Biomedical subjects

D J Carr

Publications and source records attributed to D J Carr.

At least 19 recordsLinked to original sources

PubMed2001

Topical application of the cornea post-infection with plasmid DNA encoding interferon-alpha1 but not recombinant interferon-alphaA reduces herpes simplex virus type 1-induced mortality in mice.

A study was undertaken to compare the efficacy of recombinant interferon (rIFN)-alphaA to plasmid DNA encoding IFN-alpha1 against ocular herpes simplex virus type 1 (HSV-1) infection. The topical application of rIFN-alphaA (100-300 units/eye) onto the cornea of mice subsequently infected 24 h later with HSV-1 antagonized viral-induced mortality. The enhancement in cumulative survival in the rIFN-alphaA-treated mice correlated with a reduction of viral titers recovered in the eye and trigeminal ganglion (TG) at 3 and 6 days post-infection. The protective effect was site-specific such that when rIFN-alphaA was administered orally or intranasally, no efficacy against HSV-1 was observed. However, the protective effect was time-dependent. Specifically, when the rIFN-alphaA (100-1000 units/eye) was administered at 24 h post-infection, no protective effect was observed against HSV-1 compared to the vehicle-treated group. In contrast, plasmid DNA (100 microg/eye) containing the IFN-alpha1 transgene showed significant protection when topically applied 24 h post-infection. Although the transgene was found to traffic distal from the site of application (eye), including the trigeminal ganglion and the spleen where CD11b(+) and CD11c(+) cells express the transgene, the migration of the transgene did not correlate with efficacy. Collectively, the results suggest that naked DNA encoding type I IFN applied post-infection provides a greater degree of protection against ocular HSV-1 infection in comparison with recombinant protein effectively antagonizing viral replication and spread.

Administration, Topical↗

PubMed2001

Expression of human and macaque type I IFN transgenes interferes with HSV-1 replication at the transcriptional and translational levels: IFN-beta is more potent than IFN-alpha 2.

A study was undertaken to compare the efficacy of plasmid constructs encoding human IFN-alpha 2 and IFN-beta and macaque IFN-beta against herpes simplex virus type 1 in transfected cells. All type I IFN transgenes significantly reduced viral titers in transfected cells by 3 logs. Human IFN-alpha 2-transfected cells produced significantly more IFN (2274 pg/ml) in comparison to IFN-beta-transfected cells (134-165 pg/ml). Viral lytic gene transcript and viral protein levels were lower in IFN-beta- versus IFN-alpha 2-transfected cells, which coincided with elevated PKR and OAS transcript levels and increased total STAT1 and phosphorylated STAT1 (Y701) protein levels in the IFN-beta-transfected cells. Although comparable viral titers were recovered in IFN-alpha 2 and IFN-beta plasmid-transfected cells, IFN-alpha 2 plasmid-transfected cells exhibited significantly more cytopathic effect compared to the IFN-beta transgene-transfected cells. In addition, IFN-alpha 2 transgene-transfected, infected cells displayed a cell cycle profile similar to that of vector-transfected, infected cells, whereas IFN-beta plasmid-transfected cells displayed a profile similar to uninfected control. Collectively, the results indicate that human IFN-beta is superior to IFN-alpha 2 in antagonizing herpes simplex virus type 1 infection.

2',5'-Oligoadenylate Synthetase↗

PubMed2001

ICAM-1 is required for resistance to herpes simplex virus type 1 but not interferon-alpha1 transgene efficacy.

The purpose of this study was to determine the role of ICAM-1 in ocular herpes simplex virus type 1 (HSV-1) infection. Wild-type and ICAM-1 knockout mice were assessed for resistance to ocular HSV-1 infection in the presence of naked DNA plasmid vector or plasmid DNA encoding interferon-alpha1 topically applied to the cornea of the mice. Wild-type mice showed greater resistance to HSV-1 infection compared to ICAM-1 knockout mice as measured by cumulative survival. The absence of ICAM-1 did not affect the efficacy of the interferon-alpha1 transgene against ocular HSV-1. Both ICAM-1 and wild-type mice treated with the transgene showed a reduction in viral load and antigen expression in the trigeminal ganglion compared to the plasmid vector-treated counterparts. In contrast, the presence of the transgene reduced the number of infiltrating cells into the cornea in comparison to plasmid vector DNA controls in the wild-type mice but not in the ICAM-1 knockout mice. Collectively, these results suggest that the IFN-alpha1 transgene can restore resistance against HSV-1 infection in ICAM-1-deficient mice.

