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1.
Biomedicines ; 11(9)2023 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-37760788

RESUMEN

Human rhabdomyosarcomas are rarely cured by surgical resection alone. This is also true for high-grade soft tissue sarcomas in dogs. Dogs with spontaneous sarcoma are good models for clinical responses to new cancer therapies. Strategic combinations of immunotherapy and oncolytic virotherapy (OV) could improve treatment responses in canine and human cancer patients. To develop an appropriate combination of immunotherapy and OV for dogs with soft tissue sarcoma (STS), canine cancer cells were inoculated with myxoma viruses (MYXVs) and gene transcripts were quantified. Next, the cytokine concentrations in the canine cancer cells were altered to evaluate their effect on MYXV replication. These studies indicated that, as in murine and human cells, type I interferons (IFN) play an important role in limiting MYXV replication in canine cancer cells. To reduce type I IFN production during OV, oclacitinib (a JAK1 inhibitor) was administered twice daily to dogs for 14 days starting ~7 days prior to surgery. STS tumors were excised, and MYXV deleted for serp2 (MYXV∆SERP2) was administered at the surgical site at two time points post-operatively to treat any remaining microscopic tumor cells. Tumor regrowth in dogs treated with OV was decreased relative to historical controls. However, regrowth was not further inhibited in patients given combination therapy.

2.
Vet Clin Pathol ; 50(4): 543-550, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34862629

RESUMEN

BACKGROUND: Densitometric quantification of myeloma paraproteins (M-proteins) is used to monitor secretory myeloma related disorders in humans and dogs. The previous work in dogs used agarose gel electrophoresis (AGE) but did not establish if other methods of serum protein electrophoresis, such as capillary zone electrophoresis (CZE), were comparable. OBJECTIVES: We aimed to determine if the densitometric quantification of M-proteins using CZE would yield results comparable to AGE methods. METHODS: Fifty-one serum samples from 22 dogs and 18 cats with confirmed monoclonal gammopathies and previously performed AGE were evaluated using CZE on a Sebia Minicap system. Samples were run in duplicate, and their M-proteins were densitometrically measured using the corrected perpendicular drop method previously described. Human-based quality control samples were used to determine the inter-run coefficient of variation (CV). Patient samples were used to calculate the intra-run CV. Method comparison was performed using simple linear regression, Passing-Bablok regression, and Bland-Altman analyses, and Medx evaluations. RESULTS: Inter-run and intra-run CVs for CZE were 3.71%-7.65% and 2.89%-4.74%, respectively. Simple linear regression demonstrated an excellent correlation (r > 0.98). Passing-Bablok regression was compatible with the presence of proportional bias in the entire population, and Bland-Altman plots revealed a proportional bias in the feline cases. The Medx evaluation suggested that the two methods did not perform similarly in clinical samples with poor performance at a decision limit of 0.5 gm/dL. CONCLUSIONS: Capillary zone electrophoresis is an acceptable method for M-protein densitometric quantification in canine and feline sera but cannot be used interchangeably with AGE-based evaluations.


Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Perros , Animales , Electroforesis de las Proteínas Sanguíneas/veterinaria , Gatos , Enfermedades de los Perros/diagnóstico , Perros , Electroforesis en Gel de Agar/veterinaria , Electroforesis Capilar/veterinaria , Humanos
3.
Vet Clin Pathol ; 50(2): 249-258, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33855710

RESUMEN

BACKGROUND: The diagnostic performance of routine electrophoresis (agarose gel electrophoresis [AGE] and capillary zone electrophoresis [CZE]) and species-specific immunofixation (IF) for the detection of immunoglobulin paraproteins (M-proteins) and diagnosis of secretory myeloma-related disorders (sMRD) can be improved. Available canine IF targets were IgG-FC, IgA, IgM, light chain (LC), IgG4, and free LC (fLC) antibodies. OBJECTIVE: We aimed to review specific features associated with the presence of M-proteins in canine serum samples and the common features causing inaccurate reporting of M-proteins to improve the diagnostic performance of routine electrophoresis and IF for the detection of M-proteins. METHODS: Features found in AGE, CZE, routine IF, IgG4 IF, and fLC IF of 100 canine serum samples from Part 1 of this study were evaluated by simple and multivariate logistic regression to identify factors associated with the presence of M-proteins. Cases falsely called negative or positive for M-proteins were reviewed to identify the common features that could be used to increase the diagnostic performance of SPE and IF for M-protein detection. RESULTS: The presence of hypogammaglobulinemia or any peak taller than albumin was associated with an M-protein. Total protein concentrations, globulin concentrations, or peaks wider than albumin were not associated with an M-protein. Free LC sMRD cases were not diagnosed by SPE and routine IF. Cases with infectious and inflammatory etiologies had a restricted polyclonal gammopathy with multiple γ-globulin restrictions resulting in some false-positive results. SPE combined with all available IF results and the specific features identified in this study had an estimated sensitivity of 95.1% and specificity of 81.4%. CONCLUSIONS: The identified criteria of this study increase the diagnostic performance of the electrophoretic evaluation for M-proteins.


