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Bergersen KV, Barnes A, Worth D, David C, Wilson EH. Targeted Transcriptomic Analysis of C57BL/6 and BALB/c Mice During Progressive Chronic Toxoplasma gondii Infection Reveals Changes in Host and Parasite Gene Expression Relating to Neuropathology and Resolution. Front Cell Infect Microbiol 2021; 11:645778. [PMID: 33816350 PMCID: PMC8012756 DOI: 10.3389/fcimb.2021.645778] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 12/24/2020] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Abstract
Toxoplasma gondii is a resilient parasite that infects a multitude of warm-blooded hosts and results in a lifelong chronic infection requiring continuous responses by the host. Chronic infection is characterized by a balanced immune response and neuropathology that are driven by changes in gene expression. Previous research pertaining to these processes has been conducted in various mouse models, and much knowledge of infection-induced gene expression changes has been acquired through the use of high throughput sequencing techniques in different mouse strains and post-mortem human studies. However, lack of infection time course data poses a prominent missing link in the understanding of chronic infection, and there is still much that is unknown regarding changes in genes specifically relating to neuropathology and resulting repair mechanisms as infection progresses throughout the different stages of chronicity. In this paper, we present a targeted approach to gene expression analysis during T. gondii infection through the use of NanoString nCounter gene expression assays. Wild type C57BL/6 and BALB/c background mice were infected, and transcriptional changes in the brain were evaluated at 14, 28, and 56 days post infection. Results demonstrate a dramatic shift in both previously demonstrated and novel gene expression relating to neuropathology and resolution in C57BL/6 mice. In addition, comparison between BALB/c and C57BL/6 mice demonstrate initial differences in gene expression that evolve over the course of infection and indicate decreased neuropathology and enhanced repair in BALB/c mice. In conclusion, these studies provide a targeted approach to gene expression analysis in the brain during infection and provide elaboration on previously identified transcriptional changes and also offer insights into further understanding the complexities of chronic T. gondii infection.
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Affiliation(s)
- Kristina V Bergersen
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Ashli Barnes
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Danielle Worth
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Clement David
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States.,NanoString Technologies, Seattle, WA, United States
| | - Emma H Wilson
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
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2
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McGovern KE, Nance JP, David CN, Harrison RES, Noor S, Worth D, Landrith TA, Obenaus A, Carson MJ, Morikis D, Wilson EH. SPARC coordinates extracellular matrix remodeling and efficient recruitment to and migration of antigen-specific T cells in the brain following infection. Sci Rep 2021; 11:4549. [PMID: 33633185 PMCID: PMC7907143 DOI: 10.1038/s41598-021-83952-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/03/2021] [Indexed: 01/14/2023] Open
Abstract
Central nervous system (CNS) injury and infection can result in profound tissue remodeling in the brain, the mechanism and purpose of which is poorly understood. Infection with the protozoan parasite Toxoplasma gondii causes chronic infection and inflammation in the brain parenchyma. Control of parasite replication requires the continuous presence of IFNγ-producing T cells to keep T. gondii in its slowly replicating cyst form. During infection, a network of extracellular matrix fibers, revealed using multiphoton microscopy, forms in the brain. The origin and composition of these structures are unknown but the fibers have been observed to act as a substrate for migrating T cells. In this study, we show a critical regulator of extracellular matrix (ECM) remodeling, Secreted Protein, Acidic, Rich in Cysteine (SPARC), is upregulated in the brain during the early phases of infection in the frontal cortex. In the absence of SPARC, a reduced and disordered fibrous network, increased parasite burden, and reduced antigen-specific T cell entry into the brain points to a role for SPARC in T cell recruitment to and migration within the brain. We also report SPARC can directly bind to CCR7 ligands CCL19 and CCL21 but not CXCL10, and enhance migration toward a chemokine gradient. Measurement of T cell behavior points to tissue remodeling being important for access of immune cells to the brain and facilitating cellular locomotion. Together, these data identify SPARC as an important regulatory component of immune cell trafficking and access to the inflamed CNS.
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Affiliation(s)
- Kathryn E McGovern
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
- BIO5 Institute, Department of Immunobiology, University of Arizona, Tucson, AZ, 85724, USA
| | - J Philip Nance
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
| | - Clément N David
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
- Nanostring Technologies, Inc, 530 Fairview Ave N, Seattle, WA, 98109, USA
| | - Reed E S Harrison
- Department of Bioengineering, University of California, Riverside, Riverside, CA, 92521-0129, USA
- UCSD Bioengineering and the Institute for Engineering in Medicine, San Diego, CA, 92093, USA
| | - Shahani Noor
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
- School of Medicine, MSC08, University of New Mexico, Albequerque, NM, 87131, USA
| | - Danielle Worth
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
| | - Tyler A Landrith
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
- Ambrey Genetics, Aliso Viejo, CA, 92656, USA
| | - Andre Obenaus
- School of Medicine, University of California, Irvine, Irvine, CA, 92697, USA
| | - Monica J Carson
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA
| | - Dimitrios Morikis
- Department of Bioengineering, University of California, Riverside, Riverside, CA, 92521-0129, USA
| | - Emma H Wilson
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, 92521, USA.
