Measurement of plasma levels of natriuretic peptides has been used to assess left ventricular dysfunction and prognosis. Recently levels of the N-terminal peptide fragment of the precursor of brain natriuretic peptide have been reported to be present in peripheral plasma and to be increased in chronic heart failure patients. Our aim in this study was to develop a radioimmunoassay for N-terminal proBNP, to compare its plasma concentrations in control subjects and in patients with end-stage heart failure and to define its relation to brain natriuretic peptide (BNP). A polyclonal antibody was raised in rabbits against human N-terminal proBNP fragment (amino acid 1-21). The plasma N-terminal proBNP concentrations were assayed directly without extraction. No detectable cross-reactivity existed with other natriuretic peptides: BNP, ANP or N-terminal proANP. The assay had a detection limit (2 SD from zero) of 9.7 pmol/L. Plasma N-terminal proBNP was 29 (13-75) (median (range)) pmol/L in the control group. There were no gender difference, male: 28 (13-61) vs. female 33 (13-75) pmol/L, p= NS, but there was a positive correlation to age (r=0.52, p<0.0001). In patients with end-stage heart failure the median N-terminal proBNP levels were increased significantly 616 (114-2781) pmol/L (p<0.001) and in pooled data N-terminal proBNP showed a close correlation to BNP (r=0.96, p<0.0001). Size exclusion of plasma extracts indicated that proBNP (1-108) may circulate both as intact prohormone and as split products, N-terminal proBNP (1-76) and BNP (77-108). Our results support the concept that N-terminal proBNP measurement could be a valuable tool in the biochemical indication of increased cardiac wall stress.

The province of Ontario continues to experience measles virus transmissions despite the elimination of measles in Canada. We describe an unusual outbreak of measles in Ontario, Canada, in early 2015 that involved cases with a unique strain of virus and no known association among primary case-patients. A total of 18 cases of measles were reported from 4 public health units during the outbreak period (January 25–March 23, 2015); none of these cases occurred in persons who had recently traveled. Despite enhancements to case-patient interview methods and epidemiologic analyses, a source patient was not identified. However, the molecular epidemiologic analysis, which included extended sequencing, strongly suggested that all cases derived from a single importation of measles virus genotype D4. The use of timely genotype sequencing, rigorous epidemiologic investigation, and a better understanding of the gaps in surveillance are needed to maintain Ontario’s measles elimination status.

Recombinant vesicular stomatitis viruses (rVSVs) engineered to express heterologous viral glycoproteins have proven to be remarkably effective vaccines. Indeed, rVSV-EBOV, which expresses the Ebola virus (EBOV) glycoprotein, recently received clinical approval in the United States and Europe for its ability to prevent EBOV disease. Analogous rVSV vaccines expressing glycoproteins of different human-pathogenic filoviruses have also demonstrated efficacy in pre-clinical evaluations, yet these vaccines have not progressed far beyond research laboratories. In the wake of the most recent outbreak of Sudan virus (SUDV) in Uganda, the need for proven countermeasures was made even more acute. Here we demonstrate that an rVSV-based vaccine expressing the SUDV glycoprotein (rVSV-SUDV) generates a potent humoral immune response that protects guinea pigs from SUDV disease and death. Although the cross-protection generated by rVSV vaccines for different filoviruses is thought to be limited, we wondered whether rVSV-EBOV might also provide protection against SUDV, which is closely related to EBOV. Surprisingly, nearly 60% of guinea pigs that were vaccinated with rVSV-EBOV and challenged with SUDV survived, suggesting that rVSV-EBOV offers limited protection against SUDV, at least in the guinea pig model. These results were confirmed by a back-challenge experiment in which animals that had been vaccinated with rVSV-EBOV and survived EBOV challenge were inoculated with SUDV and survived. Whether these data are applicable to efficacy in humans is unknown, and they should therefore be interpreted cautiously. Nevertheless, this study confirms the potency of the rVSV-SUDV vaccine and highlights the potential for rVSV-EBOV to elicit a cross-protective immune response.

eukaryotic viruses require strategies, such as RNA cap synthesis, in order to protect, replicate and translate their genomes in eukaryotic hosts. Figure 1. RNA 5'-cap structure. The RNA 5'cap structure is composed of a 7-methylguanosine (blue) linked to the RNA (black) through a 5'-5' triphosphate bridge (blue and black). The N7 methylation of the guanosine (green) confers a positive charge to the cap structure. Additional 2'O-methylation (red) can be found on the first few nucleotides. Conventional and unconventional 5' RNA cap synthesis mechanism Canonical cap synthesis by different virusesThe importance of the cap structure in eukaryote metabolism has resulted in an evolutionary pressure for viruses to adopt a similar cap structure. A series of enzymatic reactions is required to synthesize a cap structure at the 5'-end of RNA. The most pervasive enzymatic pathway, also termed "conventional capping", consists of three sequential enzymatic activities that are required to generate a functional 7-methylguanosine 5'-5'-triphosphate bridged cap structure. As a result of the directional 5' to 3' polymerization of nucleotide triphosphates (NTP) during RNA synthesis, nascent RNA bear at their 5'-end a triphosphate moiety (originating from the initial NTP). This 5'-triphosphate end of the RNA is first converted into a 5'-diphosphate end by hydrolysis of the terminal phosphate, or γ-phosphate, by an RNA triphosphatase (RTPase). This is followed by a two-step reaction catalyzed by an RNA guanylyltransferase (GTase). The enzyme first specifically binds and hydrolyzes a GTP molecule to form a covalent enzyme-GMP intermediate, which then catalyzes the transfer of the GMP moiety onto the 5'-end of a diphosphorylated acceptor RNA (ppRNA) in the second step of GTase reaction. Lastly, an RNA 5′-end Maturation: A Crucial Step in the Replication of Viral Genomes

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