Administration, Topical↗

PubMed2001

The application of a plasmid DNA encoding IFN-alpha 1 postinfection enhances cumulative survival of herpes simplex virus type 2 vaginally infected mice.

Using a hormonally induced susceptibility mouse model to investigate vaginal HSV type 2 (HSV-2) infection, a study was undertaken to determine the efficacy of a plasmid DNA encoding IFN-alpha1 introduced into the vaginal lumen postinfection (PI). Mice infected with HSV-2 intravaginally and treated intravaginally 24 h later with 100 microg DNA encoding IFN-alpha1 showed enhanced survival (10/15) in comparison to mice treated with 100 microg plasmid DNA vector alone (3/10) or vehicle (4/27). In contrast, mice receiving recombinant IFN-alphaA (5-500 U/vagina) 24 h PI showed no significant survival in comparison to the vehicle (saline)-treated group. The protective effect was time dependent in that mice receiving the IFN-alpha1 transgene 48 h PI succumbed at a rate similar to the plasmid DNA vector-treated group. The increase in cumulative survival elicited by the transgene corresponded with a reduction in viral replication and Ag expressed in the vaginal epithelium early (i.e., 3 days PI) during acute infection and replicating virus recovered in the spinal cord day 7 PI. By day 7 PI, HSV-2 glycoprotein B transcript expression was no longer detectable in vaginal tissue from the IFN-alpha1 transgene-treated group (0/8) compared with levels expressed in plasmid vector-treated controls (4/6 mice surveyed were positive). Collectively, these results suggest the application of DNA encoding type I IFN is an effective and alternative approach to currently prescribed therapies in controlling vaginal HSV-2 infection by antagonizing viral replication.

Acute Disease↗

PubMed2001

Treatment of systemic inflammatory response syndrome by push-pull powdered sorbent pheresis: a Phase 1 clinical trial.

An FDA-approved Phase 1 feasibility study was performed in two centers to determine the safety of the BioLogic-DTPF (detoxifier/plasma filter) system for the treatment of patients with systemic inflammatory response syndrome (SIRS). This device combines hemodiabsorption (dialysis of blood against powdered sorbents with the BioLogic-DT system) with push-pull sorbent-based pheresis (the PF add-on module). Eight adult ICU patients with both SIRS and multiple organ failure participated in the study. One 6 h treatment was planned for each patient with powdered charcoal as sorbent for 4 patients and a combination of charcoal/silica in the PF sorbent bag for 4 patients. The treatments appeared to have no negative effects in 7 patients, but 1 patient died during treatment due to progressive cardiac failure. Sepsis was resolved in 5 of the 8 patients. However, there were only 2 long-term survivors of the group. The addition of the PF module should improve the chemical function of the BioLogic-DT by allowing removal of protein-bound toxins such as cytokines. The selected patients tolerated treatment by the DTPF system well, but proof of benefit of the device remains to be proven in a Phase 2 clinical trial with randomized controls.

Adsorption↗

PubMed2001

The immune response to ocular herpes simplex virus type 1 infection.

Herpes simplex virus type 1 (HSV-1) is a prevalent microbial pathogen infecting 60% to 90% of the adult world population. The co-evolution of the virus with humans is due, in part, to adaptations that the virus has evolved to aid it in escaping immune surveillance, including the establishment of a latent infection in its human host. A latent infection allows the virus to remain in the host without inducing tissue pathology or eliciting an immune response. During the acute infection or reactivation of latent virus, the immune response is significant, which can ultimately result in corneal blindness or fatal sporadic encephalitis. In fact, HSV-1 is one of the leading causes of infectious corneal blindness in the world as a result of chronic episodes of viral reactivation leading to stromal keratitis and scarring. Significant inroads have been made in identifying key immune mediators that control ocular HSV-1 infection and potentially viral reactivation. Likewise, viral mechanisms associated with immune evasion have also been identified and will be discussed. Lastly, novel therapeutic strategies that are currently under development show promise and will be included in this review. Most investigators have taken full advantage of the murine host as a viable working in vivo model of HSV-1 due to the sensitivity and susceptibility to viral infection, ease of manipulation, and a multitude of developed probes to study changes at the cellular and molecular levels. Therefore, comments in this review will primarily be restricted to those observations pertaining to the mouse model and the assumption (however great) that similar events occur in the human condition.

