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Khanna S, Tande A, Rubin DT, Khoruts A, Kahn SA, Pardi DS. Fecal Microbiota Transplantation for Recurrent C difficile Infection During the COVID-19 Pandemic: Experience and Recommendations. Mayo Clin Proc 2021; 96:1418-1425. [PMID: 34088413 PMCID: PMC8169126 DOI: 10.1016/j.mayocp.2021.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/23/2021] [Accepted: 04/12/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. METHODS A retrospective study of patients with rCDI who underwent FMT from May 26, 2020, to September 30, 2020, with stool from well-screened donors with health and infectious screening and a newly implemented strategy for COVID-19 screening with every 2-week bookend testing with stool quarantine. Patients were followed up for development of rCDI and COVID-19. RESULTS Of the 57 patients who underwent FMT for rCDI, 29 were tested for COVID-19 via nasopharyngeal polymerase chain reaction (PCR) and 22 via serology. All results were negative, except for 1 positive serology. Donor testing every 2 weeks for COVID-19 via serology and nasopharyngeal swab PCR was negative, except for 2 donors at 1 center who were excluded. Three patients had rCDI after FMT, and 1 underwent repeat FMT. One patient developed respiratory symptoms suggestive of COVID-19 and tested negative via nasopharyngeal PCR. Eleven patients who underwent COVID-19 testing for elective procedures or hospitalizations tested negative. No SARS-CoV-2 transmission was noted. CONCLUSIONS With appropriate donor screening, FMT can be performed safely for rCDI during the COVID-19 pandemic. Development of a validated stool assay for SARS-CoV-2 will simplify this process further.
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Affiliation(s)
- Sahil Khanna
- Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
| | - Aaron Tande
- Infectious Diseases, Mayo Clinic, Rochester, MN
| | - David T Rubin
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, IL
| | - Alexander Khoruts
- Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN
| | - Stacy A Kahn
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA
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Baker D, Amor S, Kang AS, Schmierer K, Giovannoni G. The underpinning biology relating to multiple sclerosis disease modifying treatments during the COVID-19 pandemic. Mult Scler Relat Disord 2020; 43:102174. [PMID: 32464584 PMCID: PMC7214323 DOI: 10.1016/j.msard.2020.102174] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND SARS-CoV-2 viral infection causes COVID-19 that can result in severe acute respiratory distress syndrome (ARDS), which can cause significant mortality, leading to concern that immunosuppressive treatments for multiple sclerosis and other disorders have significant risks for both infection and ARDS. OBJECTIVE To examine the biology that potentially underpins immunity to the SARS-Cov-2 virus and the immunity-induced pathology related to COVID-19 and determine how this impinges on the use of current disease modifying treatments in multiple sclerosis. OBSERVATIONS Although information about the mechanisms of immunity are scant, it appears that monocyte/macrophages and then CD8 T cells are important in eliminating the SARS-CoV-2 virus. This may be facilitated via anti-viral antibody responses that may prevent re-infection. However, viral escape and infection of leucocytes to promote lymphopenia, apparent CD8 T cell exhaustion coupled with a cytokine storm and vascular pathology appears to contribute to the damage in ARDS. IMPLICATIONS In contrast to ablative haematopoietic stem cell therapy, most multiple-sclerosis-related disease modifying therapies do not particularly target the innate immune system and few have any major long-term impact on CD8 T cells to limit protection against COVID-19. In addition, few block the formation of immature B cells within lymphoid tissue that will provide antibody-mediated protection from (re)infection. However, adjustments to dosing schedules may help de-risk the chance of infection further and reduce the concerns of people with MS being treated during the COVID-19 pandemic.
