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Biomedical subjects

C C Shepard

Publications and source records attributed to C C Shepard.

At least 37 records · Page 2Linked to original sources
PubMed1980

Effect of purification steps on the immunogenicity of Mycobacterium leprae.

In studies aimed at the development of an antileprosy vaccine for use in man, Mycobacterium leprae suspensions were prepared from livers of experimentally infected armadillos. The 2 methods of purification in chief use, carried out after irradiation of the tissue with 2.5 megarads of gamma irradiation from 60Co, involved treatment with 0.1N NaOH for 2 h at room temperature, trypsin and chymotrypsin digestion for 24h at 37 degrees, and separation in a 2-phase liquid polymer (dextran:polyethylene glycol) system. All vaccines were autoclaved and injected intradermally in mice. Earlier studies have shown that heat inactivation does not interfere with the immunogenicity of M. leprae. Immunogenicity was measured by foot-pad enlargement (FPE) after challenge with heat-killed M. leprae suspensions or by protection against infectious foot-pad challenge. The results indicated that the irradiation and 2-phase separation did not decrease immunogenicity but the NaOH treatment and enzyme digestion did.

Animals↗
PubMed1980

Foot pad enlargement as a measure of induced immunity to Mycobacterium leprae.

Foot pad enlargement (FPE) has been used as a measure of induced immunity to M. leprae, FPE peaked at 2-3 days, but it sometimes persisted for 4 weeks or more. Both as the inducing and eliciting antigen, heat-killed M. leprae were effective, and the optimum dose was about 1 x 10(7) bacilli. Higher doses were associated with flattening of the dose-response curve. Disrupted bacilli were not effective in immunizing mice, but they elicited FPE responses in mice immunized with intact bacilli. Cord factor was not found to have adjuvant activity for M. leprae. In immunization, the intradermal route was confirmed to be more effective than the foot pad route; the subcutaneous route was effective in providing protection against infection. FPE tests were used to investigate the steps of standard purification procedures for M. leprae in armadillo livers. A trypsin-chymotrypsin digestion step was found to be harmful to immunogenicity in one of two experiments.

Animals↗
PubMed1979

Virulent to avirulent conversion of Legionnaires' disease bacterium (Legionella pneumophila)--its effect on isolation techniques.

Suspensions of the Legionnaries' disease bacterium (Legionella pneumophila; LDB) were prepared from the yolk sacs of infected egg embryos, the spleens of infected guinea pigs, and cultures of the organism propagated on enriched Mueller-Hinton agar. Each suspension was titrated to determine the number of bacterial colonies (cfu), yolk sac 50% lethal doses (YSLD50), guinea pig 50% infectious doses (GPID50), and guinea pig 50% lethal doses (GPLD50) produced by 1 ml of inoculum. The numbers of cfu/YSLD50, GPID50, and GPLD50 were then calculated for each suspension. The suspension from yolk sacs had 1 cfu/YSLD50 and 10 cfu/GPID50. The suspension from spleens of guinea pigs also had 1 cfu/YSLD50. Organisms propagated on Mueller-Hinton agar, however, had greater than 10(7) cfu/YSLD50 and 10(5) cfu/GPID50. Thus, the LDB lost virulence when it was cultivated on agar. Guinea pigs vaccinated either subcutaneously or intraperitoneally with LDB grown on Mueller-Hinton agar resisted challenge with virulent LDB.

Animals↗
PubMed1979

A comparison of the complement fixation, indirect fluorescent antibody, and microagglutination tests for the serological diagnosis of rickettsial diseases.

Three techniques for the serological diagnosis of Rocky Mountain spotted fever were compared by testing 417 sera from 178 patients who very probably did not have rickettsial infections and 88 sera from 41 patients who very probably had Rocky Mountain spotted fever (SF). The techniques were complement fixation (CF), indirect fluorescent antibody (IFA), and microagglutination (MA). To avoid possible degradation during unnecessary purification, the antigens were prepared by methods that were as simple as possible. In the CF tests of 417 sera from patients with nonrickettsial diseases there was only one titer of 8 and none at higher dilutions, whereas with the IFA and MA tests 4-8% of the sera reacted with SF antigens and 4-20% reacted with murine typhus (MT) antigens; the evidence indicated that these reactions were not caused by specific rickettsial antibody. With the SF sera, it could be seen that the IFA test was the most sensitive and the MA test was the least sensitive at each interval after infection. Moreover, the IFA results showed the least number of confusing cross-reactions with MT antigens and the MA test showed the most. The relative advantages of the three tests in serodiagnosis of rickettsial diseases are discussed.

