Dalgard                              McCeney
Davis                                 Mohyeldin
Elliott                                 Parrish
Ha                                     Santos-Ciminera                  
Larsen                                Simms                         
Lindsey                               Taylor



Clifton Dalgard
Neuroscience Program

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Doctor of Philosophy
2005

Major Advisor: Ajay Verma, M.D., Ph.D. Department of Neurology

Dissertation Title: Hypoxia-Inducible Factor Hydroxylases Are Oxygen Sensors in the Brain

ABSTRACT:
In mammalian cells, molecular oxygen is a requirement for normal growth, metabolism, and survival. Tissues in which oxygen demand surpasses oxygen supply become hypoxic and cannot maintain normal function. Thus, the ability to sense oxygen levels is necessary for an organism to survive and thrive in changing environmental and physiological conditions. HIF-1 is a transcription factor, complex that is essential and central to several cellular and systemic adaptations to hypoxia. For example, vascular endothelial growth factor and erythropoietin are HIF-I target genes that are important in angiogenesis and erythropoiesis, respectively. HIF-I consists of two subunits, alpha and beta, and control of HIF-1 function is accomplished through the hydroxylation of proline residues and an asparagine residue on the a-subunit of HIF-l. Under normoxic conditions, hydroxylated HIF-la is constantly and rapidly degraded, thus HIF-l is inactivated. Additionally, undegraded HIF-la is hydroxylated at an asparagine residue in the c-terminal region, which prevents it from binding to the co-transcriptional activator p300. The post-translational modifications of HIF-la are performed by four oxygen-dependent enzymes, the three HIF-la prolyl hydroxylase (HPH-l, HPH-2, and HPH-3) and the asparaginyl hydroxylase FIH-l (Factor Inhibiting HIF). Since these enzymes IV modify HIF-la in an oxygen-dependent manner, they have been suggested to function as oxygen sensors in vivo. No studies of these oxygen sensors have been conducted in the mammalian brain or brain derived cells. This dissertation describes biochemistry, cellular and molecular biology, and whole animal physiology of these oxygen sensors. Using human glioma cell lines, we demonstrate that HPHs are themselves induced by hypoxia, thus suggesting the presence of a negative feedback system to modulate hypoxic gene expression. For the three HPHs, we found differential distribution of expression between different brain cell types and different brain regions. The same HPH homologues that are regulated in permanent cell lines are regulated in brain cells in culture and in vivo. We found that different brain regions induce HPH expression to different extents and hypoxic induction of the oxygen sensors was more prominent in young animals than in old and was manifested by increases in protein expression and enzymatic activity. We also found in addition to oxygen availability, the HIF hydroxylases are also regulated by certain glycolytic metabolites. We specifically identified pyruvate and oxaloacetate as the regulatory metabolites and demonstrated that their mode of action involves a reversible inactivation of HIF hydroxylation. Pyruvate and oxaloacetate induced HIF-l in cells and also resulted in upregulation of HPH-l and HPH-2. These results suggest HIF prolyl hydroxylases are sensor of oxygen tensions as well as glycolytic metabolite accumulation. Moreover, both of these stimuli increase expression of these hydroxylases which may serve as a negative feedback system for these sensing mechanisms. Given that the brain is highly sensitive to low oxygen tensions, these studies may provide valuable insight to develop novel tools and therapies for oxygen-associated brain diseases like stroke, heart failure, and brain cancer.



Leland Davis
Molecular and Cell Biology Program

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Doctor of Philosophy
2005

Dr. Shiv Srivastava, Department of Surgery

DissertationTitle: Novel Insights into p63 Expression and Function in Prostate


ABSTRACT:
Introduction: The central hypothesis of this dissertation is that p53 homologues exist and that identification of these genes will provide a better understanding of the role p53 gene family plays in biology and cancer. At the beginning of this research, no p53 related gene was known. Subsequently, p63, a p53 homolog was described by other investigators. p63 is necessary in the development of epithelial structures. One of the isoforms of p63, DNp63, is highly expressed in prostates, which led to the hypothesis that DNp63 has critical functions in the prostate. The studies reported here provide new insights into the expression and function of p63 in the prostate and prostate cancer.

