RESUMEN
BACKGROUND: Human parainfluenza viruses (hPIV) are respiratory pathogens responsible for upper and lower respiratory tract infections. In most labs, the clinical diagnosis of hPIV is routinely done using techniques based on the detection of viral antigens such as immunofluorescence assay or/and viral isolation. STUDY DESIGN: Five hPIV-2 isolated from respiratory samples exhibited unusual phenotypic and antigenic characteristics. These isolates showed important syncytial cytopathic effect and failed to react with one specific monoclonal antibody. These variant strains were subsequently compared with hPIV-2 prototype strain by cellular and molecular techniques. RESULTS: Both variant and prototype strains showed similar growth kinetics. Observation of plaque formation and syncytia assay indicated a more important fusogenic activity for the variant strains. Sequencing of fusion (F) and hemagglutinin-neuraminidase (HN) genes showed differences between the "atypical" hPIV-2 isolates and the Greer hPIV-2 prototype strain. These differences were analyzed with molecular modelling and structure prediction soft wares. A potential new glycosylation site in HN, in addition to minor changes observed in the predicted structure for the variant strains could explain their antigenic variation. Genetic changes in the fusion peptide and the cleavage site of F could also explain the difference observed in the fusion activity. CONCLUSIONS: Continuous global viral surveillance is essential to monitor antigenic changes that may occur in nature particularly with regards to the implementation of diagnostic assays. The differences observed in F and HN between the prototype strain and clinical hPIV-2 variants could also provide new data for the analysis of Paramyxovirus fusion mechanisms and their pathogenesis.
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Proteína HN/genética , Virus de la Parainfluenza 2 Humana/fisiología , ARN Viral , Infecciones por Rubulavirus/virología , Proteínas Virales de Fusión/genética , Adulto , Secuencia de Aminoácidos , Animales , Variación Antigénica , Línea Celular , Niño , Glicosilación , Proteína HN/química , Proteína HN/inmunología , Haplorrinos , Humanos , Modelos Moleculares , Datos de Secuencia Molecular , Virus de la Parainfluenza 2 Humana/clasificación , Virus de la Parainfluenza 2 Humana/genética , Virus de la Parainfluenza 2 Humana/aislamiento & purificación , Filogenia , Conformación Proteica , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Proteínas Virales de Fusión/química , Proteínas Virales de Fusión/inmunología , Ensayo de Placa ViralRESUMEN
Although infections are often subclinical, herpes simplex virus (HSV) can cause mild to severe diseases, especially in immunocompromised patients. There are few drugs licensed for the treatment of HSV infections. Most target the viral DNA polymerase, such as acyclovir that remains the reference treatment some thirty years after its discovery! Extensive clinical use of this drug has led to the emergence of resistant strains, mainly in immunocompromised patients, these infections can be managed with only two drugs, foscarnet and cidofovir, both much more toxic than acyclovir. This highlights the crucial need for the development of new anti-herpes drugs that can inhibit infection by both wild-type viruses and drug-resistant strains. Over the last few years, significant efforts have been made to set up a range of strategies for the identification of potential new antiviral drugs. One alternative is to develop drugs with different mechanisms of action. The present article reviews potential viral and cellular targets that are now known to be involved in HSV multiplication and for which specific inhibitors with anti-HSV activity, at least in cell culture, have been identified. These drugs inhibit viral proteins involved in viral replication (DNA polymerase, ribonucleotide reductase or helicase-primase complex). Other drugs acting on cellular proteins needed for viral replication have also been described; these drugs are targetting cyclin-dependent kinases or the polyamine biosynthetic pathway.
