The potential impact of the COVID-19 pandemic on child growth and development: a systematic review

OBJECTIVE

This was a systematic review of studies that examined the impact of epidemics or social restriction on mental and developmental health in parents and children/adolescents.

SOURCE OF DATA

The PubMed, WHO COVID-19, and SciELO databases were searched on March 15, 2020, and on April 25, 2020, filtering for children (0-18 years) and humans.

SYNTHESIS OF DATA

The tools used to mitigate the threat of a pandemic such as COVID-19 may very well threaten child growth and development. These tools - such as social restrictions, shutdowns, and school closures - contribute to stress in parents and children and can become risk factors that threaten child growth and development and may compromise the Sustainable Development Goals. The studies reviewed suggest that epidemics can lead to high levels of stress in parents and children, which begin with concerns about children becoming infected. These studies describe several potential mental and emotional consequences of epidemics such as COVID-19, H1N1, AIDS, and Ebola: severe anxiety or depression among parents and acute stress disorder, post-traumatic stress, anxiety disorders, and depression among children. These data can be related to adverse childhood experiences and elevated risk of toxic stress. The more adverse experiences, the greater the risk of developmental delays and health problems in adulthood, such as cognitive impairment, substance abuse, depression, and non-communicable diseases.

CONCLUSION

Information about the impact of epidemics on parents and children is relevant to policy makers to aid them in developing strategies to help families cope with epidemic/pandemic-driven adversity and ensure their children's healthy development.

Papillary thyroid microcarcinoma (Black Ink)

We report a case of a 58-year-old Caucasian woman affected by papillary thyroid microcarcinoma (PTMC) of the left-lobe of the gland with very small size (Ø 0.3 cm). The characteristics with the Diagnostic Imaging using Ultrasonography, ADF (Advanced Dynamic Flow), and fine-needle-aspiration cytology (FNAC) are discussed, comprising a very small micro-focus of radial shape, with markedly hypoechoic echostructure, irregular margins, supplemented by peripheral vessel formation. It acquires an image which appears similar to a brisk visualization of a dark ink stain in the normal thyroid weave. We call such a pattern "Black Ink" with ultrasonographic image and believe consistent with the infiltrating variant of papillary thyroid microcarcinoma if associated with malignant cytology after FNA.

Herpes Simplex Virus Nuclear Nonvirion Antigens Detected by Anticomplement Immunofluorescence

The finding of a nuclear antigen by anticomplement immunofluorescence in cells treated with cytosine-arabinoside after infection of Herpes Simplex Virus (HSV), opens a new approach to the problem of the role of this virus in certain human cancers. Complement-fixing tests of HSV markers with cancer and control human sera as well as with hyperimmune guinea pig antisera are discussed, suggesting another parameter for studies of squamous cell carcinomas. The finding of HSV antigens in selected tumors as the expression of repressed viral genome proves a continuing release of virus specific message and supports the important role of the virus in the development of the tumor.

Herpes Simplex Virus Tumor-Associated Antigens in Cancer Patients

Data are reported on the HSV nonstructural antigens detected in GPK and RK cells after infection with the same strain of virus. Both the HSV types 1 and 2 NV antigens consist of more than one component for which the immunized guinea pigs produce distinct antibodies. It was possible to separate by PAGE, HSV-induced markers not only from cells undergoing lytic infection by the virus but also from viable cells from squamous cell carcinoma of the head and neck and the urogenital tract. These fractions were tested with sera from cancer patients, and the percentages of their CF reactivity are reported. The specificity of the antibody to the antigen from the cancer cells was less high than that of the antibody to the antigen from HSV-infected cells. It is suggested that the use of these PAGE separate antigens would eliminate the need for removal of the virion antibody from the cancer sera prior to testing them for the NV-specific antibody.