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He W, Dutta B, Grant BB, Chantigny MH, Hunt D, Bittman S, Tenuta M, Worth D, VanderZaag A, Desjardins RL, Smith WN. Assessing the effects of manure application rate and timing on nitrous oxide emissions from managed grasslands under contrasting climate in Canada. Sci Total Environ 2020; 716:135374. [PMID: 31839316 DOI: 10.1016/j.scitotenv.2019.135374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/11/2019] [Accepted: 11/02/2019] [Indexed: 06/10/2023]
Abstract
It is uncertain whether process-based models are currently capable of simulating the complex soil, plant, climate, manure management interactions that influence soil nitrous oxide (N2O) emissions from perennial cropping systems. The objectives of this study were (1) to calibrate and evaluate the DeNitrification DeComposition (DNDC) model using multi-year datasets of measured nitrous oxide (N2O) fluxes, soil moisture, soil inorganic nitrogen, biomass and soil temperature from managed grasslands applied with manure slurry in contrasting climates of Canada, and (2) to simulate the impact of different manure management practices on N2O emissions including slurry application i) rates (for both single vs. split); and ii) timing (e.g., early vs. late spring). DNDC showed "fair" to "excellent" performance in simulating biomass (4.7% ≤ normalized root mean square error (NRMSE) ≤ 29.8%; -9.5% ≤ normalized average relative error (NARE) ≤ 16.1%) and "good" performance in simulating soil temperature (13.2% ≤ NRMSE ≤ 18.1%; -0.7% ≤ NARE ≤ 10.8%) across all treatments and sites. However, the model only showed "acceptable" performances in estimating soil water and inorganic N contents which was partially attributed to the limitation of a cascade water sub-model and inaccuracies in simulating root development/uptake. Although, the DNDC model only demonstrated "fair" performance in simulating daily N2O fluxes, it generally captured the impact of the timing and rate of slurry application and soil texture (loam vs. sandy loam) on total N2O emissions. The DNDC model simulated N2O emissions from spring better than split manure application (fall and spring) at the Manitoba site partially due to the overestimation of available substrates for microbial denitrification from fall application during the wet spring periods. Although DNDC performed adequately for simulating most of the manure management impacts considered in this study we recommend improvements in the simulation of soil freeze-thaw cycles, manure decomposition dynamics, soil water storage, rainfall canopy interception, and microbial denitrification and nitrification activities in grasslands.
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Affiliation(s)
- Wentian He
- Ottawa Research and Development Centre, Agriculture and Agri-Food Canada, 960 Carling Avenue, Ottawa, Ontario K1A 0C6, Canada.
| | - B Dutta
- Department of Civil & Mineral Engineering, University of Toronto, 35 St. George Street, Toronto, Ontario M5S 1A4, Canada
| | - B B Grant
- Ottawa Research and Development Centre, Agriculture and Agri-Food Canada, 960 Carling Avenue, Ottawa, Ontario K1A 0C6, Canada
| | - M H Chantigny
- Quebec Research and Development Centre, Agriculture and Agri-Food Canada, 2560 Hochelaga Blvd., Sainte-Foy, Québec G1V 2J3, Canada
| | - D Hunt
- Agassiz Research and Development Centre, Agriculture and Agri-Food Canada, Box 1000, Agassiz, British Columbia V0M 1A0, Canada
| | - S Bittman
- Agassiz Research and Development Centre, Agriculture and Agri-Food Canada, Box 1000, Agassiz, British Columbia V0M 1A0, Canada
| | - M Tenuta
- Department of Soil Science, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - D Worth
- Ottawa Research and Development Centre, Agriculture and Agri-Food Canada, 960 Carling Avenue, Ottawa, Ontario K1A 0C6, Canada
| | - A VanderZaag
- Ottawa Research and Development Centre, Agriculture and Agri-Food Canada, 960 Carling Avenue, Ottawa, Ontario K1A 0C6, Canada
| | - R L Desjardins
- Ottawa Research and Development Centre, Agriculture and Agri-Food Canada, 960 Carling Avenue, Ottawa, Ontario K1A 0C6, Canada
| | - W N Smith
- Ottawa Research and Development Centre, Agriculture and Agri-Food Canada, 960 Carling Avenue, Ottawa, Ontario K1A 0C6, Canada.
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Shen W, Guo K, Adkins GB, Jiang Q, Liu Y, Sedano S, Duan Y, Yan W, Wang SE, Bergersen K, Worth D, Wilson EH, Zhong W. A Single Extracellular Vesicle (EV) Flow Cytometry Approach to Reveal EV Heterogeneity. Angew Chem Int Ed Engl 2018; 57:15675-15680. [PMID: 30291794 PMCID: PMC6246790 DOI: 10.1002/anie.201806901] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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: 06/14/2018] [Revised: 09/02/2018] [Indexed: 12/15/2022]
Abstract
Extracellular vesicles (EVs) actively participate in intercellular communication and pathological processes. Studying the molecular signatures of EVs is key to reveal their biological functions and clinical values, which, however, is greatly hindered by their sub-100 nm dimensions, the low quantities of biomolecules each EV carries, and the large population heterogeneity. Now, single-EV flow cytometry analysis is introduced to realize single EV counting and phenotyping in a conventional flow cytometer for the first time, enabled by target-initiated engineering (TIE) of DNA nanostructures on each EV. By illuminating multiple markers on single EVs, statistically significant differences are revealed among the molecular signatures of EVs originating from several breast cancer cell lines, and the cancer cell-derived EVs among the heterogeneous EV populations are successfully recognized. Thus, our approach holds great potential for various biological and biomedical applications.