Asunto(s)
Enfermedades de los Perros , Mieloma Múltiple , Animales , Electroforesis de las Proteínas Sanguíneas/veterinaria , Perros , Inmunoelectroforesis/veterinaria , Cadenas Ligeras de Inmunoglobulina , Mieloma Múltiple/veterinaria , Paraproteínas
4.
Vet Clin Pathol ; 50(2): 240-248, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33847384

RESUMEN

BACKGROUND: Routine electrophoresis [agarose gel electrophoresis (AGE) and capillary zone electrophoresis (CZE)] and species-specific immunofixation (IF) can be used alone or in combination to detect immunoglobulin paraprotein (M-protein) and diagnose secretory myeloma-related disorders (sMRD). OBJECTIVE: We aimed to evaluate the performance of AGE, CZE, CZE plus IF (CZE-IF), and AGE plus IF (AGE-IF) for detecting canine serum M-proteins. METHODS: One hundred canine cases that had AGE, CZE, and routine IF performed on serum, and where B-cell lineage neoplasia (such as B-cell lymphoma and plasma cell tumors) had been diagnosed or excluded, were evaluated. Routine IF protocols targeted IgG-FC, IgA, and IgM heavy chains and light chains. IgG4 IF and free light chain IF were also performed. B-cell lineage neoplasms with an M-protein detected, using any available method, were classified as sMRD. Datasets from AGE, CZE, IF, CZE-IF, and AGE-IF (electrophoretograms, gel images, and fraction concentrations) were composed and reviewed. The sensitivity, specificity, and Youden's index for M-protein detection were determined for each dataset. RESULTS: The combination of AGE-IF or CZE-IF was more sensitive (82.9%) than CZE alone (72.0%) or AGE alone (64.6%) and more specific (66.1%, 48.3%, 51.7%, respectively). Immunofixation could be used alone to detect M-proteins (sensitivity 82.9%, specificity 61.9%), but there were technical challenges that complicated the performance and evaluation of the test. Myeloma with free light chains only was found in 5/41 cases of sMRD. CONCLUSIONS: Adding routine IF to routine electrophoresis increases the ability to accurately identify M-proteins; however, there is still room for further diagnostic performance improvements.


Asunto(s)
Enfermedades de los Perros , Inmunoelectroforesis , Mieloma Múltiple , Animales , Enfermedades de los Perros/diagnóstico , Perros , Electroforesis en Gel de Agar/veterinaria , Electroforesis Capilar/veterinaria , Inmunoelectroforesis/veterinaria , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/veterinaria , Paraproteínas
5.
J Vet Intern Med ; 35(2): 1031-1040, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33634914

RESUMEN

BACKGROUND: Detection of free light chains (fLC) in animals relies on protein electrophoresis or the Bence-Jones protein test on urine. OBJECTIVE: To describe the detection of both serum fLC (sfLC) and urine fLC (ufLC) in 8 dogs and 2 cats using a commercially available human immunofixation (IF) kit. ANIMALS: Archived serum or urine samples from 27 dogs and 2 cats submitted to the Colorado State University Veterinary Diagnostic Laboratory for routine diagnostics. METHODS: Retrospective study evaluating the presence of fLC in dogs and cats using agarose gel electrophoresis and routine and fLC IF performed on serum and urine. The performance of the fLC IF reagents was evaluated using samples characterized by routine IF, tandem mass spectrometry, and a combination of fLC IF and western blotting. Free light chains were documented by paired electrophoresis and fLC IF. RESULTS: The fLC only myeloma case developed end-stage renal failure 5 months post initial diagnosis. All electrophoresis-defined urinary Bence-Jones proteins were labeled by the anti-free λ light chain (anti-fλ) reagent; none were labeled by the anti-free κ light chain (anti-fκ); 2 of these were identified as fκ by mass spectrometry. An electrophoretically identical protein restriction that was labeled by the anti-fλ reagent was present in the paired serum from 5/8 of cases, documenting sfLC. CONCLUSIONS AND CLINICAL IMPORTANCE: Commercially available human IF reagents identified sfLC and ufLC in both dogs and cats. Free light chains may be nephrotoxic in dogs.


Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Perros , Mieloma Múltiple , Animales , Enfermedades de los Gatos/diagnóstico , Gatos , Colorado , Enfermedades de los Perros/diagnóstico , Perros , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/veterinaria , Estudios Retrospectivos
6.
Equine Vet J ; 53(2): 349-355, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32557765

RESUMEN

BACKGROUND: Equid herpesvirus type 1 (EHV-1) is ubiquitous in equine populations causing respiratory disease, and complications including late-term abortion and neurological disease. Eradication of EHV-1 from housing environments that typically contain unsealed wood and porous bedding materials can be challenging. However, consideration should be given to take advantage of the viral envelope's susceptibility to environmental conditions. OBJECTIVE: To determine environmental persistence of EHV-1 on materials and in environmental conditions commonly found in equine facilities. We hypothesised that environmental conditions and materials would limit environmental persistence of EHV-1 in horse housing environments. STUDY DESIGN: Experimental study. METHODS: Standard inoculum of EHV-1 strain OH03 was applied to leather, polyester-cotton fabric, two bedding materials (pinewood shavings and wheat straw) and polystyrene (plastic), and placed under three different environmental conditions (4°C, indoors and outdoors). Virus titration and quantitative PCR (qPCR) were performed at six time points between 0 and 48 hours and the number of plaque-forming units (PFUs) was determined. RESULTS: Viable EHV-1 was recovered up to 48 hours from all material-environmental condition combinations, with persistence decreasing over time. In general, outdoor environment had the greatest impact, irrespective of material tested, followed by indoor environment and 4°C. On average, wood shavings had the greatest impact on persistence, followed by leather, straw, fabric and polystyrene. MAIN LIMITATIONS: The inoculum used in this study was not in a milieu consistent with nasal secretions. As such, virus particles may have been more sensitive to the materials and/or environmental conditions evaluated. CONCLUSIONS: Environmental factors had variable effects on environmental persistence. Although there were significant reductions in PFUs within the first 3 hours, irrespective of environment-material evaluated, viable virus was still recovered at 48 hours likely representing a transmission risk. Barrier precautions should be used to prevent spread of EHV-1 from unrecognised environmental reservoirs.


Asunto(s)
Infecciones por Herpesviridae , Herpesvirus Équido 1 , Enfermedades de los Caballos , Enfermedades Respiratorias , Animales , Femenino , Infecciones por Herpesviridae/prevención & control , Infecciones por Herpesviridae/veterinaria , Herpesvirus Équido 1/genética , Enfermedades de los Caballos/prevención & control , Caballos , Embarazo , Reacción en Cadena en Tiempo Real de la Polimerasa/veterinaria , Enfermedades Respiratorias/veterinaria
7.
Oncolytic Virother ; 9: 17-29, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32548076

RESUMEN

PURPOSE: Rhabdomyosarcomas (RMS) are difficult tumors to treat with conventional therapies. Publications indicate that oncolytic virotherapy (OV) could benefit cancer patients with tumors that are refractory to conventional treatments. It is believed that the efficacy of OV can be enhanced when used in combination with other treatments. This study evaluated the response of mice with aggressive alveolar RMS (ARMS) allografts to treatment with an OV [recombinant myxoma virus (MYXVΔserp2)] in combination with a Janus kinase (JAK) inhibitor (oclacitinib). Oclacitinib is known to inhibit JAK1 and JAK2 cell signaling pathways, which should limit the antiviral Type I interferon response. However, oclacitinib does not inhibit immune pathways that promote antigen presentation, which help stimulate an anti-cancer immune response. MATERIALS AND METHODS: To determine if MYXVΔserp2 and oclacitinib could improve outcomes in animals with ARMS, nude mice were inoculated subcutaneously with murine ARMS cells to establish tumors. Immune responses, tumor growth, and clinical signs in mice treated with combination therapy were compared to mice given placebo therapy and mice treated with OV alone. RESULTS: Combination therapy was safe; no viral DNA was detected in off-target organs, only within tumors. As predicted, viral DNA was detected in tumors of mice given oclacitinib and MYXVΔserp2 for a longer time period than mice treated with OV alone. Although tumor growth rates and median survival times were not significantly different between groups, clinical signs were less severe in mice treated with OV. CONCLUSION: Our data indicate that MYXVΔserp2 treatment benefits mice with ARMS by reducing clinical signs of disease and improving quality of life.

