Effects of calcium and bile acid feeding on colon tumors in the rat.

The hypothesis that dietary calcium alters the incidence of colorectal neoplasms was examined in an established model of carcinogenesis. Male Fischer 344 rats (28 days old) were quarantined for 2 weeks. All animals were fed the basal diet (AIN-76) supplemented with cholic acid (0.2%) and/or calcium (1.6%, corresponding to a 3-fold increase above that of the basal diet). N-Methyl-N-nitrosourea (MNU) (2 mg/dose) or saline (control) was given intrarectally to all animals on days 1 and 4 of the experiment. Groups 1-8 were fed the experimental diets concurrently with the first dose of MNU, while groups 9 and 10 were fed the diets 2 weeks prior to MNU (or saline). All animals were sacrificed after 28 weeks. No tumors were observed in the groups given saline (groups 1, 3, 5, 7, and 9). In groups receiving MNU, the addition of cholic acid to the diet (group 4) caused a significant increase in tumors (80% versus 55%), tumors/animal ratio (2.24 versus 0.75), and tumors/tumor-bearing animal ratio (2.80 versus 1.36), group 4 versus group 2, respectively. Increased dietary calcium did not inhibit tumor formation; 68% of animals in groups 6 and 10 had tumors. The combination of dietary cholic acid and calcium (group 8) gave a tumor incidence similar to cholic acid (group 4) alone (72% versus 80%, 2.00 versus 2.24 tumors/animal; 2.77 versus 2.80 tumors/tumor-bearing animal). Most tumors were adenomatous polyps but carcinomas in situ and invasive carcinomas were also present; dietary calcium reduced the number of invasive carcinomas (group 6 versus group 2, P less than 0.04).

Side-chain cleavage of cortisol by fecal flora.

The side chain of certain C-21 steroids may be removed by an enzyme, desmolase, synthesized by intestinal bacteria. With a view to isolate these organisms we examined the conditions required for their multiplication and function. The model substrate, cortisol (11 beta, 17 alpha, 21-trihydroxy-4-pregnene-3,20-dione), was metabolized by mixed fecal flora of humans and rats to a number of C-21 and C-19 compounds. The major C-21 metabolites were 21-deoxycortisol, tetrahydro-21-deoxycortisol, and tetrahydrocortisol. The C-19 metabolites obtained were identified as 5 beta-androstane-3 alpha, 11 beta-triol and 5 xi-androstane-3 alpha, 11 beta-diol-17-one. The prevalence of converting microorganisms was approximately 10(6)/g feces in both humans and rats. Conversion required an Eh below -130 mV, and an initial pH of 7.0. Optimal yield of C-19 products occurred with a fecal dilution of 10(5), though C-19 metabolites were evident from 10(1) through 10(8) fecal dilutions. Preliminary investigation indicates that the ability of converting organisms to form colonies varied with the composition of the media and the gaseous environment.

Characterization of a C21 neutral steroid hormone transforming enzyme, 21-dehydroxylase, in crude cell extracts of Eubacterium lentum.

A strain of the obligate anaerobe, Eubacterium lentum, isolated from human feces, catalyzes the 21-dehydroxylation of 11-deoxycorticosterone to progesterone. A quantitative radiochromatographic assay was developed to measure 21-dehydroxylase activity in cell extracts. Maximum enzyme activity in cell extracts required both a reduced pyridine nucleotide and an oxidized flavin coenzyme. However, photochemically reduced flavin (FMNH2) could replace the requirement for NAD(P)H plus oxidized flavin. NAD(P)H : flavin (either FMN or FAD) oxidoreductase activity was detected spectrophotometrically in cell extracts assayed under anaerobic conditions. 21-Dehydroxylase was active from pH 5.4 to 8.5 with an apparent optimum between 6.4 and 6.8 using mixtures of NADH plus FMN as coenzymes. The substrate concentration at half-maximal reaction velocity was 8.0 microM and a specific acitivity of 5.8 nmol [3H]progesterone formed . h-1 . mg-1 protein was determined using [3th]deoxycorticosterone as substrate. Atabrine, rotenone, acriflavin, and 2,4-dinitrophenol (all at 1 mM) inhibited 21-dehydroxylase activity in cell extracts by 25, 24, 35 and 84%, respectively. These results suggest that 21-dehydrogenase may be coupled to a NAD(P)H : flavin oxidoreductase system in E. lentum.

Reduction of 17-keto steroids by anaerobic microorganisms isolated from human fecal flora.

The 17-keto function of phenolic steroids is reduced by the following intestinal bacteria: Eubacterium lentum, Clostridium paraputrificum, Clostridium J-1 and Clostridium innocuum. The 17-keto group of androstenedione is reduced solely by Bacteroides fragilis.

21-Deoxyaldosterone excretion in patients with primary aldosteronism and 21-hydroxylase deficiency.