RESUMEN
Ad CFTR, a replication-deficient adenovirus expressing the human cystic fibrosis transmembrane conductance regulator (CFTR), was administered by aerosolization in a single escalating dose to three pairs (cohorts) of cystic fibrosis (CF) patients. Buffer only was administered to the nose and lungs 9-14 days before nasal instillation of virus followed the day after by aerosolization of Ad CFTR to the lung. Nasal doses (defined in terms of viral plaque forming units, pfu) were 10(5), 10(7), and 4 x 10(8), whereas aerosolized doses were 10(7), 10(8), 5.4 x 10(8) for each cohort, respectively. No acute toxic effects were observed in the first 4 weeks after virus treatment. Shedding of infectious Ad CFTR was never detected, whereas detection of vector DNA sequences and CFTR expression demonstrated DNA transfer to the nose and airways of patients. No significant deviations in immunological and inflammatory parameters were observed in serum and in bronchoalveolar lavage (BAL). Importantly, for all patients, the serum anti-adenovirus antibody levels did not change significantly from baseline and no antibodies against adenovirus were found in BAL.
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Adenoviridae/metabolismo , Aerosoles/uso terapéutico , Regulador de Conductancia de Transmembrana de Fibrosis Quística/metabolismo , Terapia Genética , Adolescente , Adulto , Southern Blotting , Lavado Broncoalveolar , Regulador de Conductancia de Transmembrana de Fibrosis Quística/análisis , Regulador de Conductancia de Transmembrana de Fibrosis Quística/genética , ADN/análisis , Femenino , Expresión Génica/genética , Vectores Genéticos/genética , Humanos , Inmunohistoquímica , Masculino , Mucosa Nasal/citología , Mucosa Nasal/metabolismo , Reacción en Cadena de la Polimerasa , ARN Mensajero/análisisRESUMEN
The emergence of a resistant strain is a theoretical threat after extensive use of antiviral drugs. We report the emergence of a ganciclovir-resistant cytomegalovirus (CMV) strain in a kidney transplant recipient during oral ganciclovir maintenance treatment. The patient was treated by oral ganciclovir for 2 months after successful treatment of CMV primary infection by intravenous ganciclovir. He developed a new episode of CMV infection with no clinical response to intravenous ganciclovir. The CMV isolate exhibited both phenotypic and genotypic resistance to ganciclovir. The CMV isolate was constituted of a mixture of strains, with and without a mutation at codon 460 of the UL97 gene. The clinical condition improved when mycophenolate mofetil (MMF) was discontinued, and a short course of intravenous globulin was added to ganciclovir. The emergence of the CMV strain could be secondary to more potent immunosuppression provide by MMF or subtherapeutic level obtained during oral ganciclovir treatment. We believe that ganciclovir resistance must be part of the differential diagnosis when a patient relapses or fails to respond to ganciclovir treatment.
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Antivirales/uso terapéutico , Citomegalovirus/efectos de los fármacos , Citomegalovirus/fisiología , Ganciclovir/uso terapéutico , Trasplante de Riñón , Administración Oral , Adulto , Antivirales/administración & dosificación , Infecciones por Citomegalovirus/tratamiento farmacológico , Infecciones por Citomegalovirus/virología , Farmacorresistencia Microbiana , Quimioterapia Combinada , Ganciclovir/administración & dosificación , Humanos , Inmunoglobulinas Intravenosas , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Masculino , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapéutico , Complicaciones Posoperatorias/tratamiento farmacológico , RecurrenciaRESUMEN
Cytomegalovirus (CMV) infection has protean presentation among immunocompromised patients, but the urinary tract is rarely involved. We report a case of extensive ureteral necrosis in a renal transplant, 12-year-old patient with typical histological feature of CMV inclusions. The role of CMV was confirmed by immunohistochemical analysis and concomitant CMV DNA detection in peripheral blood leukocytes by polymerase chain reaction analysis. CMV infection can, therefore, be regarded as a possible cause of ureteral necrosis in renal transplant recipients.
