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Sütçü M, Kara M, Yıldız F, Kılıç Ö, Tural Kara T, Akkoc G, Büyükçam A, Elmas Bozdemir Ş, Özgür Gündeşlioğlu Ö, Gül D, İseri Nepesov M, Kara A. Hand, foot, and mouth disease: could EPs® 7630 be a treatment option? A prospective randomized open-label multicenter clinical study. Front Pediatr 2024; 12:1274010. [PMID: 38832001 PMCID: PMC11146204 DOI: 10.3389/fped.2024.1274010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 04/09/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose Hand, foot and mouth disease (HFMD) is a viral contagious disease of children caused by human enteroviruses (EVs) and coxsackieviruses (CVs). There is no specific treatment option for HFMD. EPs® 7630's anti-infective and immunomodulatory properties have previously been demonstrated in several in vitro and in vivo studies; however, the use of this herbal medicine in children with HFMD has not previously been investigated. Methods This prospective randomized multicenter clinical study included 208 children with HFMD. The diagnosis was made by pediatricians. The patients who were within the first 48 h of symptom onset (according to the first onset of fever and skin findings) were enrolled. The study participants were assigned into 2 groups as EPs® 7630 and control groups. All patients were followed up twice more, 48 h after the first admission and on the 5th-7th day. Another phone evaluation was conducted for those with continued complaints from the previous visit. Results The median age was 27 (12-112) months. The male-female ratio was 0.98. One hundred thirty one (63%) of 190 patients had no history of household contact. EPs® 7630 group included 94 and control group included 96 patients. A significant difference was found between the groups in terms of complaint scores at the visits made at the 48th h of the treatment and on days 5-7 (p < 0.001). The mean ± SD disease duration of EPs® 7630 users was significantly shorter 6.07 ± 0.70 days (95% CI: 5.92-6.21)] than the control group [8.58 ± 0.94 days (95% CI: 8.39-8.77)] (p < 0.001). Besides, the hospitalization rate among the EPs® 7630 users were significantly lower (p = 0.019). No side effects were observed, except for unpleasant taste, which was reported in 5 patients (EPs® 7630 group). Conclusion Considering its efficacy and safety profile EPs® 7630 may represent a feasible herbal-based treatment option for children with HFMD. Clinical Trial Registration ClinicalTrials.gov, identifier (NCT06353477).
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Affiliation(s)
- Murat Sütçü
- Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul, Türkiye
- Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Türkiye
| | - Manolya Kara
- Pediatric Infectious Diseases, Faculty of Medicine, Yeditepe University, Istanbul, Türkiye
| | - Funda Yıldız
- Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Türkiye
| | - Ömer Kılıç
- Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Tugce Tural Kara
- Pediatric Infectious Diseases, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Gulsen Akkoc
- Pediatric Infectious Diseases, University of Health Sciences Van Research and Training Hospital, Van, Türkiye
| | - Ayşe Büyükçam
- Pediatric Infectious Diseases, Cengiz Gokcek Maternity and Children's Hospital, Gaziantep, Türkiye
| | | | | | - Doruk Gül
- Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Türkiye
| | - Merve İseri Nepesov
- Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Ateş Kara
- Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
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Shrestha S, Malla B, Sangsanont J, Sirikanchana K, Ngo HTT, Inson JGM, Enriquez MLD, Alam ZF, Setiyawan AS, Setiadi T, Takeda T, Kitajima M, Haramoto E. Detection of enteroviruses related to hand foot and mouth disease in wastewater of Asian communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169375. [PMID: 38110101 DOI: 10.1016/j.scitotenv.2023.169375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/25/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is contagious and predominantly affects children below the age of five. HFMD-associated serotypes of Enterovirus A (EVA) family include EVA71, Coxsackievirus A type 6 (CVA6), 10 (CVA10), and 16 (CVA16). Although prevalent in numerous Asian countries, studies on HFMD-causing agents in wastewater are scarce. This study aimed to conduct wastewater surveillance in various Asian communities to detect and quantify serotypes of EVA associated with HFMD. In total, 77 wastewater samples were collected from Indonesia, the Philippines, Thailand, and Vietnam from March 2022 to February 2023. The detection ratio for CVA6 RNA in samples from Vietnam was 40 % (8/20). The detection ratio for CVA6 and EVA71 RNA each was 25 % (5/20) for the Indonesian samples, indicating the need for clinical surveillance of CVA6, as clinical reports have been limited. For the Philippines, 12 % (2/17) of the samples were positive for CVA6 and EVA71 RNA each, with only one quantifiable sample each. Samples from Thailand had a lower detection ratio (1/20) for CVA6 RNA, and the concentration was unquantifiable. Conversely, CVA10 and CVA16 RNAs were not detected in any of the samples. The minimum and maximum concentrations of CVA6 RNA were 2.7 and 3.9 log10 copies/L and those for EVA71 RNA were 2.5 and 4.9 log10 copies/L, respectively. This study underscores the importance of wastewater surveillance in understanding the epidemiology of HFMD-associated EVA serotypes in Asian communities. Long-term wastewater surveillance is recommended to monitor changes in dominant serotypes, understand seasonality, and develop effective prevention and control strategies for HFMD.
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Affiliation(s)
- Sadhana Shrestha
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Jatuwat Sangsanont
- Department of Environmental Science, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand; Water Science and Technology for Sustainable Environmental Research Group, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Kwanrawee Sirikanchana
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, 54 Kamphaeng Phet 6 Rd., Talat Bang Khen, Lak Si, Bangkok 10210, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), OPS, MHESI, Bangkok 10400, Thailand.
| | - Huong Thi Thuy Ngo
- Faculty of Biotechnology, Chemistry and Environmental Engineering, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 12116, Viet Nam; Environmental Chemistry and Ecotoxicology Lab, Phenikaa University, Yen Nghia Ward - Ha Dong District, Hanoi 12116, Viet Nam.
| | - Jessamine Gail M Inson
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Ma Luisa D Enriquez
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Zeba F Alam
- Department of Biology, De La Salle University, 2401 Taft Avenue, Manila 1004, Philippines.
| | - Ahmad Soleh Setiyawan
- Department of Environmental Engineering, Institut Teknologi Bandung, Jl. Ganesha No. 10, Bandung 40132, Indonesia.
| | - Tjandra Setiadi
- Department of Chemical Engineering, Institut Teknologi Bandung, Jl. Ganesa 10, Bandung 40132, Indonesia.
| | - Tomoko Takeda
- Department of Earth and Planetary Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Masaaki Kitajima
- Division of Environmental Engineering, Hokkaido University, North 13 West 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan.
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
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Man H, Huang H, Qin Z, Li Z. Analysis of a SARIMA-XGBoost model for hand, foot, and mouth disease in Xinjiang, China. Epidemiol Infect 2023; 151:e200. [PMID: 38044833 PMCID: PMC10729004 DOI: 10.1017/s0950268823001905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease. The incidence of HFMD has a pronounced seasonal tendency and is closely related to meteorological factors such as temperature, rainfall, and wind speed. In this paper, we propose a combined SARIMA-XGBoost model to improve the prediction accuracy of HFMD in 15 regions of Xinjiang, China. The SARIMA model is used for seasonal trends, and the XGBoost algorithm is applied for the nonlinear effects of meteorological factors. The geographical and temporal weighted regression model is designed to analyze the influence of meteorological factors from temporal and spatial perspectives. The analysis results show that the HFMD exhibits seasonal characteristics, peaking from May to August each year, and the HFMD incidence has significant spatial heterogeneity. The meteorological factors affecting the spread of HFMD vary among regions. Temperature and daylight significantly impact the transmission of the disease in most areas. Based on the verification experiment of forecasting, the proposed SARIMA-XGBoost model is superior to other models in accuracy, especially in regions with a high incidence of HFMD.
