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Lin Y, Khan M, Weynand B, Laporte M, Coenjaerts F, Babusis D, Bilello JP, Mombaerts P, Jochmans D, Neyts J. A robust mouse model of HPIV-3 infection and efficacy of GS-441524 against virus-induced lung pathology. Nat Commun 2024; 15:7765. [PMID: 39237507 PMCID: PMC11377736 DOI: 10.1038/s41467-024-52071-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 08/22/2024] [Indexed: 09/07/2024] Open
Abstract
Human parainfluenza virus type 3 (HPIV-3) can cause severe respiratory tract infections. There are no convenient small-animal infection models. Here, we show viral replication in the upper and lower airways of AG129 mice (double IFNα/β and IFNγ receptor knockout mice) upon intranasal inoculation. By multiplex fluorescence RNAscope and immunohistochemistry followed by confocal microscopy, we demonstrate viral tropism to ciliated cells and club cells of the bronchiolar epithelium. HPIV-3 causes a marked lung pathology. No virus transmission of the virus was observed by cohousing HPIV-3-infected AG129 mice with other mice. Oral treatment with GS-441524, the parent nucleoside of remdesivir, reduced infectious virus titers in the lung, with a relatively normal histology. Intranasal treatment also affords an antiviral effect. Thus, AG129 mice serve as a robust preclinical model for developing therapeutic and prophylactic strategies against HPIV-3. We suggest further investigation of GS-441524 and its prodrug forms to treat HPIV-3 infection in humans.
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Affiliation(s)
- Yuxia Lin
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Virology, Antiviral Drug & Vaccine Research Group, Leuven, Belgium
| | - Mona Khan
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany
| | - Birgit Weynand
- KU Leuven Department of Imaging and Pathology, Division of Translational Cell and Tissue Research, Leuven, Belgium
| | - Manon Laporte
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Virology, Antiviral Drug & Vaccine Research Group, Leuven, Belgium
| | - Frank Coenjaerts
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | - Peter Mombaerts
- Max Planck Research Unit for Neurogenetics, Frankfurt, Germany
| | - Dirk Jochmans
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Virology, Antiviral Drug & Vaccine Research Group, Leuven, Belgium
| | - Johan Neyts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Virology, Antiviral Drug & Vaccine Research Group, Leuven, Belgium.
- VirusBank Platform, KU Leuven, Leuven, Belgium.
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Pérez A, Montoro J, Chorão P, Gómez D, Guerreiro M, Giménez E, Villalba M, Sanz J, Hernani R, Hernández-Boluda JC, Lorenzo I, Navarro D, Solano C, Ljungman P, Piñana JL. Outcome of Human Parainfluenza Virus infection in allogeneic stem cell transplantation recipients: possible impact of ribavirin therapy. Infection 2024:10.1007/s15010-024-02213-0. [PMID: 38653955 DOI: 10.1007/s15010-024-02213-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND This retrospective study focused on analyzing community-acquired respiratory virus (CARV) infections, in particular human parainfluenza virus (hPIV) after allogeneic stem cell transplant (allo-SCT) in adults recipients. It aimed to assess the impact of ribavirin treatment, clinical characteristics, and risk factors associated with lower respiratory tract disease (LRTD) progression and all-cause mortality. PATIENTS AND METHODS The study included 230 allo-SCT recipients diagnosed with hPIV between December 2013 and June 2023. Risk factors for the development of LRTD, disease severity, and mortality were analyzed. Ribavirin treatment was administered at physician discretion in 61 out of 230 cases (27%). RESULTS Risk factors for LRTD progression in multivariate analysis were corticosteroids > 30 mg/day (Odds ratio (OR) 3.5, 95% Confidence Interval (C.I.) 1.3-9.4, p = 0.013), fever at the time of hPIV detection (OR 3.89, 95% C.I. 1.84-8.2, p < 0.001), and absolute lymphocyte count (ALC) < 0.2 × 109/L (OR 4.1, 95% C.I. 1.42-11.9, p = 0.009). In addition, the study found that ribavirin therapy significantly reduced progression to LRTD [OR 0.19, 95% C.I. 0.05-0.75, p = 0.018]. Co-infections (OR 5.7, 95% C.I. 1.4-23.5, p = 0.015) and ALC < 0.2 × 109/L (OR 17.7, 95% C.I. 3.6-87.1, p < 0.001) were independently associated with higher day + 100 after hPIV detection all-cause mortality. There were no significant differences in all-cause mortality and infectious mortality at day + 100 between the treated and untreated groups. CONCLUSION ALC, corticosteroids, and fever increased the risk for progression to LRTD while ribavirin decreased the risk. However, mortality was associated with ALC and co-infections. This study supports further research of ribavirin therapy for hPIV in the allo-HSCT setting.
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Affiliation(s)
- Ariadna Pérez
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
| | - Juan Montoro
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Pedro Chorão
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Dolores Gómez
- Microbiology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - Marta Villalba
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jaime Sanz
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Rafael Hernani
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Ignacio Lorenzo
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Carlos Solano
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Per Ljungman
- Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institutet (KI), Huddinge, Sweden
| | - José Luis Piñana
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain.
- Division of Clinical Hematology, Hospital Clinico Universitario de Valencia, Avda. Blasco Ibañez, N 17, 46010, Valencia, Spain.
