinding ability of the Ricin-MIP was tested in aqueous solution. Ricin-MIP rebound more ricin when compared to the NIP. Chromatogram obtained with Ricin-MIP exhibited two peaks due to imprinting, however, chromatogram of NIP exhibited only one peak for free ricin. SDS-PAGE result confirmed the second peak observed in chromatogram of Ricin-MIP as ricin peak. Ricin-MIP exhibited an imprinting efficiency of 1.76 and it also showed 10% interference from the structurally similar protein abrin.

Dose dependent effect of ricin on DNA damage and antioxidant enzymes in mice

Ricin a glycoprotein from the Ricinus communis seeds, is known to have diverse toxic effects on cells of different visceral organs. We have studied the effect of ricin (0.5, 1.0 and 2.0 LD50) on various oxidative stress markers at 1, 3 and 7 day post exposure following i.p. administration in Swiss albino male mice. Results of this study revealed that ricin induces generation of reactive species, lipidperoxidation, DNA fragmentation and depletion of GSH. Activity of antioxidant cascade related enzyme like superoxide dismutase (SOD), glutathione peroxidase (GPx) decreased, while glutathione reductase (GR) and catalase activity increased. Superoxide dismutase and glutathione peroxidase activity was decreased significantly in liver, spleen and kidney. The decrease was more prominent on 7 day of post exposure in all the exposed doses. A significant increase in the activities of catalase was observed in plasma, liver, spleen and kidney on 7 day following ricin exposure. Glutathione reductase increased significantly as early as 24 h following 1.0 LD50 dose. Lipid peroxidation increased and non protein sulfhydryl content decreased in all the tissues at different time intervals. Total antioxidant status was reduced as early as 1 day post exposure. Nearly two fold increase was observed in DNA fragmentation following 0.5 LD50 dose of ricin on 1 day post exposure. DNA diffusion assay also indicated an early damage to DNA due to ROS. An early change in DNA fragmentation, DNA diffusion, and total antioxidant status and in the activity of various enzymes indicates that ricin produce oxidative stress by generation of reactive oxygen species as early as 24 h at a minimum dose of 0.5 LD50. Probably this is the first study which indicate that ricin induced oxidative stress at a minimum dose of 0.5 LD50.

Protective effect of ethanolic and water extracts of sea buckthorn (Hippophae rhamnoides L.) against the toxic effects of mustard gas

Ethanolic extract of H. rhamnoides L. leaf (HL-EOH), water and ethanolic extract of H. rhamnoides fruit (HF-W and HF-EOH), and H. rhamnoides flavone from fruit (HR-flavone) were evaluated against percutaneously administered sulphur mustard (SM), a chemical warfare agent. The animals administered with SM (9.7, 19.3 and 38.7 mg/kg) died at various days depending upon the dose and there was a significant reduction in the body weight. The H. rhamnoides extracts (1 g/kg; 3 doses; po) significantly protected the lethality, with a protective index of 2.4, 1.7, 1.7 and 2.2 for HL-EOH, HF-W, HF-EOH and HR-flavone respectively. Reduced glutathione (GSH) and oxidized glutalthione (GSSG) levels were reduced, and malondialdehyde (MDA) was elevated after percutaneous administration of SM. Oral administration of HL-EOH and HR-flavone significantly protected the body weight loss. Recovery in the levels of GSH, GSSG and MDA were also observed following oral administration of HL-EOH and HR-flavone. All the extracts were non-toxic and the LD50 was more than 5 g/kg. The present study shows that percutaneous administration of SM induces oxidative stress and ethanolic extract of leaf of H. rhamnoides and H. rhamnoides flavone from fruit can significantly protect it.

Effect of sub-acute oral cyanide administration in rats: Protective efficacy of alpha-ketoglutarate and sodium thiosulfate

Chronic toxicity of cyanide in humans and animals has been previously described. Alpha-ketoglutarate (alpha-KG) and sodium thiosulfate (STS) are known to confer remarkable protection against acute cyanide poisoning in rodents. Their efficacy against sub-acute or chronic cyanide exposure is not known. The objective of the present study was to assess the sub-acute toxicity of potassium cyanide (KCN) in female rats following oral administration of 7.0 mg/kg (0.5 LD50) for 14 d. The effect of alpha-KG (oral; 1.0 g/kg) and/or STS (intraperitoneal, 1.0 g/kg) on cyanide toxicity was also evaluated. Various hematological and biochemical indices were determined after 7 d of treatment and additional parameters like organ-body weight index (OBI) and histology of brain, heart, lung, liver, kidney and spleen were performed after 14 and 21 d (recovery group) of cyanide exposure. Sub-acute exposure of KCN did not produce any significant change in body weight of the animals, OBI, hematology and the levels of blood urea, creatinine, aspartate aminotransferase, triiodothyronine (T3) and tetraiodothyronine (T4). The levels of temporal glutathione disulfide (GSSG) and hepatic malondialdehyde (MDA), reduced glutathione (GSH) and GSSG were unaffected. However, in KCN treated animals elevated levels of blood glucose and reduced levels of alanine aminotransferase were observed. Activities of cytochrome c oxidase in the brain and rhodanese in the liver were diminished. Reduced levels of GSH and enhanced levels of MDA in brain were observed. Increased levels of blood thiocyanate were observed in all the treatments of KCN. Additionally, KCN also produced various histological changes in the brain, heart, liver and kidney. Although, treatment of alpha-KG and STS alone significantly blunted the toxicity of KCN, concomitant use of both interventions afforded to maximum protection. This study indicates a promising role of alpha-KG and STS for the treatment of prolonged cyanide exposures.

