Permeability and modulation of the intestinal epithelial barrier in vitro

The bioavailability of all ingested compounds is to a great extend determined by the ability of these compounds to pass the intestinal epithelium. A high bioavailability is guaranteed for most nutrients and electrolytes since they are actively absorbed by the epithelium. The same epithelium, however, renders the entrance of non-nutrient (potentially harmful) hydrophilic (macro-) molecules, viruses and bacteria into the systemic circulation very low by presenting an almost impermeable barrier to these agent. The functional and structural properties of the single cell layer forming the intestinal epithelium determine the transepithelial permeability, which is an important factor in determining the bioavailability of all ingested compounds. Thus, insight in this transepithelial permeability is of considerable interest. However, the complexity of the gastrointestinal tract, and of the pre-and post-absorptive kinetics hampered the collection of accurate data. Therefore, a simple, accurate, reproducible, and cheap in vitro model was needed to screen the vast amount of newly developed, or discovered compounds for their intestinal transepithelial permeation.One very popular model consists of the human colonic carcinoma cell line Caco-2 grown in a two-compartment system. Transport experiments with this Caco-2 system yielded in vitro permeation rates which allowed prediction of the oral bioavailability in humans for many different compounds. However, it is generally assumed that the Caco-2 cells restrict the paracellular permeation (extracellular passage along the cells) of hydrophilic compounds such as intact peptides to a greater extent than the small intestinal epithelium in vivo . Thus especially for the modeling of hydrophilic macromolecular permeation, an additional model would be of great value. We posed the question whether the small intestinal epithelium derived cell line IEC-18 could be that model. We found that whereas the Caco-2 cells presented a good model for a general screen on intestinal permeation for a wide variety of compounds, the IEC-18 cells did allow for a better discrimination between the hydrophilic compounds on the basis of their molecular weight. Consequently, experiments with the filter grown IEC-18 cells yielded discriminative permeation rates for the paracellular permeation of hydrophilic compounds with differing bioavailabilities. Thus, data presented in this thesis suggest that the filter grown IEC-18 cells could be valuable as model for paracellular permeability in the small intestine.However, the cell morphology and brush border enzyme activities of IEC-18 cells cultured under standard conditions showed that the cells obtained only a low status of differentiation, while addition of dexamethasone to the culture medium triggered the cells to acquire a more enterocyte-like phenotype. Concomitant with the morphological changes, a tightening of the paracellular barrier was found which suggests that IEC-18 cells might present a model to study the effects of intestinal epithelial cell differentiation on paracellular permeability development along the intestinal crypt-villus axis.Additionally, since it has been recognized that the intestinal epithelial barrier can be compromised by compounds such as drug absorption enhancers or ingested toxins, we studied the effects of a proposed drug absorption enhancer (palmitoyl carnitine) and the bio-active heavy metal cadmium, on structural and functional features of the two intestinal cell lines. We concluded that for studies to modulation of intestinal epithelial barrier function, the Caco-2 is a more convenient model than the IEC-18 cells due to the high basal barrier function for hydrophilic molecules of the Caco-2 cells relative to the low barrier function of IEC-18 cells. The occurrence of increased hydrophilic macromolecular permeability concomitant with membrane damage but without concurrent alterations in the expression of the tight junctional protein ZO-1, as was found after palmitoyl carnitine exposure, strongly suggests the enhancement of transcellular permeability. On the other hand, increased hydrophilic macromolecular permeability and a decreased transepithelial electrical resistance, concomitant with alterations in junctional ZO-1 expression, but without concurrent membrane damage, as was found after cadmium exposure, strongly suggests the enhancement of the paracellular pathway.In conclusion, the two intestinal cell lines Caco-2 and IEC-18, together, offer the possibility to obtain in vitro permeation rates, enabling bioavailability modeling for virtually all classes of compounds. Furthermore, the in vitro systems and research strategies presented in this thesis might help to elucidate modes of action of newly developed compounds on the barrier function of the intestinal mucosa and might thus help to assess the effectivity and safety of absorption enhancers, and to indicate mucosal toxicity of orally ingested compounds such as drugs or food related products.</p

Different virucidal activities of hyperbranched quaternary ammonium coatings on poliovirus and influenza virus

Virucidal activity of immobilized quaternary ammonium compounds (IQACs) coated onto glass and plastic surfaces was tested against enveloped influenza A (H1N1) virus and nonenveloped poliovirus Sabin1. The IQACs tested were virucidal against the influenza virus within 2 min, but no virucidal effect against poliovirus was found in 6 h

Residual viral and bacterial contamination of surfaces after cleaning and disinfection

