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Clinical and Diagnostic Laboratory Immunology, July 2005, p. 814-820, Vol. 12, No. 7
1071-412X/05/$08.00+0 doi:10.1128/CDLI.12.7.814-820.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Chronix Biomedical GmbH, 37073 Göttingen, Germany,1 Chronix Biomedical Inc., San Jose, California 95112,2 Department of Neuropathology, University of Göttingen, 37075 Göttingen, Germany,3 Institute of Veterinary Medicine, University of Göttingen, 37073 Göttingen, Germany4
Received 26 January 2005/ Returned for modification 25 March 2005/ Accepted 27 April 2005
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The clinical significance of utilizing CNAs in monitoring cancer therapy was reported in a research study on multiple myeloma (9). This retrospective study detected repetitive sequences associated with the clinical status of individual multiple myeloma patients. Both studies (Persian Gulf War veterans and multiple myeloma patients) revealed that even though exogenous primers from the nontranslated region of enteroviruses were used, CNAs showed a consistent pattern of endogenous Alu/SINE-related sequences. Additionally, the clinical value of monitoring CNA repetitive sequences, e.g., microsatellites, was confirmed in a solid-tumor research study (25).
To study in detail the association of Alu/SINE elements of blood CNA with chronic illnesses, an animal model was selected for which genomic information is available and the clinical patterns of chronic disease are well defined. Mad cow disease, or bovine spongiform encephalopathy (BSE), is a progressive, invariably fatal neurodegenerative disease of cattle. BSE was recognized as a public health concern in 1996, when a disease was diagnosed in young Britons that appeared to be a new form of Creutzfeldt-Jakob disease (CJD), which usually develops at an older age. British scientists identified the strain of "variant Creutzfeldt-Jakob Disease" to be identical with that of BSE in cattle (8). Approximately 150 deaths from variant Creutzfeldt-Jakob Disease had been diagnosed in the United Kingdom as of April 2005 (13).
Current diagnostic methods for BSE utilize post mortem tests that detect misfolded protease-resistant prion protein (PrPres) in the obex region of a cow's brain. Infection control of BSE would require an ante mortem approach. We investigated whether SINE-associated CNA could serve as an ante mortem laboratory marker for BSE-exposed cattle.
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TABLE 1. Statistics from 2001 to 2003 of the German BSE eradication program
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Serum collection. Special care was taken in collection, processing, and storage of serum samples. Blood from the tail vein or artery was collected into 18-ml plastic tubes equipped with a coagulation accelerator and kept at room temperature for 30 min to ensure proper coagulation. Until further processing, the tubes were stored at 2 to 8°C for not longer than 24 h. Centrifugation was done at 2 to 8°C at 1,000 x g for 15 min. The serum supernatant was transferred into 1.5-ml microcentrifuge cups in 0.5-ml aliquots and frozen immediately at 20°C or 80°C until use.
Preparation of serum fractions. Frozen serum was thawed at 4°C in an ice-water bath and 250 µl was transferred into a 1.5-ml microcentrifuge tube. The tube was centrifuged at 4,000 x g for 25 min at 4°C in a model 5214 bench top centrifuge (Eppendorf, Hamburg, Germany) to remove cell debris. The supernatant was transferred into a fresh tube and subjected to 35 min of centrifugation at 20,000 x g. The supernatant was carefully removed and the pellet was used for further analyses.
Nucleic acid extraction. We used 20,000 x g pellets with a standard silica-based nucleic acid extraction (NucleoSpin kit; catalog number K3064, BD-Clontech, Heidelberg, Germany; field study: NucleoMag kit, Macherey & Nagel, Düren, Germany) according to the manufacturer's instructions. The resulting nucleic acid solutions were either used immediately or frozen at 80°C until further use.
Primers. The primers used in this study were derived from preceding investigations with degenerated differential display primers (data not shown). Briefly, two BSE cattle and four normal controls were used; after PCR differentially abundant bands were extracted and sequenced, specific primers were designed and tested in all possible combinations. The best separating primer combination was designated CHX-1F and CHX-1R. CHX-1F is homologous to a cDNA bovine entry similar to calmodulin (accession number XM_592316), whereas CHX-1R is homologous to the monomer unit of Bov-tA (accession number X64124).
