Intestinal microsporidiosis in African skink Mabuya perrotetii.

Intestinal microsporidiosis was documented by detecting abundant slightly curved spores (2.9 x 1.2 microns) in the faeces of five of twelve skinks Mabuya perrotetii Duméril et Bibron, 1839 that originated from Ghana. Clinically, the microsporidiosis was characterized by decreased appetite, diarrhea, and weight loss. Histopathological changes consisted of villous atrophy, blunting of mucosa and flattening of individual epithelial cells in the large intestine. The ultrastructure of microsporidian spores was consistent with an Encephalitozoon species. The PCR-RFLP assay and the heteroduplex mobility shift analyses were used to verify that the skink microsporidian is a species of the genus Encephalitozoon Levaditi, Nicolau et Schoen, 1923 and indicate that this microsporidian is not E. hellem, E. intestinalis or a strain of E. cuniculi. The microsporidia in African skink represent an Encephalitozoon species morphologically identical to Encephalitozoon lacertae Canning, 1981.

Encephalitozoon hellem in budgerigars (Melopsittacus undulatus).

Microsporidiosis with concurrent megabacteriosis in budgerigar (Melopsittacus undulatus) chicks contributed to significant economic floss in a commercial pet bird aviary in Mississippi. Three budgerigar chicks, 1-2 weeks old, from the aviary were necropsied. Microscopic lesions in the chicks consisted of heavy infection of enterocytes with microsporidia (2/3; autolysis precluded critical evaluation of the intestine of chick No. 2), multifocal hepatic necrosis and inflammation with intralesional microsporidia (1/3), spherical clusters of microsporidia in the hepatic sinusoids in the absence of inflammation (1/3), and gastric megabacteriosis (3/3). The ultrastructure of the microsporidian spores was consistent with an Encephalitozoon species. The polymerase chain reaction and Southern blot analysis were used to identify the microsporidian as Encephalitozoon hellem, an organism that has only been identified in humans. Encephalitozoon hellem causes keratoconjunctivitis and respiratory infections in humans with acquired immunodeficiency syndrome. This report presents the first confirmed case of microsporidiosis in budgerigars. The finding of E. hellem in pet birds may be important in elucidating the epidemiology of human infections with this organism.

Encephalitozoon cuniculi microsporidiosis: infection of the brain, heart, kidneys, trachea, adrenal glands, and urinary bladder in a patient with AIDS.

A female AIDS patient, dying with widely disseminated Encephalitozoon cuniculi microsporidiosis, cytomegalovirus (CMV) disease, and Pneumocystis carinii infection, is described. Indirect immunofluorescent antibody staining studies and molecular analyses identified the microsporidian as the dog strain of E. cuniculi. Autopsy revealed necrotizing microsporidiosis of the adrenal glands and kidneys, with lesser involvement of the brain, heart, trachea, urinary bladder, spleen, and lymph nodes. Cellular targets included macrophages, epithelium, endothelium, and cardiac myocytes. Spore detection was enhanced by Gram-staining, polarization, and fluorescence chitin stains. Central nervous system microglial nodules were present and either contained microsporidia, CMV, or no identifiable pathogen. CMV disease was most severe in the central nervous system, trachea, adrenal glands, and colon, whereas the Pneumocystis carinii infection was focal in the lungs, lymph nodes, and spleen. This is the first demonstration of Encephalitozoon microsporidiosis of the brain, heart, and adrenal glands in a patient with AIDS. E. cuniculi should be included in the differential diagnosis of disseminated opportunistic infections in patients with AIDS.

A microsporidian isolated from an AIDS patient corresponds to Encephalitozoon cuniculi III, originally isolated from domestic dogs.

The ribosomal DNA internal transcribed spacer (ITS) region of a recently cultured human Encephalitozoon cuniculi isolate was analyzed by gene amplification and DNA sequencing. Restriction endonuclease digestion (FokI) and double-stranded DNA heteroduplex mobility shift analysis were performed to determine their utility for strain differentiation. The human E. cuniculi isolate was identical to E. cuniculi III, which had been isolated only from domestic dogs until now. The patient providing the isolate owned a pet dog, but no microsporidia were detected in the pet's urine.

Diagnosis of disseminated microsporidian Encephalitozoon hellem infection by PCR-Southern analysis and successful treatment with albendazole and fumagillin.