21-Deoxyaldosterone appears in urine in free and conjugated forms. Total excretion is best determined after acid hydrolysis (pH 1) of urine, followed by extraction, repeated chromatographic purification, and quantitation of the steroid by RIA. 21-Deoxyaldosterone excretion was normal in 70% of patients with essential hypertension (n = 18), while 30% (n = 8) had more or less elevated values. In patients with primary aldosteronism (n = 21) elevated as well as normal values of urinary 21-deoxyaldosterone were found, indicating that in some patients aldosterone may be formed not only from corticosterone but also from the 21-deoxy compound. In patients with 21-hydroxylase deficiency (n = 21) urinary 21-deoxyaldosterone was invariably elevated, whether the patients had the virilizing or salt-losing form of the disease. Although the clinical manifestations of the salt-losing form seem unrelated to the inability to convert 21-deoxyaldosterone to aldosterone, the determination of 21-deoxyaldosterone adds insight into the biosynthesis of aldosterone in primary aldosteronism and 21-hydroxylase deficiency.

Metabolism of biliary steroids by human fecal flora.

Biliary excreted steroid hormones are metabolized by the intestinal flora. The metabolic pathways of deoxycorticosterone and progesterone, including the bacterial species involved, have been established. The pathways for other biliary steroids are unknown. Information on the biological activities of the metabolites is lacking, but methods for their investigation are now available. Evidence suggests that the formation of the metabolites is influenced by dietary habits, and that, in some cases, it may be controlled by suppression of the responsible bacteria.

The 21-acetylation of corticosteroids by Clostridium sporogenes.

A strain of Clostridium sporogenes, an anaerobic bacterium, isolated from sewage in New York City synthesizes two constitutive enzymes with action on steroid molecules: (i) an enzyme capable of selectively acetylating the 21-hydroxyl function of certain steroids and (ii) the corresponding esterase. Under our experimental conditions the enzymes have a strict structural requirement for 3-keto-4-ene and C-20-keto or 20 alpha-hydroxyl group and convert their respective substrates to a mixture of free and acetylated products.

The friendly anaerobes.

Anaerobic bacteria include the most pathogenic of microorganisms. Their primary function, however, is hardly to cause illness. They rarely are involved in epidemics or in clinically significant infections. Some organisms, e.g. lactobacilli, control the normal vaginal ecosystem, and the intestinal anaerobes probably are instrumental in restraining the growth of Clostridium difficile in human carriers. The main role of anaerobes appears to be the provision of catabolic enzymes for organic compounds that cannot be digested by enzymes of eukaryotic origin. They are needed for the catabolism of cholesterol, bile acids, and steroid hormones; they hydrolyze a number of flavonoid glycosides to anticarcinogens; and they detoxify certain carcinogens. Anaerobic enzymes are used industrially in the production of cheese; the conversion of starch to sweeteners; and the transformation of sawdust, wood chips, and waste paper to fuel. Indeed, the anaerobes may well be the gene bank on which future generations of eukaryotic organisms will rely to adapt successfully to an ever-changing world.

Vibrio fetus infection in man: a serological test.

Antigen preparations derived from a typical human strain of Vibrio fetus were employed in four tests. Of these, the indirect bacterial hemagglutination test proved most sensitive. By this test, antibodies titering 320 to 3,200 were found in five of eight patients with confirmed infections. Two patients without antibodies were on antimetabolites. Antigenic relationship with other compounds, and in particular with Brucella organisms, was not observed. No sero-reactors were found among 184 apparently healthy young men; of 401 unselected hospital patients, four had low sero-titers.

Performance of the prompt system in identification and antimicrobial susceptibility testing of clinical isolates.

The rapid 3M Prompt inoculation system was compared with the traditional log-phase system for Autoscan identification and antibiotic susceptibility testing (MIC) of 188 recent clinical isolates. The two systems were equally effective for gram-negative rods; the Prompt system was slightly superior for the determination of MICs for gram-positive organisms.

Bacterial metabolism of natural and synthetic sex hormones undergoing enterohepatic circulation.

Steroids undergoing enterohepatic circulation are exposed to bacterial metabolism particularly by obligate anaerobes which account for 99.99% of the fecal flora. The most common transformation is hydrolysis of conjugated steroids. The glucuronidases are synthesized by Escherichia coli and Bacteroides species. The bacterial catabolism of unconjugated steroids may be considered under several headings: 1. Reduction of ring-A due to clostridia species synthesizing specific enzymes; C. paraputrificum, 3 alpha,5 beta-reductase; C. innocuum, 3 beta,5 beta-reductase; and a new species C.J-1, 3 beta,5 alpha-reductase. 2. Reduction of the delta 5 bond by human fecal flora. The specific strain(s) synthesizing the enzyme have not yet been identified. 3. Reduction of 17-keto estrogens by the above mentioned ring-A reducing clostridia and by Eubacterium lentum. 4. Reduction of 17-keto androstenes by Bacteroides fragilis. 5. Desmolase mediated side chain cleavage at C17-C20 position of 17 alpha-hydroxysteroids by two new species Clostridium scindens and Eubacterium desmolans isolated from human and cat fecal flora respectively and by Clostridium cadavaris isolated from New York City sewage. 6. And 16 alpha- and 21-dehydroxylase by E. lentum a normal inhabitant of the human gut; it is the only organism known to synthesize 16 alpha- or 21-dehydroxylases. Due to the high specificity of the enzymes and the simplicity of extracting the metabolites, biosynthesis of reference compounds and radioimmunoassay reagents is practical and inexpensive. The enzymes can also be used for titration of specific bacterial strains in fecal flora and as markers for bacterial identification in particular for the strains difficult to be defined by regular biochemical reactions.