Sequencing. Primers CHX-1F and CHX-1R (catalog numbers 42-4103 and 42-91102, respectively; Chronix Biomedical GmbH, Göttingen, Germany) were used on extracted nucleic acids in 20-µl PCR (Advantage-2 PCR kit, BD-Clontech, Heidelberg, Germany), with 30 to 35 cycles at 48 to 55°C annealing (60 seconds), 68°C extension (2 min), and 94°C denaturation (1 min). Samples from confirmed BSE cases and healthy control cows were loaded side-by-side on a polyacrylamide gel electrophoresis (PAGE) gel and analyzed as described. Bands were cut out of gels, eluted, and subjected to reamplification. The products were first blunt-ended with T7 DNA polymerase and phosphorylated with polynucleotide kinase and ATP. This reaction mixture was used for blunt-end ligation into a SmaI-digested, dephosphorylated pGEM-4Z vector.
Ligation was performed overnight at 4°C using 1 U T7 DNA ligase, 1 µg of the vector, and the PCR product prepared as described above. The product was transformed into chemically competent Escherichia coli and plated on TAXI LB-agar containing tetracycline, ampicillin, 5-bromo-4-chloro-3-indolyl-ß-D-galactopyranoside (X-Gal), and isopropylthiogalactopyranoside (IPTG). After overnight incubation at 37°C, positive (white) clones were picked and cultured in 1.5 ml LB-medium with ampicillin. Bacteria were harvested, and plasmids were isolated according to standard protocols and reconstituted in 50 µl Tris-borate-EDTA buffer. The plasmids were sequenced using either a LICOR model 4200 DNA sequencer with IRD700-labeled M13 forward and M13 reverse primers or with a model 3100 ABI capillary sequencer using unlabeled primers with Big-Dye-termination.
Raw sequences were processed using Sequencher (MAC OSX). Briefly, after trimming for the used cloning vector and ambiguities, an automatic contig assembly was performed using the default stringency parameters. From the resulting contigs, only those that included clones from at least two different samples were selected. Homologs were then defined as that portion of the contig sequence that was covered by more than 50% of the individual clones. The final homologous sequences were checked for the presence of the used primers. All homologs had one primer sequence; 18 homologs had both primer sequences present.
BLAST analysis. Genetic analysis was applied to the sequences using the Advance BLAST program (http://www.ncbi.nlm.nih.gov/BLAST/). The following parameters were set using the Megablast subprogram: low complexity filter off, expect 1000, and word size 11. All hits were compared by order and length, and the longest homologies of each region were used for comparisons. Analyses were done using the nr and est databases.
Diagnostic PCR. Three µl of the extracted nucleic acids from serum fractions was used without DNase pretreatment in a total PCR volume of 20 µl. Primers CHX-1F and CHX-1R (catalog numbers 42-4103 and 42-91102, Chronix Biomedical GmbH, Göttingen, Germany) were used at 1 µM each using a proofreading polymerase system (Advantage-2 PCR kit, BD-Clontech, Heidelberg, Germany). After 30 cycles of 95°C for 30 seconds, 55°C for 45 seconds, and 68°C for 1 min, a SybrGreen I (catalog number S7563, Molecular Probes, Eugene, OR)-derived melting curve was recorded in an MX4000 PCR system (catalog number 401260, Stratagene, La Jolla, CA). The area under the curve (AUC) of the derived melting function -d(F)/dT between 87°C and 90°C was used for analysis. This range was used since it was not prone to the influence of nonspecific products, e.g., primer-dimers, which frequently may be present due to the use of SybrGreen I during PCR. The reactivity of each individual sample was calculated on the basis of an AUC above the detection limit, which is defined as the mean + 5 standard deviations above the baseline of nontemplate controls. All initially reactive samples were retested in duplicate. Samples showing reactivity upon retesting were defined as repeatedly reactive.
Statistical analysis. The proportion of repeated reactivity in the cohort groups and the healthy control groups was calculated. The statistical significance between the cohorts and healthy controls was estimated using the chi-square test. For total group comparisons, a calculation with 9 degrees of freedom has been done, whereas for two-group comparisons, the degrees of freedom was lowered to 1.
PAGE. Eight µl of the PCR mixture was mixed with loading buffer and applied to a precast 12 to 20% polyacrylamide gel in Tris-borate-EDTA buffer (45 mM Tris, 45 mM boric acid, 1 mM EDTA) (4 to 20% Tris-borate-EDTA gel; catalog number EC62255, Novex, Karlsruhe, Germany). Electrophoresis was run at ambient temperature for 45 min at 180 V. The gels were stained for 20 min in a SybrGold (catalog number S11494, Molecular Probes) solution and photographed under UV light.
