J. Remington - Academia.edu (original) (raw)

Papers by J. Remington

Bulletin of the Entomological Society of America, 1976

Archives of Ophthalmology, 1959

Current clinical topics in infectious diseases, 2000

Infection and immunity, 1993

Toxoplasma gondii is capable of invading and multiplying within murine peritoneal macrophages. Pr... more Toxoplasma gondii is capable of invading and multiplying within murine peritoneal macrophages. Previous studies have shown that treatment of macrophage monolayers with recombinant gamma interferon but not tumor necrosis factor (TNF) is associated with intracellular killing of T. gondii by macrophages. Furthermore, infection of macrophages with T. gondii prevents their stimulation for mycobactericidal activity by TNF. Since transforming growth factor beta (TGF-beta) is known to suppress a number of functions in macrophages, we investigated the influence of infection with T. gondii on macrophage TNF receptors and on production of TGF-beta. Infection with T. gondii was associated with increased production of TGF-beta and downregulation of TNF receptors. This effect was observed early after infection and was partially inhibited by anti-TGF-beta 1 antibody.

Molecular and Biochemical Parasitology, 1989

By screening cDNA libraries in lambda gt11 with antibodies raised against the previously describe... more By screening cDNA libraries in lambda gt11 with antibodies raised against the previously described protective F3G3 antigen of Toxoplasma gondii, and subsequently screening with nucleic acid probes, we have isolated cDNA clones that encode a 28 kDa antigen of T. gondii that is likely one of the two antigenic components of the F3G3 antigen. The gene apparently exists as a single copy in the tachyzoite haploid genome of the three strains of T. gondii examined. Northern blot analyses revealed that the cDNAs hybridize with a major T. gondii RNA species of 1.1 kb. Together the cDNAs encompass 1051 bp of cDNA sequence containing an open reading frame with the capacity to encode a 28 kDa protein. Antibodies that were affinity purified using recombinant fusion proteins produced by two of the clones reacted on protein blots of whole T. gondii lysate with a single antigen having an apparent molecular mass of 28 kDa. Both recombinant fusion proteins reacted with IgG antibodies in sera of mice and humans infected with T. gondii and therefore might be useful for the development of diagnostic assays for T. gondii infection.

Human Pathology, 1981

The l)eroxidase-antiperoxidase immunolfistocllemical tecimique was employed to stain fi~rmalin fi... more The l)eroxidase-antiperoxidase immunolfistocllemical tecimique was employed to stain fi~rmalin fixed, paraffin embedded tissue sections from three cases of enceplmlitis caused by Toxoplasma gondii. We studied two cases of congenital infection and one case of acquired toxoplasmosis occurring in an immunoconapromised host. The peroxidase-antiperoxidase method was exquisitely sensitive and highly specific and stained both the encysted and tachyzoite forms of the organism, as well as allowing for easy identification of infected cells. In two cases of necrotizing encel~halitis--4me congenital, the other acqtfired--widespread dis-

Science, 1988

Mice were injected with a monoclonal antibody to interferon-gamma to examine the importance of en... more Mice were injected with a monoclonal antibody to interferon-gamma to examine the importance of endogenous production of this lymphokine in resistance against infection with the sporozoan parasite Toxoplasma gondii. Mice with intraperitoneal infections of T. gondii that received no antibody survived and developed chronic T. gondii infection, whereas the infected mice that received the monoclonal antibody died of toxoplasmosis. The activation of macrophages, which kill T. gondii in vivo, was inhibited by administration of the monoclonal antibody, but the production of antibodies to T. gondii was not suppressed. The fact that an antibody to interferon-gamma can eliminate resistance to acute Toxoplasma infection in mice suggests that this lymphokine is an important mediator of host resistance to this parasite.

PEDIATRICS, 2006

OBJECTIVES. The purpose of this work was to determine whether visual impairment caused by toxopla... more OBJECTIVES. The purpose of this work was to determine whether visual impairment caused by toxoplasmic chorioretinitis is associated with impaired performance of specific tasks on standardized tests of cognitive function. If so, then we worked to determine whether there are patterns in these difficulties that provide a logical basis for development of measures of cognitive function independent of visual impairment and compensatory intervention strategies to facilitate learning for such children.

