Chlamydia pneumoniae : modern insights into an ancient pathogen

Chlamydia pneumoniae is an enigmatic human and animal pathogen. Originally discovered in association with acute human respiratory disease, it is now associated with a remarkably wide range of chronic diseases as well as having a cosmopolitan distribution within the animal kingdom. Molecular typing studies suggest that animal strains are ancestral to human strains and that C. pneumoniae crossed from animals to humans as the result of at least one relatively recent zoonotic event. Whole genome analyses appear to support this concept – the human strains are highly conserved whereas the single animal strain that has been fully sequenced has a larger genome with several notable differences. When compared to the other, better known chlamydial species that is implicated in human infection, Chlamydia trachomatis, C. pneumoniae demonstrates pertinent differences in its cell biology, development, and genome structure. Here, we examine the characteristic facets of C. pneumoniae biology, offering insights into the diversity and evolution of this silent and ancient pathogen.

The hyperthermic patient

Concepts used in this chapter include: Thermoregulation:- Thermoregulation refers to the body’s sophisticated, multi-system regulation of core body temperature. This hierarchical system extends from highly thermo-sensitive neurons in the preoptic region of the brain proximate to the rostral hypothalamus, down to the brain stem and spinal cord. Coupled with receptors in the skin and spine, both central and peripheral information on body temperature is integrated to inform and activate the homeostatic mechanisms which maintain our core temperature at 37oC1. Hyperthermia:- An imbalance between the metabolic and external heat accumulated in the body and the loss of heat from the body2. Exertional heat stroke:- A disorder of excessive heat production coupled with insufficient heat dissipation which occurs in un-acclimated individuals who are engaging in over-exertion in hot and humid conditions. This phenomenon includes central nervous system dysfunction and critical dysfunction to all organ systems including renal, cardiovascular, musculoskeletal and hepatic functions. Non-exertional heat stroke:- In contrast to exertional heatstroke as a consequence of high heat production during strenuous exercise, non-exertional heatstroke results from prolonged exposure to high ambient temperature. The elderly, those with chronic health conditions and children are particularly susceptible.3 Rhabdomylosis:- An acute, sometimes fatal disease characterised by destruction of skeletal muscle. In exertional heat stroke, rhabdomylosis occurs in the context of strenuous exercise when mechanical and/or metabolic stress damages the skeletal muscle, causing elevated serum creatine kinease. Associated with this is the potential development of hyperkalemia, myoglobinuria and renal failure. Malignant hyperthermia:- Malignant hyperthermia is “an inherited subclinical myopathy characterised by a hypermetabolic reaction during anaesthesia. The reaction is related to skeletal muscle calcium dysregulation triggered by volatile inhaled anaesthetics and/or succinylcholine.”4 Presentation includes skeletal muscle rigidity, mixed metabolic and respiratory acidosis, tachycardia, hyperpyrexia, rhabdomylosis, hyperkalaemia, elevated serum creatine kinease, multi-organ failure, disseminated intravascular coagulation and death.5

Randomized phase II study of cetuximab plus cisplatin/vinorelbine compared with cisplatin/vinorelbine alone as first-line therapy in EGFR-expressing advanced non-small-cell lung cancer

Background: The Lung Cancer Cetuximab Study is an open-label, randomized phase II pilot study of cisplatin and vinorelbine combined with the epidermal growth factor receptor (EGFR)-targeted monoclonal antibody cetuximab versus cisplatin and vinorelbine alone, in patients with advanced EGFR-expressing, non-small-cell lung cancer (NSCLC). End points of the study are activity, safety and pharmacokinetics. Patients and methods: Following randomization, for a maximum of eight cycles, patients received three-weekly cycles of cisplatin (80 mg/m2, day 1) and vinorelbine (25 mg/m2 on days 1 and 8) alone or following cetuximab treatment (initial dose 400 mg/m, followed by 250 mg/m2 weekly thereafter). Results: Eighty-six patients were randomly allocated to the study (43 per arm). Confirmed response rates were 28% in the cisplatin/vinorelbine arm (A) and 35% in the cetuximab plus cisplatin/vinorelbine arm (B). Median progression-free survival (PFS) was 4.6 months in arm A and 5.0 months in arm B, with PFS rates at 12 months of 0% and 15%, respectively. Median survival was 7.3 months in arm A and 8.3 months in arm B. The 24-month survival rates were 0% and 16%, respectively. The cetuximab combination was well tolerated. Conclusion: In the first-line treatment of advanced NSCLC, the combination of cetuximab plus cisplatin/vinorelbine demonstrated an acceptable safety profile and the potential to improve activity over cisplatin/vinorelbine alone. © 2007 European Society for Medical Oncology.