Animals↗

PubMed2001

Type I interferons and herpes simplex virus infection: a naked DNA approach as a therapeutic option?

Herpes simplex virus (HSV) types 1 and 2 are highly successful human pathogens that can elicit blinding herpetic keratoconjunctivitis, fatal sporadic encephalitis, aseptic meningitis, and increase the risk of acquiring additional sexually transmitted diseases. Type I interferons (IFN) play a significant role in controlling HSV pathogenesis by antagonizing viral replication and spread. Taking advantage of the susceptibility of HSV to IFNs, a novel approach of employing plasmid DNA cassettes expressing type 1 IFNs to antagonize viral pathogenesis has been undertaken. This review will describe recent work in our lab and those of others using naked DNA encoding cytokines to antagonize HSV replication and virus trafficking or immune-mediated pathogenesis as a result of viral assault to ocular tissue.

Animals↗

PubMed2000

A plasmid construct encoding murine interferon beta antagonizes the replication of herpes simplex virus type I in vitro and in vivo.

In the present study, we employed a plasmid DNA encoding murine interferon (IFN)-beta to assess its antiviral efficacy in an in vitro transfection-infection assay and in an ocular HSV-1 infection model of mice. In the in vitro assay, transfection of mouse fibroblasts with the IFN-beta transgene resulted in a 17-fold or greater reduction in the viral load of HSV-1 at a multiplicity of infection (MOI) of 1 compared to that of those mice treated with the plasmid control. RT-PCR analysis of representative immediate early (ICP27), early (thymidine kinase, TK) and late (VP16) viral genes found no changes in the level of expression comparing the IFN-beta transgene- to the vector-treated control group, suggesting that the IFN-beta transgene may act at the post-transcriptional level of viral replication. In the ocular HSV-1 infection model, topical application of the plasmid DNA encoding murine IFN-beta onto mouse cornea enhanced cumulative survival and significantly reduced the viral load of HSV-1 in the eyes and trigeminal ganglia of mice at both day 3 and 6 post-infection compared with mice treated with the plasmid vector control or normal saline. Neutralizing antibody to IFN-beta blocked the protective effect elicited by the IFN-beta transgene. Unlike the in vitro experiment, viral gene expression was reduced in the trigeminal ganglion of mice pre-treated 24 h with the IFN-beta transgene day 3 (ICP27 and VP16) and day 6 (ICP27, TK, DNA polymerase, and VP16) post-infection in comparison to mice treated with the plasmid vector control as determined by semi-quantitative RT-PCR.

Animals↗

PubMed2000

Plasmid DNA encoding IFN-alpha 1 antagonizes herpes simplex virus type 1 ocular infection through CD4+ and CD8+ T lymphocytes.

The present study was undertaken to further characterize the anti-viral efficacy of a plasmid DNA encoding IFN-alpha1 against ocular herpes simplex virus type 1 (HSV-1) infection. In mice ocularly treated with plasmid DNA encoding IFN-alpha 1, the efficacy of the transgene was inversely proportional to the amount of virus used to infect the mice. Ocular treatment of mice with the IFN-alpha 1 transgene was the only mucosal route tested that showed efficacy against ocular HSV-1 infection compared with vaginal or intranasal delivery. Mice treated with the plasmid DNA encoding IFN-alpha 1 showed a significant reduction in viral Ag expression in the eyes and trigeminal ganglion that correlated with a reduction in immune cell infiltration into the cornea and iris on days 3 and 6 postinfection, as evidenced by immunohistochemical staining. Depleting mice of either CD4+ or CD8+ T lymphocytes completely blocked the resistance to herpes simplex virus type 1-induced mortality in mice treated with the IFN-alpha 1 transgene. In the absence of infection, the application of naked DNA encoding IFN-alpha 1 significantly increased the levels of IL-6- and IFN-gamma-inducible protein 10 transcript expression in the corneas 24 h post-treatment. Expression of the plasmid construct following topical application in the eye included the rectus muscles proximal to the cornea as well as the spleen. Collectively, the protective efficacy of the IFN-alpha 1 transgene against ocular HSV-1 infection is dependent upon the local or distal participation of CD4+ and CD8+ T lymphocytes early in the course of the infection, suggesting an indirect effect of the transgene against HSV-1-induced mortality.

