Development and Evaluation of an Eco-Friendly Hand Sanitizer Formulation Valorized from Fruit Peels

Hand sanitizer usage has proven to be a common and practical method for reducing the spread of infectious diseases which can be caused by many harmful pathogens. There is a need for alcohol-free hand sanitizers because most hand sanitizers on the market are alcohol-based, and regular use of them can damage the skin and can be hazardous. India is the world's largest producer of fruits and one of the major problems after fruit consumption is their peels, causing waste management problems and contributing to the formation of greenhouse gases leading to air pollution and adding to the problem of climate change. Valorization of such wastes into other value-added products and their incorporation into formulations of eco-friendly alcohol-free hand sanitizers would solve these issues, save the environment, benefit the society, and help in achieving the sustainable development goals. Thus, this research focuses on formulating an effective natural alcohol-free hand sanitizer that harnesses the antimicrobial properties of the various types of bioactive components found in fruit peels of pomegranate, sweet lime, and lemon. The peel extracts and the formulated sanitizer proved considerable antimicrobial activity against the pathogenic Escherichia coli and hand microflora. Molecular docking was also applied to examine ligand-protein interaction patterns and predict binding conformers and affinity of the sanitizer phytocompounds towards target proteins in COVID-19, influenza, and pneumonia viruses. The binding affinities and the protein-ligand interactions virtual studies revealed that the sanitizer phytocompounds bind with the amino acids in the target proteins' active sites via hydrogen bonding interactions. As a result, it is possible to formulate a natural, alcohol-free hand sanitizer from fruit peels that is effective against pathogenic germs and viruses using the basic structure of these potential findings.

Laser-Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes

OBJECTIVE

To analyze the long-term symptomatic results of laser-assisted sialolithotripsy (LAS) in cases of obstructive sialolithiasis and correlate with objective criteria using diagnostic sialendoscopy (DS) as a method of examination.

METHODS

This is a retrospective study comprising 50 consecutive patients who underwent holmium-YAG LAS and completed follow-up of at least 6 months. Symptom scoring and endoscopic scoring were done at 6 weeks and 6 months intervals for further study purposes.

RESULTS

At the end of 6 weeks post-LAS, 70% patients were asymptomatic (A-sym) and only 30% had residual symptoms (Sym). However, obstructed duct (OB-duct) was observed on endoscopic scoring in 88% due to stenosis, residual stones, or both stenosis and residual stones. The obstructed ducts were treated in outpatient clinic and followed up over time, leading to 98% of patients being in A-sym group at the end of study period of 6 months. At the end of study, 82% of patients had clear duct (CL-duct).

CONCLUSION

Holmium LAS is a viable option for the management of intermediate-sized stones. LAS if used judiciously, and in properly selected cases, has high rate of stone fragmentation and symptom resolution. A vigilant postoperative protocol taking into account residual mealtime symptoms and altered salivary characteristics combined with early DS can help identify and treat patients with residual stone fragments and ductal stenosis.

LEVEL OF EVIDENCE

3 Laryngoscope, 132:2344-2349, 2022.

Predictors of acute pulmonary embolism-related hospitalizations – an artificial neural network analysis using a nationwide cohort in the United States

Background

Considering a paucity of large-scale data on predictors of pulmonary embolism (PE) and its higher association with complications and worse outcomes, we aimed to determine the predictors of PE in this United States population-based analysis using Artificial Neural Network (ANN) Model in a nationally representative cohort.

Methods

We identified PE-related hospitalizations using 2018's National Inpatient Sample database. The relevant predictive factors for ANN were selected for this cohort. Of all admissions (unweighted n=7,105,498, weighted n=35,527,481), PE cohort (weighted n=387805) consisted of 1.1% of all admissions in 2018. The 2018 cohort was randomly split into training data (unweighted n=4716132, 70.0%) which were used to calibrate ANN and testing data (unweighted n=2019290, 30%) which were used to assess the accurateness of the algorithm. We equated the rate of incorrect prediction between training and testing data and measured the Area under Receiver Operator Curve (AUC) to determine ANN's efficacy in predicting PE hospitalizations.