8.
Viruses ; 12(5)2020 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-32397134

RESUMEN

The poxvirus, myxoma virus (MYXV) has shown efficacy as an oncolytic virus (OV) in some cancer models. However, MYXV replication within murine cancer models and spontaneous canine sarcomas is short-lived. In mice, successful treatment of tumors requires frequent injections with MYXV. We hypothesize that treatment of cancer with a recombinant MYXV that promotes apoptosis could improve the efficacy of MYXV. The orfC gene of walleye dermal sarcoma virus (WDSV), which induces apoptosis, was recombined into the MYXV genome (MYXVorfC). A marked increase in apoptosis was observed in cells infected with MYXVorfC. To ensure that expression of WDSV orfC by MYXV does not potentiate the pathogenesis of MYXV, we evaluated the effects of MYXVorfC inoculation in the only known host of MYXV, New Zealand white rabbits. Virus dissemination in rabbit tissues was similar for MYXVorfC and MYXV. Virus titers recovered from tissues were lower in MYXVorfC-infected rabbits as compared to MYXV-infected rabbits. Importantly, rabbits infected with MYXVorfC had a delayed onset of clinical signs and a longer median survival time than rabbits infected with MYXV. This study indicates that MYXVorfC is attenuated and suggests that MYXVorfC will be safe to use as an OV therapy in future studies.


Asunto(s)
Epsilonretrovirus/metabolismo , Myxoma virus/genética , Neoplasias/terapia , Viroterapia Oncolítica , Virus Oncolíticos/genética , Animales , Apoptosis , Epsilonretrovirus/genética , Femenino , Expresión Génica , Vectores Genéticos/genética , Vectores Genéticos/fisiología , Humanos , Myxoma virus/fisiología , Neoplasias/fisiopatología , Virus Oncolíticos/fisiología , Conejos , Proteínas Virales/genética , Proteínas Virales/metabolismo , Replicación Viral
9.
J Proteome Res ; 19(2): 610-623, 2020 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-31821002

RESUMEN

Lyme disease is a tick-borne bacterial illness that occurs in areas of North America, Europe, and Asia. Early infection typically presents as generalized symptoms with an erythema migrans (EM) skin lesion. Dissemination of the pathogen Borrelia burgdorferi can result in multiple EM skin lesions or in extracutaneous manifestations such as Lyme neuroborreliosis. Metabolic biosignatures of patients with early Lyme disease can potentially provide diagnostic targets as well as highlight metabolic pathways that contribute to pathogenesis. Sera from well-characterized patients diagnosed with either early localized Lyme disease (ELL) or early disseminated Lyme disease (EDL), plus healthy controls (HC), from the United States were analyzed by liquid chromatography-mass spectrometry (LC-MS). Comparative analyses were performed between ELL, or EDL, or ELL combined with EDL, and the HC to develop biosignatures present in early Lyme disease. A direct comparison between ELL and EDL was also performed to develop a biosignature for stages of early Lyme disease. Metabolic pathway analysis and chemical identification of metabolites with LC-tandem mass spectrometry (LC-MS/MS) demonstrated alterations of eicosanoid, bile acid, sphingolipid, glycerophospholipid, and acylcarnitine metabolic pathways during early Lyme disease. These metabolic alterations were confirmed using a separate set of serum samples for validation. The findings demonstrated that infection of humans with B. burgdorferi alters defined metabolic pathways that are associated with inflammatory responses, liver function, lipid metabolism, and mitochondrial function. Additionally, the data provide evidence that metabolic pathways can be used to mark the progression of early Lyme disease.


