Rare toxin A-negative and toxin B-positive strain of Clostridioides difficile from Japan lacking a complete tcdA gene.

INTRODUCTION: Clostridioides difficile (C. difficile) produces three kinds of toxins: toxin A (enterotoxin), toxin B (cytotoxin), and C. difficile transferase (CDT), a binary toxin. Some strains show positivity only for toxin B. These strains reportedly possess a gene for toxin A, tcdA. However, toxin A production is inhibited due to a mutated stop codon and/or deletion within the tcdA gene. Here for the first case in Japan, we describe toxin genomes and proteins of a strain possessing only toxin B and lacking a complete tcdA gene, along with clinical manifestations. METHODS: C. difficile was isolated from the bloody stool of a 60-year-old female patient treated with meropenem. Although a rapid detection kit of toxins (C. DIFF QUIK CHEK COMPLETE®, TechLab, Blacksburg, VA, USA) showed positivity, Western blotting detected no toxins. Therefore, we explored the strain's toxin genes and their sequences to determine whether the strain possessed a toxin. RESULTS: Polymerase chain reaction did not identify toxin genes. Whole-genome sequencing analysis showed that a gene for toxin A, tcdA, was completely deleted in the strain. Moreover, 701 mutations and some deletions/insertions were identified on the tcdB gene. CONCLUSIONS: We isolated a rare strain of C. difficile producing only toxin B and lacking a complete tcdA gene herein Japan. The possibility of a false negative needs to be considered with a genetic method for a diagnose of C. difficile infection.

Purification of human primary neuroblastomas by magnetic beads and their in vitro culture.

In the present study we have successfully isolated neuroblastoma cells from primary human neuroblastoma tissues by using a magnetic bead-mediated purification system. Since primary neuroblastoma tissues contained CD3- and CD19-positive lymphocytes, total cell suspensions were prepared and incubated with magnetic beads coated with anti-CD3 or with anti-CD19 antibody. After magnetic separation, unbound materials were recovered and analyzed by immunohistochemical staining for NB84, one of the neuroblastoma markers. Immunohistochemical and FACS analyses demonstrated that NB84-positive cells were enriched in the unbound fraction. Subsequently, unbound materials were seeded on cell culture plates and maintained at 37 degrees C overnight. After incubation, non-adherent cells were collected and stained with anti-NB84 antibody. Under our experimental conditions, a significant increase in the number of NB84-positive cells was observed. Furthermore, our purified NB84-positive cells responded to all-trans retinoic acid and nerve growth factor better than the initial primary cells. Collectively, our present results suggest that magnetic bead-mediated purification enriches neuroblastoma cells which retain their biological properties.

Analysis of mucin composition in gastric juices of chronic rheumatic patients with upper gastrointestinal damage.

Assessment of the mucin subclasses in the gastric juices of severe chronic rheumatoid arthritis (RA) patients was compared with non-RA cases which received the eradication treatment of Helicobacter pylori (H. pylori). Gastric juice samples were obtained from 8 RA patients (5 for H. pylori-negative and 3 for H. pylori-positive) and 5 control subjects in which we confirmed the successful eradication of H. pylori. The gastric luminal mucins were extracted and isolated by the ethanol precipitation method. These mucin solutions were digested with chymotrypsin, dialyzed, lyophilized, and redissolved. The obtained specimen was applied to an ion exchange column containing DEAE-Sepharose CL-6B and eluted with a discontinuous salt gradient in three salt steps. The gastric luminal mucins were divided into three fractions based on the distinctive sialic acid content. The proportion of acidic mucin rich in sialic acid from the gastric juice of RA patients without the H. pylori infection was significantly lower than those RA patients with H. pylori or the control subjects. A decrease in the acidic mucin content after eradication of H. pylori was commonly observed in all the control subjects. Our investigation raises the possibility that the gastric mucosae of RA patients have resistance against H. pylori infection. And the analysis of the composition in the gastric luminal mucin may be a very useful tool for the evaluation of gastric homeostasis in RA patients.