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Affiliation(s)
- Haojie Man
- School of Mathematics and Statistics, Beijing Institute of Technology, Beijing, China
| | - Hanting Huang
- School of Mathematical Sciences, Beihang University, Beijing, China
| | - Zhuangyan Qin
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
| | - Zhiming Li
- College of Mathematics and System Science, Xinjiang University, Urumqi, China
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Shrestha S, Malla B, Haramoto E. Monitoring hand foot and mouth disease using long-term wastewater surveillance in Japan: Quantitative PCR assay development and application. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 901:165926. [PMID: 37527711 DOI: 10.1016/j.scitotenv.2023.165926] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/03/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is a highly contagious disease that primarily affects children under five years of age. It is mainly caused by serotypes of Enterovirus A (EVA): EVA71, Coxsackievirus A types 6 (CVA6), 10 (CVA10), and 16 (CVA16). Despite being highly prevalent in Japan and other countries in the Asia-Pacific region, few studies have investigated HFMD pathogens in wastewater. The present study aimed to develop a highly sensitive and broadly reactive quantitative polymerase chain reaction (qPCR) assay of dominant serotype CVA6, to revise previously developed CVA6, CVA10, and CVA16 assays, and to test these assays in wastewater samples from Yamanashi Prefecture, Japan. The new-CVA6 qPCR assay was developed with maximal nucleotide percent identity among CVA6 isolates from Japan. The new-CVA6 and revised assays were highly sensitive and had the ability to quantify respective positive controls at levels as low as 1 copy/μL. Among the 53 grab influent samples collected between March 2022 and March 2023, EVA71, CVA10, and CVA16 RNA were not detected in any samples, whereas the new-CVA6 assay could detect CVA6 RNA in 38 % (20/53) of samples. CVA6 RNA was detected at a significantly higher concentration in the summer season (3.3 ± 0.8 log10 copies/L; 79 % (11/14)) than in autumn (2.7 ± 0.6 log10 copies/L; 69 % (9/13)). The seasonal trend of CVA6 RNA detection in wastewater aligned with the trend of HFMD case reports in the catchment of the wastewater treatment plant. This is the first study to report the detection and seasonal trends of the EVA serotypes associated with HFMD in wastewater samples in Japan. It provides evidence that wastewater-based epidemiology is applicable even for diseases that are prevalent only in specific population groups.
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Affiliation(s)
- Sadhana Shrestha
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
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Yang L, Liu T, Tian D, Zhao H, Xia Y, Wang J, Li T, Li Q, Qi L. Non-linear association between daily mean temperature and children's hand foot and mouth disease in Chongqing, China. Sci Rep 2023; 13:20355. [PMID: 37990138 PMCID: PMC10663521 DOI: 10.1038/s41598-023-47858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/19/2023] [Indexed: 11/23/2023] Open
Abstract
Chongqing was seriously affected by hand, foot, and mouth disease (HFMD), but the relationships between daily mean temperature and the incidence of HFMD remain unclear. This study used distributed lag nonlinear model to evaluate the effect of daily mean temperature on the incidence of HFMD in children aged < 5 years in Chongqing. Daily HFMD data from 2012 to 2019 in Chongqing were retrieved from the notifiable infectious disease surveillance system. A total of 413,476 HFMD cases aged < 5 years were reported in Chongqing from 2012 to 2019. The exposure-response curve of daily mean temperature and daily HFMD cases was wavy-shaped. The relative risks (RRs) increased as daily mean temperature below 5.66 °C or above 9.43 °C, with two peaks at 16.10 °C and 26.68 °C. The RRs reached the highest when the daily mean temperature at 26.68 °C on the current day (RR = 1.20, 95% CI 1.09-1.32), followed by the daily mean temperature at 16.10 °C at lag 5 days (RR = 1.07, 95% CI 1.05-1.08). The RRs for girls and daycare children were much higher than those for boys and scattered children, respectively. Taken together, daily mean temperature has strong effect on HFMD in children aged < 5 years old in Chongqing, particularly for girls and daycare children.
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Affiliation(s)
- Lin Yang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tian Liu
- Jingzhou Center for Disease Control and Prevention, Hubei, 434000, China
| | - Dechao Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Han Zhao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Yu Xia
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Ju Wang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
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Xin X, Hu X, Zhai L, Jia J, Pan B, Han Y, Jiang F. The effect of ambient temperature on hand, foot and mouth disease in Qingdao, China, 2014-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1081-1090. [PMID: 35510292 DOI: 10.1080/09603123.2022.2072818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/27/2022] [Indexed: 06/14/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is a kind of infection gastrointestinal disease. The present study aims to explore the association between ambient temperature and HFMD in Qingdao. A distributed lag nonlinear model with Poisson distribution was adopted to explore the effects of daily mean temperature on HFMD incidence. Our results found that the high temperature had acute and short-term effects and then declined rapidly along the lag days, with the maximum risk occurring 0 day of exposure. Compared with low temperature, higher effects were observed for high-temperature exposure. Overall, we found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "J" shape, with peak value occurring at 30.5℃ (RR = 2.208, 95% CI: 1.995-2.444). Our findings suggest that ambient temperature is significantly associated with the incidence of HFMD in Qingdao. Monitoring ambient temperature changes is an appropriate recommendation to prevent HFMD.
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Affiliation(s)
- Xueling Xin
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Xiaowen Hu
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Long Zhai
- Department of Occupational Health, Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Jing Jia
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Bei Pan
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Yalin Han
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Fachun Jiang
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
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Tan C, Li S, Li Y, Peng Z. Dynamic modeling and data fitting of climatic and environmental factors and people's behavior factors on hand, foot, and mouth disease (HFMD) in Shanghai, China. Heliyon 2023; 9:e18212. [PMID: 37576260 PMCID: PMC10412780 DOI: 10.1016/j.heliyon.2023.e18212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) appear to be a multi-wave outbreak with unknown mechanisms. We investigate the effects of climatic and environmental factors and changes in people's behavior factors that may be caused by external factors: temperature, relative humidity, and school opening and closing. Methods Distributed lag nonlinear model (DLNM) and dynamic model are used to research multi-wave outbreaks of HFMD. Climatic and environmental factors impact on transmission rate β ( t ) is modeled through DLNM and then substituted into this relationship to establish the dynamic model with reported case data to test for validity. Results Relative risk (RR) of HFMD infection increases with increasing temperature. The RR of infection first increases and then decreases with the increase of relative humidity. For the model fitting HFMD dynamic, time average basic reproduction number [ R 0 ] of Stage I (without vaccine) and Stage II (with EV71 vaccine) are 1.9362 and 1.5478, respectively. Temperature has the highest explanatory power, followed by school opening and closing, and relative humidity. Conclusion We obtain three conclusions about the prevention and control of HFMD. 1) According to the temperature, relative humidity and school start time, the outbreak peak of HFMD should be warned and targeted prevention and control measures should be taken. 2) Reduce high indoor temperature when more than 31.5 oC, and increase low relative humidity when less than 77.5% by opening the window for ventilation, adding houseplants, using air conditioners and humidifiers, reducing the incidence of HFMD and the number of infections. 3) The risk of HFMD transmission during winter vacations is higher than during summer vacations. It is necessary to strengthen the publicity of HFMD prevention knowledge before winter vacations and strengthen the disinfection control measures during winter vacations in children's hospitals, school classrooms, and other places where children gather to reduce the frequency of staff turnover during winter vacations.