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Key Words
- ace2, angiotensin converting enzyme two
- ards, acute respiratory distress syndrome
- asc, antibody secreting cells
- cns, central nervous system
- dmt, disease modifying therapies
- (hsct), haematopoietic stem cell therapy
- irt, immune reconstitution therapies
- ms, multiple sclerosis
- rbd, receptor binding domain
- rna, ribonucleic acid
- sars, severe acute respiratory syndrome
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Affiliation(s)
- David Baker
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT; United Kingdom.
| | - Sandra Amor
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT; United Kingdom; Pathology Department, VUmc, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Angray S Kang
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT; United Kingdom; Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Klaus Schmierer
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT; United Kingdom; Clinical Board:Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Gavin Giovannoni
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AT; United Kingdom; Clinical Board:Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
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Banat GR, Tkalcic S, Dzielawa JA, Jackwood MW, Saggese MD, Yates L, Kopulos R, Briles W, Collisson EW. Association of the chicken MHC B haplotypes with resistance to avian coronavirus. Dev Comp Immunol 2013; 39:430-437. [PMID: 23178407 PMCID: PMC7103219 DOI: 10.1016/j.dci.2012.10.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 10/18/2012] [Accepted: 10/19/2012] [Indexed: 06/01/2023]
Abstract
Clinical respiratory illness was compared in five homozygous chicken lines, originating from homozygous B2, B8, B12 and B19, and heterozygous B2/B12 birds after infection with either of two strains of the infectious bronchitis virus (IBV). All chickens used in these studies originated from White Leghorn and Ancona linages. IBV Gray strain infection of MHC homozygous B12 and B19 haplotype chicks resulted in severe respiratory disease compared to chicks with B2/B2 and B5/B5 haplotypes. Demonstrating a dominant B2 phenotype, B2/B12 birds were also more resistant to IBV. Respiratory clinical illness in B8/B8 chicks was severe early after infection, while illness resolved similar to the B5 and B2 homozygous birds. Following M41 strain infection, birds with B2/B2 and B8/B8 haplotypes were again more resistant to clinical illness than B19/B19 birds. Real time RT-PCR indicated that infection was cleared more efficiently in trachea, lungs and kidneys of B2/B2 and B8/B8 birds compared with B19/B19 birds. Furthermore, M41 infected B2/B2 and B8/B8 chicks performed better in terms of body weight gain than B19/B19 chicks. These studies suggest that genetics of B defined haplotypes might be exploited to produce chicks resistant to respiratory pathogens or with more effective immune responses.
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Key Words
- ibv, infectious bronchitis virus
- mhc, major histocompatibility complex
- m41, massachusetts 41
- rt-pcr, reverse transcription polymerase chain reaction
- sars, severe acute respiratory syndrome
- rsv, rous sarcoma virus
- mdv, marek’s disease virus
- spf, specific pathogen free
- pi, post infection
- eid50/ml, embryo infectious dose 50 per ml
- niu, northern illinois university
- pbs, phosphate buffer saline
- rna, ribonucleic acid
- 5′ utr, 5′ untranslated region
- bp, base pairs
- anova, analysis of variance
- ark, arkansas
- ctl, cytotoxic t lymphocyte
- aiv, avian influenza virus
- ifnγ, interferon gamma
- poly i:c, polyinosinic polycytidylic acid
- usda, united states department of agriculture
- nifa, national institute of food and agriculture
- infectious bronchitis virus
- chicken mhc b haplotype
- clinical illness
- infection of trachea
- lungs and kidneys
- resistant
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Affiliation(s)
- Ghida R. Banat
- College of Veterinary Medicine, Western University of Health Sciences, 309 E. 2nd St., Pomona, CA 91766-1854, USA
| | - Suzana Tkalcic
- College of Veterinary Medicine, Western University of Health Sciences, 309 E. 2nd St., Pomona, CA 91766-1854, USA
| | - Jennifer A. Dzielawa
- College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
| | - Mark W. Jackwood
- Poultry Diagnostic Research Center, Department of Population Health, College of Veterinary Medicine, University of Georgia, 953 College Station Road, Athens, GA 30602-4875, USA
| | - Miguel D. Saggese
- College of Veterinary Medicine, Western University of Health Sciences, 309 E. 2nd St., Pomona, CA 91766-1854, USA
| | - Linda Yates
- Department of Biological Sciences, Northern Illinois University, 415 Montgomery Hall, DeKalb, IL 60115-2861, USA
| | - Renee Kopulos
- Department of Biological Sciences, Northern Illinois University, 415 Montgomery Hall, DeKalb, IL 60115-2861, USA
| | - W.E. Briles
- Department of Biological Sciences, Northern Illinois University, 415 Montgomery Hall, DeKalb, IL 60115-2861, USA