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Affiliation(s)
- Wen Shen
- University of California - Riverside, Department of Chemistry, Riverside, CA, 92521, U.S.A.
| | - Kaizhu Guo
- University of California - Riverside, Department of Chemistry, Riverside, CA, 92521, U.S.A.
| | - Gary Brent Adkins
- University of California - Riverside, Department of Chemistry, Riverside, CA, 92521, U.S.A.
| | - Qiaoshi Jiang
- University of California - Riverside, Environmental Toxicology Program, Riverside, CA, 92521, U.S.A
| | - Yang Liu
- University of California - Riverside, Environmental Toxicology Program, Riverside, CA, 92521, U.S.A
| | - Sabrina Sedano
- University of California - Riverside, Department of Chemistry, Riverside, CA, 92521, U.S.A.
| | - Yaokai Duan
- University of California - Riverside, Department of Chemistry, Riverside, CA, 92521, U.S.A.
| | - Wei Yan
- University of California - San Diego, Department of Pathology, La Jolla, CA, 92093, U.S.A
| | - Shizhen Emily Wang
- University of California - San Diego, Department of Pathology, La Jolla, CA, 92093, U.S.A
| | - Kristina Bergersen
- University of California - Riverside, Division of Biomedical Sciences, Riverside, CA, 92521, U.S.A
| | - Danielle Worth
- University of California - Riverside, Division of Biomedical Sciences, Riverside, CA, 92521, U.S.A
| | - Emma H. Wilson
- University of California - Riverside, Division of Biomedical Sciences, Riverside, CA, 92521, U.S.A
| | - Wenwan Zhong
- University of California - Riverside, Department of Chemistry, Riverside, CA, 92521, U.S.A.
- University of California - Riverside, Environmental Toxicology Program, Riverside, CA, 92521, U.S.A
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5
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Shen W, Guo K, Adkins GB, Jiang Q, Liu Y, Sedano S, Duan Y, Yan W, Wang SE, Bergersen K, Worth D, Wilson EH, Zhong W. A Single Extracellular Vesicle (EV) Flow Cytometry Approach to Reveal EV Heterogeneity. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201806901] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Wen Shen
- University of California-Riverside; Department of Chemistry; Riverside CA 92521 USA
| | - Kaizhu Guo
- University of California-Riverside; Department of Chemistry; Riverside CA 92521 USA
| | - Gary Brent Adkins
- University of California-Riverside; Department of Chemistry; Riverside CA 92521 USA
| | - Qiaoshi Jiang
- University of California-Riverside; Environmental Toxicology Program; Riverside CA 92521 USA
| | - Yang Liu
- University of California-Riverside; Environmental Toxicology Program; Riverside CA 92521 USA
| | - Sabrina Sedano
- University of California-Riverside; Department of Chemistry; Riverside CA 92521 USA
| | - Yaokai Duan
- University of California-Riverside; Department of Chemistry; Riverside CA 92521 USA
| | - Wei Yan
- University of California-San Diego; Department of Pathology; La Jolla CA 92093 USA
| | - Shizhen Emily Wang
- University of California-San Diego; Department of Pathology; La Jolla CA 92093 USA
| | - Kristina Bergersen
- University of California-Riverside; Division of Biomedical Sciences; Riverside CA 92521 USA
| | - Danielle Worth
- University of California-Riverside; Division of Biomedical Sciences; Riverside CA 92521 USA
| | - Emma H. Wilson
- University of California-Riverside; Division of Biomedical Sciences; Riverside CA 92521 USA
| | - Wenwan Zhong
- University of California-Riverside; Department of Chemistry; Riverside CA 92521 USA
- University of California-Riverside; Environmental Toxicology Program; Riverside CA 92521 USA
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Radke JB, Worth D, Hong D, Huang S, Sullivan WJ, Wilson EH, White MW. Transcriptional repression by ApiAP2 factors is central to chronic toxoplasmosis. PLoS Pathog 2018; 14:e1007035. [PMID: 29718996 PMCID: PMC5951591 DOI: 10.1371/journal.ppat.1007035] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [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: 01/20/2017] [Revised: 05/14/2018] [Accepted: 04/17/2018] [Indexed: 12/20/2022] Open
Abstract
Tachyzoite to bradyzoite development in Toxoplasma is marked by major changes in gene expression resulting in a parasite that expresses a new repertoire of surface antigens hidden inside a modified parasitophorous vacuole called the tissue cyst. The factors that control this important life cycle transition are not well understood. Here we describe an important transcriptional repressor mechanism controlling bradyzoite differentiation that operates in the tachyzoite stage. The ApiAP2 factor, AP2IV-4, is a nuclear factor dynamically expressed in late S phase through mitosis/cytokinesis of the tachyzoite cell cycle. Remarkably, deletion of the AP2IV-4 locus resulted in the expression of a subset of bradyzoite-specific proteins in replicating tachyzoites that included tissue cyst wall components BPK1, MCP4, CST1 and the surface antigen SRS9. In the murine animal model, the mis-timing of bradyzoite antigens in tachyzoites lacking AP2IV-4 caused a potent inflammatory monocyte immune response that effectively eliminated this parasite and prevented tissue cyst formation in mouse brain tissue. Altogether, these results indicate that suppression of bradyzoite antigens by AP2IV-4 during acute infection is required for Toxoplasma to successfully establish a chronic infection in the immune-competent host. The Toxoplasma biology that underlies the establishment of a chronic infection is developmental conversion of the acute tachyzoite stage into the latent bradyzoite-tissue cyst stage. Despite the important clinical consequences of this developmental pathway, the molecular basis of the switch mechanisms that control formation of the tissue cyst is still poorly understood. A fundamental feature of tissue cyst formation is the expression of bradyzoite-specific genes. Here we show the transcription factor AP2IV-4 directly silences bradyzoite mRNA and protein expression in the acute tachyzoite stage demonstrating that developmental control of tissue cyst formation is as much about when not to express bradyzoite genes as it is about when to activate them. Losing the suppression of bradyzoite gene expression in the acute tachyzoite stage caused by deleting AP2IV-4 blocked the establishment of chronic disease in healthy animals via increased protective immunity suggesting a possible strategy for preventing chronic Toxoplasma infections.