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Infecciones por Citomegalovirus/complicaciones , Uréter/patología , Enfermedades Ureterales/patología , Enfermedades Ureterales/virología , Niño , Tasa de Filtración Glomerular , Humanos , Trasplante de Riñón/efectos adversos , Masculino , NecrosisRESUMEN
A strain of Bacillus polymyxa (BPl), isolated from cauliflower seeds, inhibited the growth of microbial phytopathogens. Growth of this strain in liquid medium containing lactose, ammonium sulfate, biotin, and amino acids, resulted in optimal inhibition in vitro. Two new antibacterial substances were isolated and purified from culture broth. Their molecular masses were, respectively, 911 and 903 daltons. The first compound was named gavaserin because it contained glutamic acid, alanine, valine, serine and 2,4-diaminobutyric acid, and octanoic acid. No fatty acid was detected in the second compound, which was named saltavalin because it contained serine, alanine, leucine, threonine, valine, and 2,4-diaminobutyric acid.
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Antibacterianos/aislamiento & purificación , Bacillus/metabolismo , Péptidos , Antibacterianos/biosíntesisRESUMEN
Human cytomegalovirus (HCMV) infections are frequent in immuno-compromised patients. The recent development of real-time PCR procedures that allow the rapid quantification of genome load will be helpful for accurate monitoring of these infections. Two extraction procedures were evaluated using 30 blood samples that were processed pure and diluted (1/10). Repeatability and reproducibility of the quantitative PCR procedure using an internal control for amplification were analysed, and its sensitivity compared to a qualitative PCR procedure using 50 HCMV culture positive blood samples. The real-time PCR and qualitative PCR procedures were positive in 46 and 48 of the samples tested, respectively. Discrepancies were observed for samples with a low viral load. The sensitivity of the real-time PCR procedure was evaluated at 500 HCMV DNA copies per ml of sera. The use of an internal control concomitantly processed during the HCMV quantification did not alter the sensitivity of the procedure, and was relevant for the detection of putative PCR inhibitors that may interfere with the amplification process. This procedure was used to measure genome load in two bone marrow transplant patients with HCMV disease, confirming that this new PCR procedure should be used widely for diagnosing and monitoring HCMV infections in transplant patients.
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Infecciones por Citomegalovirus/virología , Citomegalovirus/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Trasplante de Médula Ósea , Citomegalovirus/genética , ADN Viral/análisis , Humanos , Trasplante de Hígado , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Carga ViralRESUMEN
During an outbreak of meningitis in France (in the Lyon area), from June to October 1982, serum and stool samples were collected from 227 patients. An enzyme-linked immunosorbent assay (ELISA) for titrating IgG and IgM antibodies anti-echovirus type 33 was developed and compared with the virus isolation technique, and with the titration of neutralizing antibodies. In 39 patients excreting echovirus 33 in faeces, the ELISA test allowed a positive serodiagnosis in 85% of the cases by detection of specific IgM (64% of the cases) and by seroconversion (21%). Compared with the neutralization (Nt) test, ELISA was found to be more sensitive. The antibody titres in ELISA were over 50 times higher and detected earlier than the neutralizing antibodies. This early immune response allowed a rapid diagnosis by specific IgM detection in the acute sera collected within 8 days after the appearance of the clinical symptoms in more than 50% of the 97 patients examined, whereas the Nt test allowed a positive serodiagnosis in only 32% of the patients. The use of a caesium chloride purified antigen insured the specificity of the reactions.
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Anticuerpos Antivirales/análisis , Infecciones por Echovirus/diagnóstico , Ensayo de Inmunoadsorción Enzimática/métodos , Técnicas para Inmunoenzimas , Inmunoglobulina M/análisis , Meningitis Viral/diagnóstico , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Pruebas de Neutralización , Pruebas SerológicasRESUMEN
An immunocapture ELISA test for the diagnosis of human and animal influenza A and/or B is described. A monoclonal anti-nucleoprotein (NP) antibody was used to capture the NP antigen and the captured antigen was detected by an anti-NP polyclonal rabbit antiserum. Compared with the usual diagnostic method by cultivation in embryonated eggs, this test had a high specificity (97%) and sensitivity when used for diagnosis using clinical nasopharyngeal samples obtained from patients and animals. Immunocapture ELISA permitted an easier reading than the indirect immunofluorescence technique. It also permitted diagnosis in frozen samples (-20 degrees C) or in infected LLCMK2 cells mixed with uninfected nasopharyngeal cells and kept at 20 degrees C for one week. This test can be carried out in 3 h.
