Hemagglutination and proteoglycan binding by the Lyme disease spirochete, Borrelia burgdorferi.

The ability of the Lyme disease spirochete to attach to host components may contribute to its ability to infect diverse tissues. We present evidence that the Lyme disease spirochete expresses a lectin activity that promotes agglutination of erythrocytes and bacterial attachment to glycosaminoglycans. Among a diverse collection of 21 strains of Lyme disease spirochete, hemagglutinating activity was easily detected in all but 3 strains, and these three strains were noninfectious. The ability to agglutinate erythrocytes was associated with the ability of the spirochete to bind to the sulfated polysaccharide dextran sulfate and to mammalian cells. Soluble dextran sulfate was a potent inhibitor of both hemagglutination and attachment to mammalian cells, while dextran had no effect on either activity, suggesting that dextran sulfate may inhibit attachment by mimicking host cell glycosaminoglycans. Consistent with this, the spirochete bound to immobilized heparin, and soluble heparin inhibited bacterial adhesion to mammalian cells. The bacterium did not bind efficiently to Vero cells treated with heparinase or heparitinase or to mutant CHO cell lines that are deficient in proteoglycan synthesis. Sulfation of glycosaminoglycans was critical for efficient bacterial recognition, as Vero cells treated with an inhibitor of sulfation, or a mutant CHO cell line that produces undersulfated heparan sulfate, did not mediate maximal spirochetal binding. Binding of the spirochete to extracellular matrix also appeared to be dependent upon this attachment pathway. These findings suggest that a glycosaminoglycan-binding activity which can be detected by hemagglutination contributes to the attachment of the Lyme disease spirochete to host cells and matrix.     

Conjunctival cytologic features of primary Sj?gren's syndrome.

To determine whether there are specific cytologic features associated with primary Sj?gren's syndrome (SS), the authors evaluated impression cytology specimens from three conjunctival sites (temporal bulbar [TB], inferior bulbar [IB], and inferior tarsal [IT]) from 38 SS eyes, 34 eyes of aqueous tear-deficient patients without SS, 35 eyes of seborrheic blepharitis patients, and 17 eyes of normal controls in a masked fashion. The following features were observed more frequently in SS eyes than in the eyes of the other groups: squamous metaplasia of the TB and IB (P less than 0.05), extensive (greater than 75%) goblet cell loss of the TB (P less than 0.05), mucous aggregates of the bulbar conjunctiva (P less than 0.05), and inflammatory cells intercalated with epithelial cells on the IT conjunctiva (P less than 0.06). The conjunctival inflammatory cell infiltrate correlated with the presence of extensive squamous metaplasia (P less than 0.01) in SS specimens. The inflammatory cells on the IT conjunctival epithelium were found to consist predominantly of T-lymphocytes by immunofluorescent staining of cytologic specimens from six eyes. Based on these findings, the authors speculated that conjunctival squamous metaplasia, in addition to aqueous tear deficiency, may be due to primary involvement of the dysfunctional immune system of SS.     

Ten cases of transitional cell carcinoma of bladder causing ureteric obstruction

A review was carried out on 10 patients with superficial transitional cell carcinoma of the bladder (Ta lesions) that were causing ureteric obstruction. Evidence of upper tract obstruction did not necessarily indicate deep invasion.     

Therapy of post-renal transplantation hyperlipidaemia: comparative study with simvastatin and fish oil

