T-SPOT.TB: an in vitro diagnostic assay measuring T-cell reaction to Mycobacterium tuberculosis-specific antigens

The overall sensitivity of the RD1 ELISPOT assay (T-SPO.TB), which counts T cells sensitized to specific Mycobacterium tuberculosis peptide sequences, was 81-97% in populations with confirmed tuberculosis, in whom 39-78% had immunosuppressive conditions. In patients with confirmed tuberculosis, the respective RD1 ELISPOT versus tuberculin skin test (TST) sensitivities were 100% versus 89% in adults and 77% versus 35% in children (of whom 39% were HIV-positive). In contrast to that of the TST, the sensitivity of the RD1 ELISPOT assay was not significantly affected by age <36 months, or the immunological or nutritional status of the subjects. Specificity was 100% in two UK-based studies. Isolated false positives have been recorded in patients infected with non-tuberculous M. kansasii. A study investigating latent tuberculosis infection found no significant difference in results between HIV-positive and -negative participants for the RD1 ELISPOT assay, while the TST varied significantly with HIV status. Contact-tracing studies have demonstrated concordance between the RD1 ELISPOT assay and the TST of 65-89%. There is a significant correlation between a positive result and the degree of exposure to the index case for the RD1 ELISPOT assay, but not for the TST, in contact-tracing studies. Unlike the TST, the RD1 ELISPOT assay is not confounded by bacille Calmette-Guérin vaccination.     

Serological evidence of Ureaplasma urealyticum infection in neonatal respiratory disease

Since up to 80 percent of pregnant women and 30 percent of neonates may be colonized with genital mycoplasmas, it is difficult to determine whether true infection occurs. The antibody responses to eight serotypes of U. urealyticum were assessed in mothers and infants in 21 cases of neonatal respiratory disease (RD) and 24 normal cases. Among the normal population of mothers and infants, a titer of greater than or equal to 1:32 occurred in 0.25 percent (1/394). In mother-infant paired titers, a fourfold difference occurred in 2.6 percent (5/192). Among 54 RD neonates, 55.6 percent had a titer of greater than or equal to 1:32 compared to only 4.2 percent of normal neonates (p less than .001). Fourfold elevations in antibody titers of greater than 1:32 were observed in the neonate in 52.4 percent of RD cases compared to 0 percent of 24 normal pairs (p less than .001) and in 28.6 percent of mothers of RD neonates compared to 0 percent in normal cases (p = .013). We observed that 43.3 percent of RD neonates with titers greater than or equal to 1:32 died compared to 16.6 percent of RD neonates exhibiting no elevation of antibody response over the maternal level. Among the six who died, 66.7 percent of neonates and 16.7 percent of their mothers had elevated titers, compared to 33.3 percent of 15 surviving infants and 40.0 percent of their mothers. These elevated antibody responses strongly support the concept that U. urealyticum causes infection in the perinatal period in association with neonatal respiratory disease. Since the elevation in titers was detected close to delivery in many cases, the infection may occur in utero.     

The population structure of Mycobacterium tuberculosis in Mongolia as assessed using large sequence polymorphism analysis

112 strains of M. tuberculosis isolated from lung tuberculosis patients in Mongolia were genotyped using RD9, RD7, TbD1, RD105, and RD750 loci. The genotypes of all the strains studied were characterized using the conservation of RD7, RD9, and RD750 loci and the presence of the deletion in the locus TbD1. RD105 was detected in 65 isolates (58%). The isolate was classified into two groups--East-Asian and Euro-American.     

Health Risk Assessment Due to Groundwater Arsenic Contamination: Children Are at High Risk

Health risk assessment due to groundwater As contamination was conducted in two As-prone panchayats, Rampur Diara (RD) and Haldichapra (HC) of the Maner block of the Patna district, Bihar (India). All 100% of the water samples surveyed were found to be contaminated with As with a mean value of 52 μg/L (n = 10) in RD and 231 μg/L (n = 10) in HC, both exceeding the World Health Organization (WHO) guideline of 10 μg/L and the Bureau of Indian Standards (BIS) standard of 50 μg/L, respectively. The average calculated per capita consumption of As through drinking water in RD ranged from 120 μg/day for 5–10-year-old children to 320 μg/day for adults older than 41 years, while in HC the average calculated As through consumption ranged from 580 μg/day for 5–10-year-old children to 1470 μg/day for adults older than 41 years. Hazard quotients were calculated to be between 12.1 to 41.6 for the RD population and 58.3 to 192.5 for the HC population, both exceeding the typical toxic risk index 1. In addition, cancer risk of 19 per 1000 was found for RD children and 87 per 1000 for HC children. Visible symptoms of Arsenicosis were also observed in the area.     