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Autoantígenos/análisis , Ensayo de Inmunoadsorción Enzimática , Gripe Humana/diagnóstico , Nucleoproteínas/análisis , Animales , Anticuerpos Monoclonales , Autoantígenos/inmunología , Hurones , Técnica del Anticuerpo Fluorescente , Humanos , Virus de la Influenza A/inmunología , Virus de la Influenza A/aislamiento & purificación , Gripe Humana/microbiología , Gripe Humana/veterinaria , Ratones , Nucleoproteínas/inmunología , Conejos , Porcinos , TemperaturaRESUMEN
Rapid diagnosis of cytomegalovirus (CMV) infection may be obtained by molecular techniques, such as the polymerase chain reaction (PCR) and hybridization assays. The optimal technique to detect CMV in clinical samples was assessed. Two different PCR assays were used, targeting either the major immediate early 1 (MIE 1) or the HXLF 4 gene. The PCR products were detected by gel electrophoresis, dot blotting and an easy to use, rapid, solid phase hybridization assay, DNA enzyme immunoassay (DEIA). Standard tissue culture was also used. Cerebrospinal fluids (18), liver biopsies (9) from hepatic transplant recipients, amniotic fluids (7) from mothers with suspected peripartum infection, and samples (6) of miscellaneous origin (brain and fundus biopsy, pericardial and pleural fluid) were tested. Among the 40 samples, CMV was detected in 19 cases. Three were positive by both molecular techniques and tissue culture, 14 by molecular methods and 2 by culture. 16/19 or 9/19 CMV-positive samples were detected by PCR amplification of the HXLF 4 or MIE 1 gene, respectively and 14/16 HXLF 4-positive samples were detected using either dot-blot or DEIA, compared to 9/16 using gel electrophoresis. Thus, the most sensitive assays for the detection of CMV in clinical samples using the methods compared in the current study were PCR amplification of the HXLF 4 gene followed by dot-blot or DEIA hybridization.
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Infecciones por Citomegalovirus/diagnóstico , Citomegalovirus/genética , Citomegalovirus/aislamiento & purificación , ADN Viral/genética , ADN Viral/aislamiento & purificación , Hibridación de Ácido Nucleico/métodos , Reacción en Cadena de la Polimerasa/métodos , Líquido Amniótico/virología , Biopsia , Encéfalo/virología , Células Cultivadas , Infecciones por Citomegalovirus/líquido cefalorraquídeo , ADN Viral/inmunología , Electroforesis en Gel de Agar , Femenino , Fibroblastos , Genes Inmediatos-Precoces/genética , Humanos , Inmunoensayo/métodos , Immunoblotting/métodos , Hígado/virología , Trasplante de Hígado , Derrame Pericárdico/virología , Derrame Pleural/virología , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Sensibilidad y EspecificidadRESUMEN
ELISA capture technique (ELISAc) was carried out using a rabbit hyperimmune serum attached to a solid phase for capturing mumps antigens in cerebrospinal fluid (CSF) in patients with meningitis and/or in supernatants of infected Vero cells. A biotin-labelled rabbit serum prepared from the previous serum was added and the reaction was read by an enzymatic (avidine-peroxidase) reaction by automated reading. The cut-off was calculated in 100 CSFs negative for viruses by conventional diagnosis. The specificity was evaluated in Vero cells infected with 22 CSFs collected from vaccinated children (URABE AM9 attenuated vaccine) who developed meningitis. A guinea pig hyperimmune serum confirmed the specificity. Results in culture correlated with the ELISA capture technique (ELISAc). No cross-reactivity was observed with parainfluenza 1, 2, 3 human reference strains. At least 2.5 ngs of purified mumps proteins were detected corresponding to 10(1.5) infectious particles per ml. ELISAc applied directly to 14 CSFs collected from unvaccinated children with meningitis diagnosed five positive cases, whereas in four cases conventional diagnosis had to be undertaken twice. ELISAc permitted the diagnosis of one additional patient. The test can be carried out in 3 h.