Mass spectrometry-based proteomics: the road to lung cancer biomarker discovery

Lung cancer is the leading cause of cancer death in men and women in Western nations, and is among the deadliest cancers with a 5-year survival rate of 15%. The high mortality caused by lung cancer is attributable to a late-stage diagnosis and the lack of effective treatments. So, it is crucial to identify new biomarkers that could function not only to detect lung cancer at an early stage but also to shed light on the molecular mechanisms that underlie cancer development and serve as the basis for the development of novel therapeutic strategies. Considering that DNA-based biomarkers for lung cancer showed inadequate sensitivity, specificity, and reproducibility, proteomics could represent a better tool for the identification of useful biomarkers and therapeutic targets for this cancer type. Among the proteomics technologies, the most powerful tool is mass spectrometry. In this review, we describe studies that use mass spectrometry-based proteomics technologies to analyze tumor proteins and peptides, which might represent new diagnostic, prognostic, and predictive markers for lung cancer. We focus in particular on those findings that hold promise to impact significantly on the clinical management of this disease.

Tracking the 2009 H1N1 influenza virus in the Italian region Campania

A novel swine-origin influenza A (H1N1) virus affecting humans was detected in April 2009 in Mexico, Canada, and USA. The S-OIV infection caused a mild to severe febrile respiratory disease throughout the world. Here, we briefly review the main features of influenza A viruses, which caused also other pandemics in the past, and focus in particular on the epidemiology data of the H1N1 influenza in the Italian region Campania, which resulted the most affected by the S-OIV and the one with more lethal cases. In Campania, the peak of influenza preceded of about 2 weeks the incidence peak at the national level. Moreover, the percentage of H1N1-positive patients was much higher in the main town Naples, compared to the other Campania provinces. The age group from 7 months to 17 years was the most affected by the H1N1 infection (43.45%), similarly to what reported at the national level. Here, we discuss the possible reasons of the high H1N1 incidence in Campania and the implications that these findings could have on the future prevention campaigns.

Biomolecular markers of breast cancer

Here, the structure, function, biological and pathological significance and clinical utility of the principal biomolecular markers of breast cancer is reviewed. Each marker was scored for clinical utility using a recently developed tumor marker utility grading system (TMUGS). Among the tissue markers, ERs and PRs are important prognostic/predictive factors and the only tissue markers routinely determined. ER cross-talks with other growth factors while co-regulatory factors enhance (co-activators) or decrease (co-repressors) its transcriptional activity. C-erbB-2 and Ki67/MIB-1 select for adjuvant chemotherapy a subgroup of lymph-node negative patients at a high risk of relapse. Monoclonal antibodies (trastuzumab, gefitinib, erlotinib and bevacizumab) targeting tissue markers and involved in tumor growth and metastasization (EGFR, C-erbB-2, VEGF) have been developed; they showed therapeutical single agent activity as well as potent synergy with chemotherapy agents in metastatic cancer. Among circulating markers, some are potentially useful in the early detection and monitoring of metastatic disease; nevertheless, none is routinely recommended. To suspect distant metastases, CEA-TPA-CA15.3 panel attained accuracy of about 90%. ECD HER2-neu, p53 and nucleophosmin antibodies seem suitable candidates for different associations. Preliminary observations suggest that an early detection with tumor markers and successive treatment of relapses significantly prolongs disease-free and overall survival in selected patients. In conclusion, biomolecular markers are improving understanding of biology and management of breast cancer.