Mutation Detection in Patients with Retinal Dystrophies Using Targeted Next Generation Sequencing

Retinal dystrophies (RD) constitute a group of blinding diseases that are characterized by clinical variability and pronounced genetic heterogeneity. The different nonsyndromic and syndromic forms of RD can be attributed to mutations in more than 200 genes. Consequently, next generation sequencing (NGS) technologies are among the most promising approaches to identify mutations in RD. We screened a large cohort of patients comprising 89 independent cases and families with various subforms of RD applying different NGS platforms. While mutation screening in 50 cases was performed using a RD gene capture panel, 47 cases were analyzed using whole exome sequencing. One family was analyzed using whole genome sequencing. A detection rate of 61% was achieved including mutations in 34 known and two novel RD genes. A total of 69 distinct mutations were identified, including 39 novel mutations. Notably, genetic findings in several families were not consistent with the initial clinical diagnosis. Clinical reassessment resulted in refinement of the clinical diagnosis in some of these families and confirmed the broad clinical spectrum associated with mutations in RD genes.     

Self-reported reading problems in parents of twins with reading difficulties.

Parents of 323 twin pairs with reading disability (RD) reported significantly more problems learning to read (16% of mothers and 33% of fathers) than parents of 309 twin pairs without reading difficulties (6% of mothers and 9% of fathers). These rates of self-reported reading problems in parents of twins are highly similar to those previously obtained in parents of non-twin children with RD and controls, suggesting that the etiology of reading deficits in twin and non-twin children may also be highly similar. Moreover, within both the RD and control samples, twins whose parents self-reported a positive history of reading problems had lower reading performance test scores, on average, than those whose parents reported no reading problems. Therefore, results of the present twin study support those of previous studies with non-twin children in which parental self-reports have been found to provide a valid index of family history status for reading difficulties.     

Antibodies to the rhamnose determinants of the polysaccharide of streptococci group A in the sera of rheumatism patients and donors]

In the sera of patients with recurrent rheumocarditis, and especially in cases of primary rheumatism, the level of antibodies to group A streptococcal polysaccharide (A-PS) has been found, according to the results of the enzyme immunoassay, to be considerably higher than in the sera of healthy donors. The level of antibodies to rhamnose determinants (RD) of A-PS has been determined by the inhibition of the immunoenzyme reaction with A-PS under the influence of a variant of group A streptococcus and rhamnose disaccharides with the bonds alpha 1-2 and alpha 1-3. In patients with recurrent rheumocarditis the level of antibodies to A-PS has been shown to be considerably higher than in healthy donors having these antibodies. In acute primary rheumatism a high level of antibodies to A-PS has been detected only in a few cases, and at the same time the prevalence of antibodies to the specific RD of A-PS, bound with beta-N-acetylglucosamine, is observed. In the sera of patients with recurrent rheumocarditis and donors having a high content of antibodies to the rhamnose site of A-PS antibodies, seemingly active against at least two RD, have been detected. In acute primary rheumatism an insignificant amount of antibodies to the rhamnose site of A-PS may probably cause the autoimmune process accompanying rheumatism. This suggestion is substantiated by the previously established capacity of these antibodies for inducing the suppression of cytotoxic cell reactions to microbial antigens.     