Results

Patients hospitalized with PE often consisted of older (mean age 62.5±17.1 years), female (51.3%), white (70.5%) patients, and patients from lower-income quartile (0–25% income quartile: 28.8%%), often admitted non-electively (93.7%) with higher rates of cardiovascular disease risk factors. PE admissions revealed significantly higher (6.5% vs. 1.9%, p<0.001) in-hospital mortality, less frequent routine discharges (51.4% vs. 68.1%) and more frequent other facility transfers and requirement of home health care. Normalized Predictors of PE admissions are displayed in Fig. 1. Our ANN model had AUC 0.873 which correlates with an excellent prediction model. Our data demonstrated low levels (0.8%) error in both testing and training models.

Conclusion

Our ANN model showed high performance to predict risk factors for PE admissions in the US population. It will enable clinicians to screen patients at high-risk for PE admissions, curtail complication rate, improve survival and lower the healthcare cost.

Funding Acknowledgement

Type of funding sources: None.

Validation of Bifurcohaptor spp. (Monogenoidea: Dactylogyridae) reported from India using molecular methods with inclusion of insilico study: A brief report on its host-specificity

A total of 17 species of the genus Bifurcohaptor Jain, 1958 have been reported from two fish families namely Bagridae Bleeker, 1858 (Mystus vittatus (Bloch, 1794), M. tengara (Hamilton, 1822), M. keletius (Valenciennes, 1840), Hemibagrus nemurus (Valenciennes, 1840), Rita rita (Hamilton, 1822) and Sperata seenghala (Sykes, 1839)) and Sisoridae Bleeker, 1858 (Bagarius bagarius (Hamilton, 1822)). Out of these, only two species viz. B. indicus and B. giganticus are found valid in India, parasitizing gills of Mystus spp. and Bagarius sp. Taxonomic studies suggest, present specimen of B. indicus and B. giganticus, both are morphologically close to species described by Jain (1958), except morphometric variations and posses 7 pairs of marginal hooks instead of 6 pairs. Present manuscript delves with the characterization of B. indicus and B. giganticus reported from India, using molecular techniques. Partial mt COI nucleotide sequence based insilico protein analysis and partial 28S and ITS-1 rDNA based phylogenetic analysis, estimated by Neighbour-joining (NJ) and Minimum Evolution (ME) methods revealed that the species of the genus Bifurcohaptor are genetically distinct and valid. The grouping of Bifurcohaptor spp. with other representatives of family Dactylogyridae supports morphology based placement into family Dactylogyridae. Present and previous host-parasite information suggests both Bifurcohaptor spp. are species specialist however, the genus Bifurcohaptor is generalist at generic level.

Cytokine imbalance in systemic lupus erythematosus: a study on northern Indian subjects

OBJECTIVE

The phenotype of systemic lupus erythematosus (SLE) in Asian Indians is more severe as compared with that in Caucasians. The reason is not clear. In this context, we studied serum levels of interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin-4 (IL-4) and interlekin-10 (IL-10). Their interrelations and correlation with SLEDAI scores were evaluated.

MATERIALS AND METHODS

Forty patients with active SLE and 40 controls were studied. The mean SLEDAI score and anti-ds DNA level of the patients were 21.45 ± 8.61 and 176.68 ± 81.31 (IU/ml), respectively. Cytokines were estimated by enzyme-linked immunosorbent assay.

RESULTS

In controls, the levels of IFN-γ were highest, followed by TNF-α, IL-10 & IL-4. In patients, however, the levels of TNF-α were highest, followed by IFN-γ, IL-10 & IL-4. IL-10 and IL-4 correlated negatively, and IFN-γ and TNF-α correlated positively with the SLEDAI scores. As compared with controls, in patients, the mean values of TNF-α, IL-10 and TNF-α/IL-10 ratio were higher by 6.9, 2.9 and 2.3 times, respectively (p < 0.001). Significant positive correlation was found between these two cytokines in patients (r = 0.327, p < 0.05) but not in controls. The levels and ratio of IL-4 and IFN-γ were comparable between patients and controls. These two cytokines correlated negatively both in controls (r = -0.358, p < 0.05) and patients (r = -0.990, p < 0.001). The ratio of TNF-α/IL-4 was 4.2 times higher, and those of IFN-γ/IL-4 and IFN-γ/IL-10 were 1.89 and 3.40 times lower in patients as compared with controls. A positive correlation between IL-10 and IL-4 (r = 0.345, p < 0.05) and a negative correlation between IL-10 and IFN-γ (r = -0.382, p < 0.05) were observed only in patients.

