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Castro T, Sabalza M, Barber C, Abrams W, Da Costa AC, De Pádua Milagres FA, Braz-Silva PH, Malamud D, Gallottini M. Rapid diagnosis of Zika virus through saliva and urine by Loop-mediated isothermal amplification (LAMP). J Oral Microbiol 2018; 10:1510712. [PMID: 30202506 PMCID: PMC6127837 DOI: 10.1080/20002297.2018.1510712] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/30/2018] [Accepted: 08/02/2018] [Indexed: 01/09/2023] Open
Abstract
Background: Zika virus (ZIKV) is a single-stranded RNA virus and member of the Flaviviridae family. Recent studies have reported that saliva can be an important alternative to detect ZIKV. Saliva requires less processing than blood greatly simplifying the assay. Loop-mediated Isothermal Amplification (LAMP) is a rapid assay that detects nucleic acids, including ZIKV RNA. Aim: The aim of this study was to evaluate the efficacy of saliva and urine to diagnose ZIKV infection in subjects during the acute phase, through ZIKV RNA detection by LAMP. Method: A total of 131 samples (68 saliva and 63 urine samples) from 69 subjects in the acute phase of ZIKV infection, and confirmed positive for ZIKV by blood analysis through real time-PCR, were collected and analyzed by Reverse Transcriptase Loop-mediated Isothermal Amplification (RT-LAMP). Results: From the 68 saliva samples, 45 (66.2%) were positive for ZIKV with an average time to positivity (Tp) of 13.5 min, and from the 63 urine samples, 25 (39.7%) were positive with the average Tp of 15.8 min. Saliva detected more samples (p = 0.0042) and had faster Tp (p = 0.0176) as compared with urine. Conclusion: Saliva proved to be a feasible alternative to diagnose ZIKV infection during the acute phase by LAMP.
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Affiliation(s)
- Talita Castro
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Maite Sabalza
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, NY, USA
| | - Cheryl Barber
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, NY, USA
| | - William Abrams
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, NY, USA
| | - Antonio Charlys Da Costa
- Laboratory of Medical Research, Institute of Tropical Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Flavio Augusto De Pádua Milagres
- Epidemiological Surveillance and Infectious Diseases, Secretary of Health of Tocantins and Federal University of Tocantins, Palmas, TO, Brazil
| | - Paulo Henrique Braz-Silva
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.,Laboratory of Medical Research, Institute of Tropical Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Daniel Malamud
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, NY, USA
| | - Marina Gallottini
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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2
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Sabalza M, Yasmin R, Barber CA, Castro T, Malamud D, Kim BJ, Zhu H, Montagna RA, Abrams WR. Detection of Zika virus using reverse-transcription LAMP coupled with reverse dot blot analysis in saliva. PLoS One 2018; 13:e0192398. [PMID: 29401479 PMCID: PMC5798782 DOI: 10.1371/journal.pone.0192398] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/23/2018] [Indexed: 12/20/2022] Open
Abstract
In recent years, there have been increasing numbers of infectious disease outbreaks that spread rapidly to population centers resulting from global travel, population vulnerabilities, environmental factors, and ecological disasters such as floods and earthquakes. Some examples of the recent outbreaks are the Ebola epidemic in West Africa, Middle East respiratory syndrome coronavirus (MERS-Co) in the Middle East, and the Zika outbreak through the Americas. We have created a generic protocol for detection of pathogen RNA and/or DNA using loop-mediated isothermal amplification (LAMP) and reverse dot-blot for detection (RDB) and processed automatically in a microfluidic device. In particular, we describe how a microfluidic assay to detect HIV viral RNA was converted to detect Zika virus (ZIKV) RNA. We first optimized the RT-LAMP assay to detect ZIKV RNA using a benchtop isothermal amplification device. Then we implemented the assay in a microfluidic device that will allow analyzing 24 samples simultaneously and automatically from sample introduction to detection by RDB technique. Preliminary data using saliva samples spiked with ZIKV showed that our diagnostic system detects ZIKV RNA in saliva. These results will be validated in further experiments with well-characterized ZIKV human specimens of saliva. The described strategy and methodology to convert the HIV diagnostic assay and platform to a ZIKV RNA detection assay provides a model that can be readily utilized for detection of the next emerging or re-emerging infectious disease.
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Affiliation(s)
- Maite Sabalza
- Department of Basic Sciences, New York University College of Dentistry, New York, New York, United States of America
- * E-mail:
| | - Rubina Yasmin
- Rheonix, Inc., Ithaca, New York, United States of America
| | - Cheryl A. Barber
- Department of Basic Sciences, New York University College of Dentistry, New York, New York, United States of America
| | - Talita Castro
- Department of Basic Sciences, New York University College of Dentistry, New York, New York, United States of America
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Daniel Malamud
- Department of Basic Sciences, New York University College of Dentistry, New York, New York, United States of America
- Department of Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Beum Jun Kim
- Rheonix, Inc., Ithaca, New York, United States of America
| | - Hui Zhu
- Rheonix, Inc., Ithaca, New York, United States of America
| | | | - William R. Abrams
- Department of Basic Sciences, New York University College of Dentistry, New York, New York, United States of America
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3
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Abstract
High-density peptide microarrays allow screening of more than six thousand peptides on a single standard microscopy slide. This method can be applied for drug discovery, therapeutic target identification, and developing of diagnostics. Here, we present a protocol to discover specific Zika virus (ZIKV) diagnostic peptides using a high-density peptide microarray. A human serum sample validated for ZIKV infection was incubated with a high-density peptide microarray containing the entire ZIKV protein translated into 3,423 unique 15 linear amino acid (aa) residues with a 14-aa residue overlap printed in duplicate. Staining with different secondary antibodies within the same array, we detected peptides that bind to Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies present in serum. These peptides were selected for further validation experiments. In this protocol, we describe the strategy followed to design, process, and analyze a high-density peptide microarray.
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Affiliation(s)
- Maite Sabalza
- Department of Basic Sciences and Craniofacial Development, New York University College of Dentistry;
| | - Cheryl A Barber
- Department of Basic Sciences and Craniofacial Development, New York University College of Dentistry
| | - William R Abrams
- Department of Basic Sciences and Craniofacial Development, New York University College of Dentistry
| | | | - Daniel Malamud
- Department of Basic Sciences and Craniofacial Development, New York University College of Dentistry; Department of Medicine, New York University Langone School of Medicine
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4
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Nittayananta W, Weinberg A, Malamud D, Moyes D, Webster-Cyriaque J, Ghosh S. Innate immunity in HIV-1 infection: epithelial and non-specific host factors of mucosal immunity- a workshop report. Oral Dis 2017; 22 Suppl 1:171-80. [PMID: 27109285 DOI: 10.1111/odi.12451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The interplay between HIV-1 and epithelial cells represents a critical aspect in mucosal HIV-1 transmission. Epithelial cells lining the oral cavity cover subepithelial tissues, which contain virus-susceptible host cells including CD4(+) T lymphocytes, monocytes/macrophages, and dendritic cells. Oral epithelia are among the sites of first exposure to both cell-free and cell-associated virus HIV-1 through breast-feeding and oral-genital contact. However, oral mucosa is considered to be naturally resistant to HIV-1 transmission. Oral epithelial cells have been shown to play a crucial role in innate host defense. Nevertheless, it is not clear to what degree these local innate immune factors contribute to HIV-1 resistance of the oral mucosa. This review paper addressed the following issues that were discussed at the 7th World Workshop on Oral Health and Disease in AIDS held in Hyderabad, India, during November 6-9, 2014: (i) What is the fate of HIV-1 after interactions with oral epithelial cells?; (ii) What are the keratinocyte and other anti-HIV effector oral factors, and how do they contribute to mucosal protection?; (iii) How can HIV-1 interactions with oral epithelium affect activation and populations of local immune cells?; (iv) How can HIV-1 interactions alter functions of oral epithelial cells?
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Affiliation(s)
- W Nittayananta
- Excellent Research Laboratory, Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Natural Products Research Center of Excellence, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - A Weinberg
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - D Malamud
- Department of Basic Science, NYU College of Dentistry, New York, NY, USA
| | - D Moyes
- Mucosal and Salivary Biology Division, King's College Dental Institute, King's College, London, UK
| | - J Webster-Cyriaque
- University of North Carolina Chapel Hill Schools of Dentistry and Medicine, Chapel Hill, NC, USA
| | - S Ghosh
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
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Abstract
Recent years have seen a massive expansion in our understanding of how we interact with our microbial colonists. The development of new, rapid sequencing techniques such as pyrosequencing and other next-generation sequencing systems have enabled us to begin to characterise the constituents of our diverse microbial communities, revealing the astonishing genetic richness that is our microbiome. Despite this, our ignorance of how these communities change over the course of an HIV infection is profound. Whilst some steps have been made to characterise the HIV microbiome at selected sites, these reports are still limited and much remains to be done. It has become apparent, however, that host-microbiota interactions are perturbed during HIV infections, with microbial translocation of potential pathogens linked to a variety of different HIV complications, including more rapid progression of disease. The use of probiotics and prebiotics has been investigated as treatments to alleviate symptoms for a variety of conditions, and is now being proposed for the treatment of symptoms associated with HIV. However, this is a new area of investigations and many questions remain unanswered. What we know about both of these topics is a drop in the ocean compared with what we need to know. In this article, we report on a workshop where these two major under-investigated research areas were presented, and future directions explored and discussed.
