Characterization of Mycobacterium tuberculosis Beijing isolates from the Mediterranean area.

BACKGROUND: The Beijing lineage of Mycobacterium tuberculosis is causing concern due to its global distribution and its involvement in severe outbreaks. Studies focused on this lineage are mainly restricted to geographical settings where its prevalence is high, whereas those in other areas are scarce. In this study, we analyze Beijing isolates in the Mediterranean area, where this lineage is not prevalent and is mainly associated with immigrant cases. RESULTS: Only 1% (N = 26) of the isolates from two population-based studies in Spain corresponded to Beijing strains, most of which were pan-susceptible and from Peruvian and Ecuadorian patients. Restriction fragment length polymorphism typing with the insertion sequence IS6110 identified three small clusters (2-3 cases). Mycobacterial interspersed repetitive unit-variable number tandem repeat typing (MIRU-15) offered low discriminatory power, requiring the introduction of five additional loci. A selection of the Beijing isolates identified in the Spanish sample, together with a sample of Beijing strains from Italy, to broaden the analysis context in the Mediterranean area, were assayed in an infection model with THP-1 cells. A wide range of intracellular growth rates was observed with only two isolates showing an increased intracellular replication, in both cases associated with contained production of TNF-alpha. No correlation was observed between virulence and the Beijing phylogenetic group, clustered/orphan status, or resistance. The Beijing strain responsible for extensive spread on Gran Canaria Island was also identified in Madrid, but did not lead to secondary cases and did not show high infectivity in the infection model. CONCLUSIONS: The Beijing lineage in our area is a non-homogeneous family, with only certain highly virulent representatives. The specific characterization of Beijing isolates in different settings could help us to accurately identify the virulent representatives before making general assumptions about this lineage.

Human monoclonal autoantibodies that react with both pancreatic islets and thyroid.

Transformation of human peripheral blood lymphocytes with Epstein-Barr virus and rapid screening on rat insulinoma cells by an enzyme-linked immunosorbent assay were used to identify monoclonal autoantibodies that reacted with human pancreatic islets. Six such monoclonal autoantibodies were isolated and cloned. All six also were found to react with human thyroid. It is concluded that lymphocytes able to make autoantibodies that react with both the pancreas and thyroid are common in the human B cell repertoire.

Mutations responsible for Mycobacterium tuberculosis isoniazid resistance in Italy.

SETTING: The incidence of tuberculosis (TB) and drug resistance in Italy is low compared to other countries. Mutations in several genomic regions of Mycobacterium tuberculosis are involved in the occurrence of isoniazid (INH) resistance. OBJECTIVE: To investigate the mutations responsible for INH resistance among Italian isolates of M. tuberculosis, to assess the feasibility of predicting drug resistance using a genetic approach. DESIGN: The mutations responsible for INH resistance were looked for in selected regions of genes katG, kasA and ndh and in the promoter regions of inhA and ahpC by nucleotide sequencing, and the results were compared with data reported in other studies. RESULTS: Prevalent INH resistance mutations were found at codon 315 of the katG gene and at position -15 of the inhA regulatory region (respectively 37.8% and 20.0% of isolates). The prevalence of mutations at position -24 of inhA, in ahpC, and in kasA ranged from 2.2% to 4.4%. No mutations were found in 35.6% of the isolates. CONCLUSION: The identification of INH resistance by genetic analysis of the selected regions may be inappropriate in areas with a low prevalence of TB, such as Italy, as the genetic mechanisms of resistance remain unidentified for approximately one third of the isolates.

Virus-induced thyroiditis.

Mice infected with reovirus type 1 developed a mild thyroiditis characterized by focal destruction of acinar tissue, infiltration of inflammatory cells, and autoantibodies to thyroglobulin and microsomal antigens. Thyroid involvement appears to be part of a more generalized virus-induced polyendocrine disease.

A simple method for the biochemical purification of Ro/SS-A antigen.