Early diagnosis of lung cancer by detection of tumor liberated protein

Tumor liberated protein (TLP) is a protein that can be used to reveal the early development of a tumor. Besides being formed in the tumor, TLP is released in the blood when a patient starts producing cancer cells, which in turn enables the physician to intervene at a stage when the cancer is operable. To date, the available studies of tumor markers in lung cancer patients are CEA, NSE, TPA, Chromogranine, CA125, CA19-9, and Cyfra 21-1. The sensitivity and specificity for serum markers ranges between 50 and 90%, depending on the study and the clinical samples analyzed. Most of these markers show an increased rate of positivity as the stage advances. There are very limited data on TLP to draw any firm conclusion regarding the diagnostic value of this marker. TLP has been detected in 53.1% of non-small cell lung cancer (NSCLC) patients (N = 534) with 75% being positive in the early stage (stage I) and dropping to 45% in the late stage (stage IV). However, 7.6% blood donor sera and 17.4% chronic lung disease sera have also tested positive. In a confirmation study, the specificity was 89.94% and the sensibility was 63.63% from stage III to IV NSCLC patients. In an initial study of TLP as a marker for early detection in stage I, NSCLC patients showed a sensitivity of 66.7% and a specificity of 80% for TLP compared to a sensitivity of 33.3% for CA19-9, 11.1% for Cyfra 21-1 and CA125, and 0% for CEA; the specificity for all four of the latter markers was 100%. Using immunohistochemical analysis with peroxidase anti-peroxidase (PAP), we observed that NSCLC cells were positive; we used the specific rabbit antiserum to TLP, which turned out negative in the presence of 1 mg/ml of the synthetized peptide. The pre-serum was also negative. The same reactivity was found early in the modified epithelial cells of interstitial lung fibrosis and might be a predictive marker of cell transformation. The site of the peroxidase positivity was cytoplasmic, of diffuse and/or granular type.

[Papular purpuric gloves and socks syndrome. A case report]

Papulo-purpuric gloves and socks syndrome, a typical maculopurpuric exanthema limited to hands and feet, mainly associated with Parvovirus B19 infection, has not, until now been reported in the literature in relation to pediatric cases in Italy. The case of a 10-year old girl with all the characteristics of the papulo-purpuric gloves and socks syndrome, as well as being IgM positive anti Parvovirus B19, is reported. This syndrome, despite its spontaneous remission, should be included in the differential diagnosis of maculopurpuric exanthemas.

[Plasma HIV-1 RNA viral load up to one year of follow-up in 64 patients treated with HAART]

The aim of this study was to evaluate efficacy of highly active antiretroviral therapy (HAART) in 64 HIV-1 positive treatment-naive and previously treated patients, with different viral load at baseline. The HAART regimen consisted of one protease inhibitor and two reverse-transcriptase inhibitors. Plasma RNA viral load was measured by RT-PCR (Roche Amplicor Monitor kit) at enrolment and at months 3, 6, 9, and 12 of follow-up. The viral load fell below the threshold of 200 copies/ml in 46.9% of patients at month 6 and this result lasted up to month 12 of follow-up in 42.2% of patients. In these patients the CD4+ cell count increased from a baseline with a median of 194 cells/mmc at month 12. Treatment failure occurred in 35.9% of patients and the proportion was higher among previously treated patients. 7 patients stopped therapy because of poor compliance and 5 because of adverse drug effects. Also in our cases the HAART regimen showed more efficacy in treatment-naive patients, whereas baseline viral load >1x105 was the cause of less efficacy of therapy.

Characterization of a fragment containing a putative TLP cDNA sequence

With the aim of isolating the Tumor Liberated Protein (TLP) gene, reverse transcription-polymerase chain reaction (RT-PCR) was used to isolate a approximately equal to 500 bp fragment containing a putative TLP cDNA sequence. Total RNAs were extracted from several cell lines with RNAzol B reagent (Tel-Test, Inc) and reverse transcribed using the Reverse Transcription System (Promega). PCR was carried out for 35 cycles (1 minute at 95 degrees C, 2 minutes at 40 degrees C and 1 minute at 72 degrees C) using an upstream degenerate oligonucleotide, ACN AAY AAR GAR GCN TCN ATG TG, which corresponds to the amino acid sequence T N K E A S I, and random hexamers as the downstream primer. PCR products were electrophoresed on a 1% agarose gel containing ethidium bromide. The PCR products were cloned in the pGEM-T easy vector (PROMEGA) and the resulting plasmid clones were sequenced with the chain termination method using the Applied Biosystems model 373A DNA sequencer. A putative open reading frame was deducted. The results obtained can be considered as preliminary data that will require more investigation in order to confirm them. We propose to continue the studies to verify that TLP could be a diagnostic marker in human cancer.