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Affiliation(s)
- Changlei Tan
- School of Information and Mathematics, Yangtze University, Jingzhou, 434023, Hubei, PR China
- Information Engineering College, Hunan Applied Technology University, Changde, 415100, Hunan, PR China
| | - Shuang Li
- College of Mathematics and Information Science, Henan Normal University, Xinxiang, 453000, Henan, PR China
| | - Yong Li
- School of Information and Mathematics, Yangtze University, Jingzhou, 434023, Hubei, PR China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, PR China
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Zhang Y, Zhong X, Xi Z, Li Y, Xu H. Antiviral Potential of the Genus Panax: An updated review on their effects and underlying mechanism of action. J Ginseng Res 2023; 47:183-192. [PMID: 36926608 PMCID: PMC10014226 DOI: 10.1016/j.jgr.2022.11.003] [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: 07/04/2022] [Revised: 10/18/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Viral infections are known as one of the major factors causing death. Ginseng is a medicinal plant that demonstrated a wide range of antiviral potential, and saponins are the major bioactive ingredients in the genus Panax with vast therapeutic potential. Studies focusing on the antiviral activity of the genus Panax plant-derived agents (extracts and saponins) and their mechanisms were identified and summarized, including contributions mainly from January 2016 until January 2022. P. ginseng, P. notoginseng, and P. quinquefolius were included in the review as valuable medicinal herbs against infections with 14 types of viruses. Reports from 9 extracts and 12 bioactive saponins were included, with 6 types of protopanaxadiol (PPD) ginsenosides and 6 types of protopanaxatriol (PPT) ginsenosides. The mechanisms mainly involved the inhibition of viral attachment and replication, the modulation of immune response by regulating signaling pathways, including the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway, cystathionine γ-lyase (CSE)/hydrogen sulfide (H2S) pathway, phosphoinositide-dependent kinase-1 (PDK1)/ protein kinase B (Akt) signaling pathway, c-Jun N-terminal kinase (JNK)/activator protein-1 (AP-1) pathway, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway. This review includes detailed information about the mentioned antiviral effects of the genus Panax extracts and saponins in vitro and in vivo, and in human clinical trials, which provides a scientific basis for ginseng as an adjunctive therapeutic drug or nutraceutical.
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Key Words
- ARI, acute respiratory illness
- BG, black ginseng
- BVDV, bovine viral diarrhea virus
- CHB, chronic hepatitis B
- CSFV, classical swine fever virus
- CVBs, group B coxsackieviruses
- DAA, direct-acting antiviral therapies
- EBV, the Epstein-Barr virus
- EV, enterovirus
- EV71, human enterovirus 71
- GCRV, grass carp reovirus
- GSLS, Ginseng stem-leaf saponins
- HAART, highly active antiretroviral drug therapy
- HBV, hepatitis B virus
- HCV, Hepatitis C virus
- HIV-1, human immunodeficiency virus type 1
- HP, highly pathogenic
- HSV, herpes simplex virus
- HVJ, hemagglutinating virus of Japan
- IFN-1, type-I interferon
- JAK, janus kinase
- JNK, c-Jun N-terminal kinase
- KRG, Korean Red Ginseng
- KSHV, Kaposi's sarcoma-associated herpesvirus
- MHV-68, murine gammaherpesvirus 68
- NDV, Newcastle disease virus
- NK, natural killer
- PNAB, PEGylated nanoparticle albumin-bound
- PNR, P. notoginseng root water extract
- PPD, protopanaxadiol
- PPT, protopanaxatriol
- PRRSV, porcine reproductive and respiratory syndrome virus
- Panax ginseng
- RSV, respiratory syncytial virus
- RV, rotavirus
- STAT, signal transducer and activator of transcription
- antiviral activity
- ginseng
- ginsenosides
- mechanism of action
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Affiliation(s)
- Yibo Zhang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, China
| | - Xuanlei Zhong
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, China
| | - Zhichao Xi
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, China
| | - Yang Li
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Engineering Research Center of Shanghai Colleges for TCM New Drug Discovery, Shanghai, China
| | - Hongxi Xu
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Chen Y, Dai B, Han S, Duan G, Yang H, Chen S, Ji W, Jin Y. Arising Concerns of Atypical Manifestations in Patients with Hand, Foot, and Mouth Disease. Vaccines (Basel) 2023; 11:vaccines11020405. [PMID: 36851282 PMCID: PMC9966249 DOI: 10.3390/vaccines11020405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a mild exanthematous, febrile disease, but it also remains a threat to global public health. HFMD is characterized by a brief febrile illness in children and with a typical skin rash of the hand and foot, with or without mouth ulcers. However, the morphology and distribution of vesicles, as well as accompanying symptoms, are varied among atypical HFMD. An upsurge in atypical presentations of HFMD caused by Coxsackievirus A6 (CVA6), including Gianotti-Crosti-like eruptions, eczema coxsackium, petechial/purpuric eruption, and vesiculobullous exanthema, can be difficult to diagnose clinically as it may mimic other severe skin diseases, such as eczema herpeticum, varicella, disseminated zoster, and erythema multiforme major. The recognition of the distinguishing features of atypical HFMD is vital for an accurate and timely diagnosis, as is initiating appropriate laboratory evaluation and supportive care. Clinicians must identify the wide range of cutaneous and mucosal alterations caused by atypical HFMD. A systemic, high-quality overview of atypical HFMD is needed for advances in better strategies for clinical diagnosis and treatment. Hence, this review is aimed at summarizing the available data on clinical investigations and differential diagnostics to provide a scientific guide for the timely diagnosis of HFMD for preventing serious complications.
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Affiliation(s)
- Yu Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Bowen Dai
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Shujie Han
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Haiyan Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (W.J.); (Y.J.)
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (W.J.); (Y.J.)
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Xing J, Wang K, Wang G, Li N, Zhang Y. Recent advances in enterovirus A71 pathogenesis: a focus on fatal human enterovirus A71 infection. Arch Virol 2022; 167:2483-2501. [PMID: 36171507 DOI: 10.1007/s00705-022-05606-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/05/2022] [Indexed: 12/14/2022]
Abstract
Enterovirus A71 (EV-A71) is one of the major pathogens responsible for hand, foot, and mouth disease (HFMD). Many HFMD outbreaks have been reported throughout the world in the past decades. Compared with other viruses, EV-A71 infection is more frequently associated with severe neurological complications and even death in children. EV-A71 can also infect adults and cause severe complications and death, although such cases are very uncommon. Although fatal cases of EV-A71 infection have been reported, the underlying mechanisms of EV-A71 infection, especially the mode of viral spread into the central nervous system (CNS) and mechanisms of pulmonary edema, which is considered to be the direct cause of death, have not yet been fully clarified, and more studies are needed. Here, we first summarize the pathological findings in various systems of patients with fatal EV-A71 infections, focussing in detail on gross changes, histopathological examination, tissue distribution of viral antigens and nucleic acids, systemic inflammatory cell infiltration, and tissue distribution of viral receptors and their co-localization with viral antigens. We then present our conclusions about viral dissemination, neuropathogenesis, and the mechanism of pulmonary edema in EV-A71 infection, based on pathological findings.
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Affiliation(s)
- Jingjun Xing
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China
| | - Ke Wang
- The Affiliated Hospital of Medical School, Ningbo University, No. 247 Renmin Road, Jiangbei District, Ningbo, 315020, Zhejiang Province, P. R. China
| | - Geng Wang
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China
| | - Na Li
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China
| | - Yanru Zhang
- Zhejiang Key Laboratory of Pathophysiology, School of Basic Medical Science, School of Medicine, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, Zhejiang Province, P. R. China.