Results: Initially, p53 homologs were sought in human prostate epithelial derived cell cultures through degenerate RT-PCR and other techniques. When the discovery of p63 using a similar approach was reported, our effort focused on p63 evaluation in tissue microarrays of benign and malignant prostate tissues. The basal cell specific expression of DNp63 in normal prostate is very striking. DNp63 is absent in other cell types in normal prostate and is not expressed in prostate adenocarcinoma. Detectable p63 was found in immortalized and early passage cell cultures derived from benign and malignant prostate tissue, but not in senescent cultures. Experimental models using adenovirus p63 expression vectors and prostate cell culture models have been developed. Evaluation of proteins involved in cell growth and development regulation suggested that p63 overexpression reduced serine 9 phosphorylation of GSK3 and AKT.

Conclusions: The selective presence of DNp63 in basal cells of the prostate revealed it to be an excellent new bio-marker of prostate basal cells and epithelial cell cultures. DNp63 has already found translational utility in the diagnostic pathology setting for excluding prostate cancer in biopsies due to its basal cell restricted expression in only benign glands. In the prostate, DNp63 does not appear to stimulate growth, but rather functions in the maintenance of basal cell phenotype. p63 does not appear to play a role in prostate cancer. Further investigations of p63 mechanisms in basal cell biology are warranted.


Brenda M. Elliott
Department of Medical and Clinical Psychology

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Doctor of Philosophy
2005

Major Advisor: Neil E. Grunberg, Ph.D., Department of Medical and Clinical Psychology

Dissertation Title: Environmental Enrichment, Performance, and Brain Injury
in Male and Female Rats

ABSTRACT:
Environmental enrichment affects performance of intact organisms and improves recovery from brain injury. The extent to which physical vs. social aspects of enriched environments separately contribute to superior performance or the extent to which males and females differ in their response to enrichment has not been examined previously.

The goals of this doctoral research were to examine the separate and combined effects of social enrichment (SE) and physical enrichment (PE) on cognitive performance of neurologically-intact and brain-injured rats and to determine if there were gender differences in these effects. Measures of basic (i.e., locomotor habituation and ASR/PPI) and complex cognitive processing (i.e., passive avoidance, Morris water maze) were used to determine if enrichment affected performance on simple and complex cognitive measures. Experiment I examined the effects of enrichment on performance of 192 intact animals. Experiment II examined the effect of enrichment on performance of 96 injured animals.

The major findings from the current study were: 1) social enrichment has the greatest effect to improve performance for both intact and injured animals; 2) the effects of enrichment overall generally appear to be greater for males than for females; 3) overall enrichment has the greatest beneficial effect on tasks that require the active processing of information. These findings replicate and extend previous work on enrichment and may have important implications for educational programming and brain injury rehabilitation.


Cam Ha
Molecular and Cell Biology

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Doctor of Philosophy
2005

Major Advisor: Gabriela Dveksler, Ph.D., Department of Pathology

Dissertation Title: Pregnancy Specific Glycoprotein 17 Binds to the Extracellular Loop 2 of its Receptor, CD9, and Induces the Secretion of IL-10, IL-6, PGE2 and TGFß1 in Murine Macrophages

ABSTRACT:
Pregnancy specific glycoproteins (PSGs) are a family of secreted proteins produced by the placenta. In humans, the serum concentration of these glycoproteins exceeds that of other pregnancy-related proteins, reaching up to 200-400 g/ml at term. In species with hemochorial placentation, PSGs are believed to have a critical role in the success of pregnancy. We previously reported that treatment of human monocytes with PSGs induced IL-10, IL-6, and TGF-ß1 secretion. Although the receptor for human PSGs remains unknown, we identified CD9 as the receptor for both murine PSG17 and PSG19. To determine whether human and murine PSG family members have similar functions and whether CD9 mediates the response to PSG17, we treated macrophages from wild type and CD9-deficient mice with recombinant murine PSG17N, which consists of the N1-domain of this glycoprotein. Our data reveal that CD9 expression is required for PSG17N-induced secretion of IL-10, IL-6, PGE2, and TGF-ß1 in macrophages. The ability of PSG17N to induce IL-10 and IL-6 mRNA was significantly reduced in the presence of cycloheximide, and secretion of these cytokines required induction of cyclooxygenase-2. Further characterization of the response to PSG17 indicated that cAMP-dependent protein kinase A is involved in the up-regulation of IL-10 and IL-6. The induction of anti-inflammatory cytokines by various PSGs supports the hypothesis that these placenta-secreted glycoproteins have an essential role in the regulation of the maternal immune response during pregnancy.


