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Human monocytic cell lines transformed in vitro by Epstein-Barr virus display a type II latency and LMP-1-dependent proliferation.

Epstein-Barr virus (EBV) classically infects and transforms B lymphocytes in vitro, yielding lymphoblastoid cell lines (LCLs). In contrast to other herpesviruses, EBV is not described as an infectious agent for monocytes. However, recent papers described in vitro infection of monocytes leading to abortive or transient viral expression. In the present study, we report the characterization of E1, a monocytic cell line infected and transformed by EBV. This cell line was derived from an LCL by a drastic electroporation and selection of neomycin-resistant cells, unfavorable to B-cell outgrowth. E1 expressed surface molecules of monocytic lineage (CD14, major histocompatibility complex class II, and CD80) and the c-fms gene, a highly specific marker for the monocytic lineage. This cell line is able to phagocytose and secrete proinflammatory monokines tumor necrosis factor alpha, interleukin-6 (IL-6), and IL-8. E1 cells are tumorigenic after injection in nude mice, and a monocytic cell line obtained from one of these tumors (TE1) displayed immunophenotype and functional properties similar to those of E1. We detected the presence of the EBV genome in both cell lines, as well as expression of the EBNA-1 and LMP-1, but not EBNA-2, viral genes, characteristic of a type II latency. LMP-1 influences the phenotype of these monocytic cell lines, as demonstrated by down-regulation of cell proliferation and membrane intercellular adhesion molecule 1 expression due to an LMP-1 antisense strategy. This is the first description of a latently infected human monocytic cell line and the first direct demonstration of an instrumental role for LMP-1 in the proliferation of EBV-transformed cell lines expressing a type II latency.

Animals↗

Performance of a Western immunoblot assay to detect specific anti-Toxoplasma gondii IgG antibodies in human saliva.

Toxoplasma gondii represents the most prominent infectious parasitic organism found in humans. While normally asymptomatic in healthy individuals, toxoplasmosis can cause abortion in patients during pregnancy, or can be fatal in immunosupressed individuals such as persons suffering from acquired immunodeficiency syndrom (AIDS). Toxoplasma gondii infection in humans is routinely assesssed by serological means. Here, we show that detection of anti-T. gondii IgG is also possible using a non-invasive methodology employing saliva. Sera and saliva of 201 healthy volunteers were investigated for the presence of anti-T. gondii-IgG antibodies by immunoblotting. The sera of 59 (29.4%) individuals showed IgG antibodies against T. gondii by ELISA, Vidas, and immunoblotting; 58 (98.3%) of these were also positive for anti-T. gondii IgG in the saliva immunoblot, with diagnostic relevant bands of Mr of 32-35 kDa and 40-45 kDa. The saliva immunoblot test exhibits a specificity of 100% and a sensitivity of 98.5%. Thus, saliva could be used as an alternative, non-invasive means for the detection of specific anti-T. gondii IgG in humans.

Adolescent↗

[Herpes simplex virus and malignancies of female genital organs].

INTRODUCTION: Primary herpes simplex virus (HSV) infections of female genital tract usually end with remission, while the virus remains in the organism--almost in the sacral ganglion in a latent form, protected from humoral and cellular immunity. Stress induces the virus and the result is recurrent genital infection. Frequent exacerbations damage some parts of vital cellular structures without cytolysis, but stimulate malignant transformations. MATERIAL AND METHODS: Vulvar (portio vaginalis uteri) and endometrial tumor tissue samples were analyzed for HSV by direct and indirect fluorescent antibody technique (FAT). Pre and postoperative sera samples were analyzed for presence of anti-HSV antibodies--IgM and IgG by Elisa-Enzygnost method. Acellular filtrates obtained by ultrasonic destruction of malignant tissues were used as inoculum for rabbit corneal scarification. RESULTS AND DISCUSSION: Out of 63 tissue samples, 42 were positive for HSV antigen i.e. 67.3%. According to location 50% of vulvar, 76% PVU and 65% of endometrial tissues were positive. This antigen induces production of virus specific antibodies. Two types of antigens are known: the so-called T-antigen persisting in the cell nucleus and cell-surface antigen--product of the viral genome and can be evidenced by immunofluorescence method. Anti HSV antibodies were present in 63 preoperative serum samples and belonged to IgG group, but not one to IgM, implying a long and chronic course of infection excluding acute primary. Out of 38 postoperative serums the titer of antibodies decreased in 36 evidently, but in two samples remained unchanged. Two samples of endometrial and one from PVU origin contained HSV antigen type one. In the remaining 16 samples HSV 2 antigen was present. Rabbit corneal scarification was the proof of complete infectious virus in malignant tissues. Acellular filtrate of malignant tissues served as inoculum. Corneas of examined rabbits showed a mild inflammation after 24 hours which disappeared in the next 24 hours. We could not isolate the infectious virus by rabbit corneal scarification. Instead of herpetic changes, mild inflammation was evident. This abortive, incomplete symptomatology was probably caused by nonstructural early protein, which is a product of viral genome incorporated in malignant cells. CONCLUSION: On the basis of our results, we can conclude that HSV can have, beside other factors, a very important, maybe an initial role in development of malignant changes of female genital tract, not only on vulva and PVU, but on endometrium as well. HSV I can cause genital infections and have some role in malignant changes as well as HSV 2. However, complete infective virion couldn't be isolated from malignant tissues.