Agglutination Tests↗
PubMed1979

Sporadic community-acquired Legionnaires' disease in the United States. A case-control study.

One hundred patients with sporadic, community-acquired, serologically confirmed Legionnaires' disease were matched with control subjects known by the patients (acquaintance controls) and control subjects chosen from among patients with negative serodiagnostic tests for Legionnaires' disease (clinical controls). Each clinical control subject was also matched with an acquaintance control of his own. Legionnaires' disease patients had smoked more cigarettes, consumed more alcohol, and were more likely to have resided near excavation sites than acquaintance or clinical control subjects. Parallel differences between clinical controls and their acquaintances were not seen. Legionnaires' disease patients had traveled away from home for more time during the 2 weeks before onset of illness than had their acquaintances. The difference was of greater magnitude than that between clinical control subjects and their acquaintances. Legionnaires' disease patients were more likely to have resided near construction sites than clinical controls, and there were more construction workers among patients than among clinical control subjects.

Adult↗
PubMed1979

Acedapsone in the prevention of leprosy: field trial in three high prevalence villages in Micronesia.

The 1,659 non-leprous people in a Micronesian population experiencing an annual leprosy incidence rate of about 7/1,000 were offered 15 acedapsone (DADDS) injections during 1967--1970 for leprosy prevention purposes. Subsequent annual surveillance showed an initial cessation of new cases during the 3-year DADDS campaign, followed by a resumption of cases thereafter at a yearly level of about 2/1,000 with a longer pause and slower rise among those who received the full regimen. A secondary wave of cases that has occurred since 1973 among children born after 1968 shows that post-campaign transmission occurred, probably principally from relapsing multibacillary cases with onset before the campaign. Recommendations are made for a balanced, long-term control program with DADDS preventive treatment limited to contacts of multibacillary cases.

Acedapsone↗
PubMed1978

An outbreak in 1965 of severe respiratory illness caused by the Legionnaires' disease bacterium.

In January 1977 an unsolved outbreak of infection at St. Elizabeth's Hospital (Washington, D.C.) that occurred in 1965 was linked with Legionnaires' disease. The link was made by fluorescent antibody testing with the bacterium isolated from tissues of persons with Legionnaires' disease in the 1976 outbreak in Philadelphia. In July and August 1965, an epidemic of severe respiratory disease characterized by abrupt onset of high fever, weakness, malaise, and nonproductive cough, frequently accompanied by radiographic evidence of pneumonia, affected at least 81 patients at St. Elizabeth's Hospital, a general psychiatric hospital. Fourteen (17%) of the affected patients died. Intensive epidemiologic and laboratory investigations in 1965 did not determine the etiology. The etiologic organism may have become airborne from sites of soil excavation.

Air Microbiology↗
PubMed1978

In vivo susceptibility of the Legionnaires disease bacterium to ten antimicrobial agents.

The susceptibility of the Legionnaires disease bacterium to various antimicrobial agents was determined by inoculation of embryonated eggs via the yolk sac. When administered prophylactically, the minimal dose of drug preventing all deaths due to the infection was as follows: rifampin, 0.02 mg; gentamicin, 0.25 mg; streptomycin, 0.39 mg; erythromycin, 0.62 mg; sulfadiazine, 1.56 mg; chloramphenicol, 2.50 mg; and cephalothin, 20.0 mg. Smaller amounts delayed deaths, and larger or equal amounts rendered the embryos free of infection. Oxytetracycline in the largest tested amount, 5.0 mg, protected 80% of the embryos from death, and as little as 0.31 mg delayed death. Chlortetracycline (0.50 mg) and ampicillin (10.0 mg) were ineffective. The six most effective drugs were studied in an experiment in which they were administered at various times after infection in doses that were twice the minimal prophylactic dose preventing all deaths. In this therapeutic experiment, rifampin, and erythromycin allowed 100% survival when given even 72 h after infection; gentamicin, streptomycin, sulfadiazine, and chloramphenicol did so when given 48 h after infection. All six drugs increased mean survival time when administered 72 h after infection.

Animals↗
PubMed1978

Immunity to Mycobacterium leprae infections induced in mice by BCG vaccination at different times before or after challenge.

