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Dormitorio TV, Giambrone JJ, Duck LW. Sequence comparisons of the variable VP2 region of eight infectious bursal disease virus isolates. Avian Dis 1997; 41:36-44. [PMID: 9087318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The VP2 gene is part of the genomic segment A of infectious bursal disease virus (IBDV). It has been identified as the major host-protective antigen of IBDV and is known to contain conformationally dependent protective epitopes. A 643-base pair segment covering the hypervariable region of this gene from three recent serologic variant IBDV isolates from the southeastern United States, two variants from the Delmarva Peninsula, and three serologic standard viruses were amplified and sequenced using the reverse transcription polymerase chain reaction and cycle sequencing techniques. This was done to determine the molecular similarity among isolates that differ antigenically and pathologically. Sequence analysis suggested that the Arkansas (Ark) and Mississippi (Miss) isolates evolved closely and separately from the Delmarva variants (GLS and DELE), in contrast to the other southeastern variant Georgia (Ga), which is more closely related (98.32%) to Delaware E (DELE). All variants, except for Miss, underwent a shift in amino acid number 222 from proline to threonine. The sequence of Univax BD virus, a commercially available intermediate vaccine, was markedly different, evolving from a separate lineage than the others. Restriction enzyme sites could differentiate most isolates. Except for Miss, variants do not have EcoRII site at the larger hydrophilic domain. All variants lost their HaeIII, StuI, and StyI cutting sites with a change in base number 856. The TaqI site is in DELE, whereas the SpeI site is absent in the standard vaccine viruses. The SWASASGS heptapeptide is conserved in all virulent viruses, including APHIS, but not in the attenuated (Univax BD and Bursa Vac 3) and published (D78 and PBG98) vaccines.
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Dormitorio TV, Giambrone JJ, Duck LW. Sequence Comparisons of the Variable VP2 Region of Eight Infectious Bursal Disease Virus Isolates. Avian Dis 1997. [DOI: 10.2307/1592441] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Zhang X, McDaniel GR, Giambrone JJ, Smith E. Promoter and transcription of type X collagen gene in broiler chickens with tibial dyschondroplasia. Poult Sci 1996; 75:691-4. [PMID: 8737831 DOI: 10.3382/ps.0750691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Type X collagen is produced exclusively in hypertrophic chondrocytes of the growth plate of the proximal tibiotarsus and is believed to play an important role during normal development from chondrogenesis to osteogenesis. Chondrocytes of chickens with tibial dyschondroplasia (TD) fail to attain full hypertrophy and the amount of type X collagen, being a marker of hypertrophy, is likely to be reduced. It is not clear whether transcriptional regulation is functional for expression of the type X collagen gene in TD birds. Nucleotide sequence of the type X collagen gene promoter was determined by sequencing PCR-based DNA clones. Nucleotide identity of this fragment between the normal and TD carriers was 97.6%. Both normal and TD birds were similar in a putative transcription start site, the site of TATAA box, and neither had a CCAAT box. However, there were two gaps in TD carriers, four gaps in normals, and five nucleotide substitution sites. By rapid amplification of cDNA ends by PCR (RACE-PCR), transcription of the gene was assessed using total RNA and mRNA from both normal chondrocytes and TD lesions at 3 and 4 wk of age. The RACE-PCR product for type X collagen mRNA was detectable in both normal and TD birds at two stages. No difference was found between them. This result does not support the hypothesis that transcriptional regulation of type X collagen gene is important in TD development of chickens. Variations in the promoter region did not affect transcription of type X collagen gene in TD carrier chickens.