Molecular Immunology, 1993

A major cytoplasmic Toxoplasma gondii (T. gondii) antigen recognized by monoclonal antibody F3G3 ... more A major cytoplasmic Toxoplasma gondii (T. gondii) antigen recognized by monoclonal antibody F3G3 (F3G3-Ag), as well as two surface antigens recognized by monoclonal antibodies 2G11 and 1E11 respectively (2G11-Ag; 1E11-Ag), were isolated from crude Toxoplasma sonicates using affinity chromatography. Purified F3G3-Ag induced long term protection against Toxoplasma infection in mice and induced Toxoplasma specific IgG antibody. CD4+ but not CD8+ T cells from immune animals proliferated and produced IL-2 upon restimulation with either Toxoplasma sonicate or F3G3-Ag in vitro. Furthermore, CD4+ T cells from mice immunized with F3G3-Ag responded to purified 2G11- and 1E11-Ag. In contrast, CD4+ T cells from mice immunized with 2G11-Ag responded to Toxoplasma sonicate and 2G11-Ag, but not to F3G3- or 1E11-Ag. The results may indicate that the protective F3G3-Ag shares immunogenic epitopes present also on 2G11- and 1E11-Ag, since the F3G3-Ag used for the vaccination did not contain detectable amounts of 2G11- or 1E11-Ag, and none of the antigens displayed any mitogenicity. Taken together the results show that the cytoplasmic F3G3-Ag of T. gondii induces CD4+ T helper cells, Toxoplasma specific IgG antibodies and long term protection against Toxoplasma infection, but does not induce detectable sensitization of the CD8+ T cell compartment.

Molecular and Biochemical Parasitology, 1985

Functionally active poly(A)-containing mRNA was isolated from tachyzoites of the RH strain of Tox... more Functionally active poly(A)-containing mRNA was isolated from tachyzoites of the RH strain of Toxoplasma gondii. The T. gondii mRNA was capable of directing the synthesis of proteins in a wheat germ in vitro translation system, but not in a cell free system derived from rabbit reticulocyte lysate. Efficient translation in the wheat germ system required spermine and exogenous tRNA. Amino acid incorporation was maximal at 110 mM K ÷ and 1.8 mM Mg 2÷. Tachyzoite antigens synthesized in vitro were immunoprecipitated with T, gondii antibodies from rabbits, mice and humans. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis ofimmunoprecipitated polypeptides yielded patterns that differed according to antibody source, but all T. gondii antibody preparations reacted with a translation product with an apparent molecular weight of 24 000.

Molecular and Biochemical Parasitology, 1994

We describe the cloning and characterization of a novel antigen expressed in the bradyzoite stage... more We describe the cloning and characterization of a novel antigen expressed in the bradyzoite stage of Toxoplasma gondii. A cDNA library was constructed in bacteriophage Agtll Sfi-Not using messenger RNA molecules isolated from cysts of the ME49 strain of T. gondii. The recombinant phage library was subjected to screening with polyclonal antibodies against bradyzoite antigens. This screening identified a recombinant antigen that was recognized strongly by polyclonal antibodies against bradyzoite antigens as well as by sera from mice chronically infected with T. gondii. The native antigen is a protein of 65 kDa that localized to the matrix of the cyst and the cyst wall surrounding the bradyzoites. The antigen was found to be expressed abundantly in cysts but could not be detected in tachyzoites or within the parasitophorous vacuole of tachyzoite infected host cells. Genomic and cDNA sequence of the gene revealed an open reading frame encoding 452 amino acids interrupted by 2 introns: a 503-bp intron located in the 5' untranslated region preceding the protein coding sequence and a ll0-bp intron located 95 bp downstream of the first ATG.

The Lancet, 1972

ALTHOUGH candidiasis is the most common fungal infection in immunologically compromised patients,... more ALTHOUGH candidiasis is the most common fungal infection in immunologically compromised patients, only about half of those with this infection are diagnosed during life., 2 What is needed is a specific diagnostic method which can differentiate between colonisation and infection with candida and which provides rapid results. The precipitin test a,4 seems very helpful, but it often takes 48 hours or more. The specificity of the precipitin method has been questioned, but we 5 and others 6 have found that false-positive reactions are infrequent among those patients for whom rapid diagnosis and treatment is so necessary.

Journal of Clinical Microbiology, 2005

Using a single serum sample for testing for immunoglobulin G (IgG) Toxoplasma antibodies, differe... more Using a single serum sample for testing for immunoglobulin G (IgG) Toxoplasma antibodies, differences in sensitivity of the dye test (which measures primarily IgG antibodies) and an IgG enzyme immunoassay were found useful for very early diagnosis of acute Toxoplasma gondii infection.