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Chu FL, Li C, Liu Y, Dong B, Qiu Y, Fan G. Peripheral blood parameters for predicting PICU admission and mechanical ventilation in pediatric inpatients with human parainfluenza virus-induced pneumonia. J Med Virol 2023; 95:e28752. [PMID: 37185836 DOI: 10.1002/jmv.28752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/22/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
Human parainfluenza viruses (hPIVs)-induced pneumonia is an important cause of pediatric hospitalization, and some develop severe pneumonias requiring pediatric intensive care unit (PICU) admission and mechanical ventilation (MV). The aim of this study is to investigate the value of peripheral blood (PB) parameters available on admission in predicting the need for PICU admission and MV due to pneumonia caused by hPIVs. A total of 331 cases including 277 (83.69%) on the general ward (GW) and 54 (16.31%) on the PICU were enrolled between January 2016 and June 2021. Of 54 patients admitted to the PICU, 24 patients (7.25%) received MV, whereas 30 (9.06%) did not. For both the PICU and GW groups, infants accounted for the highest proportion while school children had the lowest. Compared with the GW group, the PICU group had significantly higher rates of premature birth, fatigue, sore throat, headache, chest pain, tachypnea, dyspnea, and underlying diseases including congenital tracheal stenosis, congenital heart disease (CHD), metabolic disorder, and neurological disorder (ND), but significant lower proportion of exclusive breastfeeding and Z-scores for weight-for-height, weight-for-age, height-for-age, and body-mass-index (BMI)-for-age (BMIZ). Higher levels of some leukocyte differential counts (LDC)-related parameters including counts of neutrophil (N), ratios of neutrophil-to-lymphocyte ratio (NLR), derived neutrophils/(leukocytes minus neutrophils) ratio (dNLR), and platelet-to-lymphocyte ratio (PLR), lower levels of some other LDC-related parameters including lymphocyte (L) and monocyte (M) counts, ratios of lymphocyte-to-monocyte ratio (LMR), lymphocyte-to-C-reactive protein ratio, and prognostic nutritional index (PNI), and lower levels of PB protein (PBP)-related parameters including red blood cell (RBC), hemoglobin, total protein (TP), and serum albumin were observed in the PB of patients in the PICU compared with those in the GW. Notably, higher PLR level and two comorbidities including CHD and ND were identified as independent risk factors for PICU admission, while lower PNI level as well as smaller numbers of RBC and L as good predictors. Low levels of TP might be a useful predictor of the need for MV. Overall, the relative contributions of LDC- and PBP-related factors for accurate identification of patients required PICU admission accounted for 53.69% and 46.31%, respectively. Thus, determination of whether a patient with hPIVs-induced pneumonia is admitted to PICU involves consideration of both the LDC- and PBP-related parameters.
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Affiliation(s)
- Fu-Lu Chu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Chen Li
- Department of Internal Medicine, Jinan Hospital, Jinan, Shandong, People's Republic of China
| | - Yiqing Liu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Bo Dong
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yang Qiu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Gang Fan
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
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Tabatabai J, Schnitzler P, Prifert C, Schiller M, Weissbrich B, von Lilienfeld-Toal M, Teschner D, Jordan K, Müller-Tidow C, Egerer G, Giesen N. Parainfluenza virus infections in patients with hematological malignancies or stem cell transplantation: Analysis of clinical characteristics, nosocomial transmission and viral shedding. PLoS One 2022; 17:e0271756. [PMID: 35905071 PMCID: PMC9337657 DOI: 10.1371/journal.pone.0271756] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
To assess morbidity and mortality of parainfluenza virus (PIV) infections in immunocompromised patients, we analysed PIV infections in a hematology and stem cell transplantation (SCT) unit over the course of three years. Isolated PIV strains were characterized by sequence analysis and nosocomial transmission was assessed including phylogenetic analysis of viral strains. 109 cases of PIV infection were identified, 75 in the setting of SCT. PIV type 3 (n = 68) was the most frequent subtype. PIV lower respiratory tract infection (LRTI) was observed in 47 patients (43%) with a mortality of 19%. Severe leukopenia, prior steroid therapy and presence of co-infections were significant risk factors for development of PIV-LRTI in multivariate analysis. Prolonged viral shedding was frequently observed with a median duration of 14 days and up to 79 days, especially in patients after allogeneic SCT and with LRTI. Nosocomial transmission occurred in 47 patients. Phylogenetic analysis of isolated PIV strains and combination with clinical data enabled the identification of seven separate clusters of nosocomial transmission. In conclusion, we observed significant morbidity and mortality of PIV infection in hematology and transplant patients. The clinical impact of co-infections, the possibility of long-term viral shedding and frequent nosocomial transmission should be taken into account when designing infection control strategies.
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Affiliation(s)
- Julia Tabatabai
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
- * E-mail:
| | - Paul Schnitzler
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christiane Prifert
- Institute of Virology and Immunobiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Martin Schiller
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Department of Internal Medicine, HochFranken Hospitals, Munchberg, Germany
| | - Benedikt Weissbrich
- Institute of Virology and Immunobiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Marie von Lilienfeld-Toal
- Department of Internal Medicine II, University Hospital Jena, Jena, Germany
- Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll Institut, Jena, Germany
| | - Daniel Teschner
- Department of Hematology, Medical Oncology, & Pneumology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Karin Jordan
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Gerlinde Egerer
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicola Giesen
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
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