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Li L, Giambrone JJ, Panangala VS, Hoerr FJ. Production and Characterization of Monoclonal Antibodies against Avian Reovirus Strain S1133. Avian Dis 1996. [DOI: 10.2307/1592231] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Li L, Giambrone JJ, Panangala VS, Hoerr FJ. Production and characterization of monoclonal antibodies against avian reovirus strain S1133. Avian Dis 1996; 40:349-57. [PMID: 8790885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Monoclonal antibodies (MAbs) were produced against the avian reovirus strain S1133. MAbs were isotyped and used to develop diagnostic tests. Splenocytes from immunized mice were screened by enzyme-linked immunosorbent assay (ELISA). Two hybridomas secreted MAbs against avian reovirus S1133. One MAb secreted IgG1 and the other secreted IgG2a. All MAb light chains were kappa Specificity of MAbs was tested against four avian reovirus strains: S1133, 1733, CO8, and 2408. Strains S1133, 1733, and 2408 viruses were in the same subtype; the CO8 virus belonged to a different subtype. The MAbs reacted with all reovirus strains by ELISA, dot blot, immunofluorescence assay, and immunoblotting. No MAb had neutralizing activity against the tested reoviruses. Immunoblot analysis showed the one MAb bound to protein sigma A with molecular weight of 39,000 Daltons for all reovirus strains. Another MAb bound to the protein sigma C with an approximate molecular mass of 32,000 Daltons. An indirect immunoperoxidase (IP) procedure was developed using a MAb to detect reovirus in formalin-fixed, paraffin-embedded tissues from infected chickens and chicken embryo fibroblast cell cultures. The IP test was simple, fast, and economical and enabled simultaneous evaluation of viral antigen-producing cells with tissue pathologic changes confirming that the reovirus caused the lesions.
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Zhang X, McDaniel GR, Giambrone JJ. Random amplified polymorphic DNA comparisons among broiler lines selected for incidence of tibial dyschondroplasia. Poult Sci 1995; 74:1253-8. [PMID: 7479502 DOI: 10.3382/ps.0741253] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Lines selected for high (H) and low (L) incidence of tibial dyschondroplasia (TD) for eight generations and a randombred control (C) line of broiler chickens were fingerprinted by random amplification of genomic DNA mixed from 20 individuals of each line with 20 oligonucleotide primers. Among these 20 primers, 15 could distinguish the H from the L line, 14 the H from the C line, and 13 the L from the C line. Band sharing (BS), on the average over 20 primers, was .7 for the H vs L comparison and .8 for both H vs C and L vs C comparisons. The levels of BS calculated from individuals was .6 between the H and L line, .7 between the H and C line, and .7 between the L and C line. The ranking of BS values obtained from individual DNA samples was consistent with that obtained from the mixed DNA samples. Genomic distance between divergently selected lines (H vs L) was larger than that between the divergently selected lines and randombred line (H vs C and L vs C). Individual variation within lines was detected in spite of eight generations of selection. Results showed that eight generations of divergent selection for TD incidence in broiler chickens had resulted in genetic variation among lines. The procedure of random amplified polymorphic DNA assay using mixed DNA samples could be used to evaluate genetic distance among lines of chickens.
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Liu HJ, Giambrone JJ, Dormitorio T. Detection of genetic variations in serotype I isolates of infectious bursal disease virus using polymerase chain reaction and restriction endonuclease analysis. J Virol Methods 1994; 48:281-91. [PMID: 7989444 DOI: 10.1016/0166-0934(94)90127-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Reverse transcription with polymerase chain reaction (PCR) followed by restriction endonuclease analysis detected genetic variations among serotype I isolates of infectious bursal disease virus (IBDV). Using a set of synthetic primers derived from the large genome segment of APHIS-IBDV, the hypervariable region (AccI-SpeI fragment) located in the VP2 gene was amplified. With all strains, a cDNA fragment of approximately 643 bp was amplified, indicating that there were no apparent deletions or insertions in this region among isolates. Fragments amplified from 9 isolates were digested with 14 restriction enzymes. Restriction fragment profiles generated by restriction enzymes NaeI, StuI, TaqI, and SacI, showed genetic variations among isolates. This study provided a simple and sensitive method for detection of genetic variations among isolates that are closely related serologically and could not be differentiated using current serologic methods.