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Affiliation(s)
- D L Moyes
- Mucosal and Salivary Biology Division, King's College London Dental Institute, King's College London, London, UK
| | - D Saxena
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY, USA
| | - M D John
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - D Malamud
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY, USA
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6
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Saxena D, Li Y, Devota A, Pushalkar S, Abrams W, Barber C, Corby P, Poles M, Phelan J, Malamud D. Modulation of the orodigestive tract microbiome in HIV-infected patients. Oral Dis 2017; 22 Suppl 1:73-8. [PMID: 27109275 DOI: 10.1111/odi.12392] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
More than 37 million people are living with human immunodeficiency virus 1 (HIV), and more people than ever received lifesaving antiretroviral therapy worldwide. HIV-1 infection disrupts the intestinal immune system, leading to microbial translocation and systemic immune activation. We investigated the impact of HIV-1 infection on the GI microbiome and its association with host immune activation. The data indicated that the microbiome was different in HIV-positive and HIV-negative individuals. The initial sequence analysis of saliva indicated that there were major differences in the phyla of Bacteroidetes, Firmicutes, Proteobacteria, and TM7. Phylum Tenericutes was only seen in HIV-positive saliva. At the family level, we identified differences in Streptococcacea, Prevotellaceae, Porphyromonadaceae, and Neisseriaceae, whereas data from various sites in GI tract indicated that Prevotella melaninigencia, Fusobacterium necrophorum, Burkholderia, Bradyrhizobium, Ralstonia, and Eubacterium biforme were predominant but differentially present at various sites. Furthermore, there was a decrease in seven proteins associated with the alternative complement pathway and an increase in 6 proteins associated with the lectin and classical complement pathways. The correlation with a shift in complement pathways suggests that compromised immunity could be responsible for the observed dysbiosis in the GI microbiome.
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Affiliation(s)
- D Saxena
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - Y Li
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - A Devota
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - S Pushalkar
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - W Abrams
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - C Barber
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - P Corby
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - M Poles
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - J Phelan
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - D Malamud
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA.,Department of Medicine, New York University School of Medicine, New York, NY, USA
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7
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Dishon L, Avital-Cohen N, Malamud D, Heiblum R, Druyan S, Porter T, Gumułka M, Rozenboim I. In-ovo monochromatic green light photostimulation enhances embryonic somatotropic axis activity. Poult Sci 2017; 96:1884-1890. [DOI: 10.3382/ps/pew489] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 12/13/2016] [Indexed: 11/20/2022] Open
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Abstract
Over the last 10 years there have been only a handful of publications dealing with the oral virome, which is in contrast to the oral microbiome, an area that has seen considerable interest. Here, we survey viral infections in general and then focus on those viruses that are found in and/or are transmitted via the oral cavity; norovirus, rabies, human papillomavirus, Epstein‐Barr virus, herpes simplex viruses, hepatitis C virus, and HIV. Increasingly, viral infections have been diagnosed using an oral sample (e.g. saliva mucosal transudate or an oral swab) instead of blood or urine. The results of two studies using a rapid and semi‐quantitative lateral flow assay format demonstrating the correlation of HIV anti‐IgG/sIgA detection with saliva and serum samples are presented. When immediate detection of infection is important, point‐of‐care devices that obtain a non‐invasive sample from the oral cavity can be used to provide a first line diagnosis to assist in determining appropriate counselling and therapeutic path for an increasing number of diseases.
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9
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Sanfilippo N, Vasconcelos R, Moya J, Malamud D, Barber C, Smith B, DeLacure M, Kerr R, Schmidt B, Myssiorek D, Corby P. The Effect of an Oral Care Intervention in Decreasing the Expression of Proinflammatory Cytokines in Patients Receiving Chemoradiation for Oral Cancer: A Randomized Clinical Trial. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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Chen Z, Zhu H, Malamud D, Barber C, Ongagna YYS, Yasmin R, Modak S, Janal MN, Abrams WR, Montagna RA. A Rapid, Self-confirming Assay for HIV: Simultaneous Detection of Anti-HIV Antibodies and Viral RNA. ACTA ACUST UNITED AC 2016; 7. [PMID: 26925300 PMCID: PMC4768831 DOI: 10.4172/2155-6113.1000540] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective We developed a microfluidic system to simultaneously detect host anti-HIV antibodies and viral RNA in the same specimen in order to satisfy two important diagnostic criteria, especially within resource-limited settings. First, the system can detect acute HIV infection and allow immediate confirmation of a seropositive screening result by detection of HIV RNA. It also addresses the well-known "seroconversion window" during early HIV infection when antibodies are not yet detectable and viral loads are at their highest. Methods We first developed and optimized two separate manual assays for the detection of host anti-HIV antibodies and viral RNA and then converted them to the microfluidic system. We optimized a commercially available serologic assay to run within the microfluidic device while we incorporated the isothermal LAMP assay to detect the presence of viral RNA. The microfluidic device and instrumentation were developed to simultaneously perform both assays without any user intervention. Results The finalized system consists of a disposable injection molded and film-laminated microfluidic CARD disposable device and a portable, software controlled instrument, which together can automatically perform all steps of both assays without any user intervention after the initial loading of samples and reagents. The microfluidic CARD cartridge has multiple microchannels, valves, pumps and reservoirs, which perform the immunoassay, isolates viral RNA for detection by magnetic bead based purification, and Reverse Transcriptase loop-mediated isothermal amplification (RT-LAMP). The microfluidic system was able to detect host anti-HIV antibodies and viral RNA in either a blood or saliva sample. Conclusion The ability to detect antibodies and simultaneously confirm a seropositive HIV-RNA result provides healthcare workers with a complete and accurate appraisal of a patient's infection status in the earliest stages of the disease and represents an important tool for the "Test and Treat" and "Treatment as Prevention" approaches for controlling the HIV epidemic.
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Affiliation(s)
| | - Hui Zhu
- Rheonix, Inc., Ithaca, New York, USA
| | - Daniel Malamud
- New York University College of Dentistry, Department of Basic Sciences, New York, USA; New York University School of Medicine, Department of Medicine, New York, USA
| | - Cheryl Barber
- New York University College of Dentistry, Department of Basic Sciences, New York, USA
| | | | | | - Sayli Modak
- New York University College of Dentistry, Department of Basic Sciences, New York, USA
| | - Malvin N Janal
- New York University College of Dentistry, Department of Basic Sciences, New York, USA
| | - William R Abrams
- New York University College of Dentistry, Department of Basic Sciences, New York, USA
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Modak SS, Barber CA, Geva E, Abrams WR, Malamud D, Ongagna YSY. Rapid Point-of-Care Isothermal Amplification Assay for the Detection of Malaria without Nucleic Acid Purification. Infect Dis (Lond) 2016; 9:1-9. [PMID: 26819557 PMCID: PMC4721682 DOI: 10.4137/idrt.s32162] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/25/2015] [Accepted: 11/27/2015] [Indexed: 11/30/2022] Open
Abstract
Malaria remains one of the most prevalent infectious diseases and results in significant mortality. Isothermal amplification (loop-mediated isothermal amplification) is used to detect malarial DNA at levels of ~1 parasite/µL blood in ≤30 minutes without the isolation of parasite nucleic acid from subject’s blood or saliva. The technique targets the mitochondrial cytochrome oxidase subunit 1 gene and is capable of distinguishing Plasmodium falciparum from Plasmodium vivax. Malarial diagnosis by the gold standard microscopic examination of blood smears is generally carried out only after moderate-to-severe symptoms appear. Rapid diagnostic antigen tests are available but generally require infection levels in the range of 200–2,000 parasites/µL for a positive diagnosis and cannot distinguish if the disease has been cleared due to the persistence of circulating antigen. This study describes a rapid and simple molecular assay to detect malarial genes directly from whole blood or saliva without DNA isolation.
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Affiliation(s)
- Sayli S Modak
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - Cheryl A Barber
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - Eran Geva
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - William R Abrams
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA
| | - Daniel Malamud
- Department of Basic Science, New York University College of Dentistry, New York, NY, USA.; Department of Medicine, New York University Langone School of Medicine, New York, NY, USA
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12
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Patyka M, Malamud D, Weissman D, Abrams WR, Kurago Z. Periluminal Distribution of HIV-Binding Target Cells and Gp340 in the Oral, Cervical and Sigmoid/Rectal Mucosae: A Mapping Study. PLoS One 2015; 10:e0132942. [PMID: 26172445 PMCID: PMC4501766 DOI: 10.1371/journal.pone.0132942] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/21/2015] [Indexed: 12/01/2022] Open
Abstract
Studies have shown that the transmission of HIV is most likely to occur via rectal or vaginal routes, and rarely through oral exposure. However, the mechanisms of virus entry at mucosal surfaces remain incompletely understood. Prophylactic strategies against HIV infection may be attainable once gaps in current knowledge are filled. To address these gaps, we evaluated essentially normal epithelial surfaces and mapped the periluminal distribution of CD4+ HIV target cells, including T cells and antigen-presenting cells, and an HIV-binding molecule gp340 that can be expressed by epithelial cells in secreted and cell-associated forms. Immunohistochemistry for CD4, CD16, CD3, CD1a and gp340 in human oral, rectal/sigmoid and cervical mucosal samples from HIV-negative subjects demonstrated that periluminal HIV target cells were more prevalent at rectal/sigmoid and endocervical surfaces lined by simple columnar epithelium, than at oral and ectocervical surfaces covered by multilayered stratified squamous epithelium (p<0.001). gp340 expression patterns at these sites were also distinct and strong in oral minor salivary gland acini and ducts, including ductal saliva, in individual rectum/sigmoid and endocervix periluminar columnar cells, and in ectocervix squamous cells. Only weak expression was noted in the oral non-ductal squamous epithelium. We conclude that periluminal HIV target cells, together with periluminal epithelial cell-associated gp340 appear to be most accessible for HIV transmission at rectal/sigmoid and endocervical surfaces. Our data help define vulnerable structural features of mucosal sites exposed to HIV.