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Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Hand, Foot, and Mouth Disease: A Narrative Review. RECENT ADVANCES IN INFLAMMATION & ALLERGY DRUG DISCOVERY 2022; 16:77-95. [PMID: 36284392 DOI: 10.2174/1570180820666221024095837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/08/2022] [Accepted: 09/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hand, foot, and mouth disease is a common viral disease in childhood. Because the disease has the potential to reach epidemic levels and mortality is high in some countries, early recognition of this disease is of paramount importance. OBJECTIVE This purpose of this article is to familiarize pediatricians with the clinical manifestations and management of hand, foot, and mouth disease. METHODS A search was conducted in February 2022 in PubMed Clinical Queries using the key term "hand, foot, and mouth disease". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in English were included in this review. RESULTS Hand, foot, and mouth disease is characterized by a painful oral enanthem and asymptomatic exanthem on the palms and soles. Children younger than 5 years are most commonly affected. Hand, foot, and mouth disease caused by enterovirus A71 is more severe and has a higher rate of complications than that attributed to other viruses such as coxsackievirus A16. Circulatory failure secondary to myocardial impairment and neurogenic pulmonary edema secondary to brainstem damage are the main causes of death. Fortunately, the disease is usually benign and resolves in 7 to10 days without sequelae. Given the self-limited nature of most cases, treatment is mainly symptomatic and supportive. Intravenous immunoglobulin should be considered for the treatment of severe/complicated hand, foot, and mouth disease and has been recommended by several national and international guideline committees. Currently, there are no specific antiviral agents approved for the treatment of the disease. Drugs such as ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline have emerged as potential candidates for the treatment of hand, foot, and mouth disease. Vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures to combat the disease. CONCLUSION Familiarity of the disease including its atypical manifestations is crucial so that a correct diagnosis can be made, and appropriate treatment initiated. A timely diagnosis can help avoid contact with the affected individual and decrease the risk of an outbreak.
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Affiliation(s)
- Alexander K C Leung
- Department of Paediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Paediatrics, Hong Kong Institute of Integrative Medicine, and the Jockey Club School of Public Health and Primary Care, The Chinese University Hong Kong, Hong Kong
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12
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Cheng Q, Collender PA, Heaney AK, McLoughlin A, Yang Y, Zhang Y, Head JR, Dasan R, Liang S, Lv Q, Liu Y, Yang C, Chang HH, Waller LA, Zelner J, Lewnard JA, Remais JV. Optimizing laboratory-based surveillance networks for monitoring multi-genotype or multi-serotype infections. PLoS Comput Biol 2022; 18:e1010575. [PMID: 36166479 PMCID: PMC9543988 DOI: 10.1371/journal.pcbi.1010575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 10/07/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
With the aid of laboratory typing techniques, infectious disease surveillance networks have the opportunity to obtain powerful information on the emergence, circulation, and evolution of multiple genotypes, serotypes or other subtypes of pathogens, informing understanding of transmission dynamics and strategies for prevention and control. The volume of typing performed on clinical isolates is typically limited by its ability to inform clinical care, cost and logistical constraints, especially in comparison with the capacity to monitor clinical reports of disease occurrence, which remains the most widespread form of public health surveillance. Viewing clinical disease reports as arising from a latent mixture of pathogen subtypes, laboratory typing of a subset of clinical cases can provide inference on the proportion of clinical cases attributable to each subtype (i.e., the mixture components). Optimizing protocols for the selection of isolates for typing by weighting specific subpopulations, locations, time periods, or case characteristics (e.g., disease severity), may improve inference of the frequency and distribution of pathogen subtypes within and between populations. Here, we apply the Disease Surveillance Informatics Optimization and Simulation (DIOS) framework to simulate and optimize hand foot and mouth disease (HFMD) surveillance in a high-burden region of western China. We identify laboratory surveillance designs that significantly outperform the existing network: the optimal network reduced mean absolute error in estimated serotype-specific incidence rates by 14.1%; similarly, the optimal network for monitoring severe cases reduced mean absolute error in serotype-specific incidence rates by 13.3%. In both cases, the optimal network designs achieved improved inference without increasing subtyping effort. We demonstrate how the DIOS framework can be used to optimize surveillance networks by augmenting clinical diagnostic data with limited laboratory typing resources, while adapting to specific, local surveillance objectives and constraints.
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Affiliation(s)
- Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Philip A. Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Alexandra K. Heaney
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Aidan McLoughlin
- Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Yang Yang
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Yuzi Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jennifer R. Head
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Rohini Dasan
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Song Liang
- Department of Environmental and Global Health College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Qiang Lv
- Institute of Health Informatics, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Yaqiong Liu
- Institute of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Changhong Yang
- Division of Business Management and Quality Control, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jon Zelner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Joseph A. Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Justin V. Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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Yoshida K, Fujimoto T, Muramatsu M, Shimizu H. Prediction of hand, foot, and mouth disease epidemics in Japan using a long short-term memory approach. PLoS One 2022; 17:e0271820. [PMID: 35900968 PMCID: PMC9333334 DOI: 10.1371/journal.pone.0271820] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/08/2022] [Indexed: 11/19/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common febrile illness caused by enteroviruses in the Picornaviridae family. The major symptoms of HFMD are fever and a vesicular rash on the hand, foot, or oral mucosa. Acute meningitis and encephalitis are observed in rare cases. HFMD epidemics occur annually in Japan, usually in the summer season. Relatively large-scale outbreaks have occurred every two years since 2011. In this study, the epidemic patterns of HFMD in Japan are predicted four weeks in advance using a deep learning method. The time-series data were analyzed by a long short-term memory (LSTM) approach called a Recurrent Neural Network. The LSTM model was trained on the numbers of weekly HFMD cases in each prefecture. These data are reported in the Infectious Diseases Weekly Report, which compiles the national surveillance data from web sites at the National Institute of Infectious Diseases, Japan, under the Infectious Diseases Control Law. Consequently, our trained LSTM model distinguishes between relatively large-scale and small-scale epidemics. The trained model predicted the HFMD epidemics in 2018 and 2019, indicating that the LSTM approach can estimate the future epidemic patterns of HFMD in Japan.
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Affiliation(s)
- Kazuhiro Yoshida
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
| | - Tsuguto Fujimoto
- Department of Fungal Infection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masamichi Muramatsu
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroyuki Shimizu
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
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MARLETTA DA, BERETTA AE, GENOVESE G, MARZANO AV. Bullous hand, foot, and mouth disease. Ital J Dermatol Venerol 2022; 157:284-285. [DOI: 10.23736/s2784-8671.21.07029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Li YP, Liu CR, Deng HL, Wang MQ, Tian Y, Chen Y, Zhang YF, Dang SS, Zhai S. DNA methylation and single-nucleotide polymorphisms in DDX58 are associated with hand, foot and mouth disease caused by enterovirus 71. PLoS Negl Trop Dis 2022; 16:e0010090. [PMID: 35041675 PMCID: PMC8765647 DOI: 10.1371/journal.pntd.0010090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 12/14/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND This research aimed to explore the association between the RIG-I-like receptor (RIG-I and MDA5 encoded by DDX58 and IFIH1, respectively) pathways and the risk or severity of hand, foot, and mouth disease caused by enterovirus 71 (EV71-HFMD). In this context, we explored the influence of gene methylation and polymorphism on EV71-HFMD. METHODOLOGY/PRINCIPAL FINDINGS 60 healthy controls and 120 EV71-HFMD patients, including 60 mild EV71-HFMD and 60 severe EV71-HFMD patients, were enrolled. First, MiSeq was performed to explore the methylation of CpG islands in the DDX58 and IFIH1 promoter regions. Then, DDX58 and IFIH1 expression were detected in PBMCs using RT-qPCR. Finally, imLDR was used to detect DDX58 and IFIH1 single-nucleotide polymorphism (SNP) genotypes. Severe EV71-HFMD patients exhibited higher DDX58 promoter methylation levels than healthy controls and mild EV71-HFMD patients. DDX58 promoter methylation was significantly associated with severe HFMD, sex, vomiting, high fever, neutrophil abundance, and lymphocyte abundance. DDX58 expression levels were significantly lower in mild patients than in healthy controls and lower in severe patients than in mild patients. Binary logistic regression analysis revealed statistically significant differences in the genotype frequencies of DDX58 rs3739674 between the mild and severe groups. GeneMANIA revealed that 19 proteins displayed correlations with DDX58, including DHX58, HERC5, MAVS, RAI14, WRNIP1 and ISG15, and 19 proteins displayed correlations with IFIH1, including TKFC, IDE, MAVS, DHX58, NLRC5, TSPAN6, USP3 and DDX58. CONCLUSIONS/SIGNIFICANCE DDX58 expression and promoter methylation were associated with EV71 infection progression, especially in severe EV71-HFMD patients. The effect of DDX58 in EV71-HFMD is worth further attention.