Adult↗

Acute renal failure in pregnancy.

Acute renal failure is a most challenging clinical problem when it occurs in pregnancy. It requires an understanding of the normal physiology of the kidney in pregnancy and the natural history of different underlying renal diseases when pregnancy occurs. Because patients with chronic renal disease may present with worsening proteinuria, hypertension, and renal function, these disorders must be excluded from those conditions that cause acute deterioration of renal failure in otherwise normal women during pregnancy. As in all patients who develop acute renal failure, prerenal and obstructive causes must be excluded. Particularly important causes of prerenal azotemia in pregnancy include hyperemesis gravidarum and uterine hemorrhage, especially if it is unsuspected as in abruptio placentae. Infectious causes of acute renal failure in the pregnant woman include acute pyelonephritis and septic abortion. The clinical presentation of both these conditions should be apparent, and appropriate diagnosis and treatment can then be promptly instituted. Renal cortical necrosis is another cause of renal failure that occurs more frequently in pregnancy, and it must be differentiated from the many causes of acute tubular necrosis that may be associated with pregnancy. Those conditions that cause renal failure unique to pregnancy must always be considered when renal function deteriorates in the last trimester or the postpartum period. Severe preeclampsia, acute fatty liver of pregnancy, and idiopathic postpartum acute renal failure may all present similar complications, but the approach to each of these clinical disorders must be individualized. By understanding the causes of renal functional deterioration in pregnancy, a logical differential diagnosis can be established, allowing appropriate therapeutic decisions to preserve both maternal and fetal well-being.

Acute Kidney Injury↗

Bacterial vaginosis: its importance in obstetrics.

Bacterial vaginosis is associated with adverse sequelae, including late miscarriage, preterm prelabour rupture of the membranes, chorioamnionitis, postpartum endometritis and preterm labour and delivery. It is easy to diagnose and treat; intervention reduces the incidence of adverse sequelae. Symptomatic women and those who are at increased risk of infectious morbidity should be screened.

Abortion, Spontaneous↗

Spontaneous abortion in immunodeficient SCID mice.

PROBLEM: Immunodeficient SCID mice on the CB-17 have been used to test the role of "rejection" in a xenogeneic blastocyst transfer model of recurrent miscarriage, but interpretation of the data requires knowing syngeneic within-species matings have a high success rate and do not require immunotrophic factors expected only in immunocompetent non-T-cell deficient mice. METHOD: Resorption rates were studied in a SCID CB-17 barrier facility that provided the mice used to test the role of immunology in the resorption model. RESULTS: Spontaneous resorption in syngeneically mated immunodeficient SCID mice on the CB-17 background occurred at an unexpectedly high rate and could not be prevented by treatment with anti-asialo GM1 antibody or GM-CSF, both of which are effective in ameliorating abortion in DBA/2J-mated CBA/J mice. Immunocompetent CB-17 +/+ mice showed an even higher rate of loss. The latter was also not affected by treatment with antiasialo GM1 antibody or by GM-CSF and was not prevented by tetracycline (which is effective in the DBA/2-CBA/J system) or progesterone treatment. Mating experiments showed a scid/+ x scid@+ cross gave the highest rate of loss, and it appeared that the presence of +/(+)-type embryos in the uterus could be augmenting abortion with selective discrimination against scid/scid embryos. High abortion rates were associated both with appearance of a coagulase-negative Staphylococcus sp. in feces and with loss of one component of the SPF flora. Decidual tissue from mated CB-17 +/+ mice showed premature release of TNF-alpha in absence of TGF-beta 2-related suppressor activity, and vascular lesions (fibrinoid necrosis), varying in extent, were associated with both scid/scid x scid/scid and +/+ x +/+ pregnancies. TNF-alpha also appeared prematurely in pregnant scid/scid mice, but the levels were lower (and areas of necrosis smaller than in +/+ x +/+ pregnancies). Outcrossing onto a C57B1/6 background dramatically reduced the abortion rate, indicating an important genetic effect on susceptibility with heterogeneity protecting against abortion. CONCLUSIONS: SCID mice on the CB-17 background do not have a high rate of successful syngeneic pregnancies, and a TNF-alpha induced vasculopathy may be responsible. Abortion was not caused by immunodeficiency leading to loss of immunotrophism because immunocompetent non-SCID CB-17 mice had a higher rate of loss. Factors augmenting the abortion rate included the presence of embryos of the +/+ genotype in the uterus and treatment with anti-asialo GM1 antibody. Abortion rates were not reduced by treatments effective in the DBA/2-mated CBA/J mouse model but were reduced by re-establishing a new colony with defined flora (a temporary effect) and by outcrossing mice with a different (C57B1/6) background. Together, the data suggest an infectious trigger (identity uncertain) of the vasculopathy and an important genetic influence on susceptibility with heterozygosity and a SCID mouse mutation providing against abortion a degree of protection.