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Hatkin JM, Giambrone JJ, Blagburn BL. Kinetics of serum antibody responses in broiler chicks againstCryptosporidium baileyi. Avian Pathol 1993; 22:525-32. [DOI: 10.1080/03079459308418940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hatkin J, Giambrone JJ, Blagburn BL. Correlation of Circulating Antibody and Cellular Immunity with Resistance against Cryptosporidium baileyi in Broiler Chickens. Avian Dis 1993. [DOI: 10.2307/1592032] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hatkin J, Giambrone JJ, Blagburn BL. Correlation of circulating antibody and cellular immunity with resistance against Cryptosporidium baileyi in broiler chickens. Avian Dis 1993; 37:800-4. [PMID: 8257374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The correlation of circulating antibody and cell-mediated immunity (CMI) with resistance to Cryptosporidium baileyi was studied using hormonal and chemical bursectomy in the one experiment and cyclosporin A in a second experiment. In Expt. 1, there was no correlation between antibody (confirmed by enzyme-linked immunosorbent assay) and resistance to infection as measured by body weight, gross lesions, morbidity, and mortality. Bursectomy altered antibody production, but not CMI, as measured by the delayed-type hypersensitivity skin reaction. In Expt. 2, cyclosporin A reduced CMI, but not antibody production. Chicks treated with cyclosporin A were more susceptible to C. baileyi (more severe respiratory disease) than untreated controls. Results suggested that CMI is more important in resistance to C. baileyi than circulating antibody.
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Cruz-Coy JS, Giambrone JJ, Panangala VS. Production and characterization of monoclonal antibodies against variant A infectious bursal disease virus. Avian Dis 1993; 37:406-11. [PMID: 8395799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Monoclonal antibodies (MAbs) were produced against a variant subtype of infectious bursal disease virus (IBDV) from Delaware variant isolate A (Var-A). Splenocytes from immunized mice were fused to myeloma cells, and antibody-producing hybridomas were screened by dot-blot enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IF) against the homologous isolate. Specificity of the MAbs was tested against viral isolates representing all six serologic subtypes of IBDV and three untyped IBDVs--GLS, Ark, and Miss--found in serotype 1 by dot-blot ELISA and IF. The MAb G11 recognized all isolates, whereas H7 did not recognize two viruses in subtype 1, the Lukert strain and APHIS. MAbs G11 and H7 were not neutralizing and identified both the precursor proteins (VP2a) and protein product (VP2b of VP2) in Western immunoblots. Results showed an antigenic determinant in IBDV isolates and antigenic variation between subtype 1 viruses and other subtypes. This confirms and extends previous work that showed that IBDVs evolved from subtype 1 by alteration or substitution of antigenic sites.
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Cruz-Coy JS, Giambrone JJ, Hoerr FJ. Immunohistochemical Detection of Infectious Bursal Disease Virus in Formalin-Fixed, Paraffin-Embedded Chicken Tissues Using Monoclonal Antibody. Avian Dis 1993. [DOI: 10.2307/1591691] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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38
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Cruz-Coy JS, Giambrone JJ, Hoerr FJ. Immunohistochemical detection of infectious bursal disease virus in formalin-fixed, paraffin-embedded chicken tissues using monoclonal antibody. Avian Dis 1993; 37:577-81. [PMID: 8395809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Immunoperoxidase and immunofluorescence techniques detected and localized infectious bursal disease virus (IBDV) in formalin-fixed paraffin-embedded sections of the bursa of Fabricius of experimentally and naturally infected chickens. The primary antibody was a monoclonal antibody that bound all IBDV serologic subtypes, including the GLS isolate. Both techniques were valuable in detecting IBDV. The presence and severity of microscopic lesions in the bursa correlated with the location and number of positive IBDV-infected cells as measured by either test. Mild vaccine strains induced minimal microscopic lesions and resulted in a few cells positive by either test. In contrast, virulent IBDV produced widespread lymphoid necrosis and numerous cells positive by both assays. The immunoperoxidase test was more useful than the immunofluorescence test, since the same section could be stained and examined by immunoperoxidase and then restained and examined for microscopic pathology. The presence of immunoperoxidase-positive stained cells associated with areas of microscopic pathology suggested that microscopic lesions were induced by IBDV.