Journal of Clinical Microbiology, 2002

Because congenital toxoplasmosis is almost solely the result of maternal infection acquired durin... more Because congenital toxoplasmosis is almost solely the result of maternal infection acquired during gestation, it is critical to determine whether infection during pregnancy has occurred. In the United States, definitive diagnosis of the acute infection and the time of its occurrence have been compromised by a lack of systematic screening and the fact that only a single serum sample is submitted for testing. In studies in Europe, and depending on the method used, the demonstration of high-avidity immunoglobulin G (IgG) toxoplasma antibodies has been shown to exclude infection having occurred in the first 3 to 5 months of pregnancy. We investigated the usefulness of determining the avidity of IgG toxoplasma antibodies with a VIDAS kit (herein referred to as the VIDAS Toxo-IgG avidity kit, the VIDAS kit essentially rules out acute infection having occurred within the 4 prior months) in the setting of a reference serology laboratory in the United States. Sera (132 samples) from 132 women in the first 16 weeks of pregnancy were chosen because at least one test in the toxoplasma serological profile (TSP) suggested or was equivocal for a recently acquired infection. High-avidity antibodies were demonstrated in 75% of 99 sera positive with the IgM enzyme-linked immunosorbent assay (ELISA) and 31.3% of 16 sera with acute TSP results. A significant percentage of sera with equivocal results wtih the IgM ELISA or TSP also had high-avidity test results. Of 39 women for whom treatment with spiramycin had been suggested to attempt to prevent congenital transmission, 19 (48.7%) had high-avidity antibodies. These findings highlight the value of the VIDAS IgG avidity kit when used in combination with the TSP to exclude recent infection, especially when only a single serum sample is available.

Clinical Microbiology and Infection, 2004

The fluroquinolone gemifloxacin was examined for its capacity to modulate secretion of cytokines ... more The fluroquinolone gemifloxacin was examined for its capacity to modulate secretion of cytokines by human monocytes stimulated with lipopolysaccharide (LPS). Monocytes from six male and two female healthy volunteers were stimulated with LPS, exposed to gemifloxacin and the amounts of secreted IL-1 alpha, IL-1 beta, IL-6, IL-10 and TNF-alpha measured at 3, 6 and 24 h. The results revealed that LPS alone increased secretion of each cytokine significantly. Treatment of the LPS-stimulated monocytes with gemifloxacin resulted in a significant inhibition (p < 0.01) of secretion of each of the cytokines from monocytes of the eight volunteers. Nuclear extracts of the human monocyte cell line, THP-1, were used in the electrophoretic mobility shift assay to determine whether gemifloxacin affects nuclear factor-kappa B (NF-kappa B) activation. In addition, RNA from THP-1 cells was used in Northern blots to determine whether inhibition of secretion of IL-1 beta and TNF-alpha by gemifloxacin occurred at the transcription or translation level. Whereas LPS induced a rapid increase in NF-kappa B activation, gemifloxacin alone did not. Gemifloxacin did not affect the kinetics or decrease the extent of activation. Northern blots indicated that the inhibitory activity of gemifloxacin occurred post-transcription. Thus, gemifloxacin may modulate the immune response by altering secretion of cytokines by human monocytes. Although the concentrations of gemifloxacin used were higher than those observed in the serum of human volunteers treated with the dose under clinical development, it should be taken into consideration that concentrations at tissue and intracellular levels may be considerably higher than serum concentrations.

Clinical Infectious Diseases, 1994

Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were re... more Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were referred to our study group. A uniform approach to evaluation and therapy was developed and is described herein along with the clinical characteristics of these infants and children. In addition, case histories that illustrate especially important clinical features or previously undescribed findings are presented. Factors that contributed to the more severe disabilities included delayed diagnosis and initiation of therapy; prolonged, concomitant neonatal hypoxia and hypoglycemia; profound visual impairment; and prolonged, uncorrected increased intracranial pressure with hydrocephalus and compression of the brain. Years after therapy was discontinued, three children developed new retinal lesions (without loss of visual acuity when therapy for Toxoplasma gondii was initiated promptly), and three children experienced a new onset of afebrile seizures. Most remarkable were the normal developmental, neurological, and ophthalmologic findings at the early follow-up evaluations of many--but not all--of the treated children despite severe manifestations, such as substantial systemic disease, hydrocephalus, microcephalus, multiple intracranial calcifications, and extensive macular destruction detected at birth. These favorable outcomes contrast markedly with outcomes reported previously for children with congenital toxoplasmosis who were untreated or treated for only 1 month.

