High-throughput analysis of T cell-monocyte interaction in human tuberculosis.

The lack of efficient tools for identifying immunological correlates of tuberculosis (TB) protection or risk of disease progression impedes the development of improved control strategies. To more clearly understand the host response in TB, we recently established an imaging flow cytometer-based in-vitro assay, which assesses multiple aspects of T cell-monocyte interaction. Here, we extended our previous work and characterized communication between T cells and monocytes using clinical samples from individuals with different TB infection status and healthy controls from a TB endemic setting. To identify T cell-monocyte conjugates, peripheral blood mononuclear cells (PBMC) were stimulated with ds-Red-expressing Mycobacterium bovis bacille Calmette-Guérin or 6-kDa early secreted antigenic target (ESAT 6) peptides for 6 h, and analyzed by imaging flow cytometer (IFC). We then enumerated T cell-monocyte conjugates using polarization of T cell receptor (TCR) and F-actin as markers for synapse formation, and nuclear factor kappa B (NF-κB) nuclear translocation in the T cells. We observed a reduced frequency of T cell-monocyte conjugates in cells from patients with active pulmonary tuberculosis (pTB) compared to latent TB-infected (LTBI) and healthy controls. When we monitored NF-κB nuclear translocation in T cells interacting with monocytes, the proportion of responding cells was significantly higher in active pTB compared with LTBI and controls. Overall, these data underscore the need to consider multiple immunological parameters against TB, where IFC could be a valuable tool.

Serum antibodies in mares and foals to Actinobacillus equuli whole cells, outer membrane proteins, and Aqx toxin.

Actinobacillus equuli is carried in the alimentary tract of mares and can cause severe septicemia of neonatal foals. A hemolytic subspecies, A. equuli subsp. haemolyticus, and a non-hemolytic subspecies, A. equuli subsp. equuli, have been identified. Hemolytic strains produce the RTX toxin Aqx. The purpose of this study was to demonstrate sequentially in two sets of mare-foal pairs antibodies to A. equuli whole bacterial cells, outer membrane proteins, and recombinant Aqx and to compare the transfer of antibodies to these antigens between mares and their foals. Two mare/foal sets of sera were evaluated. Cohort A consisted of 18 mare-foal pairs obtained in the spring of 2005. Cohort B consisted of 10 mare-foal pairs obtained in the spring of 2006. For both sets, mare and foal sera were obtained immediately after foaling and prior to nursing (time 0) as well as at 12 and 24h and daily thereafter for 7 days. For Cohort B, sera were also obtained 30 days after birth. At parturition all mares had detectable antibodies to A. equuli whole cells and outer membranes; however, of those mares, two in Cohort A had undetectable antibodies to Aqx and their foals likewise had undetectable anti-Aqx antibodies. Antibodies against whole cells, outer membrane proteins, and Aqx were readily transferred from mares to foals. In most cases, there were significant correlations (p<0.05) between antibodies against whole cells, outer membrane proteins, and Aqx in mares' sera at the time of parturition and foal sera 24 after birth. Antibodies against the three antigen preparations had declined insignificantly (p>0.05) by day 30.

Time budget analysis as a tool for PHC planning (with examples from Ethiopia).

Few health or development programs take into account the way in which real life communities structure and value their own time. Many programs are 'time stealing', and when communities find time inputs are too expensive, many adverse effects on community health and development appear. Even the spare time produced by leisure and seasonality may be mitigated by time costs related to sickness, and taking long journeys needed to reach areas of services like clinics, markets, churches, weddings.... One effective way of introducing time, in health and social development, is to prepare a community time budget or more precisely a balance sheet of community activities, where alternative uses and effective allocations of time become a primary concern of community planning. This paper, by applying a time budget analysis with examples from Ethiopia, aims to demonstrate what the problem is and how it might be solved. One of the major bases of the social goal of 'health for all by the year 2000' is community enthusiasm and participation in Primary Health Programs. This paper aims to show that the way to achieve self-reliant development, appropriate to local conditions and aspirations, is by employing time budget analysis for activity planning in rural areas.

Response of Pasteurella haemolytica to erythromycin and dexamethasone in calves with established infection.