Tumor liberated protein (TLP): its potential for diagnosis and therapy

Our earlier studies led to the purification of a similar antigen from several types of human tumours which had the following properties: It provoked a delayed reaction in certain cancer patients which could be demonstrated both in vivo and in vitro (1). In contrast, healthy individuals did not react to this antigen. Subsequent studies led to a higher degree of purity of tumour antigen which enabled a partial sequence (2). The eight amino acid sequence obtained led to the synthesis of the corresponding peptide. This synthetic peptide was then used to raise specific antibodies in rabbits. The availability of such antibodies enabled to undertake a range of studies. Those investigations revealed that the antibodies were tumour specific because they reacted only with certain types of tumours but not with normal cells nor with other types of tumour tissues. We decided to name this tumour antigen as TLP for tumour liberated protein.

Immunohistochemical characterization of tumor liberated particles (TLP) expression pattern in lung cancer

The role of serum tumor markers in lung cancer has not been defined. It is widely believed that almost all neoplasms produce at least a few substances, but the identity of most of the known substances has not been correlated with a positive role in either the diagnosis or prognosis of patients with these neoplasms. We observed a significant immunogenic response after injecting patients with an antigen extracted from tumor-liberated particles (TLP). A specific ELISA test for TLP performed on sera from patients with lung cancer was reported recently. Based on this information, we developed a polyclonal antibody anti-TLP and screened several cell lines and tumor specimens. We concluded that TLP is a cytoplasmatic antigen specific for epithelial derived neoplasms because it was not detected in non neoplastic tissue cells, in neuroendocrine-tumors or in mesenchymal-derived tumors and normal cells. In addition, the finding that TLP is detectable in neoplasms and tumoral cell lines with common embryologic features seems to suggest that TLP might be an "oncofetal antigen". However, these preliminary observations need confirmation by additional studies using larger numbers of patients and tumor types.

[Cytomegalovirus and herpes simplex virus antibodies in patients with idiopathic ulcerative rectocolitis]

The total and fractioned titres of circulating anticytomegalovirus (CMV) and antiherpesvirus (HSV) antibodies were evaluated in 63 idiopathic ulcerative proctocolitis patients in follow-up. The population was disaggregated applying criteria related to the stage of the disease: duration, extension, number of observed relapses over the follow-up. It was noted that just the anti-HSV antibodies were correlated in a statistically significant way to the extension (p less than 0.025) and duration (p less than 0.025) of the disease. We believe that this behaviour is a manifestation of the disease and that the antiHSV titration may be included in a score of evaluation during the follow-up.

Screening haemodialysis patients for infection with human immune deficiency virus (HIV)

A group of 484 patients having regular haemodialysis was tested for the presence of antibodies to the human immunodeficiency virus (HIV). With a commercial enzyme-linked immunoassay kit, the serum of 17 appeared positive. When these 17 samples were retested by a different method, however, none was found to contain antibodies to the virus. Furthermore, evaluation of the clinical state of these 17 patients for the presence of any prodromal symptoms associated with the acquired immune deficiency syndrome was negative. It is therefore suggested that patients having regular haemodialysis are presently at low risk of contracting infection by HIV. By contrast, 81% of these patients had antibodies to cytomegalovirus.

Serological and virological investigations of young children with acute respiratory syndrome associated with respiratory syncytial virus

From January 1979 to March 1979, 341 young children from the metropolitan area of Naples, Italy, were hospitalized with respiratory virus disease. Diagnosis of patients made from virus isolation and seroconversion indicate that the respiratory syncytial virus was a primary cause of this acute respiratory syndrome.

Human tumor antigens inducing in vivo delayed hypersensitivity and in vitro mitogenic activity

Significant immunogenic properties were observed with an antigen extracted from tumor-liberated particles (TLP). Several different tumors were used to obtain antigens by such cell analysis and purification procedures as: gel filtration on Sephadex G-100, ion-exchange chromatography, affinity chromatography, and gel filtration on Sephadex G-200. The molecular weight determined on SDS-PAGE was about 214,000 daltons. In vivo, TLP yields delayed hypersensitivity reactions both in autologous and homologous hosts. TLP does not seem to have any nonspecific mitogenic activity, but it does have specific mitogenic activity, since lymphocyte blastogenesis (TLP-induced in presensitized patients) could mean its ability when intradermally inoculated to sensitize a lymphocytic clone.