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Affiliation(s)
- Joshua B. Radke
- Department of Global Health, University of South Florida, Tampa, FL, United States of America
| | - Danielle Worth
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States of America
| | - David Hong
- Department of Global Health, University of South Florida, Tampa, FL, United States of America
| | - Sherri Huang
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - William J. Sullivan
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Emma H. Wilson
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States of America
| | - Michael W. White
- Department of Global Health, University of South Florida, Tampa, FL, United States of America
- * E-mail:
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David CN, Frias ES, Szu JI, Vieira PA, Hubbard JA, Lovelace J, Michael M, Worth D, McGovern KE, Ethell IM, Stanley BG, Korzus E, Fiacco TA, Binder DK, Wilson EH. GLT-1-Dependent Disruption of CNS Glutamate Homeostasis and Neuronal Function by the Protozoan Parasite Toxoplasma gondii. PLoS Pathog 2016; 12:e1005643. [PMID: 27281462 PMCID: PMC4900626 DOI: 10.1371/journal.ppat.1005643] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [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: 05/21/2015] [Accepted: 04/28/2016] [Indexed: 01/09/2023] Open
Abstract
The immune privileged nature of the CNS can make it vulnerable to chronic and latent infections. Little is known about the effects of lifelong brain infections, and thus inflammation, on the neurological health of the host. Toxoplasma gondii is a parasite that can infect any mammalian nucleated cell with average worldwide seroprevalence rates of 30%. Infection by Toxoplasma is characterized by the lifelong presence of parasitic cysts within neurons in the brain, requiring a competent immune system to prevent parasite reactivation and encephalitis. In the immunocompetent individual, Toxoplasma infection is largely asymptomatic, however many recent studies suggest a strong correlation with certain neurodegenerative and psychiatric disorders. Here, we demonstrate a significant reduction in the primary astrocytic glutamate transporter, GLT-1, following infection with Toxoplasma. Using microdialysis of the murine frontal cortex over the course of infection, a significant increase in extracellular concentrations of glutamate is observed. Consistent with glutamate dysregulation, analysis of neurons reveal changes in morphology including a reduction in dendritic spines, VGlut1 and NeuN immunoreactivity. Furthermore, behavioral testing and EEG recordings point to significant changes in neuronal output. Finally, these changes in neuronal connectivity are dependent on infection-induced downregulation of GLT-1 as treatment with the ß-lactam antibiotic ceftriaxone, rescues extracellular glutamate concentrations, neuronal pathology and function. Altogether, these data demonstrate that following an infection with T. gondii, the delicate regulation of glutamate by astrocytes is disrupted and accounts for a range of deficits observed in chronic infection. The protozoan parasite Toxoplasma gondii infects a third of the world’s population and causes a chronic lifelong infection in the brain of the host. The consequences of such an infection are poorly understood. Here, we demonstrate that Toxoplasma infection can induce profound changes in astrocyte physiology leading to significant disruption of neuronal networks. Pathology can be rescued by upregulating the astrocytic glutamate transporter, GLT-1, restoring concentrations of extracellular glutamate and EEG power. We suggest that such global dysregulation of neurotransmitters should be considered when determining the effects of infection on the CNS.