Mechanism of ricin-induced apoptosis in human cervical cancer cells

The mechanism of ricin-induced apoptosis in human cervical cancer cell line HeLa was studied. The present study demonstrated that ricin induces apoptosis of human cervical cancer cells (HeLa) in a time dependent manner with an IC(50) for cell viability of 1 microg/ml. Ricin treatment resulted in a time dependent increase in LDH leakage, DNA fragmentation, percent apoptotic cells, generation of reactive oxygen species and depletion of intracellular glutathione levels. DNA agarose gel electrophoresis showed typical oligonucleosomal length DNA fragmentation. Additionally, DNA diffusion assay was performed to confirm DNA damage and apoptosis. Ricin activated caspase-3 as evidenced by both proteolytic cleavage of procaspase-3 into 20 and 18 kDa subunits, and increased protease activity. Caspase activity was maximum at 4h and led to the cleavage of 116 kDa poly(ADP-ribose) polymerase (PARP), resulting in the 85 kDa cleavage product. Ricin-induced caspase-3 activation also resulted in cleavage of DNA fragmentation factor-45 (DFF45/ICAD) and DFF40 or caspase-activated DNase in HeLa cells. Activation of caspase-3, cleavage of PARP and DNA fragmentation was blocked by pre-treatment with caspase-3 specific inhibitor Ac-DEVD-CHO (100 microM) and broad-spectrum caspase inhibitor Z-VAD-FMK (40 microM). Ricin-induced DNA fragmentation was inhibited by pre-treatment with PARP inhibitors 3-aminobenzamide (100 microM) and DPQ (10 microM). Our results indicate that ricin-induced cell death was mediated by generation of reactive oxygen species and subsequent activation of caspase-3 cascade followed by down stream events leading to apoptotic mode of cell death.

Oxidative stress associated hepatic and renal toxicity induced by ricin in mice

Ricin a glycoprotein from the Ricinus communis seeds, is known to have diverse toxic effects on cells of different visceral organs. We have studied the hepatotoxicity, nephrotoxicity, and oxidative stress following i.p. administration of ricin (25 microg/kg) in Swiss albino male mice. The results of this study revealed that activities of various enzymes like glutamic pyruvic transaminase (GPT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (gamma-GT), and lactate dehydrogenase (LDH) were increased in plasma, liver, and kidney tissues indicating damage in liver and kidney. Blood urea level was also increased. However, blood creatinine and bilirubin were not altered. Lipid peroxidation increased to 49 and 25% in hepatic and renal tissue. Total non-protein sulfhydryl content decreased in plasma (12%), hepatic (29%), and renal (16%) tissues. Superoxide dismutase activity decreased significantly in liver (43%) and kidney (37%). The activity of glutatione peroxidase was also decreased. The decrease was more prominent in kidney than liver. A significant increase, 20 to 27% in the activity of catalase was observed in plasma, liver, and kidney. These results indicate that ricin produces hepatoxicity, nephrotoxicity, and oxidative damage at 24 h of post treatment. The hepatotoxicity was more prominent than nephrotoxicity.

Covert bacteriuria in nephrotic syndrome

Prevalence of covert bacteriuria in patients of nephrotic syndrome admitted for kidney biopsy was studied in 205 patients. Age ranged from 10 years to 65 years. 148 patients were male and 57 were female. Prevalence of covert bacteriuria was found in 38 patients (18.53%). In bacteriuric patients 30 were male, 8 were female. Escherichia coli was the commonest organism grown in bacteriuric patients (30 or 78.9%). Serum albumin was low and 24-hour urinary protein excretion was high in bacteriuric patients in comparison to abacteriuric patients. In bacteriuric patients membranous nephropathy was the commonest histopathological finding present in 15 patients (39.47%).

Covert bacteriuria in nephrotic syndrome

Prevalence of covert bacteriuria in patients of nephrotic syndrome admitted for kidney biopsy was studied in 205 patients. Age ranged from 10 years to 65 years. 148 patients were male and 57 were female. Prevalence of covert bacteriuria was found in 38 patients (18.53%). In bacteriuric patients 30 were male, 8 were female. Escherichia coli was the commonest organism grown in bacteriuric patients (30 or 78.9%). Serum albumin was low and 24-hour urinary protein excretion was high in bacteriuric patients in comparison to abacteriuric patients. In bacteriuric patients membranous nephropathy was the commonest histopathological finding present in 15 patients (39.47%).