Toxicity profile of the immunomodulatory thalidomide analogue, lenalidomide : Phase I clinical trial of three dosing schedules in patients with solid malignancies

Thalidomide is an anti-angiogenic agent currently used to treat patients with malignant cachexia or multiple myeloma. Lenalidomide (CC-5013) is an immunomodulatory thalidomide analogue licensed in the United States of America (USA) for the treatment of a subtype of myelodysplastic syndrome. This two-centre, open-label phase I study evaluated dose-limiting toxicities in 55 patients with malignant solid tumours refractory to standard chemotherapies. Lenalidomide capsules were consumed once daily for 12 weeks according to one of the following three schedules: (I) 25 mg daily for the first 7 d, the daily dose increased by 25 mg each week up to a maximum daily dose of 150 mg; (II) 25 mg daily for 21 d followed by a 7-d rest period, the 4-week cycle repeated for 3 cycles; (III) 10 mg daily continuously. Twenty-six patients completed the study period. Two patients experienced a grade 3 hypersensitivity rash. Four patients in cohort I and 4 patients in cohort II suffered grade 3 or 4 neutropaenia. In 2 patients with predisposing medical factors, grade 3 cardiac dysrhythmia was recorded. Grade 1 neurotoxicity was detected in 6 patients. One complete and two partial radiological responses were measured by computed tomography scanning; 8 patients had stable disease after 12 weeks of treatment. Fifteen patients remained on treatment as named patients; 1 with metastatic melanoma remains in clinical remission 3.5 years from trial entry. This study indicates the tolerability and potential clinical efficacy of lenalidomide in patients with advanced solid tumours who have previously received multi-modality treatment. Depending on the extent of myelosuppressive pre-treatment, dose schedules (II) or (III) are advocated for large-scale trials of long-term administration. © 2006 Elsevier Ltd. All rights reserved.

Total transcriptome, proteome, and allergome of Johnson grass pollen, which is important for allergic rhinitis in subtropical regions

Background Genomic data are lacking for many allergen sources. To circumvent this limitation, we implemented a strategy to reveal the repertoire of pollen allergens of a grass with clinical importance in subtropical regions, where an increasing proportion of the world's population resides. Objective We sought to identify and immunologically characterize the allergenic components of the Panicoideae Johnson grass pollen (JGP; Sorghum halepense). Methods The total pollen transcriptome, proteome, and allergome of JGP were documented. Serum IgE reactivities with pollen and purified allergens were assessed in 64 patients with grass pollen allergy from a subtropical region. Results Purified Sor h 1 and Sor h 13 were identified as clinically important allergen components of JGP with serum IgE reactivity in 49 (76%) and 28 (43.8%), respectively, of patients with grass pollen allergy. Within whole JGP, multiple cDNA transcripts and peptide spectra belonging to grass pollen allergen families 1, 2, 4, 7, 11, 12, 13, and 25 were identified. Pollen allergens restricted to subtropical grasses (groups 22-24) were also present within the JGP transcriptome and proteome. Mass spectrometry confirmed the IgE-reactive components of JGP included isoforms of Sor h 1, Sor h 2, Sor h 13, and Sor h 23. Conclusion Our integrated molecular approach revealed qualitative differences between the allergenic components of JGP and temperate grass pollens. Knowledge of these newly identified allergens has the potential to improve specific diagnosis and allergen immunotherapy treatment for patients with grass pollen allergy in subtropical regions and reduce the burden of allergic respiratory disease globally.

