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Biomedical subjects

M J Levine

Publications and source records attributed to M J Levine.

At least 19 recordsLinked to original sources

MUC7 gene expression and genetic polymorphism.

This study examined differential expression of several mucin genes in the human submandibular gland and trachea, MUC7 tissue and species specificity, and MUC7 genetic polymorphism. Mucin gene expression examined by RT-PCR indicated that MUC1, MUC4 and MUC7 are expressed in the human submandibular gland, while MUC1, MUC2, MUC4, MUC5 and MUC7 are expressed in the human trachea. Northern blot analysis confirmed the expression of MUC7 in the human trachea and MUC4 in the human submandibular gland. Northern blot analysis also demonstrated that MUC7 is not expressed in the submandibular/sublingual gland complexes of hamster, mouse and rat. Southern blot analysis suggested the presence of a MUC7 homologue in monkey genomic DNA. Genetic polymorphism studies of MUC7 by PCR and Southern blot analysis revealed the presence of a limited variable number of tandem repeats (VNTR) polymorphism.

Animals

Role of the carboxyl-terminal region of Porphyromonas gingivalis fimbrillin in binding to salivary proteins.

Porphyromonas gingivalis fimbriae are considered to play an important role in the adherence and colonization of the bacteria in the oral cavity. In this study, we generated and purified three carboxyl-terminal variants of recombinant fimbrillin (r-FimA 224-337, r-FimA 266-337, and r-FimA 287-337, corresponding to amino acid residues 224 to 337, 266 to 337, and 287 to 337, respectively, of the 43-kDa fimbrillin of P. gingivalis 2561). They were used as inhibitors of P. gingivalis cell binding to human salivary protein-coated hydroxyapatite (HAP) beads. All of the carboxyl-terminal region polypeptides inhibited binding in a dose-dependent manner; however, the inhibitory effect of r-FimA 287-337 was less than that of the other two polypeptides when HAP beads were coated with whole saliva or purified salivary proline-rich protein 1 (PRP1). Assays of binding of a synthetic peptide corresponding to amino acid residues 266 to 286 of P. gingivalis 2561 fimbrillin to salivary proteins showed that this peptide bound strongly to whole saliva or PRP1 but only weakly to statherin. These results suggest that the carboxyl-terminal region corresponding to amino acid residues 266 to 337 of P. gingivalis fimbrillin plays an important role in binding to salivary proteins and that the domain corresponding to amino acids 266 to 286 is likely a major binding site for PRP1s and the domain corresponding to amino acids 287 to 337 is likely a major binding site for statherin.

Adult

Bivector traction for unstable cervical spine fractures: a description of its application and preliminary results.

The management of acute, displaced odontoid fractures requires the restoration of sagittal alignment and rigid external or internal immobilization to prevent late instability and achieve union. This report introduces a new traction technique for the reduction of posteriorly displaced type 2 odontoid fractures. Seven patients with traumatic injuries to the dens were placed in bivector traction for an awake closed reduction. Sagittal alignment was restored and maintained in all patients with no neurologic deterioration or traction-related complications during an average of 11 days (range, 2-28 days) in traction. The overall sagittal alignment corrected from an initial average of 12.2 mm (range, 5-22 mm) of posterior displacement to an average of 1.1 mm (range, 0-3 mm) at the completion of reduction. Only one patient had residual angulation, which measured 5 degrees. Three patients achieved an osseous union and the remaining four required a posterior C1-C2 fusion for nonunion. Although operative stabilization may be the preferred approach in this patient population and injury pattern, we conclude that bivector traction is a safe and effective technique for the initial management of posteriorly displaced odontoid fractures. In addition, its role can be expanded to the closed reduction of lower cervical spine fractures in patients with fixed flexion deformities secondary to ankylosing spondylitis or disseminated intraosseous segmental hyperostosis.

Accidental Falls

Stabilization of helix by side-chain interactions in histatin-derived peptides: role in candidacidal activity.