CONCLUSION

This study showed a distinct profile of cytokine imbalance in patients with SLE from the northern plains of India. The levels, ratios and correlations of cytokines in patients suggested significant deviation from normal. Correlations of cytokines with SLEDAI scores indicated that TNF-α contributes significantly to the pathological manifestations of SLE in patients from the region. A detailed study is warranted.

Tyrosine kinase inhibitors and development of brain metastasis in metastatic renal cell carcinoma: A retrospective review

340

Background: Tyrosine kinase inhibitors (TKIs) have been shown to improve overall survival (OS) in metastatic renal cell carcinoma (mRCC) but their effect on brain metastasis (BM) development is unclear. The purpose of our study is to evaluate the impact of TKIs on incidence of BM and OS in patients with mRCC.

Methods: Searched the M. D. Anderson Cancer Center (MDACC) tumor registry for patients who presented with mRCC in 2002-2003 and 2006-2007 with no BM at initial staging. The following items were retrospectively collected: age, sex, Fuhrman grade, sites of disease, nephrectomy, systemic therapy including TKIs (sorafenib or sunitinib), MSKCC risk category, BM treatment, and vital status. Interaction between OS and incidence of BM and these variables was estimated using the Cox proportional hazards model. OS and incidence of BM were estimated using the Kaplan-Meier (K-M) method.

Results: 338 patients were identified; 154 (46%) were treated with a TKI prior to BM, and 184 (54%) were not. There were no significant differences in age, histology, involved sites of disease other than lung, nephrectomy, or MSKCC risk category between the groups. A higher proportion of the nonTKI group received other systemic agents and had lung metastasis at initial staging (p=0.03). Median OS was longer in the TKI-treated group (25 months versus 12.1 months, p<0.0001). In Cox multivariate analysis, TKI treatment (HR=0.53, 95% CI 0.38-0.74, p<0.001) was associated with improved OS and lung/mediastinal involvement and ECOG performance status > 2 (HR 1.87, 95% CI 1.28-2.71, p=0.001) were associated with poor OS. Median OS after BM was not significantly different between TKI treated and untreated groups. 44 patients (13%) developed a BM, including 29 (15.8%) of the nonTKI group and 15 (9.7%) of the TKI group. In K-M analysis, the 5-year incidence of BM was 40% versus 17% respectively (logrank p<0.001). In Cox multivariate analysis, TKI treatment was associated with lower incidence of BM (HR=0.39, 95% CI 0.21-0.73, p=0.003). Lung metastasis increased the risk of BM (HR=9.61, 95% CI 2.97-31.1, p<0.001).

Conclusions: Treatment with TKI agents reduces the incidence of BM in mRCC. Lung metastasis is a risk factor for BM development.

No significant financial relationships to disclose.

Effect of graded levels of aflatoxin, ochratoxin and their combinations on the performance and immune response of broilers

1. The effects of dietary aflatoxin (AF, 0.5, 1.0 and 2.0 mg/kg), ochratoxin (OA, 1.0, 2.0 and 4.0 mg/kg) or combinations of these on body weight gain, feed efficiency, organ weights and immune response were studied in broilers. 2. Significant growth depression, reduced food consumption and poor food conversion efficiency were recorded in broilers fed a diet containing the greater concentrations of AF (1 and 2 mg/kg) and OA (2 and 4 mg/kg). 3. The combination of 2 mg/kg AF and 4 mg/kg OA exerted the maximum adverse effect on growth, feed intake and feed efficiency, indicating a synergistic effect on performance. 4. AF at 2 mg/kg in the diet caused a significant increase in the relative weight of liver, whereas the relative weight of kidney was significantly increased at 4 mg/kg of OA. A significant decrease in the relative weight of the bursa of Fabricius was noted at the highest concentration of AF (2 mg/kg) and combinations of 1 and 2 mg/kg AF and 2 and 4 mg/kg OA. 5. Cell mediated immunity (CMI), in terms of mean skin thickness (MST) sensitive to dinitrochlorobenzene (DNCB), was significantly reduced in chicks given the combination of 2 mg/kg AF and 4 mg/kg OA. Haemagglutination (HA) titre against sheep red blood cells (SRBCs) peaked at 42 d of age. At 42 and 47 d of age, a significant decrease in HA titres was recorded in chicks given 4 mg/kg OA or a combination of AF (1 or 2 mg/kg) and OA (2 or 4 mg/kg). 6. AF at a dietary concentration of 1 mg/kg or more and OA at 2 mg/kg or more, either alone or in combination, caused severe reductions in growth and immune response.