Abortion, Veterinary↗

Infectious causes of recurrent pregnancy loss.

Current knowledge supports the view that nonviral organisms may be responsible for repeated pregnancy wastage through chronic or recurrent occupancy in the maternal reproductive tract. However, two forms of evidence that would establish more clearly such a role lack for all of the organisms presented: recovery of the same organism from the products of conception in successive pregnancy losses, and demonstration of improved pregnancy outcome following specific treatment in a randomized prospective controlled trial. While acquisition of such data is scientifically justified, the necessary study designs may be viewed as unethical if the body of information derived from circumstantial cases and therapeutic trials using historical controls only continues to shape clinical opinion. Further confirmation of a specific role in pregnancy wastage for any of these organisms eventually will have to address the mysterious discrepancy between the prevalence of colonization and the incidence of sporadic and recurrent abortion purportedly due to the organism.

Abortion, Habitual↗

Porcine abortions associated with Fungi, Actinomycetes, and Rhodococcus sp.

History, lesions, and results of microbiologic examinations are given for four porcine abortions associated with fungi and one each associated with Actinomadura madurae, an aerobic actinomycete, and Rhodococcus sp. The fungi were Gliomastix sp., Petriellidium boydii, Aspergillus fumigatus, and Exophiala jeanselmei. Parvovirus, isolated from one fetus, was the only other infectious agent identified. The presence of fungi, Actinomadura madurae, and Rhodococcus sp. in fetal and placental lesions indicates that they are a primary cause of sporadic abortion in pigs.

Abortion, Veterinary↗

[Did vaccination with an infectious bovine rhinotracheitis (IBR) marker vaccine on thirteen cattle farms give rise to chronic wasting among dairy cattle?].

At the end of May 1999 the author was asked by the Dutch Animal Health Service (GD) to evaluate problems with 'chronic wasting' cows on 13 farms. The cows were thought to have become ill after vaccination with an IBR marker vaccine. On nine farms a number of cows aborted shortly after vaccination. On eight farms lameness was a problem, as was mastitis. Diarrhoea occurred on four farms. A number of farms had problems with stillbirth, subfertility, abomasal displacement, and decreasing body condition. It was concluded that the abortions, stillbirth, and weak calves at birth in the first weeks after vaccination might be associated with the vaccination. However, the author found no indication that the other problems were associated with the vaccination. This was because the symptoms on the 13 farms were not uniform, and many of the herds already had problems before the herd was vaccinated. The 'chronic wasting' problem cannot be attributed to vaccination with the IBR marker vaccine. 'Chronic wasting' concerns a multifactorial complex of diseases, and has always been present, but has increased in incidence in the last years as a result of 'Holsteinization', a very high milk production, longer periods of housing indoors (and in many cases insufficient quality of the stable and cubicles), a too high work load, and insufficient management.

Abortion, Veterinary↗

Reproductive consequences of infection with bovine viral diarrhea virus.

Reproductive efficiency is imperative for the maintenance of profitability in both dairy and cow-calf enterprises. Bovine viral diarrhea virus is an important infectious disease agent of cattle that can potentially have a negative effect on all phases of reproduction. Reduced conception rates,early embryonic deaths, abortions, congenital defects, and weak calves have all been associated BVDV infection of susceptible females. In addition, the birth of calves PI with BVDV as a result of in utero fetal exposure is extremely important in the perpetuation of the virus in an infected herd or spread to other susceptible herds. Bulls acutely or PI with BVDV may bea source of viral spread through either natural service or semen used in artificial insemination. Management practices including elimination of PI cattle, biosecurity measures and strategic use of vaccination can be implemented to reduce the risk of BVDV related reproductive losses. Development of vaccines and vaccine strategies capable of providing better protection against fetal infection would be of benefit.

Abortion, Veterinary↗

Comparison of the pathogenicity for pregnant sheep of Rift Valley fever virus and a live attenuated vaccine.