Virulence of the Nine Serovar Reference Strains of Haemophilus paragallinarum

The virulence of the reference strains of the nine currently recognized Kume serovars of Haemophilus paragallinarum was investigated. The capacity of the H. paragallinarum strains to cause the typical clinical signs of upper respiratory tract disease associated with infectious coryza in unvaccinated, nasal-challenged chickens was assessed. Differences in virulence were assessed by means of a standardized scoring system for clinical signs. All nine strains were pathogenic to chickens, producing typical clinical signs of infectious coryza. The highest clinical signs score was obtained for serovar C-1 (1.72), while the lowest clinical signs score was obtained for serovar C-4 (0.32). Our results indicate that virulence differences exist among the serovars of H. paragallinarum.

The vaccination-challenge trial: the gold standard test to evaluate the protective efficacy of infectious coryza vaccines

Infectious coryza is an upper respiratory tract disease of chickens with the major impact occurring in multi-age flocks. We investigated the relationship between the level of antibodies, as detected by a haemagglutination-inhibition (HI) assay, in infectious coryza-vaccinated chickens and the protection against challenge in those chickens. In one experiment, chickens given a single dose of either of two infectious coryza vaccines lacked a detectable HI response to vaccination but showed significant levels of protection 11 weeks after vaccination. In contrast, in chickens given two doses of an infectious coryza vaccine and challenged 3 weeks after the second vaccine dose, there was a strong serological response with 36/40 birds having a HI titre of 1/20 or greater. In this trial there was an apparent relationship between titre and subsequent protection, with none of the 32 chickens with a titre of 1/40 or 1/80 showing any clinical signs and only one of the same group yielding the challenge organism on culture. In contrast, three of the four vaccinated chickens with a HI titre less than 1/5 developed the typical clinical signs of coryza and yielded the challenge organism on culture. Overall, our results suggest that HI titres cannot be regarded as a definitive predictor of vaccine efficacy. We suggest that the vaccination-challenge trial is the gold standard for the evaluation of the immune response to infectious coryza vaccines.

Unusual growth variants of Avibacterium paragallinarum.

Two isolates of haemophilic bacteria originally isolated in the 1980s from chickens were re-examined. The addition of a 10% sterile filtrate from an overnight culture of Staphylococcus epidermidis allowed growth of both isolates in solid and liquid media that were otherwise not capable of supporting the growth of these isolates. Using the modified media, genotypic and serotypic studies were performed, which confirmed both isolates to be Avibacterium paragallinarum, with one isolate being serovar A and the other serovar C. The unusual growth requirements of these two isolates reinforces the need for careful interpretation by diagnostic laboratories examining chickens showing signs of upper respiratory tract disease.

Immune responses to hemagglutinin-neuraminidase protein of peste des petits ruminants virus expressed in transgenic peanut plants in sheep

Peste des petits ruminants (PPR) is an acute, highly contagious disease of small ruminants caused by a morbillivirus, Peste des petits ruminants virus (PPRV). The disease is prevalent in equatorial Africa, the Middle East, and the Indian subcontinent. A live attenuated vaccine is in use in some of the countries and has been shown to provide protection for at least three years against PPR. However, the live attenuated vaccine is not robust in terms of thermotolerance. As a step towards development of a heat stable subunit vaccine, we have expressed a hemagglutinin-neuraminidase (HN) protein of PPRV in peanut plants (Arachis hypogea) in a biologically active form, possessing neuraminidase activity. Importantly. HN protein expressed in peanut plants retained its immunodominant epitopes in their natural conformation. The immunogenicity of the plant derived HN protein was analyzed in sheep upon oral immunization. Virus neutralizing antibody responses were elicited upon oral immunization of sheep in the absence of any mucosal adjuvant. In addition, anti-PPRV-HN specific cell-mediated immune responses were also detected in mucosally immunized sheep. (C) 2010 Elsevier B.V. All rights reserved.