Viable suspensions of BCG, an attenuated strain of Mycobacterium bovis, have been previously shown to immunize mice against infections with M. leprae. Usually, the mice have been vaccinated about 1 month before challenge. Experiments have now been carried out with single intradermal injections of BCG given before or after the M. leprae challenge. Approximately equal immunizing effect was seen in one experiment when the BCG was given at -168, -119, -70, and -28 days relative to challenge. Approximately equal protection was observed in another experiment when the vaccine was given at -28, +28, and +56 days. In the latter experiment, however, vaccine given at +91 days appeared to be somewhat less effective. Enlargement of the lymph nodes regional to the intradermal vaccine site persisted for at least the duration of the experiment, approximately 400 days. Thus, antigenic stimulation appears to have continued throughout the period of observation.

Animals↗
PubMed1978

Heat stability of Mycobacterium leprae immunogenicity.

The protection provided to mice by vaccines administered intradermally was measured after footpad challenge with Mycobacterium leprae. The protection offered by M. leprae suspensions was not decreased when the vaccines were killed by 60 degrees C heat or at the higher temperatures tested, which included 215 degrees C (autoclave). Even highly purified suspensions retained their immunogenicity. In contrast, the vaccine protection provided by intradermal M. bovis (strain BCG) was markedly reduced when heated to 60 degrees C. The enlargement of the lymph nodes regional to the intradermal vaccines was measured and found generally to parallel the vaccine protection provided by M. leprae and by BCG.

Animals↗
PubMed1977

Legionnaires' disease: description of an epidemic of pneumonia.

An explosive, common-source outbreak of pneumonia caused by a previously unrecognized bacterium affected primarily persons attending an American Legion convention in Philadelphia in July, 1976. Twenty-nine of 182 cases were fatal. Spread of the bacterium appeared to be air borne. The source of the bacterium was not found, but epidemiologic analysis suggested that exposure may have occurred in the lobby of the headquarters hotel or in the area immediately surrounding the hotel. Person-to-person spread seemed not to have occurred. Many hotel employees appeared to be immune, suggesting that the agent may have been present in the vicinity, perhaps intermittently, for two or more years.

Adolescent↗
PubMed1977

Legionnaires' disease: isolation of a bacterium and demonstration of its role in other respiratory disease.

To identify the etiologic agent of Legionnaire's disease, we examined patients' serum and tissue specimens in a search for toxins, bacteria, fungi, chlamydiae, rickettsiae and viruses. From the lungs of four of six patients we isolated a gram-negative, non-acid-fast bacillus in guinea pigs. The bacillus could be transferred to yolk sacs of embryonated eggs. Classification of this organism is incomplete. We used yolk-sac cultures of the bacillus as antigen to survey suspected serum specimens, employing antihuman-globulin fluorescent antibody. When compared to controls, specimens from 101 to 111 patients meeting clinical criteria of Legionnaires' disease showed diagnostic increases in antibody titers. Diagnostic increases were also found in 54 recent sporadic cases of severe pneumonia and, retrospectively, in stored serum from most patients in two other previously unsolved outbreaks of respiratory disease. We conclude that Legionnaires' disease is caused by a gram-negative bacterium that may be responsible for widespread infection.

Adult↗
PubMed1977

Lack of protection afforded by ribonucleic acid preparations from Mycobacterium tuberculosis against Mycobacterium leprae infections in mice.

Mycobacterial ribonucleic acid preparations from H37Ra, an attenuated strain of Mycobacterium tuberculosis, provide their usual marked protection against M. tuberculosis challenge; however, they provided no protection against Mycobacterium leprae challenge. Suspensions of intact H37Ra were not effective against M. leprae. Suspensions of BCG gave their usual distinct protection against M. leprae challenge.

Animals↗
PubMed1977

Effect of levamisole on Mycobacterium leprae in mice.

Levamisole, an antihelminthic drug that is capable of enhancing immune responses in mice and in humans, was tested in experimental Mycobacterium leprae infections in mice by a number of schedules. Intermittent schedules were used, and administration of the drug was started (i) around the time of inoculation with M. leprae, (ii) when the M. leprae population was approaching the plateau level, (iii) after the onset of the plateau phase, or (iv) after BCG vaccination 28 days following the inoculation with M. leprae. No effect of drug could be discerned with any of the schedules.

Administration, Oral↗
PubMed1977

Acedapsone treatment of leprosy patients: response versus drug disposition.