Use of Directigen and acridine orange for rapid identification of human blood culture isolates.

Of 7,871 blood cultures from hospital patients, 22 yielded growth of Streptococcus pneumoniae or Haemophilus influenzae type b. The identities of 19 (86%) of these 22 strains could be verified after 18 to 24 h of incubation by application of the Directigen meningitis test kit to the unheated, uncentrifuged supernatant from the cultures; thus, the turnaround time for these cultures was halved. Growth in 16 (72%) of the Directigen-positive cultures was detected by visual inspection, and that in 3 (14%) of the cultures was detected by acridine orange staining. Growth in the three remaining bottles (14%) was detected by blind subculturing after 18 to 24 h or incubation and, therefore, was delayed by 24 h. The systematic application the acridine orange stain was helpful in 40 (44%) of 91 cases for which macroscopic inspection failed to reveal growth after 24 h of incubation.

Systematic investigation of enrichment media for wild-type Campylobacter jejuni strains.

Of the media examined, thioglycolate broth supplemented with 5% lysed sheep blood, Butzler antibiotic mixture, and 0.1% lauryl sulfate was the most sensitive enrichment medium for recovery of wild-type strains of Campylobacter jejuni from cecal contents of chickens and chicken livers. It allowed the retrieval of 1 CFU as did solid media but permitted the screening of 50-times larger volumes. Double-strength enrichment medium required 5 to 10 CFU for growth. Omission of lauryl sulfate reduced the sensitivity. Replacement of Butzler antibiotic mixture with Blaser antibiotic mixture increased overgrowth and, therefore, decreased retrieval of C. jejuni.

Primary isolation of Campylobacter fetus subspecies jejuni.

Primary isolation of Campylobacter fetus ss. jejuni following selective filtration can be achieved equally well on a Columbia agar supplemented with sheep blood (5%), horse blood (5-10%), or heat-treated horse blood (chocolate agar). Larger, but not more, colonies were formed at 42C. However, the higher temperature inhibits C. fetus ss. Intestinalis. Reduced oxygen tension (5%) was advantageous for cultures on media supplemented with sheep blood. All other media tested did equally well as long as the atmosphere was enriched with 5-10% CO2.

Broiler chickens as potential source of Campylobacter infections in humans.

Of 46 broiler chickens from a live poultry market in New York City, 38 (83%) harbored Campylobacter fetus subsp. jejuni in their rectal flora. The observed mean number of C. fetus per g of feces was 4.4 x 10(6). The organisms survived in the feces for at least 96 h at 4 degrees C whether stored in the gut or transferred to a vial. The best survival medium for pure cultures of C. fetus subsp.jejuni was heart infusion broth supplemented with sterile blood and kept in a microaerophilic atmosphere.

Bacterial 7-dehydroxylation of cholic acid and allocholic acid.

An obligate anaerobic organism capable of dehydroxylating cholic acid to deoxycholic acid and allocholic acid to allodeoxycholic acid was isolated from feces of the rabbit. It was a member of the bacteroides group (Gram-variable, nonsporulating anaerobes). The growth of the organism was inhibited by neomycin, 10-20 micro g/ml. The existence of this organism affords a satisfactory explanation for the development of gallstones in the cholestanol-fed rabbit and for their absence in rabbits simultaneously treated with neomycin.

Location of Campylobacter jejuni in infected chicken livers.

To determine whether chicken livers infected with Campylobacter jejuni are seeded in vivo or contaminated after slaughtering, 117 livers purchased in retail outlets in New York were examined for surface and tissue infections. Of 56 livers positive for C. jejuni, 36 yielded surface growth only, 18 both surface and tissue growth, and 2 tissue growth only. The scanty growth from tissue samples suggests a carry-over of organisms from the surface. It was concluded, therefore, that contamination is most likely due to unhygienic handling of offal. Infection rates of livers varied from retailer to retailer.

Bacterial metabolism of corticoids with particular reference to the 21-dehydroxylation.

Clostridium paraputrificum, an obligate anaerobe recovered from human feces, reduces the alpha,beta-unsaturated carbonyl of deoxycorticosterone, corticosterone, cortisone, and cortisol. The same steroids are 21-dehydroxylated by Culture 116, recently isolated from human feces, and by a closely related organism, Eubacterium lentum. The 21-dehydroxylase has no effect on hydroxyl groups at carbon atoms 11 and 17.