Joseph C. Larsen
Emerging Infectious Diseases Graduate Program

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Doctor of Philosophy
2004

Major Advisor: Patricia Guerry, Ph.D., Department of Enteric Diseases, Naval Medical Research Center

Dissertation Title: Characterization of a plasmid-encoded type IV secretion system in
Campylobacter jejuni 81-176

ABSTRACT:
The Gram-negative bacterium Campylobacter jejuni is major cause of diarrheal illness in both the United States and the world abroad. Although well established as an etiological agent, little is understood regarding the molecular mechanisms underlying its pathogenesis. Additionally, inter-strain variations in clinical manifestations, in vitro epithelial cell invasion levels, and virulence in animal models suggest that genetic elements account for these phenotypic differences.

One strain of C. jejuni, 81-176, is a particularly virulent strain that invades epithelial cells at levels higher than most C. jejuni isolates. This strain possesses two plasmids, designated pVir and pTet, both of which contain genes with homology to type IV secretion systems (TFSS). TFSS are systems capable of translocating DNA, protein, or nucleoprotein complexes across bacterial membranes. Such systems are found in a number of human pathogens, where they facilitate various pathogenic processes. A mutational analysis in some of the pVir TFSS genes reduced levels of intestinal epithelial cell invasion and natural competence. Additionally, a mutation in one of the TFSS genes led to an attenuation of virulence in the ferret diarrhea model. These data led us to hypothesize that the pVir TFSS contributes to the pathogenesis of C. jejuni 81-176 and accounts for the phenotypic differences observed in virulence models.

This work represents a characterization of the pVir TFSS found in C. jejuni 81-176. Following purification and the generation of antisera, it was demonstrated that VirB10, a structural component of the pVir TFSS is glycosylated. Lectin affinity, enzymatic cleavage, and a reconstitution of glycosylation in Escherichia coli suggested that VirB10 was glycosylated by the general N-linked glycosylation pathway (pgl) of C. jejuni. Site-specific mutagenesis of VirB10 revealed two glycosylation sites at N32 and N97. Previously, mutation of virB10 resulted in a modest reduction in levels of natural competence. Mutation of N97 but not N32 resulted in levels of natural competence consistent with the virB10 mutant, suggesting glycosylation is required for the function of the pVir TFSS.

Secondly, an initial biochemical characterization of a putative type IV secretion ATPase was undertaken. A VirB11 homolog from the pVir plasmid was expressed and purified. This protein was shown in both a time and concentration dependent manner to possess ATPase activity and mutation of the nucleotide-binding site of VirB11 resulted in a form of the protein that was devoid of enzymatic activity. Yeast 2-hybrid analysis and chemical cross-linking experiments suggested that VirB11 formed hexameric structures, consistent with other VirB11 family members.

Lastly, characterization of a pVir-encoded protein linked with the TFSS was performed. This protein, Cjp29, bears homology to eukaryotic cell proteins and its expression is dependent on the TFSS genes. The regulation with the TFSS suggests that Cjp29 may be a protein substrate of the pVir TFSS.

Taken together, the characterization of the pVir TFSS represented here has provided a substantial foundation upon which to launch future research to elucidate the specific contributions of this system to clinical illness.


Kathryn Tierney Lindsey
Department of Medical and Clinical Psychology

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Doctor of Philosophy
2005

Major Advisor: Kelly J. Rohan, Ph.D., Department of Medical and Clinical Psychology

Dissertation Title: Surface Facial Electromyography Reactions to Light-Relevant
and Season-Relevant Stimuli in Seasonal Affective Disorder


Facial electromyography (EMG) activity was recorded from the zygomaticus major and corrugator supercilii muscle regions to examine emotion-specific reactivity in 24 currently depressed individuals meeting DSM-IV criteria for Major Depression, Recurrent with Seasonal Pattern, and no other current Axis I diagnosis, and 24 controls with normal mood and no history of depression. Based on models of seasonal affective disorder (SAD) and a proposed role for learned associations between depressive behavior and environmental stimuli signaling low light and winter season, participants were exposed to light- and season-relevant environmental stimuli and were asked to imagine what they would be feeling and thinking if they were actually in the picture. Skin conductance response was also assessed to determine participants’ general sympathetic arousal to the stimuli.

