Synthesis and ligand binding of cocaine isomers at the cocaine receptor

The cocaine binding site at the dopamine transporter has been found to be stereoselective. Thus, the seven possible stereoisomers of (-)-cocaine have been synthesized and found to inhibit [3H]-2 beta-carbomethoxy-3 beta-(4-fluoro-phenyl)tropane [( 3H]WIN 35,428) with potencies ranging from 1/60 to 1/600 of that of (-)-cocaine. The synthesis and characterization of all new compounds is presented.     

Importance of immunoglobulin isotype in human antibody-dependent, cell- mediated cytotoxicity directed by murine monoclonal antibodies

Using the fluorescence activated cell sorter to select rare IgG2a- and IgG2b-producing variants, we developed switch variant families of hybridomas from IgG1-producing hybridomas, ME1 and MA2.1. The IgG2a and IgG2b antibodies produced by such switch variants have the same binding activities for HLA as the IgG1 antibodies produced by the parent hybridomas. Using these antibodies, we directly compared the IgG1, IgG2a, and IgG2b murine Ig isotypes for their capacities to direct human peripheral blood lymphocytes (PBL) in antibody-dependent cell-mediated cytotoxicity (ADCC) against a B lymphoblastoid cell line. We demonstrate that, for antibodies of identical binding affinity and specificity, the murine IgG2a isotype is the most effective in directing ADCC by human effector cells. The murine IgG2b directs intermediate levels of ADCC activity while IgG1 is inactive. We identified the effector cells in human PBL that mediate IgG2a or IgG2b ADCC as nonadherent killer (K) cells. These cells express the C3bi receptor and have cytolytic activity which is specifically blocked by a monoclonal antibody (anti-Leu-11a) that binds the Fc receptor (FcR) of such cells. Finally, FcR-bearing K cells bind to target cell-bound, rather than free, IgG2a or IgG2b molecules.     

Chromosomally and Extrachromosomally Mediated High-Level Gentamicin Resistance in Streptococcus agalactiae

Streptococcus agalactiae (group B Streptococcus [GBS]) is a leading cause of sepsis in neonates. The rate of invasive GBS disease in nonpregnant adults also continues to climb. Aminoglycosides alone have little or no effect on GBS, but synergistic killing with penicillin has been shown in vitro. High-level gentamicin resistance (HLGR) in GBS isolates, however, leads to the loss of a synergistic effect. We therefore performed a multicenter study to determine the frequency of HLGR GBS isolates and to elucidate the molecular mechanisms leading to gentamicin resistance. From eight centers in four countries, 1,128 invasive and colonizing GBS isolates were pooled and investigated for the presence of HLGR. We identified two strains that displayed HLGR (BSU1203 and BSU452), both of which carried the aacA-aphD gene, typically conferring HLGR. However, only one strain (BSU1203) also carried the previously described chromosomal gentamicin resistance transposon designated Tn3706. For the other strain (BSU452), plasmid purification and subsequent DNA sequencing resulted in the detection of plasmid pIP501 carrying a remnant of a Tn3 family transposon. Its ability to confer HLGR was proven by transfer into an Enterococcus faecalis isolate. Conversely, loss of HLGR was documented after curing both GBS BSU452 and the transformed E. faecalis strain from the plasmid. This is the first report showing plasmid-mediated HLGR in GBS. Thus, in our clinical GBS isolates, HLGR is mediated both chromosomally and extrachromosomally.     

Students’ self-perceptions of interprofessional education following participation on a diagnostic team for autism spectrum disorder

Interprofessional education is essential for producing future allied-health and education professionals. Unfortunately, opportunities for students to get authentic interprofessional field-based experiences are lacking. This pilot study explored students’ self-perceptions towards interprofessional education (IPE) following participation on an interprofessional diagnostic team designed to rule in or out the diagnosis of autism spectrum disorder (ASD). Thirty-nine students from seven professions responded to a survey before and after completing this interprofessional education experience. The results indicated that the students’ self-perceptions remained consistent during the experience. They reflected positive self-perceptions in the areas of collaboration, professional identity, and the desire to work with others, all in the context of an ASD-focused team. The findings suggest that students entering the IPE experience with positive expectations remained positive during the experience. This pilot study provides support for the benefits of providing students with the opportunity to engage in authentic collaborative practice when working with children with ASD.     

Consensus of microbiology reporting of ear swab results to primary care clinicians in patients with otitis externa

Otitis externa is a ubiquitous inflammatory disease; although it arises most commonly from an infection, there is no consensus in the UK for the reporting of ear swab culture results. This study aims to review current microbiology laboratory reporting of ear swab specimens to primary care and reach an evidence-based consensus for a reporting policy. Fifty consecutive ear swab reports were reviewed from each of 12 laboratories in the South West region to determine and discuss reporting practice. The Health Protection Agency (HPA) GP Microbiology Laboratory Use Group reviewed the underlying evidence and worked towards a consensus of expert microbiology opinion for laboratory reporting of ear swab results using a modified version of the Delphi technique. A total of 487 reports from primary care were reviewed (54% female; 46% male). Cultures most commonly yielded Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%) and fungi (11%). Five reporting policies were agreed: Policy 1: Common pathogens such as group A beta-haemolytic streptococci, Streptococcus pneumoniae, Staphylococcus aureus - Always reported by name with antibiotic susceptibilities. Policy 2: Pseudomonas species - Always reported, but antibiotic susceptibilities only reported in severe disease. Policy 3: Aspergillus, Candida, coliforms and Proteus species, as well as non-group A streptococci and anaerobes - Only reported if moderate numbers of colonies and it is the predominant organism present; if appropriate report antibiotic susceptibilities. Policy 4: Coagulase-negative staphylococci, diphtheroids and enterococci - Not reported by name; generic terms used and antibiotic susceptibilities not reported. Policy 5: When antibiotic susceptibilities reported these must include susceptibility to a topical antibiotic. It is suggested that laboratories should consider adopting this evidence-based reporting consensus for ear swab culture results from primary care patients with otitis externa.