TAF-test: a tumor diagnosis device in oncologic urology

A screening test for detecting antibodies to HSV-TAA was performed on 26 sera, from urinary bladder carcinoma patients and on 30 sera from prostatic carcinoma patients. Positive results were found in 50% of the urinary bladder cancer sera and in 60% of the prostatic carcinoma sera. As control 10/11 sera from benign prostatic hypertrophy and 4/4 sera from renal pelvis or ureter neoplasias (tumors never previously associated to HSV) were negative before and after surgery. The only one positive of the former group became negative after surgical treatment. The TAF-test can therefore be a meaningful test for monitoring antibody levels in the sera of patients before, during or after the treatment, in order to evaluate the presence of metastases or the success of a therapy.

Purification of herpes simplex virus tumor associated antigen from human kidney carcinoma

In the present study, we attempted to purify herpes simplex virus (HSV) tumor associated antigen(s) (TAA) extracted from human kidney carcinoma. Trypsinized human tumor cells were sonicated for 9 minutes and clarified at 100,000 x g for 1 hour; the supernate yielded 70% of detectable TAA as determined by means of quantitative absorption with specific antisera. The supernate used as source of soluble HSV-TAA was concentrated and the pellet was resuspended in 0.02 M tris, pH 7.2, and purified by means of filtration on Sephadex G-100 followed by chromatography on DEAE Sephadex A-50 and then affinity chromatography on concanavalin A (Con A) sepharose. The TAA bound to Con A sepharose was eluted by 0.5 M of alpha-CH3D-mannoside (alpha-MM) and behaved as a glycoprotein. The molecular weight determined on SDS-PAGE was about 70,000 daltons in relation to standard marker proteins. This antigen reacted in complement fixing tests with hyperimmune guinea pig sera as well as with certain human squamous cancer sera. As a control we used a human kidney carcinoma which showed no complement fixing activity in any of the procedural steps, and as control sera, guinea pig sera prepared by inoculation of uninfected guinea pig cells.

[Association between viral infection and pleuropericarditis: study of a case list of pleurisy and pericarditis]

The Authors report a study on a group of 47 patients affected by serositis (pleuritis, pericarditis, pleuro-pericarditis) of suspected viral origin. Two serum samples were taken from each patient at different times and were tested with many viral antigens by the complement fixation technique. The discussion is carried out on the lines followed by the majority of people in giving importance to their viral etiology and the viruses involved as agents of serositis are reported. In the present study 18 patients (38%) showed a significant rise of antibodies for viral antigens and therefore their disease might be due to viral etiology: 5 influenza viruses, 1 parainfluenza, 1 coxsackie, 1 RSV, 3 mumps virus, 5 CMV, 1 adenovirus.

Enzyme-linked immunosorbent assay for herpes simplex virus tumor-associated antigen

The antibodies against herpes simplex virus (HSV) tumor-associated antigen (TAA) in human sera were investigated by the enzyme-linked immunosorbent assay (ELISA). By combining the findings of antibody levels in many human sera, a significant level of discrimination between normal and cancer sera could be reached. Thus, 57 of 74 pathological sera had increased levels of antibodies against HSV-TAA antigen as compared to 26 of 512 normal sera. A significant correlation between the ELISA values and complement fixing (CF) and radioimmunoassay (RIA) values was also found. The results suggest that serodiagnosis with the ELISA test may therefore be of some use in the detection of specific antibodies against HSV-TAA antigen in sera of cancer patients.

[Prospects of respiratory syncytial virus vaccines]

The latest vaccines for Respiratory Syncytial Virus (RSV) are reviewed. A ts-1 variant is being studied in the attempt to complete the attenuation of the vaccine strain. Further investigations of live RSV vaccine administered parenterally indicate that a target population over 6 months of age could benefit soon of this preparation.