Results indicated that SAD participants: 1) responded to bright light stimuli with decreased corrugator mean EMG activity relative to low light stimuli; 2) demonstrated no increases in zygomatic mean EMG activity to bright light stimuli; 3) reported an exacerbation of baseline depressed mood following low light and winter stimuli and an improvement in depressed mood following bright light stimuli; and 4) evidenced increased SCR magnitude to bright light stimuli as compared to low light stimuli. Notably, corrugator and self-report mood ratings support previous findings of heightened psychophysiological reactivity and exacerbated depressed mood after exposure to light-relevant stimuli in SAD and suggest that light intensity may be more salient than seasonal cues in determining affective reactivity. Further research is needed to understand how these associations develop, and to establish the clinical implications for psychophysiological measures in SAD assessment and treatment monitoring.


Melissa K. McCeney
Department of Medical and Clinical Psychology

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Doctor of Philosophy
2004

Major Advisor: David S. Krantz, Ph.D., Department of Medical and Clinical Psychology

DissertationTitle: Biobehavioral Triggers of Cardiac Arrhythmia during Daily Life: The Role of Emotion, Physical Activity, and Heart Rate Variability

ABSTRACT:
Biobehavioral factors, such as physical activity and emotions, have been associated with adverse cardiac outcomes, including myocardial ischemia and infarction, in individuals with coronary artery disease. However, cardiac arrhythmia has largely been neglected with regard to psychosocial influences. The present study examined the role of physical activity and acute emotions in triggering arrhythmia in susceptible individuals during everyday activities. In addition, it addressed the impact of chronic factors, including trait anxiety, hostility, depression, and usual levels of physical activity on arrhythmia. Finally, this research explored short-term and long-term heart rate variability (HRV) as a potential mechanism for the impact of biobehavioral factors on cardiac arrhythmia.

Participants included 40 men and 10 women with documented coronary artery disease who have received implantable cardioverter defibrillators (ICDs). As part of the Triggers of Arrhythmia in Defibrillator Patients (TRIAD) study, these individuals were monitored for 48 hours using ambulatory electrocardiogram (ECG) recorders. During the monitoring period, participants completed two structured diaries, recording their activities and moods. Participants also completed standardized measures of depression, hostility, and trait anxiety.

Ambulatory ECG tapes were analyzed to identify arrhythmic events, and these events were correlated with changes in physical activity and/or emotions to identify acute triggers of arrhythmia. Acute changes in HRV immediately coincident and following these triggers were evaluated. Long-term HRV and chronic factors were be correlated with arrhythmia.

As predicted, higher levels of trait anxiety and chronic depressive symptoms were associated with lower measures of heart rate variability. Although all associations between hostility and HRV were negative (i.e., higher hostility was associated with lower HRV), the associations were small and did not reach statistical significance.

Participants appeared to have been more likely to be exposed to acute negative emotions prior to more severe cardiac arrhythmia, such as bigeminy, triplets, and ventricular runs, compared to control periods when no arrhythmia occurred. This association was not present when couplets were included in the analyses.

In the present sample, HRV did not change significantly prior to arrhythmic events. However, nonsignificant changes were consistently in the predicted direction (decreasing prior to arrhythmias). The changes in HRV prior to more severe arrhythmias, particularly ventricular runs, were considerably larger than those prior to more benign arrhythmias (such as couplets), but the small number of more severe arrhythmias experienced by the present sample prevented those changes from reaching statistical significance.

Surprisingly, participants were less likely to have been exposed to acute physical activity prior to arrhythmia than during control periods when no arrhythmia occurred. This finding is likely due to the fact that patients didn’t feel well prior to arrhythmias and therefore chose not to be physically active at that time. Although they did not report increased chest pain or shortness of breath prior to arrhythmias, there was no measure of general malaise, and patients were significantly more likely to report feeling tired prior to arrhythmias compared to control periods.

Further, higher depressive symptoms were unexpectedly associated with fewer arrhythmias. This disparate finding may be due to a type of selection bias due to the length of time that had passed since participants had their first infarct and the length of time that had passed since their ICDs were implanted. Given the low levels of depressive symptoms in this sample, this finding may also reflect a maladaptive level of unrealistic optimism. Further study is necessary to determine the role of unrealistic optimism in cardiovascular outcomes. Neither hostility nor trait anxiety was associated with cardiac arrhythmia.

