PRL3 enhances T-cell acute lymphoblastic leukemia growth through suppressing T-cell signaling pathways and apoptosis

T cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy of thymocytes and is largely driven by the NOTCH/MYC pathway. Yet, additional oncogenic drivers are required for transformation. Here, we identify protein tyrosine phosphatase type 4 A3 (PRL3) as a collaborating oncogenic driver in T-ALL. PRL3 is expressed in a large fraction of primary human T-ALLs and is commonly co-amplified with MYC. PRL3 also synergized with MYC to initiate early-onset ALL in transgenic zebrafish and was required for human T-ALL growth and maintenance. Mass spectrometry phosphoproteomic analysis and mechanistic studies uncovered that PRL3 suppresses downstream T cell phosphorylation signaling pathways, including those modulated by VAV1, and subsequently suppresses apoptosis in leukemia cells. Taken together, our studies have identified new roles for PRL3 as a collaborating oncogenic driver in human T-ALL and suggest that therapeutic targeting of the PRL3 phosphatase will likely be a useful treatment strategy for T-ALL.

Ergonomic Evaluation of Winegrape Trellis Systems Pruning Operation

The winegrape industry suffers from high incidence rates of work-related musculoskeletal disorders. Pruning of dormant vines is a significant task, requiring long periods of highly repetitive and physically demanding work. The purpose of this study is to quantitatively evaluate five commonly used winegrape trellis systems with regard to the risk of developing musculoskeletal injuries to the wrist and lower back while pruning. Eleven subjects participated in this study. Subjects performed a simulated pruning task as wrist and trunk postures were gathered using electrogoniometers. The results showed significant postural differences among the trellis systems. Compared to the other systems, the VSP was determined to be the optimal system in terms of decreasing relative MSD risk. These results will assist vineyards in the selection process of suitable trellis systems that will include the worker health aspect in conjunction with other trellis-related parameters such as grape quality and productivity.

Anti-embryonation immunity in murine schistosomiasis japonica (Philippines)

The hypothesis that granuloma modulation and disease abatement in chronic infection with Schistosoma japonicum could be ascribed to antibody-mediated effects on egg maturation and egg viability, arose from studies performed with mice in the Philippines. This novel hypothesis has not yet been integrated into the schistosomiasis literature despite being formulated more than a decade ago. One reason for this is that the phenomenon might be confined to S. japonicum, even S. japonicum (Philippines).

A field method for the determination of whole blood cholinesterase

Blood cholinesterase activity is an efficient indicator of exposure to organophosphate insecticides. Field methods, in spite of lacking sensitivity, are important when practical determinations and immediate results are necessary One of the mostly used field methods to assess blood cholinesterase activity is the Lovibond Cholinesterase Field Kit. This paper proposes to substitute the comparator disk of the Lovibond Field Kit with a set of standard solutions that exhibit similar colours. Dilutions of Bromothymol blue, whole blood and acetic acid in different concentrations were used to construct a set of coloured solutions which correspond to different degrees of ChE inhibition. The comparison of acetylcholinesterase activity measured with the two methods showed good agreement and satisfactory reproducibility of results. The use of a standard colored solution kit seems more suitable and manageable for field studies than the Lovibond comparator disk.

Neurologic complications associated with internal jugular vein cannulation in critically ill patients: a prospective study

To determine the frequency of neurologic complications after internal jugular cannulation, we performed a prospective study in 66 consecutive critically ill patients. Of these 66 patients, one had Horner's syndrome probably associated with a large carotid sheath hematoma (2%; 95% CI, 1 to 8%). No cerebrovascular complications occurred. The frequency of neurologic complications following internal jugular vein catheterization is low in critical illness.

Attempts to induce resistance in mice to Schistosoma japonicum and Schistosoma mansoni by exposure to crude schistosome antigens plus cloned glutathione-S-transferases

Several attempts have been made to induce resistance in mice to Schistosoma japonicum (Philippines) or Schistosoma mansoni by exposure to living male and/or female adult worms, their antigens or irradiated cercariae. No resistance was demonstrated in the following cases: re-exposure of mice to cercariae following praziquantel (PZQ) treatment of existing infection; re-exposure of mice following cyclosporin A (CsA) treatment at the time of first cercarial exposure; subcutaneous or intraperitoneal deposition of living male or female worms; repeated intranasal administration of crude worm homogenates plus Bordetella pertussis vaccine (BPV) as adjuvant. Homologous 60Co-irradiated cercariae were very effective at inducing resistance to infection with S. mansoni but not to infection with S. japonicum (Philippines) in a limited series of experiments. A regime of infection, immunization with homologous Escherichia coli-derived glutathione-S-transferases (GST), then PZQ treatment followed by homologous re-exposure did not result in significant resistance in either the S. mansoni or the S. japonicum (Philippines) systems. Mice given irradiated cercariae plus GST were not more resistant to subsequent S. mansoni infection than mice given irradiated cercariae alone. The results generally confirm and extend those reported by others with the conclusion that resistance to schistosomes in mice is difficult to achieve by exposure to adult worm antigens alone. Moreover, additional immunization with the GST available to date as cloned gene products, and injected in Freund's complete adjuvant, does not influence the outcome of exposure to crude worm antigens including any additive effects of protective irradiated cercariae.