Detection of early antigens in nuclei of cells infected with cytomegalovirus or herpes simplex virus type 1 and 2 by anti-complement immunofluorescence, and use of a blocking assay to demonstrate their specificity

Skin fibroblasts exposed to cytosine arabinoside (Ara C) were infected with either cytomegalovirus (CMV) or herpes simplex virus (HSV) type 1 and 2. Herpesvirus-determined early antigens (HV-EA), detected by anti-complement immunofluorescence (ACIF), occurred primarily in the nucleic, and the specificity of these results was established by an ACIF blocking reaction using F(ab')2 fragments of human and hyperimmune reference sera. Direct tests with selected sera and cross-blocking experiments between early antigenic systems of CMV, HSV-1 and the Epstein-Barr virus (EBV) did not demonstrate common HV-EA.

Cell-mediated immunity to herpes simplex virus types 1 and 2 antigens in leukoplakia and carcinoma in man

Cell-mediated immune responses to herpes simplex virus 1 and type 2 virion and non-virion antigens were assessed in patients and in controls with oral leukoplakia, carcinoma and recurrent herpes labialis. Enhanced proliferation was found in lymphocytes from patients with recurrent herpes labialis or with leukoplakia showing epithelial atypia, and depressed responses were found in carcinoma. Very significantly positive correlations were shown between the responses to each of the herpes virus antigens. A specific increase in cell-mediated immunity to herpes virus in epithelial atypia was confirmed, but separation of the nonvirion from virion antigen is necessary before specific cell-mediated immune responses to the non-virion antigen can be assessed.

Herpes simplex and herpes genitalis viruses in etiology of some human cancers

The results of complement fixation tests on 202 sera from people without cancer and from patients with cancer in 29 different areas of the body indicated that only those with nine varieties of advanced cancer (lip, mouth, oropharynx, nasopharynx, kidney, urinary bladder, prostate, cervix uteri, and vulva-all of 56 tested) gave positive specific reactions with nonvirion antigens induced by the DNA herpes simplex (HSV 1) and herpes genitalis (HSV 2) viruses. None of 57 people without cancer (including 10 with current and 18 with recurrent HSV 1 or HSV 2 infections), none of 81 patients with 20 other varieties of advanced cancer (gum, tongue, tonsil, salivary gland, accessory sinus, epiglottis, lung-bronchus, stomach, colon, breast, corpus uteri, ovary, testis, liver, thyroid, Wilms' embryonal kidney, melanoma, Hodgkin's disease, acute lymphocytic leukemia, and acute myelocytic leukemia), and none of four women with early malignant changes in the cervix uteri gave positive results. The seven patients with advanced cancer of the lip or oropharynx gave positive reactions with HSV 1 but not with HSV 2 nonvirion antigens (compatible with involvement of only HSV 1), all of the 13 women with advanced cancer of the cervix uteri and the one woman with advanced cancer of the vulva gave positive reactions with both HSV 1 and HSV 2 nonvirion antigens (compatible with involvement of only HSV 2), while among the 35 other positive patients only two (one with cancer of the kidney and one with cancer of the bladder) reacted with HSV 1 and not at all with HSV 2 nonvirion antigens. Positive sera failed to react with cells harvested at different times after high-multiplicity infection with the DNA vaccinia virus. Massive absorption of positive sera with trypsinized, uninfected human embryonic kidney cells failed to remove, or lower the titer of, the HSV 1 and HSV 2 nonvirion antibodies. All of these data taken together are interpreted as indicating that HSV 1 and HSV 2 play an etiologic role in certain human cancers, because they provide the kind of evidence by which virus-free experimental cancers can be proved to have been originally induced by such DNA viruses as polyoma, Simian Virus 40, or certain types of adenovirus.