Asunto(s)
Enfermedad de Lyme , Neuroborreliosis de Lyme , Asia , Cromatografía Liquida , Europa (Continente) , Humanos , Enfermedad de Lyme/diagnóstico , Espectrometría de Masas en Tándem
10.
Int J Infect Dis ; 84: 30-38, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31009738

RESUMEN

BACKGROUND: Diagnosis of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is challenging and new tools are needed for early diagnosis as well as to understand the biochemical events that underlie the pathology in TB-IRIS. METHODS: Plasma samples were obtained from participants from a randomized HIV/TB treatment strategy study (AIDS Clinical Trials Group [ACTG] A5221) with (n = 26) and without TB-IRIS (n = 22) for an untargeted metabolomics pilot study by liquid-chromatography mass spectrometry. The metabolic profile of these participants was compared at the study entry and as close to the diagnosis of TB-IRIS as possible (TB-IRIS window). Molecular features with p < 0.05 and log2 fold change ≥0.58 were submitted for pathway analysis through MetaboAnalyst. We also elucidated potential metabolic signatures for TB-IRIS using a LASSO regression model. RESULTS: At the study entry, we showed that the arachidonic acid and glycerophospholipid metabolism were altered in the TB-IRIS group. Sphingolipid and linoleic acid metabolism were the most affected pathways during the TB-IRIS window. LASSO modeling selected a set of 8 and 7 molecular features with the potential to predict TB-IRIS at study entry and during the TB-IRIS window, respectively. CONCLUSION: This study suggests that the use of plasma metabolites may distinguish HIV-TB patients with and without TB-IRIS.


Asunto(s)
Síndrome Inflamatorio de Reconstitución Inmune/sangre , Metabolómica , Adulto , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/uso terapéutico , Cromatografía Liquida , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/tratamiento farmacológico , Humanos , Síndrome Inflamatorio de Reconstitución Inmune/inmunología , Masculino , Proyectos Piloto , Espectrometría de Masas en Tándem , Tuberculosis Pulmonar/sangre , Tuberculosis Pulmonar/diagnóstico
11.
Sci Rep ; 8(1): 12204, 2018 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-30111850

RESUMEN

Metabolites detectible in human biofluids are attractive biomarkers for the diagnosis of early Lyme disease (ELD), a vector-borne infectious disease. Urine represents an easily obtained clinical sample that can be applied for diagnostic purposes. However, few studies have explored urine for biomarkers of ELD. In this study, metabolomics approaches were applied to evaluate small molecule metabolites in urine from patients with ELD (n = 14), infectious mononucleosis (n = 14) and healthy controls (n = 14). Metabolic biosignatures for ELD versus healthy controls and ELD versus infectious mononucleosis were generated using untargeted metabolomics. Pathway analyses and metabolite identification revealed the dysregulation of several metabolic processes in ELD as compared to healthy controls or mononucleosis, including metabolism of tryptophan. Linear discriminant analyses demonstrated that individual metabolic biosignatures can correctly discriminate ELD from the other patient groups with accuracies of 71 to 100%. These data provide proof-of-concept for use of urine metabolites as biomarkers for diagnostic classification of ELD.


Asunto(s)
Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/orina , Líquidos Corporales , Estudios de Casos y Controles , Cromatografía Liquida , Análisis Discriminante , Femenino , Humanos , Masculino , Metabolómica/métodos , Persona de Mediana Edad , Prueba de Estudio Conceptual , Triptófano/metabolismo , Orina/química , Adulto Joven
12.
J Clin Microbiol ; 56(8)2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29743307

RESUMEN

Standard two-tiered testing (STTT) is the recommended algorithm for laboratory diagnosis of Lyme disease (LD). Several limitations are associated with STTT that include low sensitivity in the early stages of disease, as well as technical complexity and subjectivity associated with second-tier immunoblotting; therefore, modified two-tiered testing (MTTT) algorithms that utilize two sequential first-tier tests and eliminate immunoblotting have been evaluated. Recently, a novel MTTT that uses a VlsE chemiluminescence immunoassay followed by a C6 enzyme immunoassay has been proposed. The purpose of this study was to evaluate the performance of the VlsE/C6 MTTT using well-characterized serum samples. Serum samples from the CDC Lyme Serum Repository were tested using three MTTTs, VlsE/C6, whole-cell sonicate (WCS)/C6, and WCS/VlsE, and three STTTs (immunoblotting preceded by three different first-tier assays: VlsE, C6, and WCS). Significant differences were not observed between the results of the MTTTs assessed; however, the VlsE/C6 MTTT resulted in the highest specificity (100%) when other diseases were tested and the lowest sensitivity (75%) for LD samples. Significant differences were present between the results for various MTTTs and STTTs evaluated. Specifically, all MTTTs resulted in higher sensitivities than the STTTs for all LD groups combined and were significantly more accurate (i.e., higher proportion of correct classifications) for this group, with the exception of the WCS/ViraStripe STTT. Additionally, when other diseases were tested, only the results of the VlsE/C6 MTTT differed significantly from those of the WCS/ViraStripe STTT, with the VlsE/C6 MTTT resulting in a 6.2% higher accuracy. Overall, the VlsE/C6 MTTT offers an additional laboratory testing algorithm for LD with equivalent or enhanced performance compared to that of the other MTTTs and STTTs evaluated in this study.