A subcutaneous soft tissue infection model in calves was used to study the in vivo response of Pasteurella haemolytica to erythromycin and dexamethasone. Two tissue chambers were implanted SC in each of 12 calves. At 45 days after implantation, all tissue chambers were inoculated with an erythromycin-sensitive strain of P haemolytica. Starting 24 hours after inoculation, calves were allotted to 4 groups of equal size and a 2 x 2-factorial arrangement of treatments was applied: 3 calves were given erythromycin (30 mg/kg of body weight, IM, for 5 days), 3 calves were given dexamethasone (0.05 mg/kg, IM, for 2 days), 3 calves were given erythromycin and dexamethasone, and the remaining calves served as nontreated controls. Chamber fluids were tested daily, and the response to treatment was measured. Neither erythromycin nor dexamethasone affected viability or growth of bacteria within tissue chambers. Dexamethasone had no effect on the influx of neutrophils into infected chambers. Despite repeated administration of a high dose of erythromycin and attainment of adequate concentration in serum, erythromycin concentration in chamber fluids did not exceed the minimal inhibitory concentration established in vitro. These results indicate that the clinical efficacy of erythromycin against P haemolytica sequestered in consolidated pneumonic lesions may not be well correlated with predictions based on serum pharmacokinetic and in vitro susceptibility data.

Assessment of rational drug use and prescribing in primary health care facilities in north west Ethiopia.

A study on rational drug use was undertaken in nine health centres (HCs) and nine health stations (HSs) in Ethiopia. Prescribing, patient care and facility specific factors were measured using drug use indicators. Prescribing patterns of drugs were also assessed. With only few exceptions, the drug use indicators in HCs and HSs and between retrospective and prospective studies were similar despite differences in manpower and facilities. The average consultation time (in minutes) in HSs and HCs was 5.1 +/- 0.8 and 5.8 +/- 1.06, respectively. The dispensing time (in minutes) was 1.5 +/- 0.7 in HSs and 1.9 +/- 0.6 in HCs. Both patient care indicators seem to be adequate to influence patient satisfaction to the overall health service and patient knowledge of important dosage instructions. Most drugs (more than 89% in HCs and 71% in HSs) were actually dispensed from the health facilities and labelling was satisfactory. Prescribing by generic names (average: 75% in HCs and 83% in HSs) was encouraging. While the availability of key drugs was ensured, essential documents were missing in most facilities or they were unpopular for use, and those available required revision and updating. Polypharmacy in which the number of drugs/encounter was < 2.5 was minimal, but that a large proportion of the prescriptions contained two or more drugs could result in adverse drug-drug interactions. The most frequently prescribed drugs were anti-infectives and analgesics accounting for over 76% in HCs and 82% in HSs and in most cases they are probably prescribed with little justification. The exposure of patients to antibiotics (average: 60% in HCs and 65% in HSs) was unacceptably high to justify epidemiological trends. The high exposure of patients to injections, especially in the HSs (over 37%), should be seen from the health and economic points of view. The results revealed priority areas for intervention. They also provide standard references to compare drug use situations and their change over time in different settings, area and time in Ethiopia.

PIP: In a study on rational drug use in 9 health centers (HC) and 9 health stations (HS) in Ethiopia, prescribing, patient care, and facility-specific factors were observed and measured through drug use indicators during February-June 1995. With only few exceptions, the drug use indicators in HCs and HSs were similar despite differences in manpower and facilities. The average consultation times in minutes in HSs and HCs were 5.1 and 5.8, respectively, while the dispensing times were 1.5 and 1.9 minutes, respectively. More than 89% of drugs in HCs and 71% in HSs were dispensed from the health facilities, and labeling was satisfactory. On average, generic brands were prescribed 75% of the time in HCs and 83% of the time in HSs. Key drugs were available, but important documents were missing in most facilities or were unpopular for use. When documents were available, they needed to be revised and updated. The level of polypharmacy was low. The most often prescribed drugs were anti-infectives and analgesics, accounting for more than 76% in HCs and 82% in HSs, and probably often prescribed with little justification. 60% of patients in HCs and 65% in HSs were exposed to antibiotics, levels too high for the prevailing disease conditions. More than 37% of HS patients received injections.

Intranasal vaccination of calves with Mannheimia haemolytica chimeric protein containing the major surface epitope of outer membrane lipoprotein PlpE, the neutralizing epitope of leukotoxin, and cholera toxin subunit B.