Environmental surfaces contaminated with pathogens can be sources of indirect transmission, and cleaning and disinfection are common interventions focused on reducing contamination levels. We determined the efficacy of cleaning and disinfection procedures for reducing contamination by noroviruses, rotavirus, poliovirus, parechovirus, adenovirus, influenza virus, Staphylococcus aureus, and Salmonella enterica from artificially contaminated stainless steel surfaces. After a single wipe with water, liquid soap, or 250-ppm free chlorine solution, the numbers of infective viruses and bacteria were reduced by 1 log10 for poliovirus and close to 4 log10 for influenza virus. There was no significant difference in residual contamination levels after wiping with water, liquid soap, or 250-ppm chlorine solution. When a single wipe with liquid soap was followed by a second wipe using 250- or 1,000-ppm chlorine, an extra 1- to 3-log10 reduction was achieved, and except for rotavirus and norovirus genogroup I, no significant additional effect of 1,000 ppm compared to 250 ppm was found. A reduced correlation between reduction in PCR units (PCRU) and reduction in infectious particles suggests that at least part of the reduction achieved in the second step is due to inactivation instead of removal alone. We used data on infectious doses and transfer efficiencies to estimate a target level to which the residual contamination should be reduced and found that a single wipe with liquid soap followed by a wipe with 250-ppm free chlorine solution was sufficient to reduce the residual contamination to below the target level for most of the pathogens tested

Increase in ECHOvirus 6 infections associated with neurological symptoms in the Netherlands, June to August 2016

The Dutch virus-typing network VIRO-TypeNed reported an increase in ECHOvirus 6 (E-6) infections with neurological symptoms in the Netherlands between June and August 2016. Of the 31 cases detected from January through August 2016, 15 presented with neurological symptoms. Ten of 15 neurological cases were detected in the same province and the identified viruses were genetically related. This report is to alert medical and public health professionals of the circulation of E-6 associated with neurological symptoms

Effect of Pulsed or Continuous Delivery of Salt on Sensory Perception Over Short Time Intervals

Salt in the human diet is a major risk factor for hypertension and many countries have set targets to reduce salt consumption. Technological solutions are being sought to lower the salt content of processed foods without altering their taste. In this study, the approach was to deliver salt solutions in pulses of different concentrations to determine whether a pulsed delivery profile affected sensory perception of salt. Nine different salt profiles were delivered by a Dynataste device and a trained panel assessed their saltiness using time–intensity and single-score sensory techniques. The profile duration (15 s) was designed to match eating conditions and the effects of intensity and duration of the pulses on sensory perception were investigated. Sensory results from the profiles delivered in either water or in a bouillon base were not statistically different. Maximum perceived salt intensities and the area under the time– intensity curves correlated well with the overall perceived saltiness intensity despite the stimulus being delivered as several pulses. The overall saltiness scores for profiles delivering the same overall amount of sodium were statistically not different from one another suggesting that, in this system, pulsed delivery did not enhance salt perception but the overall amount of salt delivered in each profile did affect sensory perception

Of gastro and the gold standard: evaluation and policy implications of norovirus test performance for outbreak detection

<p>Abstract</p> <p>Background</p> <p>The norovirus group (NVG) of caliciviruses are the etiological agents of most institutional outbreaks of gastroenteritis in North America and Europe. Identification of NVG is complicated by the non-culturable nature of this virus, and the absence of a diagnostic gold standard makes traditional evaluation of test characteristics problematic.</p> <p>Methods</p> <p>We evaluated 189 specimens derived from 440 acute gastroenteritis outbreaks investigated in Ontario in 2006–07. Parallel testing for NVG was performed with real-time reverse-transcriptase polymerase chain reaction (RT²-PCR), enzyme immunoassay (EIA) and electron microscopy (EM). Test characteristics (sensitivity and specificity) were estimated using latent class models and composite reference standard methods. The practical implications of test characteristics were evaluated using binomial probability models.</p> <p>Results</p> <p>Latent class modelling estimated sensitivities of RT²-PCR, EIA, and EM as 100%, 86%, and 17% respectively; specificities were 84%, 92%, and 100%; estimates obtained using a composite reference standard were similar. If all specimens contained norovirus, RT²-PCR or EIA would be associated with > 99.9% likelihood of at least one test being positive after three specimens tested. Testing of more than 5 true negative specimens with RT²-PCR would be associated with a greater than 50% likelihood of a false positive test.</p> <p>Conclusion</p> <p>Our findings support the characterization of EM as lacking sensitivity for NVG outbreaks. The high sensitivity of RT²-PCR and EIA permit identification of NVG outbreaks with testing of limited numbers of clinical specimens. Given risks of false positive test results, it is reasonable to limit the number of specimens tested when RT²-PCR or EIA are available.</p

Detection of Norovirus genogroup I and II by multiplex real-time RT- PCR using a 3'-minor groove binder-DNA probe