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Ensayo de Inmunoadsorción Enzimática , Meningitis Viral/diagnóstico , Paperas/diagnóstico , Animales , Biotina/metabolismo , Niño , Preescolar , Chlorocebus aethiops , Estudios de Evaluación como Asunto , Cobayas , Humanos , Meningitis Viral/sangre , Meningitis Viral/inmunología , Paperas/sangre , Paperas/inmunología , Estudios Prospectivos , Conejos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Células VeroRESUMEN
OBJECTIVE: To determine the incidence of cytomegalovirus in the ejaculates of infertile men who were seropositive for IgG antibodies to cytomegalovirus. DESIGN: Prospective study. PATIENT(S): We tested cytomegalovirus infection in the semen of men participating in an IVF-ET program. MAIN OUTCOME MEASURE(S): IgG and IgM antibodies to cytomegalovirus were measured in sera. We used polymerase chain reaction (PCR) and cell culture to look for both cytomegalovirus DNA and infectious virus in the semen of 70 men with cytomegalovirus-specific antibodies detected in sera. RESULT(S): Of the infertile couples, 13.5% exhibited "mismatching" serology (i.e., detection of IgG antibodies to cytomegalovirus in male serum only and not in female serum) and constituted a potential risk for cytomegalovirus transmission. Cytomegalovrius was identified in the semen of two patients who were positive for IgG antibodies to cytomegalovirus. Cytomegalovirus DNA also was detected in one positive sample after centrifugation through a three-layer Percoll gradient. CONCLUSION(S): Human cytomegalovirus was present in the semen from a population of infertile men. Rapid detection can be achieved by molecular techniques such as PCR combined with a hybridization assay. Even though cytomegalovirus was infrequently detected in semen, these data must be considered in determining the risk of transmission and developmental anomalies in infected fetuses.
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Citomegalovirus/aislamiento & purificación , Infertilidad Masculina/virología , Semen/virología , Adulto , Anticuerpos Antivirales/sangre , Células Cultivadas , Citomegalovirus/genética , Citomegalovirus/inmunología , ADN Viral/análisis , Electroforesis en Gel de Agar , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Reacción en Cadena de la Polimerasa , Estudios ProspectivosRESUMEN
Some pesticides are hematotoxic and cause aplastic anemia, agranulocytosis, neutropenia, and thrombopenia. In order to evaluate hematopoietic progenitor cultures in the exploration of pesticide hematotoxicity, human and rat colony-forming unit-granulocyte and macrophage (CFU-GM) were cultured in the presence of different concentrations of pesticides, known to be either hematotoxic or innocuous for blood cells. The results were compared to the control culture of the same sample. Four insecticides (lindane, azinphos, mevinphos, parathion methyl), three herbicides, (2,4,5, T, bromacil, MCPA), and two fungicides (fosethyl-aluminum, DNOC) were tested and exhibited the following data: 1) Pesticides, known to be hematotoxic, inhibited the development of progenitors. Different phenomena were observed and suggested different mechanisms: cell destruction, block in mitosis, decrease or delay in mitosis. 2) Difference in sensitivity to molecules between human and rat progenitors was observed. Human progenitors were more sensitive to pesticides, except for 2,4,5 T.