Studies on the sex ratio of worms in schistosome infections

Sex ratios of adult schistosomes in mice are almost invariably different from 1.0 and are biased towards males. The bias applies to wild rats infected with Schistosoma japonicum and trapped in an endemic area of the Philippines (male:female ratio = 1.7). It also applies to cercariae of snails collected in such areas and assessed by infection of laboratory mice using cercariae from individual snails (male:female ratio may approach 6.0). Experiments were designed to determine if duration of infection in the mammalian host was a factor that influenced the sex ratio of miracidia used for infecting snails and subsequently mice. BALB/c and C57BL/6 mice were infected with 100 cercariae of S. mansoni, and liver eggs harvested at early and late time points for infection of snails and production of cercariae. Two phenomena were demonstrated: firstly, a more pronounced male bias when eggs were harvested late compared with early in infection; secondly, a reduced apparent hatchability of eggs in BALB/c compared with C57BL/6 livers. The possibility is raised by the data that female miracidia within eggs of chronically infected individuals may be more prone to immune damage than male miracidia with important epidemiological consequences.

Schistosoma japonicum: monoclonal antibodies to the Mr 26,000 schistosome glutathione S-transferase (Sj26) in an assay for circulating antigen in infected individuals

Two monoclonal antibodies have been produced that bind to separate epitopes on the Mr 26,000 glutathione S-transferase (GST) of Schistosoma japonicum worms (Sj26). Both antibodies have been used in an enzyme immunoassay (EIA) with sera from infected individuals from the Philippines. Relatively high signals were obtained with sera from some, but not all, individuals who are positive for fecal eggs. Evidence was obtained that the material detected by the monoclonal antibodies was present in minute amounts and in some sera was bound in a complex with phosphorylcholine-containing molecules. It could not be absorbed by reaction with glutathione-agarose columns. There was no detectable immunoglobulin in the complex. The possibility exists that the complexes are composed of schistosome GST, or fragments, and damaged tegumental lipids shed as a result of surface immune attack. However, the presence of the native Sj26 molecule has not been proven. More detailed longitudinal studies in endemic areas are required to determine whether the assay can be used as an indicator of acquired resistance ("concomitant immunity") and whether it will be useful in the search for immunological correlates of this resistance in humans.

Monoclonal antibodies reacting with Schistosoma japonicum eggs and their target epitopes

Ten monoclonal antibodies (McAbs) raised to Schistosoma japonicum eggs could be assigned using several serological and immunochemical techniques to 3 groups. The McAbs, termed A, B and C-McAbs, apparently recognize carbohydrate epitopes that can be located on the same antigen molecule. The antibodies, generally of IgM isotype, are idiotypically related. They are distinct from another IgM McAb (Group D-McAb) the carbohydrate target epitope of which can also be associated with the epitopes of A, B and C-McAbs. The McAbs produce large vacuolated bleb reactions in the circumoval precipitin test (COPT) and target epitopes have different representations in various life cycle stages such as immature and mature eggs, male and female worms (including S. mansoni). Antigens affinity purified on columns containing A, B, C and D-McAbs stimulate proliferation of T cells from egg-sensitized mice and elicit DTH reactions in such mice. This raises the possibility that the target antigens of these carbohydrate-reactive monoclonal antibodies are immunopathologic and involved in egg-induced granuloma formation.

Effects of induction of anti-embryonation immunity on liver granulomas, spleen weight and portal pressure in mice infected with Schistosoma japonicum

BALB/c mice sensitized with injections of viable immature Schistosoma japonicum eggs had significantly fewer and smaller granulomas in the liver, lower portal pressure and smaller spleens at D + 75 of infection compared to similarly infected unsensitized controls. The portal pressure and spleen weights of the mice sensitized with immature eggs were not different from uninfected unsensitized mice of similar ages at D + 75 of infection. The results strongly support our hypothesis that it should be possible to prevent serious hepatosplenic disease in schistosomiasis japonica by vaccination to induce anti-embryonation immunity.

Sensitization against the parasite antigen Sj26 is not sufficient for consistent expression of resistance to Schistosoma japonicum in mice

Mice immunized with purified antigen preparations produced in Escherichia coli and containing the glutathione S-transferase (GST) isoenzyme of Schistosoma japonicum (Sj26) can be partially resistant to infection with this parasite. Maximum resistance was approximately 50% and no protection was obtained in BALB/c mice, known low responders to Sj26. Although only Freund's complete adjuvant has been used, the data obtained indicate that satisfactory levels of resistance to S. japonicum will not be attained by vaccination with Sj26 alone. Other antigens, including the additional GST isoenzyme of S. japonicum Sj28, will probably be required to establish whether Sj26 will be an important component of a defined multivalent vaccine against schistosomiasis japonica.