BACKGROUND: Due to an increasing number of norovirus infections in the last years rapid, specific, and sensitive diagnostic tools are needed. Reverse transcriptase-polymerase chain reactions (RT-PCR) have become the methods of choice. To minimize the working time and the risk of carryover contamination during the multi-step procedure of PCR the multiplex real-time RT-PCR for the simultaneous detection of genogroup I (GI) and II (GII) offers advantages for the handling of large amounts of clinical specimens. METHODS: We have developed and evaluated a multiplex one-tube RT-PCR using a combination of optimized GI and GII specific primers located in the junction between ORF1 and ORF2 of the norovirus genome. For the detection of GI samples, a 3'- minor groove binder-DNA probe (GI-MGB-probe) were designed and used for the multiplex real-time PCR. RESULTS: Comparable results to those of our in-house nested PCR and monoplex real-time-PCR were only obtained using the GI specific MGB-probe. The MGB-probe forms extremely stable duplexes with single-stranded DNA targets, which enabled us to design a shorter probe (length 15 nucleotides) hybridizing to a more conserved part of the GI sequences. 97 % of 100 previously norovirus positive specimens (tested by nested PCR and/or monoplex real-time PCR) were detected by the multiplex real-time PCR. A broad dynamic range from 2 × 10^1 to 2 × 10^7 genomic equivalents per assay using plasmid DNA standards for GI and GII were obtained and viral loads between 2.5 × 10^2 and 2 × 10^12 copies per ml stool suspension were detected. CONCLUSION: The one-tube multiplex RT real-time PCR using a minor groove binder -DNA probe for GI is a fast, specific, sensitive and cost-effective tool for the detection of norovirus infections in both mass outbreaks and sporadic cases and may have also applications in food and environmental testing

Replication of Norovirus in Cell Culture Reveals a Tropism for Dendritic Cells and Macrophages

Noroviruses are understudied because these important enteric pathogens have not been cultured to date. We found that the norovirus murine norovirus 1 (MNV-1) infects macrophage-like cells in vivo and replicates in cultured primary dendritic cells and macrophages. MNV-1 growth was inhibited by the interferon-αβ receptor and STAT-1, and was associated with extensive rearrangements of intracellular membranes. An amino acid substitution in the capsid protein of serially passaged MNV-1 was associated with virulence attenuation in vivo. This is the first report of replication of a norovirus in cell culture. The capacity of MNV-1 to replicate in a STAT-1-regulated fashion and the unexpected tropism of a norovirus for cells of the hematopoietic lineage provide important insights into norovirus biology

Clostridium difficile is not associated with outbreaks of viral gastroenteritis in the elderly in the Netherlands

The coincidental increase in norovirus outbreaks and Clostridium difficile infection (CDI) raised the question of whether these events could be related, e.g. by enhancing spread by diarrhoeal disease outbreaks. Therefore, we studied the prevalence of C. difficile in outbreaks of viral gastroenteritis in nursing homes for the elderly and characterised enzyme immunoassay (EIA)-positive stool samples. Stool samples from nursing home residents (n = 752) in 137 outbreaks of viral aetiology were investigated by EIA for the presence of C. difficile toxins. Positive samples were further tested by a cell neutralisation cytotoxicity test, a second EIA and culture. Cultured isolates were tested for the presence of toxin genes, the production of toxins and characterised by 16S rRNA polymerase chain reaction (PCR) and sequencing. Twenty-four samples (3.2%) tested positive in the EIA. Of these 24 positive samples, only two were positive by cytotoxicity and three by a second EIA. Bacterial culture of 21 available stool samples yielded a toxinogenic C. difficile PCR ribotype 001 in one patient sample only. In conclusion, we found no evidence in this retrospective study for an association between viral gastroenteritis outbreaks and C. difficile. The high rate of false-positive EIA samples emphasises the need for second confirmation tests to diagnose CDI

Effect of Food Residues on Norovirus Survival on Stainless Steel Surfaces

Background: In households and food processing plants, minute food residues left behind from improper cleaning may influence the survivability of human norovirus on surfaces. In this study, the survivability of norovirus on desiccated food residue-attached stainless steel coupons was investigated. Methodology/Principal Findings: Using murine norovirus-1 (MNV-1) as a surrogate of human norovirus, the survivability of norovirus was investigated on lettuce, cabbage, or ground pork-attached stainless steel coupons. A 6.2 log MPN/ml of MNV-1 infectivity was completely lost at day 30 in residue-free coupons, whereas only a 1.4 log MPN/ml reduction was observed in coupons with residues. Moreover, the disinfective effect of sodium hypochlorite was reduced when residues were present on the coupons. Conclusions/Significance: This study revealed that the food residues increased the survivability and the resistance to chemicals of norovirus, indicating the need of thorough cleaning in food processing plants and household settings