Asunto(s)
Algoritmos , Borrelia burgdorferi/inmunología , Inmunoensayo/normas , Enfermedad de Lyme/diagnóstico , Pruebas Serológicas/normas , Anticuerpos Antibacterianos/sangre , Antígenos Bacterianos/inmunología , Proteínas Bacterianas/inmunología , Borrelia burgdorferi/aislamiento & purificación , Humanos , Lipoproteínas/inmunología , Enfermedad de Lyme/sangre , Sensibilidad y Especificidad
13.
Community Ment Health J ; 54(3): 312-333, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29185150

RESUMEN

A proliferation of recent literature provides substantial direction as to the key ingredients-target groups, messages and methods, and evaluation-of local-level, public interventions to counter stigma and discrimination. This paper provides a selective narrative review of that literature from the perspective or standpoint of anti-stigma experts with lived experience of mental distress, the key findings of which have been synthesised and presented in diagrammatic overviews (infographics). These are intended to guide providers in planning, delivering and evaluating lived experience-directed local-level, public interventions to counter stigma and discrimination in accord with current best practice.


Asunto(s)
Servicios Comunitarios de Salud Mental/métodos , Trastornos Mentales/psicología , Desarrollo de Programa/métodos , Discriminación Social/psicología , Estigma Social , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Humanos , Metaanálisis como Asunto , Narración , Pacientes/psicología , Evaluación de Programas y Proyectos de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Religión y Psicología
14.
Sci Transl Med ; 9(403)2017 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-28814545

RESUMEN

Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early Lyme disease and STARI. Specifically, a metabolic biosignature consisting of 261 molecular features (MFs) revealed that altered N-acyl ethanolamine and primary fatty acid amide metabolism discriminated early Lyme disease from STARI. Development of classification models with the 261-MF biosignature and testing against validation samples differentiated early Lyme disease from STARI with an accuracy of 85 to 98%. These findings revealed metabolic dissimilarity between early Lyme disease and STARI, and provide a powerful and new approach to inform patient management by objectively distinguishing early Lyme disease from an illness with nearly identical symptoms.


Asunto(s)
Exantema/diagnóstico , Exantema/parasitología , Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/metabolismo , Infestaciones por Garrapatas/diagnóstico , Infestaciones por Garrapatas/metabolismo , Animales , Estudios de Casos y Controles , Simulación por Computador , Diagnóstico Diferencial , Exantema/sangre , Femenino , Geografía , Humanos , Enfermedad de Lyme/sangre , Enfermedad de Lyme/clasificación , Masculino , Redes y Vías Metabólicas , Metaboloma , Metabolómica , Persona de Mediana Edad , Infestaciones por Garrapatas/sangre , Infestaciones por Garrapatas/clasificación
15.
Clin Infect Dis ; 60(12): 1767-75, 2015 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-25761869

RESUMEN

BACKGROUND: Early Lyme disease patients often present to the clinic prior to developing a detectable antibody response to Borrelia burgdorferi, the etiologic agent. Thus, existing 2-tier serology-based assays yield low sensitivities (29%-40%) for early infection. The lack of an accurate laboratory test for early Lyme disease contributes to misconceptions about diagnosis and treatment, and underscores the need for new diagnostic approaches. METHODS: Retrospective serum samples from patients with early Lyme disease, other diseases, and healthy controls were analyzed for small molecule metabolites by liquid chromatography-mass spectrometry (LC-MS). A metabolomics data workflow was applied to select a biosignature for classifying early Lyme disease and non-Lyme disease patients. A statistical model of the biosignature was trained using the patients' LC-MS data, and subsequently applied as an experimental diagnostic tool with LC-MS data from additional patient sera. The accuracy of this method was compared with standard 2-tier serology. RESULTS: Metabolic biosignature development selected 95 molecular features that distinguished early Lyme disease patients from healthy controls. Statistical modeling reduced the biosignature to 44 molecular features, and correctly classified early Lyme disease patients and healthy controls with a sensitivity of 88% (84%-95%), and a specificity of 95% (90%-100%). Importantly, the metabolic biosignature correctly classified 77%-95% of the of serology negative Lyme disease patients. CONCLUSIONS: The data provide proof-of-concept that metabolic profiling for early Lyme disease can achieve significantly greater (P < .0001) diagnostic sensitivity than current 2-tier serology, while retaining high specificity.


