Vol 41 # 3 September 2009 - Kma.org.kw

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September 2009 KUWAIT MEDICAL JOURNAL 261 Selected Abstracts of Articles Published Elsewhere by Authors in Kuwait Kuwait Medical Journal 2009, 41 (3): 261-264 Th1 Cell Reactivity and HLA-DR Binding Prediction for Promiscuous Recognition of MPT63 (Rv1926c), A Major Secreted Protein of Mycobacterium Tuberculosis Mustafa AS Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait E-mail: abusalim@hsc.edu.kw Scand J Immunol 2009; 69:213-222 MPT63 (Rv1926c), a major secreted protein of Mycobacterium tuberculosis, is immunoreactive in antibody assays in humans and animals and provides protection as a combined DNA vaccine in mice. This study was undertaken to determine the reactivity of MPT63 in T helper 1 (Th1) cell assays, i.e. antigen-induced proliferation and interferon-gamma secretion, using peripheral blood mononuclear cells (PBMCs) obtained from 72 Mycobacterium bovis Bacille Calmette-Guérin vaccinated healthy subjects. PBMCs were tested with complex mycobacterial antigens and pools of synthetic peptides corresponding to MPT63, MPB70, MT24, PPE68, CFP10 and ESAT-6. The results showed that MPT63 induced moderate Th1 cell reactivity which was equivalent to the reactivity induced by other secreted antigens of M. tuberculosis, i.e. MT24 and MPB70. Furthermore, human leucocyte antigen (HLA) heterogeneity of the responding donors suggested that MPT63 was presented to Th1 cells promiscuously. Analysis of the MPT63 sequence and its peptides for binding to 51 alleles of 9 serologically defined HLA-DR molecules, using a virtual matrix-based prediction program (ProPred) showed that MPT63 sequence could bind to all the 51 alleles, whereas 9 of the 10 peptides of MPT63 were also predicted to bind promiscuously. When tested with PBMCs of HLA-DR heterogeneous donors that responded to MPT63 in interferon-gamma assays, at least 9 of the 10 peptides of MPT63 were recognized by PBMCs from HLA heterogeneous donors. These results suggested that promiscuous Th1 cell reactive epitopes are scattered throughout the sequence of MPT63, and further support the inclusion of this protein in an antigen cocktail to develop a new anti-tuberculosis vaccine. Multilevel Modeling of Household Contextual Determinants of Tuberculin Skin Test Positivity among Contacts of Infectious Tuberculosis Patients, Umerkot, Pakistan Akhtar S, Rathi SK Department of Community Medicine and Behavioral Sciences, Kuwait University, Safat 13110, Kuwait E-mail: saeed.akhtar@hsc.edu.kw Am J Trop Med Hyg 2009; 80:351-358 This cross-sectional study sought to identify household contextual determinants that might be associated with Mycobacterium tuberculosis infection as assessed by tuberculin skin test (TST) positivity among familial contacts of index patients of infectious pulmonary tuberculosis (TB) while controlling for the effects of individual-level factors. We analyzed data on TST results on 359 household contacts of 77 index cases of acid-fast bacilli (AFB) sputum smear-positive pulmonary TB using multilevel logistic regression analysis with characteristics of household contacts at the first level and that of households at the second level. The prevalence of M. tuberculosis infection as assessed by TST positivity among household contacts
262 Selected Abstracts of Articles Published Elsewhere by Authors in Kuwait September 2009 of index TB patients was 49.9% (179/359). After taking into account the individual-level risk factors, household-level contextual determinants significantly associated with contact’s TST positivity were gender of index TB patient (adjusted odds ratio [OR] = 2.2; 95% confidence interval [CI]: 1.3-3.9%) and density of AFB sputum smear (adjusted OR = 3.2; 95% CI: 1.9-5.5%). Household variances in multilevel models indicated significant inter-household heterogeneity in TST positivity among contacts. This study provided the evidence for substantive effects of household-level contextual variables on the TST positivity among contacts of index TB patients. Thus, both individual-level and household-level characteristics need to be taken into account while prioritizing contacts for investigations to improve TB control and prevention in resource-constrained countries such as Pakistan. Severity of Liver Disease Predicts the Development of Glucose Abnormalities in Patients with Chronic Hepatitis B or C following Achievement of Sustained Virological Response to Antiviral Therapy Chehadeh W, Al-Nakib W Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait E-mail: wchehadeh@hsc.edu.kw J Med Virol 2009; 81:610-618 A higher prevalence of glucose abnormalities has been reported in patients with hepatitis C virus (HCV) infection compared to patients with hepatitis B virus (HBV) infection. However, previous studies considered some confounding factors and ignored others, which might influence the comparative risk assessment between HBV and HCV infections. Fasting plasma glucose concentration, severity of liver disease and viral load were determined in 220 patients with HCV genotype 4 infection, and 200 patients with HBV infection. Patients completing antiviral therapy were followed-up, and the fasting plasma glucose levels were determined in patients with and without sustained virological response. The prevalence of glucose abnormalities in HCV infection (41%) was significantly higher than that in HBV infection (16%). However, when controlling the severity of liver disease and other risk factors, the prevalence of glucose abnormalities in patients with HCV infection was comparable to that in patients with HBV infection. After attaining of sustained virological response, a decrease of the median fasting plasma glucose value was observed only in chronic hepatitis C. In the group of patients with normal fasting plasma glucose levels, an association of nonsustained virological response with the development of impaired fasting glucose was only observed in chronic hepatitis C. The severity of liver disease was a common predictor of impaired fasting glucose in hepatitis B and C infections. These results indicate that high prevalence of glucose abnormalities can be associated with HBV- and HCVrelated liver disease, and that clearance of HCV, but not HBV, may improve glucose metabolism. The Prevalence of Antimicrobial Resistance and Carriage of Virulence Genes in Staphylococcus Aureus Isolated from Food Handlers in Kuwait City Restaurants BMC Res Notes 2009; 2:108 Udo EE, Al-Mufti S, Albert MJ Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait E-mail: edet@hsc.edu.kw Background: Staphylococcus aureus is a major cause of food poisoning due to their ability to produce enterotoxins which if ingested in sufficient amounts results in sickness. Food handlers carrying enterotoxin-
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186 Swine-origin Influenza A (H1N1)
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Vol 41 # 3 September 2009 - Kma.org.kw

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