A 37-year old AIDS patient presented with foreign body sensation. Microsporidia were detected in smears from a conjunctival swab and urine sediment stained with calcofluor and a modified trichrome blue stain and by indirect fluorescent-antibody staining with murine polyclonal antiserum raised against Encephalitozoon hellem. This antiserum cross-reacted with other Encephalitozoon species, so PCR was performed to amplify the microsporidian ribosomal DNA (rDNA) with pan-Encephalitozoon primers. The PCR DNA products from the urine and conjunctival clinical specimens, along with the tissue culture-derived microsporidian controls, were assayed by Southern analysis with oligonucleotide probes specific for Encephalitozoon cuniculi, E. hellem, and Encephalitozoon (Septata) intestinalis. The PCR product amplified from the urine specimen hybridized with the E. hellem probe only, while insufficient DNA was amplified from the conjunctiva specimen for detection by Southern analysis. For corroboration of the PCR-Southern analysis results, aliquots of the urine and conjunctiva specimens were seeded onto RK-13 cell monolayers. The rDNA extracts of the cultured microsporidia were amplified by PCR with pan-Encephalitozoon primers, and the PCR DNA products were subjected to digestion with restriction endonuclease FokI. The amplified rDNA of both the urine and conjunctiva isolates generated digestion patterns that were identified to the E. hellem PCR rDNA digestion pattern. In addition, double-stranded heteroduplex mobility shift analysis with these PCR products indicated that the urine and conjunctiva isolates were identical to each other and to E. hellem. The patient was treated with albendazole and topical fumagillin and responded rapidly, with no recurrence of ophthalmologic signs. The results of this study demonstrate that PCR-Southern analysis provides a basis for distinguishing E. cuniculi, E. hellem, and E. intestinalis in clinical specimens.

Characterization of Encephalitozoon (Septata) intestinalis isolates cultured from nasal mucosa and bronchoalveolar lavage fluids of two AIDS patients.

Microsporidia are obligate intracellular protozoan parasites that can cause opportunistic infections in AIDS patients. Species from five genera of microsporidia are presently known to infect man. One species, Septata intestinalis originally was detected in stool specimens of individuals with chronic diarrhea and subsequently was found to disseminate to the kidneys, lungs, and nasal sinuses. This organism has since been reclassified as Encephalitozoon and in this study, we report the culture of Encephalitozoon intestinalis from a bronchoalveolar lavage specimen and a nasal mucus aspirate of two AIDS patients living in the USA. The bronchoalveolar and nasal microsporidian isolates grew in several continuous cell lines including RK-13, MDCK, HT-29, Caco-2, Vero, and I047. Transmission electron microscopy of the clinical and cell culture specimens revealed that the new isolates appeared to be E. intestinalis based on morphology and growth of organisms in septated membrane-bound parasitophorous vacuoles. The new E. intestinalis isolates were characterized and compared with the first isolated E. intestinalis that was cultured from stool to confirm their identity and to determine if there existed any minor differences, as seen in the closely related Encephalitozoon cuniculi strains. By the methods of sodium dodecyl sulfate-polyacrylamide gel electrophoresis staining for proteins and carbohydrates, Western blot immunodetection, and polymerase chain reaction-based methods with restriction endonuclease digestion, double-stranded DNA heteroduplex mobility shift analysis, and DNA sequencing of the ribosomal DNA intergenic spacer region, the new isolates were identical to each other and to the reference isolate of E. intestinalis. In addition, with any of these methods, the E. intestinalis organisms could be distinguished from the three E. cuniculi strains, Encephalitozoon hellem, and Vittaforma corneae, which is important for diagnostics, therapeutic strategies, and epidemiology.

Comparison of three staining methods for detecting microsporidia in fluids.

Calcofluor white 2MR, modified trichrome blue, and indirect immunofluorescent antibody (IFA) staining methods were evaluated and compared for detecting microsporidia in stool. Serial 10-fold dilutions of Encephalitozoon (Septata) intestinalis were prepared in three formalinized stool specimens or in Tris-buffered saline. Ten-microliter aliquots were smeared onto glass slides, fixed with methanol, stained, and read by at least three individuals. The results indicated that the calcofluor stain was the most sensitive method, required approximately 15 min to perform, but did generate some false-positive results due to similarly staining small yeast cells. The modified trichrome blue stain was nearly as sensitive as the calcofluor stain and allowed for easier distinction between microsporidia and yeast cells. This stain, however, required approximately 60 min to perform. The IFA stain with polyclonal murine antiserum against E. intestinalis was the least sensitive of the methods and required approximately 130 min to perform. The lower limit of detection with the calcofluor and modified trichrome stains was a concentration of about 500 organisms in 10 microliters of stool to detect one microsporidian after viewing 50 fields at a final magnification of x1,000. Reliability was also addressed by use of 74 stool, urine, and intestinal fluid specimens, 50 of which were confirmed for the presence of microsporidia by transmission electron microscopy (TEM). All TEM-positive specimens were detected by calcofluor and modified trichrome blue staining. Ten specimens were not detected by the IFA stain. An additional seven TEM-negative specimens were read positive for microsporidia with the calcofluor stain, and of these, five also were read positive with the modified trichrome blue stain. The resulting diagnostic paradigm was to screen specimens with the calcofluor stain and to confirm the results with the modified trichrome stain. IFA, which was less sensitive, may become useful for microsporidian species identification as specific antibodies become available.

Identification and characterization of three Encephalitozoon cuniculi strains.