Schistosoma mansoni and S. japonicum worm numbers in 129/J mice of two types and dominance of susceptibility in F1 hybrids

In a study on the genetics of resistance to schistosomiasis in WEHI 129/J mice, susceptibility to either Schistosoma mansoni or Schistosoma japonicum was shown to be unequivocally dominant in F1 hybrid crosses between genetically resistant WEHI 129/J and susceptible BALB/c mice. The operation of only 1 or 2 genes in the expression of resistance to S. mansoni was suggested by backcross analysis. Thus, approximately 25% of (BALB/c x WEHI 129/J) F1 x WEHI 129/J mice were resistant to S. mansoni infection, whereas resistance was manifest in approximately 50% of WEHI 129/J mice. The data are consistent with resistance being controlled by 1 recessive gene having 50% penetrance. We also report that 129/J mice obtained directly from the Jackson Laboratories (Bar Harbor, Maine) (designated JAX 129/J), differ from locally bred WEHI 129/J in being entirely susceptible to S. mansoni infection. However, both WEHI 129/J and JAX 129/J are relatively resistant to S. japonicum infection.

Responses in mice to Sj26, a glutathione S-transferase of Schistosoma japonicum worms

The genetic variation in antibody responses of mice to glutathione S-transferase (GST) enzymes of Schistosoma japonicum worms, and in particular to a Mr 26,000 species termed Sj26, was analysed. Sera from infected mice, or mice immunized with adjuvant and an Sj26 beta-galactosidase fusion protein produced in Escherichia coli (Sj26FP), or purified near-native recombinant Sj26 produced in E. coli (rSj26), were assayed by enzyme-linked immunosorbent assay (ELISA) for antibody titres to GST purified from adult worms. Anti-GST antibody levels are high in a mouse strain, WEHI 129/J, that is genetically resistant to infection with S. japonicum. Antibody responses to GST are low in BALB/c mice and intermediate in most other mouse strains analysed such as CBA/H and C57B1/6. Responsiveness to Sj26 in adjuvant is dominant in (BALB/c x WEHI 129/J)F1 hybrids. BALB/c.H-2b and BALB/c.H-2k mice are higher responders than BALB/c. One feature of antibody responses to Sj26 is the variability within a group of mice. When rSj26 conjugated to the hapten azobenzenearsonate was used as immunogen, BALB/c mice produced substantial amounts of anti-Sj26 antibodies. In an attempt to correlate antibody levels with resistance in infected mice, a new functional assay was devised to measure the ability of sera to inhibit the binding of rSj26 to glutathione. However, there was no correlation between inhibitory titre in this assay and the numbers of worms recovered. In regard to the candidacy of GST as a vaccinating antigen in schistosomiasis japonica, the data raise the problem of variable responsiveness to the antigen that will need to be overcome by antigen modification and/or powerful adjuvants.

Evidence of anti-embryonation immunity and egg destruction in mice sensitized with immature eggs of Schistosoma japonicum

BALB/c mice sensitized by repeated injections of immature eggs of the trematode worm, Schistosoma japonicum, were challenged with low numbers of cercariae and evidence was sought for inhibition of embryonation by examination of eggs in livers and intestines at days 40 - 42 of infection. In contrast to the situation in unsensitized control mice, a greater proportion of dead eggs was noted in tissues of many of egg-sensitized mice. There was also a decrease in the proportion of mature eggs relative to control mice. A substantial number of egg - sensitized mice contained no eggs in the liver though eggs were readily detected in their intestinal walls. The data support the concept that immune effector mechanisms act on eggs in a manner that prevents their full development into a miracidium and thus a rich source of immunopathologic antigens.

Host identification by Schistosoma japonicum cercariae

Attachment, the first phase of host identification by Schistosoma japonicum cercariae, can occur in 2 different ways. Cercariae clinging to the water surface simply swing around and transfer to the host skin. Free-swimming cercariae behave like S. mansoni: upon touching a substrate, they switch from tailward to forward movement, swim in an arc, and attach to it with the penetration organ. Neither type of attachment is influenced by chemical, thermal, or specific mechanical stimuli from the host. The second phase, remaining on the host, requires a solid hydrophobic surface and seems to depend only on the cercaria's ability to cling to it. This phase is not influenced by chemical or thermal stimuli. The third phase, creeping across the host surface, is independent of chemical and mechanical stimuli. Cercariae migrate in thermal gradients to a preferred temperature of 37 +/- 3 C and then attempt to penetrate. Penetration, the fourth phase, was evoked by human skin surface lipids. The free fatty acid (FA) fraction was identified as exclusively stimulating components. Saturated FA's were effective at chain lengths between 10 and 14 carbon atoms (pH 7.0), and unsaturated FA's were effective at longer chains and their activity increased with increasing number of double bonds. Dog skin surface components did not stimulate cercarial penetration, which can be attributed to the lack of free FA's. A temperature of 32-40 C also stimulated penetration responses, which might be the main stimulus in animal hosts, whose skin surfaces contain no or only a few free FA's. FA's and heat evoked a transformation of cercarial tegument simultaneous with penetration behavior, making the organisms osmotically sensitive. The host identification of S. japonicum cercariae is very nonspecific compared with the differentiated host recognition of S. mansoni.