Prevalence of hepatopulmonary syndrome in cirrhosis and extrahepatic portal venous obstruction

OBJECTIVE

Hepatopulmonary syndrome (HPS) is characterized by arterial hypoxemia in patients with chronic liver disease caused by abnormal intrapulmonary vasodilations. Data on its frequency vary from 5% to 29%. Most of these studies are from the West and in patients with cirrhosis. We, therefore, studied the prevalence of HPS in patients with liver cirrhosis and extrahepatic portal venous obstruction (EHPVO).

METHODS

We studied 54 consecutive patients with liver cirrhosis (42 men and 12 women; mean age = 44.2 +/- 13 yr; Child grade A: 13, B: 22, and C: 19) and 50 patients with EHPVO (31 men and 19 women; mean age = 23.3 +/- 7.8 yr) Diagnosis of cirrhosis was made by history, liver function abnormalities, endoscopy, and sonography, whereas EHPVO was diagnosed by demonstration of a block in the splenoportovenous axis on sonography. Each of the patients underwent chest x-ray, arterial blood gas analysis, contrast-enhanced echocardiography (CEE), and pulmonary function tests. HPS was diagnosed in a patient with positive CEE, in the presence of hypoxia (PaO2 < 70 mm Hg) and/or elevated alveolar arterial oxygen gradient of > 20 mm Hg in the absence of any underlying cardiopulmonary disease.

RESULTS

Ten of 54 patients (18.5%) with cirrhosis were positive on CEE compared with two of 50 patients (4%) with EHPVO. Six of the 10 patients positive with cirrhosis for CEE had associated hypoxia, whereas only one EHPVO patient with positive CEE had an elevated pulmonary alveolar arterial oxygen gradient of > 20 mm Hg. Thus, the incidence of HPS was 11.1% in patients with cirrhosis, compared with 2% in patients with EHPVO. One patient with HPS and cirrhosis had clinical cyanosis.

CONCLUSION

HPS occurs more commonly in patients with cirrhosis but can also be seen in patients with EHPVO.

Fusarium solani major allergen peptide IV-1 binds IgE but does not release histamine

BACKGROUND

Fusarium solani (FS) is an important allergen source afflicting 4% of the nasobronchial allergy patients. Fus s I3596*, a 65 kDa major glycoprotein allergen of FS reacts with 95% fungus sensitive patients.

OBJECTIVES

To purify and characterize a potent peptide from Fus s I3596* which may be useful for therapeutic purposes.

METHODS

The 65 kDa protein was sequentially cleaved with trypsin and cyanogen bromide (CNBr). The cleaved products were purified on reverse phase high performance liquid chromatography (rpHPLC) column and functionally characterized by in vitro and in vivo methods for its IgE binding and histamine release.

RESULTS

The protein on cleavage showed 11 peaks (I to XI). Of these, peaks I, III, IV and V were highly allergenic as determined by IgE ELISA. These peaks were further purified and peptide IV-1 was most potent in comparison to other peptides by ELISA-inhibition. This peptide showed IgE binding but could not evoke intradermal response in Fusarium-sensitive patients. Heparinized blood challenged with peptide IV-1 does not release histamine. Preincubation of heparinized blood with peptide IV-1 and challenging with crude extract blocked histamine release in a dose dependent manner.

CONCLUSION

Peptide IV-1 binds to IgE but does not release histamine, demonstrating its potential use in therapy of Fusarium-allergic patients.

Purification and partial characterization ofa 67-kD cross-react ive allergen from Imperata cylindrica pollen extract

BACKGROUND

Grass pollens are known to induce type I allergic reactions in a large number of genetically predisposed individuals. Earlier studies have recognized Imperata cylindrica (Ic) pollen as an important source of aeroallergen which contained 7 IgE binding proteins in the MW range of 85-16 kD.