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Affiliation(s)
- Clément N. David
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Elma S. Frias
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Jenny I. Szu
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Philip A. Vieira
- Department of Psychology, University of California, Riverside, Riverside, California, United States of America
| | - Jacqueline A. Hubbard
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Jonathan Lovelace
- Department of Psychology, University of California, Riverside, Riverside, California, United States of America
| | - Marena Michael
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Danielle Worth
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Kathryn E. McGovern
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Iryna M. Ethell
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - B. Glenn Stanley
- Department of Psychology, University of California, Riverside, Riverside, California, United States of America
| | - Edward Korzus
- Department of Psychology, University of California, Riverside, Riverside, California, United States of America
| | - Todd A. Fiacco
- Department of Neuroscience, University of California, Riverside, Riverside, California, United States of America
| | - Devin K. Binder
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
| | - Emma H. Wilson
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, United States of America
- * E-mail:
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8
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Worth D, Nance JP, Jang J, David C, Nair M, Wilson E. A role for dectin-1 in the CNS during chronic Toxoplasma gondii infection (MPF5P.739). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.137.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
The latent stage of T.gondii infection is characterized by the formation of tissue cysts within the CNS. These tissue cysts are formed by manipulation of the parasitophorous vacuole, and chitin is a structural component of the cyst wall. Our lab has shown that Toxoplasma cysts induce an M2 phenotype in macrophages in a contact-dependent manner. Upon contact, these macrophages actively secrete the mammalian chitinase, AMCase, to break down the cyst wall. We have previously demonstrated that AMCase production by macrophages is essential for control of cyst burden in the brain during T. gondii infection. The molecular interactions involved in macrophage-cyst recognition, and the signaling pathway for AMCase production are as yet unknown. Although chitin recognition has been poorly defined, studies suggest dectin-1 may be a receptor. Here, we present data on a role for dectin-1 during T. gondii infection. Dectin-1 is upregulated in the brain in response to infection and is expressed on arginase-1+, M2 macrophages. Consistent with dectin-1 expression on M2 macrophages, dectin-1 is not required to control parasite burden or induce an inflammatory immune response in vivo. However, dectin-1 deficient mice do exhibit trends towards decreased cyst numbers in the brain and a concomitant increase in AMCase transcripts and AMCase activity ex vivo. Thus, this data suggests that dectin-1 is modulating the immune response and chitinase production during chronic Toxoplasma infection.
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Affiliation(s)
- Danielle Worth
- 1Biomedical Sciences, University of California Riverside, Riverside, CA
| | - John Philip Nance
- 1Biomedical Sciences, University of California Riverside, Riverside, CA
| | - Jessica Jang
- 1Biomedical Sciences, University of California Riverside, Riverside, CA
| | - Clement David
- 1Biomedical Sciences, University of California Riverside, Riverside, CA
| | - Meera Nair
- 1Biomedical Sciences, University of California Riverside, Riverside, CA
| | - Emma Wilson
- 1Biomedical Sciences, University of California Riverside, Riverside, CA
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Worth D, Nance JP, Wilson EH. Chitinase Assay from Cultured Bone Marrow Derived Macrophages. Bio Protoc 2013; 3:e983. [PMID: 27453907 DOI: 10.21769/bioprotoc.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Chitinases are chitin-degrading enzymes. Chitinases play essential roles in combating chitin-containing pathogens as well as established roles in asthmatic inflammation. This assay is designed to detect chitinase activity in macrophage cell lysates. The chitin substrate is labeled with 4-methylumbelliferone. Hydrolysis of chitin releases 4-methylumbelliferone, and is measured fluorometrically to determine chitinase activity.
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Affiliation(s)
- Danielle Worth
- Division of Biomedical Sciences, University of California, Riverside, USA
| | - J Philip Nance
- Division of Biomedical Sciences, University of California, Riverside, USA
| | - Emma H Wilson
- Division of Biomedical Sciences, University of California, Riverside, USA
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10
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Nance JP, Vannella KM, Worth D, David C, Carter D, Noor S, Hubeau C, Fitz L, Lane TE, Wynn TA, Wilson EH. Chitinase dependent control of protozoan cyst burden in the brain. PLoS Pathog 2012; 8:e1002990. [PMID: 23209401 PMCID: PMC3510238 DOI: 10.1371/journal.ppat.1002990] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [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: 05/08/2012] [Accepted: 09/10/2012] [Indexed: 02/07/2023] Open
Abstract
Chronic infections represent a continuous battle between the host's immune system and pathogen replication. Many protozoan parasites have evolved a cyst lifecycle stage that provides it with increased protection from environmental degradation as well as endogenous host mechanisms of attack. In the case of Toxoplasma gondii, these cysts are predominantly found in the immune protected brain making clearance of the parasite more difficult and resulting in a lifelong infection. Currently, little is known about the nature of the immune response stimulated by the presence of these cysts or how they are able to propagate. Here we establish a novel chitinase-dependent mechanism of cyst control in the infected brain. Despite a dominant Th1 immune response during Toxoplasma infection there exists a population of alternatively activated macrophages (AAMØ) in the infected CNS. These cells are capable of cyst lysis via the production of AMCase as revealed by live imaging, and this chitinase is necessary for protective immunity within the CNS. These data demonstrate chitinase activity in the brain in response to a protozoan pathogen and provide a novel mechanism to facilitate cyst clearance during chronic infections. Described here is a novel mechanism of protozoan cyst clearance in the CNS during chronic infection. These data show the presence of a population of alternatively activated macrophages in the brain that secrete the active chitinase, AMCase, in response to chitin in the cyst wall. Using both chemical and genetic inhibition in vitro, it is revealed that this enzyme is required for efficient degradation and destruction of the cyst. The necessity for AMCase is demonstrated in vivo, as the absence of the enzyme resulted in a significant increase in cyst burden and decrease in survival during chronic infection. Together, these data identify an important mechanism of parasite control and cyst clearance in the CNS. Currently, no therapies exist that lead to the total clearance of this parasite from the brain. Therefore, developing an understanding of the natural mechanisms of cyst clearance has the potential to lead to new and effective therapies for this and other chronic infections.