Acute Disease↗

PubMed2000

Push-pull sorbent-based pheresis and hemodiabsorption in the treatment of hepatic failure: preliminary results of a clinical trial with the BioLogic-DTPF System.

The BioLogic-DTPF System combines hemodiabsorption (the BioLogic-DT System with dialysis against powdered sorbent) with push-pull sorbent-based pheresis (the BioLogic-PF System with powdered sorbent surrounding plasma filters). At blood flow rates of 200 ml/min, the system clears creatinine and aromatic amino acids at 120-160 ml/min, unconjugated bilirubin at 20-40 ml/min, and cytokines at 15-25 ml/min. This article outlines a study of the DTPF System in treatment of patients with hepatic failure with Grade 3 or 4 encephalopathy and respiratory and kidney insufficiency. Treatment appeared to be safe, and there are no significant hematologic changes. Physiologic changes include improved blood pressure and encephalopathy and stable urine output. Chemical changes include decrease in plasma levels of bilirubin, aromatic amino acids, ammonium, creatinine, and interleukin-3 (IL-1beta). The BioLogic-DT System is now marketed for treatment of acute hepatic failure with encephalopathy. The BioLogic-DTPF System adds the capability of removing bilirubin and other strongly protein-bound toxins from treated patients and may be of clinical benefit in management of patients with the most severe hepatic failure and encephalopathy.

Acute Disease↗

PubMed2000

IFN-alpha1 plasmid construct affords protection against HSV-1 infection in transfected L929 fibroblasts.

The purpose of the present study was to evaluate the resistance against herpes simplex virus type 1 (HSV-1) using an interferon-alpha1 (IFN-alpha1) transgene in specifically targeted cells in vitro. Transfection of mouse fibroblast L929 cells with an IFN-alpha1 plasmid construct reduced viral load and viral gene expression in a time-dependent fashion. Supernatants from IFN-alpha1-transfected cells augmented natural killer (NK) cell activity, and such an effect was antagonized with neutralizing antibody to IFN-alpha/beta. In addition, transfected cells displayed an increase in the IFN inducible genes (2',5'-oligoadenylate synthetase [2',5'-OAS], T cell-specific guanine nucleotide triphosphate-binding protein, IFN regulatory factor 1 [IRF-1], and major histocompatibility complex [MHC] class I) compared with plasmid vector-treated controls. Collectively, these results show that IFN-alpha1 transfection of cells in vitro induces or upregulates a spectrum of IFN-regulated genes involved in the direct or indirect antiviral action of this cytokine. In addition, the transgene significantly increases the resistance of transfected cells in vitro to HSV-1 infection.

2',5'-Oligoadenylate Synthetase↗

PubMed2000

Therapeutic efficacy of DNA encoding IFN-alpha1 against corneal HSV-1 infection.

PURPOSE: Type I interferons (IFN-alpha and -beta) are an innate immune component that plays a critical role in controlling herpes simplex virus type 1 (HSV-1) infection. We have previously shown that topical administration of a plasmid DNA encoding IFN-alpha1 onto mouse corneas prior to ocular HSV-1 infection provided prophylactic efficacy against HSV-1-induced encephalitis. As a result, the present study was undertaken to investigate the kinetics of the efficacy mediated by the IFN-alpha1 transgene following ocular challenge with HSV-1. METHODS: Mice were ocularly infected with a lethal dose of HSV-1 (450 plaque forming units/eye, McKrae strain) following corneal scarification and topically administered the pCMV-IFN-alpha1 transgene or pCMV-beta (plasmid vector) starting at 12, 24, or 48 hr post infection. Cumulative survival of infected mice was recorded. In addition, the effect of the transgene on viral replication and viral gene expression was determined from tissues 3 and 6 days post infection by plaque assay and RT-PCR respectively. RESULTS: Mice treated with the pCMV-IFNalpha1 transgene survived to a greater degree compared to mice topically administered the plasmid vector alone in a time-dependent manner. The protective effect correlated with a decrease in the viral load and expression of HSV-1 immediate early and early gene transcripts, infected cell protein-27 and thymidine kinase respectively in the trigeminal ganglion 6 days post infection. CONCLUSION: These results suggest that the application of plasmid DNA encoding IFN-alpha1 transgene is beneficial as a therapeutic approach when applied early after HSV-1 infection of the corneas.