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Células Madre Hematopoyéticas/efectos de los fármacos , Plaguicidas/toxicidad , Animales , Médula Ósea/efectos de los fármacos , Células de la Médula Ósea , Ensayo de Unidades Formadoras de Colonias , Granulocitos/citología , Granulocitos/efectos de los fármacos , Enfermedades Hematológicas/inducido químicamente , Humanos , Macrófagos/citología , Macrófagos/efectos de los fármacos , Ratas , Sensibilidad y EspecificidadRESUMEN
The aim of this study was to optimize by micellar electrokinetic chromatography the separation of four glucosinolates, i.e. sinigrin, glucobrassicin and methoxyglucobrassicin involved in Cruciferae resistance mechanisms and glucotropaeolin used as an internal standard. The separation borate buffer which contained sodium dodecyl sulphate, tetramethylammonium hydroxide and methanol was firstly optimized by using a three variable Doehlert experimental design. The optimum concentrations found enabled, for the first time, to obtain an acceptable resolution between the two indole glucosinolates, glucobrassicin and methoxyglucobrassicin. Modifications of the method such as a capillary pre-rinse with pure borate buffer and a step change in voltage during experiment were performed to improve the resolutions between glucosinolates and to reduce the analysis time. This method was validated by a statistical analysis and showed good linearity, repeatability and reproducibility.
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Cromatografía Capilar Electrocinética Micelar/métodos , Glucosinolatos/aislamiento & purificación , Indoles , Isotiocianatos , Tampones (Química) , Ácidos Hidroxámicos/aislamiento & purificación , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Tioglucósidos/aislamiento & purificación , Verduras/químicaRESUMEN
An enzyme-linked immunosorbent assay (ELISA) was developed for the fungicide thiram. Two types of haptens were synthesized. The first type exhibits the two symmetrical N-alkyl dithiocarbamate patterns of thiram with a spacer arm linked to one of the N-methyl terminal group. The second type exhibits one of the two symmetrical N-alkyl dithiocarbamate patterns of thiram with a variable-length spacer arm linked to one sulfur atom. Polyclonal antibodies suitable for thiram detection were obtained from immunization with an hapten of the first type, while haptens of the second type were used as coating antigens to develop a competitive ELISA against thiram. The IC(50) value for thiram was estimated to be 0.24 microg/mL, with a detection limit of 0.03 microg/mL. The assay seems to be thiram-specific since no or little cross-reaction with other dithiocarbamates were observed.
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Fungicidas Industriales/análisis , Haptenos/química , Tiram/análisis , Unión Competitiva , Ensayo de Inmunoadsorción EnzimáticaRESUMEN
Two competitive immunoassays, a laboratory assay based on microwell plates and a field test based on the use of polystyrene tubes, have been developed for the quantification of thiram in lettuces. Concerning the laboratory assay, the calibration curve for thiram had a linear range of 11 to 90 ng/mL and a detection limit of 5 ng/mL. Precision of the assay presented coefficient of variation values <9% and the recovery of thiram from lettuce averaged 89% across the range of the immunoassay method using 30 min extraction with water/acetone (50:50, v/v). The tube-based method was developed in order that an extract of lettuce, containing thiram at the MRL (8 ppm), would be found on the linear part of the standard curve. The calibration curve for thiram has a linear range of 100 to 800 ng/mL (1.39 to 11.1 ppm in lettuce) and a detection limit of 40 ng/mL.
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Fungicidas Industriales/análisis , Lactuca/química , Residuos de Plaguicidas/análisis , Tiram/análisis , Ensayo de Inmunoadsorción Enzimática/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Tiram/inmunología , Factores de TiempoRESUMEN
Blood dyscrasias such as aplastic anaemia and leukopenia are described following the use of lindane for agricultural purposes or against ectoparasites in animal and human health. In order to determine the involvement of lindane in these effects, an in vitro model of haematotoxicity evaluation has been used. Culture of haematopoietic progenitors, Colony Forming Unit-Granulocyte and Macrophage (CFU-GM), have been performed in the presence of lindane with increasing concentrations. Results showed that lindane was cytotoxic for human progenitors. They were one thousand times more sensitive to the lindane than rat CFU-GM. This cytotoxicity was observed with lindane concentrations similar to those measured in human blood in cases of acute intoxication and in fat tissues of exposed populations.