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Affiliation(s)
- J. Philip Nance
- Division of Biomedical Sciences, University of California, Riverside, California, United States of America
| | - Kevin M. Vannella
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Danielle Worth
- Division of Biomedical Sciences, University of California, Riverside, California, United States of America
| | - Clément David
- Division of Biomedical Sciences, University of California, Riverside, California, United States of America
| | - David Carter
- Institute for Integrative Genome Biology, University of California, Riverside, California, United States of America
| | - Shahani Noor
- Division of Biomedical Sciences, University of California, Riverside, California, United States of America
| | - Cedric Hubeau
- Department of Inflammation and Immunology, Pfizer, Cambridge, Massachusetts, United States of America
| | - Lori Fitz
- Department of Inflammation and Immunology, Pfizer, Cambridge, Massachusetts, United States of America
| | - Thomas E. Lane
- Department of Molecular Biology and Biochemistry, Institute for Immunology, University of California, Irvine, Irvine, California, United States of America
| | - Thomas A. Wynn
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Emma H. Wilson
- Division of Biomedical Sciences, University of California, Riverside, California, United States of America
- * E-mail:
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11
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Vergé X, Dyer J, Desjardins R, Worth D. Long-term trends in greenhouse gas emissions from the Canadian poultry industry. J APPL POULTRY RES 2009. [DOI: 10.3382/japr.2008-00091] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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13
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Fraser AD, Worth D. Urinary excretion profiles of 11-nor-9-carboxy-delta9-tetrahydrocannabinol: a delta9-THCCOOH to creatinine ratio study. J Anal Toxicol 1999; 23:531-4. [PMID: 10517562 DOI: 10.1093/jat/23.6.531] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Monitoring the major cannabinoid metabolite (delta9-THCCOOH) to creatinine ratio (M/C) has been used to predict new drug use. According to Huestis and Cone, the best accuracy (85.4%) for predicting new marijuana use was a ratio > or = 0.5 from two urine specimens collected at least 24 h apart. Manno et al. recommended an M/C ratio of > or = 1.5. Subjects with a history of chronic marijuana use were screened for cannabinoid use by immunoassay (50-ng/mL cutoff), and presumptive positives were confirmed by gas chromatography-mass spectrometry for delta9-THCCOOH (15-ng/mL cutoff). Creatinine was analyzed with a cutoff concentration of 25 mg/dL. The study objective was to apply the criteria from both groups of workers to determine if consecutive urine specimens (collected at least 24 h apart) positive for cannabinoids could be used to differentiate new marijuana use from the excretion of residual cannabinoid metabolite (delta9-THCCOOH) in an uncontrolled setting. Serial urine specimens (826) were collected from 26 individuals. Huestis and Cone and Manno et al. ratios indicated new drug use in 83% and 33% of serial urine specimens collected at least 24 h apart, respectively. Clinically, the Huestis and Cone ratio is recommended because of a lower false-negative rate (7.4%) than the Manno et al. false-negative rate (24%). In legal situations, we recommend using the Manno et al. ratio because of its lower false-positive rate (0.1%) as stated by Huestis and Cone.
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Affiliation(s)
- A D Fraser
- Department of Pathology and Laboratory Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
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14
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Abstract
Until recently, most laboratories used an opiate immunoassay screening and confirmation cutoff value of 300 ng/mL for codeine and morphine detection by gas chromatography-mass spectrometry (GC-MS). The cutoff value for opiates was increased to 2000 ng/mL or higher in various laboratories because of concerns that small doses of codeine and foods containing poppy seeds would give a positive opiate-screening result. Workplace drug-testing programs in the U.S. raised the opiate cutoff value to 2000 ng/mL on 30 November 1998. The objective of this study is to describe the results of opiate testing of 8600 urine specimens collected over 24 months with a 2000-ng/mL screening and confirmation (codeine and morphine) cutoff value. Specimens were screened by the EMITdau opiate assay using an in-house 2000-ng/mL morphine calibrator. Presumptive positive findings (N = 621) were analyzed quantitatively by GC-MS for codeine and morphine. One hundred and eighty six urine specimens were positive for codeine and morphine (> 2000 ng/mL), 298 specimens were positive for codeine only (> 2000 ng/mL) and 26 specimens were positive for morphine only (> 2000 ng/mL). All remaining specimens had codeine and morphine values < 2000 ng/mL. The codeine and morphine confirmation rate in this program reduced from 7.1% in 1994-1996 (300-ng/mL cutoff) to 2.1% in 1997-1998 with a 2000-ng/mL cutoff value. The codeine-only confirmation rate lowered from 6.6% (300-ng/mL cutoff) to 3.4% (2000-ng/mL cutoff). It was concluded that increasing opiate screening and codeine and morphine confirmation cutoff values led to > 300% reduction in the confirmed-positive rate for codeine and morphine and a 47% reduction in codeine-only confirmations in a urine drug-testing program where codeine was the major opiate used.
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Affiliation(s)
- A D Fraser
- Toxicology Laboratory, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
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15
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Amevo B, Worth D, Bogduk N. Instantaneous axes of rotation of the typical cervical motion segments: a study in normal volunteers. Clin Biomech (Bristol, Avon) 1991; 6:111-7. [PMID: 23915484 DOI: 10.1016/0268-0033(91)90008-e] [Citation(s) in RCA: 94] [Impact Index Per Article: 2.8] [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] [Received: 02/08/1990] [Accepted: 08/12/1990] [Indexed: 02/07/2023]
Abstract
The locations of the instantaneous axes of rotation for the cervical motion segments C2-3 to C6-7 were determined from flexion-extension radiographs of 40 normal subjects using a modified overlay technique. The biological variation of the instantaneous axes of rotation was small, as was the technical error associated with the technique used. The data obtained enabled the formal definition of the normal range of locations for the instantaneous axes of rotation of the typical cervical motion segments.
