梅毒螺旋体重组蛋白Tp0136的表达、纯化及免疫活性分析

【摘要】 目的 克隆并表达梅毒螺旋体Tp0136基因,对其表达产物进行纯化以及免疫活性分析。方法 全基因合成Tp0136基因,构建E.coli表达载体;诱导表达并纯化重组蛋白,用SDS-PAGE和Western印迹鉴定。用纯化的重组蛋白Tp0136免疫新西兰兔,并以重组Tp0136作为包被抗原建立间接酶联免疫吸附试验（ELISA）以鉴定其免疫原性,Western印迹检测梅毒阳性血清鉴定其免疫反应性。结果 成功构建E.coli表达载体pET28a-Tp0136,并表达和纯化出膜蛋白Tp0136,相对分子质量为50 000,纯度 > 95%。用重组蛋白Tp0136免疫新西兰兔,能刺激其产生高滴度抗体,具有较强的免疫原性。Western印迹显示其能与梅毒阳性血清发生特异性反应,具有较好的免疫反应性。结论 成功表达具有Tp0136全基因和较强免疫活性的膜蛋白,Ｔp０１３６可能在梅毒螺旋体的免疫致病机制中起到重要作用。     

梅毒螺旋体TP0136蛋白的研究进展

黏附介导的微生物定植在病原菌感染的起始阶段发挥重要作用,特别是能黏附到宿主多个组织器官,导致全身性播散,引起梅毒螺旋体(Tp)的感染。因此如何能在感染早期通过阻断Tp黏附到宿主成分从而避免传播成为近年研究热点。TP0136蛋白作为三种已知能黏附到细胞外基质纤连蛋白的Tp蛋白之一,在Tp的黏附定植和病原体感染早期发挥重要作用。本文对TP0136蛋白作为Tp重要的黏附蛋白在梅毒致病机制、临床检测和疫苗开发中的研究价值三方面进行综述。     

梅毒免疫研究进展

 梅毒是由梅毒螺旋体感染引起的一种性传播疾病,主要通过黏膜或受伤的皮肤传播,其临床表现复杂多样,几乎可侵犯全身各器官。机体对于梅毒螺旋体的免疫应答过程十分复杂,固有免疫、细胞免疫及体液免疫均参与该过程。梅毒螺旋体免疫逃逸机制尚未明确。梅毒螺旋体免疫应答及免疫逃逸机制的研究,可为梅毒发病机制的进一步明确及疫苗的研制奠定基础。本文综述梅毒免疫以上几个方面的研究进展。     

梅毒螺旋体Tp0453重组蛋白的表达纯化及免疫活性研究

目的表达梅毒螺旋体膜蛋白Tp0453(28-288 aa),纯化表达产物并进行免疫活性分析,为探索Tp0453重组蛋白在梅毒血清学诊断中的应用提供实验依据。方法通过生物信息学分析,挑选Tp0453抗原的优势表位,进行诱导表达;以W estern-b lot和间接ELISA法检测重组蛋白的免疫反应性;用重组蛋白免疫新西兰家兔,评价其免疫原性。结果纯化后获得了相对分子量约为32×103的融合蛋白。W estern-b lot检测其能与梅毒患者阳性血清发生特异性反应;同时以重组蛋白为包被抗原建立间接ELISA法,检测梅毒诊断试剂参考血清,其阴阳性符合率均为100%。用纯化的Tp0453重组蛋白免疫新西兰家兔,能诱导其产生特异性免疫应答,ELISA法测定免疫血清中特异性抗体滴度在1∶1280以上。结论基因重组表达的Tp0453重组蛋白具有良好的免疫原性和免疫反应性,为进一步研究其在梅毒血清学诊断中的应用和其生物学功能奠定了基础。     

梅毒螺旋体Tp0821基因的克隆、表达、纯化及免疫活性研究

目的 构建梅毒螺旋体(Tp)膜脂蛋白Tp0821的重组质粒,表达、纯化其相应蛋白,研究其免疫活性.方法 构建重组质粒pQE32/Tp082l,诱导表达其相应蛋白,以纯化的重组蛋白免疫新西兰兔,制备多克隆抗体并测定其效价.建立间接ELISA法,检测80份梅毒参比血清、临床经FTA-ABS确诊的阳性血清各150份.结果 成功构建重组质粒pQE32/Tp0821,十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)分析重组蛋白分子量与预期结果相符.将亲和层析后所获高纯度重组蛋白免疫新西兰兔,制备的多克隆抗体效价达1:6400.间接ELISA法检测梅毒参比血清、临床梅毒患者血清,与间接免疫荧光螺旋体抗体吸附试验(FTA-ABS)法比较,其灵敏度、特异度分别为92.6%和98.6%,差异有统计学意义(P<0.05).结论 Tp0821重组蛋白具有较好的免疫活性,可用于梅毒血清学检测.     