Nucleotide sequence accession numbers. The sequences of the PCR products from BSE and BSE-exposed cows based on primers CHX-1F and CHX-1R were deposited with the EMBL database (accession numbers AJ780924 to AJ780929).
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FIG. 1. Upper panel. Post-PCR (CHX-1F/CHX-1R) PAGE analysis of sera from two BSE cattle, four BSE-exposed cohort animals, and three normal controls. Lanes 1 to 3: normal control samples N1 to N3; lanes 4 to 7: cohort samples C1 to C4; lanes 8 and 9: PrPres-positive BSE cases BSE1 and BSE2; lane 10: size markers with sizes shown at the right. Lower panel. Melting curves from the same experiment as shown in the upper panel; 30 cycles of PCR with primers CHX-1F and CHX-1R were performed. The differences between cohort (C1 to C4) and BSE (BSE1 and BSE2) samples within the diagnostic range (87 to 90°C) are statistically significant (P < 0.01) versus the nontemplate control (NTC) and versus normals (N1 to N3). The AUC values are shown in parentheses.
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TABLE 2. CNA SINE fragments in BSE-infected and BSE-exposed cohort seraa
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FIG. 2. DNA sequence alignments (5' to 3', left to right) from three individual CNA fragments derived from PCR with the CHX-1F and CHX-1R primers. A common element identified from two confirmed BSE cases (CNA4), depicted as a solid gray box, in all CNA fragments is homologous to the monomer region of the Bov-tA SINE sequence (accession number X64124). The 5' Bov-tA-like sequence in CNA4 is followed 3' downstream by homologous fragments derived from accession number AC092496. CNA6 is a sequence identified from BSE cow 1 and cohort sera. The 5' Bov-tA-like sequence is followed 3' downstream by homologous fragments derived from accession number AC091728.2. CNA1 is a sequence identified from BSE cow 2 and cohort sera. The 5' Bov-tA-like sequence is followed 3' downstream with homologous fragments derived from accession number AC091660.2. Open boxes are plus/plus homologies (11 to 20 bp); diagonally striped boxes are plus/minus homologies (11 to 20 bp).
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TABLE 3. Study populations
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FIG. 3. Reactivity of four confirmed BSE cases (solid black bar), eight unrelated BSE cohorts, and healthy control animals. All eight cohorts (diagonally striped bars; cohort numbers are given according to Table 3) showed a higher proportion of repeatedly reactive samples than random healthy controls (solid gray bar), ranging from 33% to 91% of each cohort. Only one healthy control out of 176 was found to be repeatedly reactive (0.6%). The differences between cohorts and an apparently healthy control herd as well as randomly selected cattle without detectable PrPres post mortem are highly significant (P < 0.001).
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BSE-confirmed and at-risk animals from exposed cohorts (see Materials and Methods for definitions) of PrPres-confirmed BSE index cases were defined as BSE-exposed cases. The rationale for studying at-risk cohorts is clear from Table 1. According to the data provided by the German Ministry of Consumer Safety, Nutrition and Agriculture (6), the likelihood of detecting a PrPres-positive animal among cohorts is more than 100-fold greater than in healthy, noncohort cattle. Such BSE cohort cattle are in fact challenged with the same contaminated chow as the BSE index case. Approximately 1,000 cattle were used in this study to confirm the feasibility of a PCR test to detect SINE-associated CNA as an ante mortem surrogate marker for BSE exposure.
Three major findings arose from the study of SINE-associated CNAs in BSE. First, the 3' region of the Bov-tA fragments was detected in the PCR products derived from the serum of confirmed BSE cases or BSE-exposed cohorts. The genomes of ruminants contain three related SINE elements: Bov-tA, Bov-A2, and Bov-B. The Bov-tA element, which is present in about 285,000 copies, comprising approximately 1.6% of the bovine genome, is a tRNAGly pseudogene (16). It is frequently present within the 3' untranslated region of genes. Compared to the other bovine SINEs, the Bov-tA elements are relatively heterogeneous, harboring a 73-bp stretch of the tRNAGly gene (19), 115 bp of a central monomeric region, and a short 3' repeat region of 2- to 6-bp sequence elements. The variability within the DNA sequences of the Bov-tA elements suggests that these elements are evolutionarily older fragments. The 3' SINE fragment derived from BSE-associated CNAs was an average 80-bp consensus sequence revealing an expected range of homology (81% to 94%) with heterogeneous Bov-tA repetitive sequences.