Background: Recipients of renal transplantation (RT) exhibit disturbances of serum lipids and apoproteins that may contribute to their cardiovascular morbidity and mortality. In our renal transplant department the hypercholesterolaemia prevalence at the first and fifth year of RT is 70.0% and 81.2%, respectively. Lipid-lowering therapy has been utilized in many Transplant Units. The aim of our study was to evaluate post-RT hyperlipidaemia control with simvastatin or fish oil. Method: Forty-three RT patients (26 men and 17 women) with persistent hypercholesterolaemia and stable graft function which were resistant to a lipid-lowering diet (American Heart Association Step Two) were randomized into two groups and treated for 3 months with simvastatin (S) (10 mg/day; n=25) and fish oil (F) (6 g/day; n=18). Total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), lipoprotein a (Lp(a)), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were monitored and at the study baseline they were similar between the two groups. Results: No side effects were detected after 3 months of therapy. In group S, the concentrations of TC (271±46 mg% vs 228±49mg%; P <0.001), TG (180±78 vs 134±45; P<0.01), LDL-C (177& plusmn;40 vs 144±43; P <0.01) and Apo B (96±18 vs 82±16; P <0.001) were significantly reduced, and Apo A1 concentration had increased (135±24 vs 149±30; P <0.01). In group F, the concentrations of TC (266±25 vs 240±31; P <0.001), TG (203±105 vs 156±72; P=0.02) and HDL-C (63±15 vs 53±12; P <0.01) were significantly reduced. Conclusion: We concluded that low-dose simvastatin and fish oil are both effective and safe in correcting post-RT hyperlipidaemia. Further prospective studies with larger follow-up are needed to clarify whether this therapy has an impact on cardiovascular morbidity and mortality in RT patients.     

Detection of HIV1 proviral DNA by PCR and hybridization with digoxigenin labelled probes.

One of the main obstacles for the introduction of PCR method to identify HIV1 proviral DNA in routine diagnostic laboratories is the use of radiolabelled oligodeoxynucleotide probes. Nonradioactive labelled probes have several advantages over radioactive labelling: they are stable for over 1 year, they can be produced easily in large amounts and they are safe. Polymerase chain reaction is an efficient and simple method to produce vector free inserts to use as probes. In this paper we describe a procedure for labelling DNA probes with digoxigenin-11-dUTP using the polymerase chain reaction. This non-radioactive labelling system was applied to detect HIV proviral sequences, amplified in vitro by PCR, from peripheral blood mononuclear cells DNA of infected subjects. We found identical sensitivities and specificities for probes synthesized with the non-radioactive and radioactive labelling procedures. The digoxigenin-11-dUTP can be efficiently incorporated during amplification of a DNA fragment using the polymerase chain reaction. This labelling and detection method proved to be specific, sensible and simple enough to be used in routine diagnostic laboratories for the detection of HIV1 infected individuals.     

Choreic syndrome and coeliac disease: a hitherto unrecognised association.

Coeliac disease has been associated with a variety of neurological conditions, most frequently cerebellar ataxia and peripheral neuropathy. To date, chorea has not been associated with coeliac disease. We present the case histories of 4 individuals with coeliac disease and chorea (4 women, average age of onset of chorea 61 years). Unexpectedly, most of these patients showed a notable improvement in their motor symptoms after the introduction of a gluten-free diet.     

Manifestations of insulin-dependent diabetes mellitus in the periodontium of young Brazilian patients

The periodontal condition of patients with insulin-dependent diabetes mellitus was evaluated in terms of plaque, gingival indices, pocket depth, and alveolar bone loss. Thirty male and female diabetic patients aged 5 to 18 years were compared with 30 non-diabetic subjects and correlated with sex and age. Statistical analyses of the data showed that the mean plaque index was significantly higher (P less than 0.01) among the diabetic patients (1.23) than among the control subjects (0.81). The plaque index was significantly higher (P less than 0.01) among diabetic females (1.34) than among diabetic males (1.10), whereas no sex differences were observed in the control group. The arithmetic means obtained for gingival index were statistically higher (P less than 0.01) for the diabetics (0.58) when compared with the controls (0.15), but no significant differences were obtained when the values were correlated with sex and age. Pocket depth did not differ statistically between groups. When pocket depth was correlated with sex, a statistically significant difference (P less than 0.05) was observed only for the palatal region, with a depth of 2.1 mm in female patients and 1.92 mm in male patients. When pocket depth was correlated with age, a positive correlation (P less than 0.01) was detected in the diabetic group for all regions investigated, whereas the correlation was not significant in the control group. Mean alveolar bone loss was higher in the anterior upper (1.94 mm) and anterior lower (1.87 mm) regions of the diabetic group when compared to the controls (1.52 and 1.37 mm respectively), the difference being significant at the 5% level of probability.(ABSTRACT TRUNCATED AT 250 WORDS)