Asunto(s)
Biomarcadores/sangre , Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/metabolismo , Borrelia burgdorferi , Niño , Cromatografía Liquida , Femenino , Humanos , Enfermedad de Lyme/epidemiología , Masculino , Espectrometría de Masas , Metaboloma/fisiología , Metabolómica , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos , Adulto Joven
16.
J Clin Microbiol ; 52(10): 3755-62, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25122862

RESUMEN

Serological assays and a two-tiered test algorithm are recommended for laboratory confirmation of Lyme disease. In the United States, the sensitivity of two-tiered testing using commercially available serology-based assays is dependent on the stage of infection and ranges from 30% in the early localized disease stage to near 100% in late-stage disease. Other variables, including subjectivity in reading Western blots, compliance with two-tiered recommendations, use of different first- and second-tier test combinations, and use of different test samples, all contribute to variation in two-tiered test performance. The availability and use of sample sets from well-characterized Lyme disease patients and controls are needed to better assess the performance of existing tests and for development of improved assays. To address this need, the Centers for Disease Control and Prevention and the National Institutes of Health prospectively collected sera from patients at all stages of Lyme disease, as well as healthy donors and patients with look-alike diseases. Patients and healthy controls were recruited using strict inclusion and exclusion criteria. Samples from all included patients were retrospectively characterized by two-tiered testing. The results from two-tiered testing corroborated the need for novel and improved diagnostics, particularly for laboratory diagnosis of earlier stages of infection. Furthermore, the two-tiered results provide a baseline with samples from well-characterized patients that can be used in comparing the sensitivity and specificity of novel diagnostics. Panels of sera and accompanying clinical and laboratory testing results are now available to Lyme disease serological test users and researchers developing novel tests.


Asunto(s)
Pruebas Diagnósticas de Rutina/métodos , Pruebas Diagnósticas de Rutina/normas , Enfermedad de Lyme/diagnóstico , Suero/inmunología , Manejo de Especímenes/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Serológicas/métodos , Pruebas Serológicas/normas , Estados Unidos , Adulto Joven
17.
Indian J Plast Surg ; 47(1): 92-4, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24987211

RESUMEN

INTRODUCTION AND OBJECTIVES: Hypospadias is the most common congenital abnormality of the penis, and is most commonly diagnosed during the postnatal physical examination. However, milder forms of the condition can be difficult to detect, leading to delayed referral to specialist teams. We aim to determine whether there is an association between hypospadias and the position of the penoscrotal raphe. MATERIALS AND METHODS: A case - control study was performed where clinical photographs from children undergoing hypospadias correction were compared with a control group of children without the condition. The position of the penoscrotal raphe was documented as midline, left or right. Pearson's chi squared test was used to determine significance. RESULTS: Images for 80 children undergoing hypospadias correction were compared with 80 normal children in the maternity ward. 88.8% of the children with hypospadias had a penoscrotal raphe deviated from the midline compared with only 13.8% in the control group (P < 0.0003). CONCLUSIONS: Our study demonstrates a significant association between hypospadias and deviation of the penoscrotal raphe from the midline. Consideration should be given to whether to include this finding within the spectrum of abnormalities seen in hypospadias. Examination of the penoscrotal raphe is simple to perform and could aid in the early diagnosis in children with milder forms of the condition.

18.
Virology ; 464-465: 76-86, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25046270

RESUMEN

Recently, the product of equine herpesvirus type 1 (EHV-1) ORF1, a homolog to HSV-1 pUL56, was shown to modulate MHC-I expression and innate immunity. Here, we investigated modulation of respiratory epithelial immunity by EHV-1 pUL56 and compared responses to those of PBMCs, which are important target cells that allow cell-associated EHV-1 viremia. The salient observations are as follows: (i) EHV-1 significantly down-modulated MHC-I and MHC-II expression in equine respiratory epithelial cells (ERECs). MHC-I expression remained unaffected in PBMCs and MHC-II expression was increased. (ii) Infection with an EHV-1 ORF1 deletion mutant partially restored MHC-I and MHC-II expression and altered IFN-alpha and IL-10 mRNA expression. (iii) Deletion of EHV-1 ORF1 also significantly increased chemokine expression and chemotaxis of monocytes and neutrophils in ERECs. Collectively, these results suggest a role for EHV-1 pUL56 in modulation of antigen presentation, cytokine expression and chemotaxis at the respiratory epithelium, but not in PBMC.