Candida albicans is an opportunistic pathogen prevalent in AIDS patients and oral candidiasis. Azolebased drugs are currently used in the treatment of candidiasis. Histidine-rich peptides (histatins), are the natural inhibitors of candida species present in human salivary secretions. Sequence comparison of histatins revealed the common motif--KRKFHE--in active peptide fragments. Molecular modeling analysis showed structural similarity between this segment of histatins and azole-based drugs. The helical conformation adopted by histatin-5 may be stabilized by two side chain-side chain interactions (Phe... His and Arg ... Glu). Based on sequence comparison of histatin peptides and molecular modeling, a synthetic 10-residue peptide derived from histatin-5 was helical and possessed significant anti candida activity. This peptide may be used as a template to develop histatin-based drugs for treating oral candidiasis.

AIDS-Related Opportunistic Infections

Structure and chromosomal localization of the human salivary mucin gene, MUC7.

We have isolated and characterized several MUC7 genomic clones encoding the human low-molecular-weight salivary mucin, MG2. The MUC7 gene spans approximately 10.0 kb and comprises of three exons and two introns. Intron 1 is approximately 1.7 kb long and is located in the 5'-untranslated region of the corresponding MUC7 cDNA. Intron 2 spans approximately 6.0 kb and is located close to the boundary of the putative leader peptide and secreted protein. The entire region encoding the secreted peptide is located on exon 3, spanning approximately 2.2 kb. The nucleotide sequence of sections of the MUC7 gene, including 1500 bp of the 5'-flanking region, was determined and analyzed for motifs identical or homologous to other known response elements. A modified RACE procedure was used to determine the 5'-end of the MUC7 mRNA. PCR, the human-hamster somatic cell hybrid panel PCRable DNAs kit, and an in situ hybridization analysis on the complete metaphase chromosome spreads were used for the chromosomal localization of the MUC7 gene. It was mapped to chromosome 4q13-q21.

Animals

Lubrication of saliva substitutes at enamel-to-enamel contacts in an artificial mouth.

Mechanisms of salivary lubrication can be quantitatively measured by a reduction in the coefficient of friction. It is important that lubrication be assessed under the conditions of the oral cavity to properly assess lubrication regimes. The relative lubricity of three artificial salivas and two controls were assessed at a bovine enamel interface in an artificial mouth with a range of conditions that approximate oral function. Statistical analysis indicated that the enamel lubricity of sodium dodecylsulfate (SDS) and Oracare-D saliva substitutes were different from the other saliva substitutes and water. The low friction with Oracare-D and SDS saliva substitutes was because of resident amphipaths adsorbed at the enamel interface. Amphipaths adsorbed on enamel may provide a reduction in interocculsal friction and its resulting complications for patients with xerostomia.

Animals

The Coventry Award. Polymerase chain reaction detection of bacterial infection in total knee arthroplasty.

Synovial fluid aspirates from 50 patients with symptoms after total knee arthroplasty were analyzed by means of the polymerase chain reaction for the presence of bacterial deoxyribonucleic acid indicative of infection. Synovial fluid specimens were processed using a rapid bacterial lysis and extraction protocol, subjected to polymerase chain reaction amplification using universal bacterial primers, and polymerase chain reaction products analyzed by deoxyribonucleic acid hybridization methodology. Polymerase chain reaction testing on preoperative aspirates yielded 32 specimens positive for bacterial infection. Standard microbiologic culturing assays performed on the same samples gave 6 positive bacterial infection tests; intraoperative culturing identified 9 additional infected specimens. All culture positive specimens were polymerase chain reaction positive; in contrast, there were no false polymerase chain reaction positives in 21 negative control specimens obtained from aseptic joints. The synovial fluid processing protocol and polymerase chain reaction analysis can be performed with a minimum of time and may provide greater sensitivity than standard diagnostic tests. In view of the high incidence of false negative test results from standard microbiologic assays of synovial fluid specimens, the use of molecular biology based bacterial detection methodology should provide an additional, or alternative, assay to identify infected patient specimens.

Awards and Prizes

The influence of hard water (calcium) and surfactants on irritant contact dermatitis.

