Significance of serum IgA in patients with acute hepatitis E virus infection

Aim: To study the significance of serum anti-hepatitis E virus (HEV) IgA in patients with hepatitis E. Methods: A new method was established to assay anti-HEV IgA, which could be detected in the middle phase of the infection. We compared anti-HEV IgA assay with anti-HEV IgM and anti-HEV IgG assay in sera from 60 patients with positive HEV-RNA. Results: The 60 patients with positive HEV-RNA had both anti-HEV IgA and anti-HEV IgM and 410 patients with negative HEV-RNA were used as control. Periodic serum samples obtained from 60 patients with hepatitis E were tested for HEV RNA, anti-HEV IgM, anti-HEV IgA and anti-HEV IgG. Their HEV-RNA was detectable in the serum until 20 +/- 11 d. We used anti-HEV IgM and anti-HEV IgA assay to detect HEV infection and positive results Were found in 90 +/- 15 d and 120 +/- 23 d respectively, the positive rate of anti-HEV IgA was higher than that of anti-HEV IgM and HEV-RNA (P<0.05). Conclusion: The duration of anti-HEV IgA in serum is longer than that of anti-HEV IgM, and anti-HEV IgA assay is a good method to detect HEV infection. (C) 2006 The WJG Press. All rights reserved

Inactivation of pathogens on food and contact surfaces using ozone as a biocidal agent

This study focuses on the inactivation of a range of food borne pathogens using ozone as a biocidal agent. Experiments were carried out using Campylobacter jejuni, E. coli and Salmonella enteritidis in which population size effects and different treatment temperatures were investigate

J Viral Hepat

We investigated an outbreak of jaundice in urban Bangladesh in 2010 to examine the cause and risk factors and assess the diagnostic utility of commercial assays. We classified municipal residents reporting jaundice during the preceding 4 weeks as probable hepatitis E cases and their neighbours without jaundice in the previous 6 months as probable controls. We tested the sera collected from probable cases and probable controls for IgM anti-hepatitis E virus (HEV), and the IgM-negative sera for IgG anti-HEV using a commercial assay locally. We retested the IgM-positive sera for both IgM and IgG anti-HEV using another assay at the Centre for Disease Control and Prevention (CDC), USA. Probable cases positive for IgM anti-HEV were confirmed cases; probable controls negative for both IgM and IgG anti-HEV were confirmed controls. We explored the local water supply and sanitation infrastructure and tested for bacterial concentration of water samples. Probable cases were more likely than probable controls to drink tap water (adjusted odds ratio: 3.4; 95% CI: 1.2-9.2). Fifty-eight percentage (36/62) of the case sera were IgM anti-HEV positive; and 75% of the IgM-positive samples were confirmed positive on retesting with another assay at CDC. Compared to confirmed controls, cases confirmed using either or both assays also identified drinking tap water as the risk factor. Two tap water samples had detectable thermotolerant coliforms. Research exploring decentralized water treatment technologies for sustainable safe water might prevent HEV transmission in resource-poor cities. Detection of serological markers in a majority of probable cases implied that available diagnostic assays could adequately identify HEV infection during outbreaks.CC999999/ImCDC/Intramural CDC HHSUnited States

DNA Logic-A novel approach to semiconductor based genetics

In the coming years, genetic test results will be increasingly used as indicators that influence medical decision-making. With chronic disease on the rise and the continuing global spread of infectious disease, novel instruments able to detect relevant mutations in a point-of-care setting are being developed to facilitate this increased demand in personalized health care. However, diagnosis for such demand often requires laboratory facilities and skilled personnel, meaning that diagnostic tests are restricted by time and access. This thesis presents a novel configuration for Ion sensitive Field Effect Transistors (ISFETs) to be used as a threshold detector during nucleic acid base pairs match. ISFET-based inverters are used as reaction threshold detectors to convey the chemical reaction level to a logic output once a threshold has been reached. Using this method, novel DNA logic functions are derived for nucleotides allowing local digital computations. The thesis also presents business models that enable such technology to be utilised in point of care applications, and experiment as results and business models given for an HIV point of care example are proposed

Diagnosis of HEV infection by serological and real-time PCR assays: a study on acute non-A-C hepatitis collected from 2004 to 2010 in Italy

Abstract Background The impact of hepatitis E in developed countries, like Italy, still requires a clear definition. In the present study, we evaluated HEV infection in patients with acute non-A-C hepatitis by an approach comparing data from Real-time PCR and serological assays. Methods In a first analysis, sera from 52 patients hospitalized with a diagnosis of acute viral non-A-C hepatitis in Italy were tested by in-house Real-Time PCR assay for identification of Hepatitis E Virus (HEV) RNA and by anti-HEV IgM and IgG assays. In a subsequent analysis, selected samples were evaluated by additional IgM tests to confirm diagnosis. Results Among the 52 samples, 21 showed positive results for all three markers (IgM, IgG and HEV RNA). One patient showed HEV RNA as single marker. Uncertain results were found in 8 samples while the remaining 22 were negative for all markers. Further analysis of the 8 undefined samples by additional IgM tests confirmed HEV infection in 1 patient. Overall, acute HEV infections were reliably identified in 23 (44.2%) out of 52 patients. Conclusions In the present paper, we performed a study evaluating HEV infection in 52 sporadic non-A-C acute hepatitis cases. All samples were collected from 2004 to 2010 in Italy. By a diagnostic strategy based on genomic and serological assays we identified HEV infections in 23 out of 52 patients (44.2%), a percentage higher than previous estimates. Thus, the actual impact of HEV infections in Italy needs to be further evaluated on a national scale by a diagnostic strategy based on multiple and last generation assays. </jats:sec

