An animal model for acute and persistent Epstein-Barr virus infection.

Epstein-Barr virus (EBV) is a human lymphocryptovirus that causes infectious mononucleosis, persists asymptomatically for life in nearly all adults, and is associated with the development of B cell lymphomas and nasopharyngeal carcinomas. A highly similar rhesus lymphocryptovirus naturally endemic in rhesus monkeys was used to orally infect naïve animals from a pathogen-free colony. This animal model reproduced key aspects of human EBV infection, including oral transmission, atypical lymphocytosis, lymphadenopathy, activation of CD23(+) peripheral blood B cells, sustained serologic responses to lytic and latent EBV antigens, latent infection in the peripheral blood, and virus persistence in oropharyngeal secretions. This system may be useful for studying the pathogenesis, prevention, and treatment of EBV infection and associated oncogenesis.

Tap-1 and Tap-2 gene therapy selectively restores conformationally dependent HLA Class I expression in type I diabetic cells.

Genetic susceptibility to many autoimmune diseases, including insulin-dependent diabetes mellitus (IDDM) is statistically linked to the HLA class II region of chromosome 6. However, a distinguishing feature of patients with HLA class II-linked autoimmune disease is an abnormally low density of conformationally correct, self-peptide filled HLA class I molecules on the lymphocyte cell surface. The transporters associated with antigen processing (Tap-1 and Tap-2) are essential for normal class I expression and presentation of intracellular peptides, and these genes are located within the HLA class II region. The aims of this project were to determine if Tap genes could be implicated in the defective class I expression associated with IDDM by using a novel Epstein-Barr virus (EBV)-mediated gene transfer system to introduce a cloned, normal Tap-2 or Tap-1 gene into B cell lines from normal and IDDM patients and analyzing the effect on conformationally dependent class I expression. The results show that Tap-2 gene transfer in B cells from 40% of randomly selected IDDM patients increased expression of conformationally correct, cell-surface class I molecules to levels comparable with similarly treated B cells from normal control individuals. B cells from another 40% of IDDM patients responded to Tap-1 gene transfer. These effects were specific because B cells from normal individuals did not respond to Tap-1 or Tap-2 gene transfer with increased class I expression, and B cells from IDDM patients responding to Tap-2 gene transfer did not respond to Tap-1 gene transfer and vice versa. Thus, these complementation studies identify distinct, non-overlapping subsets of IDDM patients whose class I defect in B cells can be reversed by Tap-1 or Tap-2 gene transfer. The increase in class I expression induced by Tap gene transfer is associated with a reduction in the number of peptide-empty class I molecules as demonstrated by the response to exogenous peptide loading. Furthermore, the increase in self-peptide filled class I molecules induced by Tap gene transfer into B cells from IDDM patients is associated with restored antigen presentation to autologous T cells. These studies conclude that Tap gene dysfunctions may contribute to the defect in class I phenotype and antigen presentation demonstrated by IDDM patients. Defective presentation of self-peptides by antigen presenting cells can lead to the failed T cell education and tolerance to self antigens evident in IDDM. These studies functionally identify HLA class II region genes that contribute to an immunologic defect in IDDM.

Familial and acquired paroxysmal dyskinesias. A proposed classification with delineation of clinical features.

On a clinical basis the paroxysmal dyskinesias can be classified into two distinct categories--familial and acquired. The former begins in childhood and the dyskinesia may or may not be induced by sudden movements (kinesigenic or nonkinesigenic forms). In the familial kinesigenic form, the movements are brief, usually occur daily, and respond readily to anticonvulsants. This form has an autosomal dominant or recessive mode of inheritance. In the familial nonkinesigenic form, the movements are of longer duration, occur less frequently, and rarely respond to anticonvulsants. This form has a clear autosomal dominant mode of inheritance. The etiology is obscure. The acquired form of paroxysmal dyskinesia has a later onset and is an expression of an underlying neurological or metabolic disease. Some cases of acquired paroxysmal dyskinesia are manifestations of unusual forms of epilepsy. In these cases the differential diagnosis may be extremely difficult and must be based on EEG findings during an ictal episode.

Effects of molecular entanglements during electrospray of high molecular weight polymers.

Concentration-dependent bimodal size distributions (comprised of single-molecule particles and multimolecule clusters) observed by microscopic examination of particles collected during electrospray (ES) of dilute solutions of high molecular weight polymers suggest that chain entanglement can interfere with the droplet subdivisions believed to be intrinsic to the electrospray process. The feasibility of such interference is discussed in the context of the spray model of Kebarle, along with its potential impact on the ES mass spectrometry of macromolecules.