Clinical Infectious Diseases, 1996

Congenital transmission of Toxoplasma gondii from a mother who was apparently immunologically com... more Congenital transmission of Toxoplasma gondii from a mother who was apparently immunologically competent and who had toxoplasmic lymphadenitis 2 months before conception is described. Since no T. gondii-specific serological data were available for this mother from the time her lymph node biopsy specimen was obtained, the specimen was studied by polymerase chain reaction (PCR) to determine whether the T. gondii B1 gene was present. The predictive diagnostic value of histologic findings previously considered to be classic signs of T. gondii lymphadenitis also was studied. This was done by correlation of serological tests diagnostic of acute acquired T. gondii infection and presence of characteristic findings in biopsy specimens from persons without known immunocompromise. Both PCR and review of the characteristic features of her lymph node biopsy specimen confirmed the diagnosis of preconceptual infection in the mother. We also discuss two other cases in which apparently immunologically competent mothers with preconceptually acquired infection transmitted this parasite to their fetuses.

Clinical Infectious Diseases, 2006

Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-t... more Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-term follow-up of infants with congenital toxoplasmosis treated throughout their first year of life with pyrimethamine and sulfadiazine has not been reported. Between 1981 and 2004, one hundred twenty infants (current mean age +/- standard deviation, 10.5 +/- 4.8 years) with congenital toxoplasmosis were treated with 1 of 2 doses of pyrimethamine plus sulfadiazine; therapy was initiated shortly after birth and continued for 12 months. Children who received treatment were evaluated at birth and at predetermined intervals; the focus of the evaluations was on prespecified end points: motor abnormalities, cognitive outcome, vision impairment, formation of new eye lesions, and hearing loss. Treatment of infants without substantial neurologic disease at birth with pyrimethamine and sulfadiazine for 1 year resulted in normal cognitive, neurologic, and auditory outcomes for all patients. Treatment of infants who had moderate or severe neurologic disease (as defined in this article in the Treatments subsection of Methods) at birth resulted in normal neurologic and/or cognitive outcomes for >72% of the patients, and none had sensorineural hearing loss. Ninety-one percent of children without substantial neurologic disease and 64% of those with moderate or severe neurologic disease at birth did not develop new eye lesions. Almost all of these outcomes are markedly better than outcomes reported for children who were untreated or treated for 1 month in earlier decades (P<.01 to P<.001). Sex and severity of disease were comparable in our 2 treatment groups, and no significant differences in efficacy or toxicity were noted between the 2 treatment groups (P > .05). Although not all children did well with treatment, the favorable outcomes we noted indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis.

Antimicrobial Agents and Chemotherapy, 2003

Linezolid, an oxazolidinone antibiotic, has 100% oral bioavailability and favorable activities ag... more Linezolid, an oxazolidinone antibiotic, has 100% oral bioavailability and favorable activities against grampositive pathogens including multidrug-resistant staphylococci, enterococci, and pneumococci. Safety assessments were conducted for 2,046 linezolid-treated patients and 2,001 comparator drug-treated patients from seven controlled clinical trials comparing the activities of linezolid and comparator drugs against nosocomial and community-acquired pneumonia, skin and skin structure infections, and methicillin-resistant staphylococcal infections. Drug-related adverse events were primarily transient. The most frequent (>2%) adverse events caused by linezolid and the comparator drugs were diarrhea (4.3 and 3.2%, respectively; P ‫؍‬ 0.074), nausea (3.4 and 2.3%, respectively; P ‫؍‬ 0.036), and headache (2.2 and 1.3%, respectively; P ‫؍‬ 0.047). Treatment discontinuations due to drug-related events (2.4 and 1.9%, respectively), serious adverse events (11.4 and 10.6%, respectively), and deaths (4.8 and 4.9%, respectively) were similar. No clinically significant drug-related hematologic events were reported, and laboratory safety data were comparable. In the first 6 months of postmarketing surveillance, hematologic abnormalities were reported in 0.1% of linezolid-treated patients, but no irreversible blood dyscrasias were documented. The risk for transient, reversible hematologic effects from treatment with linezolid should be considered together with the clinical benefits associated with its use.

Antimicrobial Agents and Chemotherapy, 1979

Candida lusitaniae associated with infection in a patient with acute myelogenous leukemia develop... more Candida lusitaniae associated with infection in a patient with acute myelogenous leukemia developed resistance to amphotericin B during systemic treatment of the patient. The organism, when isolated initially, was inhibited by 0.31 mug of amphotericin B per ml in yeast nitrogen base agar, but when isolated (20 days later) just antemortem and postmortem, required 100 and 50 mug/ml, respectively, for complete inhibition at 48 h.