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Affiliation(s)
- Mariia Patyka
- Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Daniel Malamud
- NYU College of Dentistry, Department of Basic Sciences, HIV/AIDS Research Program (HARP), New York, New York, United States of America
- NYU School of Medicine, Infectious Disease, New York, New York, United States of America
| | - Drew Weissman
- Medicine (Infectious Disease), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - William R. Abrams
- NYU College of Dentistry, Department of Basic Sciences, HIV/AIDS Research Program (HARP), New York, New York, United States of America
| | - Zoya Kurago
- Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, Augusta, Georgia, United States of America
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13
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Phelan JA, Abrams WR, Norman RG, Li Y, Laverty M, Corby PM, Nembhard J, Neri D, Barber CA, Aberg JA, Fisch GS, Poles MA, Malamud D. Design aspects of a case-control clinical investigation of the effect of HIV on oral and gastrointestinal soluble innate factors and microbes. PLoS One 2014; 9:e112901. [PMID: 25409430 PMCID: PMC4237510 DOI: 10.1371/journal.pone.0112901] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 10/16/2014] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The impaired host defense system in HIV infection impacts the oral and gastrointestinal microbiota and associated opportunistic infections. Antiretroviral treatment is predicted to partially restore host defenses and decrease the oral manifestation of HIV/AIDS. Well-designed longitudinal studies are needed to better understand the interactions of soluble host defense proteins with bacteria and virus in HIV/AIDS. "Crosstalk" was designed as a longitudinal study of host responses along the gastrointestinal (GI) tract and interactions between defense molecules and bacteria in HIV infection and subsequent therapy. PURPOSE The clinical core formed the infrastructure for the study of the interactions between the proteome, microbiome and innate immune system. The core recruited and retained study subjects, scheduled visits, obtained demographic and medical data, assessed oral health status, collected samples, and guided analysis of the hypotheses. This manuscript presents a well-designed clinical core that may serve as a model for studies that combine clinical and laboratory data. METHODS Crosstalk was a case-control longitudinal clinical study an initial planned enrollment of 170 subjects. HIV+ antiretroviral naïve subjects were followed for 9 visits over 96 weeks and HIV uninfected subjects for 3 visits over 24 weeks. Clinical prevalence of oral mucosal lesions, dental caries and periodontal disease were assessed. RESULTS During the study, 116 subjects (47 HIV+, 69 HIV-) were enrolled. Cohorts of HIV+ and HIV- were demographically similar except for a larger proportion of women in the HIV- group. The most prevalent oral mucosal lesions were oral candidiasis and hairy leukoplakia in the HIV+ group. DISCUSSION The clinical core was essential to enable the links between clinical and laboratory data. The study aims to determine specific differences between oral and GI tissues that account for unique patterns of opportunistic infections and to delineate the differences in their susceptibility to infection by HIV and their responses post-HAART.
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Affiliation(s)
- Joan A. Phelan
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, New York, United States of America
| | - William R. Abrams
- Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, New York, New York, United States of America
- * E-mail:
| | - Robert G. Norman
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, United States of America
| | - Yihong Li
- Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, New York, New York, United States of America
| | - Maura Laverty
- Departments of Medicine and Infectious Diseases and Immunology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Patricia M. Corby
- Bluestone Center for Clinical Research, New York University College of Dentistry, New York, New York, United States of America
| | - Jason Nembhard
- Bluestone Center for Clinical Research, New York University College of Dentistry, New York, New York, United States of America
| | - Dinah Neri
- Bluestone Center for Clinical Research, New York University College of Dentistry, New York, New York, United States of America
| | - Cheryl A. Barber
- Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, New York, New York, United States of America
| | - Judith A. Aberg
- Departments of Medicine and Infectious Diseases and Immunology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Gene S. Fisch
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, United States of America
| | - Michael A. Poles
- Department of Medicine, Division of Gastroenterology, New York University Langone Medical Center, New York, New York, United States of America
| | - Daniel Malamud
- Department of Basic Sciences and Craniofacial Biology, New York University College of Dentistry, New York, New York, United States of America
- Department of Medicine, New York University School of Medicine, New York, New York, United States of America
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Barber C, Weissman D, Barnhart K, Dalvi M, Abrams WR, Malamud D. An electrochemiluminescence assay for gp340 (DMBT1). Anal Biochem 2013; 440:78-80. [PMID: 23727557 DOI: 10.1016/j.ab.2013.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/17/2013] [Accepted: 05/21/2013] [Indexed: 11/18/2022]
Abstract
Gp340 is a member of the scavenger receptor cysteine-rich family of innate immune molecules and also functions as a tumor suppressor. This study describes a picogram-level assay using electrochemiluminescence technology on the MesoScale Discovery platform. Antibodies were evaluated and the best pair was used to assay whole-mouth stimulated saliva and cervical/vaginal lavage. The assay was tested using specimens obtained from healthy volunteers to determine if gp340 concentration in saliva correlates with levels in vaginal lavage fluid. Interestingly, no correlation was determined between gp340 content in these two fluids.
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Affiliation(s)
- Cheryl Barber
- Department of Basic Sciences, College of Dentistry, New York University, New York, NY 10010, USA
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15
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Zhang N, Zhang Z, Feng S, Wang Q, Malamud D, Deng H. Quantitative analysis of differentially expressed saliva proteins in human immunodeficiency virus type 1 (HIV-1) infected individuals. Anal Chim Acta 2013; 774:61-6. [PMID: 23567117 PMCID: PMC4507271 DOI: 10.1016/j.aca.2013.02.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/15/2013] [Accepted: 02/19/2013] [Indexed: 02/05/2023]
Abstract
In the present study, we have established a new methodology to analyze saliva proteins from HIV-1-seropositive patients before highly active antiretroviral therapy (HAART) and seronegative controls. A total of 593 and 601 proteins were identified in the pooled saliva samples from 5 HIV-1 subjects and 5 controls, respectively. Forty-one proteins were found to be differentially expressed. Bioinformatic analysis of differentially expressed salivary proteins showed an increase of antimicrobial proteins and decrease of protease inhibitors upon HIV-1 infection. To validate some of these differentially expressed proteins, a high-throughput quantitation method was established to determine concentrations of 10 salivary proteins in 40 individual saliva samples from 20 seropositive patients before HAART and 20 seronegative subjects. This method was based on limited protein separation within the zone of the stacking gel of the 1D SDS PAGE and using isotope-coded synthetic peptides as internal standards. The results demonstrated that a combination of protein profiling and targeted quantitation is an efficient method to identify and validate differentially expressed salivary proteins. Expression levels of members of the calcium-binding S100 protein family and deleted in malignant brain tumors 1 protein (DMBT1) were up-regulated while that of Mucin 5B was down-regulated in HIV-1 seropositive saliva samples, which may provide new perspectives for monitoring HIV-infection and understanding the mechanism of HIV-1 infectivity.
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Affiliation(s)
- Nawei Zhang
- Beijing Chaoyang Hospital Affiliated Capital Medical University, Beijing, China
| | - Zhenyu Zhang
- Beijing Chaoyang Hospital Affiliated Capital Medical University, Beijing, China
| | - Shan Feng
- MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing, China
| | - Qingtao Wang
- Beijing Chaoyang Hospital Affiliated Capital Medical University, Beijing, China
| | - Daniel Malamud
- NYU College of Dentistry, 345 East 24th Street, New York, NY 10010, USA
| | - Haiteng Deng
- MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing, China
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16
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Ongagna-Yhombi SY, Corstjens P, Geva E, Abrams WR, Barber CA, Malamud D, Mharakurwa S. Improved assay to detect Plasmodium falciparum using an uninterrupted, semi-nested PCR and quantitative lateral flow analysis. Malar J 2013; 12:74. [PMID: 23433252 PMCID: PMC3605351 DOI: 10.1186/1475-2875-12-74] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 02/18/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A rapid, non-invasive, and inexpensive point-of-care (POC) diagnostic for malaria followed by therapeutic intervention would improve the ability to control infection in endemic areas. METHODS A semi-nested PCR amplification protocol is described for quantitative detection of Plasmodium falciparum and is compared to a traditional nested PCR. The approach uses primers that target the P. falciparum dihydrofolate reductase gene. RESULTS This study demonstrates that it is possible to perform an uninterrupted, asymmetric, semi-nested PCR assay with reduced assay time to detect P. falciparum without compromising the sensitivity and specificity of the assay using saliva as a testing matrix. CONCLUSIONS The development of this PCR allows nucleic acid amplification without the need to transfer amplicon from the first PCR step to a second reaction tube with nested primers, thus reducing both the chance of contamination and the time for analysis to < two hours. Analysis of the PCR amplicon yield was adapted to lateral flow detection using the quantitative up-converting phosphor (UCP) reporter technology. This approach provides a basis for migration of the assay to a POC microfluidic format. In addition the assay was successfully evaluated with oral samples. Oral fluid collection provides a simple non-invasive method to collect clinical samples.