新型重组VPAC2激动剂RD的制备及促进胰岛素功能的分子机制

利用DNA重组、原核表达、Chitin-Beads柱和HPLC纯化、质谱鉴定等技术,制备了一种新型具有抗2型糖尿病功能的VPAC2受体激动剂RD,并初步研究和揭示了其在Ⅱ型糖尿病治疗中有效促进胰岛素信号传导的分子机制。实验结果表明:利用基因重组技术制备的VPAC2受体激动剂RD的分子量为3 785.0 Da,纯度为96%;将重组肽作用于正常或胰岛素抵抗的3T3-L1 脂肪细胞(IR模型细胞),1和5μmol/L 重组肽RD可促进正常3T3-L1脂肪细胞IRS-1 蛋白的表达(分别增加36%和42%),而促进IR模型细胞IRS-1 蛋白的表达增加更为明显(分别增加55%和63%)。IR模型细胞经1,5和10μmol/L重组肽RD处理后,pIRS1(ser307)的表达水平分别比降低了5.9%,10.7%和32.7%。在IR模型细胞中,5和10μmol/L RD处理组,IRS-2蛋白的表达水平分别降低12.8%和40.6%;而1,5和10μmol/L RD各处理组pIRS2蛋白的表达水平分别降低35.1%,40.8%和48.5%。5 and 10μmol/L RD处理的IR模型细胞中Akt蛋白的表达显著增强,表达量分别增加74%和77%。1,5 和10μmol/L的重组肽RD处理的IR模型细胞中,Akt Ser473磷酸化水平分别降低33.9%,64.0%和71.1%;Akt Thr308磷酸化水平分别升高13.5%,78.6%和83.3%。建立了重组VPAC2受体激动剂RD的制备技术,并在体外细胞水平检测了其效果(显著促进正常3T3-L1脂肪细胞及IR模型细胞IRS-1 蛋白的表达;降低IR模型细胞pIRS1(ser307),IRS-2,pIRS2蛋白的表达;促进IR模型细胞Akt蛋白的表达及Akt Thr308磷酸化水平等),为阐明其在2型糖尿病治疗中的分子作用机制及药用研发提供了实验基础。     

苏州地区儿童感染志贺菌的耐药监测

目的调查苏州地区2000年至2006年儿童感染志贺菌的耐药情况,了解其耐药趋势,以指导临床合理用药。方法对2000年至2006年苏州大学附属儿童医院临床标本中分离的589株志贺菌（福氏志贺菌470株,宋内志贺菌119株）采用K-B法对氨苄西林、哌拉西林、头孢哌酮、头孢曲松、环丙沙星、SMZ＋TMP、亚胺培南进行药敏试验。结果于7年中470株福氏志贺菌的耐药率：氨苄西林：始终在90．0％以上;哌拉西林：从22．6％逐渐上升到63．2％;头孢哌酮：1．1％～56．1％;头孢曲松：2．2％～43．9％;环丙沙星：一直在10．0％左右;SMZ＋TMP：在70．0％～96．0％波动;对亚胺培南均敏感。119株宋内志贺菌的耐药率：氨苄西林：从7．1％逐渐上升到82．8％;哌拉西林：0～79．3％;头孢哌酮：0～55．2％;头孢曲松：0～51．7％;SMZ＋TMP：在62．5％～100．0％波动;对环丙沙星和亚胺培南均敏感。结论本地区儿童感染福氏志贺菌对氨苄西林严重耐药,同时伴有对SMZ＋TMP的高耐药率,对哌拉西林和3代头孢菌素的耐药率呈逐年上升趋势。宋内志贺菌的耐药率在2004年之前（除对复方新诺明外）,远低于福氏志贺菌,但在2005年其对氨苄西林和3代头孢菌素的耐药率突然上升,大有赶超福氏志贺菌之势。因此苏州地区儿童感染志贺菌的耐药情况不容乐观,对儿童细菌性痢疾的治疗将会面临困境。     

Transplacental measles immunity in infants in the 1st year of life]

A total of 187 parturients (66 with a history of measles and 121 immunized with live measles vaccine, or LMV, in childhood) and their 187 newborn infants, as well as 195 children aged up to 1 year, were examined. Antimeasles antibodies in blood sera were detected in the hemagglutination inhibition test. In all mothers with a history of measles and in their newborn infants antimeasles antibodies in different titers were detected. In mothers, formerly immunized with LMV, antimeasles antibodies were absent in 5.8% and in their newborn infants, in 6.6% of the examinees. Among children aged up to 1 year, born of formerly immunized mothers, more rapid disappearance of passive antimeasles immunity was observed. In cases of contact with measles, the serological examinations of all children born of mothers immunized with LMV should be carried out in order to protect seronegative children by passive or active immunization.     

Rotavirus and adenovirus in Rondônia

Acute gastroenteritis is one of the most common diseases in humans worldwide. Viral gastroenteritis is a global problem in infants and young children. In this study the incidence of diarrhea was assessed in 877 hospitalized children under five years old, over a period of 24 months and distributed in 470 cases of diarrhea and 407 age-matched group with other pathologies, as control group. Two antigen detection techniques based on enzyme immunoassay (EIA) and latex particles were used for detection of rotavirus and adenovirus. Rotavirus A was a major cause of gastroenteritis with 23.6% of cases, being 90% of these cases in young children. Adenovirus infections was detected by EIA with frequency of 6.4%. Rotavirus and adenovirus were detected in 10.1 and 1.7% of stools from control group, respectively. Interestingly, the frequency of the youngest children in the control group excreting Rotavirus A was comparable to that detected in stools from diarrheic children. We cannot rule out the existence of other enteric viruses because the etiology of 171 cases of diarrhea was not determined and active search for astrovirus and calicivirus was not done. This is the first study that shows the presence of enteric viruses in the infantile population from Western Brazilian Amazonia and it was important to help physicians in the treatment of viral gastroenteritis.     