Bulletin of the Entomological Society of America, 1976

Archives of Ophthalmology, 1959

Current clinical topics in infectious diseases, 2000

Infection and immunity, 1993

Toxoplasma gondii is capable of invading and multiplying within murine peritoneal macrophages. Pr... more Toxoplasma gondii is capable of invading and multiplying within murine peritoneal macrophages. Previous studies have shown that treatment of macrophage monolayers with recombinant gamma interferon but not tumor necrosis factor (TNF) is associated with intracellular killing of T. gondii by macrophages. Furthermore, infection of macrophages with T. gondii prevents their stimulation for mycobactericidal activity by TNF. Since transforming growth factor beta (TGF-beta) is known to suppress a number of functions in macrophages, we investigated the influence of infection with T. gondii on macrophage TNF receptors and on production of TGF-beta. Infection with T. gondii was associated with increased production of TGF-beta and downregulation of TNF receptors. This effect was observed early after infection and was partially inhibited by anti-TGF-beta 1 antibody.

Molecular and Biochemical Parasitology, 1989

By screening cDNA libraries in lambda gt11 with antibodies raised against the previously describe... more By screening cDNA libraries in lambda gt11 with antibodies raised against the previously described protective F3G3 antigen of Toxoplasma gondii, and subsequently screening with nucleic acid probes, we have isolated cDNA clones that encode a 28 kDa antigen of T. gondii that is likely one of the two antigenic components of the F3G3 antigen. The gene apparently exists as a single copy in the tachyzoite haploid genome of the three strains of T. gondii examined. Northern blot analyses revealed that the cDNAs hybridize with a major T. gondii RNA species of 1.1 kb. Together the cDNAs encompass 1051 bp of cDNA sequence containing an open reading frame with the capacity to encode a 28 kDa protein. Antibodies that were affinity purified using recombinant fusion proteins produced by two of the clones reacted on protein blots of whole T. gondii lysate with a single antigen having an apparent molecular mass of 28 kDa. Both recombinant fusion proteins reacted with IgG antibodies in sera of mice and humans infected with T. gondii and therefore might be useful for the development of diagnostic assays for T. gondii infection.

Human Pathology, 1981

The l)eroxidase-antiperoxidase immunolfistocllemical tecimique was employed to stain fi~rmalin fi... more The l)eroxidase-antiperoxidase immunolfistocllemical tecimique was employed to stain fi~rmalin fixed, paraffin embedded tissue sections from three cases of enceplmlitis caused by Toxoplasma gondii. We studied two cases of congenital infection and one case of acquired toxoplasmosis occurring in an immunoconapromised host. The peroxidase-antiperoxidase method was exquisitely sensitive and highly specific and stained both the encysted and tachyzoite forms of the organism, as well as allowing for easy identification of infected cells. In two cases of necrotizing encel~halitis--4me congenital, the other acqtfired--widespread dis-

Science, 1988

Mice were injected with a monoclonal antibody to interferon-gamma to examine the importance of en... more Mice were injected with a monoclonal antibody to interferon-gamma to examine the importance of endogenous production of this lymphokine in resistance against infection with the sporozoan parasite Toxoplasma gondii. Mice with intraperitoneal infections of T. gondii that received no antibody survived and developed chronic T. gondii infection, whereas the infected mice that received the monoclonal antibody died of toxoplasmosis. The activation of macrophages, which kill T. gondii in vivo, was inhibited by administration of the monoclonal antibody, but the production of antibodies to T. gondii was not suppressed. The fact that an antibody to interferon-gamma can eliminate resistance to acute Toxoplasma infection in mice suggests that this lymphokine is an important mediator of host resistance to this parasite.

PEDIATRICS, 2006

OBJECTIVES. The purpose of this work was to determine whether visual impairment caused by toxopla... more OBJECTIVES. The purpose of this work was to determine whether visual impairment caused by toxoplasmic chorioretinitis is associated with impaired performance of specific tasks on standardized tests of cognitive function. If so, then we worked to determine whether there are patterns in these difficulties that provide a logical basis for development of measures of cognitive function independent of visual impairment and compensatory intervention strategies to facilitate learning for such children.

