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Human leptospirosis--a review of 50 cases.

Epidemiological and clinical aspects of 50 consecutive patients, 47 adults and three children, hospitalized between 1977 and 1987 for human leptospirosis, were reviewed. 45 (90%) of the patients were from rural regions. 32 (64%) cases occurred in individuals at occupational risk for the infection. 35 (70%) cases were registered in the warm season. The source of infection was known in 34 (68%) cases. Weil's disease was diagnosed in 31 (62%) patients, aseptic meningitis in 12 (24%) and acute unexplained fever in seven (14%). Haemodialysis was required for 11 (35%) patients with Weil's disease. Three (6%) patients died. Cause of death was massive gastrointestinal haemorrhage in two and renal failure in one. Leptospira icterohaemorrhagiae was responsible for 39 (78%) cases, Leptospira canicola for six (12%), Leptospira grippotyphosa for two (4%), and Leptospira australis, Leptospira ballum and Leptospira sejroe, for one case each. A muscle biopsy was performed in six patients and a renal biopsy in three. Focal necrotic muscular changes, with mild mononuclear infiltrate, were found. Pigmented casts in distal convoluted tubules, mild interstitial inflammatory infiltrate and mesangial enlargement of some glomeruli were observed in kidney biopsies. A good knowledge of the protean clinical manifestations of leptospirosis and an accurate laboratory study are required for a correct diagnosis.

Adolescent↗

Expression of antigen genes of Leptospira interrogans serovar canicola in Escherichia coli.

Leptospira interrogans serovar canicola DNA was cloned into the plasmid pBR322 and introduced into E. coli. Eight out of approximately 10,000 transformants were found to express antigens of canicola by ELISA including colony ELISA blot test using anti-canicola antiserum. The canicola antigens expressed in the transformants reacted with the antisera against the serovars belonging to Canicola serogroup and other serogroups of L. interrogans. They did not react, however, with the antiserum against L. biflexa (with only one exception) nor with the antiserum against Leptonema illini. Thus, the recombinant DNA technique may provide alternative possibilities for preparing antigens of leptospires.

Antigens, Bacterial↗

Leptospirosis and panuveitis in a dog.

A case of panuveitis as a result of leptospiral infection in an 8-year-old Jack Russell Terrier is reported. Mild hyphema, aqueous flare, and partial serous retinal detachments were noted in both eyes on initial ophthalmic examination. The serum microscopic agglutination testing for Leptospira serovarieties revealed titers of 1 : 12 800 for Leptospira canicola and 1 : 200 for Leptospira icterohemorrhagiae. With medical therapy, the panuveitis resolved and functional vision was regained. Four weeks after the initial presentation, convalescent titers were 1 : 200 for L. canicola and 1 : 100 for L. icterohemorrhagiae. The incidence of leptospirosis, along with difficulties diagnosing, and current medical therapies for this disease are also discussed.

Agglutination Tests↗

Serological and chemical interrelationship of antigens from Leptospira interrogans serovar canicola.

Antigens of the outer envelope from Leptospira interrogans serovar canicola (Hond Utrecht IV) were extracted by 50% (v/v) ethanol or by sodium dodecyl sulphate and serological analysis suggested that they were identical. The "fraction 4" extracted by alkali was found to contain glycoproteins of high (retentate) and low (filtrate) molecular weight; the latter behaved like a hapten in serology and in animal immunization experiments. Antibodies were raised in rabbits against this hapten by conjugating it to bovine albumin fraction V. The antiserum was found to react with both the low molecular weight and high molecular weight glycoproteins. This anti-hapten serum contained little or no whole-cell-agglutinating antibodies. The fraction 4 retentate behaved like a complete antigen in serological and immunization studies. Fraction 4 retentate and the outer envelope preparations were serologically related but they were not identical. Chemical studies revealed similarities between the carbohydrate component of the outer envelope obtained by ethanol extraction and fraction 4. The outer envelope extracted by ethanol, fraction 4 and its low and high molecular weight glycoproteins contained arabinose, rhamnose, fucose, xylose, mannose, galactose, glucose, glucosamine and glucuronic acid. Three unidentified peaks were observed in gas-liquid chromatographic analysis of the O-trimethylsilyl derivatives of methyl glycosides of all these samples and one of these peaks co-eluted with the O-trimethylsilyl derivative of 3-O-methylmannose.

Antigens, Bacterial↗

Protective activity of glycolipid antigen against infection by Leptospira interrogans serovar canicola.