A live attenuated mutant of Rift Valley fever virus, MV P12, was previously shown to be non-pathogenic in young lambs, but capable of producing protective immunity. The studies reported here show that the abortion in sheep caused by an infection with virulent virus is the result of necrosis of the maternal villi and cotyledons arising from an acute inflammation of the maternal caruncles. Pregnant ewes infected with the attenuated mutant virus MV P12 showed none of these lesions in the placenta and gave birth to healthy lambs. Colostrum from ewes infected with MV P12 virus was able to induce protective immunity in the offspring. These data along with previously published results suggest that the mutant virus MV P12 is an excellent candidate for use as a live attenuated veterinary vaccine.

Abortion, Veterinary↗

HIV screening for pregnant women in south eastern France: evolution 1992-1994-1996.

OBJECTIVES: To assess the evolution of the HIV screening practices towards pregnant women between 1992 and 1996, in relation with the 1993 French mandatory obligation to offer prenatal HIV testing and recent therapeutic possibilities to reduce HIV vertical transmission. STUDY DESIGN: Three successive surveys (January 1992, May 1994 and May 1996) about HIV screening policies among medical chiefs of all prenatal care and abortion departments of South Eastern France. Sixty-seven of the 74 departments concerned agreed to participate in the three surveys. RESULTS: The proportion of departments practising routine prenatal HIV screening had not increased since 1992 (89%) but systematic women's consent is more often requested (65.5 vs. 38.2%, P < 0.01). In the context of abortion, HIV testing is more often routinely offered (38.1 vs. 16.4%, P < 0.05) but selective screening remains a frequent practice (29.1%). CONCLUSION: Mandatory proposal of HIV testing to women who terminate could improve access to test but is not sufficient to guarantee adequate preventive counselling.

Abortion, Induced↗

Salmonella sepsis and miscarriage.

We present a case of a miscarriage at 16 weeks of gestation due to infection and transplacental passage of Salmonella group C. This was identified as being Salmonella Virchow from genital tract swab culture, and placental Gram-staining revealed numerous colonies of Gram-negative bacilli within the fibrin between the placental villi, confirming a true villitis associated with a hematogenous infection. Based on the patient's history, it was suggested that she had contracted the salmonella infection from eating undercooked eggs. Treatment of salmonella infection in pregnancy is controversial, and antibiotic therapy should be reserved for cases of invasive disease, using amoxicillin or a cephalosporin.

Abortion, Spontaneous↗

Bacterial vaginosis and miscarriage.

PURPOSE OF REVIEW: This review aims to summarize current knowledge about the relationship between bacterial vaginosis and miscarriage. RECENT FINDINGS: Studies investigating the relationship between bacterial vaginosis and infertility, implantation and early pregnancy loss have produced conflicting results. One study demonstrated a beneficial effect of colonization with hydrogen peroxide producing lactobacilli. A community based study found no association between bacterial vaginosis and first trimester loss, but a positive association with early second trimester loss. In a randomized controlled trial, treatment of bacterial vaginosis with oral clindamycin was associated with a fivefold reduction in the incidence of late miscarriage. SUMMARY: The relationship between bacterial vaginosis and infertility and first trimester loss needs further elucidation. Measures to support a healthy lactobacillus flora such as probiotic therapy warrant study. The randomized controlled trials of clindamycin treatment need to be replicated in different settings.

Abortion, Spontaneous↗

Uterine and placental alterations in pregnant sows associated with the porcine epidemic abortion and respiratory syndrome (PEARS).

In the winter of 1990/91 a new, economically devastating disease occurred in european pig breeding herds, characterized by late-term abortion, stillbirth and a high morbidity and mortality of suckling piglets. Because of the clinical picture the disease was named porcine epidemic and respiratory syndrome (PEARS). In this study investigations were carried out in tissues of uterus and placentae of late gestational sows (107 to 112 days of gestation) in three different groups of animals: group I = control animals (n = 2) group II = naturally infected sows (n = 12) from farms, where PEARS recently had been introduced; group III = sows (n = 2), experimentally inoculated with placental homogenates from animals of group II. Both in naturally infected as well as in experimentally infected sows a multifocal, lymphohistiocytic vasculitis and perivascular cell infiltration was observed in the endometrium and maternal part of the placenta, but not in the fetal one. In the fetomaternal unit there were multifocal microseparations of the epithelial layers present. Transmission electron microscopically spherical or oval virus-like particles of 45 to 75 mm in diameter were frequently found on the surface of endothelial cells of blood vessels in the maternal placenta, in a few cases in the intercellular channel system between uterine epithelial cells or on endothelial cells of capillaries in the fetal placenta. Serological results indicate, that an infection with Lelystad virus had occurred in naturally and experimentally infected sows and that transplacental infection was present.

Abortion, Veterinary↗