Refinement of the 6p21.3 quantitative trait locus influencing dyslexia: linkage and association analyses

Reading disability (RD), or dyslexia, is the most common learning disability with a prevalence rate of ~5%–10% in school-age children. RD is highly heritable with evidence of a neurobiological origin. Linkage studies have identified several quantitative trait loci (QTLs) for RD. The QTL on chromosome 6p21.3 has been independently replicated by several groups and spans a 16.4-Mb (13.8 cM) interval from D6S109 to D6S291. In this study, we performed sib-pair linkage analyses with Haseman–Elston and DeFries–Fulker methods to define more accurately the QTL interval. Linkage was assessed by using five quantitative phenotypes, including a composite measure of reading performance and four component phenotypes. When probands were selected for severe scores, single- and multi-point analyses showed significant linkage with all five phenotypes, converging over an interval of ~3.24 Mb spanning D6S1597 to D6S1571. Maximal linkage converged at marker D6S1554 across phenotypes. Out of 12 genes in the linkage interval, ten clustered within ~680 kb and were selected for association analysis based on central nervous system expression and putative function. Marker-trait associations were assessed by using QTDT (a general test of association for quantitative traits) and the family-based association test (FBAT), and haplotype analysis was performed by using FBAT and the GeneHunter Transmission/Disequilibrium Test TDT. Marker associations were detected in five of the ten genes, results that were corroborated by our haplotype TDT analysis. The results of the association study have thereby allowed us to significantly reduce the number of possible candidate genes and to prioritize genes for further mutation screening.     

Intestinal microbiocenosis in children with thymomegaly and acute lower respiratory tract infections and regimen of its correction

57 children with thymomegaly from 3 months to 3 years of age with acute lower respiratory tract infections were studied. Disturbances of gut microflora - changes in both obligate and potentially harmful symbionts were detected in 70.2% of cases. In 47,5% of cases increased quantity of enterococci was observed. Decreased quantities of bifidobacteria and lactobacilli were observed in all and 27.5% of studied patients respectively. Most diverse gut microflora has been observed in children with pneumonia and thymomegaly of II level. During treatment of children with thymomegaly changes in gut microflora should be considered along with changes in the immune system.     

Bioconversion of 3-chlorobenzoate to 2-chloromuconate controlled by on line HPLC

Summary Strain RD330 a transposon mutant of Alcaligenes eutrophus JMP134 was considered to be dienelactone hydrolase defective (Don et al. 1985). During a bioconversion experiment with 3CB (3-chlorobenzoate) 2CMA (2-chloro-cis,cis-muconate) was accumulated by RD330 with an overall amount of 31%, but no dienelactone could be detected. Enzyme tests revealed that both enzymes 2CMA-cycloisomerase and dienelactone-hydrolase were induced at low levels in RD330 by 3CB and its metabolites.The control of 3CB addition during the bioconversion experiment was performed by on line HPLC (high pressure liquid chromatography).     

City-wide screening for urinary abnormalities in schoolgirls

Screening for urinary tract infection was carried out in 23,427 schoolgirls, aged 5 to 14 years, using Uricult and, for hematuria, glycosuria and proteinuria using Hema-combistix. Cultures of 10⁵ colonies per ml. or more on two occasions were obtained in 2.3% and a positive culture was confirmed by the family physician using standard culture techniques in 82.7% of cases, giving an overall incidence of infection of 1.9%. Fifty-eight percent of these children had no previous history of any urinary tract symptoms. Of the infected group 9.5% had pyelonephritic scarring, 58.7% chronic cystitis and 58.7% urethral stenosis. Two additional cases had unilateral ureteropelvic junction obstruction with hydronephrosis. Reflux occurred in 26.6% of those investigated by voiding cystogram. In 58% of cases the urinary tract infection was not accompanied by significant proteinuria, hematuria or pyuria.Proteinuria was detected on two occasions in 1.6% of the children and confirmed by the family physician in 33% of cases, giving an overall incidence of 0.5%. In this group 9.2% had evidence of pyelonephritic scarring without a positive urine culture.Hematuria was detected on two occasions in 0.6% of the children and was confirmed by the family physician in 53%, giving an overall incidence of 0.3%. Only one case with pyelonephritic scarring was seen in this group.Of the 25 cases with pyelonephritic changes only six had been previously diagnosed radiologically.Four previously unrecognized diabetics were also detected.     