Self-reported usual levels of light, vigorous, heavy, and extreme physical activity were not significantly associated with any type of arrhythmia. However, nonsignificant correlations were all in the predicted direction; that is, more frequent heavy and extreme activity were associated with fewer arrhythmias. Unexpectedly, higher levels of moderate activity were significantly associated with more frequent arrhythmias, which may indicate that the acute risk of physical activity outweighs the benefit of consistent activity. It may also be that participants in the present sample did not exercise frequently enough for physical activity to be beneficial. It is unclear whether self-reported usual levels of physical activity adequately reflect physical fitness levels. However, correlations between reported activity levels, resting heart rate, and body mass index suggest that they do reflect physical fitness, at least to some extent. Additional research using more objective measures of physical fitness, such as aerobic capacity and cardiovascular endurance, may help to clarify these findings. Usual levels of physical activity were not associated with any measure of heart rate variability.

Contrary to predictions, heart rate variability did not change following negative emotions, perhaps due to low baseline levels of HRV that did not allow for much fluctuation. This finding may help to explain why exposure to acute negative emotions did not increase the risk of arrhythmia. Measures of 24-hour HRV were not associated with the frequency of arrhythmias in the present sample, which may reflect the lack of an association between HRV and arrhythmia in ICD patients, but may also be the result of lingering effects of beta-blockers.


Ahmed Mohyeldin
Neuroscience Program

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Doctor of Philosophy
2005

Major Advisor: Ajay Verma, M.D., PhD, Department of Neurology

Dissertation Title: The Role of Erythropoietin Signaling in Human Cancer

ABSTRACT:
Hypoxia in solid tumors emanates from a structural and functionally disturbed vascular supply. Intratumoral oxygen levels are associated with poor prognosis, treatment resistance and cancer metastases, yet mechanisms for such phenomenon remain poorly understood. The major objective of this dissertation was to test whether or not erythropoietin (Epo), a hypoxia inducible cytokine, plays a role in astrocytoma treatment resistance and progression. The specific aims of this dissertation were to: 1) Determine whether or not hypoxia regulates the expression of Epo and EpoR (erythropoietin receptor) in astrocytomas. 2) Examine if Epo treatment results in treatment resistance in astrocytomas against chemotherapy. 3) Evaluate if Epo signaling promotes invasiveness in human astrocytomas. We examined the expression of erythropoietin and its receptor using immunohistochemistry in human glioma and head and neck tumor biopsies. We also established several in vitro cell death and cell invasion assays to examine the effects of Epo signaling on human malignant astrocytoma and head and neck cancer cell lines. In addition, we developed primers to measure baseline and hypoxia-inducible Epo and EpoR mRNA expression in cancer cells with quantitative RT-PCR.

Collectively, this work answers key questions that provide insight into how hypoxia promotes cancer malignancy. Human cancers express Epo as well as functional EpoR. Expression of these proteins is most pronounced in hypoxic tumor regions and in invasive tumor margins. This work demonstrates that recombinant human Epoetin-a can directly stimulate the invasiveness of human cancer cells through Matrigel®. Epo also promotes tyrosine phosphorylation in human glioma cell lines. Hypoxia upregulates the expression of both Epo and EpoR in cancer cell lines and also promotes invasiveness. Moreover, hypoxia-induced invasiveness is blunted in stably transfected cells expressing a truncated form of the Epo receptor and diminished by Epo neutralizing antibodies. Together these findings suggest that autocrine or paracrine Epo signaling may play a significant role in cancer cell invasiveness. Furthermore, the use of Epo to treat anemia in cancer patients may have the deleterious side effect of promoting local cancer spread. Our work may also have profound implications for the treatment and management of cancer patients since Epo is used to treat anemia associated with cancer therapy.


LT Douglas K. Parrish
Department of Preventive Medicine and Biometrics

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Doctor of Philosophy
2005

Major Advisor: CDR Gary L. Hook, Department of Preventive Medicine and Biometrics

Dissertation Title: Application of Solid Phase Microextraction with Gas Chromatography-Mass Spectrometry as a Rapid, Reliable, and Safe Method for Field Sampling and Analysis of Chemical Warfare Agent Precursors

ABSTRACT:
Solid phase microextraction was combined with gas chromatography-mass spectrometry (SPME-GC-MS) for detection of hydrogen cyanide (HCN) in the headspace above deionized (DI) water samples, with linear results that were sensitive to below Department of Defense short-term drinking water standards. HCN and several common volatile organic contaminants were also detected in 3 water types in a laboratory and field setting. The method provides an advantage over the standard drinking water detection methods for HCN as it can also simultaneously detect common low molecular weight hydrocarbons.

