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J Fr Ophtalmol. 2000 Oct;23(8):794-6.
[A case of Leber's neuroretinitis]

[Article in French]

Esteve C, Achibet AM, Junot F, Ghassemi A, Rousseau B.

Service d'Ophtalmologie, Centre Hospitalier de Fontainebleau, 55, boulevard du Marechal Joffre, 77300 Fontainebleau.

BACKGROUND: Described in 1916 by Theodore Leber, this rare syndrome characterized by low visual acuity, papillary edema, and a macular star (dry exsudates) occurs classically in the 30 to 40 year age range but also as frequently in children. The visual prognosis is excellent. An infectious cause is found in almost all cases. Case report A 34-year-old man consulted for declining visual acuity of the right eye which began suddenly without pain and was preceded by a flu-like syndrome lasting two weeks. Visual acuity on the right side was 2/10 P6, there was optic disk edema associated with dry macular exsudate (macular star) and a paleness of the posterior pole progressing to the periphery and readily visualized on the angiography, and a central scotome, but no dyschromatopsy. The left eye was strictly normal. Laboratory tests showed an erythrocyte sedimentation rate at 45, C reactive protein at 61, normal red cell count and minimal transaminase elevation. Spinal tap showed: 3 elements/mm(3), protein 0.28g/l, 18% gammaglobulins. Serology tests were negative. Brain imaging was normal. RESULTS: Corticosteroid flashes for three days were initiated and the patient was seen again two weeks later with clear clinical improvement. Visual acuity was 6/10 P2 with considerable resorption of the edema. DISCUSSION: This case is a typical illustration of acute Leber's neuroretinititis, probably caused by viral infection. The cerebrospinal fluid tests and brain imaging ruled out multiple sclerosis, and serology tests for syphilis, tuberculosis, Lyme disease and possible parasite infection were negative. CONCLUSION: Acute lever's neuroretinitis is an uncommon condition which must be distinguished from inflammatory optic neuropathy, particularly in multiple sclerosis which has a very different prognosis and clinical course.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11033501&dopt=Abstract

CMAJ. 2000 Oct 3;163(7):823-8.
Expanding the epidemiologic profile: risk factors for active tuberculosis in people immigrating to Ontario.

Wobeser WL, Yuan L, Naus M, Corey P, Edelson J, Heywood N, Holness DL.

Department of Medicine, Queen's University, Kingston, Ont. wlost.queensu.ca

BACKGROUND: Many people immigrating to Canada come from countries with a high burden of tuberculosis. The aim of this study was to develop a detailed epidemiologic profile of foreign-born people with tuberculosis living in Ontario. METHODS: In this population-based case-control study, cases of tuberculosis diagnosed in 1994-1995 were identified from the database of the Ontario Reportable Disease Information Service and were considered eligible for analysis if a record of landing (receipt of permission to establish residence in Canada) from the period 1986-1995 was found in the Citizenship and Immigration Canada (CIC) database, if the person was at least 11 years of age at the time their visa was issued, and if the person had not been diagnosed with tuberculosis before becoming legally landed in Canada. Control subjects, who met the same criteria as the case subjects but who did not have tuberculosis in 1994-1995, were identified from a CIC database for landed immigrants. RESULTS: A total of 1341 cases of tuberculosis in foreign-born people were reported in Ontario in 1994-1995. A record of landing was found in CIC databases for 1099 of these people, 224 of whom were not legally landed at the time of diagnosis. In total, 602 cases met the inclusion criteria. The 2 strongest determinants of risk among those who had become landed within the preceding 10 years were referral for medical surveillance by immigration officials (odds ratio [OR] 3.8, 95% confidence interval [CI] 2.6-6.0) and world region of origin (Somalia [OR 67.7, 95% CI 31.3-154.9], Vietnam [OR 25.0, 95% CI 12.5-50.0], the Philippines [OR 11.9, 95% CI 6.0-23.3], other sub-Saharan African countries [OR 11.6, 95% CI 5.7-23.2], India [OR 9.7, 95% CI 4.9-18.9], China [OR 6.1, 95% CI 3.1-12.1], other Asian countries [OR 4.7, 95% CI 2.4-9.1], the Middle East [OR 4.1, 95% CI 2.0-8.3], Latin America [OR 1.9, 95% CI 0.9-3.8), and the former socialist countries of Europe [OR 1.8, 95% CI 0.8-3.8]; the reference category was countries with established market economies). Low socioeconomic status was an independent risk factor. INTERPRETATION: The risk of tuberculosis in groups of people migrating to Ontario is highly variable and is influenced by several factors. Successful population-based tuberculosis prevention strategies will need to accommodate this variability.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11033709&dopt=Abstract

Sarcoidosis Vasc Diffuse Lung Dis. 2000 Oct;17(3):256-65.
Proliferative response of peripheral blood mononuclear cells and levels of antibody to recombinant protein from Propionibacterium acnes DNA expression library in Japanese patients with sarcoidosis.