Mr 26,000 antigen of Schistosoma japonicum recognized by resistant WEHI 129/J mice is a parasite glutathione S-transferase

Mice of the inbred strain 129/J bred at this Institute (WEHI 129/J) are relatively resistant to chronic infection with the parasitic helminth Schistosoma japonicum. In contrast to more permissive mouse strains such as BALB/c, the WEHI 129/J mice are high responders to a Mr 26,000 adult worm antigen designated Sj26. Cloned cDNAs corresponding to Sj26 have been identified in a S. japonicum phage lambda gt11 amp3 expression library, and their nucleotide sequences have been deduced. The predicted amino acid sequence of the antigen specified by these cDNAs shows striking homology with class mu isozymes of mammalian glutathione S-transferases (RX:glutathione R-transferase, EC 2.5.1.18). Extracts of adult worms contain glutathione S-transferase activity, and affinity chromatography of enzyme activity on glutathione columns leads to the purification of a Mr 26,000 molecule that comigrates with Sj26. Although vaccination studies in mice with a beta-galactosidase-Sj26 fusion protein from Escherichia coli are encouraging, more immunogenic preparations of the antigen are likely to be required to establish the utility of Sj26 as a model vaccine.

Resistance of 129/J mice to Schistosoma mansoni infection

Mice of the strain 129/J bred at this Institute (WEHI 129/J) were exposed once or repeatedly to cercariae of Schistosoma mansoni and worm burdens determined. In keeping with reports of S. japonicum infection in these mice, a high level of resistance was recorded. Radio-labelled extracted antigens of S. mansoni adult worms were reacted with sera from exposed 129/J mice and infected BALB/c mice. Immunoprecipitated antigens preferentially recognized by antibodies in 129/J mice include proteins of Mr 99,000 and 21,000. Whether responses to these antigens are a cause or a consequence of resistance remains to be established.

Expression of Schistosoma japonicum antigens in Escherichia coli

A cloned library of DNA complementary to the mRNA of adult Schistosoma japonicum has been prepared and expressed as fusion proteins with Escherichia coli beta-galactosidase. Colonies expressing the S. japonicum cDNA clones were screened both with antibodies from individuals with a history of schistosomiasis and with antibodies obtained from a rabbit immunized with whole adult worms. In both cases colonies were detected which bound antibody, although the frequency of antigen-positive clones was much higher with the rabbit antiserum than with human sera. In both cases the proportion of colonies reacting with antibodies was markedly lower than that published for equivalent screens of Plasmodium falciparum cDNA with sera from individuals with a history of falciparum malaria. Several major S. japonicum antigens were identified by the affinity purification of antibodies using immobilised fusion proteins produced during lytic growth of the recombinant bacteriophage.

Schistosoma japonicum: the modulation of lung granuloma and inhibition of egg maturation in mice by human sera

Human sera taken from patients with chronic schistosomiasis japonica have been demonstrated to have two effects on mice. Sera from those patients reduced the size of granuloma in mice sensitised for accelerated granuloma formation to eggs entrapped in the lungs of mice injected with the sera shortly before and at day 2 after intravenous egg challenge. The sera with this effect on the mouse lung granuloma models caused large segmented precipitates in the optimised circumoval precipitin test (COPT). Such sera also reduced the rate at which eggs matured in the liver and intestines of mice infected with S. japonicum. The results strongly support our postulate that a major cause of granuloma modulation in cases of chronic schistosomiasis japonica is antiembryonation immunity and that mice provide useful models for the analysis of our postulate. Identification of egg antigens responsible for the anti-embryonation effect should facilitate progress towards the development of a vaccine against granulomatous disease.