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MESH Headings
- Child
- Child, Preschool
- CpG Islands/genetics
- DEAD Box Protein 58/genetics
- DEAD Box Protein 58/metabolism
- DNA Methylation/genetics
- Enterovirus A, Human
- Female
- Genetic Predisposition to Disease/genetics
- Hand, Foot and Mouth Disease/pathology
- Hand, Foot and Mouth Disease/virology
- Humans
- Infant
- Interferon-Induced Helicase, IFIH1/genetics
- Interferon-Induced Helicase, IFIH1/metabolism
- Male
- Polymorphism, Single Nucleotide/genetics
- Promoter Regions, Genetic/genetics
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
- Severity of Illness Index
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Affiliation(s)
- Ya-Ping Li
- Department of Infectious Diseases, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Chen-Rui Liu
- Department of Infectious Diseases, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Hui-Ling Deng
- Department of Infectious Diseases, Xi’an Children’s Hospital, Xi’an, China
- Department of Pediatric, Xi’an Central Hospital, Xi’an, China
| | - Mu-Qi Wang
- Department of Infectious Diseases, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Yan Tian
- Department of Infectious Diseases, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Yuan Chen
- Department of Infectious Diseases, Xi’an Children’s Hospital, Xi’an, China
| | - Yu-Feng Zhang
- Department of Infectious Diseases, Xi’an Children’s Hospital, Xi’an, China
| | - Shuang-Suo Dang
- Department of Infectious Diseases, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
| | - Song Zhai
- Department of Infectious Diseases, Xi’an Jiaotong University Second Affiliated Hospital, Xi’an, China
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Sous D, Starace MV, Chen L, Nieman EL, Anadkat MJ, Piraccini BM, Coughlin CC. Recurrent Onychomadesis of the Toenails in Children and Adults: A Case Series. Skin Appendage Disord 2022; 8:31-33. [PMID: 35118126 PMCID: PMC8787582 DOI: 10.1159/000519016] [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: 07/20/2021] [Accepted: 08/06/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Onychomadesis occurs when the nail plate separates from the nail matrix and nail bed, eventually leading to shedding of the nail. This condition has been attributed to viral infections, autoimmune disorders, drug side effects, and physical trauma. A subset of patients has a recurrent form of onychomadesis without a clear trigger; this phenomenon is not well characterized in the literature. CASE PRESENTATION We present a case series of pediatric and adult patients with recurrent toenail onychomadesis in order to better characterize the disorder and explore possible etiologies, risk factors, and treatments. DISCUSSION/CONCLUSION For the cases herein, we propose microtrauma associated with footwear as the underlying etiology given the periodicity of nail shedding, exclusion of other etiological factors, and presence of predisposing risk factors in certain patients. Many patients saw improvement with application of urea 40% cream, suggesting this can be a valuable part of a treatment strategy, in addition to minimizing injury to involved digits.
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Affiliation(s)
- Dana Sous
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Michela V.R. Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Lu Chen
- Dermatopathology, The Institute for Dermatopathology, Newtown Square, Pennsylvania, USA
| | - Elizabeth L. Nieman
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Milan J. Anadkat
- Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Carrie C. Coughlin
- Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA,Departments of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA,*Carrie C. Coughlin,
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Masomian M, Lalani S, Poh CL. Molecular Docking of SP40 Peptide towards Cellular Receptors for Enterovirus 71 (EV-A71). Molecules 2021; 26:molecules26216576. [PMID: 34770987 PMCID: PMC8587434 DOI: 10.3390/molecules26216576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/13/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Enterovirus 71 (EV-A71) is one of the predominant etiological agents of hand, foot and mouth disease (HMFD), which can cause severe central nervous system infections in young children. There is no clinically approved vaccine or antiviral agent against HFMD. The SP40 peptide, derived from the VP1 capsid of EV-A71, was reported to be a promising antiviral peptide that targeted the host receptor(s) involved in viral attachment or entry. So far, the mechanism of action of SP40 peptide is unknown. In this study, interactions between ten reported cell receptors of EV-A71 and the antiviral SP40 peptide were evaluated through molecular docking simulations, followed by in vitro receptor blocking with specific antibodies. The preferable binding region of each receptor to SP40 was predicted by global docking using HPEPDOCK and the cell receptor-SP40 peptide complexes were refined using FlexPepDock. Local molecular docking using GOLD (Genetic Optimization for Ligand Docking) showed that the SP40 peptide had the highest binding score to nucleolin followed by annexin A2, SCARB2 and human tryptophanyl-tRNA synthetase. The average GoldScore for 5 top-scoring models of human cyclophilin, fibronectin, human galectin, DC-SIGN and vimentin were almost similar. Analysis of the nucleolin-SP40 peptide complex showed that SP40 peptide binds to the RNA binding domains (RBDs) of nucleolin. Furthermore, receptor blocking by specific monoclonal antibody was performed for seven cell receptors of EV-A71 and the results showed that the blocking of nucleolin by anti-nucleolin alone conferred a 93% reduction in viral infectivity. Maximum viral inhibition (99.5%) occurred when SCARB2 was concurrently blocked with anti-SCARB2 and the SP40 peptide. This is the first report to reveal the mechanism of action of SP40 peptide in silico through molecular docking analysis. This study provides information on the possible binding site of SP40 peptide to EV-A71 cellular receptors. Such information could be useful to further validate the interaction of the SP40 peptide with nucleolin by site-directed mutagenesis of the nucleolin binding site.
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Affiliation(s)
- Malihe Masomian
- Correspondence: (M.M.); (C.L.P.); Tel.: +603-74918622 (ext. 7603) (M.M.); +603-74918622 (ext. 7338) (C.L.P.)
| | | | - Chit Laa Poh
- Correspondence: (M.M.); (C.L.P.); Tel.: +603-74918622 (ext. 7603) (M.M.); +603-74918622 (ext. 7338) (C.L.P.)
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Maduray K, Parboosing R. Metal Nanoparticles: a Promising Treatment for Viral and Arboviral Infections. Biol Trace Elem Res 2021; 199:3159-3176. [PMID: 33029761 PMCID: PMC7540915 DOI: 10.1007/s12011-020-02414-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
Globally, viral diseases continue to pose a significant threat to public health. Recent outbreaks, such as influenza, coronavirus, Ebola, and dengue, have emphasized the urgent need for new antiviral therapeutics. Considerable efforts have focused on developing metal nanoparticles for the treatment of several pathogenic viruses. As a result of these efforts, metal nanoparticles are demonstrating promising antiviral activity against pathogenic surrogates and clinical isolates. This review summarizes the application of metal nanoparticles for the treatment of viral infections. It provides information on synthesis methods, size-related properties, nano-bio-interaction, and immunological effects of metal nanoparticles. This article also addresses critical criteria and considerations for developing clinically translatable nanosized metal particles to treat viral diseases.
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Affiliation(s)
- Kaminee Maduray
- Department of Virology, University of KwaZulu-Natal/National Health Laboratory Service, Durban, South Africa.
| | - Raveen Parboosing
- Department of Virology, University of KwaZulu-Natal/National Health Laboratory Service, Durban, South Africa
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Abstract
A variety of acute oral lesions may be encountered in the scope of dermatology. Oral lesions may be single or multiple; may arise secondary to infectious, immune, congenital, medication use, or idiopathic causes; and may take a variety of forms. A thorough evaluation of the oral cavity is required to assess patients with oral lesions. Affected patients may be monitored, treated, or referred to an appropriate specialist for further management as needed. Many acute oral lesions are self-limiting in nature and patients may require only assessment and reassurance. Several common acute oral lesions are discussed in this article.