Nonvirion antigens produced by herpes simplex viruses 1 and 2

Of nine herpes simplex virus 1 strains (from lip, mouth, throat, cornea, or brain) only five produced enough nonvirion antigen (i.e., not a structural component of the virus) to be detected by complement fixation with specially prepared, virion-absorbed, type-1 guinea pig antisera, while the remaining four strains produced only enough of the same antigen to induce specific antibody in hyperimmunized guinea pigs. While the type 1 virion antiserum used reacted equally well by complement fixation with the type 1 and type 2 strains, the type 1 nonvirion antisera failed to react with nonvirion antigens produced by three type-2 (genital) strains. However, type 2 nonvirion antiserum reacted equally well with the three type 2 and four type 1 nonvirion antigens that were tested. It appears, therefore, that while herpes simplex virus 1 codes only for type 1 nonvirion antigen, herpes simplex 2 codes not only for an immunologically distinct type 2 nonvirion antigen but also for enough type 1 nonvirion antigen to stimulate antibody production for it. Herpes simplex 2 nonvirion antigen exhibited the same properties as type 1, i.e., its activity was lost on storage at 4 degrees for 15 days, it was sedimented by centrifugation at 33,360 x g for 1 hr, and the maximum concentration was found at 3 hr in guinea pig kidney culture cells, but at 24 hr in HEp 2 and rabbit kidney culture cells. Sera from patients with genital lesions caused by herpes simplex virus 2, as well as from randomly selected adults, failed to react with either type 2 or type 1 nonvirion antigens. Accordingly, the basic information is now available to permit the use of these nonvirion antigens to determine the possible role of the herpes simplex viruses in certain human cancers.

Soluble membrane antigens of lip and cervical carcinomas: reactivity with antibody for herpesvirus nonvirion antigens

With the use of antibody for herpesvirus nonvirion antigens (not structural components of the virus) complement fixing reactivity has been shown for soluble membrane antigens separated from lip and cervical carcinomas but not for similar extracts from normal vaginal tissue or intestinal carcinoma. Neither the serum obtained from the guinea pig before hyperimmunization with the herpesvirus nonvirion antigen nor the antiserum of guinea pigs immunized with comparable uninfected cell extracts reacted with these tumor soluble membrane antigens. Since the above soluble membrane antigens could be specific markers for the presence of virus genome within the tumor cells, the findings could support an etiological role of herpesvirus in selected human malignancies.

Appearance in trypsinized normal cells of reactivity with antibody presumably specific for malignant cells

Trypsinization of normal human diploid cells (WI-38 and MRC 5) resulted in the appearance of complement-fixing reactivity with an immunoglobulin (anti-HeLa G globulin), prepared against a purified HeLa (malignant human) cell antigen (G), which reacts with various malignant human cell lines and tumors but not with certain normal human cells. The presence of receptors in the nonreacting, untrypsinized normal human cells and the specificity of the reactive groups that appeared after trypsinization was established by the fact that the antibody could be completely absorbed with large quantities of packed, untrypsinized human cells but not with similar quantities of either rabbit or guinea-pig kidney tissue-culture cells, which did not react with this antibody either before or after treatment with trypsin. The change produced by trypsinization is thus similar to the previously demonstrated appearance of reactive groups with the same anti-HeLa G globulin in normal human cells at certain times after infection with herpes simplex and vaccinia viruses. The fact that the trypsinized WI-38 cells absorbed more antibody than the same number of cells before trypsinization indicated that trypsinization resulted not only in the appearance of reactivity with antibody but also in a greater concentration of combining receptors, which is unlike the situation with lectins producing agglutinability without an increase in the number of receptors. Moreover, the fact that absorption with trypsinized normal cells removed larger amounts not only of the antibody reacting with the trypsin-treated WI-38 cells but also of antibody that reacts with WI-38 cells infected with herpes simplex virus and with the malignant HEp-2 cells, suggests that the combining groups that emerge after trypsinization of the normal human cells are the same or similar to those present in malignant human cells (HEp 2) and to those that emerge after infection of the normal human cells with herpes simplex virus.