Immune response of humans to the circumsporozoite protein of Plasmodium falciparum: limited T cell response to the immunodominant central repeat region.

Most adults in highly malarious areas have antibodies to the repeat region of the circumsporozoite protein of Plasmodium falciparum. To determine if a T cell epitope on the repeat region stimulated T cell help for this antibody, we used R32tet32, a recombinant construct derived from the repeat region of the circumsporozoite protein of P. falciparum, to stimulate in vitro mononuclear cells from residents of an area hyperendemic for malaria. Three groups differing in the length of time they had resided in a malarious area were studied. The percentage of individuals in each group who had positive antibody responses to R32tet32 increased with increased exposure to malaria. However, antibody positivity was not correlated with in vitro lymphocyte proliferation responses to the antigen. Lymphocytes from 79% of the individuals showing serum antibodies to R32tet32 failed to respond in a lymphocyte transformation assay, suggesting that T cell helper activity in these individuals was based upon the recognition of a T cell epitope not located within this peptide.

Borrelia burgdorferi in eastern Virginia: comparison between a coastal and inland locality.

In Virginia, Borrelia burgdorferi was more prevalent in a site along the Atlantic Ocean, near Maryland, than in an inland site near Williamsburg and Yorktown. At the coastal site on Assateague Island, B. burgdorferi was isolated from 4.2% of 475 animals sampled, including four species of small mammals. Serologic tests indicated that 25-37% of the small rodents assayed had been exposed to B. burgdorferi. Immunofluorescence antibody assays specific for B. burgdorferi showed spirochete infection in Ixodes scapularis and Dermacentor variabilis but not in other species of ticks also examined from this site. At another coastal site (Parramore Island), no evidence of Peromyscus leucopus was found, no immature specimens of I. scapularis were collected, and no isolations were made from numerous raccoons or small mammals sampled. Borrelia burgdorferi infection was found in one I. cookei nymph, but not in numerous specimens of I. scapularis or other tick species from this locality. At the inland site between Williamsburg and Yorktown, B. burgdorferi was isolated from two small mammal species and antibodies to B. burgdorferi were found in only 7-10% of the small mammals sampled. Ixodes scapularis were less abundant at this locality than at the Assateague Island site. Borrelia burgdorferi spirochetes were found in I. scapularis and a single nymph of Amblyomma americanum, but not in any of numerous specimens of four other species. Infection with B. burgdorferi was found in 20% of unfed adult I. scapularis from vegetation, but in only 0.2% of numerous adults from hunter-killed deer. Infection in immature ticks was much lower than at Assateague Island. Borrelia burgdorferi may be more prevalent along the Atlantic coast than in inland areas. Isolations, seroprevalence, immature I. scapularis densities, and spirochete infection rates in ticks were higher at the Assateague Island site than the Williamsburg/Yorktown site. Consequently, the risk of human exposure to Lyme disease may be higher in some parts of the coastal area than elsewhere in Virginia. Overall, B. burgdorferi is less intense in Virginia than in the northeastern United States.

Age-dependent acquired protection against Plasmodium falciparum in people having two years exposure to hyperendemic malaria.

An epidemiologic study of susceptibility to frequent and high-grade parasitemia by Plasmodium falciparum revealed that age-dependent acquired protection developed within a two-year period of exposure to hyperendemic infection pressure. The study was conducted in a single village in northeastern Irian Jaya, Indonesia, where half the residents were native to the province and the other half were transmigrants from areas of Java, where there is little or no malaria transmission. Five separate measures of susceptibility to the asexual parasitemia of falciparum malaria were derived from results of four months of biweekly surveillance of 240 volunteers. Increasing protection as a function of age among the Javanese was a consistent pattern among the five estimates of susceptibility. These age-dependent functions of protection were quantitatively parallel to those among life-long residents of Irian Jaya. When humoral immune responsiveness to ring-infected erythrocyte surface antigen (RESA) was measured by ELISA, a similar pattern emerged; the relative level of antibody to RESA increased as parallel functions of age among the two subpopulations. Acquired protective immunity against P. falciparum was not the cumulative product of many years of heavy exposure to antigen. Instead, the full benefit of protection appeared to develop quickly. The degree of protection was governed by recent exposure and age, independent of history of chronic heavy exposure.