This study was done to determine if intranasal vaccination of weaned beef calves with a chimeric protein containing the immunodominant surface epitope of Mannheimia haemolytica PlpE (R2) and the neutralizing epitope of leukotoxin (NLKT) covalently linked to truncated cholera toxin (CT) subunit B (CTB) could stimulate secretory and systemic antibodies against M. haemolytica while enhancing resistance of cattle against M. haemolytica intrabronchial challenge. Sixteen weaned beef calves were intranasally vaccinated with CTB-R2-NLKT chimeric (SAC102) or with R2-NLKT-R2-NLKT chimeric (SAC89) protein with or without native CT on days 0 and 14 and were challenged intrabronchially on day 28. In vitro, SAC102 bound the CT receptor molecule, GM(1)-ganglioside. Mean IgA antibodies to M. haemolytica whole cells (WC) and to LKT were high on day 0. A small, yet significant increase (p<0.05) was found in mean nasal antibodies to M. haemolytica WC for the SAC89+CT and SAC102 vaccinates after the second vaccination. SAC102 stimulated significant (p<0.05) mean serum antibody responses to all three antigens by day 28. Following challenge, mean antibodies to WC and LKT significantly increased (p<0.05) for the SAC102, SAC89 and SAC89+CT groups with the mean antibody responses to rPlpE stimulated by SAC102 vaccination being significantly higher (p<0.05) than for the other vaccinated and control groups. On day 1 after challenge, mean clinical score for the control group was significantly higher (p<0.05) than for the SAC102 and SAC89+CT vaccinates, and by day 2 after challenge, clinical score for the control group was significantly higher (p<0.05) than for all three chimeric vaccinated groups. Therefore, intranasal vaccination with CTB-R2-NLKT (SAC102) and R2-NLKT-R2-NLKT (SAC89) chimeric proteins enhanced resistance against intrabronchial challenge with the bacterium as well as stimulating antibody responses to M. haemolytica antigens.

Immunity of cattle following vaccination with a Mannheimia haemolytica chimeric PlpE-LKT (SAC89) protein.

UNLABELLED: We developed several chimeric PlpE-leukotoxin (LKT) constructs containing the major epitope of Mannheimia haemolytica outer membrane lipoprotein PlpE (epitope R2) and the neutralizing epitope of M. haemolytica LKT (NLKT) [Ayalew et al. Mannheimia haemolytica chimeric protein vaccine composed of the major surface-exposed epitope of outer membrane lipoprotein PlpE and the neutralizing epitope of leukotoxin. Vaccine 2008;26(38):4955-61]. Vaccination of mice with these PlpE-LKT chimeric proteins stimulated anti-PlpE antibodies that caused complement-mediated bacteriolysis of M. haemolytica as well as neutralizing anti-LKT antibodies. Chimeric protein SAC89, which contains two copies of R2 and two copies of NLKT, generally stimulated the best overall responses in mice. The objectives of the current study were: (1) to determine through a dose titration study if vaccination of cattle with SAC89 stimulated antibodies to both PlpE and LKT and (2) evaluate SAC89-induced immunity against experimental M. haemolytica challenge of cattle. In the dose titration study, vaccine doses ranged from 100 to 400 microg. SAC89 significant anti-M. haemolytica surface and LKT antibodies were detected following vaccination with each dose. The vaccination/challenge study was conducted with 30 weaned beef cattle distributed among four groups: Control (no vaccine), 100 microg SAC89, M. haemolytica Bacterin, and SAC89+M. haemolytica bacterin. On day 42 after two vaccinations, cattle were challenged transthoracically with M. haemolytica. There was significant reduction (p<0.05) in lesion scores for the SAC89+bacterin-vaccinated group (74.6% reduction compared to control lesion scores) when compared to the other groups (34.7% and 35.6% reduction compared to control lesion scores). Evaluation of antibody responses demonstrated that the control group failed to develop antibody responses to M. haemolytica surface antigens or to LKT. Bacterin-vaccinated cattle developed anti-M. haemolytica antibodies after the second vaccination. SAC89- and SAC89+bacterin-vaccinated groups developed significant antibody responses 14 days after the first vaccination and further significant increases in antibodies after the second vaccination. CONCLUSIONS: Vaccination with the chimeric protein SAC89 in conjunction with a M. haemolytica bacterin stimulated significant protection against a severe transthoracic challenge with the bacterium.

Nucleotide sequence analysis of the termini and chromosomal locus involved in site-specific integration of the streptococcal conjugative transposon Tn5252.