Although the induction of irritant contact dermatitis has been extensively studied for surfactants, the role of the environmental factor water hardness (i.e., calcium content) on the induction process has not received attention. Our objective was to investigate differences in surfactant-induced irritant skin reactions from cumulative exposure to 3 different personal cleansing agents and determine whether the irritation potential can be affected by the hardness of the water. 2 commonly used exaggerated washing procedures were variously employed to evaluate representative sodium soap, triethanolamine-soap, or synthetic detergent cleansers under conditions where the water hardness varied from 0-grain to 11-grain (gr). Subjects were clinically evaluated for skin dryness, skin redness, and instrumentally for hydration. Soap binding to skin was quantified using Fourier transform infrared reflectance spectroscopy. Using the more mild wash procedure, skin sites treated under conditions of hard, 11 gr water were significantly drier, had more erythema, and were less hydrated than corresponding sites treated with deionized 0 gr water. All 3 surfactant cleanser behaved similarly. We also found the hardness of the rinse water to be the more significant factor versus that of the wash water. Effect of water hardness on soap binding to skin revealed a similar outcome. Under a more exaggerated wash condition the relationship between water hardness and irritation broke down.

Adolescent

Surface-modified poly(methyl methacrylate) enhances adsorption and retains anticandidal activities of salivary histatin 5.

Denture-induced stomatitis is a common intraoral disease which is associated with high levels of Candida albicans adhesion to a denture surface. The aim of this study was to produce a surface-modified denture resin, which is usually manufactured from poly(methyl methacrylate) (PMMA), carrying an immobilized anticandidal protein. PMMA was modified by surface polymerization of methyl methacrylic acid to enhance adsorption of a potent candidacidal salivary protein, histatin 5. The modified PMMA showed higher surface adsorption and desorption of histatin 5 than the unmodified material. Because histatin 5 destabilizes C. albicans cell membranes and allows efflux of intracellular molecules, candidacidal activity was monitored by dye release from fungal cells. Adsorbed histatin 5 did not release dye from the yeast cells; however, dye was detected as histatin was desorbed from the surface. In an adhesion assay, modified PMMA decreased human submandibular-sublingual saliva (HSMSL) mediated adherence of yeast cells to the polymer. Precoating histatin 5 onto unmodified PMMA also abolished HSMSL-mediated adhesion. These experiments show that dental acrylic may be surface modified and loaded with histatin 5 as a means of controlled release of histatin 5 to an affected area. This surface modification may additionally reduce adhesion of C. albicans cells to the saliva-coated material.

Adsorption

Development of a novel, rapid processing protocol for polymerase chain reaction-based detection of bacterial infections in synovial fluids.

We describe the development of a molecular detection system designed for use with synovial fluid (SF)-based infections. The methodology employs a lysis/extraction procedure that effectively disrupts microorganisms allowing for release of the microbial DNA and its amplification by polymerase chain reaction (PCR). We tested the effectiveness of adding a mixed-bed, ion-exchange resin to the extract to remove PCR inhibitory components present in the SF. After centrifugation to separate the resin, DNA contained in the supernatant is subjected to PCR using oligonucleotide primers designed for broad-spectrum microorganism detection. Amplification products are analyzed by agarose gel electrophoresis and/or DNA hybridization methodology. We report here the detection sensitivity and specificity of the protocol using SF inoculated with Escherichia coli and Staphyloccocus aureus. We have applied this new methodology to clinical SF specimens with results superior to standard laboratory culturing assays.

Bacterial Infections

Lubrication of human and bovine enamel compared in an artificial mouth.

Bovine enamel has been a good model for human enamel across a broad range of studies. The present work sought to consider if bovine enamel would be a suitable substitute for human enamel in experiments on simulated oral lubrication. Enamel samples of the same size were prepared from bovine and human teeth for use as maxillary and mandibular elements in a miniature artificial mouth. Sliding speeds from 1.99 to 7.84 mm/s and occlusal forces of 3.8-19.5 N were used. Water and four solutions consisting of a mucin-rich fraction, a statherin-rich fraction, 3[(3-cholamidopropyl)-dimethylammonio]-1-propanesulphonate and sodium dodecyl sulphate were evaluated. The high correlations between widely different lubricants on the two enamel substrates gives confidence in the use of bovine enamel as a model for human enamel in salivary lubrication studies. Knoop hardness indentations on enamel samples were combined with friction data and calculations of the true contact area to give a method for the indirect determination of surface shear. The calculated surface shear value was compared with published values obtained by punch shear testing.