OBJECTIVES

To isolate, purify and characterize a cross-reactive allergenic protein from Ic pollen extract for diagnosis and therapy of grass pollen allergy.

METHODOLOGY

Ic pollen extract was fractionated using DEAE Sephadex A-50, Sephadex G-200 and Mono Q column. Allergenic activity of the fractions was checked by ELISA, skin tests, ELISA inhibition and immunoblot using sera of Ic-sensitive patients. A 67-kD protein was purified to homogeneity from Ic-VIII. The allergenic determinants of this protein were identified by SDS-PAGE and immunoblot after CNBr treatment.

RESULTS

Among Ic fractions, Ic-VIII was highly potent by ELISA, skin tests and showed cross-reactivity with 4 other tropical grasses by immunoblot and ELISA inhibition. The subfraction Ic-VIIIe1 of Ic-VIII showed a band at 67 kD on SDS-PAGE. On CNBr treatment, it gave 7 peptides, 3 of which were found to be allergenic.

CONCLUSION

A 67-kD protein (Ic-VIIIe1) was isolated, purified to homogeneity and partially characterized. It showed cross-reactivity with tropical grasses tested and contained at least three allergenic determinants.

Isolation and immunobiochemical characterization of a major allergen (65 kDa) from Fusarium equiseti

Fusarium equiseti is one of the most important species in the class Deuteromycetes (Fungi Imperfecti). For proper diagnosis and immunotherapy, isolation and characterization of allergens of F. equiseti are necessary. In the present study, culture filtrate (CF) extract of F. equiseti was resolved into 35-37 bands on isoelectric focusing pI (3-9) and SDS-PAGE (mol. wt. 10-100 kDa). Most of them were glycoproteins, as identified by PAS staining. F. equiseti CF revealed 15 allergenic proteins on immunoblot with an allergic serum pool. It was fractionated into nine fractions (I-IX) on a Superose-12 column by FPLC. Fraction IV (65 kDa) and fraction VI (25 kDa) were found to be highly allergenic by IgE ELISA. A 65-kDa protein was observed as a major allergen because it was recognized by most of the patient sera on immunoblot. After elution from SDS-PAGE gel, it gave two bands of pI 7.4 and 6.0. Inhibition in IgE-binding components of F. equiseti CF with CF extracts of F. solani and F. moniliforme by immunoprint inhibition assay indicated the allergenicity shared between the extracts of Fusarium species. Data suggested that the 65-kDa is the major allergen in the Fusarium species and can be used for the treatment of allergic patients.

Immunobiochemical characterization of Putranjiva roxburghii pollen extract and cross-reactivity with Ricinus communis

Putranjiva roxburghii (PR) pollen has been found to be an important aeroallergen for type I hypersensitivity. In the present study, the IgE binding proteins of PR pollen have been characterized and compared with pollen allergens of Ricinus communis (RC) belonging to family Euphorbiaceae. On isoelectric focusing, PR pollen extract resolved into 35 bands (pI 3-9), whereas SDS-PAGE separated it into 18 protein components (MW 14-100 kD). Pooled patient's sera (ID +ve to PR) recognized 12 allergenic proteins in Putranjiva and five of them (MWs 92, 80, 55, 43 and 30 kD) showed immunologic reactivity to most of the sera samples tested individually by immunoblot. A number of shared allergenic proteins (MWs 92, 80, 66, 50, 43 and 14 kD) were observed between PR and RC pollen extracts on immunoblot using Putranjiva allergic serum pool. Inhibition in the binding for most of PR pollen allergenic proteins was obtained with higher concentration of RC extract than PR itself, depicting the presence of cross-reacting allergens in both. Putranjiva pollen extract was fractionated by a combination of DEAE Sephadex-A 50 and Sephadex-G 200 column chromatography. Periodate deglycosylation of western blotted PR extract and Put I fraction indicated the involvement of carbohydrate moieties in the allergenic activity. Of the two fractions from Put I (Ia and Ib), Put Ib was found to be the most allergenic protein by ELISA inhibition. Dot blot analysis with individual patients sera identified it as a major allergen of PR.