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17
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Nassry DD, Phelan JA, Ghookasian M, Barber CA, Norman RG, Lloyd MM, Schenkel A, Malamud D, Abrams WR. Patient and Provider Acceptance of Oral HIV Screening in a Dental School Setting. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2012.76.9.tb05369.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- David D. Nassry
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; College of Dentistry New York University
| | - Joan A. Phelan
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; College of Dentistry, New York University
| | | | | | - Robert G. Norman
- Epidemiology and Health Promotion; College of Dentistry, New York University
| | - Madeleine M. Lloyd
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; College of Dentistry, New York University
| | - Andrew Schenkel
- Department of Cariology and Comprehensive Care; College of Dentistry, New York University
| | - Daniel Malamud
- Basic Sciences, College of Dentistry, New York University
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18
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Nassry DD, Phelan JA, Ghookasian M, Barber CA, Norman RG, Lloyd MM, Schenkel A, Malamud D, Abrams WR. Patient and provider acceptance of oral HIV screening in a dental school setting. J Dent Educ 2012; 76:1150-1155. [PMID: 22942410 PMCID: PMC4041101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In 2006, the Centers for Disease Control and Prevention (CDC) recommended routine HIV screening in health care settings regardless of the patient's level of risk. This pilot study was developed in response to the suggestion by some health care professionals that dental settings would be appropriate for expansion of HIV testing. This project consisted of two parts: oral fluid HIV testing of patients in the clinic of a dental school and a survey of the clinical dental faculty members' attitudes about acceptability of routine HIV testing in the dental clinic. When patients' agreement to participate in oral fluid HIV testing was examined, 8.2 percent of the patients contacted by the clinic administration staff completed testing. When approached by a faculty member or student during the dental visit admission and tested during the dental visit, however, 88.2 percent completed testing. Of the faculty members who took the survey, 27.4 percent were neutral, 26.4 percent were somewhat in agreement, and 32.1 percent were willing to incorporate HIV testing into routine dental care. In this pilot study, HIV testing of dental patients was most successful when a dental care provider approached patients about testing. If consent was given, the testing was performed during the visit. For the faculty members, the major barrier to testing was a lack of protocol familiarity.
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Affiliation(s)
- David D Nassry
- College of Dentistry, New York University, 345 East 24th St., New York, NY 10010, USA
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19
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Liu G, Saxena D, Chen Z, Norman RG, Phelan JA, Laverty M, Fisch GS, Corby PM, Abrams W, Malamud D, Li Y. HIV infection affects Streptococcus mutans levels, but not genotypes. J Dent Res 2012; 91:834-40. [PMID: 22821240 DOI: 10.1177/0022034512454298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a clinical study that examines whether HIV infection affects Streptococcus mutans colonization in the oral cavity. Whole stimulated saliva samples were collected from 46 HIV-seropositive individuals and 69 HIV-seronegative control individuals. The level of S. mutans colonization was determined by conventional culture methods. The genotype of S. mutans was compared between 10 HIV-positive individuals before and after highly active antiretroviral therapy (HAART) and 10 non-HIV-infected control individuals. The results were analyzed against viral load, CD4+ and CD8+ T-cell counts, salivary flow rate, and caries status. We observed that S. mutans levels were higher in HIV-infected individuals than in the non-HIV-infected control individuals (p = 0.013). No significant differences in S. mutans genotypes were found between the two groups over the six-month study period, even after HAART. There was a bivariate linear relationship between S. mutans levels and CD8+ counts (r = 0.412; p = 0.007), but not between S. mutans levels and either CD4+ counts or viral load. Furthermore, compared with non-HIV-infected control individuals, HIV-infected individuals experienced lower salivary secretion (p = 0.009) and a positive trend toward more decayed tooth surfaces (p = 0.027). These findings suggest that HIV infection can have a significant effect on the level of S. mutans, but not genotypes.
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Affiliation(s)
- G Liu
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, 345 E. 24 Street, New York, NY 10010-4086, USA
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20
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Hutchinson MK, VanDevanter N, Phelan J, Malamud D, Vernillo A, Combellick J, Shelley D. Feasibility of implementing rapid oral fluid HIV testing in an urban University Dental Clinic: a qualitative study. BMC Oral Health 2012; 12:11. [PMID: 22571324 PMCID: PMC3436777 DOI: 10.1186/1472-6831-12-11] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 03/07/2012] [Indexed: 11/12/2022] Open
Abstract
Background More than 1 million individuals in the U.S. are infected with HIV; approximately 20% of whom do not know they are infected. Early diagnosis of HIV infection results in earlier access to treatment and reductions in HIV transmission. In 2006, the CDC recommended that health care providers offer routine HIV screening to all adolescent and adult patients, regardless of community seroprevalence or patient lifestyle. Dental providers are uniquely positioned to implement these recommendations using rapid oral fluid HIV screening technology. However, thus far, uptake into dental practice has been very limited. Methods The study utilized a qualitative descriptive approach with convenience samples of dental faculty and students. Six in-depth one-on-one interviews were conducted with dental faculty and three focus groups were conducted with fifteen dental students. Results Results were fairly consistent and indicated relatively high levels of acceptability. Barriers and facilitators of oral fluid HIV screening were identified in four primary areas: scope of practice/practice enhancement, skills/knowledge/training, patient service/patient reactions and logistical issues. Conclusions Oral fluid HIV screening was described as having benefits for patients, dental practitioners and the public good. Many of the barriers to implementation that were identified in the study could be addressed through training and interdisciplinary collaborations.
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21
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Rosedale M, Malaspina D, Malamud D, Strauss SM, Horne JD, Abouzied S, Cruciani RA, Knotkova H. Developing patient-centered treatment protocols in brain stimulation: a rationale for combining quantitative and qualitative approaches in persons with HIV. J Am Psychiatr Nurses Assoc 2012; 18:166-74. [PMID: 22412085 DOI: 10.1177/1078390311436128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article reports and discusses how quantitative (physiological and behavioral) and qualitative methods are being combined in an open-label pilot feasibility study. The study evaluates safety, tolerability, and acceptability of a protocol to treat depression in HIV-infected individuals, using a 2-week block of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex. Major depressive disorder (MDD) is the second most prevalent psychiatric disorder after substance abuse among HIV-positive adults, and novel antidepressant treatments are needed for this vulnerable population. The authors describe the challenges and contributions derived from different research perspectives and methodological approaches and provide a philosophical framework for combining quantitative and qualitative measurements for a fuller examination of the disorder. Four methodological points are presented: (1) the value of combining quantitative and qualitative approaches; (2) the need for context-specific measures when studying patients with medical and psychiatric comorbidities; (3) the importance of research designs that integrate physiological, behavioral, and qualitative approaches when evaluating novel treatments; and (4) the need to explore the relationships between biomarkers, clinical symptom assessments, patient self-evaluations, and patient experiences when developing new, patient-centered protocols. The authors conclude that the complexity of studying novel treatments in complex and new patient populations requires complex research designs to capture the richness of data that inform translational research.
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Affiliation(s)
- Mary Rosedale
- New York University College of Nursing, 246 Greene St, NY 10003, USA.
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22
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Abstract
Understanding of the human microbiome continues to grow rapidly; however, reports on changes in the microbiome after HIV infection are still limited. This review surveys the progress made in methodology associated with microbiome studies and highlights the remaining challenges to this field. Studies have shown that commensal oral, gut, vaginal, and penile bacteria are vital to the health of the human immune system. Our studies on crosstalk among oral and gastrointestinal soluble innate factors, HIV, and microbes indicated that the oral and gut microbiome was altered in the HIV-positive samples compared to the negative controls. The importance of understanding the bacterial component of HIV/AIDS, and likelihood of "crosstalk" between viral and bacterial pathogens, will help in understanding the role of the microbiome in HIV-infected individuals and facilitate identification of novel antiretroviral factors for use as novel diagnostics, microbicides, or therapeutics against HIV infection.
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Affiliation(s)
- Deepak Saxena
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY, USA.
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23
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VanDevanter N, Combellick J, Hutchinson MK, Phelan J, Malamud D, Shelley D. A Qualitative Study of Patients' Attitudes toward HIV Testing in the Dental Setting. Nurs Res Pract 2012; 2012:803169. [PMID: 22474584 PMCID: PMC3306903 DOI: 10.1155/2012/803169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 12/05/2011] [Indexed: 11/20/2022] Open
Abstract
An estimated 1.1 million people in the USA are living with HIV/AIDS. Nearly 200,000 of these individuals do not know that they are infected. In 2006, the CDC recommended that all healthcare providers routinely offer HIV screening to adolescent and adult patients. Nurse-dentist collaborations present unique opportunities to provide rapid oral HIV screening to patients in dental clinic settings and reach the many adults who lack primary medical providers. However, little is known about the feasibility and acceptability of this type of innovative practice. Thus, elicitation research was undertaken with dental providers, students, and patients. This paper reports the results of qualitative interviews with 19 adults attending a university-based dental clinic in New York City. Overall, patients held very positive attitudes and beliefs toward HIV screening in dental sites and identified important factors that should be incorporated into the design of nurse-dentist collaborative HIV screening programs.
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Affiliation(s)
| | - Joan Combellick
- NYU College of Nursing, 726 Broadway, New York, NY 10003, USA
| | | | - Joan Phelan
- NYU College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA
| | - Daniel Malamud
- NYU College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA
| | - Donna Shelley
- NYU College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA
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24
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Abstract
There have been significant advances in techniques for the detection of biomarker signals in the oral cavity (e.g., ELISAs for proteins, PCR for RNA and DNA) as well as the engineering and development of microfluidic approaches to make oral-based point-of-care (POC) methods for the diagnosis for both local and systemic conditions a reality. In this section, we focus on three such approaches, namely, periodontal disease management, early markers for systemic diseases, and salivary markers useful for pharmacogenomic studies. Novel approaches using non-invasive, salivary samples and user-friendly devices offer results that are as sensitive and specific as laboratory-based analyses using blood or urine.