Animals↗

PubMed1999

Structural and functional neuropathology in transgenic mice with CNS expression of IFN-alpha.

Cytokines belonging to the type I interferon (e.g. interferon-alpha) family are important in the host response to infection and may have complex and broad ranging actions in the central nervous system (CNS) that may be beneficial or harmful. To better understand the impact of the CNS expression of the type I interferons (IFN), transgenic mice were developed that produce IFN-alpha(1) chronically from astrocytes. In two independent transgenic lines with moderate and low levels of astrocyte IFN-alpha mRNA expression respectively, a spectrum of transgene dose- and age-dependent structural and functional neurological alterations are induced. Structural changes include neurodegeneration with loss of cholinergic neurons, gliosis, angiopathy with mononuclear cell cuffing, progressive calcification affecting basal ganglia and cerebellum and the up-regulation of a number of IFN-alpha-regulated genes. At a functional level, in vivo and in vitro electrophysiological studies revealed impaired neuronal function and disturbed synaptic plasticity with pronounced hippocampal hyperexcitability. Severe behavioral alterations were also evident in higher expressor GFAP-IFNalpha mice which developed fatal seizures around 13 weeks of age precluding their further behavioral assessment. Modest impairments in discrimination learning were measured in lower expressor GFAP-IFNalpha mice at various ages (7-42 weeks). The behavioral and electrophysiological findings suggest regional changes in hippocampal excitability which may be linked to abnormal calcium metabolism and loss of cholinergic neurons in the GIFN mice. Thus, these transgenic mice provide a novel animal model in which to further evaluate the mechanisms that underlie the diverse actions of type I interferons in the intact CNS and to link specific structural changes with functional impairments.

Animals↗

PubMed1999

Ectopic expression of DNA encoding IFN-alpha 1 in the cornea protects mice from herpes simplex virus type 1-induced encephalitis.

A novel approach to combat acute herpes simplex virus type 1 (HSV-1) infection has recently been developed by administration with a plasmid DNA construct encoding cytokine genes. Cytokines, especially type I IFNs (IFN-alpha and IFN-beta) play an important role in controlling acute HSV-1 infection. The purpose of the present study was to investigate the potential efficacy of ectopically expressed IFN-alpha 1 against ocular HSV-1 infection following in situ transfection of mouse cornea with a naked IFN-alpha 1-containing plasmid DNA. Topical administration of the IFN-alpha 1 plasmid DNA exerted protection against ocular HSV-1 challenge in a time- and dose-dependent manner and antagonized HSV-1 reactivation. In addition, IFN-alpha 1-transfected eyes expressed a fivefold increase in MHC class I mRNA over vector-treated controls. The protective efficacy of the IFN-alpha 1 transgene antagonized viral replication, as evidenced by the reduction of the viral gene transcripts (infected cell polypeptide 27, thymidine kinase, and viral protein 16) and viral load in eyes and trigeminal ganglia during acute infection. The administration of neutralizing Ab to IFN-alpha beta antagonized the protective effect of the IFN-alpha 1 transgene in mice. Collectively, these findings demonstrate the potential of using naked plasmid DNA transfection in the eye to achieve ectopic gene expression of therapeutically active agents.

Animals↗

PubMed1999

Lymphocytes delay kinetics of HSV-1 reactivation from in vitro explants of latent infected trigeminal ganglia.

A persistent immune response to herpes simplex virus type 1 (HSV-1) is evidenced by the expression of cytokine transcripts along with infiltrating mononuclear cells in the ganglia of latently infected mice. In trigeminal ganglion (TG) explant co-cultures, the presence of nonirradiated or irradiated primed splenocytes significantly reduced HSV-1 reactivation as defined by secreted infectious HSV-1 found in the supernatants of TG explant cultures. Primed splenocytes depleted of CD4+ or CD8+ cells did not antagonize HSV-1 reactivation. Cytokines including interleukin (IL)-2, IL-6, IL-10, and IL-12 were all detected in the TG explant cultures containing splenocytes. To further study the role of cytokines in HSV-1 reactivation, dissociated TG cell cultures were treated with exogenous recombinant cytokines including IFN-alpha or -gamma, IL-4, 6, 10, 12 or tumor necrosis factor (TNF)-alpha at concentrations ranging from 2.0 pg to 2.0 ng/culture (or 0.3-300 units/culture for the IFNs). While no cytokines tested at any concentration significantly modified HSV-1 reactivation, neutralizing antibody to IL-6, but not to IFN-alpha/beta, significantly antagonized HSV-1 reactivation. Collectively, the results suggest that IL-6 is directly or indirectly involved in HSV-1 reactivation in TG explant cultures.