Inter-relationship of zinc levels in serum and semen in oligospermic infertile patients and fertile males

Infertility is a problem affecting 10-12% of couples. Zinc is necessary for growth, sexual maturation and reproduction. Semen analysis is helpful in ascertaining the evidence of spermatogenesis, sperm transport, sperm quantity and quality and also provides clue to the functioning of the accessory glands i.e. seminal vesicles and prostate. The present study was conducted in 50 oligospermic infertile males and control group consisting of 25 normospermic known fertile males. Semen and Serum samples were obtained from each case in study as well as control group. Semen and serum were processed by wet ash method. The seminal and serum zinc levels of each case in study and control group were estimated. Statistically, serum zinc and semen zinc levels were significantly lower in infertile patients than fertile males. A significant correlation was observed between serum and semen zinc levels in study group.

Studies on shared antigenic/allergenic components among fungi

Fungal allergens have been found to be one of the most prevalent aeroallergens in India. Knowledge of shared/unique components among different fungi is necessary for proper diagnosis and treatment of patients allergic to fungi. In the present study, crude extracts (CE) of 11 common fungi (Alternaria alternata, Aspergillus flavus, Asp. fumigatus, Asp. niger, Asp. tamarii, Asp. versicolor, Cladosporium herbarum, Curvularia lunata, Mucor hiemalis, Penicillium citrinum, and Fusarium solani) were characterized by isoelectric focusing (IEF), SDS-PAGE, and immunoblot. On IEF (pI 3-9), the number of protein bands was found to be greatest (46) in M. hiemalis extract. SDS-PAGE exhibited a varied number of bands, generally 18-40, with mol. mass ranging from 14 to 100 kDa. IgG-specific immunoprint using rabbit anti-F. solani CF antibodies demonstrated a mol. mass distribution of shared antigenic proteins of 14-100 kDa in most of the fungi. Shared allergenicity was observed in a number of allergenic proteins in fungal extracts with mol. mass ranging between 14 and 70 kDa on IgE-specific immunoblot using pooled sera of patients allergic to Fusarium. A 45-kDa protein was found to be common among these fungi on immunoblot with patients as well as with rabbit antibodies. F. solani CF extract contained more antigenic/allergenic proteins than F. solani CE. It was concluded that F. solani CF shared several antigenic/allergenic components with CE of other common fungi. This fact needs to be taken into account when fungal extracts are used in diagnosis and immunotherapy of allergic patients.

Immunobiochemical characterization of Brassica campestris pollen allergen

Brassica campestris (BC), Eng. Mustard, is an important source of pollen allergen, responsible for type I hypersensitivity disorders. In the present study, BC pollen extract was characterized by TLIEF, SDS-PAGE and immunoprinting. The extract separated into 50 silver stained bands of pI 3-9 on isoelectric focusing whereas it resolved into 14 Coomassie blue stained protein bands of 14-100 kD on SDS-PAGE. Immunoblot analysis with individual patient sera detected four allergenic proteins of 90, 67, 60 and 14 kD. BC separated into 8 peaks (Bras 1-8) on DEAE Sephadex A-50 column. Bras 2 was found to be most potent by IgE specific ELISA, hence further fractionated on Sephadex G-200. A protein of 90 kD (Bras 2a) isolated by gel filtration was found to be most allergenic protein by ELISA inhibition. The findings shall be applicable in standardization of future batches of BC pollen extract to be used for allergy diagnosis and immunotherapy.

Antigenic and allergenic relationships among airborne grass pollens in India

BACKGROUND

Pollen from grasses (Poaceae) are predominant aeroallergens throughout the world including tropical countries. Studies from USA, Europe, and Australia have shown extensive allergenic/antigenic cross reactivity among the grass pollen allergens prevalent there. No such information is available about airborne grass pollens of tropical countries.

OBJECTIVE

The present study was undertaken to explore common antigenic/allergenic components, if any, of five important grass pollens of India.