Ebe Y, Ikushima S, Yamaguchi T, Kohno K, Azuma A, Sato K, Ishige I, Usui Y, Takemura T, Eishi Y.

Department of Pathology, Tokyo Medical and Dental University, Japan.

BACKGROUND AND AIM OF THE WORK: The causes of sarcoidosis are unknown. Propionibacterium acnes has been isolated from sarcoid lesions, and many genomes of P. acnes or P. granulosum have been detected in all biopsy samples tested from Japanese patients with sarcoidosis. We searched for protein antigens from propionibacteria that caused immune responses in patients with sarcoidosis but not in subjects without sarcoidosis. METHODS: A lambda gt11 genomic DNA expression library of P. acnes was screened with sera from patients with sarcoidosis. Antibodies to a recombinant protein from the insert recovered by the screening were measured in serum and bronchoalveolar lavage (BAL) fluid from patients with or without sarcoidosis by an immunofluorescence-based method. Peripheral blood mononuclear cells from patients with and without sarcoidosis were used to examine the lymphoproliferative response to the protein. RESULTS: Of 180,000 plaques screened, two clones coded for an identical recombinant protein, termed RP35, were recognized by sera. RP35 was the C-terminal region of P. acnes trigger factor. RP35 caused sarcoidosis specific proliferation of the mononuclear cells from 9 (18%) of the 50 patients with sarcoidosis; in a similar way, purified protein derived from Mycobacterium tuberculosis evoked specific responses in 8 (38%) of 21 patients with tuberculosis. Serum levels of IgG and IgA antibodies to RP35 were high in patients with sarcoidosis and other lung diseases. In BAL fluid levels IgG or IgA antibodies were high in 7 (18%) and 15 (39%), respectively, of 38 patients with sarcoidosis, and in 2 (3%) and 2 (3%), respectively, of 63 patients with other lung diseases. CONCLUSIONS: The RP35 protein from P. acnes causes a cellular immune response in some patients with sarcoidosis but not in subjects without sarcoidosis.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11033841&dopt=Abstract

FEMS Microbiol Lett. 2000 Sep 15;190(2):309-16.
Recombinant BCG approach for development of vaccines: cloning and expression of immunodominant antigens of M. tuberculosis.

Dhar N, Rao V, Tyagi AK.

Department of Biochemistry, University of Delhi, India.

In spite of major advances in our understanding of the biology and immunology of tuberculosis, the incidence of the disease has not reduced in most parts of the world. In an attempt to improve the protective efficacy of Mycobacterium bovis bacille Calmette-Guerin (BCG), we have developed a generic vector system, pSD5, for expression of genes at varying levels in mycobacteria. In this study, we have cloned and overexpressed three immunodominant secretory antigens of M. tuberculosis, 85A, 85B and 85C, belonging to the antigen 85 complex. All the genes were cloned under the control of a battery of mycobacterial promoters of varying strength. The expression was analysed in the fast-growing strain M. smegmatis and the slow-growing vaccine strain M. bovis BCG. The recombinant BCG constructs were able to express the antigens at high levels and the majority of the expressed antigens was secreted into the medium. These results show that by using this strategy the recombinant BCG approach can be successfully used for the development of candidate vaccines against infections associated with mycobacteria as well as other pathogens.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11034297&dopt=Abstract

FEBS Lett. 2000 Sep 1;480(2-3):221-5.
Inteins invading mycobacterial RecA proteins.

Saves I, Laneelle MA, Daffe M, Masson JM.

Institut de Pharmacologie et Biologie Structurale UMR5089, CNRS Universite Paul Sabatier Toulouse III, Toulouse, France. savepbs.fr

Five new inteins were discovered in a survey of 39 mycobacterial strains that was undertaken to clarify the role of RecA inteins in mycobacteria. They are all inserted at the RecA-b site of the recA gene of Mycobacterium chitae, 4. fallax, M. gastri, M. shimodei and M. thermoresistibile and belong to the MleRecA allelic family. Sequence analysis showed that although only M. tuberculosis harbours an intein at the RecA-a site the sequence of the RecA-b site is well conserved between species. Furthermore, the presence of inteins does not correlate with specific characteristics of the species such as pathogenicity or growth rate.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11034333&dopt=Abstract

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