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Affiliation(s)
- Katherine France
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, 513 Parnassus Avenue, Suite 512A, San Francisco, CA 94143, USA
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Luo J, Huo C, Qin H, Hu J, Lei L, Pan Z. Chimeric enterovirus 71 virus-like particle displaying conserved coxsackievirus A16 epitopes elicits potent immune responses and protects mice against lethal EV71 and CA16 infection. Vaccine 2021; 39:4135-4143. [PMID: 34116877 DOI: 10.1016/j.vaccine.2021.05.093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/29/2021] [Accepted: 05/27/2021] [Indexed: 12/15/2022]
Abstract
Hand-foot-and-mouth disease (HFMD) is an infectious disease of infants and young children frequently caused by the enterovirus A species, mainly enterovirus 71 (EV71) and coxsackievirus A16 (CA16). In this study, we prepared the EV71 virus-like particle (EV71-VLP) and its chimeras using recombinant baculovirus (Bac-P1-3CD) co-expressing EV71 P1 (under polyhedrin promoter) and 3CD (under CMV-IE promoter) proteins in Sf9 cells. EV71-VLP chimera ChiEV71(1E)-VLP or ChiEV71(4E)-VLP displayed single CA16 PEP71 epitope in VP1 or four conserved CA16 neutralizing epitopes (PEP71 in VP1, aa136-150 in VP2, aa176-190 in VP3 and aa48-62 in VP4) by substitution of the corresponding regions of EV71 structure proteins, respectively. In mice, EV71-VLP and its chimeras elicited similar EV71-specific IgG and neutralizing antibody (NAb) titers compared to inactivated EV71. Expectedly, vaccination of ChiEV71(1E)-VLP or ChiEV71(4E)-VLP resulted in significantly increased CA16-specific IgG and NAb production and improved cross-protection against CA16 infection compared to EV71-VLP. Interestingly, the VLPs induced potent cellular immune responses and significantly decreased Th2 type (IL-4 and IL-10) cytokines secretion in the splenocytes of immunized mice compared to inactivated EV71 or inactivated CA16. Neonatal mice born to dams immunized with the chimeric VLPs or neonatal mice passively transferred with sera of immunized mice were completely protected from lethal EV71 challenge and partially protected from lethal CA16 infection. Our study provides a novel bivalent or multivalent vaccine strategy to prevent EV71 and related-enterovirus infections.
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Affiliation(s)
- Jin Luo
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Chunling Huo
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Huan Qin
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Junhong Hu
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Lei Lei
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China.
| | - Zishu Pan
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China.
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Denison AM, Bhatnagar J, Jahan-Tigh RR, Fair P, Hale GL. Detection of coxsackievirus A6 in formalin-fixed, paraffin-embedded skin biopsy specimens using immunohistochemistry and real-time reverse-transcriptase PCR. JOURNAL OF CLINICAL VIROLOGY PLUS 2021; 1:10.1016/j.jcvp.2021.100018. [PMID: 38481773 PMCID: PMC10936323 DOI: 10.1016/j.jcvp.2021.100018] [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] [Indexed: 11/28/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD), classically a childhood viral infection, has an atypical and severe clinical presentation in adults. Coxsackievirus A6 is a leading cause of atypical HFMD, but current diagnostic methods utilizing formalin-fixed, paraffin-embedded skin biopsy specimens often lack sensitivity and specificity. Methods Formalin-fixed, paraffin-embedded skin biopsies from seven case patients with clinical and histopathological suspicion of atypical HFMD were evaluated by coxsackievirus A6 (CVA6) immunohistochemistry, enterovirus-specific conventional reverse transcriptase-PCR with subsequent Sanger sequencing targeting the 5'UTR, and CVA6-specific real-time PCR targeting the VP1 gene. Results The CVA6-specific antibody demonstrated appropriate antigen distribution and staining intensity in keratinocytes in all cases. Conventional RT-PCR and sequencing also detected the presence of enterovirus, and CVA6-specific real-time RT-PCR analysis identified CVA6. Conclusion Applying these immunohistochemistry and molecular techniques to formalin-fixed, paraffin-embedded tissues, CVA6 was determined to be the causative infectious agent in seven cases of atypical hand, foot, and mouth disease.
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Affiliation(s)
- Amy M. Denison
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julu Bhatnagar
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard R. Jahan-Tigh
- University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA
| | - Pamela Fair
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gillian L. Hale
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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22
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Jiang Z, Zhang Y, Lin H, Cheng Q, Lu X, Liu W, Zhou R, Zhong B, Tian X. A 10-Day-Old Murine Model of Coxsackievirus A6 Infection for the Evaluation of Vaccines and Antiviral Drugs. Front Immunol 2021; 12:665197. [PMID: 34054834 PMCID: PMC8155526 DOI: 10.3389/fimmu.2021.665197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Coxsackievirus A6 (CVA6) is recognized as a major enterovirus type that can cause severe hand, foot, and mouth disease and spread widely among children. Vaccines and antiviral drugs may be developed more effectively based on a stable and easy-to-operate CVA6 mouse infection model. In this study, a wild CVA6-W strain was sub-cultured in newborn mice of different ages (in days), for adaptation. Therefore, a CVA6-A mouse-adapted strain capable of stably infecting the mice was generated, and a fatal model was built. As the result indicated, CVA6-A could infect the 10-day-old mice to generate higher levels of IFN-γ, IL-6, and IL-10. The mice infected with CVA6-A were treated with IFN-α1b at a higher dose, with complete protection. Based on this strain, an animal model with active immunization was built to evaluate antiviral protection by active immunization. The three-day-old mice were pre-immunized with inactivated CVA6 thereby generating IgM and IgG antibodies within 7 days that enabled complete protection of the pre-immunized mice following the CVA6 virus challenge. There were eight mutations in the genome of CVA6-A than in that of CVA6-W, possibly attributed to the virulence of CVA6 in mice. Briefly, the CVA6 infection model of the 10-day-old mice built herein, may serve as an applicable preclinical evaluation model for CVA6 antiviral drugs and vaccine study.
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Affiliation(s)
- Zaixue Jiang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,Dongguan Institute of Paediatrics, Dongguan Children's Hospital, The Eighth People's Hospital of Dongguan City, Guangdong Medical University, Dongguan, China
| | - Yaozhong Zhang
- Dongguan Institute of Paediatrics, Dongguan Children's Hospital, The Eighth People's Hospital of Dongguan City, Guangdong Medical University, Dongguan, China
| | - Huayuan Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Qingqiu Cheng
- Dongguan Institute of Paediatrics, Dongguan Children's Hospital, The Eighth People's Hospital of Dongguan City, Guangdong Medical University, Dongguan, China
| | - Xiaomei Lu
- Dongguan Institute of Paediatrics, Dongguan Children's Hospital, The Eighth People's Hospital of Dongguan City, Guangdong Medical University, Dongguan, China
| | - Wenkuan Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Rong Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Baimao Zhong
- Dongguan Institute of Paediatrics, Dongguan Children's Hospital, The Eighth People's Hospital of Dongguan City, Guangdong Medical University, Dongguan, China
| | - Xingui Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
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Oska S, Bedford LM, Potts GA. Alopecia totalis following hand-foot-and-mouth disease. Pediatr Dermatol 2021; 38:640-642. [PMID: 33650159 DOI: 10.1111/pde.14550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/17/2021] [Accepted: 01/30/2021] [Indexed: 11/29/2022]
Abstract
We present a case of a 13-month-old male patient with alopecia totalis that began two months after an episode of hand-foot-and-mouth disease. It is hypothesized that the viral infection triggered an autoimmune response, which lead to production of lymphocytes targeting an antigen present in the hair bulb. Future research is necessary to determine whether and how the pathophysiology of alopecia totalis may be triggered by viral infection.