Asunto(s)
Células Epiteliales/inmunología , Herpesvirus Équido 1/inmunología , Enfermedades de los Caballos/inmunología , Mucosa Respiratoria/inmunología , Proteínas no Estructurales Virales/inmunología , Animales , Quimiocinas/genética , Quimiocinas/inmunología , Células Epiteliales/virología , Herpesvirus Équido 1/genética , Enfermedades de los Caballos/genética , Enfermedades de los Caballos/virología , Caballos , Interacciones Huésped-Patógeno , Inmunidad Innata , Leucocitos Mononucleares/inmunología , Leucocitos Mononucleares/virología , Mucosa Respiratoria/citología , Mucosa Respiratoria/virología , Proteínas no Estructurales Virales/genética
19.
Vet Microbiol ; 170(1-2): 28-38, 2014 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-24560592

RESUMEN

Equine herpesvirus-1 (EHV-1) is the cause of respiratory disease, abortion and myelitis in horses worldwide. Protection following infection or vaccination is typically incomplete and this lack of protective immunity is thought to be due to the immunomodulatory properties of EHV-1. EHV-1 immune modulation is likely initiated early in the infection cycle at the respiratory epithelium, but to date, immunity to EHV-1 at the epithelial cell barrier remains poorly characterized. Thus, the purpose of this study was to use a recently established primary equine respiratory epithelial cell culture (EREC) system to characterize innate immunity to EHV-1. Differentiated ERECs were inoculated with a neuropathogenic strain of EHV-1 and cytokine responses were determined using quantitative real-time polymerase chain reaction and ELISA. Major histocompatibility complex (MHC)-I and MHC-II as well as toll-like receptor (TLR)3 and TLR9 protein expression were examined using fluorescence activated cell-sorting analysis and chemotaxis of neutrophils and monocytes were evaluated using chemotaxis assays. Infection with EHV-1 resulted in increased expression of TLR3 and 9 as well as inflammatory cytokines (IL-1, TNF-alpha, IFN-alpha, and IL-6) and chemokines (IL-8, MCP-1). In contrast, EHV-1 infection caused marked decreases of MHC-I and MHC-II expression as well as a reduction in IFN-gamma production. In summary, these results provide an initial characterization of the early immune response to EHV-1 at the epithelial cell barrier and show that, while EHV-1 maintains induction of an inflammatory response, it causes an attenuation of IFN-gamma responses and down-modulates expression of MHC-I and MHC-II, which are important molecules for antigen presentation.


Asunto(s)
Infecciones por Herpesviridae/veterinaria , Herpesvirus Équido 1/inmunología , Enfermedades de los Caballos/inmunología , Interacciones Huésped-Patógeno/inmunología , Inmunidad Innata/inmunología , Mucosa Respiratoria/inmunología , Mucosa Respiratoria/virología , Animales , Células Cultivadas , Quimiocinas/genética , Quimiocinas/inmunología , Citocinas/genética , Citocinas/inmunología , Células Epiteliales/inmunología , Células Epiteliales/virología , Regulación de la Expresión Génica/inmunología , Infecciones por Herpesviridae/inmunología , Caballos , Internalización del Virus
20.
Vet Med Int ; 20102010 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-20847948

RESUMEN

Infection of dogs with canine influenza virus (CIV) is considered widespread throughout the United States following the first isolation of CIV in 2004. While vaccination against influenza A infection is a common and important practice for disease control, antiviral therapy can serve as a valuable adjunct in controlling the impact of the disease. In this study, we examined the antiviral activity of nitazoxanide (NTZ) and tizoxanide (TIZ) against three CIV isolates in vitro. NTZ and TIZ inhibited virus replication of all CIVs with 50% and 90% inhibitory concentrations ranging from 0.17 to 0.21 µM and from 0.60 to 0.76 µM, respectively. These results suggest that NTZ and TIZ are effective against CIV and may be useful for treatment of canine influenza in dogs but further investigation of the in vivo efficacy against CIV as well as the drug's potential for toxicity in dogs is needed.

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