Zika en la gestación. Afectación de las destrezas de ejecución y edad madurativa en infantes

Introducción: El virus Zika se transmite por la picadura de mosquitos infectados, pero también puede ocurrir a través de una infección intrauterina antes del parto, y el virus pasa al feto. Objetivo: describir el nivel de afectación en destrezas de ejecución y edad madurativa de niños del programa Valientes del Futuro con la infección neonatal por virus Zika. Materiales y Métodos: La investigación se enmarca con enfoque cuantitativo de tipo correlacional apoyada con una investigación de campo y diseño no experimental, con una muestra de 15 infantes de 3, 4 y 5 años. La técnica de recolección utilizada fue la Escala Abreviada. Resultados: En cuanto a las áreas evaluadas con respecto a la edad madurativa se encontró que la ponderación de la destreza motora y praxis halló un coeficiente de correlación de 0,601 (moderada) y en la muestra de las destrezas de ejecución de los niños de 3 años con zika gestacional se obtuvo una correlación de 0,853 (fuerte). Discusión: la infección por virus zika en niños y niñas, adquirida durante la gestación, limita fuertemente las destrezas de ejecución propias de la edad madurativa en esta población. Conclusiones: Existe correlación entre los infantes con zika gestacional y la afectación fuerte en las acciones o comportamientos que un paciente tenga para moverse e interactuar físicamente con actividades, objetos y por ende realizar una actividad motora aprendida.

Zika Virus and Neurologic Disease

Zika virus (ZIKV) is an arthropod-borne virus that belongs to the Flaviviridae family. Although most cases are mild or go undetected, rare severe neurologic effects, including congenital ZIKV syndrome (CZS) and Guillain-Barré syndrome, have been identified. The serious neurologic complications associated with ZIKV prompted the declaration of the public health emergency of international concern by the World Health Organization. Overall, transmission occurred throughout South and Central America as well as the Caribbean, affecting 48 countries and territories from March 2015 to March 2017. Long-term management of CZS requires a comprehensive combination of supportive services throughout early development.

Zika virus infection of cellular components of the blood-retinal barriers: implications for viral associated congenital ocular disease

BACKGROUND

Ocular abnormalities present in microcephalic infants with presumed Zika virus (ZIKV) congenital disease includes focal pigment mottling of the retina, chorioretinal atrophy, optic nerve abnormalities, and lens dislocation. Target cells in the ocular compartment for ZIKV infectivity are unknown. The cellular response of ocular cells to ZIKV infection has not been described. Mechanisms for viral dissemination in the ocular compartment of ZIKV-infected infants and adults have not been reported. Here, we identify target cells for ZIKV infectivity in both the inner and outer blood-retinal barriers (IBRB and OBRB), describe the cytokine expression profile in the IBRB after ZIKV exposure, and propose a mechanism for viral dissemination in the retina.

METHODS

We expose primary cellular components of the IBRB including human retinal microvascular endothelial cells, retinal pericytes, and Müller cells as well as retinal pigmented epithelial cells of the OBRB to the PRVABC56 strain of ZIKV. Viral infectivity was analyzed by microscopy, immunofluorescence, and reverse transcription polymerase chain reaction (RT-PCR and qRT-PCR). Angiogenic and proinflammatory cytokines were measured by Luminex assays.

RESULTS

We find by immunofluorescent staining using the Flavivirus 4G2 monoclonal antibody that retinal endothelial cells and pericytes of the IBRB and retinal pigmented epithelial cells of the OBRB are fully permissive for ZIKV infection but not Müller cells when compared to mock-infected controls. We confirmed ZIKV infectivity in retinal endothelial cells, retinal pericytes, and retinal pigmented epithelial cells by RT-PCR and qRT-PCR using ZIKV-specific oligonucleotide primers. Expression profiles by Luminex assays in retinal endothelial cells infected with ZIKV revealed a marginal increase in levels of beta-2 microglobulin (β2-m), granulocyte macrophage colony-stimulating factor (GMCSF), intercellular adhesion molecule 1 (ICAM-1), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP1), and vascular cell adhesion molecule 1 (VCAM-1) and higher levels of regulated upon activation, normal T cell expressed and presumably secreted (RANTES) but lower levels of interleukin-4 (IL-4) compared to controls.

CONCLUSIONS

Retinal endothelial cells, retinal pericytes, and retinal pigmented epithelial cells are fully permissive for ZIKV lytic replication and are primary target cells in the retinal barriers for infection. ZIKV infection of retinal endothelial cells and retinal pericytes induces significantly higher levels of RANTES that likely contributes to ocular inflammation.