Molecular Immunology, 1993

A major cytoplasmic Toxoplasma gondii (T. gondii) antigen recognized by monoclonal antibody F3G3 ... more A major cytoplasmic Toxoplasma gondii (T. gondii) antigen recognized by monoclonal antibody F3G3 (F3G3-Ag), as well as two surface antigens recognized by monoclonal antibodies 2G11 and 1E11 respectively (2G11-Ag; 1E11-Ag), were isolated from crude Toxoplasma sonicates using affinity chromatography. Purified F3G3-Ag induced long term protection against Toxoplasma infection in mice and induced Toxoplasma specific IgG antibody. CD4+ but not CD8+ T cells from immune animals proliferated and produced IL-2 upon restimulation with either Toxoplasma sonicate or F3G3-Ag in vitro. Furthermore, CD4+ T cells from mice immunized with F3G3-Ag responded to purified 2G11- and 1E11-Ag. In contrast, CD4+ T cells from mice immunized with 2G11-Ag responded to Toxoplasma sonicate and 2G11-Ag, but not to F3G3- or 1E11-Ag. The results may indicate that the protective F3G3-Ag shares immunogenic epitopes present also on 2G11- and 1E11-Ag, since the F3G3-Ag used for the vaccination did not contain detectable amounts of 2G11- or 1E11-Ag, and none of the antigens displayed any mitogenicity. Taken together the results show that the cytoplasmic F3G3-Ag of T. gondii induces CD4+ T helper cells, Toxoplasma specific IgG antibodies and long term protection against Toxoplasma infection, but does not induce detectable sensitization of the CD8+ T cell compartment.

Molecular and Biochemical Parasitology, 1985

Functionally active poly(A)-containing mRNA was isolated from tachyzoites of the RH strain of Tox... more Functionally active poly(A)-containing mRNA was isolated from tachyzoites of the RH strain of Toxoplasma gondii. The T. gondii mRNA was capable of directing the synthesis of proteins in a wheat germ in vitro translation system, but not in a cell free system derived from rabbit reticulocyte lysate. Efficient translation in the wheat germ system required spermine and exogenous tRNA. Amino acid incorporation was maximal at 110 mM K ÷ and 1.8 mM Mg 2÷. Tachyzoite antigens synthesized in vitro were immunoprecipitated with T, gondii antibodies from rabbits, mice and humans. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis ofimmunoprecipitated polypeptides yielded patterns that differed according to antibody source, but all T. gondii antibody preparations reacted with a translation product with an apparent molecular weight of 24 000.

Molecular and Biochemical Parasitology, 1994

We describe the cloning and characterization of a novel antigen expressed in the bradyzoite stage... more We describe the cloning and characterization of a novel antigen expressed in the bradyzoite stage of Toxoplasma gondii. A cDNA library was constructed in bacteriophage Agtll Sfi-Not using messenger RNA molecules isolated from cysts of the ME49 strain of T. gondii. The recombinant phage library was subjected to screening with polyclonal antibodies against bradyzoite antigens. This screening identified a recombinant antigen that was recognized strongly by polyclonal antibodies against bradyzoite antigens as well as by sera from mice chronically infected with T. gondii. The native antigen is a protein of 65 kDa that localized to the matrix of the cyst and the cyst wall surrounding the bradyzoites. The antigen was found to be expressed abundantly in cysts but could not be detected in tachyzoites or within the parasitophorous vacuole of tachyzoite infected host cells. Genomic and cDNA sequence of the gene revealed an open reading frame encoding 452 amino acids interrupted by 2 introns: a 503-bp intron located in the 5' untranslated region preceding the protein coding sequence and a ll0-bp intron located 95 bp downstream of the first ATG.

The Lancet, 1972

ALTHOUGH candidiasis is the most common fungal infection in immunologically compromised patients,... more ALTHOUGH candidiasis is the most common fungal infection in immunologically compromised patients, only about half of those with this infection are diagnosed during life., 2 What is needed is a specific diagnostic method which can differentiate between colonisation and infection with candida and which provides rapid results. The precipitin test a,4 seems very helpful, but it often takes 48 hours or more. The specificity of the precipitin method has been questioned, but we 5 and others 6 have found that false-positive reactions are infrequent among those patients for whom rapid diagnosis and treatment is so necessary.

Journal of Clinical Microbiology, 2005

Using a single serum sample for testing for immunoglobulin G (IgG) Toxoplasma antibodies, differe... more Using a single serum sample for testing for immunoglobulin G (IgG) Toxoplasma antibodies, differences in sensitivity of the dye test (which measures primarily IgG antibodies) and an IgG enzyme immunoassay were found useful for very early diagnosis of acute Toxoplasma gondii infection.