Increase in preexisting cellular antigen-combining groups at different times after infection with different viruses

During the course of experiments designed to determine whether infection of normal cells with certain strains of Herpesvirus hominis (HSV) gives rise to a specific neoantigen, presumably characteristic for human malignant cells ("HeLa G"), it was found that the seeming appearance of such a new antigen actually represents only an increase in concentration of previously existing normal antigen groups. The complement fixation tests for this antigen were carried out with antibody prepared by McKenna against a fraction, purified with the fluorocarbon genetron, from HeLa cells. This antibody reacted with extracts of tissue culture cells derived from various human malignant tumors and from the spontaneously transformed WISH cell line, originally derived from normal human amnion, but not with cells derived from early-passage cultures of normal human kidney, or from primary cultures of young rabbit kidney or new-born guinea pig kidney. Infection of rabbit and guinea pig kidney tissue culture cells with HSV strains derived from brain or lip lesions at a high input multiplicity of virus failed to yield the "G" antigen. Infection of human kidney tissue culture cells with the same HSV strains yielded two units of the "G" antigen at 6 hr and 32 units at 24 hr. The conclusion that this was, nevertheless, not a new antigen, but only an increase in amount of preexisting antigen, was based on the demonstration that absorption of the anti-"HeLa G" globulin with uninfected human kidney tissue culture cells completely removed the antibody for the "G" antigen formed during the course of infection with HSV and also that present in uninfected WISH and HEp2 cells. Infection by the same HSV strains of the human WISH cells which have a small amount of preexisting "G" antigen resulted in an increase which was maximal at 24 hr. Infection of WISH cells with vaccinia virus resulted in a rapid increase of "G" antigen, which was demonstrable at 10 min but not at 3, 6, and 24 hr. Absorption of the anti-"HeLa G" globulin with uninfected WISH cells removed the antibody for the G antigen present in the WISH cells before infection as well as after infection with the herpes and vaccinia viruses, and also the antigen present in human tissue culture cells of malignant origin.

Virus-specific, labile, nonvirion antigen in herpesvirus-infected cells

The search for a specific, serologically identifiable nonvirion antigen (i.e., not a structural component of the virus) in cells infected with herpes simplex virus (HSV) was undertaken as an approach to the problem of the possible role of this virus in certain types of human cancer.Synthesis of structural components of HSV could not be prevented by a variety of inhibitors of DNA synthesis or by incubation at certain high or low temperatures, and it was, therefore, necessary to devise methods for the detection of nonvirion antigen in the presence of virion antigens. This was achieved by means of specially prepared and absorbed antisera only after the unusual lability and sedimentability of the nonvirion component became apparent. The special sera were derived from guinea pigs hyperimmunized with uncentrifuged extracts of guinea pig kidney culture cells freshly prepared three hours after infection with 20 to 30 plaque-forming units (PFU) of HSV per cell. It was possible to remove the neutralizing (N) antibodies for live virus and the complement-fixing (CF) antibodies for the sedimentable and soluble virion antigens, without loss of CF antibodies for nonvirion antigen, by absorption of these sera with uncentrifuged, HSV infected cell extracts that had been stored at +4 degrees or -66 degrees C, or both, for a sufficiently long time to permit the disappearance of the labile, nonvirion components. Human, rabbit, and guinea pig sera obtained after infection or after "ordinary" hyperimmunization had no CF antibodies for the labile, nonvirion antigen after comparable absorption. The nonvirion antigen detected in this manner is specific not only for HSV but also for the type (or strain?) of HSV, since infection of guinea pig kidney culture cells with vaccinia virus or type 2 (genital) HSV yielded no antigen detectable with the absorbed serum prepared against the type 1 HSV strain; the type 2 HSV produced large amounts of type 1 HSV virion antigen under these conditions, and the vaccinia virus large amounts of antigen reactive with ordinary rabbit antivaccinial serum. The nonvirion antigen was formed at maximum concentration early (3 hr) after high multiplicity HSV infection in guinea pig cells but late in the infectious process (12-24 hr) in rabbit or HEp 2 cells. The supernatant fluid had only 50 per cent of the activity after centrifugation at 1500 g for ten minutes and none after a further centrifugation at 33,360 g for one hour. Storage at +4 degrees C for eight to nine days led to complete loss of activity of the nonvirion antigen but no loss of activity of the various sedimentable and soluble virion antigens. At -66 degrees C or lower temperatures 50 per cent of the activity was lost in seven days and further loss occurred at different rates in extracts of guinea pig, rabbit and HEp 2 cells.