Antibody responses to the antigen Sj26 of Schistosoma japonicum worms that is recognized by genetically resistant 129/J mice

Serum antibody responses of mice exposed to Philippine isolates of Schistosoma japonicum have been analysed by immunoprecipitation of exogenously radiolabelled antigens extracted from adult worms. Attention was focused on labelled protein antigens differentially recognized by sera of mice that differ genetically in their resistance status. Mice of the inbred strain 129/J can show high level resistance to first or repeated infection with S. japonicum. Even after six percutaneous administrations of 25 cercariae, approximately 50% of 129/J mice remain healthy with no or very few worms present in the portal system. Sera from 129/J mice exposed to S. japonicum consistently and differentially recognise an antigen of adult worms of mol. wt. 26,000. This antigen, termed Sj26, is not immunoprecipitated from S. mansoni adult worms by sera from resistant 129/J mice. Serum antibodies to Sj26 are present in at least some patients with a history of schistosomiasis japonica. Whether immune responses to Sj26 are involved directly in expression of resistance to S. japonicum remains to be determined. However, this antigen produced by cloned DNA in expression vectors, or isolated from adult worms, is an obvious candidate to be tested for vaccination efficacy in mice.

The strain specificity of vaccination with ultra violet attenuated cercariae of the Chinese strain of Schistosoma japonicum

Mice vaccinated with ultra violet (u.v.) attenuated cercariae of the Chinese mainland strain of S. japonicum were resistant to homologous challenge, but were not resistant to challenge with the Philippine strain of S. japonicum. Thus vaccination using u.v. attenuated S. japonicum cercariae is strain specific.

Attempts to modify lung granulomatous responses to Schistosoma japonicum eggs in low and high responder mouse strains

A radioisotopic assay for acute granulomatous hypersensitivity (AGH) to lyophilized eggs of Schistosoma japonicum has been used to further examine responses to egg antigens in various inbred strains of mice. The ranking of responsiveness in mice from high (C57BL/6), intermediate (BALB/c) to low (CBA/H) was not influenced by high or low egg-sensitization regimens. However, the low responsiveness of responder mice sensitized with eggs by the intraperitoneal compared with the subcutaneous route of injection appears to be an egg dose-related phenomenon. The high AGH responsiveness of C57BL/6 mice can be increased further by sensitization with eggs in the presence of purified pertussigen from Bordetella pertussis but CBA/H mice treated identically remain low responders. The monoclonal anti-egg antibody, P.41, which produces a prominent bleb-type circumoval precipitate with eggs, has been shown to be directed against major 'immunopathologic antigen(s)' of S. japonicum eggs. Thus, C57BL/6 mice were sensitized for AGH by injection of soluble extracted egg antigen (SEA) bound to an immunoabsorbent of P.41 antibody on Sepharose. No success has been achieved in modulating AGH in C57BL/6 mice by injection of hyperimmune antisera raised against lyophilized eggs in either high or low responder mouse strains. This failure is in line with previous results using antisera as well as monoclonal anti-egg antibodies. The consistent failure to demonstrate a modulating effect of antibodies in this compared with other laboratories may be related to the use of lyophilized rather than viable eggs. The data suggest that activities of antisera in granuloma modulation in murine schistosomiasis japonica result from egg destruction or inhibition of production of immunopathologic antigens by eggs rather than through effects on immunopathologic immune responses.

Resistance to reinfection with Schistosoma japonicum in the mouse

BALB/c and outbred mice infected with a Philippine isolate of Schistosoma japonicum for 50 to 60 days expressed strong resistance to reinfection. The extent of this reinfection resistance ranged from 72 to 93% in 5 experiments (mean = 80% resistance) as determined by numbers of immature worms recovered from already infected and age- and sex-matched challenge control mice exposed 20 days previously to cercariae. Determination of numbers of recoverable worms from (the initial) infection suggest that adult worms are lost progressively during the period in which impressive resistance to reinfection is demonstrable. An important unresolved question is whether loss of adult worms is related in any way to expression of resistance to reinfection. Some indirect evidence indicates that the major component of reinfection resistance is expressed prior to day 4 of challenge infection. This evidence derives from analysis of lung petechiae which, in a primary infection, have been shown to provide an indication of number of adult worms which can be detected subsequently (e.g. at 30-40 days of infection). Although anti-parasite immune response have not yet been shown to be responsible for this apparent concomitant immunity, the magnitude of resistance to reinfection in the S. japonicum/mouse system should facilitate identification of any immunological effector mechanisms involved.

Competitive radioimmunoassays using hybridoma and anti-idiotype antibodies in identification of antibody responses to, and antigens of, Schistosoma japonicum

A hybridoma-derived monoclonal antibody, I.134, with apparent specificity for Schistosoma japonicum adult worms has immunodiagnostic potential for schistosomiasis japonica in the Philippines. Sera from known infected individuals will inhibit the binding of 125I-labelled I.134 to a crude adult worm extract (AWE) in a competitive radioimmunoassay (CRIA), although a 10% false negative rate has been noted. Another monoclonal antibody, P.41, which produces circumoval precipitation (COP) reactions with S. japonicum eggs was shown previously not to be useful in identification of heavily infected individuals using a CRIA with extracted egg antigens (EA). However, the 125I-P.41/EA assay has now been demonstrated to be capable of detecting a small subset of infected persons. Thus, four infected individuals with serum COP reactions shown to be consistently of the bleb type only (and with no segmented precipitates seen in the optimized COP test) have serum inhibitory activity in the P.41 CRIA. These same sera are negative in the I.134 CRIA. Unsuccessful attempts have been made to substitute a large pool of affinity-purified anti-I.134 idiotypic (Id) antibodies for antigen (i.e. AWE) in the immunodiagnostic I.134 CRIA. However, anti-Id CRIAs have been shown to be useful in monitoring the isolation of target antigens of hybridoma anti-schistosome antibodies. The availability of a range of hybridoma antibody-based CRIAs will greatly facilitate the quantitative analysis of anti-S. japonicum antibody specificities in sera from clinically defined patient groups and the isolation of antigens of immunoparasitological interest.