METHODS

Intradermal tests (ID) were performed with pollen extracts of Cenchrus, Cynodon, Imperata, Pennisetum, and Sorghum in patients with nasobronchial allergy. ELISAs were performed for estimating the allergen-specific IgE in sera of patients eliciting markedly positive ID response (2+ to 4+). To detect cross reactivity, ELISA inhibition experiments were carried out using pooled patient sera and five grasses, individually, as inhibitors with different solid phase antigens. To evaluate common antigenic components in Cenchrus, Imperata, and Pennisetum pollen extracts, rocket immunoelectrophoresis (RIE) and ELISA inhibition were conducted using rabbit antisera.

RESULTS

Among 133 patients, Cynodon extract elicited markedly positive skin reactivity in most patients followed by Pennisetum, Imperata, Cenchrus, and Sorghum. A large number of patients showed markedly positive skin reactions and enhanced specific IgE levels to more than one grass pollen extract. ELISA inhibition experiments showed different degrees of cross reactivity among the grass pollens studied. Rocket immunoelectrophoresis and ELISA inhibition using rabbit antisera with homologous and heterologous pollen revealed the presence of shared antigenic components in Cenchrus, Imperata, and Pennisetum extracts.

CONCLUSION

The varied dose-response curves obtained with ELISA inhibition using different inhibitors suggest the presence of both common and specific antigens/allergens in the grass pollens studied. Based on the extensive immunologic cross reactivity, among the tropical grass species, it may be possible to use mixed allergen preparations for allergy diagnosis and immunotherapy.

Studies on Fusarium solani. Cross-reactivity among Fusarium species

Allergenic cross-reactivity among three Fusarium species (F. solani, F. equiseti, and F. moniliforme) was determined by crossed immunoelectrophoresis (CIE), ELISA inhibition, and immunoprint-inhibition analysis. Inhibiting immunoprint was used to assess the cross-reactivity of individual allergenic proteins in culture filtrate (CF), separated on SDS-PAGE. Dose-response inhibition of band 14 kDa in immunoprints of F. solani CF by antigens of F. solani CF, F. equiseti CF, and F. moniliforme CF demonstrated significant cross-reactivity of allergenic proteins on analysis of densitometric scans. CIE and ELISA inhibition using hyperimmune sera raised in rabbits against F. solani CF antigen also demonstrated shared antigenicity among Fusarium species. Collectively, this study revealed the presence of shared as well as unique antigenic and allergenic determinants in F. solani CF, F. equiseti CF, and F. moniliforme CF antigens.

Purification and characterization of Fus sI3596*, a 65 kd allergen of Fusarium solani

A component of Fusarium solani (F. solani), identified as the major allergen, Fus sI3596* was purified to homogeneity from culture filtrate (CF) by means of anion-exchange column chromatography, gel filtration and FPLC. The homogeneity of Fus sI3596* was assessed by IEF, PAGE, SDS-PAGE (non-reducing), immunoblot and HPLC. Fus sI3596* was isolated as a glycoprotein of MW 65 kd and pI 3.6. The IgE ELISA-inhibition assay after periodate treatment of the fraction showed a lower IgE binding capacity suggesting involvement of carbohydrate moiety in IgE binding reactions of the allergen. Peptide fragments of Fus sI3596* obtained after CNBr and trypsin treatment were analysed by immunoblotting for their allergenicity. This study indicated that there could be at least 3 allergenic determinants in the major allergen, Fus sI3596* of F. solani CF.

Fusarium solani: immunochemical characterization of allergens

Allergenic components of the fungus Fusarium solani were isolated using (NH4)2SO4 precipitation and ion-exchange column chromatography. The allergenicity of fractions was studied by enzyme-linked immunosorbent assay and radioallergosorbent test inhibition techniques. Proteins of culture filtrate (CF), mycelium (MY), and spore (SP) extracts of F. solani were characterized by isoelectrofocusing, sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and IgE-specific immunoblotting. CF antigen of F. solani contained more allergenic proteins than MY and SP, visible on immunoblot analysis using allergenic serum pool. A 65-kD protein component of CF was found to be a major allergen, as it was strongly visible on immunoblots of all 15 patient sera tested. Crossed immunoelectrophoresis and enzyme-linked immunosorbent assay inhibition using rabbit antibodies raised against F. solani CF demonstrated shared antigenicity between CF, MY, and SP extracts. It was observed that F. solani is a significant allergen, and most of the allergens of MY and SP extracts were found in CF extract. Therefore, CF alone can be used in the preparation of a standard extract. However, few unique allergenic proteins were observed in MY as well as in SP extracts of F. solani. Hence, the use of combined CF, MY, and SP extracts of F. solani is recommended for diagnosis and immunotherapy.