Linear results were achieved for the detection of diisopropylamine (DIPA) by SPME-GC-MS in soil from 0.72 - 3584.5 g DIPA/g soil and in DI water from 0.018 - 17.9 g/mL. The methods were successfully field tested with common hydrocarbon contaminants in 3 common agricultural soil types and 3 water types. In particular, this methodology would be useful for investigation of a suspected VX nerve agent production facility.

Solid phase dynamic extraction (SPDE) was compared to passive SPME for vapor sampling of DIPA and dimethyl methylphosphonate (DMMP) with analysis by fast GC-MS. Equilibrium sampling by SPDE for DIPA and DMMP vapor provided linear results at lower concentrations and gave larger extracted ion peak areas than comparable SPME sampling. This unique application has shown great potential for further laboratory and field use, both for health risk assessment and initial chemical detection employment.

A fast GC capillary column was integrated with a novel low pressure, quadrupole ion trap, time-of-flight photoionization mass spectrometer (Qit Tof PI-MS). The addition of a GC injection port and column allowed the use of SPME to provide headspace extraction of several chemical warfare agent (CWA) precursors for introduction to this GC/PI-MS. This prototype instrumentation was shown to be able to detect CWA precursor vapors in air individually and in mixtures.

The central research goal was to develop the ability to rapidly detect CWA precursors in a field setting. The greatest benefit to using these SPME-GC-MS methods is they allow unambiguous detection and identification of CWA precursors as well as common environmental contaminants. These detection methods are applicable to the military environmental scientist as well as homeland defense and hazardous material detection personnel. Identification of environmental chemicals is the first step in assessing military deployment exposures and health risks.


Patricia Dantas Santos-Ciminera
Emerging Infectious Diseases Program

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Doctor of Philosophy
2005

Major Advisor: Gerald V. Quinnan, Jr., M.D., Department of Preventive Medicine and Biometrics

Dissertation Title: Molecular Epidemiology of Epidemic Severe Malaria Caused by Plasmodium vivax in the State of Amazonas, Brazil.

ABSTRACT:
Malaria in South America is a major public health problem. In Brazil, most of the cases occur in the Amazon Region, particularly in the State of Amazonas. In Manaus, the capital of Amazonas, atypical cases of P. vivax infections, including patients presenting with severe thrombocytopenia and bleeding, led to the formulation of the hypothesis that severe disease could be related to a particular, emergent and more pathogenic genotype of P. vivax. We described the epidemiology of malaria for the Amazonas State and city of Manaus by comparing patients admitted in the hospital to those treated as outpatients in the Fundação de Medicina Tropical do Amazonas (FMT-AM). Admissions due to vivax malaria increased significantly from 1997 through 2003 suggesting a change in clinical presentation. The admitted group presented higher mean parasite counts, lower platelet counts, and higher levels of liver enzymes, higher total and indirect bilirubin, and higher blood urea nitrogen when compared to the outpatient group. Clinical symptoms of severe disease, including hematuria, hemolytic anemia, and thrombocytopenia were only noted in the admitted group. Furthermore, the presence of a palpable liver was more frequent in admitted patients. Nucleic acid sequences of three genes from P. vivax, the 18S SSUrRNA Type A gene, CSP gene and MSP-1 gene, were determined. Strains from test samples were compared to each other, to the reference strains Salvador I and Belém and to sequences retrieved from the Gene Bank. There were two main polymorphisms in the 18S SSUrRNA Type A gene, a cytosine/thymidine polymorphism at residue 100 of the alignment and a thymidine (T)/adenine (A) polymorphism at residue 117. Ten of eleven (10/11) admitted patients were 117:T compared to 13/21 outpatients. This frequency difference was statistically significant (P<0.05). The Salvador I strain was T at this position and the Belém strain was A. In the CSP gene, we identified 15 unique sequences of the VK210 strain; one sample had a mixed infection with P. vivax-like. The sources of variation in the CSP gene included the numbers of repeat segments, alanine/aspartic acid polymorphism at position five of a common repeat, and sporadic mutations. Frequent synonymous substitutions of the common repeat occurred in codons 1, 2 and 7, while the mutations at codon 5 were always non-synonymous. Among MSP-1 gene sequences, four recombination sites were distinguished between the interspecies conserved regions 5 and 6. Recombination among progenitor strains, closely related to the Salvador I and Belém strains, was the main source of diversity among the strains. The second most significant form of variation was in the polyglutamine region of strains with Belém-like sequences in the central part of this gene segment. There was no clustering of MSP-1 sequences in patients with severe disease. It was not possible to demonstrate the evolutionary relationship among our test samples by tests of phylogeny that incorporated sequence data for all three genes tested. The factors that may have limited the power of a combined analysis included small sample size and differences in the mechanisms and extent of variation among the genes. The retrospective study was unable to demonstrate that a particular strain of P. vivax was responsible for severe disease requiring hospitalization. This is the first detailed description of the genetic diversity among the P. vivax population in the Amazonas State of Brazil.