A protective glycolipid antigen (PAg) was extracted from Leptospira interrogans serovar canicola with chloroform/methanol/water (1:2:0.8, by vol.) and partially purified by silica gel column chromatography. The PAg elicited a protective response in hamsters and in cyclophosphamide-treated mice subsequently challenged with homologous Leptospira. The PAg band was detected as a single smear-like band, corresponding to a protein of 23-30 kDa, by silver-staining in SDS-PAGE. In immunoblots, this band reacted with a monoclonal antibody, A5, which agglutinated serovar canicola and recognized a serovar-specific antigen. Furthermore, the PAg did not migrate on silica gel TLC, but was detected at the origin as a ninhydrin- and naphthol-positive spot. This suggests that PAg is a hydrophilic molecule with a carbohydrate chain that contains amino groups, possibly as amino sugars.

Animals↗

Monoclonal antibody against Leptospira interrogans serovar canicola.

Nine cell lines producing monoclonal antibodies (MAbs) against Leptospira interrogans serovar canicola strain Moulton were established by the cell fusion technique. The immunological reactivity of these MAbs with various kinds of serogroups, serovars and strains were examined by microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA). MAbs W1-W3 derived from mice, which were immunized with whole cells of the strain Moulton, reacted with the serogroups Canicola, Icterohaemorrhagiae and Pyrogenes. On the other hand, MAbs A1-A6 derived from mice immunized with the outer envelope (OE) fraction, which showed a potent protective activity and was extracted with ammonium hydroxide from the strain Moulton, reacted specifically with the serogroup Canicola alone in MAT. A difference in antigenic structure between subserogroup A (canicola subgroup) and subserogroups B (schüeffneri subgroup) of the serogroup Canicola was demonstrated by MAT using the MAbs. All the MAbs clearly agglutinated serovars of subserogroup A except for serovars kamituga, jonsis and bindjei, but did not react with any serovars of subserogroup B. These findings suggest that MAb highly specific to each serovar is readily available by OE immunization and is useful for the classification of Leptospira.

Animals↗

Chemical properties of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton.

The aqueous layer was isolated from Leptospira interrogans serovar canicola strain Moulton by the hot phenol-water method. After ultracentrifugation, the precipitate was designated as lipopolysaccharide-like substance (LLS) fraction and the chemical composition was compared with that of bacterial LPS. The LLS fraction consists of 35.2% carbohydrate, 3.8% amino sugar, 36.4% lipid, 15.2% protein, and 0.3% phosphorus. Neutral sugars were detected as rhamnose, arabinose, xylose, 4-O-methylmannose, mannose, galactose, and a small amount of erythrose, fucose and glucose by gas-liquid chromatography (GLC), but 2-keto-3-deoxyoctonic acid was not detected in the LLS by thiobarbituric acid test and high voltage paper electrophoresis. Fatty acids detected by GLC were decanoic acid (C10: 0), dodecanoic acid (C12: 0), dodecenoic acid (C12: 1), tridecenoic acid (C13: 1), tetradecanoic acid (C14: 0), hexadecanoic acid (C16: 0), hexadecenoic acid (C16: 1), and octadecenoic acid (C18: 1). With SDS-polyacrylamide gel electrophoresis, bacterial LPS showed many orderly bands, while the banding pattern of the leptospiral LLS was very simple. These findings demonstrate that the physicochemical properties and chemical composition of LLS fraction from Leptospira are different from those of LPS extracted from gram-negative bacteria such as Enterobacteriaceae, and suggesting that Leptospira has no typical LPS.

Amino Sugars↗

Purification, characterization and serological properties of a glycolipid antigen reactive with a serovar-specific monoclonal antibody against Leptospira interrogans serovar canicola.

A glycolipid antigen possessing a serovar-specific antigenic determinant of Leptospira interrogans serovar canicola was purified from a chloroform/methanol extract of the organism. The purification procedures included silicic acid column chromatography and preparative thin-layer chromatography (TLC). Antigenic activity was detected by a TLC-enzyme immunostaining technique using monoclonal antibody CT3, which specifically agglutinates serovar canicola and only weakly serovar sumneri but no other serovars of Leptospira. The purified glycolipid reacted with CT3 antibody, indicating that the glycolipid possessed a serovar-specific antigenic determinant. Infrared spectrum and proton nuclear magnetic resonance analyses showed that the glycolipid contained sugar and lipid moieties, which possessed amide linkages and an acetyl group. Gas-liquid chromatography-mass spectrometry analysis showed that the glycolipid contained two unknown sugars, one of which (unknown sugar II) appeared to be associated with the antigenic determinant specific for canicola. The serovar-specific antigenic determinant was destroyed by mild alkali treatment of the glycolipid. These findings suggested that the antigenic determinant was an alkali-labile moiety which may be related to the unknown sugar II.