In 22 lepromatous Filipino patients receiving their first injection of 225 mg acedapsone (DADDS), dapsone (DDS), and monoacetyl DDS (MADDS) were present in plasma in approximately equal quantities. Peak levels of parent drug, DDS, and MADDS occurred between 22 and 35 days. The half-times of disappearance (T1/2) from plasma were 43 days for DDS and MADDS and 46 days for DADDS. Acetylator phenotyping with sulfamethazine (SMZ) and DDS showed that 17 patients were rapid and 5 patients were slow acetylators. Correlations between acetylation of SMZ and DDS after DDS and of acetylation of DDS after DDS and DADDS were highly significant. However, acetylation of DDS after DADDS did not differentiate the patients into acetylator phenotypes. The T1/2 of DDS after DDS in the patients was directly related to the minimum levels of DDS at 77 days after DADDS treatment. These minimum levels were 8-fold higher than the minimum inhibitory concentration (MIC) of DDS for Mycobacterium leprae in mice and rats, but not all patients responded satisfactorily. No relationship could be demonstrated between the bacteriologic response and any of the pharmacologic parameters examined in these Filipino patients. In a companion study, minimum levels of DADDS, MADDS, and DDS were determined in 447 leprosy patients of all disease types from the Karimui District of Papua New Guinea who had been receiving 225 mg DADDS every 70 to 80 days for the past 5 years. All patients exhibited DDS levels above the MIC of DDS for M. leprae, no significant differences in plasma sulfone levels were found among disease types, no relationship between rate of healing in paucibacillary patients and sulfone levels were found, and type of response in multibacillary patients and sulfone levels were unrelated. No substantial accumulation of the sulfones in the Karimui patients receiving continuous therapy with DADDS for 5 years was indicated from a comparison with the levels in the Filipino patients following a single injection of DADDS.

Acedapsone↗
PubMed1976

Immunity to Mycobacterium leprae infections in mice stimulated by M. leprae, BCG, and graft-versus-host reactions.

Infections of mice with Mycobacterium leprae in one rear foot pad immunized them against a second infection in the other rear foot pad. Purified bacilli harvested from the first infection also produced immuniy when injection into the foot pads of previously uninfected mice. Injections of BCG afforded similar protection, but had no adjuvant effect on M. leprae. M. duvali, a cultivable mycobacterium that is reported to be more closely related antigenically to M. leprae than BCG is, provided much less protection against M. leprae challenge than BCG did. Moreover, when M. duvali was mixed with BCG, it was not any more effective than BCG alone. Graft-versus-host reactions, induced by injections of parental spleen cells into F1 hybrids, provided no protection against M. tuberculosis and M. marinum challenge. They gave moderate protection against M. leprae in one experiment but not in another with a different schedule. Allogenic spleen cells had a protective effect when injected locally into the infected foot pad. The effect produced by these injections of spleen cells was a delay in the appearance of bacterial growth; however, there was no decrease in the rate of logarithmic growth when it did appear and no reduction in the eventual plateau level.

Animals↗
PubMed1976

Recent experience with the complement fixation test in the laboratory diagnosis of rickettsial diseases in the United States.

Sera from patients suspected of having rickettsial infections were tested in the complement fixation test with antigens prepared from the rickettsiae of Rocky Mountain spotted fever (SF), rickettsial pox (RP), murine typhus, epidemic typhus, and from Rickettsia canada (RC). Eight units of antigen were used in all cases and two units in man. Only those patients with antibody titers of 1:16 or higher were included in the study. Largely on the basis of comparative titers, the patients were divided into two groups: 102 with SF and 35 with infections by one of the members of the typhus group. The antibody titers were higher with SF antigen than RP antigen in 72% of the SF patients, and in only two SF patients was the RP titer higher, and then by only one tube (twofold dilution). There seemed little advantage in including the RP antigen in the battery of rickettsial antigens. Cross-reaction with at least one of the typhus antigens was observed in the sera from 64% of the SF patients. It was extensive enough to be confusing (within one tube) in 17% with eight units of antigen, but the differentiation was more distinct with two units of antigen. The cross-reaction with typhus antigens was as frequent in children with SF as it was in adults; thus, it is unlikely that these cross-reactions resulted from previous typhus vaccination. The serological differentiation between murine typhus and epidemic typhus was frequently difficult, but the epidemiological background was distinct. Five patients had higher titers to RC antigen, and four of these may possibly have had RC infections.

Adolescent↗