梅毒螺旋体Tp0319重组蛋白的表达及免疫活性研究

目的 克隆和表达梅毒螺旋体Tp0319基因,并对其表达产物进行免疫活性分析。方法 挑选并克隆出Tp0319免疫优势区基因,构建原核表达载体;诱导表达并纯化重组蛋白,用十二烷基硫酸钠-聚丙烯酰胺凝胶电泳（SDS-PAGE）和Western印迹法鉴定;用纯化的重组蛋白免疫新西兰兔;间接ELISA法检测梅毒螺旋体参考血清及临床标本。结果 成功构建原核表达载体pQE32/Tp0319;高效表达和纯化出一相对分子质量约30 000的重组蛋白。用重组蛋白免疫新西兰兔,能刺激其产生高水平抗体滴度。Western印迹证明其能与梅毒患者血清发生特异性反应,阴性对照菌未见目的表达条带。间接ELISA法检测80份梅毒螺旋体参考血清（阴性、阳性各40份）,阳性和阴性结果的符合率均为100%。检测200份临床梅毒血清标本及200份正常人血清,结果与梅毒螺旋体明胶凝集试验相比,灵敏度和特异度分别为92.6%和100%,符合率为96%。结论 制备的Tp0319重组蛋白具有良好的免疫活性,为进一步研究其在梅毒血清学诊断中的应用奠定一定的基础。     

梅毒螺旋体重复基因K与梅毒持续感染

近年来,全球梅毒发病率呈现上升趋势。梅毒螺旋体（ Tp）作为梅毒的致病病原体,可引起宿主慢性持续感染。 Tp是如何出现抗原变异从而逃避宿主免疫识别,最终导致持续感染正成为近年研究热点。 Tp重复基因K（ tprK）作为Tp重复基因（ tpr）家族成员之一,由于其基因序列具有高度可变性,在Tp逃避宿主免疫监视、造成慢性感染中发挥重要作用。本文从tprK来源、基因结构特点、抗原变异和免疫逃逸机制及研究应用等方面对其进行综述。     

基于梅毒核酸疫苗pcD/Tp92的不同接种策略

目的 评估基于梅毒核酸疫苗pcD/Tp92的各接种优化策略对新西兰兔梅毒螺旋体(Tp)皮肤感染的免疫保护效应.方法 核酸疫苗pcD/Tp92采用2次肌内注射免疫或肌内注射初免鼻饲加强的免疫方式结合黏膜佐剂CpG ODN及Tp92重组蛋白,分别或联合免疫新西兰兔.酶联免疫吸附法(ELISA)检测各接种策略组免疫期间(0~8周)兔特异性抗体产生及变化水平,免疫8周后兔鼻咽部、阴道黏膜SIgA产生水平及兔脾细胞IL-2、γ干扰素(IFN-γ)诱导水平,噻唑蓝法(MTT)检测兔脾淋巴细胞增殖水平.记录各组在初次免疫后第10周兔皮下接种Tp标准株感染后接种部位感染早期皮损的变化.结果 采用pcD/Tp92核酸疫苗肌内注射初免,CpG-ODN联合Tp92重组蛋白抗原鼻饲新西兰兔加强免疫的接种策略组(C2组)分别与pcD/Tp92疫苗肌注组(A2组),pcD/Tp92疫苗肌注初免,pcD/Tp92鼻饲加强免疫组(B1组)或结合黏膜佐剂CpG ODN联合免疫的接种策略组(B2组)相比,既能促进pcD/Tp92核酸疫苗在兔体内免疫期间(8周)诱生更高特异性抗体水平(C2组:1.825±0.175;A2组:1.372±0.322;B1组:0.893±0.297;B2组:1.294±0.124;P<0.05),IL-2(C2组:154.7±14.6;A2组:112.3±13.4;B1组:76.6±21.5;B2组:97.3±18.7;P<0.05)及IFN-γ(C2组:277.4±24.4;A2组:232.8±25.3;B1组:165.7±22.6;B2组:211.3±24.6;P<0.05)分泌水平,以及更高的T细胞增殖分化水平(SI C2组:3.57±0.24;A2组:3.08±0.22;B1组:2.12±0.14;B2组:2.88±0.18;P<0.05),还能刺激更高的黏膜特异性SIgA抗体,导致最低Tp感染部位皮损Tp阳性率(6.67%)及溃疡病灶形成率(6.67%)从而达到有效的保护作用.结论 pcD/Tp92核酸疫苗肌内注射初免,CpG ODN联合Tp92重组蛋白鼻饲加强免疫的接种策略能在新西兰兔体内诱导最强的黏膜免疫和免疫保护效应.     