Animals

Salivary amylase promotes adhesion of oral streptococci to hydroxyapatite.

Recent studies have demonstrated that several species of oral streptococci, such as Streptococcus gordonii, bind soluble salivary alpha-amylase. The goal of the present study was to determine if amylase immobilized onto a surface such as hydroxyapatite can serve as an adhesion receptor for S. gordonii. Initially, human parotid saliva was fractionated on Bio-Gel P60, and fractions were screened for their ability to promote adhesion of S. gordonii to hydroxyapatite. Fractions containing alpha-amylase and proline-rich proteins promoted the adhesion of [3H]-labeled S. gordonii to hydroxyapatite. Similar findings were obtained with purified amylase and acidic proline-rich protein 1 (PRP1). Incubation of S. gordonii G9B in the presence of starch and maltotriose increased the binding of this strain to amylase-coated hydroxyapatite, while the adhesion of S. sanguis 10556 to amylase-coated hydroxyapatite was not affected by these saccharides. These results suggest that amylase may serve as a hydroxyapatite pellicle receptor for amylase-binding streptococci. Furthermore, starch and starch metabolites may enhance the adhesion of amylase-binding streptococci to amylase in dental pellicles to augment the formation of dental plaque.

Adhesins, Bacterial

A custom distal femoral prosthesis for reconstruction of large defects following wide excision for sarcoma: results and prognostic factors.

Between 1979 and 1986, 37 patients with sarcoma of the distal femur underwent limb salvage using a custom prosthetic knee replacement. Thirteen (35%) had early complications. Fourteen (38%) had late complications, which consisted of 6 aseptic femoral loosenings, 1 aseptic tibial loosening, 2 tibial fractures, 2 contractures, 1 femoral fracture, 1 prosthetic fracture, and 1 septic loosening. By 1988, nine patients died. Thirteen prostheses failed in 12 patients, resulting in 9 revisions, 2 above-knee amputations, and 2 Van Nes rotationplasties. The 2- and 5-year prosthetic survival rates were 82% and 57%, respectively. Twenty-two of the 26 survivors (85%) had successful limb salvage. Preventable factors were implicated in the loosening of six femoral components and in one femoral fracture. The mean Hospital for Special Surgery Knee Score was 69 (range: 62 to 86).

Adolescent

Biological activities and secondary structures of variant forms of human salivary cystatin SN produced in Escherichia coli.

Using an Escherichia coli expression system, pGEX-2T, that expresses foreign sequences as fusion proteins with a glutathione S-transferase (GST) carrier, we have produced several recombinant human salivary cystatin SN (reCsnSN) variants. These include a N-terminal-truncated form (aa 17-121), a C-terminal-truncated form (aa 1-102) and two deletion mutants (delta 12-16 and delta 56-60). A large amount of the insoluble fusion protein (approx. 15 mg/l) was produced in each case. These were solubilized with urea and refolded by dialysis. The GST carrier was then cleaved with thrombin and the reCsn variants (except delta 56-60) were purified by anion-exchange chromatography. The CysP inhibitory activities against papain, and bovine and human cathepsin B, and secondary structures of the reCsnSN variants were determined and compared to natural salivary CsnSN. The full-length reCsnSN, the N-truncated and the delta 12-16 variants inhibited the CysP activity of papain and displayed circular dichroism (CD) spectra similar to that of natural CsnSN. On the other hand, the delta 56-60 mutant and the C-truncated variant exhibited very little inhibitory activity towards papain. The CD spectrum of the C-truncated variant indicated a change in the secondary structure (e.g., a decrease in beta-sheet and an increase of an alpha-helical content). Neither, the natural nor the full-length reCsnSN or the delta 12-16 mutant exhibited any inhibitory activity towards bovine and human cathepsin B.