刺参急性口围肿胀病和皱纹盘鲍肌肉萎缩症的病理学研究

本论文以大连沿海养殖刺参劾皱纹盘鲍为研究对象，利用组织学、超微病理学、病理生理学的方法，开展了患病病理学研究，并对可能诱发刺参和皱纹盘鲍病害的原因，以及病变过程进行了初步探讨。 中国北方养殖刺参[Apostichopus japonicus (Selenka)]幼参和成参的急性口围肿胀病。急性口围肿胀病是爆发于中国北方辽宁省和山东省沿岸养殖刺参群体中的一种新发现的疾病，并且从2004年开始已经引起刺参的大面积死亡现象，经济损失重大。 本文报道在养殖患病刺参的肠上皮细胞内发现大量的病毒样颗粒。这是首次报道病毒样粒子感染刺参。组织学检查表明该病毒具有包涵体结构，寄生于肠上皮细胞中。电镜检查的结果表明，该病毒粒子呈球形，直径80-100纳米，螺旋状核衣壳，具有囊膜结构且囊膜表面具有纤突结构。 进一步的形态学和病理学分析发现该病毒具有许多报道的关于冠状病毒的特征。细胞质内的 病毒颗粒大部分以团聚方式存在于一个完整的包膜内，形成典型的病毒包涵体结构。最明显的细胞病理学特征是细胞质内大面积的粒状物质的存在，该区域相对缺少相应的细胞器。在病毒包涵体内的管状结构，核衣壳包涵体以及双层膜囊泡也在病变细胞内发现。 在病参体内未发现立克次氏体，衣原体，细菌以及其他寄生生物。 中国北方养殖皱纹盘鲍(Haliotis discus hannai)的肌肉萎缩症病理研究 。 在2004年和2005年的中国北方海区，养殖皱纹盘鲍幼体和成体群体中爆发了严重的肌肉萎缩症。肌电图监测显示病鲍的肌肉萎缩是肌源性的而不是神经源性的。 与正常对照组对比结果显示，病鲍的肌纤维数量和肌纤维直径都显著降低。 肌酶谱测定结果显示，病鲍血清中的肌酸激酶水平，肌酸激酶—肌同工酶水平和乳酸脱氢酶水平，与正常血清对比，呈显著升高状态，说明病鲍体内发生了肌细胞损伤。超薄切片电镜检测结果显示在发生病变的肌细胞内存在双螺旋丝状结构的包涵体（Paired helical filaments, PHFs）, 该结构是人类患包涵体肌炎的主要的病理特征。 本文首次报道在无脊椎动物中发现双螺旋丝包涵体结构。 对损伤的肌纤维的进一步研究发现了异常增生的小圆柱体结构（Small Cylinder Structure, SCS）和致密小体(Dense colored particles, DCP),同时观察到这两种异常结构与肌纤维的损伤直接相关。本文还对该病的感染机制作了探讨。 中国北方皱纹盘鲍(Haliotis discus hannai)肌肉萎缩的病理生理研究。严重的足肌肉萎缩症是鲍的一种慢性致死性疾病。在中国北方的养殖皱纹盘鲍群体中第一次发现是在2000年，随后在各养殖海区，自然海区及实验室养殖过程中都发现了该病的暴发。 超微结构电镜检测显示肌肉纤维损伤严重，其内的大部分肌原纤维断裂或消失。 大量的花瓣状的糖原颗粒聚集在断裂的肌原纤维中，还有一些被包裹在包膜内。 这说明在病鲍体内的糖原代谢处于被抑制状态（或停止状态），随后的血清学检测表明病鲍血清中的葡萄糖含量与正常对照的含量显著降低，也证明了糖代谢途径的终止。病鲍血清中胆固醇和甘油三酯的量显著降低，伴随着高密度脂蛋白的水平显著升高，说明脂肪代谢途径的亢进状态。病鲍血清中的二氧化碳水平的显著降低说明出现了酸碱平衡紊乱，通过病因学分析可知该酸碱平衡紊乱应属于代谢性酸中毒。病鲍血清中的钠离子和钾离子浓度显著升高，无机磷和镁离子浓度显著降低说明出现了患病皱纹盘鲍体内出现了电解质紊乱。病鲍血清中蛋白质含量的检测表明患病皱纹盘鲍已出现低蛋白血症，说明病鲍出现了严重的营养不良。病鲍血清中的尿酸含量，胆碱酯酶水平和γ-转肽酶水平与正常对照组相比显著降低。各项指标检测的结果说明糖代谢途径的终止造成了病鲍一系列的调节体系的不平衡和各种生理功能的紊乱，甚至造成了鲍的最终死亡。