Malaria vaccine study site in Irian Jaya, Indonesia: Plasmodium falciparum incidence measurements and epidemiologic considerations in sample size estimation.

Malaria epidemiologic and entomologic studies were performed during both the high transmission and low transmission seasons to characterize the Plasmodium falciparum malaria transmission at a proposed malaria vaccine trial site in Irian Jaya, Indonesia. The study population consisted of two subsets: native Irianese men with lifelong exposure to malaria and transmigrants who arrived from a nonmalarious area 2.5 years before the start of the study. All subjects received a radical cure for malaria and were then monitored weekly by blood film. Both P. falciparum malaria attack rates and incidence densities were calculated; transmigrants had a significantly higher rate (P = 0.003) than the Irianese during the low transmission season study (20-weeks long) but not during the high transmission season study (12-weeks long). Lack of exposure-induced immunity left the transmigrants at a minimum 17-25% greater relative risk of becoming parasitemic compared with the Irianese during the low transmission season study. During the high transmission season study, 50% of the transmigrants were P. falciparum positive by week 6 and 50% of the Irianese by week 9. During the low transmission season, 50% of the transmigrants were positive by week 10 and 43% of the Irianese were positive by week 17. Entomologic studies showed that Anopheles koliensis was the predominant vector (> 98% of anopheline catch). Entomologic inoculation rates for P. falciparum were 0.018 and 0.39 infective bites/person/night for the low and high transmission seasons, respectively. New P. vivax cases represented between 16% and 42% of all initial malaria cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Immune modulation of human B lymphocytes by gene transfer with recombinant Epstein-Barr virus amplicons.

We described previously a novel mode of gene transfer by infection of human B lymphocytes with recombinant Epstein-Barr virus (EBV) amplicons. This system was explored for its potential use in expressing various recombinant genes, including the cytokine IL-4, the HIV envelope glycoprotein (gp120) and a suicide and gag gene. Recombinant genes were present as multiple copy episomes and stable, high level recombinant gene expression could be detected by antigenic and functional assays. Amplicon-infected B cells secreted high levels of recombinant cytokine and efficiently presented recombinant antigens through classes I and II MHC-restricted antigen processing pathways. Thus, recombinant EBV amplicons can be used to express components of the immune system or heterologous genes for immune recognition in human B cells. Combining gene transfer with EBV infection may provide unique advantages for in vitro and in vivo gene transfer.

Recurrent Cushing's disease: successful treatment by pituitary irradiation or trans-sphenoidal hypophysectomy in two cases.

Two patients developed recurrent Cushing's disease 3 and 7 years after total bilateral adrenalectomy. In the first patient, a 65-year-old man, the adrenal tissue was not localized by radioactive cholesterol scintigraphy. Plain x-ray films of the skull revealed a normal sella turcica. Although clinical improvement resulted from the discontinuation of cortisone replacement therapy, urinary free cortisol levels remained elevated and the patient was treated with pituitary irradiation. Serum and urine cortisol levels gradually returned to normal. Four years after irradiation, the plasma adrenocorticotropic hormone (ACTH) concentration was elevated, but tomography of the sella turcica and urinary cortisol excretion remained normal. The second patient, a 41-year-old man, displayed elevated ACTH levels and x-ray evidence of a pituitary tumor at the time of recurrent Cushing's disease. After trans-sphenoidal hypophysectomy, the hypercortisolism abated and the ACTH concentration returned to normal. Adrenal scintigraphy frequently locates cortisol-secreting tissue in patients with recurrent Cushing's disease, and some investigators suggest treatment by the surgical removal of the adrenal remnant. Although the etiology of Cushing's disease is controversial, current evidence suggests that most cases result from ACTH-producing pituitary tumors. We suggest, therefore, that the anterior pituitary gland may be a more suitable target than the adrenal remnant for the treatment of recurrent Cushing's disease.

Comparison of the effectiveness of two formulations of deet against Anopheles flavirostris.

The effectiveness of 2 formulations of deet (diethylmethylbenzamide) was tested against the principal vector of malaria in the Philippines, Anopheles flavirostris. A new extended duration repellent formulation (EDRF) was compared with the standard military-issue liquid formulation. The EDRF was significantly more effective than the liquid formulation between 6 and 12 h post-application. There was no difference between the 2 formulations in the first 6 h following application, or between 12 and 15 h post-application. The continued usefulness of the liquid formulation is discussed in light of these results.