Hybridoma antibody-based competitive ELISA in Schistosoma japonicum infection

A competitive enzyme-linked immunosorbent assay (ELISA) has been developed and compared with the circumoval precipitin test (COPT) for diagnosis of schistosomiasis japonica using Philippine sera. The assay is based on the inhibition, by sera, of the binding of a penicillinase-conjugated hybridoma-derived antibody, I. 134, to a crude Schistosoma japonicum adult worm extract. A change in pH subsequent to addition of the substrate is used as the indicator system. Development of the color change in this assay is relatively slow, a fact which presumably facilitates detection of inhibition by serum. Relative to the COPT, no false positive reactions were obtained and the false negative rate was less than 10%. A wide range of inhibitory titers was obtained using sera in the competitive ELISA similar to that found in a competitive radioimmunoassay using 125I-labeled I. 134. The competitive ELISA will be of more general application for diagnosis of schistosomiasis japonica than the competitive RIA using hybridoma antibodies, and will provide more precise quantitative information than is obtainable in the COPT.

Sj23, the target antigen in Schistosoma japonicum adult worms of an immunodiagnostic hybridoma antibody

An IgG2a mouse hybridoma-derived antibody (designated I.134) has been identified which binds to Schistosoma japonicum adult worms and which has immunodiagnostic potential (for detection of antibody) in schistosomiasis japonica in the Philippines. The target epitope of this hybridoma antibody is contained in a 23 000 molecular weight protein of adult worms as analysed by one-dimensional sodium dodecyl sulphate-polyacrylamide gel electrophoresis of immunoprecipitates and a gel overlay technique. This adult worm antigen has been labelled biosynthetically using 35S-methionine as well as exogenously using lactoperoxidase-catalysed radioiodination and the Bolton and Hunter reagent with intact worms. As anticipated, the low molecular weight protein antigen (designated Sj23) appears to be one of several major immunogenic proteins of worms which induce antibodies in infected Philippine patients.

Lung granulomatous hypersensitivity to eggs of Schistosoma japonicum in mice analysed by a radioisotopic assay and effects of hybridoma (idiotype) sensitization

The radioisotopic assay for acute granulomatous hypersensitivity (AGH) to eggs of Schistosoma japonicum in mice sensitized with eggs in adjuvant has been examined in the high responder strain. C57BL/6. Responsiveness is expressed as the lung-kidney ratio of radioactivity in mice challenged intravenously with eggs and injected with 125I-iododeoxyuridine. Eggs vary in their AGH sensitizing and eliciting potency; eggs proven to be superior in the circumoval precipitation (COP) test for detection of human serum anti-S. japonicum antibodies are superior in the C57BL/6 AGH assay. CBA/H are non responders and BALB/c are low to intermediate responders and are thus different from C57BL/6 mice. Short-term infected CBA/H mice are low COP antibody responders relative to infected C57BL/6 and titres of IgM anti-egg antibodies are low in the CBA/H strain as determined in a solid-phase radioimmunoassay (RIA). Following egg sensitization, CBA/H mice are also lower responders than C57BL/6 mice in terms of antibodies with the specificity of a COP-positive IgM hybridoma-derived antibody, P.41, measured in a competitive RIA. No evidence has been obtained that alteration of the response to the target epitope of P.41 alters the responsiveness of C57BL/6 mice to S. japonicum eggs. Thus, large amounts of injected P.41 antibody do not alter lung AGH and induced anti-idiotype responses to the P.41 protein do not influence AGH in egg-sensitized C57BL/6 mice. However, immunization of C57BL/6 mice with another IgM anti-schistosome hybridoma antibody, 1.39, results in partial inhibition of lung AGH responsiveness. The nature of the effect of 1.39 immunization on AGH to eggs remains unknown, but further analysis of the phenomenon may lead to novel approaches to the control of granulomatous inflammatory disease in high responders.