Amy N. Simms
Department of Microbiology & Immunology

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Doctor of Philosophy
2005

Major Advisor: Ann E. Jerse, Ph.D. Department of Microbiology and Immunology

Dissertation Title: Examination of Neisseria gonorrhoeae Opacity Protein Expression During Experimental Murine Genital Tract Infection

The opacity (Opa) proteins of Neisseria gonorrhoeae are a family of phase- variable outer membrane proteins that bind to host cells. Phase variable expression occurs via a reversible frameshift mechanism within each opa gene. Opa protein expression is selected for, or induced during experimental genital tract infection of female mice, similar to that which was reported in male volunteers. Using a genetically marked strain of FAI090 to follow recovery of a specific population of Opa variants during murine infection, here we showed that selection of a pre-existing population of Opa-positive gonococci present in the inoculum was responsible for the reisolation of mainly Opa-positive variants early during infection. We conclude that the preferential recovery of Opa-positive gonococci observed early during murine infection is due to selection of a pre-existing population of Opa-positive variants caused by factors other than binding to human CEACAM receptors. In long-term infection of mice, a cyclical pattern of Opa protein expression was observed in which a decreased recovery of Opa- positive variants followed early selection for Opa protein expression; reemergence of Opa-positive gonococci occurred later in infection. To examine rates of phase variation in a N gonorrhoeae background under physiologically relevant conditions, we engineered a translational opaB::phoA fusion and introduced it into the chromosome of N. gonorrhoeae strain FAIO90 to generate strain ANSIOO. No change was seen in the frequency or rate of opaB::phoA phase variation in all in vitro conditions tested. We next examined whether increased phase variation of the opaB::phoA fusion occurred during murine infection. No significant change occurred in the frequency of "on" variants among vaginal isolates when mice were inoculated with predominantly "off' variants; however, a marked increase in the recovery of "off' variants was observed following inoculation with predominantly "on" variants. The inability to show differences in opa gene phase variation under different conditions in vitro leads us to conclude at this time that induction ofopa gene phase variation may be spontaneous and random. However, the in vivo studies suggest that increased opa gene phase variation may occur under conditions that we have not yet been able to mimic in vitro.


Jean Taylor
Department of Preventive Medicine & Biometrics

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Doctor of Public Health
2005

Major Advisor: COL Robert Lipnick, USA, Department of Preventive Medicine & Biometrics

Dissertation Title: Birth Weight and Acute Leukemia: A Meta-Analysis of Observational Studies

ABSTRACT
The major objective of this study was to determine whether high birth weight is associated with ALL and AML among children and to quantify the strength of the relationships. We conducted a meta-analysis of nine case-control studies (published between 1991 and 2004) encompassing over 6,200 children with ALL and over 12,000 controls. We found that children weighing 4,000 g or more at birth had 24% (OR: 1.24; 95% CI: 1.12, 1.37) higher odds of developing ALL than children weighing less (without consideration to reference weight). Regardless of peer-review status, response rates among cases and controls, or choice of threshold for high birth weight, studies consistently demonstrated a similar overall odds ratio ranging from 1.23 to 1.29. In addition, our data analysis identified possible reasons for inconsistent findings among previous studies that examined high birth weight as a risk factor for ALL. Possible explanations include: use of different reference birth weights, different data source for birth weight (i.e., birth certificate vs. interview), and different ethnic makeup of the study population. Our data supports the growing evidence for the link between high birth weight and childhood ALL. Women who are pregnant or considering pregnancy should know that unbounded weight gain may increase the odds of childhood ALL in their baby. Whether a positive association with high birth weight applies to AML is less clear from our results. Based on a meta-analysis of only three case-control studies (published between 1997 and 2004) involving over 700 children with AML and over 1,900 controls, high birth weight (> 4,000 g) appeared to increase the odds of developing AML by 14% (OR: 1.14; 95% CI: 0.84, 1.54).