The significance of detecting SINE fragments in CNA fractions is that the expression of SINE elements is associated with cell stress. Studying human SINEs (Alus), Liu et al. (17) reported that cells stressed by exposure to cycloheximide or puromycin "rapidly and transiently increased the abundance of Alu RNA." Kalkkila et al. (14) reported in a Mongolian gerbil model that SINE B1 and B2 transcripts could be detected in the CA1 region of the hippocampus after ischemia induction. The authors concluded that SINE elements are "stress-inducible factors in the central nervous system." Our finding of SINE-associated CNA common to both BSE and BSE-exposed cohorts suggests that there may be an underlying cell stress condition associated with BSE. The concept of an underlying condition fits well with the observation from an experimental model that cattle exposed to infective material at doses equivalent to those of contaminated cattle chow develop the disease at an incidence of less than 10% at 6 years postexposure (15). The failure to reach higher infection frequency with low-dose exposure implies underlying complex dynamics of BSE clinical development and therefore may reflect the contribution of cell stress-associated etiopathological mechanisms for the manifestation of BSE.
The second major finding from this study was that the 3' SINE fragment-associated PCR CNA products were contiguous with unique sequences of variant lengths (Table 2). It would appear that the unique sequence may in fact be chimeric sequences from germ line DNA as determined from NCBI BLAST analysis. In Table 2, 150 out of 163 clones (92%) had a 3' SINE fragment (sizes ranged from 52 to 87 bp) with homology to Bov-tA. These 150 clones corresponded to 19 homologs. The 19 Bov-tA-containing homologs had unique downstream sequences that varied in length from 19 bp to 214 bp. NCBI BLAST analysis indicated that these downstream sequences are composed of 11-mer to 83-mer sequences present in the bovine genome. The downstream sequences are linked at the 5' end of the monomer unit of Bov-tA, which is equivalent to the proposed harbor position of ALU (4).
SINE and Alu sequences are known to be strongly involved in recombinatorial events (20, 27). The unique sequences found downstream from the SINE sequence appear to be rearrangements of bovine germ line sequences. The biologic significance of these unique sequences in CNA from microvesicle/exosome-enriched fractions is unclear but might suggest a role in regulatory control via extracellular messaging (10).
The third major finding from this study is that repeatedly reactive CNA patterns are found in BSE at-risk, PrPres-negative cows. As mentioned above, cohort animals which are exposed to the infectious agent together with the BSE index case during the first years of their lives are 100 times more likely to become PrPres positive than noncohort animals (Table 1). Such BSE-exposed cohorts showed from 33% to 91% repeatedly reactive individuals per cohort in eight out of eight PrPres-negative cohorts. The resulting PCR products generated by repeatedly reactive PrPres-negative cohort animals were similar to the PCR products from four cases of confirmed BSE. In the specificity study, only five samples out of 845 combined healthy controls (0.59%) showed repeated reactivity. These data suggest that there is a low incidence of CHX-1R-specific SINE-associated CNAs in the healthy control population.
The presence of a 3' SINE element-associated CNA supports the notion that SINE detection might be a useful early-stage disease marker of a cell stress-associated clinical disease. The results of this study using primers CHX-1F and CHX-1R show that the general bovine population expresses a low incidence of specific detectable SINE associated CNAs, while 63% of BSE-exposed cohorts are repeatedly reactive. The CNAs are found in fractions that are enriched for microparticles (exosomes and plasma membrane microvesicles). Fevrier and Raposo have proposed that exosomes/microvesicles are involved in extracellular messaging (10). Further, they note that detection of scrapie prions in exosomes has been reported (11). Although nucleic acids have been reported to be associated with misfolded prions (18), it is not clear if the unique CNAs detected in this study might be involved in such an association.
The results of this study identified genetic sequences associated with BSE and BSE exposure and support the laboratory diagnostic use of circulating nucleic acids for detecting BSE-exposed animals (3, 5, 22, 23, 26). Future studies should be able to determine whether the unique fragments associated with SINE CNA can reveal the cell or cells of origin and consequently define the associated clinical diseases in terms of diagnostic criteria.
This research was supported by Chronix Biomedical GmbH and ERIC (Erxleben Research & Innovation Council).
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