Hepatic-pericardio-phrenic collateral (natural shunt) in a patient with Budd-Chiari syndrome

Hepatic venous outflow tract obstruction, Budd-Chiari syndrome (BCS), leads to portal hypertension and to the development of collaterals that bypass the obstruction. Described here is a BCS patient with an unusually large transdiaphragmatic collateral between the left hepatic and left innominate veins, which decompressed the oesophageal varices. This has not been reported earlier in the literature.

A study on antigenic and allergenic changes during storage in three different biological extracts

The stability of three allergens common in tropical countries was evaluated under different storage conditions. Prosopis juliflora (PJ), Rhizopus nigricans (RN), and wheat dust (WD), were taken as representatives of various groups of allergens viz, pollen, fungi and dust. The extracts were stored in buffer containing phenol (0.4%) or glycerol (50%) at temperatures ranging from 4-55 degrees C for 15 to 60 days. Protein content of PJ extract was reduced remarkably when it was stored at 40 degrees C for 45 days. Thin layer isoelectric focusing and rocket immunoelectrophoresis of PJ showed that certain antigenic proteins degrade rapidly even at 25 degrees C as early as day 15. However, two to three proteins of PJ remain stable at a higher temperature (40 degrees C) for two months. Relative radioallergosorbent test (RAST) inhibition showed substantial loss of allergenic activity in all the three extracts, when stored at higher temperatures (25-55 degrees C) even for short durations, i.e., 15 days. Extracts (PJ and RN) containing 50% glycerol were found to be stable, retaining more than 50% activity, even when stored at 55 degrees C for 40 days, while extracts without glycerol lost more than 75% of their allergenic activity. However, addition of glycerol did not change the stability of wheat dust allergenic extract. The present findings indicate that allergenic extracts behave differently when stored. Hence, the stability of each extract should be determined individually.

Role of oxygen free radicals generated by blood monocytes and neutrophils in the pathogenesis of rheumatic fever and rheumatic heart disease

The generation of oxygen free radicals by peripheral blood monocytes and neutrophils of patients with rheumatic fever and rheumatic heart disease has been studied using luminol enhanced chemiluminescence technique. Five groups of patients; acute rheumatic fever, recurrence of rheumatic activity, chronic rheumatic heart disease, acute pharyngitis and normal controls were studied. In all groups except the controls, measurements were made on 0, 15, 90 and 180 days. The chemiluminescence was measured in response to streptococcal membrane antigen, carbohydrate antigen and latex as triggering agents. Chemiluminescent response of monocytes, as well as, neutrophils was significantly higher (P less than 0.01) in acute rheumatic fever and recurrence of rheumatic heart disease as compared to patients with acute pharyngitis and chronic rheumatic heart disease through the study period and with all the triggering agents. A significant decline (P less than 0.001) in chemiluminescence was observed from day 0 to day 180 in the acute rheumatic fever, recurrence of rheumatic heart disease and pharyngitis patients while no such change, was observed in the chronic rheumatic heart disease group. This study raises the possibility that these phagocytic cells, which infiltrate the myocardium, may have a role in the pathogenesis of cardiac disease seen in patients with rheumatic heart disease, through the generation of oxygen free radicals.

An epidemiological study of hepatitis B virus amongst blood donors

The study was carried out on 186 professional blood donors. A detailed-socio economic profile of these donors was taken and the serum was tested for HBs. Ag. Majority (63.4 per cent) of the donors were in the age bracket of 30-40 years with an average age of 34 years. About 83.3 per cent were illiterate and belonged to the lowest rung of the socio economic scale. The average length of blood donation was observed to be 4 years with blood letting frequency of 4.4 within a stipulated period of three months. Most of them were anaemic with an average haemoglobin level of 8.2 gm per cent. The HBs Ag prevalence was observed to be 15.59 per cent. HBs Ag positivity was found to be significantly associated with the length and the frequency of blood donation (P less than .05). Remedial measures for prevention of viral hepatitis-B through professional blood donors was emphasized.