| | - Ellen W. Collisson
- College of Veterinary Medicine, Western University of Health Sciences, 309 E. 2nd St., Pomona, CA 91766-1854, USA
- College of Veterinary Medicine, Texas A&M University, College Station, TX 77845, USA
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Jartti T, Söderlund-Venermo M, Hedman K, Ruuskanen O, Mäkelä MJ. New molecular virus detection methods and their clinical value in lower respiratory tract infections in children. Paediatr Respir Rev 2013; 14:38-45. [PMID: 23347659 PMCID: PMC7106250 DOI: 10.1016/j.prrv.2012.04.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
During the past decade, several new respiratory viruses and their subgroups have been discovered. All these new viruses, as well as previously known respiratory viruses, can be detected by sensitive PCR methods, which have become popular in the diagnostic workup of respiratory viral infections. Currently, respiratory viruses can be detected in up to 95% of children with lower respiratory tract illness. On the other hand, virus detection rates in asymptomatic children are also high (up to 68%), as are coinfection rates in symptomatic children (up to 43%) and justified concerns of causality have been raised. Imposing progress has been made in developing multiplex quantitative PCR assays; here, several primer sets are run within a single PCR mixture. These PCR assays give a better understanding of the dominant viral infection, of viral infections that may be incipient and of any waning infections than does a single-target PCR. Multiplex PCR assays are also gaining popularity due to their cost-effectiveness and short throughput time compared to multiple single-target PCRs. Our understanding of the indications of virus PCRs and our ability to interpret the results from a clinical point of view have improved. This paper reviews the progress in PCR assays and discusses their role in the diagnosis of lower respiratory tract infections in children.
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Key Words
- dna, deoxyribonucleic acid
- hbov, human bocavirus
- hmpv, human metapneumovirus
- hrv, human rhinovirus
- lrti, lower respiratory tract illness
- n, number of samples
- np, nasophryngeal
- npa, nasopharyngeal aspirate
- pcr, polymerase chain reaction
- piv, parainfluenza virus
- qpcr, quantitative pcr
- rna, ribonucleic acid
- rsv, respiratory syncytial virus
- rt, reverse transcriptase
- rvp, respiratory virus panel
- child
- infection
- lower respiratory tract
- multiplex
- pcr
- quantitative
- respiratory
- virus
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Affiliation(s)
- Tuomas Jartti
- Department of Pediatrics, Turku University Hospital, Turku, Finland.
| | | | - Klaus Hedman
- Department of Virology; University of Helsinki; Helsinki
| | - Olli Ruuskanen
- Department of Pediatrics, Turku University Hospital, Turku
| | - Mika J. Mäkelä
- Pediatric division, Department of Allergy, Skin and Allergy Hospital, University of Helsinki, Helsinki, all in Finland
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Teles FSRR. Biosensors and rapid diagnostic tests on the frontier between analytical and clinical chemistry for biomolecular diagnosis of dengue disease: a review. Anal Chim Acta 2011; 687:28-42. [PMID: 21241843 PMCID: PMC7094386 DOI: 10.1016/j.aca.2010.12.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 11/09/2010] [Accepted: 12/07/2010] [Indexed: 11/26/2022]
Abstract
The past decades have witnessed enormous technological improvements towards the development of simple, cost-effective and accurate rapid diagnostic tests for detection and identification of infectious pathogens. Among them is dengue virus, the etiologic agent of the mosquito-borne dengue disease, one of the most important emerging infectious pathologies of nowadays. Dengue fever may cause potentially deadly hemorrhagic symptoms and is endemic in the tropical and sub-tropical world, being also a serious threat to temperate countries in the developed world. Effective diagnostics for dengue should be able to discriminate among the four antigenically related dengue serotypes and fulfill the requirements for successful decentralized (point-of-care) testing in the harsh environmental conditions found in most tropical regions. The accurate identification of circulating serotypes is crucial for the successful implementation of vector control programs based on reliable epidemiological predictions. This paper briefly summarizes the limitations of the main conventional techniques for biomolecular diagnosis of dengue disease and critically reviews some of the most relevant biosensors and rapid diagnostic tests developed, implemented and reported so far for point-of-care testing of dengue infections. The invaluable contributions of microfluidics and nanotechnology encompass the whole paper, while evaluation concerns of rapid diagnostic tests and foreseen technological improvements in this field are also overviewed for the diagnosis of dengue and other infectious and tropical diseases as well.