Journal of Clinical Microbiology, 2002

Because congenital toxoplasmosis is almost solely the result of maternal infection acquired durin... more Because congenital toxoplasmosis is almost solely the result of maternal infection acquired during gestation, it is critical to determine whether infection during pregnancy has occurred. In the United States, definitive diagnosis of the acute infection and the time of its occurrence have been compromised by a lack of systematic screening and the fact that only a single serum sample is submitted for testing. In studies in Europe, and depending on the method used, the demonstration of high-avidity immunoglobulin G (IgG) toxoplasma antibodies has been shown to exclude infection having occurred in the first 3 to 5 months of pregnancy. We investigated the usefulness of determining the avidity of IgG toxoplasma antibodies with a VIDAS kit (herein referred to as the VIDAS Toxo-IgG avidity kit, the VIDAS kit essentially rules out acute infection having occurred within the 4 prior months) in the setting of a reference serology laboratory in the United States. Sera (132 samples) from 132 women in the first 16 weeks of pregnancy were chosen because at least one test in the toxoplasma serological profile (TSP) suggested or was equivocal for a recently acquired infection. High-avidity antibodies were demonstrated in 75% of 99 sera positive with the IgM enzyme-linked immunosorbent assay (ELISA) and 31.3% of 16 sera with acute TSP results. A significant percentage of sera with equivocal results wtih the IgM ELISA or TSP also had high-avidity test results. Of 39 women for whom treatment with spiramycin had been suggested to attempt to prevent congenital transmission, 19 (48.7%) had high-avidity antibodies. These findings highlight the value of the VIDAS IgG avidity kit when used in combination with the TSP to exclude recent infection, especially when only a single serum sample is available.

Clinical Microbiology and Infection, 2004

The fluroquinolone gemifloxacin was examined for its capacity to modulate secretion of cytokines ... more The fluroquinolone gemifloxacin was examined for its capacity to modulate secretion of cytokines by human monocytes stimulated with lipopolysaccharide (LPS). Monocytes from six male and two female healthy volunteers were stimulated with LPS, exposed to gemifloxacin and the amounts of secreted IL-1 alpha, IL-1 beta, IL-6, IL-10 and TNF-alpha measured at 3, 6 and 24 h. The results revealed that LPS alone increased secretion of each cytokine significantly. Treatment of the LPS-stimulated monocytes with gemifloxacin resulted in a significant inhibition (p < 0.01) of secretion of each of the cytokines from monocytes of the eight volunteers. Nuclear extracts of the human monocyte cell line, THP-1, were used in the electrophoretic mobility shift assay to determine whether gemifloxacin affects nuclear factor-kappa B (NF-kappa B) activation. In addition, RNA from THP-1 cells was used in Northern blots to determine whether inhibition of secretion of IL-1 beta and TNF-alpha by gemifloxacin occurred at the transcription or translation level. Whereas LPS induced a rapid increase in NF-kappa B activation, gemifloxacin alone did not. Gemifloxacin did not affect the kinetics or decrease the extent of activation. Northern blots indicated that the inhibitory activity of gemifloxacin occurred post-transcription. Thus, gemifloxacin may modulate the immune response by altering secretion of cytokines by human monocytes. Although the concentrations of gemifloxacin used were higher than those observed in the serum of human volunteers treated with the dose under clinical development, it should be taken into consideration that concentrations at tissue and intracellular levels may be considerably higher than serum concentrations.

Clinical Infectious Diseases, 1994

Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were re... more Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were referred to our study group. A uniform approach to evaluation and therapy was developed and is described herein along with the clinical characteristics of these infants and children. In addition, case histories that illustrate especially important clinical features or previously undescribed findings are presented. Factors that contributed to the more severe disabilities included delayed diagnosis and initiation of therapy; prolonged, concomitant neonatal hypoxia and hypoglycemia; profound visual impairment; and prolonged, uncorrected increased intracranial pressure with hydrocephalus and compression of the brain. Years after therapy was discontinued, three children developed new retinal lesions (without loss of visual acuity when therapy for Toxoplasma gondii was initiated promptly), and three children experienced a new onset of afebrile seizures. Most remarkable were the normal developmental, neurological, and ophthalmologic findings at the early follow-up evaluations of many--but not all--of the treated children despite severe manifestations, such as substantial systemic disease, hydrocephalus, microcephalus, multiple intracranial calcifications, and extensive macular destruction detected at birth. These favorable outcomes contrast markedly with outcomes reported previously for children with congenital toxoplasmosis who were untreated or treated for only 1 month.