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Affiliation(s)
- Sandra Oska
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lisa M Bedford
- Department of Dermatology, Wayne State University, Dearborn, MI, USA
| | - Geoffrey A Potts
- Department of Dermatology, Wayne State University, Dearborn, MI, USA
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24
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Kim YJ, Kim TG. Pseudomembranous conjunctivitis with hand, foot and mouth disease in a pregnant woman : a case report. BMC Ophthalmol 2021; 21:113. [PMID: 33653308 PMCID: PMC7922717 DOI: 10.1186/s12886-021-01878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is a common systemic infection that is caused by an enterovirus, normally Coxsackie A16. Generally, it affects children or immunocompromised adults. Only a few reports have described pseudomembranous conjunctivitis associated with HFMD. We aim to describe the clinical outcomes and ocular findings of a 37-year-old female with HFMD and concurrent severe pseudomembranous conjunctivitis, who was 28 weeks pregnant. Case presentation A female patient who was 28-weeks pregnant was referred for an ophthalmological review due to pain and injection in both eyes. The patient was hospitalized under obstetrics and gynecology and evaluated for Behcet’s disease with oral and perineal ulcers. In an ophthalmic examination, both eyes were observed to have a conjunctival injection. Behcet’s disease-associated conjunctivitis was diagnosed. Topical steroids and antibiotics were administered every 6 h. Two days after her presentation, a maculopapular eruption occurred on her palms. Enterovirus type 71 was detected in a serum virus antibody test, and the patient was diagnosed with HFMD. After 7 days, severe pseudomembranous conjunctivitis and corneal epithelial defects occurred in both eyes. Topical steroids were administered every 3 h, and the pseudomembrane was removed every 2 to 3 days. The pseudomembrane did not occur after 3 weeks, but corneal erosion persisted. After 3 months, the corneal erosion had completely resolved. Conclusions HFMD-associated conjunctivitis is a rare complication in adults, however it can appear as a severe pseudomembranous conjunctivitis. In this case, the removal of the pseudomembrane and topical steroids helped improve the symptoms.
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Affiliation(s)
- Yoo Jin Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, 05278, Seoul, Korea
| | - Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, # 892, Dongnam-ro, Gangdong-gu, 05278, Seoul, Korea.
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25
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Li ML, Shih SR, Tolbert BS, Brewer G. Enterovirus A71 Vaccines. Vaccines (Basel) 2021; 9:vaccines9030199. [PMID: 33673595 PMCID: PMC7997495 DOI: 10.3390/vaccines9030199] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Enterovirus A71 (EV-A71) is a major causative agent of hand, foot, and mouth disease (HFMD) and herpangina. Moreover, EV-A71 infection can lead to neurological complications and death. Vaccination is the most efficient way to control virus infection. There are currently three inactivated, whole EV-A71 vaccines licensed by the China NMPA (National Medical Products Administration). Several other types of vaccines, such as virus-like particles and recombinant VP1 (capsid protein), are also under development. In this review, we discuss recent advances in the development of EV-A71 vaccines.
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Affiliation(s)
- Mei-Ling Li
- Department of Biochemistry and Molecular Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA;
- Correspondence:
| | - Shin-Ru Shih
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Research Center for Chinese Herbal Medicine, Research Center for Food and Cosmetic Safety, and Graduate Institute of Health Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan
| | - Blanton S. Tolbert
- Department of Chemistry, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Gary Brewer
- Department of Biochemistry and Molecular Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA;
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26
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Wang B, Zhu Y, Liu L, Wang B, Chen M, Wang J, Yang L, Liu J. Enterovirus 71 induces autophagy in mice via mTOR inhibition and ERK pathway activation. Life Sci 2021; 271:119188. [PMID: 33581126 DOI: 10.1016/j.lfs.2021.119188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
AIMS Enterovirus 71 (EV71) is one of the main viruses that cause hand-foot-mouth disease; however, its pathogenic mechanism remains unclear. This study characterized the relationship between EV71 infection and autophagy in vivo and explored the molecular mechanism underlying EV71-induced autophagy. MATERIALS AND METHODS A mouse model of EV71 infection was prepared by intraperitoneally injecting one-day-old BALB/c suckling mice with 30 μL/g of EV71 virus stock solution for 3 days. The behavior, fur condition, weight, and mice mortality were monitored, and disease scores were calculated. The pathological damage to the brain, lung, and muscle tissues after the viral infection was assessed by hematoxylin and eosin staining. Western blot and immunofluorescence analyses were used to detect the expression levels of viral protein 1, Beclin-1, microtubule-associated protein light chain 3B, mammalian target of rapamycin (mTOR), phosphorylated (p)-mTOR, extracellular signal-regulated protein kinase (ERK) 1/2, and p-ERK. KEY FINDINGS EV71 infection can trigger autophagy in the brains, lungs, and muscles of infected mice. The autophagy response triggered by EV71 is achieved by the simultaneous mTOR inhibition and the ERK pathway activation. Blocking the mTOR pathway may aggravate autophagy, whereas ERK inhibition alleviates autophagy but cannot completely prevent it. SIGNIFICANCE EV71 infection can induce autophagy in mice, involving mTOR and ERK signaling pathways. These two signaling pathways are independent and do not interfere with each other.
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Affiliation(s)
- Baixin Wang
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China
| | - Yuanzhi Zhu
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China
| | - Lei Liu
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China
| | - Binshan Wang
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China
| | - Mei Chen
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China
| | - Jingtao Wang
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China
| | - Limin Yang
- School of Medicine, Dalian University, Dalian 116622, China.
| | - JiGuang Liu
- School of Basic Medicine, Jiamusi University, Jiamusi 154007, China.
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27
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Abstract
Bacterial and viral infections of the nail unit are very common as primary infections, especially bacterial paronychia and warts, but they can also be superinfections complicating other nail disorders. In many nail unit infections, the clinical presentation is nonspecific: in these cases, diagnostic tests are mandatory before treatment, to avoid spread of the infection and drug resistance. The most common forms of bacterial and viral infections that may affect the nail unit are herein described in detail, with diagnostic and treatment options provided.
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Affiliation(s)
- Matilde Iorizzo
- Private Dermatology Practice, Viale Stazione 16, Bellinzona 6500, Switzerland.
| | - Marcel C Pasch
- Department of Dermatology, Radboud University Medical Center, Rene Descartesdreef 1, Nijmegen 6525GL, The Netherlands
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28
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Bellet JS. Pediatric Nail Disorders. Dermatol Clin 2021; 39:231-243. [PMID: 33745636 DOI: 10.1016/j.det.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Many pediatric nail findings are normal variants and are no cause for alarm. Others represent congenital abnormalities or genetic syndromes for which there is no cure. Still others are inflammatory or infectious entities that require treatment. Pediatric nail disorders are reviewed, along with management.
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Affiliation(s)
- Jane Sanders Bellet
- Duke University School of Medicine, 5324 McFarland Drive, Suite 410, Durham, NC 27707, USA.
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29
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Head JR, Collender PA, Lewnard JA, Skaff NK, Li L, Cheng Q, Baker JM, Li C, Chen D, Ohringer A, Liang S, Yang C, Hubbard A, Lopman B, Remais JV. Early Evidence of Inactivated Enterovirus 71 Vaccine Impact Against Hand, Foot, and Mouth Disease in a Major Center of Ongoing Transmission in China, 2011-2018: A Longitudinal Surveillance Study. Clin Infect Dis 2020; 71:3088-3095. [PMID: 31879754 PMCID: PMC7819528 DOI: 10.1093/cid/ciz1188] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Enterovirus 71 (EV71) is a major causative agent of hand, foot, and mouth disease (HFMD), associated with severe manifestations of the disease. Pediatric immunization with inactivated EV71 vaccine was initiated in 2016 in the Asia-Pacific region, including China. We analyzed a time series of HFMD cases attributable to EV71, coxsackievirus A16 (CA16), and other enteroviruses in Chengdu, a major transmission center in China, to assess early impacts of immunization. METHODS Reported HFMD cases were obtained from China's notifiable disease surveillance system. We compared observed postvaccination incidence rates during 2017-2018 with counterfactual predictions made from a negative binomial regression and a random forest model fitted to prevaccine years (2011-2015). We fit a change point model to the full time series to evaluate whether the trend of EV71 HFMD changed following vaccination. RESULTS Between 2011 and 2018, 279 352 HFMD cases were reported in the study region. The average incidence rate of EV71 HFMD in 2017-2018 was 60% (95% prediction interval [PI], 41%-72%) lower than predicted in the absence of immunization, corresponding to an estimated 6911 (95% PI, 3246-11 542) EV71 cases averted over 2 years. There were 52% (95% PI, 42%-60%) fewer severe HFMD cases than predicted. However, the incidence rate of non-CA16 and non-EV71 HFMD was elevated in 2018. We identified a significant decline in the trend of EV71 HFMD 4 months into the postvaccine period. CONCLUSIONS We provide the first real-world evidence that programmatic vaccination against EV71 is effective against childhood HFMD and present an approach to detect early vaccine impact or intended consequences from surveillance data.