Antibodies, Monoclonal↗

Immunising potency of Leptospira interrogans serotype canicola after heat inactivation at different temperatures.

The immunogenicity of Leptospira interrogans serotype canicola suspensions inactivated by various degrees of heat exposure was examined in hamsters. No differences between leptospires killed at 50 degrees C and at 98 degrees C were shown. After exposure to 121 degrees C, suspensions retained their ability to protect against lethal infections but lost their ability to prevent leptospiruria. Tests with vaccines inactivated at or below 98 degrees C showed that the doses required for complete protection varied with the interval between vaccination and challenge. Larger doses were required to prevent the development of leptospiruria than to prevent death.

Animals↗

[The reactogenicity and immunogenicity of the first Cuban vaccine against human leptospirosis].

A controlled double-blind trial was conducted with the participation of 80 adult volunteers of both sexes, who were randomly divided into groups of 40 individuals each one. The case-base study received the vaccine and the control group was administered placebo to know the safety, the behaviour of reactogenicity, and to star the immunogenicity studies of the first Cuban vaccine against human leptospirosis. The vaccine used in the case-base study was an inactivated and trivalent vaccine containing strains of Leptospira canicola, icterohaemorrhagiae and pomona, since they have the highest circulation in the country. The results obtained showed the inocuity of the vaccine as no adverse severe reactions were detected. The general symptomatology observed was low, where as febricula was the most common general symptom. It appeared during the first 3 days of observation and there were no significant differences between the 2 group. Only a mild pain at the site of the injection was reported as a local symptom, which was more frequent in the vaccinated group than in the control group (7.8 against 1.5%, respectively). The seroconversion obtained was of 29% by microagglutination, and of 34.2% by ELISA. The final results allowed to conclude that this vaccine is safe for human adults at the ages under study, and give the possibility to continue other studies in more advanced stages to complete the requirements for obtaining its license.

Adult↗

Immunological properties of cellular and whole-culture leptospiral bacterins.

Two bivalent leptospiral bacterins were compared for safety in guinea pigs and for potency in hamsters. One bacterin (Bacterin A) was prepared from the cellular material of Leptospiral icterohaemorrhagiae and Leptospira canicola cultures propagated in Stuart's modified medium with 7% rabbit serum. The 2nd bacterin (Bacterin B) contained whole leptospiral cultures grown in synthetic medium. Neither bacterin induced adverse local or systemic reactions when injected intraperitoneally (I/P) in guinea pigs. In hamsters, 1/400 and 1/800 of the recommended dose of bacterin B for cattle protected 100% of the vaccinated hamsters against challenge exposure of either virulent leptospiral serotype. A dose representing 1/400 of the recommended dose of bacterin A for cattle protected 80% of vaccinated hamsters against challenge exposure to L. icterohaemorrhagiae and 90% against challenge exposure to L. canicola, whereas the 1/800 dose level protected only 10% of the vaccinated hamsters challenge exposed to virulent culture of L. icterohaemorrhagiae or canicola. The possibility was demonstrated that at least one soluble antigen of strong immunogenic properties is produced in cultures of L. icterohaemorrhagiae and L. canicola.

Animals↗

Effects of static magnetic field on growth of leptospire, Leptospira interrogans serovar canicola: immunoreactivity and cell division.

The effects of the exposure of the bacterium, Leptospira interrogans serovar canicola to a constant magnetic field with magnetic flux density from a permanent ferrite magnet=140+/-5 mT were studied. Changes in Leptospira cells after their exposure to the field were determined on the basis of changes in their growth behavior and agglutination immunoreactivity with a homologous antiserum using dark-field microscopy together with visual imaging. The data showed that the exposed Leptospira cells have lower densities and lower agglutination immunoreactivity than the unexposed control group. Interestingly, some of the exposed Leptospira cells showed abnormal morphologies such as large lengths. We discussed some of the possible reasons for these observations.

Journal Article↗

A neutral sugar is responsible for serovar specificity of the antigenic determinant of Leptospira interrogans serovar canicola.

To provide information on the chemical structures of antigenic determinants of leptospira, glycolipids of Leptospira interrogans serovar canicola strain Hond Utrecht IV (Ut-IV) and its antigenic variant selected in the presence of a serovar-specific monoclonal antibody were compared physicochemically. Gas-liquid chromatography-mass spectrometry analysis revealed that the glycolipid of Ut-IV contained 6 neutral sugar species; rhamnose, mannose, galactose, glucose, and unknown sugars III and IV, in addition to unknown sugars I and II that had been previously reported. On the other hand, the glycolipid of the variant lacked unknown sugar III, suggesting that this sugar is responsible for the serovar-specific antigenic determinant.