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Affiliation(s)
- W V Giannobile
- Department of Periodontics, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, USA
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25
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Knotkova H, Rosedale M, Strauss SM, Horne J, Soto E, Cruciani RA, Malaspina D, Malamud D. Using Transcranial Direct Current Stimulation to Treat Depression in HIV-Infected Persons: The Outcomes of a Feasibility Study. Front Psychiatry 2012; 3:59. [PMID: 22719732 PMCID: PMC3376409 DOI: 10.3389/fpsyt.2012.00059] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 05/25/2012] [Indexed: 01/07/2023] Open
Abstract
UNLABELLED Transcranial direct current stimulation (tDCS) is a novel non-invasive neuromodulatory method that influences neuronal firing rates and excitability of neuronal circuits in the brain. tDCS has been shown to relieve Major Depressive Disorder (MDD) in the general population, suggesting its potential for other vulnerable populations with high MDD prevalence. AIMS This study evaluated the feasibility, safety, acceptability, and clinical outcomes of a 2-week tDCS antidepressant treatment in HIV-MDD co-diagnosed patients, and the feasibility of collecting serum and saliva for analysis of immunity biomarkers. METHODS Ten enrolled patients underwent baseline evaluation and started the tDCS treatment (Monday-Friday for 2 weeks) delivered with Phoresor II 850 PM for 20 min at 2 mA at each visit, using two saline-soaked sponge electrodes placed over the F3 position of EEG 10-20 system and the contralateral supraorbital region. Outcome measures were collected at baseline, after the last tDCS and 2 weeks later. A quantitative microarray (Ray Bio Tech Inc.) for TH1/TH2 cytokines was used for saliva and plasma analysis. RESULTS Analyzable outcome-data were obtained from eight subjects. Depression scores significantly decreased (p < 0.0005) after the treatment. No serious adverse events occurred. Several transient minor AEs and occasional changes of blood pressure and heart rate were noted. Mini-mental state examination scores remained unchanged or increased after the treatment. All subjects were highly satisfied with the protocol and treatment results and described the desire to find new treatments for HIV-MDD as motivating participation. CONCLUSION Findings support feasibility and clinical potential of tDCS for HIV-MDD patients, and justify larger-sample, sham-controlled trials.
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Affiliation(s)
- Helena Knotkova
- Research Division, Department of Pain Medicine and Palliative Care, Institute for Non-Invasive Brain Stimulation, Beth Israel Medical Center New York, NY, USA
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26
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Abstract
Many of the target molecules that reside in blood are also present in oral fluids, albeit at lower concentrations. Oral fluids are, however, relatively easy and safe to collect without the need for specialized equipment and training. Thus, oral fluids provide convenient samples for medical diagnostics. Recent advances in lab-on-a-chip technologies have made minute, fully integrated diagnostic systems practical for an assortment of point-of-care tests. Such systems can perform either immunoassays or molecular diagnostics outside centralized laboratories within time periods ranging from minutes to an hour. The article briefly reviews recent advances in devices for point-of-care testing with a focus on work that has been carried out by the authors as part of a NIH program.
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Affiliation(s)
- R W Hart
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA 19104-6315, USA
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27
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Abstract
In this review, the authors survey the large number of antibacterial and antiviral proteins present in human saliva. Of interest, most of these antibacterial proteins display antiviral activity, typically against specific viral pathogens. The review focuses on one protein that interacts with both bacteria and viruses-gp340, originally referred to as salivary agglutinin. In the oral cavity, soluble gp340 binds to and aggregates a variety of bacteria, and this is thought to increase bacterial clearance from the mouth. However, when bound to the tooth surface, gp340 promotes bacterial adherence. In the oral cavity, most gp340 is found soluble in saliva and can function as a specific inhibitor of infectivity of HIV-1 and influenza A. In contrast, in the female reproductive track, most gp340 is bound to the cell surface, where it can promote HIV-1 infection.
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Affiliation(s)
- D Malamud
- Department of Basic Sciences, NYU College of Dentistry, New York, New York, USA.
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28
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Liu C, Geva E, Mauk M, Qiu X, Abrams WR, Malamud D, Curtis K, Owen SM, Bau HH. An isothermal amplification reactor with an integrated isolation membrane for point-of-care detection of infectious diseases. Analyst 2011; 136:2069-76. [PMID: 21455542 DOI: 10.1039/c1an00007a] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A simple, point of care, inexpensive, disposable cassette for the detection of nucleic acids extracted from pathogens was designed, constructed, and tested. The cassette utilizes a single reaction chamber for isothermal amplification of nucleic acids. The chamber is equipped with an integrated, flow-through, Flinders Technology Associates (Whatman FTA®) membrane for the isolation, concentration, and purification of DNA and/or RNA. The nucleic acids captured by the membrane are used directly as templates for amplification without elution, thus simplifying the cassette's flow control. The FTA membrane also serves another critical role-enabling the removal of inhibitors that dramatically reduce detection sensitivity. Thermal control is provided with a thin film heater external to the cassette. The amplification process was monitored in real time with a portable, compact fluorescent reader. The utility of the integrated, single-chamber cassette was demonstrated by detecting the presence of HIV-1 in oral fluids. The HIV RNA was reverse transcribed and subjected to loop-mediated, isothermal amplification (LAMP). A detection limit of less than 10 HIV particles was demonstrated. The cassette is particularly suitable for resource poor regions, where funds and trained personnel are in short supply. The cassette can be readily modified to detect nucleic acids associated with other pathogens borne in saliva, urine, and other body fluids as well as in water and food.
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Affiliation(s)
- Changchun Liu
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, 19104-6315, USA
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29
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Abstract
Salivary diagnostics is a dynamic and emerging field utilizing nanotechnology and molecular diagnostics to aid in the diagnosis of oral and systemic diseases. In this article the author critically reviews the latest advances using oral biomarkers for disease detection. The use of oral fluids is broadening perspectives in clinical diagnosis, disease monitoring, and decision making for patient care. Important elements determining the future possibilities and challenges in this field are also discussed.
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Affiliation(s)
- Daniel Malamud
- Department of Basic Sciences, New York University College of Dentistry, New York, NY 10010, USA.
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30
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Vernillo A, Welie JVM, Naidoo S, Malamud D. The challenges of oral-based diagnostics in extending the role of dentistry as a health care profession: property rights, privacy, and informed consent. J Am Coll Dent 2011; 78:33-40. [PMID: 22263370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Saliva may be a legal and ethical counterpart of other bodily fluids in diagnostic testing to blood and urine, with regard to its role in diagnostic testing. Two paradigms that have been proposed in the literature to address these challenges are reviewed in this paper. The first is centered on ownership and property rights to saliva, including financial compensation from commercially developed products using saliva. The commodification of saliva as property is also discussed. The second paradigm is related to privacy and the potential for genetic discrimination, given the unwarranted disclosure of confidential information. The management of saliva specimens from dental patients and research participants will also require the implementation of innovative approaches to obtain informed consent.
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Affiliation(s)
- Anthony Vernillo
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, USA.
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31
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Chen D, Mauk M, Qiu X, Liu C, Kim J, Ramprasad S, Ongagna S, Abrams WR, Malamud D, Corstjens PLAM, Bau HH. An integrated, self-contained microfluidic cassette for isolation, amplification, and detection of nucleic acids. Biomed Microdevices 2010; 12:705-19. [PMID: 20401537 DOI: 10.1007/s10544-010-9423-4] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A self-contained, integrated, disposable, sample-to-answer, polycarbonate microfluidic cassette for nucleic acid-based detection of pathogens at the point of care was designed, constructed, and tested. The cassette comprises on-chip sample lysis, nucleic acid isolation, enzymatic amplification (polymerase chain reaction and, when needed, reverse transcription), amplicon labeling, and detection. On-chip pouches and valves facilitate fluid flow control. All the liquids and dry reagents needed for the various reactions are pre-stored in the cassette. The liquid reagents are stored in flexible pouches formed on the chip surface. Dry (RT-)PCR reagents are pre-stored in the thermal cycling, reaction chamber. The process operations include sample introduction; lysis of cells and viruses; solid-phase extraction, concentration, and purification of nucleic acids from the lysate; elution of the nucleic acids into a thermal cycling chamber and mixing with pre-stored (RT-)PCR dry reagents; thermal cycling; and detection. The PCR amplicons are labeled with digoxigenin and biotin and transmitted onto a lateral flow strip, where the target analytes bind to a test line consisting of immobilized avidin-D. The immobilized nucleic acids are labeled with up-converting phosphor (UCP) reporter particles. The operation of the cassette is automatically controlled by an analyzer that provides pouch and valve actuation with electrical motors and heating for the thermal cycling. The functionality of the device is demonstrated by detecting the presence of bacterial B.Cereus, viral armored RNA HIV, and HIV I virus in saliva samples. The cassette and actuator described here can be used to detect other diseases as well as the presence of bacterial and viral pathogens in the water supply and other fluids.
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Affiliation(s)
- Dafeng Chen
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA 19104, USA
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32
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Liu G, Saxena D, Deng H, Norman RG, Chen Z, Abrams WR, Malamud D, Li Y. Effect of protease inhibitors on the quantitative and qualitative assessment of oral microorganisms. FEMS Microbiol Lett 2010; 312:63-70. [PMID: 20831596 DOI: 10.1111/j.1574-6968.2010.02100.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Protease inhibitor cocktails are routinely added to clinical samples used for proteomic studies to inactivate proteases. As these same samples are often used for microbial studies, we determined whether the addition of protease inhibitors could affect the quantitative or qualitative assessment of microbial profiles. Twenty-two saliva samples were collected and processed immediately with or without the addition of a protease inhibitor cocktail. Conventional cultivation methods were used to evaluate total bacterial growth. Total genomic DNA was isolated and a specific 16S rRNA gene-targeted region was PCR-amplified and separated by denaturing gradient gel electrophoresis. A combination of 1D sodium dodecyl sulfate polyacrylamide gel electrophoresis and LC-MS/MS methods was used to determine the effect of the protease inhibitors on the integrity of salivary proteins and peptides. Interestingly, no significant differences were observed in either the bacterial growth and composition or the integrity of salivary proteins between the two groups. Correlation coefficients between the paired samples for total cultivable microbiota (r(2) =0.847), total mutans streptococci (r(2) =0.898), total oral lactobacilli (r(2) =0.933), and total Streptococcus mutans (r(2) =0.870) also exceeded expected values. The results suggest that the addition of a protease inhibitor cocktail in saliva samples does not impact the growth of oral microbiota or compromise the ability to characterize its composition.