栉孔扇贝对急性病毒性坏死症病毒的生理和免疫应答

栉孔扇贝（Chlamys farreri）是我国北方重要养殖扇贝种类，在海湾扇贝和虾夷扇贝引进以前，其年产量占我国扇贝总产量的80%。但自1997 年以来，我国北方大部分养殖区连续发生养殖栉孔扇贝大批死亡事件，严重影响和损害了栉孔扇贝养殖业的发展。我国栉孔扇贝大规模死亡是多种因素综合作用的结果。大致可分为生物因素与非生物因素：非生物的因素有夏季水温过高、养殖密度过高、养殖环境退化等。生物因素有流行性病原生物的侵害和扇贝种质的退化等。其中，急性病毒性坏死症（Acute Viral Necrobiotic Disease, AVND）病毒造成栉孔扇贝大规模死亡现象的研究已经开展。本研究通过生理学、免疫学技术和手段研究栉孔扇贝对急性病毒性坏死症病毒的生理和免疫应答，以期更好的了解栉孔扇贝对这一病毒的防御机制，为扇贝病害防治提供资料。 本研究对不同温度下栉孔扇贝感染AVND 病毒后的耗氧率和排氨率进行了测定。结果显示，在17℃下，病毒组和注射生理盐水组栉孔扇贝的耗氧率逐渐升高，但两者无显著差异；方差分析显示，各组间排氨率的变化无显著差异。在25℃下，栉孔扇贝闭壳肌注射AVND 病毒和注射生理盐水组栉孔扇贝的耗氧率逐渐升高，在12 小时取得最大值，对照组则变化不大。方差分析显示，注射病毒组与注射生理盐水组和对照组之间有显著差异（P<0.05）。同时，对栉孔扇贝感染AVND 病毒的致病剂量进行了研究，在25℃水温下，栉孔扇贝肌肉注射感染AVND 病毒后，只有150 μl 组表现出明显患病症状并在第三天开始出现死亡现象，注射50、100 μl 组则无明显症状；17℃下栉孔扇贝感染AVND 病毒后无明显患病症状，表明AVND 病毒对栉孔扇贝的感染致病具有剂量和温度依赖性。 对于25℃水温下栉孔扇贝感染AVND 病毒后血清中相关免疫酶类活力变化进行了测定。栉孔扇贝感染AVND 病毒后血清中SOD 的活性逐渐升高，在48小时达到最大值，方差分析显示不同时间点之间的SOD 活性有显著差异（P<0.05），在48 小时，病毒组和生理盐水组间的SOD 活性有显著差异（P<0.05），在其它时间点无显著差异。酸性磷酸酶（ACP）的活力在感染病毒2 小时后升高，在12 小时下降，然后又升高，在48 小时达到最大值。方差分析显示不同时间点之间的ACP 活性有显著差异（P<0.05），在2 小时和48 小时，病毒组和生理盐水组间的ACP 活性有显著差异（P<0.05）。碱性磷酸酶（AKP）的活力变化趋势与ACP 相同，在24 小时达到最大值。方差分析显示不同时间点之间的AKP 活性有显著差异（P<0.05）。在2 小时、12 小时、24 小时病毒组和生理盐水组间有显著差异（P<0.05）。栉孔扇贝酚氧化酶的活性最大值在48 小时，但与生理盐水对照组之间无显著差异。溶菌酶（Lysozyme）活性在病毒组和生理盐水对照组间无显著差异，病毒组最大值在2 小时取得，对照组在24 小时取得。结果表明栉孔扇贝通过升高或调节自身免疫相关蛋白酶类合成应对AVND 病毒侵染。 采用荧光实时定量PCR 技术，对栉孔扇贝感染AVND 病毒后免疫相关基因的时空表达规律进行了研究。水温17℃下，栉孔扇贝肌肉注射感染AVND 病毒后超氧化物歧化酶（SOD）基因mRNA 的表达量逐渐上升，在注射后24 小时达到最大值，约为空白对照组的1.8 倍，方差分析显示，病毒组SOD 的表达量不同时间点之间有显著变化（P<0.05）；但与生理盐水对照组相比较，病毒组SOD表达量无显著差异。在水温25℃下SOD 基因mRNA 的表达量逐渐上升，在注射后6 小时达到最大值，约为对照组的1.5 倍，空白对照组的2.2 倍。病毒组SOD的表达量不同时间点之间有显著差异（P<0.05）；在感染后2、6、12、24 小时病毒组SOD 表达量比对照组有显著升高（P<0.05）。溶菌酶基因在肝胰脏中的表达升高，在6 小时达到最大值，约为生理盐水对照组的1.5 倍，空白对照组的2.7倍，在48 小时取得最小值（低于空白对照组）。病毒感染后不同时间之间溶菌酶基因表达有显著差异（P<0.05），感染后6、24 和48 小时病毒组溶菌酶基因表达比对照组有显著升高（P<0.05）。在AVND 病毒感染后6 小时，在肝胰脏、性腺、肌肉、鳃中溶菌酶mRNA 量急剧增加，分别达到了空白对照组的4.7 倍、3.8 倍、13.43 倍和25.15 倍。方差分析显示在不同组织部位的表达有显著差异（P<0.05）。表明AVND 病毒感染后栉孔扇贝免疫相关基因的表达具有时序性和组织部位特异性。