梅毒螺旋体Tp0844重组蛋白的表达、纯化及免疫反应性研究

目的 克隆、表达梅毒螺旋体重组蛋白Tp0844,纯化表达产物并进行免疫反应性分析,筛选与宿主具有高反应性的Tp主要蛋白。 方法 通过生物信息学分析,获取Tp0844基因序列,构建原核载体进行诱导表达;Ni-NTA亲合层析柱纯化重组蛋白,Western印迹法检测其重组蛋白与梅毒阴阳性血清的反应情况。结果 成功构建PET-30a（+）-Tp0844原核表达重组体,经诱导表达后发现该重组体可高表达出可溶性的重组蛋白,经亲和层析纯化后获得了相对分子质量为43 000的重组蛋白;以梅毒IgG抗体阴、阳性血清为一抗,采用Western印迹法检测发现,Tp0844重组蛋白与梅毒阳性血清能发生明显特异反应,而与健康阴性血清未出现反应条带。 结论 可溶性重组表达的Tp0844蛋白具有较好的免疫反应性,可作为梅毒发病机制研究的候选抗原。     

梅毒免疫和梅毒螺旋体的研究进展

梅毒螺旋体有着独特的基因和蛋白结构,对其基因分型有利于梅毒分子流行病学的研究.梅毒螺旋体缺乏脂多糖与外膜蛋白,但可表达多种脂蛋白,这些脂蛋白同梅毒螺旋体的组织黏附及播散有关,同时可诱导机体发生免疫应答.机体对于梅毒螺旋体的免疫应答过程十分复杂,固有免疫、体液免疫及细胞免疫均在梅毒螺旋体的感染过程中参与了应答过程.Th1型细胞免疫在梅毒的发生发展过程中起重要作用,梅毒患者在局部及系统免疫方面都存在细胞免疫的异常.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Evidence‐based skin care in preterm infants

Most guidelines on neonatal skin care emphasize issues pertaining to healthy, term infants. Few address the complex task of skin barrier maintenance in preterm, very preterm, and extremely preterm infants. Here, we provide an evidence‐based review of the literature on skin care of preterm neonates. Interestingly, the stratum corneum does not fully develop until late in the third trimester, and as such, the barrier function of preterm skin is significantly compromised. Numerous interventions are available to augment the weak skin barrier of neonates. Plastic wraps reduce the incidence of hypothermia while semipermeable and transparent adhesive dressings improve skin quality and decrease the incidence of electrolyte abnormalities. Tub bathing causes less body temperature variability than sponge bathing and can be performed as infrequently as once every four days without increasing bacterial colonization of the skin. Topical emollients, particularly sunflower seed oil, appear to reduce the incidence of skin infections in premature neonates—but only in developing countries. In developed countries, studies indicate that topical petrolatum ointment increases the risk of candidemia and coagulase‐negative Staphylococcus infection in the preterm population, perhaps by creating a milieu similar to occlusive dressings. For preterm infants with catheters, povidone‐iodine and chlorhexidine are comparably effective at preventing catheter colonization. Further studies are necessary to examine the safety and efficacy of various skin care interventions in premature infants with an emphasis placed on subclassifying the patient population. In the interim, it may be beneficial to develop guidelines based on the current body of evidence.     

Occupational allergic contact dermatitis from spices

About 1000 patients were investigated at our clinic during 1991 for occupational skin disease. and 5 had occupational allergic contact dermatitis from spices. The patients were chefs, or kitchen, coffee room, and restaurant workers. All patients had hand (or finger) dermatitis. The causative spices were: garlic, cinnamon, ginger, allspice and clove, The same patients also had allergic patch test reactions to foods: tomato, lettuce and carrot. Paprika elicited a weak allergic patch test reaction in 2 patients. Occupational allergic contact dermatitis from spices is relatively rare, but needs to be taken into consideration in patients who have hand dermatitis, and work with spices and foods, Patch testing with spices as is useful, but testing with dilutions in pet, may be needed to confirm that the patch test reactions are allergic. Patients also need to be prick tested with spices and foods.     

Subfascial endoscopic perforator vein surgery

Chronic venous insufficiency is a tremendous health care problem in western societies. Venous disease can affect any combination of the superficial, deep, and perforator venous systems of the lower extremities. Generally the superficial venous deficits are addressed through sclerotherapy, enovenous ablation, stab phlebectomy, and or stripping. Patients with advanced clinical sequelae (lipodermatosclerosis or ulceration) of CVI should also be evaluated for the presence of incompetent perforating veins. Open surgical approached to the calf perforating veins (ie. Linton procedure) were complicated by significant wound complications and have largely been replaced by the less invasive Subfascial Endoscopic Perforator Surgery (SEPS). The use of SEPS in patients with ulceration has been shown to be safe and to reduce the time that patients will have ulcers during follow-up. This chapter will review the pathophysiology, diagnosis, and treatment of incompetent perforating veins of the legs with particular attention to surgical issues.