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Title: Bacterial toxins in sudden unexpected nocturnal deaths
Author: Atmadani, O.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1999
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Sudden Unexpected Nocturnal Deaths (SUND) occur in young immigrant workers, mainly from Southeast Asia employed in countries such as Singapore and Saudi Arabia. Enzyme linked immunosorbent assays (ELISA) and flow cytometry method were developed to screen body fluids and tissues for toxic shock syndrome (TSST-1) and staphylococcal enterotoxins A (SEA), B (SEB) and C (SEC). Both frozen and formalin fixed tissues were obtained from infants who died suddenly and unexpectedly in Scotland, France or Australia. The flow cytometry method detected toxin in both frozen and fixed tissues, but ELSIA was suitable only for frozen tissues or those fixed less than 12 months. TSST-1 and enterotoxins were identified in over half the specimens from infants. Of the 4 samples from SUND victims, one was borderline positive for TSST-1; however the bodies had been stored for extended period prior to autopsy. Human buffy coats were used to examine the effect of IgG to the toxins for neutralising activity and the effect of cortisol. Tumour necrosis factor α (TNF-α) was detected by bioassay with L929 cells, interluekin-6 (IL-6) and interluekin-10 (IL-10) were measured by ELSIA. IL-6 and TNF-α elicited by the toxins were not reduced by night time level of cortisol (5-10 μg dl -1) levels. Day time levels of cortisol (10-20 μg dl -1) significantly inhibited IL-6 production but not TNF-α in responses. Stress levels of cortisol (40-80 μg dl -1) significantly reduced all three cytokines earlier than the normal day time levels. The methods developed for collection of tissue specimens, detection of toxins and quantitative IgG assays for antitoxins can be applied to investigation of SUND victims to test the hypothesis that some of these deaths are precipitated by pyrogenic staphylococcal toxins.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available