Trade-offs between cancer and other diseases: do they exist and influence longevity?

Relationships between aging, disease risks, and longevity are not yet well understood. For example, joint increases in cancer risk and total survival observed in many human populations and some experimental aging studies may be linked to a trade-off between cancer and aging as well as to the trade-off(s) between cancer and other diseases, and their relative impact is not clear. While the former trade-off (between cancer and aging) received broad attention in aging research, the latter one lacks respective studies, although its understanding is important for developing optimal strategies of increasing both longevity and healthy life span. In this paper, we explore the possibility of trade-offs between risks of cancer and selected major disorders. First, we review current literature suggesting that the trade-offs between cancer and other diseases may exist and be linked to the differential intensity of apoptosis. Then we select relevant disorders for the analysis (acute coronary heart disease [ACHD], stroke, asthma, and Alzheimer disease [AD]) and calculate the risk of cancer among individuals with each of these disorders, and vice versa, using the Framingham Study (5209 individuals) and the National Long Term Care Survey (NLTCS) (38,214 individuals) data. We found a reduction in cancer risk among old (80+) men with stroke and in risk of ACHD among men (50+) with cancer in the Framingham Study. We also found an increase in ACHD and stroke among individuals with cancer, and a reduction in cancer risk among women with AD in the NLTCS. The manifestation of trade-offs between risks of cancer and other diseases thus depended on sex, age, and study population. We discuss factors modulating the potential trade-offs between major disorders in populations, e.g., disease treatments. Further study is needed to clarify possible impact of such trade-offs on longevity.

High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort

Aims
Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population.

Methods and results
High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events.

Conclusion
Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.