Microsporidia are increasingly recognized as causing opportunistic infections in immunocompromised individuals. Encephalitozoon cuniculi is probably the most studied mammalian microsporidian that infects insects and mammals, including man. In this study, 8 E. cuniculi isolates were compared and were found to fall into 3 strains. Strain type I includes the rabbit type isolate, as well as isolates from an additional rabbit, a dwarf rabbit, and a mouse. Strain type II includes 2 murine isolates and strain type III includes 2 isolates obtained from domestic dogs. By SDS-PAGE, the 3 strains differ primarily in the molecular weight range of 54-59 kDa where strain type I displays an apparent broad singlet at 57 kDa, strain type II displays an apparent doublet at 54 and 58 kDa, and strain type III displays an apparent broad band at 59 kDa. Antigenic differences were detected in the molecular weight regions of 54-58 kDa as well as 28-40 kDa by Western blot immunodetection using murine antisera raised against E. cuniculi, Encephalitozoon hellem, and the Encephalitozoon-like Septata intestinalis. Polymerase chain reaction (PCR) products containing only small subunit rDNA sequences from the different E. cuniculi isolates formed homoduplexes whereas PCR products containing intergenic rRNA gene sequences formed heteroduplexes in mobility shift analyses. Fok I digestion of the PCR products containing the intergenic rRNA gene region resulted in unique restriction fragment length polymorphism patterns, and DNA sequencing demonstrated that in the intergenic spacer region, the sequence 5'-GTTT-3' was repeated 3 times in strain type I, twice in strain type II, and 4 times in strain type III. This study indicates that there exist at least 3 E. cuniculi strains which may become important in the epidemiology of human E. cuniculi infections. Furthermore, as additional E. cuniculi isolates are characterized, these strains will be named or reclassified once the criteria for taxonomy and phylogenetic tree construction for microsporidia become better defined.

Computational studies of the chiral separations of three N-acyl-1-aryl-1-aminoethanes on an (R)-N-dinitrobenzoylphenylglycine stationary phase.

The chiral chromatographic separations of three N-acyl-1-aryl-1-aminoethanes on silica modified with (R)-N-dinitrobenzoylphenylglycine-N'-propylamide have been modeled by use of molecular mechanics. Formyl groups were substituted for the nitro groups, and a methyl group was tested as a replacement for the propyl group. With the propyl group, the correct elution order was obtained for the two pairs that had the largest alpha-values, and the third pair had a calculated alpha-value very close to unity. The relative sizes of the alpha-values were correctly predicted for all three. Substitution of methyl for propyl gave data that did not agree as well with the experimental values, thereby confirming the important role of the spacer in these separations.

Molecular modelling of structural changes which affect chromatographic selectivity in chiral separations.

A molecular mechanics program, MM2, was utilized to model two chromatographic systems. It was first used to locate the most stable conformers of homologs of two derivatized silica stationary phases, N-tert-butyloxycarbonyl-d-valine-N'-n-butylamide and N-tert-butyloxycarbonyl-d-alanine-N'-n-butylamide, and also of the enantiomers of 2,2,2-trifluoroanthrylethanol (TFAE). The most stable (R) and (S) conformers of TFAE were then docked with those of the amino-acid derivatives. The calculations correctly predicted the elution order as well as the relative resolving powers of the two bonded phases. Replacing the n-butyl "spacer" chain with a methyl, ethyl, or n-propyl group confirmed the importance of chain length. Calculations involving the n-propyl spacer correctly predicted the elution order of enantiomers of TFAE on both phases as well as the relative enantiomeric resolving power of the two stationary phases. Similar calculations involving either ethyl or methyl spacers on the alanine derivative did not make correct predictions, thereby confirming the important influence of the spacer on fractionation of enantiomers.

Chiral separations of amino acids using di- and tri-peptides for zwitter-ion pair chromatography.

Separations of tryptophan enantiomers by zwitter-ion pair chromatography using small peptides as ion-pairing agents have been studied with emphasis upon the nature of the peptide, the mobile phase composition, and the nature of the chromatographic support. In addition, this procedure has been extended successfully to two other amino acids.

Elastomeric impression materials: effect of bulk on accuracy.

Impression trays were fabricated providing 2, 4, and 6 mm spaces to determine the stability and accuracy of nine elastomeric impression materials on a simulated full crown preparation steel die. The interface space of 2 mm produced the most accurate impressions for all of the materials tested. All impression materials except one fell within the revised American Dental Association Specifications. The clinical-type tests, using castings on dies poured from these materials, corroborated the acceptance of those materials and techniques exhibiting the least dimensional change.

Pyrolysis gas chromatography of enzymes.

Pyrolysis gas chromatography (PGC) has been shown to be useful for differentiating enzymes. The enzymes alpha-chymotrypsin, lactate dehydrogenase, catalase, and urease were easily "fingerprinted" on a 1.8 m 0.5% Carbowax 20 M column. Also, in some cases, isoenzymes of lactate dehydrogenase could be distinguished. Based on the pyrolyses of the free aromatic amino acids, four major enzyme pyrolysis peaks were tentatively identified as organic compounds derived from tyrosine and tryptophan. The use of a nitrogen-selective detector in conjunction with the FID and measurement of peak retention times by computer on three different types of columns permitted confirmations of peak identity.