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Affiliation(s)
- B Amevo
- Faculty of Medicine, University of Papua New Guinea, Papua New Guinea
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16
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Amevo B, Worth D, Bogduk N. Instantaneous axes of rotation of the typical cervical motion segments: II. optimization of technical errors. Clin Biomech (Bristol, Avon) 1991; 6:38-46. [PMID: 23916343 DOI: 10.1016/0268-0033(91)90040-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [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] [Received: 02/08/1990] [Accepted: 08/14/1990] [Indexed: 02/07/2023]
Abstract
The reliability of a modified protocol for plotting the instantaneous axes of sagittal rotation for the cervical spine was evaluated by measuring the observer differences when the process was performed separately by two observers, and by a single observer, on two separate occasions. Small observer differences were found both for individual steps in the process and for the process as a whole. These differences were substantially less than those found using the conventional technique for plotting the instantaneous axes of rotation. The improvement in the technique was resultant from the use of stricter criteria for recognizing and tracing vertebral landmarks.
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Affiliation(s)
- B Amevo
- Faculty of Medicine, University of Papua New Guinea, Papua New Guinea
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17
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Amevo B, Macintosh JE, Worth D, Bogduk N. Instantaneous axes of rotation of the typical cervical motion segments: I. an empirical study of technical errors. Clin Biomech (Bristol, Avon) 1991; 6:31-7. [PMID: 23916342 DOI: 10.1016/0268-0033(91)90039-s] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [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] [Received: 02/08/1990] [Accepted: 08/14/1990] [Indexed: 02/07/2023]
Abstract
The reliability of the conventional technique for determining the instantaneous axes of rotation of the cervical motion segments was evaluated by comparing the determinations made by two observers and the same observer on two separate occasions. Different observers found the same mean location for the instantaneous axis at each segment in a test population of 17 normal subjects, but for any given subject the interobserver and intraobserver differences were large, with a relative variation of up to 35%. Thus, while reliable for determining the mean location of the instantaneous axis of rotation in a population, the technique was not reliable for determining the axis in a given subject. Qualitative analysis suggested that the identification of the radiographic images of the vertebrae and their tracing is the greatest source of error for this technique.
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Affiliation(s)
- B Amevo
- Faculty of Medicine, University of Papua New Guinea, Papua New Guinea
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18
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Chavkin W, Cohen J, Ehrhardt AA, Fullilove MT, Worth D. Women and AIDS. Science 1991; 251:359-62. [PMID: 1989069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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19
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Worth D. Sexual decision-making and AIDS: why condom promotion among vulnerable women is likely to fail. Stud Fam Plann 1989; 20:297-307. [PMID: 2623725] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This article examines the reasons for resistance to condom use among high-risk women (primarily intravenous drug users and/or the sexual partners of intravenous drug users) in two New York City AIDS prevention programs. The data collected indicate that a lack of economic, social, cultural, sexual, and technological options combine to lead vulnerable women to concentrate on addressing the more immediate risks in their lives: poverty, homelessness, and the frequent disruption of socioeconomic support systems. Resistance to condom use was also found to be related to its negative associations (promiscuity, for example). The process by which decisions are made about using condoms (and other contraceptives) is related to a complex mixture of social, economic, and cultural influences that promote the role of motherhood for a woman, even when she knows that she might already be infected with human immunodeficiency virus (HIV). The implications of these findings have far-reaching effects, as the socioeconomic context of these women's lives, as well as imbalances in power in the relationships between the women and their male partners, are replicated in many communities where AIDS is already present.
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Affiliation(s)
- D Worth
- Department of Epidemiology and Social Medicine, Montefiore Medical Center, Bronx, New York 10467
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Worth D, Harvey J, Brown J, Lee M. The effects of intravenous L-dopa on plasma renin activity, renal function, and blood pressure in man. Eur J Clin Pharmacol 1988; 35:137-41. [PMID: 3056728 DOI: 10.1007/bf00609242] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
L-dopa 7 micrograms.kg-1.min-1 was given intravenously over 2 h to six healthy subjects, controlled by an infusion of saline on a separate occasion, with measurement of plasma renin activity (PRA), urinary sodium and potassium excretion, effective renal plasma flow (ERPF), glomerular filtration rate (GFR), blood pressure, and pulse rate. Mean PRA fell by 50% following L-dopa, which was significantly different from the slight rise which occurred after saline infusion. There was a significant increase in urinary sodium excretion and effective renal plasma flow on infusion of L-dopa. Mean diastolic blood pressure fell during L-dopa infusion, in contrast to the slight increase which occurred during the control study. These observations confirm the anticipated renal dopaminergic effects of L-dopa and also suggest a dopaminergic influence on renin release in man.