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Granulocitos/citología , Células Madre Hematopoyéticas/efectos de los fármacos , Hexaclorociclohexano/toxicidad , Macrófagos/citología , Animales , Células de la Médula Ósea , Células Cultivadas , Ensayo de Unidades Formadoras de Colonias , Granulocitos/efectos de los fármacos , Humanos , Macrófagos/efectos de los fármacos , RatasRESUMEN
Herpes simplex virus (HSV) and varicella zoster virus (VZV) are susceptible to acyclovir which inhibits viral replication through two viral enzymes, thymidine kinase (TK) and DNA polymerase. Resistance may occur, it is a rare phenomenon among immunocompetent patients but resistance is more frequent and may be associated with serious complications among immunocompromised patients. Virological survey of these at risk patients is needed to detect resistant virus as soon as possible through phenotypic tests performed on virus isolated on cell cultures. Resistant virus may also be genetically characterised by detection of mutations within TK and DNA polymerase genes. Pharmacological parameters also have to be taken into consideration and a determination of acyclovir blood concentration should be performed in case of unexplained therapeutic failure. Improvement of immune system, when possible, may resolve these infections. Alternative treatments using drugs such as foscarnet or cidofovir which have a different mechanism of action compared to acyclovir, are recommended but these molecules are often more toxic than acyclovir.
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Aciclovir/farmacología , Antivirales/farmacología , Farmacorresistencia Viral , Herpesvirus Humano 3/efectos de los fármacos , Simplexvirus/efectos de los fármacos , Varicela/tratamiento farmacológico , Herpes Simple/tratamiento farmacológico , Herpes Zóster/tratamiento farmacológico , Herpesvirus Humano 3/genética , Humanos , Mutación , Fenotipo , Simplexvirus/genéticaRESUMEN
Herpes simplex virus (HSV) infections are very common and may present various manifestations. Mostly asymptomatic, often mild, these infections may become life-threatening, specially in neonates. The acute and rapid diagnosis of HSV infections can prevent infections in these patients and is also helpful to confirm clinical diagnosis. The sensitivity of "classical" diagnosis methods, such as culture and antigen detection by immunofluorescence and ELISA, is highly dependent on the quality of the sample. Antigen detection techniques give results in short delays, compatible with the initiation of antiviral treatment; however their sensitivity decreases when lesions get older and they are not convenient for the diagnosis of asymptomatic infections. Isolation of HSV on cell culture remains the gold standard, because it is easy to perform and exhibits good sensitivity whatever the stage of the lesions; the isolation of the virus is required for HSV typing and to determine susceptibility to antiviral agents in case of clinical resistance to the treatment. Serodiagnosis is helpful to determine the immune status of a patient and to distinguish between primary infection and recurrence. It is now possible to differentiate HSV1 and HSV2 antibodies; the benefit of type-specific serology is clear for epidemiological surveys but may be discussed for individual follow-up, specially for genital herpes, both for the diagnosis and the prevention of HSV infections.
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Herpes Genital/diagnóstico , Herpes Simple/diagnóstico , Ensayo de Inmunoadsorción Enzimática , Técnica del Anticuerpo Fluorescente/métodos , Herpesvirus Humano 1 , Herpesvirus Humano 2 , Humanos , Inmunocompetencia , Sensibilidad y EspecificidadRESUMEN
Herpes simplex virus (HSV) infections are prevalent worldwide. HSV are characterized by their ability to establish and maintain latent infections that can be reactivated. Various clinical presentations of HSV infections are described. Mostly asymptomatic, these infections may become life-threatening when occurring in neonates or when infecting the central nervous system. Accurate diagnosis of HSV infections is important and PCR is the most sensitive technique for detecting HSV. Type-specific serologies could be particularly useful for seroprevalence rates. Aciclovir is an efficient drug for the treatment of herpes simplex virus infections and resistance to this drug has been reported mainly in immunocompromised patients during the course of aciclovir treatment. There is a variety of potential vaccines for prophylaxis of HSV infection, but no vaccine is now available.