Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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    Development of recombinant protein antigens using a bacterial expression system for the detection of anti-Chikungunya (CHIK) antibodies
    (Sri Lanka College of Microbiologists, 2013) Athapaththu, A.M.M.H.; Khanna, N.; Inouve, S.; Gunasena, S.; Abeyewickreme, W.; Hapugoda, M.
    INTRODUCTION AND OBJECTIVE: Laboratory confirmation of Chikungunya (CHIK) virus is very useful as clinical symptoms of CHIK can overlap with other diseases. Chikungunya virus specific antigen, which shows high specificity, sensitivity and low cross reactivity with other related diseases, is required for laboratory confirmation. Objective of this study was to develop and compare two recombinant protein antigens for detection of anti-CHIK antibodies. DESIGN, SETTING AND METHODS: Recombinant CHIK protein antigens were prepared using Envelope (E1 and E2) regions of the CHIK virus. The genes were custom designed and chemically synthesized with a 6X His tag. Bacterial expression systems [BL21 (DE3)] were used to clone and express the recombinant proteins. The recombinant proteins were purified with >95% of purity per liter of culture using Ni-NTA columns under denature conditions. In this study, two antigens were evaluated for detection of anti-CHIK antibody by using novel optimized in-house IgM and IgG ELISAs, using a panel of well characterized serum samples obtained from the Dept. of Virology (WHO Reference Center for Viral Reference and Research) Institute of Tropical Medicine, Nagasaki University, Japan. RESULTS: Atotal of 55 serum samples confirmed as positives and 186 confirmed as negatives by HA! test, IgM capture ELISA and indirect IgG ELISA using the purified CHIK antigen were used to evaluate the antigens using novel IgM ELISA. A total of 78 serum samples confirmed as positives and 148 (E1) or 227 (E2) (148 + extra 79) confirmed ac negatives were used to evaluate the antigens using novel IgG ELISA. The E1 recombinant protein showed 5% (3/ 55) sensitivity and 99% (184/186) specificity for IgM ELISA and 60% (47/78) sensitivity and 63% (94/148) specificity for IgG ELISA. The E2 recombinant protein showed 65% (36/55) sensitivity and 70% (131/186) specificity for IgM ELISA and 83% (65/78) sensitivity and 86% (195/227) specificity for IgG ELISA. CONCLUSION: Recombinant CHIK-E2 protein antigen showed higher specificity and sensitivity in detection of both IgM and IgG antibodies. Thus the E2 recombinant protein antigen used in this study could be expressed in an eukaryotic expression system to achieve much higher results. ACKNOWLEDGMENT: International Center for Genetic Engineering and Biotechnology (ICGEB CRP SRL 08/02), National Science Foundation (NSF/RG/2009/BT/01) and International Atomic Energy Authority (lAEA/SRL/5/042) are gratefully acknowledged.
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    Clinical and virological features of dengue in 2010
    (Sri Lanka College of Microbiologists, 2011) Hapugoda, M.D.; Manamperi, H.; Gunasena, S.; Athapaththu, A.M.M.H.; Premawansa, G.; Wellawaththage, C.; Jayarathna, T.D.S.S.; Abeyewickreme, W.
    INTRODUCTION: Dengue is an important viral infection in Sri Lanka. All 4 serotypes co-circulate in Sri Lanka. OBJECTIVE: To study the clinical and virological features of dengue in 2010. DESIGN, SETTING AND METHODS: A hospital-based study was carried out at North Colombo Teaching Hospital, Ragama in 2010. Patients clinically suspected of having dengue, with fever less than 5 days were recruited. Acute and convalescent blood samples were collected within 7 days after obtaining informed written consent. Demographic, clinical information and laboratory results were obtained. Acute serum samples were tested using molecular (RT-PCR and Semi-Nested PCR) and serological (ELlSAs and HAI) assays. Convalescent samples were tested by serological assays. RESULTS: Of 209 patients enrolled, 93 % (195/209) were laboratory confirmed as recent positive cases of dengue viral infection; of these, 5% (9/195) were classified as dengue fever; 85%(1G5/195) dengue haemorrhagic fever (DHF) and 0.5% (1/195) dengue shock syndrome. Mean platelet value and packed cell volume (PCV) in laboratory confirmed dengue patients were 56,107/mm3 (range 10,000-306,000) and 42%(range 34-61 %) respectively. Patients infected with DHF showed both primary (n=45) and secondary (n=102) infections. Interestingly, secondary infection was not significantly correlated with DHF (x2-0.3:p=0.6). DEN-1 was responsible for the majority of cases, with a minority due to other three serotypes; all serotypes contributed to severe disease. CONCLUSION: DEN-1 was responsible for the majority of cases in 2010 but it circulated at a low level during previous epidemics. Majority of patients had severe clinical symptoms. In this epidemic, the clinical presentation of dengue differed according to the geographic region and viral serotype. ACKNOWLEDGMENTS: Financial assistance and technical co-operation by International Center for Genetic Engineering and Biotechnology (ICGEB CRP SRL 08/02), National Science Foundation (NSF/RG/2009/BT/01) and International Atomic Energy Authority (lAEA/SRL/5/042) is acknowledged.
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    Comparison of recombinant protein and cell lysate antigens for detection of anti-chikungunya (CHIK) IgM antibody
    (Sri Lanka College of Microbiologists, 2011) Athapaththu, A.M.M.H.; Khanna, N.; Inouve, S.; Gunasena, S.; Abeyewickreme, W.; Hapugoda, M.D.
