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gTo improve the clinical diagnosis of pneumococcal infection in bacteremic and nonbacteremic community-acquired pneumonia (CAP), a Luminex technology-based multiplex urinary antigen detection (UAD) diagnostic assay was developed and validated. The UAD assay can simultaneously detect 13 different serotypes of Streptococcus pneumoniae by capturing serotype-specific S. pneumoniae polysaccharides (PnPSs) secreted in human urine. Assay specificity is achieved by capturing the polysaccharides with serotype-specific monoclonal antibodies (MAbs) on spectrally unique microspheres. Positivity for each serotype was based on positivity cutoff values calculated from a standard curve run on each assay plate together with positive-and negative-control urine samples. The assay is highly specific, since significant signals are detected only when each PnPS was paired with its homologous MAb-coated microspheres. Validation experiments demonstrated excellent accuracy and precision. The UAD assay and corresponding positivity cutoff values were clinically validated by assessing 776 urine specimens obtained from patients with X-ray-confirmed CAP. The UAD assay demonstrated 97% sensitivity and 100% specificity using samples obtained from patients with bacteremic, blood culture-positive CAP. Importantly, the UAD assay identified Streptococcus pneumoniae (13 serotypes) in a proportion of individuals with nonbacteremic CAP, a patient population for which the pneumococcal etiology of CAP was previously difficult to assess. Therefore, the UAD assay provides a specific, noninvasive, sensitive, and reproducible tool to support vaccine efficacy as well as epidemiological evaluation of pneumococcal disease, including CAP, in adults.

Staphylococcus aureus and other staphylococci cause severe human disease, and there are currently no vaccines available. We evaluated whether manganese transport protein C (MntC), which is conserved across the staphylococcal species group, could confer protection against S. aureus and Staphylococcus epidermidis . In vivo analysis of S. aureus MntC expression revealed that expression occurs very early during the infectious cycle. Active immunization with MntC was effective at reducing the bacterial load associated with S. aureus and S. epidermidis infection in an acute murine bacteremia model. Anti-MntC monoclonal antibodies have been identified that can bind S. aureus and S. epidermidis cells and are protective in an infant rat passive protection model and induce neutrophil respiratory burst activity. This is the first description of a protein that has the potential to provide protection across the staphylococcal species group.

It is unknown how the contrasting events of positive and negative selection can lead to the distinct biological outcomes of life or death. An increasing body of evidence suggests that the duration of extracellular signal-regulated kinase (ERK) signaling plays a role in thymocyte selection. However, it remains unclear what the kinetics of ERK activation are during positive selection in vivo. In this study, we examined the magnitude and duration of ERK signaling in intact murine thymic tissues cultured under conditions of negative or positive selection. We found that negative selection induced a rapid and robust ERK activation that is associated with death, whereas positive selection stimulated a lower intensity and brief ERK activation that quickly declined and then gradually increased and was sustained over several days. The expression pattern of Egr-1 (early growth response-1), a downstream ERK effector, correlates with the biphasic kinetics of ERK during positive selection. Id3 (inhibitor of differentiation͞DNA binding 3) also exhibits biphasic kinetics but appeared to be independent of ERK signaling. Furthermore, inhibitors of T cell receptor ligation and ERK activation block maturation of CD8 single-positive thymocytes even when added after 24 h. These results demonstrate that the in vivo duration of ERK signaling must be sustained to support positive selection.T cell development T he T cell repertoire must be as diverse as possible to recognize a vast array of foreign pathogens yet at the same time remain devoid of self-reactive clones. This apparent dichotomy is established during thymic development through the tightly controlled processes of positive and negative selection. Thymocytes bearing T cell receptors (TCRs) that fail to productively interact with selfpeptide-MHC complexes die by neglect. Positive selection ensures self-MHC restriction, whereas negative selection eliminates cells that are specific for self-peptides, ensuring self-tolerance. Thus, ligation of the TCR by self-peptide-MHC complexes can result in either death or differentiation of the thymocytes into mature T cells (1). Yet it is unknown how a thymocyte can distinguish between signals that lead to the opposing outcomes of survival and death.Differential intracellular signals, such as the various mitogenactivated protein kinase (MAPK) cascades, extracellular signalregulated kinase (ERK), c-Jun N-terminal kinase (Jnk), and p38, could discriminate between positive and negative selection. Studies with knockout mice and specific MAPK inhibitors have demonstrated that Jnk and p38 may be important in mediating negative selection and that ERK is important for positive selection (2-5). ERK is activated through Ras and the sequential activation of Raf and MEK (MAPK kinase) upon stimulation through the TCR. A dominant-negative Ras transgene and inhibitors of MEK-1 impaired positive selection of thymocytes yet had no effect on negative selection (3, 6, 7). ERK-1 knockout mice showed a partial block in positive selection, and mice deficient for th...

Staphylococcus aureus can cause severe life threatening invasive diseases. The principal immune effector mechanism by which humans are protected from Gram positive bacteria such as S. aureus is antigen specific antibody- and complement-dependent opsonophagocytosis. This process can be measured in vitro using the opsonophagocytic antibody assay (OPA), which is a complex assay composed of live S. aureus bacteria, a complement source, phagocytic effector cells such as differentiated HL-60 cells, and test serum. In this report, we investigated the impact on the OPA of S. aureus surface antigens capsular polysaccharides (CP) and protein A (SpA). We demonstrated that higher CP expression renders bacteria more resistant to non-specific opsonophagocytic killing than increased SpA expression, suggesting that the expression of capsular polysaccharides may be the more important immune evasion strategy for S. aureus. Bacteria that were not fully encapsulated were highly susceptible to non-specific killing in the assay in the absence of immune serum. This non-specific killing was prevented by growing the bacteria under conditions that increased capsular polysaccharide levels on the surface of the bacteria. In contrast, the level of SpA expression had no detectable effect on non-specific killing in OPA. Using anti-CP antibodies we demonstrated type-specific killing in OPA of both MRSA and MSSA clinical isolates. SpA expression on the cell surface did not interfere with OPA activity, providing evidence that despite the role of SpA in sequestering antibodies by their Fc region, killing is easily accomplished in the presence of high titered anti-capsular polysaccharide antibodies. This highlights the role of CP as an important immune evasion mechanism and supports the inclusion of capsular polysaccharide antigens in the formulation of multi-component prophylactic vaccines against S. aureus.