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Affiliation(s)
- Gaoxia Liu
- Department of Basic Sciences, New York University College of Dentistry, New York, NY 10010-4086, USA
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Nossa CW, Oberdorf WE, Yang L, Aas JA, Paster BJ, DeSantis TZ, Brodie EL, Malamud D, Poles MA, Pei Z. Design of 16S rRNA gene primers for 454 pyrosequencing of the human foregut microbiome. World J Gastroenterol 2010; 16:4135-44. [PMID: 20806429 PMCID: PMC2932916 DOI: 10.3748/wjg.v16.i33.4135] [Citation(s) in RCA: 286] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To design and validate broad-range 16S rRNA primers for use in high throughput sequencing to classify bacteria isolated from the human foregut microbiome.
METHODS: A foregut microbiome dataset was constructed using 16S rRNA gene sequences obtained from oral, esophageal, and gastric microbiomes produced by Sanger sequencing in previous studies represented by 219 bacterial species. Candidate primers evaluated were from the European rRNA database. To assess the effect of sequence length on accuracy of classification, 16S rRNA genes of various lengths were created by trimming the full length sequences. Sequences spanning various hypervariable regions were selected to simulate the amplicons that would be obtained using possible primer pairs. The sequences were compared with full length 16S rRNA genes for accuracy in taxonomic classification using online software at the Ribosomal Database Project (RDP). The universality of the primer set was evaluated using the RDP 16S rRNA database which is comprised of 433 306 16S rRNA genes, represented by 36 phyla.
RESULTS: Truncation to 100 nucleotides (nt) downstream from the position corresponding to base 28 in the Escherichia coli 16S rRNA gene caused misclassification of 87 (39.7%) of the 219 sequences, compared with misclassification of only 29 (13.2%) sequences with truncation to 350 nt. Among 350-nt sequence reads within various regions of the 16S rRNA gene, the reverse read of an amplicon generated using the 343F/798R primers had the least (8.2%) effect on classification. In comparison, truncation to 900 nt mimicking single pass Sanger reads misclassified 5.0% of the 219 sequences. The 343F/798R amplicon accurately assigned 91.8% of the 219 sequences at the species level. Weighted by abundance of the species in the esophageal dataset, the 343F/798R amplicon yielded similar classification accuracy without a significant loss in species coverage (92%). Modification of the 343F/798R primers to 347F/803R increased their universality among foregut species. Assuming that a typical polymerase chain reaction can tolerate 2 mismatches between a primer and a template, the modified 347F and 803R primers should be able to anneal 98% and 99.6% of all 16S rRNA genes in the RDP database.
CONCLUSION: 347F/803R is the most suitable pair of primers for classification of foregut 16S rRNA genes but also possess universality suitable for analyses of other complex microbiomes.
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Qiu X, Thompson JA, Chen Z, Liu C, Chen D, Ramprasad S, Mauk MG, Ongagna S, Barber C, Abrams WR, Malamud D, Corstjens PLAM, Bau HH. Finger-actuated, self-contained immunoassay cassettes. Biomed Microdevices 2010; 11:1175-86. [PMID: 19597994 DOI: 10.1007/s10544-009-9334-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The building blocks for an inexpensive, disposable, luminescence-based microfluidic immunoassay cassette are described, and their integration in a point-of-care diagnostic system is demonstrated. Fluid motion in the cassette is driven by depressing finger-actuated pouches. All reagents needed for the immunoassay can be stored in the cassette in liquid form. Prior to use, the cassette consists of two separate parts. A top storage component contains pouches, sealed storage chambers, a metering chamber, and needle seats. The bottom processing component contains connection needles, a mixing chamber, and a detection chamber with immobilized proteins. Subsequent to sample introduction, the storage and processing components are mated. The needles form hydraulic connections between the two parts and, in some cases, close valves. The pouches are then actuated sequentially to induce flow of various reagents and facilitate process operations. The cassette is compatible with different detection modalities. Both a cassette with immunochromatographic-based detection and a cassette with microbead-based detection were constructed and evaluated. The immunochromatographic cassette was used to detect antibodies to HIV in saliva samples. The bead-based cassette was used to detect the proinflammatory chemokine IL-8. The experimental data demonstrates good repeatability and reasonable sensitivity.
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Affiliation(s)
- Xianbo Qiu
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA 19104, USA
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Liu C, Qiu X, Ongagna S, Chen D, Chen Z, Abrams WR, Malamud D, Corstjens PL, Bau HH. A timer-actuated immunoassay cassette for detecting molecular markers in oral fluids. Lab Chip 2009; 9:768-76. [PMID: 19255658 PMCID: PMC2706488 DOI: 10.1039/b814322f] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
An inexpensive, hand-held, point-of-care, disposable, self-contained immunoassay cassette comprised of air pouches for pumping, a metering chamber, reagents storage chambers, a mixer, and a lateral flow strip was designed, constructed, and tested. The assay was carried out in a consecutive flow format. The detection was facilitated with up-converting phosphor (UCP) reporter particles. The automated, timely pumping of the various reagents was driven by a spring-loaded timer. The utility of the cassette was demonstrated by detecting antibodies to HIV in saliva samples and further evaluated with a non-contagious, haptenized DNA assay. The cassette has several advantages over dip sticks such as sample preprocessing, integrated storage of reagents, and automated operation that reduces operator errors and training. The cassette and actuator described herein can readily be extended to detect biomarkers of other diseases in body fluids and other fluids at the point of care. The system is particularly suitable for resource-poor countries, where funds and trained personnel are in short supply.
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Affiliation(s)
- Changchun Liu
- Department of Mechanical Engineering and Applied Mechanics, Philadelphia, PA 19104-6315, USA
| | - Xianbo Qiu
- Department of Mechanical Engineering and Applied Mechanics, Philadelphia, PA 19104-6315, USA
| | - Serge Ongagna
- Department of Basic Sciences, New York University College of Dentistry, New York, 10010, USA
| | - Dafeng Chen
- Department of Mechanical Engineering and Applied Mechanics, Philadelphia, PA 19104-6315, USA
| | - Zongyuan Chen
- Department of Mechanical Engineering and Applied Mechanics, Philadelphia, PA 19104-6315, USA
| | - William R. Abrams
- Department of Basic Sciences, New York University College of Dentistry, New York, 10010, USA
| | - Daniel Malamud
- Department of Basic Sciences, New York University College of Dentistry, New York, 10010, USA
- Department of Medicine, NYU School of Medicine, New York, 10010, USA
| | | | - Haim H. Bau
- Department of Mechanical Engineering and Applied Mechanics, Philadelphia, PA 19104-6315, USA
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Yan W, Apweiler R, Balgley BM, Boontheung P, Bundy JL, Cargile BJ, Cole S, Fang X, Gonzalez-Begne M, Griffin TJ, Hagen F, Hu S, Wolinsky LE, Lee CS, Malamud D, Melvin JE, Menon R, Mueller M, Qiao R, Rhodus NL, Sevinsky JR, States D, Stephenson JL, Than S, Yates JR, Yu W, Xie H, Xie Y, Omenn GS, Loo JA, Wong DT. Systematic comparison of the human saliva and plasma proteomes. Proteomics Clin Appl 2009; 3:116-134. [PMID: 19898684 DOI: 10.1002/prca.200800140] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The proteome of human salivary fluid has the potential to open new doors for disease biomarker discovery. A recent study to comprehensively identify and catalog the human ductal salivary proteome led to the compilation of 1166 proteins. The protein complexity of both saliva and plasma is large, suggesting that a comparison of these two proteomes will provide valuable insight into their physiological significance and an understanding of the unique and overlapping disease diagnostic potential that each fluid provides. To create a more comprehensive catalog of human salivary proteins, we have first compiled an extensive list of proteins from whole saliva (WS) identified through MS experiments. The WS list is thereafter combined with the proteins identified from the ductal parotid, and submandibular and sublingual (parotid/SMSL) salivas. In parallel, a core dataset of the human plasma proteome with 3020 protein identifications was recently released. A total of 1939 nonredundant salivary proteins were compiled from a total of 19 474 unique peptide sequences identified from whole and ductal salivas; 740 out of the total 1939 salivary proteins were identified in both whole and ductal saliva. A total of 597 of the salivary proteins have been observed in plasma. Gene ontology (GO) analysis showed similarities in the distributions of the saliva and plasma proteomes with regard to cellular localization, biological processes, and molecular function, but revealed differences which may be related to the different physiological functions of saliva and plasma. The comprehensive catalog of the salivary proteome and its comparison to the plasma proteome provides insights useful for future study, such as exploration of potential biomarkers for disease diagnostics.
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Affiliation(s)
- Weihong Yan
- Department of Chemistry and Biochemistry, University of California-Los Angeles, Los Angeles, CA, USA
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37
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Cannon G, Yi Y, Ni H, Stoddard E, Scales DA, Van Ryk DI, Chaiken I, Malamud D, Weissman D. HIV envelope binding by macrophage-expressed gp340 promotes HIV-1 infection. J Immunol 2008; 181:2065-70. [PMID: 18641344 DOI: 10.4049/jimmunol.181.3.2065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The scavenger receptor cysteine-rich protein gp340 functions as part of the host innate immune defense system at mucosal surfaces. In the genital tract, its expression by cervical and vaginal epithelial cells promotes HIV trans-infection and may play a role in sexual transmission. Gp340 is an alternatively spliced product of the deleted in malignant brain tumors 1 (DMBT1) gene. In addition to its innate immune system activity, DMBT1 demonstrates instability in multiple types of cancer and plays a role in epithelial cell differentiation. We demonstrate that monocyte-derived macrophages express gp340 and that HIV-1 infection is decreased when envelope cannot bind it. Inhibition of infection occurred at the level of fusion of M-, T-, and dual-tropic envelopes. Additional HIV-1 envelope binding molecules, such as dendritic cell-specific ICAM-3-grabbing nonintegrin (DC-SIGN), mannose-binding lectin, and heparan sulfate, enhance the efficiency of infection of the cells that express them by increasing the local concentration of infectious virus. Our data suggest that gp340, which is expressed by macrophages in vivo, may function to enhance infection in much the same manner. Its expression on tissue macrophages and epithelial cells suggests important new opportunities for HIV-1 pathogenesis investigation and therapy.