In the present study, Ro/SS-A antigen has been isolated from human spleen by a two-step procedure. In the first step most of the non-antigenic material was removed by means of ammonium sulphate precipitation and ion exchange chromatography. The final purification was obtained by passing the Ro/SS-A-containing fractions twice through a Mono Q ion exchange fast protein liquid chromatography (FPLC) column. The purified antigen showed identical immunoreactivity with crude material on CIE and was composed of two polypeptides with a molecular weight of approximately 60,000 and 55,000 respectively on SDS-PAGE, both reacting on Western blotting with a panel of anti-Ro/SS-A antisera. This system permits milligrams of highly purified antigen to be obtained from grams of human spleen.

A human monoclonal autoantibody isolated from a patient with infectious mononucleosis reactive with both self antigens and Epstein-Barr virus nuclear antigen (EBNA).

In order to investigate the mechanism(s) by which Epstein-Barr virus (EBV) induces the outcome of autoantibodies during infectious mononucleosis (IM), a human IgM (k) monoclonal antibody to cytoskeletal filaments of epithelial cells has been prepared by EBV transformation of peripheral blood B lymphocytes obtained from a patient with IM. The antibody was also found to react with smooth muscle of frozen sections of human stomach tissue by immunofluorescence, and with the Epstein-Barr nuclear antigen (EBNA) by an enzyme-linked immunosorbent assay. These findings demonstrate at the clonal level the epitope homology between host's cell antigens and EBV-encoded nuclear antigen, which might have relevance in EBV-induced autoimmunity.

Antibodies to histones in infectious mononucleosis.

A polyspecific human monoclonal (auto)antibody, isolated from a patient in the acute phase of infectious mononucleosis, was found to react with all subfractions (H1, H2A, H2B, H3 and H4) of histones. This finding prompted us to study the occurrence of antibodies to histones in sera of patients with infectious mononucleosis. It was found that IgM binding to histones was detectable both in control and patient sera; however, sera from patients showed binding values of IgM antibodies to histones significantly higher than those of healthy controls; moreover, both in control and patient groups anti-histone IgM activity was found to correlate with serum IgM concentration. These findings suggest that anti-histone IgM antibodies belong to the class of antibodies defined as "natural antibodies" and that their increase during infectious mononucleosis is due to Epstein-Barr virus-induced polyclonal B cell activation.

Epstein-Barr virus-transformed human B lymphocytes produce natural antibodies to histones.

To study the mechanism(s) responsible for the appearance of Epstein-Barr virus (EBV)-induced anti-histone autoantibodies, peripheral blood B lymphocytes from healthy donors were infected with EBV and the resulting lymphoblastoid cell lines were tested for secretion of antibodies reacting with histones. It was found that EBV-transformed cells produce IgM antibody reactive with histones and that the frequency of EBV-inducible circulating B lymphocytes that produce antibodies to histones is at least 10(-5). Moreover, in cultures of tonsillar lymphoid cells, the enrichment in CD5+ B lymphocytes increases the percentage of EBV-transformed cultures making anti-histone IgM antibodies. EBV may therefore, also in vivo, induce natural anti-histone antibody by polyclonal B-cell activation without any requirement of antigen to trigger antibody response.

Detection of B epitopes on the p24 gag protein of feline immunodeficiency virus by monoclonal antibodies.

Seven monoclonal antibodies were obtained after immunization of mice with purified sodium dodecyl sulfate (SDS)-disrupted feline immunodeficiency virus (FIV). Six antibodies specifically bound antigens in the cytoplasm of FIV-infected cells as determined by indirect immunofluorescence and reacted with FIV p24 gag gene product in immunoblots. One reacted positively with virus-infected cells, but failed to recognize FIV structural proteins by immunoblotting. Using competition binding studies, the anti-p24 monoclonals were shown to detect four distinct B-cell epitopes. Competition with sera of FIV-infected cats showed that such epitopes are immunogenic also in the natural host species.

Most potential linear B cell epitopes of Env glycoproteins of feline immunodeficiency virus are immunogenically silent in infected cats.