Animals↗

PubMed1999

The inherent quantitative capacity of the reverse transcription-polymerase chain reaction.

The quantitative capacity of the reverse transcription-polymerase chain reaction (RT-PCR) is generally underestimated. In this study, PCR and RT-PCR products were amplified from serially diluted DNA and RNA templates, respectively, using a 35-cycle PCR. In the approximate 30- to 100-fold range of template input above the lower limit of detection, herpes simplex virus ICP27 RT-PCR product yield was dependent on the logarithm of template mRNA input (r2 = 0.99). Likewise, regression analysis indicated that yields of interleukin-12 p40, herpes simplex virus DNA polymerase, and interferon-gamma PCR products were dependent on the logarithm of template DNA input over 40- (r2 = 0.98), 60- (r2 = 0.96), and 100-fold (r2 = 0.99) ranges, respectively. This quantitative relationship appears to derive from the competition for reactants between specific PCR products and nonspecific primer-dimers that occurs at limiting concentrations of template. Although primer-dimers are not generally considered a common feature of PCR, 30 of 32 primer pairs tested in this study produced primer-dimer amplification in the absence of template. Because the coefficient of variation in replicate PCRs was typically 10-20% in the linear range, the precision of PCR was sufficient to measure 4-fold differences in template concentration. Thus, with statistically adequate sample numbers, an appropriate standard curve, and the inherent quantitative capacity of the method, differences in the abundance of a mRNA species are measurable by 35-cycle RT-PCR.

Animals↗

PubMed1999

The relationship between interleukin-6 and herpes simplex virus type 1: implications for behavior and immunopathology.

Cytokines are hormones once thought to be restricted to the immune system produced solely by hematopoietic-derived cells and acting on receptors expressed by cells of the immune system. However, it is now clear that many cytokines are produced not only by lymphocytes, monocytes, granulocytes, and dendritic cells but are also synthesized by cells outside the realm of the immune system in response to stimuli that may not be associated with immune homeostasis. In fact, there is evidence supporting a role of selected cytokines modifying behavior and neuroendocrine function. Recently, a potential relationship between the cytokine interleukin (IL)-6 and herpes simplex virus type 1 (HSV-1) reactivation has been found. This article discusses the relevance of these findings and considers the potential impact that HSV-1 infection has on behavior and chronic inflammatory processes that can occur in the nervous system during "latent" virus infection as a result of chronic IL-6 expression.

Herpes Simplex↗

PubMed1999

Morphine reduces mortality in mice following ocular infection with HSV-1.

To determine the effect of chronic opioid treatment on mice infected with herpes simplex virus (HSV-1), female ICR mice were administered saline or morphine (25 mg/kg) subcutaneously (s.c.) 3 X /day and infected five days later via corneal scarification and inoculation with 150-210 plaque forming units of HSV-1. Mice deprived of morphine succumbed following infection faster than morphine- or saline-maintained mice, and morphine-maintained mice had a higher cumulative survival than either saline-maintained or morphine-deprived mice. There was no significant difference in cytokine mRNA or protein levels by RT-PCR and ELISA, respectively, in the eyes, trigeminal ganglia, cerebellum, or brain stem, comparing morphine-maintained to saline-treated mice. Similarly, there were no differences in the viral load in the eyes and trigeminal ganglia during the acute infection comparing these two groups assayed three and six days post-infection. While there were no differences in the expression of viral transcripts in the eyes and trigeminal ganglia during the acute infection, HSV-1 infected cell polypeptide 27 expression was reduced in the brain stem of morphine-maintained mice. Collectively, the results suggest that mice maintained on morphine antagonize the spread of HSV-1 in the central nervous system and thus, reduce the incidence of viral-induced encephalitis.

Animals↗