Molecular alterations induced by Yersinia pestis, dengue virus and Staphylococcal enterotoxin B under severe stress.

BACKGROUND: Severe stress can have drastic and systemic effects with dire implications on the health and wellbeing of exposed individuals. Particularly, the effect of stress on the immune response to infection is of interest to public health because of its implications for vaccine efficacy and treatment strategies during stressful scenarios. Severe stress has previously been shown to cause an anergic state in the immune system that persists following exposure to a potent mitogen. METHODS: Transcriptome and microRNA changes were characterized using blood samples collected from U.S. Army Ranger candidates immediately before and after training, followed by exposure to representative pathogenic agents: Yersinia pestis, dengue virus 2, and Staphylococcal enterotoxin B (SEB). We employed experimental and computational approaches to characterize altered gene expression, processes, pathways, and regulatory networks mediating the host's response towards severe stress; to assess the protective immunity status of the stressed host towards infection; and to identify pathogen-induced biomarkers under severe stress conditions. RESULTS: We observed predicted inhibition of pathways significantly associated with lymphopoiesis, wound healing, inflammatory response, lymphocyte activation, apoptosis, and predicted activation of oxidative stress. Using weighted correlation network analyses, we demonstrated preservation of these pathways across infection and stress combinations. Regulatory networks comprising a common set of upstream regulators: transcription factors, microRNAs and post-translational regulators (kinases and phosphatases) may be drivers of molecular alterations leading to compromised protective immunity. Other sets of transcripts were persistently altered in both the pre- and post-stress conditions due to the host's response to each pathogenic agent, forming specific molecular signatures with the potential to distinguish infection from that of severe stress. CONCLUSIONS: Our results suggest that severe stress alters molecules implicated in the development of leukopoietic stem cells, thereby leading to depletion of cellular and molecular repertoires of protective immunity. Suppressed molecules mediating membrane trafficking of recycling endosomes, membrane translocation and localization of the antigen processing mechanisms and cell adhesions indicate suboptimal antigen presentation, impaired formation of productive immunological synapses, and inhibited T-cell activations. These factors may collectively be responsible for compromised protective immunity (infection susceptibility, delayed wound healing, and poor vaccine response) observed in people under severe stress.

Early indicators of exposure to biological threat agents using host gene profiles in peripheral blood mononuclear cells.

BACKGROUND: Effective prophylaxis and treatment for infections caused by biological threat agents (BTA) rely upon early diagnosis and rapid initiation of therapy. Most methods for identifying pathogens in body fluids and tissues require that the pathogen proliferate to detectable and dangerous levels, thereby delaying diagnosis and treatment, especially during the prelatent stages when symptoms for most BTA are indistinguishable flu-like signs. METHODS: To detect exposures to the various pathogens more rapidly, especially during these early stages, we evaluated a suite of host responses to biological threat agents using global gene expression profiling on complementary DNA arrays. RESULTS: We found that certain gene expression patterns were unique to each pathogen and that other gene changes occurred in response to multiple agents, perhaps relating to the eventual course of illness. Nonhuman primates were exposed to some pathogens and the in vitro and in vivo findings were compared. We found major gene expression changes at the earliest times tested post exposure to aerosolized B. anthracis spores and 30 min post exposure to a bacterial toxin. CONCLUSION: Host gene expression patterns have the potential to serve as diagnostic markers or predict the course of impending illness and may lead to new stage-appropriate therapeutic strategies to ameliorate the devastating effects of exposure to biothreat agents.

A study of the enterotoxigenicity of coagulase-negative and coagulase-positive staphylococcal isolates from food poisoning outbreaks in Minas Gerais, Brazil.

OBJECTIVES: The purpose of this study was to identify enterotoxin genes from isolates of coagulase-negative staphylococci and coagulase-positive staphylococci obtained from dairy products, responsible for 16 outbreaks of food poisoning. METHODS: From the pool of 152 staphylococcal isolates, 15 coagulase-negative and 15 coagulase-positive representatives were selected for this study. The 15 coagulase-negative isolates were tested for the presence of coa and femA genes, which are known to be characteristic of Staphylococcus aureus. After testing for enterotoxin genes by polymerase chain reaction (PCR), the 30 selected isolates were tested for the presence of toxin by immunoassay. RESULTS: Seven of the coagulase-negative isolates amplified the coa gene and were subsequently reclassified as coagulase-positive. Twenty-one of 30 selected isolates had staphylococcal enterotoxin genes and most of these produced toxin as well. The most frequently encountered enterotoxin genes were sea and seb. Among eight coagulase-negative isolates, five had enterotoxin genes, all of which were found to have detectable toxin by immunoassay. CONCLUSIONS: The results from this study demonstrate that coagulase-negative as well as coagulase-positive staphylococci isolated from dairy products are capable of genotypic and phenotypic enterotoxigenicity. Furthermore, these data demonstrate that PCR is a sensitive and specific method for screening outbreak isolates regardless of coagulase expression.

A case study of a massive staphylococcal food poisoning incident.

In the summer of 1998, approximately 8000 individuals gathered to celebrate a Catholic priest's ordination in Minas Gerais, Brazil. Within hours of food consumption, 4000 patients experienced acute gastroenteritis, and approximately 2000 (50%) overwhelmed Emergency Departments of 26 local hospitals. Of the triaged patients, 396 ( approximately 20%) required subsequent admission, and of these patients, 81 ( approximately 20%) were admitted to intensive care units. A total of 16 ( approximately 20% of those admitted to the ICU) patients progressed on to develop irreversible multi-system shock and expired while hospitalized. The trace-back investigation implicated food preparers who were culture positive for enterotoxigenic Staphylococcus aureus as the source of contamination. This study provides information on the magnitude and severity of oral exposure to Staphylococcal enterotoxin.