H. Stern

DEVELOPMENT OF A VACCINE AGAINST MENTAL RETARDATION CAUSED BY CYTOMEGALOVIRUS INFECTION IN UTERO

Abstract Cytomegalovirus infection in utero is an important cause of mental retardation. A live tissue-culture-adapted strain of the virus was tested in volunteers. The subcutaneous route of inoculation was successful in stimulating neutralising and complement-fixing antibody production without important side-effects. It is suggested that the use of such a vaccine in adolescent girls would reduce the incidence of primary cytomegalovirus infection in pregnancy and thus eliminate fetal brain damage due to this cause.

The prophylactic role of intravenous and long-term oral acyclovir after allogeneic bone marrow transplantation

Eighty-two patients were randomly allocated to receive intravenous acyclovir 5 mg kg-1 t.d.s. for 23 days followed by oral acyclovir 800 mg 6-hourly for 6 months or matching placebos after allogeneic bone marrow transplantation. Herpes simplex and varicella zoster virus infections were significantly reduced during the period of administration of acyclovir. No reduction in cytomegalovirus infection was demonstrated. The drug was not toxic.

MICROBIAL CAUSES OF MENTAL RETARDATION THE ROLE OF PRENATAL INFECTIONS WITH CYTOMEGALOVIRUS, RUBELLA VIRUS, AND TOXOPLASMA

Abstract Mentally retarded children, all under 6 years of age and living at home with their parents, were studied for evidence of congenital infection with cytomegalovirus, rubella virus, and toxoplasma. They were compared with normal children of the same ages. A significant association was found between cytomegalovirus infection and microcephalic mental deficiency. This virus may account for about 10% of such cases. Rubella and toxoplasmosis together probably were responsible for about 2-3% of all the cases of mental deficiency.

An early marker of fetal infection after primary cytomegalovirus infection in pregnancy.

Fourteen patients with primary cytomegalovirus infection diagnosed by serological screening at antenatal attendances were examined for their responses in the lymphocyte transformation test against cytomegalovirus. Tests were done during pregnancy, shortly after the diagnosis of primary infection. Eight women showed positive lymphocyte transformation responses and gave birth to uninfected babies. Six showed negative responses and four of the babies were born congenitally infected. Cellular immunity therefore plays a part in preventing intrauterine transmission of cytomegalovirus, and its depression after primary infection in the mother during pregnancy may be used as an early marker of fetal infection.

A simple immunoalkaline phosphatase method for the rapid diagnosis of cytomegalovirus (CMV) infection

Abstract Eight hundred and eighty-four specimens, comprising mainly buffy coats, urines, throat swabs and other respiratory tract specimens, were examined for the presence of cytomegalovirus (CMV) by conventional virus isolation in tissue culture and by a rapid alkaline phosphatase technique. The rapid method has an overall sensitivity of 81·2%, compared with conventional virus isolation, and a specificity of 95·8%. The sensitivity for buffy coat specimens, however, was only 53·3%.

Coxsackie B virus-specific IgM antibody and myocardial infarction

The ELISA technique was shown to be group-specific for the detection of IgM antibodies against coxsackie B viruses, and probably against a wider range of enteroviruses. No evidence was obtained that recent coxsackie B-virus infection predisposes to myocardial infarction.

Acyclovir for cytomegalovirus infection.

volume and with degree of insulin sensitivity in vivo.4 5 We propose that an increase in androgenic activity may result in enlargement ofabdominal fat cells and thus a high waist to hips girth ratio, leading to the development of insulin resistance both in adipose tissue and in other metabolically active tissues-such as skeletal muscle6-which in turn results in the development of metabolic aberrations and hence in an increased susceptibility to coronary heart disease. As previously suggested, measurement of waist to hips girth ratio is a simple practical means of assessing body fat distribution, comparing well with more complex indices such as those based on skinfold thicknesses or the brachiofemoral adipomuscular ratio (paper by D J Evans and others presented at the proceedings of the North American Association for the Study of Obesity in Ploughkeepsie, New York, 1982), and may provide a useful marker of predisposition to metabolic aberrations and cardiovascular disease.

INDIRECT ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) FOR DETECTION OF IgG ANTIBODIES AGAINST COXSACKIE B VIRUSES

In tests for IgG antibodies against Coxsackie B viruses in man, the enzyme-linked immunosorbent assay (ELISA) was essentially group-specific and, unlike the type-specific neutralisation test, usually failed to detect rises in antibody titre in paired, acute and convalescent, sera. However, in rabbits immunised against Coxsackie B viruses, ELISA demonstrated both group- and type-specific antibody responses. The lack of type-specificity of ELISA in man is probably because repeated infection with enteroviruses--echoviruses and Coxsackie A as well as Coxsackie B--results in masking of the type-specific antibody response by group-specific antibody.