The 47-kb, broad-host-range, streptococcal conjugative transposon Tn5252 is capable of site-specific integration into the pneumococcal chromosome. We present the nucleotide sequence of the terminal regions of the transposon and its target site in the pneumococcal genome. No inverted repeats were found at the termini of the transposon. A 72-bp region of the target was present on either side following the insertion of Tn5252 and appeared to serve as a signal for its integration and excision. The data suggest that the left copy of the 72-bp segment was a part of the conjugative element, the crossover point of integration was nonrandom within this region, and the mechanism of insertion could resemble that of the site-specific temperate phages.

The rnhB gene encoding RNase HII of Streptococcus pneumoniae and evidence of conserved motifs in eucaryotic genes.

A single RNase H enzyme was detected in extracts of Streptococcus pneumoniae. The gene encoding this enzyme was cloned and expressed in Escherichia coli, as demonstrated by its ability to complement a double-mutant rnhA recC strain. Sequence analysis of the cloned DNA revealed an open reading frame of 290 codons that encodes a polypeptide of 31.9 kDa. The predicted protein exhibits a low level of homology (19% identity of amino acid residues) to RNase HII encoded by rnhB of E. coli. Identification of the S. pneumoniae RNase HII translation start site by amino-terminal sequencing of the protein and of mRNA start sites by primer extension with reverse transcriptase showed that the major transcript encoding rnhB begins at the protein start site. Comparison of the S. pneumoniae and E. coli RNase HII sequences and sequences of other, putative bacterial rnhB gene products surmised from sequencing data revealed three conserved motifs. Use of these motifs to search for homologous genes in eucaryotes demonstrated the presence of rnhB genes in a yeast and a roundworm. Partial rnhB gene sequences were detected among expressed sequences of mouse and human cells. From these data, it appears that RNase HII is universally present in living cells.

A bactericidal monoclonal antibody elicits a change in its antigen, OspB of Borrelia burgdorferi, that can be detected by limited proteolysis.

mAb CB2, directed against outer surface protein B (OspB), causes bacteriolysis of Borrelia burgdorferi in the absence of complement. How this happens is unknown. We examined the effect of mAb binding on OspB tertiary structure by using limited proteolysis to probe changes in protein conformation. Truncated OspB (tOspB) that lacked N-terminal lipid was cleaved by four enzymes: trypsin, endoproteinase Arg-C, endoproteinase Asp-N, and endoproteinase Glu-C. CB2 affected the cleavage by trypsin and Arg-C, but not by AspN or Glu-C. None of the enzymes cleaved CB2 under these conditions. Both trypsin and Arg-C cleaved tOspB near the N-terminus; CB2 slowed the rate of cleavage, but did not affect the identity of the sites cleaved. Irrelevant mAb had no effect, indicating that the effect was specific. CB2 was active against tOspB of strain B31, but not against tOspB of strain BEP4, to which it does not bind, suggesting that binding was required to elicit the effect on cleavage. With trypsin, CB2 showed a maximal effect at 8 mol of tOspB to 1 mol of mAb. At this ratio, not enough CB2 was present to bind all the tOspB; therefore, either CB2 shows turnover or CB2 acts by binding tOspB and effecting a change in this tOspB such that it, in turn, propagates the effect in other molecules of tOspB. Regardless of the mechanism, these data show that CB2 elicits a change in tOspB that can be measured by its reduced susceptibility to protease cleavage.

Regulation of competence for genetic transformation in Streptococcus pneumoniae: expression of dpnA, a late competence gene encoding a DNA methyltransferase of the DpnII restriction system.

The chromosomal DpnII gene cassette of Streptococcus pneumoniae encodes two methyltransferases and an endonuclease. One methyltransferase acts on double-stranded and the other on single-stranded DNA. Two mRNAs are transcribed from the cassette. One, a SigA promoter transcript, includes all three genes; the other includes a truncated form of the second methyltransferase gene (dpnA) and the endonuclease gene. The truncated dpnA, which is translated from the second start codon in the full gene, was shown to produce active enzyme. A promoter reporter plasmid for S. pneumoniae was devised to characterize the promoter for the second mRNA. This transcript was found to depend on a promoter that responded to the induction of competence for genetic transformation. The promoter contains the combox sequence recognized by a SigH-containing RNA polymerase. As part of the competence regulon, the dpnA gene makes a product able to methylate incoming plasmid strands to protect them from the endonuclease and allow plasmid establishment. Its function differs from most genes in the regulon, which are involved in DNA uptake. Comparison of R6 and Rx strains of S. pneumoniae showed the temperature dependence of transformation in R6 to result from temperature sensitivity of the uptake apparatus and not the development of competence.