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Cruz-Coy JS, Giambrone JJ, Panangala VS. Production and Characterization of Monoclonal Antibodies against Variant A Infectious Bursal Disease Virus. Avian Dis 1993. [DOI: 10.2307/1591666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Giambrone JJ, Dormitorio T, Lockaby SB. Coarse-Spray Immunization of One-Day-Old Broilers against Enteric Reovirus Infections. Avian Dis 1992. [DOI: 10.2307/1591514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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41
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Hathcock TL, Giambrone JJ. Digoxigenin-labeled nucleic acid probe for the detection of infectious bursal disease virus in infected cells. Avian Dis 1992; 36:206-10. [PMID: 1320860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A cDNA probe was synthesized from the VP-4 region of a virulent field isolate of infectious bursal disease virus (IBDV). The probe was labeled during synthesis with a non-radioactive steroid hapten, digoxigenin. The probe was used to develop a hybridization assay to detect the presence of IBDV in infected cell-culture and tissue suspensions from the bursa of Fabricius of infected chickens. The test was rapid, reproducible, and sensitive, and it could detect four serologic subtypes of IBDV, including the GLS-5 isolate.
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Hathcock TL, Giambrone JJ. Tissue-Print Hybridization Using a Non-Radioactive Probe for the Detection of Infectious Bursal Disease Virus. Avian Dis 1992. [DOI: 10.2307/1591491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Giambrone JJ, Dormitorio T, Lockaby SB. Coarse-spray immunization of one-day-old broilers against enteric reovirus infections. Avian Dis 1992; 36:364-8. [PMID: 1320865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Coarse-spray (CS) administration of a commercial S1133 reovirus vaccine was evaluated in 1-day-old specific-pathogen-free broilers for prevention of clinical infection induced by intratracheal challenge with two enteric reovirus isolates. In Expt. 1, chickens were challenged at 4 days of age with either the 2408 or CO8 isolate. In Expt. 2, chickens were challenged at 7 days of age with either isolate. In Expt. 3, chickens were challenged at 3, 5, or 7 days of age with the 2408 isolate. In Expt. 1, vaccinated birds showed significant protection against challenge with either isolate at 4 days of age as measured by morbidity, mortality, gross lesions, and body weight. In Expt. 2, vaccinated birds showed greater protection against challenge at 7 days of age. In Expt. 3, resistance in vaccinated birds increased with time between vaccination and challenge. Vaccinated birds challenged at 3 days of age showed no significant protection, whereas vaccinated birds challenged at 5 or 7 days of age had increased resistance. This vaccine did not induce a drop in weight gain, morbidity, mortality, or microscopic lesions in the tendons.
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Hathcock TL, Giambrone JJ. Digoxigenin-Labeled Nucleic Acid Probe for the Detection of Infectious Bursal Disease Virus in Infected Cells. Avian Dis 1992. [DOI: 10.2307/1591492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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45
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Hathcock TL, Giambrone JJ. Tissue-print hybridization using a non-radioactive probe for the detection of infectious bursal disease virus. Avian Dis 1992; 36:202-5. [PMID: 1320859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Tissue-print hybridization was evaluated as a simplified means for detection of infectious bursal disease virus (IBDV) in the bursa of Fabricius from infected chickens. The assay employed a biotin-labeled synthetic oligonucleotide as a probe. The bound probe was detected using a color assay consisting of streptavidin conjugated to alkaline phosphatase. Bursae were imprinted onto nitrocellulose and then hybridized with the biotinylated probe. Bursal prints from IBDV-infected chickens were readily distinguished from control prints by color development and differences in signal intensity.