Amino Acid Sequence

Membrane-induced helical conformation of an active candidacidal fragment of salivary histatins.

The conformational preference of the candidacidal C-terminal 16 residue fragment (9-24; G-Y-K-R-K-F-H-E-K-H-H-S-H-R-G-Y) of salivary histatin 5 was examined in water, methanol, and dimethyl sulfoxide solutions using 500 MHz two-dimensional-NMR. Fourier transform infrared and CD spectroscopy were used to delineate its membrane-bound conformation in lipid vesicles. The peptide backbone and side-chain proton resonance assignments were accomplished by two-dimensional total correlated and nuclear Overhauser effect (NOE) spectra. The coupling constant (JNH-C alpha H) values determined from the double quantum-filtered correlated spectra, temperature coefficients of NH chemical shifts (d delta/dT), 1H/2H exchange rates on amide resonances, and the set of NOE connectivities were used to delineate backbone conformational features. The high JNH-C alpha H values (> or = 7.4 Hz), absence of any characteristic NH-NH (i, i + 1) or C alpha H-C beta H (i, i + 3) NOE connectivities, high d delta/dT values (> or = 0.004), and the fast 1H/2H amide exchange suggest that the histatin peptide favors unfolded random conformations in aqueous solution at pH 3.8. In contrast, the JNH-C alpha H values (< or = 6.5 Hz), slow 1H/2H exchange, low d delta/dT values (< or = 0.003) observed for amide resonances of residues 5-16, and the characteristic NH-NH (i, i + 1), C alpha H-C beta H (i, i + 3) NOE connectivities, provide evidence for the presence of largely alpha-helical conformations in dimethyl sulfoxide, which mimics the polar aprotic membrane environment. In methanolic solutions, 3(10)-helical conformations could exist as a minor population together with the major alpha-helical conformations. Fourier transform infrared spectroscopy and CD data indicate that lipid environments such as dimyristoylphosphatidylcholine vesicles could induce the peptide to fold into predominantly alpha-helical conformation. The results suggest that in dimethyl sulfoxide and dimyristoylphosphatidylcholine vesicles the candidacidal domain of salivary histatin 5 prefers a largely helical conformation, which could facilitate its interaction with the membrane of Candida albicans. The mechanism of antimicrobial action of this class of polypeptides appears to involve primarily electrostatic and hydrogen-bonding interaction of cationic and polar residues with the head groups of the plasma membranes of target cells.

Amino Acid Sequence

Glucosyltransferase mediates adhesion of Streptococcus gordonii to human endothelial cells in vitro.

Human umbilical vein endothelial cells (HUVEC) were used as an experimental host model to investigate the mechanism(s) of streptococcal adhesion in infective endocarditis. Adhesion activity of Streptococcus gordonii was maximal during the logarithmic phase of growth and was greatly reduced or eliminated by pretreatment of bacteria with heat, formaldehyde, or trypsin. At saturating numbers of streptococci, an average of 81 bacteria were bound per HUVEC. Streptococcal adhesion was inhibited by low-molecular-weight dextran and heparin but not by sucrose, fibronectin, or laminin. Adhesion was also prevented by pretreatment of HUVEC with proteins dissociated from the surface of S. gordonii with 10 mM EDTA or isolated from spent culture medium. Western blot (immunoblot) assays detected a single adhesion protein of 153 kDa (AP153) on HUVEC after incubation with unfractionated extracts of streptococci. The adhesin exhibited glucosyltransferase (GTF) activity when incubated with sucrose and Triton X-100 after sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The AP153 was purified by affinity chromatography on dextran beads and show to have binding activity for HUVEC, GTF activity, an amino acid composition similar to that reported for GTF of S. gordonii, and the ability to inhibit S. gordonii adhesion. Incubation of the streptococci with antibodies to the adhesin inhibited bacterial attachment to HUVEC monolayers. These results indicate that surface-localized GTF mediates adhesion of S. gordonii to HUVEC in vitro and may serve as a mechanism for colonization of the endocardium in infective endocarditis.

Adhesins, Bacterial