Petra Kucerova

Real-time PCR method for the detection of the gene encoding surface lipoprotein LipL32 of pathogenic Leptospira: use in the laboratory diagnosis of the acute form of leptospirosis.

Abstract Background: The aims of this work were to replace the obsolete PCR method for the laboratory diagnosis of the acute form of leptospirosis using the G1, G2 and B64 I, B64 II primers, and to improve the PCR detection time. Methods: We introduced a real-time PCR method for the detection of the gene encoding the surface lipoprotein LipL32 of pathogenic Leptospira into our laboratory diagnosis of the acute form of leptospirosis. The positive and negative analytical specificities of the real-time PCR method were both equal to 100%; the detection limit was determined to be 1–5 genome copies/1 ml of liquid biological material. The method was further validated on 230 laboratory strains of leptospires. Results: All laboratory strains of pathogenic Leptospira were evaluated as LipL32-positive and all non-pathogenic strains as LipL32-negative. In addition, 455 biological materials (253 plasma, 121 urine, 72 cerebrospinal fluid (CSF), 7 bronchoalveolar lavage, and 2 sputum) from 295 patients with suspected leptospirosis were examined. From this set of patients, 9 were evaluated to be LipL32-positive, from 15 positive biological materials (10 urine, 4 blood plasma, and 1 CSF). Conclusions: This real-time PCR method for the detection of the gene encoding the surface lipoprotein LipL32 is a reliable, sensitive, and rapid method for the detection of the acute form of leptospirosis.

Spontaneous regression of malignant melanoma - is it based on the interplay between host immune system and melanoma antigens?

Malignant melanoma (MM) is the most aggressive and uneasily treatable form of skin cancer. Up to 90% of deaths because of skin tumours are estimated to be caused by this malignancy. Spontaneous regression is described as a partial or complete disappearance of cancer. It can be defined if the clinical and histological diagnosis of malignancy is verified and any therapeutic intervention potentially inducing mechanisms leading to regression has not been applied. Regression occurs more frequently in melanoma than in other types of tumours; it is reported to be six times higher than in other malignancies. Up to 50% of primary MM is reported to undergo spontaneous regression. However, spontaneous regression of the metastatic form of tumour is a rare phenomenon observed in only 0.23% of cases. The most frequently mentioned factors leading to spontaneous regression of MM are operative trauma, infection, vaccination (BCG and rabies vaccines) and immunological factors. Other well-documented circumstances associated with regression of metastatic MM include blood transfusion and various endocrine factors.

Leptospirosis: possibilities of early laboratory and clinical diagnosis

This retrospective study aims to identify and describe the problems associated with the laboratory and clinical diagnosis of leptospirosis. A total of 4,813 patients with suspected leptospirosis from an area of the Czech Republic, with a total population of 1.15 million, were examined during the period 2002–2010. Our study included only 855 patients: 545 men (mean age 41.03 ± 19.24) and 310 women (mean age 41.47 ± 20.3) who were examined using microscopic agglutination test (MAT) and a polymerase chain reaction (PCR). All patients and their physicians filled in questionnaires, which included anamnestic data, clinical symptoms and the results of laboratory tests. Out of total suspected, 89 patients (1.85%), tested positive for leptospirosis, of which 50 have been examined only serologically by MAT. Of 855 patients in our study undergoing both PCR and MAT tests, 39 have tested positive for leptospirosis. The most frequent symptom in patients with leptospirosis included fever (91.6%) and headache (69.4%). The correct laboratory diagnosis of leptospirosis depends on biological material being tested before the start of antibiotic treatment, since leptospires are extremely sensitive to antibiotics. Consequently, the PCR results alone may produce a false negative result after 24 hours following treatment with antibiotics.

Our experience using real-time PCR for the detection of the gene that encodes the superficial lipoprotein LipL32 of the pathogenic leptospires to confirm the acute form of human leptospirosis

AIMS To examine biological materials (blood, urine, cerebrospinal fluid) of patients with suspected leptospirosis using real-time PCR for detecting the gene that codes the superficial LipL32 lipoprotein, and to evaluate the contribution of the real-time PCR method for the laboratory diagnosis of the acute form of leptospirosis. MATERIAL AND METHODS During the monitored period of April 2010 - December 2011, a total of 340 biological materials samples were examined (177x blood plasma, 88x urine, 68x, cerebrospinal fluid, 6x bronchoalveolar lavage and 1x sputum) from 216 patients with suspected leptospirosis using real-time PCR LipL32 gene detection. RESULTS From the mentioned 216 patients suspected of leptospirosis, 8 patients were evaluated as being PCR LipL32 positive, from which 14 positive biological materials originated (9 x urine, 4x blood and 1x liquor). CONCLUSION As demonstrated in the study, the real-time PCR method for detecting the gene for the superficial lipoprotein LipL32 is an appropriate, quick and reliable method for the diagnosis of the acute form of leptospirosis.

Leptospirosis: a neglected zoonosis of global distribution

This review details the basic characteristics about a neglected zoonosis of worldwide distribution – leptospirosis. Prevalence of infection caused by pathogenic leptospires ranges from 1 to 100 per 100 000 inhabitants. Leptospirosis can manifest itself as a mild flu-like illness associated with sudden fever, headache and myalgia. In 90% of cases, anicteric forms of the disease develop and in the remaining 10% of cases severe icteric course of infection is seen. More than 500 000 cases of severe leptospirosis are described annually with mortality from 5 to 15%. This review will primarily focus on the pathogenesis, the clinical manifestations, the laboratory diagnosis and treatment of this infectious disease.

Coley's toxin and Bcg vaccine in prevention and treatment of malignant melanoma in humans

&NA; Malignant melanoma is the most severe form of skin cancers in humans. Incidence of this malignancy is still increasing worldwide. The highest incidence is mentioned in Australia (50–60/100,000 of cases). Success of malignant melanoma therapy depends on the stage of disease revelation. Localized cutaneous melanoma is generally well curable. The main problem is the treatment of advanced malignant melanoma with distant metastases. Therapy of this malignancy is based on surgical resection of lesion, chemotherapy, immunotherapy, biochemotherapy, and so on. The current results of malignant melanoma treatment are unfortunately often unsatisfactory. Improvement and enhancement of efficacy of contemporary immunotherapeutic methods should be in the forefront of interest. Renaissance of the old concepts of immunotherapy (Coleys toxin and Bacillus Calmette-Guérin vaccine administration) could be one way to reduce possible adverse effect of standard methods of malignant melanoma treatment.

Toxoplasmosis in at-risk groups of patients

Toxoplasmosis, one of the most common parasitic zoonoses worldwide caused by the protozoan Toxoplasma gondii, is found all over the world, and can affect any warm-blooded animal, including humans, although the primary host is the cat. Disease transmission occurs from eating undercooked lamb, beef or