Recombinant Subgroup B Human Respiratory Syncytial Virus Expressing Enhanced Green Fluorescent Protein Efficiently Replicates in Primary Human Cells and Is Virulent in Cotton Rats

Human respiratory syncytial virus (HRSV) is the most important viral cause of severe respiratory tract disease in infants. Two subgroups (A and B) have been identified, which cocirculate during, or alternate between, yearly epidemics and cause indistinguishable disease. Existing in vitro and in vivo models of HRSV focus almost exclusively on subgroup A viruses. Here, a recombinant (r) subgroup B virus (rHRSV(B05)) was generated based on a consensus genome sequence obtained directly from an unpassaged clinical specimen from a hospitalized infant. An additional transcription unit containing the gene encoding enhanced green fluorescent protein (EGFP) was introduced between the phosphoprotein and matrix genes (position 5) of the genome to generate rHRSV(B05)EGFP(5). The recombinant viruses replicated efficiently in both HEp-2 cells and in well-differentiated normal human bronchial cells grown at air-liquid interface. Intranasal infection of cotton rats (Sigmodon hispidus) resulted in high numbers of EGFP(+) cells in epithelia of the nasal septum and conchae. When administered in a relatively large inoculum volume, the virus also replicated efficiently in bronchiolar epithelial cells and spread extensively in both the upper and lower respiratory tracts. Virus replication was not observed in ciliated epithelial cells of the trachea. This is the first virulent rHRSV strain with the genetic composition of a currently circulating wild-type virus. In vivo tracking of infected cells by means of EGFP fluorescence in the absence of cytopathic changes increases the sensitivity of virus detection in HRSV pathogenesis studies.

IMPORTANCE

Virology as a discipline has depended on monitoring cytopathic effects following virus culture in vitro. However, wild-type viruses isolated from patients often do not cause significant changes to infected cells, necessitating blind passage. This can lead to genetic and phenotypic changes and the generation of high-titer, laboratory-adapted viruses with diminished virulence in animal models of disease. To address this, we determined the genome sequence of an unpassaged human respiratory syncytial virus from a sample obtained directly from an infected infant, assembled a molecular clone, and recovered a wild-type recombinant virus. Addition of a gene encoding enhanced green fluorescent protein allowed this wild-type virus to be tracked in primary human cells and living animals in the absence of significant cytopathic effects. Imaging of fluorescent cells proved to be a highly valuable tool for monitoring the spread of virus and may help improve assays for evaluating novel intervention strategies.

Relative Contribution of P5 and Hap Surface Proteins to Nontypable Haemophilus influenzae Interplay with the Host Upper and Lower Airways

Nontypable Haemophilus influenzae (NTHi) is a major cause of opportunistic respiratory tract disease, and initiates infection by colonizing the nasopharynx. Bacterial surface proteins play determining roles in the NTHi-airways interplay, but their specific and relative contribution to colonization and infection of the respiratory tract has not been addressed comprehensively. In this study, we focused on the ompP5 and hap genes, present in all H. influenzae genome sequenced isolates, and encoding the P5 and Hap surface proteins, respectively. We employed isogenic single and double mutants of the ompP5 and hap genes generated in the pathogenic strain NTHi375 to evaluate P5 and Hap contribution to biofilm growth under continuous flow, to NTHi adhesion, and invasion/phagocytosis on nasal, pharyngeal, bronchial, alveolar cultured epithelial cells and alveolar macrophages, and to NTHi murine pulmonary infection. We show that P5 is not required for bacterial biofilm growth, but it is involved in NTHi interplay with respiratory cells and in mouse lung infection. Mechanistically, P5NTHi375 is not a ligand for CEACAM1 or α5 integrin receptors. Hap involvement in NTHi375-host interaction was shown to be limited, despite promoting bacterial cell adhesion when expressed in H. influenzae RdKW20. We also show that Hap does not contribute to bacterial biofilm growth, and that its absence partially restores the deficiency in lung infection observed for the ΔompP5 mutant. Altogether, this work frames the relative importance of the P5 and Hap surface proteins in NTHi virulence.