    INTRODUCTION: Chikungunya (CHIK) virus specific antigen which has high specificity and low cross reactivity with other related diseases is required for laboratory confirmation. OBJECTIVE: To compare two antigens for detection of anti-CHIK antibody. DESIGN, SETTING AND METHODS: In this study, two antigens {viral cell lysate and recombinant protein) were evaluated for detection of anti-1 CH IK antibody by using IgM ELISA. A novel recombinant | protein antigen was designed based on envelope domain, a critical antigenic region of the major structural protein, I This protein was expressed in Escherichia coli and resultant protein was affinity purified and ~10mg with >95% of purity per liter of culture was obtained. Cell lysate antigen was prepared using a crude culture fluid. Two antigens were evaluated separately using a panel of well characterized serum samples obtained from the Dept. of Virology (WHO Reference Centre for Viral Reference and Research), Institute of Tropical Medicine,] Nagasaki University. RESULTS: Atotal of 64 serum samples confirmed as positives andl 22 confirmed as negatives were used to evaluate the antigens. Specificity and sensitivity of the recombinant protein antigen was 48% and 90% respectively. Specificity and sensitivity of the viral lysate antigen was] 17% and 100% respectively. Conclusion Viral lysate antigens can cause biohazard risk, high production cost and cross reactivity with other organisms of the same genus/family. Recombinant protein antigen which shows high specificity and sensitivity used in this study is important to overcome problems associated with viral lysate antigen. Testing of a large number of samples is needed to reconfirm this finding. ACKNOWLEDGMENT: Financial assistance and technical co-operation by International Center for Genetic Engineering and Biotechnology (ICGEB CRP SRL 08/02), National Science Foundation (NSF/RG/2009/BT/01) and International Atomic Energy Authority (IAEA/SRL/5/042) is acknowledged.
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    Enzyme-linked Immunosorbent Assay (ELISA) using recombinant protein antigens for detection of anti-chikungunya antibodies
    (Faculty of Tropical Medicine, Mahidol University, 2010) Athapaththu, A.M.M.H.; Khanna, N.; Abeyewickreme, W.; Gunasena, S.; Hapugoda, M.D.
    OBJECTIVES: Chikungunya is a mosquito borne viral infection that has caused great medical and public health problems in South East Asia during last few years. Currently available laboratory diagnostic kits depend on Enzyme-Linked Immunosorbent Assay (ELISA) based on whole viral antigens caused biohazard risk, high production cost and cross reactivity with other organisms of the same genus/family. These problems can be avoided by using recombinant protein antigens in ELISAs. METHODOLOGY: Two novel recombinant protein antigens based on Envelope (E) domain, a critical antigenic region of the major structural protein of chikungunya virus were expressed separately in a bacterial expression system (Escherichia coli). Two proteins were purified under denatured conditions. They were evaluated as potential diagnostic intermediates for detection of and-chikungunya antibodies in Immunoglobulin M (IgM) and Immunoglobulin G (IgG) ELISAs separately using a panel of serum samples confirmed by the gold standard assay, Heamagglutination Inhibition (HAI) assayRESULTS: These 2 protein antigens: El and E2 showed more than 60% positivity in IgG ELISAs and IgM ELISAs. A field validation using a large number of serum samples should be done for further confirmation of these results. It can be concluded that these 2 novel recombinant protein antigens can be used as a diagnostic intermediate to detect anti-chikungunya antibodies. ACKNOWLEDGEMENTS: Financial assistance from the International Centre for Genetic Engineering and Biotechnology (1CGEB CRP/ SRI08-02) is gratefully acknowledged
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    Shifting of circulating serotypes in dengue outbreaks during 2009/2010 in Sri lanka
    (Faculty of Tropical Medicine, Mahidol University, 2010) Manamperi, N.H.; Athapaththu, A.M.M.H.; Premawansa, G.; Wellawaththage, C.; Jayarathna, T. D. S. S.; Abeyewickreme, W.; Hapugoda, M.D.
    OBJECTIVES: Sri Lanka has experienced explosive outbreaks of dengue infection in 2009 and 2010. It has been identified that DEN- 3 and DEN- 2 were the predominant serotypes with DEN-1 and DEN- 4 circulating at a lower level in previous dengue outbreaks during 2003-2006, Objective of this study was to identify the circulating serotype/s during 2009 - 2010 outbreaks. METHODOLOGY: A prospective study was carried out at North Colombo Teaching Hospital, Sri Lanka during December 2009-August 2010. Clinically suspected dengue patients, with fever less than 5 days were recruited. An interviewer administered questionnaire was filled for each patient, by a Medical Officer. Venous blood samples confirmed for the presence of dengue virus by RT-PCR were typed by Semi-Nested PCR. RESULTS: Out of the 209 patients recruited in the study 80 (38%) were positive for dengue virus by RT-PCR. Of the positives, 43 (54%) were typed and circulation of all 4 serotypes was observed- Of the 43 positives, presence of DEN-1, DEN-2, DEN-3 and DEN-4 serotypes was 34 (79%), 3 (7%), 2 (5%) and 3 (7%) respectively DEN-1 was the predominant serotype in the recent epidemics which was circulating at a low level in previous epidemics. In DEN-1 infected patients, the mean platelet value was 58,588/ rnm3 and the mean PCV value was 41.4%. Associated symptoms such as headache, retro-orbital pain, neck pain and limb pain were present in 94% (32/34), 59% (20/34), 24% (8/34J and 91% (31/34) patients respectively. Bleeding manifestation developed in 47 % (16/34) patients. The mortality rate ranged from 0.7%- 1.0% during the recent outbreaks. Acknowledgement: Financial and technical assistance from the International Centre for Genetic Engineering and Biotechnology (ICGEB CRP/ SRI08-02) and the International Atomic Energy Agency (IAEA SRI 5/042) is gratefully acknowledged.