Comparison of the effectiveness of two deet formulations against Aedes albopictus in the Philippines.

The effectiveness of 2 formulations of deet was tested in the Philippines against Aedes albopictus. A new military issue extended duration repellent formulation (EDRF) was compared with the older standard liquid formulation. Consistently fewer mosquitoes landed on subjects treated with the EDRF than on those treated with the liquid formulation for up to 12 h post-application. However, the difference between the 2 formulations was not statistically significant. Both treatments were significantly different from untreated control subjects. The same was true when other day-biting mosquitoes including Armigeres subalbatus, Ar. flavus and Ae. vexans were analyzed as a group.

Suppression of larval Aedes aegypti populations in household water storage containers in Jakarta, Indonesia, through releases of first-instar Toxorhynchites splendens larvae.

Weekly releases of first-instar Toxorhynchites splendens larvae were made in household water storage containers in a neighborhood in Jakarta, Indonesia, between April 1987 and April 1988. A single larva was placed in each container surveyed. Forty-one percent of all containers in the treatment area were treated each week and the average container was treated once every 2.4 weeks. Aedes aegypti populations were suppressed but not controlled by treatment. It is hypothesized that first-instar Toxorhynchites larvae were poor control agents due to their inability to withstand periods of starvation and to their accidental removal from containers during the act of water consumption.

Toxorhynchites amboinensis larvae released in domestic containers fail to control dengue vectors in a rural village in central Java.

The efficacy of Toxorhynchites amboinensis larvae for control of dengue vectors in household water storage containers was tested in a rural village in Central Java, Indonesia. Concrete cisterns and clay jars were the most common types of containers used for long-term water storage, although smaller numbers of metal drums were also used. All containers in use in the village received 5-10 second- or third-instar Tx. amboinensis larvae biweekly for 7 months. Vector surveillance (adult and larval) was conducted biweekly between treatments. No differences in man-biting rates or larval population indices were noted between the treatment and control areas. It is hypothesized that the multiplicity of larval habitats in this rural area accounted for the lack of impact of predator releases, which were directed solely toward artificial containers.

Insecticide susceptibility status of Anopheles koliensis (Diptera: Culicidae) in northeastern Irian Jaya, Indonesia.

Anopheles koliensis, an important malaria vector in the interior region of Irian Jaya, Indonesia, was evaluated for susceptibility to three different insecticide compounds using the standard World Health Organization diagnostic test kit and pretreated impregnated papers. A series of tests were conducted in Arso PIR I, a transmigrant settlement 60 km south of Jayapura, from January 1988 to May 1989. All compounds were tested at the recommended diagnostic dosage and exposure time. An. koliensis were susceptible to 1.0% fenitrothion at two hour exposure (N = 358) and 5.0% malathion at one hour exposure (N = 371) after the 24-hour holding period. Significant resistance to DDT was observed in both the An. koliensis and Culex quinquefasciatus populations. Approximately 30% of the An. koliensis population (N = 468) was resistant to 4% DDT at both one and two hour exposures. These findings indicate that routine use of DDT in Arso PIR I for indoor residual house spraying may be of limited effectiveness, in part, because of physiological resistance. However, use of an alternative insecticide will be more expensive and might prove equally ineffective because of the exophilic behavior of the species. This is the first confirmed report from repeated observations of DDT resistance in An. koliensis from Indonesia.

[World deliberations in Rio]. / Deliberaciones mundiales en Rio.

PIP: The United Nations Conference on Environment and Development (UNCED) was held in Rio de Janeiro in June 1992 and dealt with world trade, environmental education, environmental emergencies, the transfer of technology and financial resources, and the restructuring of international systems for tackling environmental problems. Other issues on the agenda were the protection of the atmosphere, the ozone shield, deforestation, the conservation of biological diversity, sustainable urban and rural development, and the safeguarding of human health and quality of life. The preparation for the conference took place through a series of meetings, which also featured the problems of rural areas in the Americas. Some environmental organizations based in Washington, D.C. had become impassive over the years and promoted bipartisan and apolitical issues in order to obtain funds. Nonetheless, some groups criticized the projects of the World Bank. In 1990 the World Bank established the World Environmental Program for developing countries, which envisioned the execution of 15 projects and 11 technical assistance proposals. Nongovernmental organizations (NGOs) were also active in this effort. The Interamerican Development Bank also launched a forest policy for preserving forest resources. This was the consequence of the 1982 scheme that aimed at protecting forest populations and promoting sustainable forest industries. At another conference of development specialists the discrimination against women was cited as a major factor in the deleterious use of natural resources. A new development concept was urged that would incorporate the rights and participation of women as a central strategy in solving the global environmental crisis. The global population is growing at a rate of 95 million people per year, which underlines the need for better representation of women, poor people, and rural areas in state agencies and multilateral and environmental organizations for promoting sustainable local development. The increasing use of energy, the North-South dichotomy, and the issue of global warming were also explored.^ieng