Total occlusion of the left main coronary artery: report of seven cases from 5312 cardiac catheterizations and review of the literature

Of the 5312 cardiac catheterizations performed at the Clayton Foundation for Research Cardiovascular Laboratories from 1974 to early 1981, seven patients (0.13%) had total occlusion of the left main coronary artery. All seven had a history of myocardial infarction, and were markedly symptomatic (New York Heart Association, Classes III and IV), with anginal pain that had existed from 2 to 13 years. Left ventricular end-diastolic pressure was notably elevated in all patients, and ejection fractions ranged from 16% to 69%. In all patients, there was significant collateral circulatory flow to the left coronary system from the right coronary artery and its branches. Six underwent coronary artery bypass at our institution, and one was operated on at another hospital. The six patients operated on in our institution were markedly improved after the operation. Our results support previously reported findings about patients with total occlusion of the left main coronary artery in that (1) no definitive clinical pattern leads to simple diagnosis, (2) the anomaly is rarely encountered during cardiac catheterization, and (3) myocardial revascularization alleviates symptoms and prolongs life.

Hybridoma antibody immunoassays for the detection of parasitic infection: further studies on a monoclonal antibody with immunodiagnostic potential for Schistosomiasis japonica

The binding of a hybridoma-derived antibody (designated IPH.134-18-6) to an extract of the adult worn of Schistosoma japonicum has been further characterized. This antibody has immunodiagnostic potential for detection of infection with S. japonicum in the Philippines since the binding of labeled hybridoma antibody to a crude adult worm extract in a solid-phase radioimmunoassay (RIA) is inhibited by sera from greater than 90% of known infected individuals, and no false positive reactions have yet been observed. Moreover, most patients with high fecal egg outputs or prominent disease have high serum inhibitory activity. All evidence indicates that IgG antibodies are the serum inhibitors in the competitive RIA. By estimating the amount of inhibitory activity (antibody?) of IPH.134-18-6 type in sera of infected patients and animals, the conclusion was reached that the antigen to which this hybridoma is directed is a strong immunogen. Moreover, no evidence of genetic unresponsiveness was obtained in strains of inbred mice infected with S. japonicum. IPH.134-18-6 does not bind to S. japonicum egg extracts. However, the actual stage and species specificity of this antibody has not yet been determined unequivocally and must await the screening of sera from individuals with monospecific S. mansoni and S. hematobium infections as well as assays using schistosomules, male and female adult worms and juveniles.

Attempts to standardize the circumoval precipitin test (copt) for Schistosomiasis japonica

The circumoval precipition test (COPT) is a simple and inexpensive immunodiagnostic test for schistosomiasis japonica which, in the Philippines, has high sensitivity and specificity. Lack of standardization does, however, increase the variability of the test. Parameters which influence the COPT have been examined using large numbers of sera from known S. japonicum infected individuals. In this series of experiments, optimal conditions were determined to be as follows using 2 drops of neat serum and incubation at 37 degrees C in a sealed slide chamber; - approximately 100 eggs from 55 or 60 days infected rabbits for a 24 to 48 hour incubation period. COP reactions (i.e. precipitates associated with eggs) were much less obvious when either immature eggs or eggs obtained from long-term infected rabbits were used. The results emphasize the prime importance of the source of Schistosoma japonicum eggs in the performance of a standardized COPT.

Murine hybridoma-derived antibodies producing circumoval precipitation (COP) reactions with eggs of Schistosoma japonicum

Of 7 hybridomas which secrete immunoglobulins binding to crude extracts of Schistosoma japonicum adult worms and/or eggs in solid-phase radioimmunoassays (RIAs), 3 gave positive precipitation reactions in the circumoval precipitin test (COPT). The COPT is a simple and inexpensive immunodiagnostic test for schistosomiasis japonica which involves the incubation of a selected batch of S. japonicum eggs with sera from patients and examination for precipitates one or more days later. Using a competitive RIA with an egg antigen extract and a labelled COPT-positive hybridoma ascites fluid, PwF.41-1-3, the surprising observation was made that only one anti-egg antibody specificity appeared to be represented in the series of 3 antibodies (as ascites fluids). Using sera as inhibitors in the competitive RIA, inhibitory activity (presumably antibodies to the target antigenic determinant of PwF.41-1-3) was readily detected in sera from egg-immunized mice and was of relatively high titre in a strain of mouse (C57BL/6) which can be readily sensitized for large granuloma formation around entrapped eggs in the lungs. Negligible inhibitory activity was found in the sera from S. japonicum-infected patients, even with sera from patients with prominent hepatosplenomegaly. The availability of COPT-positive hybridoma antibodies should facilitate isolation of at least one S. japonicum egg antigen involved in COP reactions and perhaps induction of immunopathological immune responses at least in mice.