Microbiocenosis of the large intestine in acute complicated pneumonia in children

Fifty-six children of early age with pneumonia developed on the background of frequent respiratory infections were placed under observation. In 91.1% of these cases microecological disturbances in the intestine were detected, 46.6% of the patients having third-degree dysbacteriolysis. In such cases it is more correct to regard the "intestinal" syndrome as the clinical manifestation of disturbances in the biocenosis of the intestine, the state of its microflora. Intestinal dysbacteriosis aggravates the course of acute aggravated pneumonia in children and requires the inclusion of special therapy aimed at normalizing intestinal microflora.     

On the significance of true trisomy 20 mosaicism in amniotic fluid culture

Summary Nine new cases of prenatally detected true mosaic trisomy 20 (T20) are reported. In three instances the fetuses were aborted. One fetus showed multiple malformations associated with a high percentage of T20 cells among amniotic fluid (AF) cells and fibroblasts of different fetal tissues. In two other fetuses only a slight facial dysmorphy was seen which was accompanied by a low percentage of T20 cells among AF cells. In five instances the pregnancies were carried to term, and normal somatic and psychomotor development of the children has been observed, in one case up to the age of 24 months. In one case the pregnancy is continuing. The T20 cells were not detected among cultured lymphocytes of these children.A review of the hitherto known cases of prenatally detected mosaic T20 indicates a relationship between the prenatal findings and the fetal development. This may serve as a provisory basis for genetic counselling: in the case of a percentage above 50% of T20 cells among AF cells there seems to be a risk of about 50% for the fetus to be affected by severe anomalies. However, in cases of a prenatally detected mosaic T20 with a percentage equal to or less than 50, fetal or congenital malformations have not been observed among 23 individuals so far examined.     

The value of ultrasonography alone in screening surveys of cystic echinococcosis in children in Turkey

A total of 1205 primary school children were examined for cystic echinococcosis in five villages of Manisa, Turkey, to evaluate the efficacy of diagnostic methods of this infection in community-based screening surveys. Six hundred and thirty children from three villages, examined by a portable ultrasound scanner, chest microfilm and serological methods (ELISA, indirect hemagglutination) in our previous study, were designated as Study Group 1; and 575 children, from two adjacent villages, examined by ultrasonography alone in the present study, were designated as Study Group 2. In Study Group 1, hepatic cystic echinococcosis was detected in two cases (0.3%) by ultrasonography, while 43 (8.9%) and 49 (10.1%) cases were found to be positive for cystic echinococcosis by ELISA and indirect hemagglutination, respectively. Three of 575 children (0.5%) were diagnosed with cystic echinococcosis (two hepatic and one renal involvement) by ultrasonography alone in Study Group 2; and lung lesions were later detected in both cases with liver involvement by chest radiography.

Our results suggested that serological tests may be beneficial in suspected cases for confirmation and differential diagnosis, but have some drawbacks, such as discrepancy in results and high false seropositivity rates. Chest microfilm is not easy in field studies and exposure to X-ray is undesirable. As a reliable, simple, inexpensive and rapid technique, ultrasonography alone is recommended to be used in community-based screening surveys for cystic echinococcosis with confirmatory tests for suspected cases found during the screening program.     

Streptococcus pneumoniae serotypes in children with acute pneumonia and pleurisy

The study of pneumococci of different serotypes, isolated from patients with acute pneumonia and pleuritis and from healthy children was carried out. Among the pneumococcal serotypes causing pneumonia and pleuritis in children serotypes 1, 6, 19, 14 and 3 were most widely spread and constituted 62.3% of all isolated pneumococci. In young children cases of acute pneumonia and pleuritis were more often induced by serotypes 6 and 14 and in older children, by serotypes 1 and 3. In patients with uncomplicated pneumonia and pleuritis differences in the detected serotypes of pneumococci were observed, and the disease course differed in severity. Serotypes 14, 3 and 3 induced destructive processes in the lungs more often than other serotypes. Monitoring of the sensitivity of pneumococci to antibiotics showed that most of the strains retained high sensitivity to penicillin and ampicillin. In most cases the detected resistant pneumococcal strains belonged to serogroup 19.