A battery of sixty-six 20- to 23-amino acid synthetic peptides, partially overlapping by 10-12 amino acids, spanning the entire sequence of the envelope (Env) glycoproteins of the Petaluma isolate of feline immunodeficiency virus (FIV-Pet), has been used to map Env linear B cell epitopes. By screening FIV-infected cat sera for anti-peptide reactivity, the existence of two immunodominat domains, namely the V3 region of the surface (SU) glycoprotein and the domain including the highly conserved sequence QNQFF of the transmembrane (TM) glycoprotein, was detected; antibody-binding sites were also mapped in the domain overlapping the cleavage site between SU and TM encompassing the V6 variable region. Moreover, at least two novel linear B epitopes, the former spanning residues 427M-H446 and the latter spanning residues 737N-N756 and likely representing a "type-specific" determinant, have been revealed. The battery of synthetic peptides was then used to immunize outbred Swiss mice in the attempt to reveal other potential sites of immunogenicity of the Env glycoproteins. Analysis of peptide-immunized mouse sera for anti-peptide reactivity revealed more numerous B cell epitopes, generally mapping in different peptides, as compared with those defined in the feline system. None of the mouse anti-peptide sera, however, proved neutralizing for FIV-Pet.

Effect of Escherichia-coli thioredoxin, a homolog to the adult T-cell leukemia-derived factor, on epstein-barr virus-transformed B-lymphocytes.

In order to investigate the role of autocrine growth factors on cell growth of Epstein-Barr virus (EBV)-transformed human B lymphocytes, we have studied the effect of E. coli recombinant thioredoxin (r-thioredoxin), a homologue of adult-T-cell leukemia-derived factor (ADF), on the cell growth of various human lymphoid cell lines, either EBV-positive or -negative. It was found that, in serum-free culture conditions, exogenous r-thioredoxin increases DNA synthesis in lymphoblastoid and Burkitt's cell lines, independently of EBV genome expression; moreover, the combined effect of r-thioredoxin and interleukin-I (IL-1) or IL-6 resulted in a marked increase in DNA synthesis in lymphoblastoid cells, but not in Burkitt's cell lines. Anti r-thioredoxin monoclonal antibodies were developed and used to test the possibility of interfering with r-thioredoxin-induced cell proliferation. It was found that the growth-promoting activity of r-thioredoxin was inhibited by an anti-r-thioredoxin monoclonal antibody in a dose-dependent manner in P3HR-1 cells, a Burkitt's lymphoma cell line harboring an EBNA-2-defective virus, but not in other lymphoid cell lines, thus indicating that target cells may play an active role in antibody-mediated thioredoxin neutralization.

Detection of an idiotope on a human monoclonal autoantibody by monoclonal anti-idiotypic antibody and its relationship to Epstein-Barr virus-induced autoimmunity.

We have recently described a human IgM monoclonal antibody (mAb), reactive with both self antigens, i.e., cytoskeleton filaments and smooth muscle, and Epstein-Barr virus (EBV)-induced nuclear antigen (EBNA), produced by EBV-transformed B lymphocytes isolated from a patient with infectious mononucleosis (IM). In order to achieve higher antibody secretion in culture supernatant, the mAb-producer cells were fused with ouabain-resistant mouse myeloma cells and a stable human-mouse heterohybrid, coded HY 5488, producing up to 80 micrograms/ml IgM mAb, was isolated after 4 cloning procedures. Purified HY 5844 mAb was used to immunize mice for the production of a murine anti-idiotypic mAb, which was used to probe the expression of the idiotope of HY 5488 mAb (Id 5488) in sera of IM patients and normal controls by ELISA. It was found that Id 5488 is expressed both in IM patients and normal controls, and that Id 5488 expression is significantly higher in IM patients' sera; furthermore, in IM sera a statistically significant correlation between Id 5488 expression and anti-cytoskeleton and anti-smooth muscle autoantibodies was found. It is suggested that at least part of EBV-induced IgM autoantibodies appearing during IM are secreted by B lymphocytes programmed to the production of "natural antibodies" bearing Id 5488-like idiotopes.

Activation of murine autoreactive b cells by interleukin 1-like factors released from synovial inflammatory cells of rheumatoid arthritis patients.

The effect of interleukin 1 (IL-1)-like factor(s), produced by cells isolated from the synovial fluids of rheumatoid arthritis (RA) patients, on an in vitro murine model of spontaneous autoimmunity, i.e., the development of plaque-forming cells (PFC) to bromelain-treated mouse red blood cells (Br-MRBC) in mouse peritoneal cell (PC) cultures, has been investigated. It has been found that IL-1-containing culture supernatants from cells isolated from joint fluids of RA patients, as well as recombinant IL-1, determine a marked increase in anti-Br-MRBC PFC development. Moreover, factor(s) of 10-20 KD molecular weight, with IL-1-like biological activity, capable of increasing the anti-Br-MRBC PFC development in mouse PC cultures, have been demonstrated in joint fluids from RA patients. The finding that synovial inflammatory cells produce factors that activate autoreactive B cells further supports the role of autoimmunity in the pathogenesis of rheumatoid arthritis, as self-perpetuing disorder.