Hybridoma-derived antibody with immunodiagnostic potential for schistosomiasis japonica

A murine hybridoma-derived antibody (IPH.134) has been produced which has apparent high binding specificity for an extract of Schistosoma japonicum adult worms. No binding was detected to extracts of S. japonicum eggs or to extracts from other adult trematodes (Fasciola hepatica, Paragonimus westermanii, Clonorchis sinensis, and Schistosoma mansoni) and several other helminths and protozoa. When sera from two series of S. japonicum-infected Philippine patients (19 and 20 patients, respectively) were tested for inhibition of binding of 125I-labeled IPH.134 to S. japonicum adult worm antigen, a low (10%) false-negative rate was obtained. In the 19-patient series, the 4 patients with highest fecal egg counts had high inhibitory activity in their sera. In the 20-patient series, the 3 patients with prominent disease had high inhibitory activity in their sera. Evidence was obtained that IgG anti-S. japonicum antibodies (rather than circulating antigens, immune complexes, or anti-idiotypic antibodies) were most likely to be responsible for serum inhibitory activity in the test. No false-positive reactions have been obtained with pooled or individual sera from patients infected with numerous parasites other than S. japonicum, although no information is yet available on the inhibitory activities of sera fro S. mansoni- or S. hematobium-infected individuals. On the basis of the data obtained to date, it is a reasonable prediction that the molecule or determinant to which this hybridoma antibody is directed will be a useful immunodiagnostic antigen for schistosomiasis japonica in the Philippines. A test based on detection of serum antibodies to this antigen should have high specificity and may provide additional information on the level of infection or disease status in patients.

Schistosoma japonicum: use of a radioimmunoassay for anti egg antibodies in human sera

A solid-phase radioimmunoassay (RIA) was developed for schistosomiasis japonica using extracted egg antigens and compared with circumoval precipitin test (COPT) results on 20 sera from known S. japonicum-infected individuals and on 10 control sera. The quantitative RIA very clearly differentiated between infected and uninfected individuals with highest titers being obtained in teenagers. However, in the series employed, information relevant to immunodiagnosis of S. japonicum infection was contained in the non-quantitative but simple COPT and little was apparently added to the quantitative but expensive RIA.

Clinical standardization of the new dual cardiac probe

A new mobile dual cardiac probe has been introduced for measurements of the left ventricular ejection fraction (LVEF). In 28 patients, correlation between LVEFs measured by the dual probe and biplane contrast ventriculography was 0.83. Central and peripheral injections yielded comparable curves, and the resultant LVEFs correlated well (R = 0.95). Correlation between LFEVs determined by the probe and by gated blood pool imaging in 43 patients was also 0.83. In 21 patients given three serial injections of 99mTc-albumin, the mean variation of the ejection fraction was 4.2 +/- 3.2%; however, reproducibility was unsatisfactory using 99mTc-sulfur colloid due to sequestration in hepatic background tissue.

Treatment of multiple intestinal helminthiasis with oxantel and pyrantel

32 elementary school children were treated for multiple intestinal helminthiasis (ascariasis, trichuriasis and hookworm infections) with a combination of the pamoate salts of oxantel and pyrantel in a dose of 15 to 20mg/kg body weight of each in 1 daily dose for 3 consecutive days. The cure rate for ascariasis was 96.7%, and 84.4% for both trichuriasis and hookworm infections. 68.7% were completely cured of all 3 helminths. However, among those not completely cured, only 1 species of the previous 3 infecting helminths was present after treatment and then with a very marked reduction in egg count.

Treatment of symptomatic intestinal amoebiasis with tinidazole

Tinidazole was given in a single dose of 2g a day for 2 days to 17 adults, and in a single dose of 50mg/kg bodyweight daily for 3 days to 4 children, with symptomatic, but not severe, intestinal amoebiasis. All 21 patients showed clinical improvement but only 20 (95%) were parasitologically cured as evinced by failure to demonstrate Entamoeba histolytica in 3 stool samples collected on the 4th, 15th and 22nd day after treatment. Two subjects had mild nausea within a few hours of taking the first dose, while 8 had constipation of 3 to 5 days duration after treatment. 1 patient had nausea and constipation and another had palpitations.

Treatment for trichuriasis with oxantel

Single doses of oxantel given to 24 children and 37 adults with light to moderate infections of Trichuris trichiura effected cures in 20 of 26 (77%) trials with 10 mg/kg body weight, in 23 of 25 (92%) with 15 mg/kg, and in 10 of 10 trials with 20 mg/kg. In cases not cured, the egg-counts were reduced 50% to 91%. Side effects were not observed, and no drug-associated changes were detected by biochemical, hematologic, and urine examinations before and after treatment.

The biology of Schistosoma japonicum, Philippine strain: a review

Some important and adequately studied aspects of the biology of Schistosoma japonicum in the Philippines were reviewed and presented. The identity of the species of human blood fluke in the Philippines was established by Tubangui who also was the first to complete the life cycle of the parasite in his laboratory. Successful cross-infections of different strains of S. Japonicum from different mammalian hosts including man suggest that there is only one common strain for all of the definitive hosts in the Philippines. Studies on egg-laying habits, factors affecting hatching of eggs, eruption of cercariae from snails, cercarial survival and undocumented obervations are considered in this review.