Clinical Infectious Diseases, 1996

Congenital transmission of Toxoplasma gondii from a mother who was apparently immunologically com... more Congenital transmission of Toxoplasma gondii from a mother who was apparently immunologically competent and who had toxoplasmic lymphadenitis 2 months before conception is described. Since no T. gondii-specific serological data were available for this mother from the time her lymph node biopsy specimen was obtained, the specimen was studied by polymerase chain reaction (PCR) to determine whether the T. gondii B1 gene was present. The predictive diagnostic value of histologic findings previously considered to be classic signs of T. gondii lymphadenitis also was studied. This was done by correlation of serological tests diagnostic of acute acquired T. gondii infection and presence of characteristic findings in biopsy specimens from persons without known immunocompromise. Both PCR and review of the characteristic features of her lymph node biopsy specimen confirmed the diagnosis of preconceptual infection in the mother. We also discuss two other cases in which apparently immunologically competent mothers with preconceptually acquired infection transmitted this parasite to their fetuses.

Clinical Infectious Diseases, 2006

Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-t... more Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-term follow-up of infants with congenital toxoplasmosis treated throughout their first year of life with pyrimethamine and sulfadiazine has not been reported. Between 1981 and 2004, one hundred twenty infants (current mean age +/- standard deviation, 10.5 +/- 4.8 years) with congenital toxoplasmosis were treated with 1 of 2 doses of pyrimethamine plus sulfadiazine; therapy was initiated shortly after birth and continued for 12 months. Children who received treatment were evaluated at birth and at predetermined intervals; the focus of the evaluations was on prespecified end points: motor abnormalities, cognitive outcome, vision impairment, formation of new eye lesions, and hearing loss. Treatment of infants without substantial neurologic disease at birth with pyrimethamine and sulfadiazine for 1 year resulted in normal cognitive, neurologic, and auditory outcomes for all patients. Treatment of infants who had moderate or severe neurologic disease (as defined in this article in the Treatments subsection of Methods) at birth resulted in normal neurologic and/or cognitive outcomes for >72% of the patients, and none had sensorineural hearing loss. Ninety-one percent of children without substantial neurologic disease and 64% of those with moderate or severe neurologic disease at birth did not develop new eye lesions. Almost all of these outcomes are markedly better than outcomes reported for children who were untreated or treated for 1 month in earlier decades (P<.01 to P<.001). Sex and severity of disease were comparable in our 2 treatment groups, and no significant differences in efficacy or toxicity were noted between the 2 treatment groups (P > .05). Although not all children did well with treatment, the favorable outcomes we noted indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis.

Antimicrobial Agents and Chemotherapy, 2003

Linezolid, an oxazolidinone antibiotic, has 100% oral bioavailability and favorable activities ag... more Linezolid, an oxazolidinone antibiotic, has 100% oral bioavailability and favorable activities against grampositive pathogens including multidrug-resistant staphylococci, enterococci, and pneumococci. Safety assessments were conducted for 2,046 linezolid-treated patients and 2,001 comparator drug-treated patients from seven controlled clinical trials comparing the activities of linezolid and comparator drugs against nosocomial and community-acquired pneumonia, skin and skin structure infections, and methicillin-resistant staphylococcal infections. Drug-related adverse events were primarily transient. The most frequent (>2%) adverse events caused by linezolid and the comparator drugs were diarrhea (4.3 and 3.2%, respectively; P ‫؍‬ 0.074), nausea (3.4 and 2.3%, respectively; P ‫؍‬ 0.036), and headache (2.2 and 1.3%, respectively; P ‫؍‬ 0.047). Treatment discontinuations due to drug-related events (2.4 and 1.9%, respectively), serious adverse events (11.4 and 10.6%, respectively), and deaths (4.8 and 4.9%, respectively) were similar. No clinically significant drug-related hematologic events were reported, and laboratory safety data were comparable. In the first 6 months of postmarketing surveillance, hematologic abnormalities were reported in 0.1% of linezolid-treated patients, but no irreversible blood dyscrasias were documented. The risk for transient, reversible hematologic effects from treatment with linezolid should be considered together with the clinical benefits associated with its use.

Antimicrobial Agents and Chemotherapy, 1979

Candida lusitaniae associated with infection in a patient with acute myelogenous leukemia develop... more Candida lusitaniae associated with infection in a patient with acute myelogenous leukemia developed resistance to amphotericin B during systemic treatment of the patient. The organism, when isolated initially, was inhibited by 0.31 mug of amphotericin B per ml in yeast nitrogen base agar, but when isolated (20 days later) just antemortem and postmortem, required 100 and 50 mug/ml, respectively, for complete inhibition at 48 h.