Epstein-Barr virus-transformed B lymphocytes produce low molecular mass molecules with autocrine growth factor and competence factor activity.

A human Epstein-Barr virus (EBV)-positive lymphoblastoid B cell line, named BA-D10-4, produces a factor of a molecular mass less than 10 kDa that promotes cell proliferation of both BA-D10-4 cells and other human T or B lymphoid cell lines, either EBV-positive or -negative. The factor synergizes with higher molecular mass autocrine growth factors and makes both BA-D10-4 cells and B cell lines from Burkitt's lymphoma, but not cells from T cell leukemia, more responsive to interleukin-1 and interleukin-6. Therefore, this low molecular mass factor seems to be an autocrine growth factor per se and to have the characteristics of a competence factor.

Comparison of three restriction endonucleases in IS1245-based RFLP typing of Mycobacterium avium.

IS1245-based restriction fragment length polymorphism (RFLP) analysis has been proposed recently for molecular typing of Mycobacterium avium isolates. As there is no standardised method with respect to the optimal restriction enzyme, three restriction endonucleases were tested for analysis of 17 human isolates. The restriction endonucleases, selected on the basis of the physical maps of IS1245 and of the highly homologous IS1311, were BsaAI, that cleaves IS1245, PvuII, that cleaves IS1311, and NruI, that cleaves both IS1245 and IS1311. All the restriction endonucleases yielded polymorphic and complex RFLP patterns. However, BsaAI- and NruI-generated bands were more evenly distributed and easier to detect than PvuII-generated bands, most of which clustered in a narrow zone of the fingerprint. In some cases, DNA digestion with BsaAI or NruI yielded probe-specific restriction fragments of molecular size lower than expected. Moreover, digestion with NruI, which was expected to generate the highest numbers of bands in all the isolates, yielded fewer bands than were obtained with BsaAI or PvuII in 14 and 5 isolates, respectively. These findings might suggest the existence of unidentified IS1245-related insertion element(s) in M. avium isolates. Computer analysis of the IS1245-based RFLP patterns of M. avium isolates showed that the restriction endonucleases were capable, although with minor differences, of defining distinct banding patterns and clusters of identical or highly related isolates, thus confirming IS1245-based RFLP analysis as a useful technique for epidemiological studies.

PCR ELISA for the quantitative detection of Epstein-Barr virus genome.

A highly sensitive and nonradioactive microplate hybridization assay for the detection of Epstein-Barr virus (EBV)-specific polymerase chain reaction (PCR) product was developed. The PCR product is labelled by adding digoxigenin-dUTP directly to the reaction mixture and, after denaturation, is captured by a microtitre plate coated with an extravidin-linked biotinylated probe. Captured products are reacted with a peroxidase-conjugated anti-digoxigenin antibody and detected using tetramethylbenzidine. The assay detected less than ten EBV genomes in a background EBV-negative DNA of 0.75 microg and, when tested on clinical samples, it was able to define the viral load in throat washings of patients with acute infectious mononucleosis, immunosuppressed patients with HIV infection, and rare normal individuals who shed the virus in the oropharynx.

Detection of feline immunodeficiency virus p24 antigen and p24-specific antibodies by monoclonal antibody-based assays.

A panel of monoclonal antibodies (mAbs) detecting distinct B-cell epitopes on p24 core viral protein of feline immunodeficiency virus (FIV) were employed to develop immunoassays to measure p24 concentration in culture and serum samples, to localize p24 in FIV-infected cells and tissues, and to detect anti-p24 antibodies in cat sera. In its optimized configuration the p24 capture assay detected as little as 0.25 ng/ml of protein. The assay was found at least as sensitive as the reverse transcriptase activity assay in FIV-infected lymphocyte cultures and proved capable of detecting p24 antigen in acid pretreated sera from a high proportion of FIV-infected cats. The mAbs were also successfully used to detect the p24 antigen in permeated FIV-infected cells by flow cytometry and in tissue sections from FIV-infected cats by immunohistochemical staining. Anti-p24 antibodies in FIV-infected cat sera were assayed by a competitive capture ELISA which readily identified occasional false positive results provided by a standard ELISA using purified whole FIV-coated wells.