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Blagburn BL, Lindsay DS, Hoerr FJ, Davis JF, Giambrone JJ. Pathobiology of cryptosporidiosis (C. baileyi) in broiler chickens. THE JOURNAL OF PROTOZOOLOGY 1991; 38:25S-28S. [PMID: 1667932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pathologic and clinicopathologic changes were examined in broiler chickens inoculated with Cryptosporidium baileyi (Cb) alone or in combination with infectious bronchitis virus (IBV), infectious bursal disease virus (IBDV) or Escherichia coli (Ec). Concurrent infections with Cb and either IBV or Ec resulted in a greater respiratory inflammatory response than either agent given alone. Concurrent Cb, IBV or Ec infections resulted in a decreased density of respiratory cryptosporidial stages. No interactions between Cb and IBDV were observed. Clinicopathologic results in broiler chicks exhibiting signs of respiratory cryptosporidiosis indicated that pO2 decreased, pCO2 increased, HCO3 increased and CO2 increased. Changes in blood gases and serum electrolyte values correlated with signs of acute respiratory disease. Blood gases and serum electrolyte values were unchanged in birds with bursal and cloacal infections only. Results of these studies clarified pathogenetic events associated with avian respiratory cryptosporidiosis, and demonstrated that cryptosporidiosis may enhance the severity of respiratory disease caused by other avian pathogens.
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Giambrone JJ, Hathcock TL, Lockaby SB. Effect of a live reovirus vaccine on reproductive performance of broiler breeder hens and development of viral tenosynovitis in progeny. Avian Dis 1991; 35:380-3. [PMID: 1854320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A live commercial reovirus vaccine, Enterovax, was administered to adult broiler breeder hens via the drinking water to determine its efficacy in stimulation of circulating antibody. This vaccine was compared with a commercial inactivated reovirus vaccine. Only the inactivated product resulted in increased antibody as measured by a commercial enzyme-linked immunosorbent assay. However, the live reovirus vaccine caused diarrhea in the hens and decreased eggshell quality, fertility, and hatchability. In addition, the live vaccine virus was vertically transmitted from hens to their progeny, resulting in increased embryonic mortality and viral tenosynovitis.
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Giambrone JJ, Hathcock TL, Lockaby SB. Effect of a Live Reovirus Vaccine on Reproductive Performance of Broiler Breeder Hens and Development of Viral Tenosynovitis in Progeny. Avian Dis 1991. [DOI: 10.2307/1591193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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49
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Giambrone JJ, Hathcock TL. Efficacy of Coarse-Spray Administration of a Reovirus Vaccine in Young Chickens. Avian Dis 1991. [DOI: 10.2307/1591315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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50
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Giambrone JJ, Hathcock TL. Efficacy of coarse-spray administration of a reovirus vaccine in young chickens. Avian Dis 1991; 35:204-9. [PMID: 1851416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Coarse-spray (CS) administration of a commercial S1133 reovirus vaccine in chickens for prevention of clinical viral tenosynovitis (VT) infection was evaluated. In Expt. 1, one-day-old specific-pathogen-free (SPF) white leghorns were vaccinated with a combination of reovirus, Newcastle disease (ND), and infectious bronchitis (IB) vaccines by CS and infectious bursal disease vaccine by the subcutaneous (SQ) route. In Expt. 2, one-day-old commercial broilers were vaccinated by CS with reovirus vaccine and Marek's disease (MD) vaccine by SQ. In Expt. 3, one-day-old commercial broilers received reovirus vaccine in combination with ND-IB vaccines at 1 day of age by CS and MD vaccine by SQ. Some birds received an initial or second vaccination at 7 days of age by CS or the drinking-water (DW) route. Birds vaccinated by CS at 1 day of age with reovirus vaccine did not produce circulating virus-neutralizing antibody against reovirus, although they had resistance to VT infection. In contrast, initial or booster vaccination at 7 days of age by CS or DW resulted in an antibody response and greater resistance to challenge than did CS vaccination at 1 day of age. There was no difference in efficacy between CS and DW routes at 7 days of age. The reovirus vaccine did not interfere with other vaccines as measured by serologic (ND-IB-IBD) or challenge (MD) studies.
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