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Affiliation(s)
- Georgetta Cannon
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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38
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Denny P, Hagen FK, Hardt M, Liao L, Yan W, Arellanno M, Bassilian S, Bedi GS, Boontheung P, Cociorva D, Delahunty CM, Denny T, Dunsmore J, Faull KF, Gilligan J, Gonzalez-Begne M, Halgand F, Hall SC, Han X, Henson B, Hewel J, Hu S, Jeffrey S, Jiang J, Loo JA, Ogorzalek Loo RR, Malamud D, Melvin JE, Miroshnychenko O, Navazesh M, Niles R, Park SK, Prakobphol A, Ramachandran P, Richert M, Robinson S, Sondej M, Souda P, Sullivan MA, Takashima J, Than S, Wang J, Whitelegge JP, Witkowska HE, Wolinsky L, Xie Y, Xu T, Yu W, Ytterberg J, Wong DT, Yates JR, Fisher SJ. The proteomes of human parotid and submandibular/sublingual gland salivas collected as the ductal secretions. J Proteome Res 2008; 7:1994-2006. [PMID: 18361515 DOI: 10.1021/pr700764j] [Citation(s) in RCA: 320] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Saliva is a body fluid with important functions in oral and general health. A consortium of three research groups catalogued the proteins in human saliva collected as the ductal secretions: 1166 identifications--914 in parotid and 917 in submandibular/sublingual saliva--were made. The results showed that a high proportion of proteins that are found in plasma and/or tears are also present in saliva along with unique components. The proteins identified are involved in numerous molecular processes ranging from structural functions to enzymatic/catalytic activities. As expected, the majority mapped to the extracellular and secretory compartments. An immunoblot approach was used to validate the presence in saliva of a subset of the proteins identified by mass spectrometric approaches. These experiments focused on novel constituents and proteins for which the peptide evidence was relatively weak. Ultimately, information derived from the work reported here and related published studies can be used to translate blood-based clinical laboratory tests into a format that utilizes saliva. Additionally, a catalogue of the salivary proteome of healthy individuals allows future analyses of salivary samples from individuals with oral and systemic diseases, with the goal of identifying biomarkers with diagnostic and/or prognostic value for these conditions; another possibility is the discovery of therapeutic targets.
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Affiliation(s)
- Paul Denny
- School of Dentistry, University of Southern California, Los Angeles, California 90089, USA
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39
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Stoddard E, Cannon G, Ni H, Karikó K, Capodici J, Malamud D, Weissman D. gp340 Expressed on Human Genital Epithelia Binds HIV-1 Envelope Protein and Facilitates Viral Transmission. J Immunol 2007; 179:3126-32. [PMID: 17709527 DOI: 10.4049/jimmunol.179.5.3126] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
During sexual transmission of HIV in women, the first cells likely to be infected are submucosal CD4(+) T cells and dendritic cells of the lower genital tract. HIV is segregated from these target cells by an epithelial cell layer that can be bypassed even when healthy and intact. To understand how HIV penetrates this barrier, we identified a host protein, gp340, that is expressed on genital epithelium and binds the HIV envelope via a specific protein-protein interaction. This binding allows otherwise subinfectious amounts of HIV to efficiently infect target cells and allows this infection to occur over a longer period of time after binding. Our findings suggest a mechanism of viral entry during heterosexual transmission where HIV is bound to intact genital epithelia, which then promotes the initial events of infection. Understanding this step in the initiation of infection will allow for the development of tools and methods for blocking HIV transmission.
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Affiliation(s)
- Earl Stoddard
- Department of Medicine, Division of Infectious Diseases, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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40
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Blackburn AC, Hill LZ, Roberts AL, Wang J, Aud D, Jung J, Nikolcheva T, Allard J, Peltz G, Otis CN, Cao QJ, Ricketts RSJ, Naber SP, Mollenhauer J, Poustka A, Malamud D, Jerry DJ. Genetic mapping in mice identifies DMBT1 as a candidate modifier of mammary tumors and breast cancer risk. Am J Pathol 2007; 170:2030-41. [PMID: 17525270 PMCID: PMC1899446 DOI: 10.2353/ajpath.2007.060512] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Low-penetrance breast cancer susceptibility alleles seem to play a significant role in breast cancer risk but are difficult to identify in human cohorts. A genetic screen of 176 N2 backcross progeny of two Trp53(+/-) strains, BALB/c and C57BL/6, which differ in their susceptibility to mammary tumors, identified a modifier of mammary tumor susceptibility in an approximately 25-Mb interval on mouse chromosome 7 (designated SuprMam1). Relative to heterozygotes, homozygosity for BALB/c alleles of SuprMam1 significantly decreased mammary tumor latency from 70.7 to 61.1 weeks and increased risk twofold (P = 0.002). Dmbt1 (deleted in malignant brain tumors 1) was identified as a candidate modifier gene within the SuprMam1 interval because it was differentially expressed in mammary tissues from BALB/c-Trp53(+/-) and C57BL/6-Trp53(+/-) mice. Dmbt1 mRNA and protein was reduced in mammary glands of the susceptible BALB/c mice. Immunohistochemical staining demonstrated that DMBT1 protein expression was also significantly reduced in normal breast tissue from women with breast cancer (staining score, 1.8; n = 46) compared with cancer-free controls (staining score, 3.9; n = 53; P < 0.0001). These experiments demonstrate the use of Trp53(+/-) mice as a sensitized background to screen for low-penetrance modifiers of cancer. The results identify a novel mammary tumor susceptibility locus in mice and support a role for DMBT1 in suppression of mammary tumors in both mice and women.
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Affiliation(s)
- Anneke C Blackburn
- Department of Veterinary and Animal Sciences, Molecular and Cellular Biology Program, Paige Laboratory, University of Massachusetts, 161 Holdsworth Way, Amherst, MA 01003-6410, USA
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41
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Abrams WR, Barber CA, McCann K, Tong G, Chen Z, Mauk MG, Wang J, Volkov A, Bourdelle P, Corstjens PLAM, Zuiderwijk M, Kardos K, Li S, Tanke HJ, Sam Niedbala R, Malamud D, Bau H. Development of a microfluidic device for detection of pathogens in oral samples using upconverting phosphor technology (UPT). Ann N Y Acad Sci 2007; 1098:375-88. [PMID: 17435143 DOI: 10.1196/annals.1384.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Confirmatory detection of diseases, such as HIV and HIV-associated pathogens in a rapid point-of-care (POC) diagnostic remains a goal for disease control, prevention, and therapy. If a sample could be analyzed onsite with a verified result, the individual could be counseled immediately and appropriate therapy initiated. Our group is focused on developing a microfluidic "lab-on-a-chip" that will simultaneously identify antigens, antibodies, RNA, and DNA using a single oral sample. The approach has been to design individual modules for each assay that uses similar components (e.g., valves, heaters, metering chambers, mixers) installed on a polycarbonate base with a common reporter system. Assay miniaturization reduces the overall analysis time, increases accuracy by simultaneously identifying multiple targets, and enhances detector sensitivity by upconverting phosphor technology (UPT). Our microfluidic approach employs four interrelated components: (1) sample acquisition-OraSure UPlink collectors that pick-up and release bacteria, soluble analytes, and viruses from an oral sample; (2) microfluidic processing-movement of microliter volumes of analyte, target analyte extraction and amplification; (3) detection of analytes using UPT particles in a lateral flow system; and (4) software for processing the results. Ultimately, the oral-based microscale diagnostic system will detect viruses and bacteria, associated pathogen antigens and nucleic acids, and antibodies to these pathogens.
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Affiliation(s)
- William R Abrams
- Department of Basic Sciences, New York University College of Dentistry, New York, New York 10010, USA.
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42
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Corstjens PLAM, Chen Z, Zuiderwijk M, Bau HH, Abrams WR, Malamud D, Sam Niedbala R, Tanke HJ. Rapid assay format for multiplex detection of humoral immune responses to infectious disease pathogens (HIV, HCV, and TB). Ann N Y Acad Sci 2007; 1098:437-45. [PMID: 17435148 DOI: 10.1196/annals.1384.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A novel assay is described for multiplex detection of antibodies against different pathogens from a single sample. The assay employs a modified lateral flow format (consecutive flow, CF) together with a sensitive reporter particle technology (up-converting phosphor technology, UPT) that allows for fully instrumented assay analysis. Lateral flow (LF) strips developed for the detection of human antibodies against human immunodeficiency virus type-1 and -2 (HIV-1 and -2) with additional capture zones to detect antibodies against Myobacterium tuberculosis (TB) and hepatitis C Virus (HCV) provided the strips to test multiplexing. Data are presented that show the performance of the TB and HCV test, as well as two multiplex assays, TB with HIV and HCV with HIV. The TB/HCV assays demonstrate excellent detection capability, and HIV multiplexing does not affect the qualitative test result. The bench-top CF format was converted to a microfluidic platform and a first prototype semiautomated chip capable of performing CF is presented here.