5' Coding and regulatory region sequence divergence with conserved function of the Epstein-Barr virus LMP2A homolog in herpesvirus papio.

B-lymphotropic herpesviruses naturally infecting Old World primates share biologic, epidemiologic, pathogenic, and molecular features with the human pathogen Epstein-Barr virus (EBV). These related gammaherpesviruses have colinear genomes with considerable nucleotide homology. The replicative cycle genes share a high degree of homology across species, whereas the transformation-associated EBV latent genes appear to be much more divergent. For example, the EBV BamHI Nhet fragment, which encodes all or part of the EBV latent infection membrane proteins, cross-hybridizes poorly to DNA from nonhuman primate B-lymphotropic herpesviruses. A viral DNA fragment corresponding to this region of the EBV genome was isolated from the baboon B-lymphotropic herpesvirus, herpesvirus papio, and used to clone a herpesvirus papio cDNA corresponding to EBV LMP2A. At least three tyrosine kinase interaction motifs are conserved despite significant amino acid divergence of the herpesvirus papio LMP2A first exon from the EBV homolog. Functionally, the herpesvirus papio LMP2A is tyrosine phosphorylated and induces tyrosine phosphorylation of cell proteins similar to EBV LMP2A. The 12 hydrophobic LMP2 transmembrane domains are well conserved. Two CBP (Jk) binding sites important for EBNA-2-induced transactivation of the LMP2A promoter are also present in the herpesvirus papio LMP2A promoter, and the simian LMP2A promoter is also responsive to EBV EBNA-2-induced transactivation in human B cells. Thus, transcriptional regulation, splicing, kinase interaction sites, and tyrosine phosphorylation of the LMP2A homologs have been conserved despite significant sequences heterogeneity in the preterminal repeat regions of these human and nonhuman primate EBVs. The conservation of the LMP2 gene, despite its apparent nonessential role for in vitro EBV infection, suggests an important role for LMP2A in vivo. The similarities between these human and simian B-lymphotropic herpesviruses, and the LMP2 genes in particular, suggest that the function of LMP2 in vivo could be addressed by using recombinant LMP2A-mutant simian viruses and experimental infection of Old World primates.

Infection of human B lymphocytes with lymphocryptoviruses related to Epstein-Barr virus.

Lymphocryptoviruses (LCVs) naturally infecting Old World nonhuman primates are closely related to the human LCV, Epstein-Barr virus (EBV), and share similar genome organization and sequences, biologic properties, epidemiology, and pathogenesis. LCVs can efficiently immortalize B lymphocytes from the autologous species, but the ability of a given LCV to immortalize B cells from other Old World primate species is variable. We found that LCV from rhesus monkeys did not immortalize human B cells, and EBV did not immortalize rhesus monkey B cells. In this study, baboon LCV could not immortalize human peripheral blood B cells but could readily immortalize rhesus monkey B cells. Thus, efficient LCV-induced B-cell immortalization across distant Old World primate species appears to be restricted by a species-specific block. To further characterize this species restriction, we first cloned the rhesus monkey LCV major membrane glycoprotein and discovered that the binding epitope for the EBV receptor, CD21, was highly conserved. Stable infections of human B cells with recombinant amplicons packaged in rhesus monkey or baboon LCV envelopes were also consistent with a species-restricted block occurring after virus binding and penetration. Transient infections of human B cells with simian LCV resulted in latent LCV EBNA-2 gene expression and activation of cell CD23 gene expression. EBV-immortalized human B cells could be coinfected with baboon LCV, and the simian virus persisted and replicated in human B cells. Thus, several lines of evidence indicate that the species restriction for efficient LCV-induced B-cell immortalization occurs beyond virus binding and penetration. This has important implications for the study of LCV infection in Old World primate models and for human xenotransplantation where simian LCVs may be inadvertently introduced into humans.