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Affiliation(s)
- D Worth
- Department of Medicine, General Infirmary, Leeds, UK
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21
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Worth D, Rodriguez R. Latina women and AIDS. SIECUS Rep 1987:5-7. [PMID: 12268416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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22
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Ram S, Skinner M, Kalvin D, Wise DS, Townsend LB, McCall JW, Worth D, Ortwine D, Werbel LM. Synthesis of potential antifilarial agents. 1-(5-Benzoylbenzimidazol-2-yl)-3-alkyl- and -arylureas. J Med Chem 1984; 27:914-7. [PMID: 6737434 DOI: 10.1021/jm00373a017] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A series of 1-(5-benzoylbenzimidazol-2-yl)-3-substituted ureas have been synthesized by reacting an appropriate isocyanate with 2-amino-5-benzoylbenzimidazole or by reacting methyl (5-benzoylbenzimidazol-2-yl)carbamate with various amines. Several of the compounds have demonstrated antifilarial activity against Brugia pahangi and Litomosoides carinii.
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Angelo M, Ortwine D, Worth D, Werbel LM, McCall JW. Synthesis and antifilarial activity of N-[4-[[4-alkoxy-3-[(dialkylamino)methyl]phenyl]amino]- 2-pyrimidinyl]-N'-phenylguanidines. J Med Chem 1983; 26:1258-67. [PMID: 6887202 DOI: 10.1021/jm00363a010] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A series of N-[4-[[4-alkoxy-3-[(dialkylamino)methyl]phenyl]amino]- 2-pyrimidinyl]-N'-phenylguanidines have been synthesized for antifilarial evaluation. Reaction of the appropriate benzenamines with N-cyanoguanidine, followed by condensation of the resultant N-phenylimidodicarbonimidic diamides (V) with ethyl 4,4,4-trifluoro-3-oxobutanoate provided the intermediate N-(4-hydroxy-2-pyrimidinyl)-N'-phenylguanidines VIa. Alternatively, compounds VIa were synthesized by reaction of the requisite beta-keto esters (VII) with N-cyanoguanidine to give the (4-hydroxy-2-pyrimidinyl)cyanamides (VIII), followed by treatment with the desired benzenamines. Chlorination with POCl3 and condensation with the appropriate benzenamines (IX) generated the desired guanidines (X). Antifilarial activity was confined to adult Litomosoides carinii infections, and a structure-activity relationship for this activity is discussed. Lack of activity against L. carinii microfilaria and adult Brugia pahangi infections preclude further work in this area pending evaluation in additional experimental models.
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Ginzler EM, Diamond HS, Weiner M, Schlesinger M, Fries JF, Wasner C, Medsger TA, Ziegler G, Klippel JH, Hadler NM, Albert DA, Hess EV, Spencer-Green G, Grayzel A, Worth D, Hahn BH, Barnett EV. A multicenter study of outcome in systemic lupus erythematosus. I. Entry variables as predictors of prognosis. Arthritis Rheum 1982; 25:601-11. [PMID: 7092960 DOI: 10.1002/art.1780250601] [Citation(s) in RCA: 217] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A retrospective study of factors influencing survival in 1,103 patients with systemic lupus erythematosus (SLE) was carried out at 9 university centers diverse in geographic, socioeconomic, and racial characteristics. The mortality and disease characteristics of the patients at study entry varied widely among centers. The survival rates from the time patients with a diagnosis of SLE were first evaluated at the participating center was 90% at 1 year, 77% at 5 years, and 71% at 10 years. Patients with a serum creatinine greater than 3 mg/dl at study entry had the lowest survival rates: 48%, 29%, and 12% at 1, 5, and 10 years, respectively. Survival rate also correlated independently with the entry hematocrit, degree of proteinuria, number of preliminary American Rheumatism Association criteria for SLE satisfied, and source of funding of medical care. When data were corrected for socioeconomic status, race/ethnic origin did not significantly influence survival. Survival rates varied widely at different participating institutions, generally due to differences in disease severity. Place of treatment was independently associated with survival only in the second year after study entry. Disease duration before study entry did not account for the differences in disease severity.
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Rosner S, Ginzler EM, Diamond HS, Weiner M, Schlesinger M, Fries JF, Wasner C, Medsger TA, Ziegler G, Klippel JH, Hadler NM, Albert DA, Hess EV, Spencer-Green G, Grayzel A, Worth D, Hahn BH, Barnett EV. A multicenter study of outcome in systemic lupus erythematosus. II. Causes of death. Arthritis Rheum 1982; 25:612-7. [PMID: 7046757 DOI: 10.1002/art.1780250602] [Citation(s) in RCA: 259] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Causes of death were examined for 1,103 systemic lupus erythematosus patients who were followed from 1965 to 1978 at 9 centers that participated in the Lupus Survival Study Group. A total of 222 patients (20%) died. Lupus-related organ system involvement (mainly active nephritis) and infection were the most frequent primary causes of death. Causes of death were similar throughout the followup period. Hemodialysis had little impact on the length of survival for patients with nephritis. Active central nervous system disease and myocardial infarction were infrequent causes of death. There were no deaths from malignancy.
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Worth D, Beck AM. Multiple ownership of animals in New York City. Trans Stud Coll Physicians Phila 1981; 3:280-300. [PMID: 7043819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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27
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Worth D. Community nursing: not in their perfect mind. Nurs Mirror 1978; 147:50-2. [PMID: 250811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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