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Affiliation(s)
- Paul L A M Corstjens
- Department of Molecular Cell Biology, Leiden University Medical Center, RC Leiden, the Netherlands.
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43
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Chen Z, Mauk MG, Wang J, Abrams WR, Corstjens PLAM, Niedbala RS, Malamud D, Bau HH. A microfluidic system for saliva-based detection of infectious diseases. Ann N Y Acad Sci 2007; 1098:429-36. [PMID: 17435147 DOI: 10.1196/annals.1384.024] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A "lab-on-a-chip" system for detecting bacterial pathogens in oral fluid samples is described. The system comprises: (1) an oral fluid sample collector; (2) a disposable, plastic microfluidic cassette ("chip") for sample processing including immunochromatographic assay with a nitrocellulose lateral flow strip; (3) a platform that controls the cassette operation by providing metered quantities of reagents, temperature regulation, valve actuation; and (4) a laser scanner to interrogate the lateral flow strip. The microfluidic chip hosts a fluidic network for cell lysis, nucleic acid extraction and isolation, PCR, and labeling of the PCR product with bioconjugated, upconverting phosphor particles for detection on the lateral flow strip.
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Affiliation(s)
- Zongyuan Chen
- University of Pennsylvania School of Engineering and Applied Science, Philadelphia, Pennsylvania, USA
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44
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Cummins JE, Christensen L, Lennox JL, Bush TJ, Wu Z, Malamud D, Evans-Strickfaden T, Siddig A, Caliendo AM, Hart CE, Dezzutti CS. Mucosal innate immune factors in the female genital tract are associated with vaginal HIV-1 shedding independent of plasma viral load. AIDS Res Hum Retroviruses 2006; 22:788-95. [PMID: 16910835 DOI: 10.1089/aid.2006.22.788] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Recent studies indicate that mucosal innate immune factors modulate HIV-1 infection in vitro. Our interest was to examine the levels of innate mucosal factors for their potential association with HIV-1 shedding in the female genital tract. Vaginal lavages were collected from HIV-1-infected women who had vaginal viral loads (VVL) that were below, within, or above the 90% confidence interval (CI) predicted by their matched plasma viral loads. Innate immune factors [cathepsin D, lactoferrin (Lf), myeloid related protein (MRP)-8, MRP-8/14, secretory leukocyte protease inhibitor, and gp340], cytokines (IL-1beta and TNF-alpha), and chemokines (MIP-1alpha, MIP-1beta, RANTES, and SDF-1alpha) were quantified by ELISA. Leukocyte levels were determined using a leukocyte reagent strip for urinalysis. Lf, MRP-8/14, gp340, and IL-1beta levels were significantly higher in vaginal lavages above the 90% CI and generally correlated with each other and with VVL. Leukocyte levels were significantly higher in the lavages that had virus shedding above the 90% CI and correlated strongly with Lf levels and VVL. In this group of women, these results suggest that the levels of certain innate immune factors are more closely associated with HIV-1 shedding in the genital mucosa than plasma virus concentrations.
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Affiliation(s)
- James E Cummins
- Laboratory Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Wu Z, Lee S, Abrams W, Weissman D, Malamud D. The N-terminal SRCR-SID domain of gp-340 interacts with HIV type 1 gp120 sequences and inhibits viral infection. AIDS Res Hum Retroviruses 2006; 22:508-15. [PMID: 16796526 DOI: 10.1089/aid.2006.22.508] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Proteins encoded by the SRCR superfamily including gp340 recognize repeated patterns on pathogenic microorganisms and play important roles in innate immune defense as well as epithelial cell differentiation. Based upon the presence of SRCR domains in proteins with broad binding specificities and high amino acid sequence homology, it was speculated that SRCR domains may be involved in ligand binding. In this study, a truncated gp340 molecule representing the N-terminal sequence including the first SRCR and one-half of the first SID was expressed in mammalian 293 cells as a 35-kDa recombinant protein. The expressed protein was recognized by a panel of antibodies specific for human salivary agglutinin (SAG) and the full-length parental gp340 and exhibited biological properties similar to the entire 340-kDa glycoprotein. The truncated gp340 protein bound to the same HIV-1 V3 sequences previously identified to interact with full-length SAG in a Ca2+ -dependent manner. The recombinant N-terminal SRCR protein also demonstrated potent anti-HIV- 1 activity against both CCR5- and CXCR4-using isolates, similar to the full-length glycoprotein. We have, thus, demonstrated that the N-terminal SRCR of gp340 directly interacts with viral gp120 and likely mediates anti-HIV-1 activity via this interaction.
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Affiliation(s)
- Zhiwei Wu
- Department of Biochemistry, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania 19104, USA
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Malamud D, Abrams WR, Bau H, Wang J, Chen Z, Corstjens P, Niedbala S. Oral-based techniques for the diagnosis of infectious diseases. J Calif Dent Assoc 2006; 34:297-301. [PMID: 16900987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Saliva and other types of oral samples can readily be used for noninvasive diagnosis of diseases of the oral cavity and systemic diseases. Following an introduction outlining the types of oral samples and the analytes that can be measured in these samples, a detailed description of a novel oral-based diagnostic system to detect multiple bacterial and/or viral pathogens is presented. A reasonably priced, portable, point-of-care diagnostic system should be available within five years.
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Affiliation(s)
- Daniel Malamud
- New York University College of Dentistry, Department of Basic Science and Laboratory for Infectious Disease, New York, NY 10010, USA
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Affiliation(s)
- D Malamud
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104-6030, USA.
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Catalone BJ, Kish-Catalone TM, Neely EB, Budgeon LR, Ferguson ML, Stiller C, Miller SR, Malamud D, Krebs FC, Howett MK, Wigdahl B. Comparative safety evaluation of the candidate vaginal microbicide C31G. Antimicrob Agents Chemother 2005; 49:1509-20. [PMID: 15793133 PMCID: PMC1068583 DOI: 10.1128/aac.49.4.1509-1520.2005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
C31G is currently the focus of clinical trials designed to evaluate this agent as a microbicidal and spermicidal agent. In the following studies, the in vivo safety of C31G was assessed with a Swiss Webster mouse model of cervicovaginal toxicity and correlated with results from in vitro cytotoxicity experiments and published clinical observations. A single exposure of unformulated 1% C31G resulted in mild-to-moderate epithelial disruption and inflammation at 2 and 4 h postapplication. The columnar epithelium of the cervix was the primary site of damage, while no perturbation of the vaginal mucosa was observed. In contrast, application of unformulated 1.7% C31G resulted in greater levels of inflammation in the cervical epithelium at 2 h postapplication and severe epithelial disruption that persisted to 8 h postapplication. Application of a nonionic aqueous gel formulation containing 1% C31G resulted in no apparent cervicovaginal toxicity at any time point evaluated. However, formulation of 1.7% C31G did not substantially reduce the toxicity associated with unformulated C31G at that concentration. These observations correlate with findings gathered during a recent clinical trial, in which once-daily applications resulted in no adverse events in women receiving the formulation containing 1% C31G, compared to moderate-to-severe adverse events in 30% of women receiving the 1.7% C31G formulation. The Swiss Webster mouse model was able to effectively discriminate between concentrations and formulations of C31G that produced distinct clinical effects in human trials. The Swiss Webster animal model may be a highly valuable tool for preclinical evaluation of candidate vaginal microbicides.
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MESH Headings
- Administration, Intravaginal
- Animals
- Anti-Infective Agents, Local
- Betaine/administration & dosage
- Betaine/adverse effects
- Betaine/analogs & derivatives
- Betaine/toxicity
- Cell Line
- Cervix Uteri/cytology
- Cervix Uteri/drug effects
- Fatty Acids, Unsaturated/administration & dosage
- Fatty Acids, Unsaturated/adverse effects
- Fatty Acids, Unsaturated/toxicity
- Female
- HeLa Cells
- Humans
- Mice
- Nonoxynol/administration & dosage
- Nonoxynol/adverse effects
- Nonoxynol/toxicity
- Vagina/cytology
- Vagina/drug effects
- Vaginal Creams, Foams, and Jellies/administration & dosage
- Vaginal Creams, Foams, and Jellies/adverse effects
- Vaginal Creams, Foams, and Jellies/toxicity
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Affiliation(s)
- Bradley J Catalone
- Department of Microbiology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Barnhart KT, Pretorius ES, Timbers K, Shera D, Shabbout M, Malamud D. Distribution of a 3.5-mL (1.0%) C31G vaginal gel using magnetic resonance imaging. Contraception 2005; 71:357-61. [PMID: 15854637 DOI: 10.1016/j.contraception.2004.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2004] [Revised: 10/29/2004] [Accepted: 11/01/2004] [Indexed: 11/18/2022]
Abstract
C31G (Savvy) has been developed as a topical vaginal microbicide with broad-spectrum antibacterial and antiviral properties. The objective of this study was to evaluate the distribution of a 1.0% concentration of (3.5 mL) C31G vaginal gel in the human pelvis using magnetic resonance imaging (MRI). Gel delivery with a standard applicator was primarily to the upper vagina and was well tolerated. Vaginal mucosal coverage at 18 min was excellent with 92% linear coverage and 75% surface contact coverage of the vagina. The upper vagina was almost completely covered and gel was also noted in the lower vagina. Coverage 6 h after application was substantially decreased, with 60% of maximal linear coverage and 41% surface contact. There was a very minimal coverage of the vaginal mucosa noted 24 h following insertion. Simulated intercourse resulted in relatively little change in overall distribution at all three time points. Repeat application of the gel may be necessary if intercourse has not occurred within the first few hours after initial insertion.
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Affiliation(s)
- Kurt T Barnhart
- Center for Reproductive Medicine and Surgery, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
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