Molecular mechanisms in human hepatocellular carcinoma

MD ThesisHepatocellular carcinoma (HCQ is one of the commonest cancers worldwide. There is, however, a marked geographical variation in incidence and it has been suggested that the pathogenesis may vary in different parts of the world. A retrospective analysis of 110 HCC patients was initially undertaken which confirmed that only 29% of British patients had markers of hepatitis B infection, suggesting a possible role for other environmental agents in the pathogenesis, and that 80% of patients had underlying cirrhosis. The nature of the strong relationship between HCC and cirrhosis has not been established but it has been postulated that increased hepatocyte turnover in the cirrhotic liver may predispose to DNA damage by environmental mutagens. Cell proliferation is required to express the strongly promutagenic DNA base lesion 0'-methylguanine, produced by alkylating agents, as a mutation. &- methylguanine is repaired by the DNA repair enzyme 06-methylguanine-DNA methyltTansferase (06-MT). A microassay was developed which could reliably measure 06-MT levels in liver biopsy samples. Using this approach 06-MT levels were found to be significantly lower in cirrhotic liver when compared to non-cirrhotic and normal liver tissue. No correlation was found between lymphocyte and liver levels from individual patients with liver disease indicating that the deficiency in DNA repair is disease-a nd tissue-specific. Three polyclonal antibodies were subsequently raised to 06-MT peptides and characterised by immunoblotting in an attempt to establish the tissue distribution of the enzyme in liver. Although none of the antisera were able to detect &-MT in tissue sections they were used to analyse structural differences in the enzyme between cirrhotic and non-cirrhotic liver using SDS-PAGE followed by immunoblotting and fluorography. A band of M, 24,000r,e presentingn ative enzyme, was visualised by fluorography in all liver extracts. Densitometry of these bands correlated with the enzyme activity determined by the direct enzyme assay, validating the assay findings. Other small molecular weight bands were seen in all liver extracts and comparison with immunoblots suggested that these bands represent C-terminal truncated enzyme. The spectrum of smaller molecular weight enzyme forms was similar in cirrhotic and non-cirrhotic liver. It was, thus, concluded that although 06-MT levels were lower in'cirrhosis this was not accounted for by structural differences in the enzyme. DNA mutations (G to A) produced by the failure to repair 06-methylguanine are known to activate oncogenes and turnour suppressor genes such as p53. However only 5/55 (9%) of HCC expressed mutant p53. Other factors potentially involved in hepatocarcinogenesis include the growth factor TGF-a and a growth factor receptor encoded by the c-erb B-2 proto-oncogene. Expression of TGF-a and the C-erbB -2 oncoprotein were seen in 8/28 (28%) and 2/26 (8%) of HCC respectively, findings which differ from those observed in HCC from the Far East. Deficient DNA repair by &-MT provides one possible reason why cirrhosis is an important risk factor for the development of HCC. However, failure to repair 06-mothylguanine does not result in mutations within the p53 gene in British HCC. Furthermore, the finding of low expression of mutant p53, TGF-a and the c-erb B-2 oncoprotein in HCC from Britain compared to HCC from the Far East and Africa suggests geographical differences in the molecular mechanisms involved in hepatocarcinogenesis between areas of high and low HCC prevalence.North Of England Cancer Research Campaign

The Effects of Exercise Stress on Equine Immune Function.

The physiologic demands of exercise constitute a form of stress which is accompanied by modulation of immune responses. However, numerous studies in many different model systems have failed to clearly define the effects of exercise on immunity. Furthermore, the role of the neuroendocrine system in exercise-induced immunomodulation has been largely unexplored. To address these issues, we evaluated the effect of acute exercise stress on 3 indices of immune function in horses, before and after completion of a 12 week treadmill-based physical conditioning program. In addition, we determined the effects of corticosteroids, catecholamines, beta endorphin, and adrenocorticotropic hormone on these same immune parameters. In this work, we found that an acute severe exercise challenge of unconditioned horses induced immediate and significant post-exercise decreases in pokeweed mitogen (PWM) and equine influenza virus type 2 lymphoproliferative responses. Lymphokine activated killer (LAK) cell activity was also significantly elevated. After training, basal immune responses of resting horses were unchanged compared to those of untrained animals. Further, acute exercise stress no longer produced significant elevations of equine LAK activity, and depressions in PWM responses were delayed and enhanced. Of the neuroendocrine compounds tested for their effects on immune responses, most were capable, at one or more of their tested concentrations, of causing changes in PWM, influenza, or LAK responses similar to those observed after exercise. Physical conditioning attenuated their effects. Surprisingly, in vitro corticosteroids augmented influenza, LAK, and PWM responses depending upon concentration. However, intravenous cortisol injection did not mimic immediate post-exercise changes in the hemogram or immune responses. We conclude that acute exercise stress of horses may be temporarily immunosuppressive, but the observed decrease in lymphoproliferative responses is partially offset by increases in LAK cell-mediated cytotoxicity. While providing no enhancement of basal immune responses, physical conditioning may serve to increase the severity of immune suppression following exercise, possibly contributing to increased morbidity of equine athletes experiencing repeated episodes of exercise stress. Finally, direct effects of corticosteroids, catecholamines and neuropeptides on immune cell function may contribute to exercise effects on immunity in unfit horses and to a lesser extent in fit horses