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Key Words
- cdc, centers for disease control
- denv1–4, dengue virus serotypes (1–4)
- ssrna, single-stranded ribonucleic acid
- orf, open-reading frame
- ns1, non-structural 1
- dhf, dengue hemorrhagic fever
- dss, dengue shock syndrome
- who, world health organization
- hi, hemagglutination-inhibition
- mac-eia, monoclonal antibody capture-enzyme linked immunosorbent assay
- rt-pcr, reverse transcription-polymerase chain reaction
- 3′-nr, 3′noncoding region
- rna, ribonucleic acid
- igg, immunoglobulin g
- igm, immunoglobulin m
- dna, deoxyribonucleic acid
- qcm, quartz-crystal microbalance
- mip, molecularly imprinted polymer
- gnp, gold nanoparticle
- sam, self-assembled monolayer
- bsa, bovine serum albumin
- spr, surface plasmon resonance
- nasba, nucleic acid sequence-based amplification
- s/n, signal-to-noise ratio
- cmos, complementary metal oxide semiconductor
- fia, flow-injection analysis
- fccs, fluorescence cross-correlation spectroscopy
- fcs, fluorescence correlation spectroscopy
- eis, electrochemical impedance spectroscopy
- bst, barium strontium titanate
- fet, field-effect transistor
- pna, peptide nucleic-acid
- lod, limit of detection
- cdna, complementary dna
- tdr, special programme for research and training in tropical diseases
- undp, united nations development programme
- pdvi, pediatric dengue vaccine initiative
- stard, standards for reporting of diagnostic accuracy
- fiocruz, fundação oswaldo cruz
- dpp®, dual-path platform
- blm, bilayer lipid membrane
- qd, quantum dot
- cnt, carbon nanotube
- ms, mass spectrometry
- sars, severe acute respiratory syndrome
- biosensor
- dengue
- diagnosis
- evaluation
- rapid test
- tropical disease
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Affiliation(s)
- Fernando Sérgio Rodrigues Ribeiro Teles
- Centre for Malaria and Tropical Diseases, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
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Chirila TV, Rakoczy PE, Garrett KL, Lou X, Constable IJ. The use of synthetic polymers for delivery of therapeutic antisense oligodeoxynucleotides. Biomaterials 2002; 23:321-42. [PMID: 11761152 PMCID: PMC7124374 DOI: 10.1016/s0142-9612(01)00125-9] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2000] [Accepted: 03/26/2001] [Indexed: 12/20/2022]
Abstract
Developed over the past two decades, the antisense strategy has become a technology of recognised therapeutic potential, and many of the problems raised earlier in its application have been solved to varying extents. However, the adequate delivery of antisense oligodeoxynucleotides to individual cells remains an important and inordinately difficult challenge. Synthetic polymers appeared on this scene in the middle 1980s, and there is a surprisingly large variety used or proposed so far as agents for delivery of oligodeoxynucleotides. After discussing the principles of antisense strategy, certain aspects of the ingestion of macromolecules by cells, and the present situation of delivery procedures, this article analyses in detail the attempts to use synthetic polymers as carrier matrices and or cell membrane permeabilisation agents for delivery of antisense oligodeoxynucleotides. Structural aspects of various polymers, as well as the results, promises and limitations of their use are critically evaluated.