Animals↗

The use of 16S rDNA sequence analysis to investigate the phylogeny of Leptospiraceae and related spirochaetes.

The 16S rDNA sequences from 15 Leptospiraceae were determined by automated PCR-directed cycle sequencing. Nucleotide comparisons, including those from published sequences for Leptospira canicola Moulton and Serpulina spp., were used to construct phylogenetic trees. Serpulina hyodysenteriae and S. innocens were related to each other but were distinct from the Leptospiraceae comprising Leptospira parva incertae sedis (Turneria parva H), Leptonema illini and Leptospira spp. The pathogenic and the saprophytic leptospires were distinct and separated from each other. Leptospira inadai occupied an intermediate position between the two forms. The pathogens formed three groups. Group I was represented by L. interrogans sensu stricto and L. kirschneri, Group II by L. weilii, L. borgpetersenii and L. santarosai, and Group III comprised L. noguchii and L. meyeri. The saprophytic species, L. wolbachii and L. biflexa sensu stricto shared about 99% sequence similarity. The freshwater isolates were distinct from the marine isolate L. biflexa sensu lato ancona Ancona Porto.

Base Sequence↗

Hemolytic activity of Leptospira interrogans serovar canicola cultured in protein-free medium.

Hemolytic activity of the culture supernatant of Leptospira interrogans serovar canicola strain Moulton grown in protein-free medium was demonstrated. The activity began to appear in the late logarithmic phase of growth of the organism and reached a plateau after 2 weeks of cultivation. It was inactivated by the addition of dipotassium ethylenediaminetetraacetate, but was effectively restored by Mg2+. Hemolysis by the culture supernatant was stimulated by "hot-cold" incubation. Sleep erythrocytes treated with the culture supernatant of the organism were transformed into spherocytes, in which invagination was observed. A hemolysis inhibitor in rabbit serum was found to be in the chloroform-methanol soluble fraction of the serum. The hemolysin of Leptospira may be phospholipase C.

Animals↗

Biological activities of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton.

The biological activities of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton by the hot phenol-water method were studied in mice. The addition of 12.5 micrograms/ml or more of LLS fraction increased the incorporation of [3H]thymidine into in vitro cultured spleen cells of C57BL/6 mice, while the activity of the LLS fraction was about 20 times weaker than that of Salmonella typhimurium lipopolysaccharide (LPS). Pretreatment of murine spleen cells with rabbit anti-mouse thymocyte antiserum did not diminish the mitogenic activity of leptospiral LLS, and the LLS could not increase the incorporation of [3H]thymidine into thymocytes, suggesting that LLS acts on a B-lymphocyte population of lymphocytes. When sheep erythrocytes and LLS fraction were injected intraperitoneally into BALB/c mice, LLS exhibited an enhancing effect on antibody response in vivo. However, lethal toxicity of the LLS fraction was about 500 times lower than that of LPS in C57BL/6 mice loaded with galactosamine. No antitumor activity of leptospiral LLS (250-1,000 micrograms/mouse) against the ascites form of Ehrlich carcinoma in ddY mice was observed. The biological activities of the LLS fraction from the organism were weaker than those of gram-negative bacterial LPS, suggesting that Leptospira possesses no typical LPS.

Adjuvants, Immunologic↗

Isolation of an antigenic oligosaccharide fraction from Leptospira interrogans serovar canicola with a monoclonal antibody.

An oligosaccharide fraction containing the antigenic determinant of lipopolysaccharide antigen (TM antigen) from Leptospira interrogans serovar canicola, recognized by a monoclonal antibody (CT3) which agglutinates serovars canicola and broomi, was isolated by formic acid and successive sulphuric acid hydrolyses. Separation of the antigenic compounds was done by Bio-Gel P-2 and Sephadex G-25 gel filtration, and high-performance liquid chromatography with two different columns. The fraction finally obtained was a mixture of two oligosaccharides, both of which migrated as a single spot having a slightly higher mobility than an authentic tetrasaccharide (stachyose) on thin layer chromatography. The fraction contained rhamnose, arabinose and two major and two minor unknown sugars which were shown to be N- or O-acetylated and/or O-methylated sugars by nuclear magnetic resonance. The fraction inhibited the binding of CT3 antibody with TM antigen in enzyme-linked immunosorbent assay and microscopic agglutination of serovar canicola with the antibody. The inhibitory activity was destroyed by periodate oxidation or mild alkaline treatment, but was resistant to sodium borohydride reduction.

Antibodies, Monoclonal↗