Isolation of a novel sequevar of Mycobacterium flavescens from the synovial fluid of an AIDS patient.

This report describes the characterisation of a mycobacterium involved in a case of septic arthritis in an AIDS patient that was treated successfully with specific anti-mycobacterial drugs. The biochemical and cultural features, and the mycolic acid pattern as assessed by high-performance liquid chromatography, were fully compatible with the isolate being Mycobacterium flavescens. However, the isolate's 16S rDNA sequence differed by five nucleotides from the two known sequevars of M. flavescens, thus indicating that this isolate belonged to a new 16S rDNA sequevar.

Potential role of the Epstein-Barr virus in systemic lupus erythematosus autoimmunity.

OBJECTIVE: To investigate the possibility that Epstein-Barr virus (EBV), the agent of infectious mononucleosis (IM), may play a role in systemic lupus erythematosus (SLE). METHODS: EBV was searched for by PCR and by culture isolation in oropharyngeal lavage fluids of 15 SLE patients and, as controls, in 13 IM patients and in 28 healthy individuals with past EBV infection. Computer analysis was performed to select an antigenic domain of the virus-encoded nuclear antigen EBNA-2, in order to set up a synthetic peptide-based immunoassay. IgG antibodies to a 20-amino acid synthetic peptide derived from the selected domain of EBNA-2 (354GRGKGKSRDKQRKPGGPWRP373) were titrated in the sera of 20 SLE patients, 24 IM patients and 12 healthy subjects. RESULTS: EBV type 1 DNA was demonstrated by PCR in the oropharyngeal secretions of 8 SLE patients and the virus was isolated from 6 DNA-positive specimens. Moreover, 50% of the patients with SLE and 100% of the patients in the acute phase of IM, but none of the EBV-seropositive normal individuals, produced IgG antibodies to the EBNA-2-derived synthetic peptide. Computer analysis revealed a high degree of homology between the EBNA-2 354GRGKGKSRDKQRKPGGPWRP373 sub-sequence and the antigenic C-terminal domain 101GRGRGRGRGRGRGRGGPRR119 of the SmD1 ribonucleoprotein, a target of autoantibodies in a portion of SLE patients. CONCLUSION: We suggest the possibility that EBV may establish a persistent infection at least in a certain number of SLE patients. The antibodies elicited by the viral antigen EBNA-2 may cross-react with SmD1, thus indicating a role of EBV-specific immune responses in the outcome of SmD1 autoantibodies in SLE patients.

Genes of Mycobacterium tuberculosis H37Rv downregulated in the attenuated strain H37Ra are restricted to M. tuberculosis complex species.

By comparing gene expression of virulent Mycobacterium tuberculosis H37Rv and attenuated strain H37Ra, we previously detected six genes that appear to be markedly downregulated in the attenuated strain compared with the virulent one. Three of these genes, i.e. Rv1345, Rv2770c, and Rv0288, code for proteins that can be predictively associated to immunological or pathogenetic aspects of M. tuberculosis infection; the other genes, i.e. Rv2336, Rv1320c, and Rv2819c, code for proteins with unknown functions (Rindi et al., 1999). In this paper we searched for the above mentioned genes in Pvu II-digested genomic DNA of a number of mycobacterial species by southern blot analysis employing PCR-generated probes in high-stringency conditions. Hybridization signals were only found in species belonging to the M. tuberculosis complex, i.e., M. tuberculosis, M. bovis, including the BCG strain, and M. microti, but not in other mycobacterial species, including M. avium, M. intracellulare, M. malmoense, M. xenopi, M. kansasii, M. simiae, M. marinum, M. scrofulaceum, M. gordonae, M. fortuitum, and M. smegmantis. These results indicate that genes Rv1345, Rv2770c, Rv0288, Rv2336, Rv1320c, and Rv2819c are associated with the most virulent mycobacteria and further support their potential role in M. tuberculosis virulence.