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Key Words
- a, adenine
- as, antisense
- c, cytosine
- cd, cyclodextrin
- dna, deoxyribonucleic acid
- evac, poly(ethylene-co-vinyl acetate)
- g, guanine
- hart, hybrid-arrested translation
- help, high-efficiency liquid phase
- hema, 2-hydroxyethyl methacrylate
- hpma, n-(2-hydroxypropyl)methacrylamide
- ipec, interpolyelectrolyte complex
- odn, oligodeoxyribonucleotide, oligodeoxynucleotide
- pamam, polyamidoamines
- pca, polycyanoacrylates
- pdtema, n-[2-(2-pyridyldithio)]ethylmethacrylamide
- pedot, poly(3,4-ethylenedioxythiophene)
- peg, poly(ethylene glycol)
- pei, polyethyleneimine
- peo, poly(ethylene oxide)
- pga, poly(glycolic acid)
- pl, polylysine
- pla, poly(lactic acid)
- pll, poly(l-lysine)
- por, polyornithine
- ps, polyspermine
- rme, receptor-mediated endocytosis
- rna, ribonucleic acid
- mrna, messenger ribonucleic acid
- rnase, ribonuclease
- snaige, synthetic or small nucleic acids interfering with gene expression
- t, thymine
- vp, 1-vinyl-2-pyrrolidinone
- antisense strategy
- antisense oligodeoxynucleotides
- endocytosis
- drug delivery
- charged polymers
- neutral polymers
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Affiliation(s)
- Traian V Chirila
- Centre for Ophthalmology & Visual Science and Lions Eye Institute, University of Western Australia, Nedlands, Australia.
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Abstract
The carboxypeptidase activity occurring in hog intestinal mucosa is apparently due to two distinct enzymes which may be responsible for the release of basic COOH-terminal amino acids from short peptides. The plasma membrane-bound carboxypeptidase activity which occurs at neutral optimum pH levels was found to be enhanced by CoCl(2) and inhibited by guanidinoethylmercaptosuccinic acid, o-phenanthroline, ethylenediamine tetraacetic acid and cadmium acetate; whereas the soluble carboxypeptidase activity which occurs at an optimum pH level of 5.0 was not activated by CoCl(2) and only slightly inhibited by o-phenanthroline, ethylenediamine tetraacetic acid, NiCl(2) and CdCl(2). The latter activity was presumably due to lysosomal cathepsin B, which is known to be present in the soluble fraction of hog intestinal mucosa. Although the membrane-bound enzyme was evenly distributed along the small intestine, it was not anchored in the phospholipidic bilayer via a glycosyl-phosphatidylinositol moiety, as carboxypeptidase M from human placenta is. The enzyme was not solubilized by phosphatidylinositol-specific phospholipase C, but was solubilized to practically the same extent by several detergents. The purified trypsin-solubilized form is a glycoprotein with a molecular mass of 200 kDa, as determined by performing SDS-PAGE and gel filtration, which differs considerably from the molecular mass of human placental carboxypeptidase M (62 kDa). It was found to cleave lysyl bonds more rapidly than arginyl bonds, which is not so in the case of carboxypeptidase M, and immunoblotting analysis provided further evidence that hog intestinal and human placental membrane-bound carboxypeptidases do not bear much resemblance to each other. Since the latter enzyme has been called carboxypeptidase M, it is suggested that the former might be carboxypeptidase D, the recently described new member of the carboxypeptide B-type family.
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Key Words
- carboxypeptidase
- membrane-bound protein
- metalloprotein
- (hog intestine)
- amc, 4-methyl-7-coumarylamide
- chaps, 3-[(3-cholamidopropyl)dimethylammonio]-1-propane sulfonate
- cmc, critical micellar concentration
- cp, carboxypeptidase
- dtt, dithiothreitol
- edta, ethylenediamine tetraacetic acid
- fplc, fast protein liquid chromatography
- gemsa, guanidinoethylmercaptosuccinic acid
- gpi, glycosyl-phosphatidylinositol
- hepes, 4-(2-hydroxyethyl)-1-piperazine ethanesulfonic acid
- hplc, high-performance liquid chromatography
- mdck, madin darby canine kidney
- nadph, nicotinamide adenine dinucleotide phosphate
- octyl-glucoside, n-octyl-β-d-glucopyranoside
- page, polyacrylamide gel electrophoresis
- pcms, p-chloromercuriphenyl sulfonate
- pi-plc, phosphatidylinositol-specific phospholipase c
- pitc, phenylisothiocyanate
- pmsf, phenylmethylsulfonyl fluoride
- ptc, phenylthiocarbamyl
- pvdf, polyvinylidene difluoride
- rna, ribonucleic acid
- sds, sodium dodecyl sulfate
- tfa, trifluoroacetic acid
- tlck, nα-p-tosyl-l-lysine chloromethylketone
- tris, tris(hydroxymethyl)aminomethane
- z, benzyloxycarbonyl
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