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Affiliation(s)
- Jennifer R Head
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Philip A Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Joseph A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, USA
- Center for Computational Biology, College of Engineering, University of California, Berkeley, Berkeley, California, USA
| | - Nicholas K Skaff
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Ling Li
- Institute for Public Health Information, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Qu Cheng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Julia M Baker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Charles Li
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Dehao Chen
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Alison Ohringer
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Changhong Yang
- Institute for Public Health Information, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Alan Hubbard
- Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Benjamin Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
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30
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Laor P, Apidechkul T, Khunthason S, Keawdounglek V, Sudsandee S, Fakkaew K, Siriratruengsuk W. Association of environmental factors and high HFMD occurrence in northern Thailand. BMC Public Health 2020; 20:1829. [PMID: 33256665 PMCID: PMC7706220 DOI: 10.1186/s12889-020-09905-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/17/2020] [Indexed: 02/02/2023] Open
Abstract
Background The major population vulnerable to hand, foot and mouth disease (HFMD) is children aged less than 5 years, particularly those who are cared for at day care centers (DCCs). This study aimed to assess the associations of environmental and sanitation factors with high HFMD occurrence rates in DCCs of northern Thailand. Methods A case-control study was used to gather information from caregivers and local government administrative officers. DCCs in areas with high and low HFMD occurrence rates were the settings for this study. A validated questionnaire was used to collect environmental and sanitation information from the DCCs. In-depth interviews were used to collect information from selected participants who were working at DCCs and from local government administrative officers on the HFMD capacity and prevention and control strategies in DCCs. Logistic regression analysis was used to determine the associations between many environmental factors and HFMD at the α = 0.05 significance level while the content analysis was used to extract information from the interviews. Results Two variables were found to be associated with a high rate of HFMD occurrence: the number of sinks available in restrooms and the DCC size. Children attending DCCs that did not meet the standard in terms of the number of sinks in restrooms had a greater chance of contracting HFMD than children who were attending DCCs that met the standard (AOR = 4.21; 95% CI = 1.13–15.04). Children who were attending a large-sized DCC had a greater chance of contracting HFMD than those attending a small-sized DCC (AOR = 3.28; 95% CI = 1.21–5.18). The yearly budget allocation and the strategies for HFMD control and prevention, including collaborations among stakeholders for HFMD control and prevention in DCCs, were associated with the effectiveness of HFMD control and prevention. Conclusions The number of sinks in restrooms and DCC size are major concerns for HFMD outbreaks. Sufficient budget allocation and good collaboration contribute to effective strategies for preventing and controlling HFMD in DCCs.
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Affiliation(s)
- Pussadee Laor
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand. .,Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Muang Chiang Rai, Thailand.
| | - Siriyaporn Khunthason
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.,Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Muang Chiang Rai, Thailand
| | - Vivat Keawdounglek
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Suntorn Sudsandee
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Krailak Fakkaew
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
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Shao J, Wang J, Li Y, Elzo MA, Tang T, Lai T, Ma Y, Gan M, Wang L, Jia X, Lai S. Growth, behavioural, serum biochemical and morphological changes in female rabbits fed high-fat diet. J Anim Physiol Anim Nutr (Berl) 2020; 105:345-353. [PMID: 33038071 DOI: 10.1111/jpn.13459] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/23/2020] [Accepted: 09/03/2020] [Indexed: 12/26/2022]
Abstract
This study aimed to determine whether high-fat diet (HFD) could cause growth, behavioural, biochemical and morphological changes in young female rabbits. Thirty-six female rabbits were randomly divided into two groups fed with either a high-fat diet (HFD) or a standard normal diet (SND) for 5 weeks. Growth and behavioural changes were recorded during the 5-week feeding period. Tissue samples, including blood and adipose tissue, were obtained after slaughter. HFD rabbits weighed more by the end of the feeding period, had a higher percent body weight and adipose tissue weight change and had longer body and bust lengths than SND rabbits. HFD rabbits significantly reduced their feed intake and feeding frequency during the fourth and fifth weeks. HFD rabbits also showed lower frequency of drinking and resting and increased stereotypical behaviour. Besides, HFD rabbits showed significant physiological abnormalities. HFD rabbits had higher serum cholesterol (TC) and triglycerides (TG) levels than SND rabbits at the end of the feeding period, and higher free fatty acid (FFA) levels than rabbits in the SND group after the third week of feeding. Serum thyroxine (T4) increased significantly in week 2 and week 5 and triiodothyronine (T3) increased significantly in week four. However, there was no significant change in serum glucose (GLU) and insulin (INS) levels. Additionally, HFD reduced the area and diameter of perirenal and subcutaneous fat cells and increased their density. Our findings suggest that HFD rabbits had higher weight gains, accumulation of fat, and more behavioural changes than SND rabbits. Although high levels of fat in the diet had a low impact on hyperglycaemia, it could lead to hyperlipidemia and hyperthyroidism. Our results also suggest that sustained HFD may cause the proliferation of adipocytes in young female rabbits.
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Affiliation(s)
- Jiahao Shao
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Jie Wang
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Yanhong Li
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Mauricio A Elzo
- Department of Animal Science, University of Florida, Gainesville, FL, USA
| | - Tao Tang
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Tianfu Lai
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Yuan Ma
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Mingchuan Gan
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Li Wang
- College of Animal Science and Technology, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Xianbo Jia
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
| | - Songjia Lai
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University - Chengdu Campus, Chengdu, China
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Management guidelines for pregnant health care workers exposed to infectious dermatoses. Int J Womens Dermatol 2020; 6:142-151. [PMID: 32313827 PMCID: PMC7165119 DOI: 10.1016/j.ijwd.2020.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 01/08/2023] Open
Abstract
Exanthematous diseases are frequently of infectious origin, posing risks, especially for pregnant health care workers (HCWs) who treat them. The shift from cell-mediated (Th1 cytokine profile) to humoral (Th2 cytokine profile) immunity during pregnancy can influence the mother’s susceptibility to infection and lead to complications for both mother and fetus. The potential for vertical transmission must be considered when evaluating the risks for pregnant HCWs treating infected patients because fetal infection can often have devastating consequences. Given the high proportion of women of childbearing age among HCWs, the pregnancy-related risks of exposure to infectious diseases are an important topic in both patient care and occupational health. Contagious patients with cutaneous manifestations often present to dermatology or pediatric clinics, where female providers are particularly prevalent; a growing number of these physicians are female. Unfortunately, the risks of infection for pregnant HCWs are not well defined. To our knowledge, there is limited guidance on safe practices for pregnant HCWs who encounter infectious dermatologic diseases. In this article, we review several infectious exanthems, their transmissibility to pregnant women, the likelihood of vertical transmission, and the potential consequences of infection for the mother and fetus. Additionally, we discuss recommendations with respect to avoidance, contact, and respiratory precautions, as well as the need for treatment after exposure.
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Liu J, Qi J. Prevalence and Management of Severe Hand, Foot, and Mouth Disease in Xiangyang, China, From 2008 to 2013. Front Pediatr 2020; 8:323. [PMID: 32754560 PMCID: PMC7366859 DOI: 10.3389/fped.2020.00323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/18/2020] [Indexed: 11/13/2022] Open
Abstract
Therapeutic strategies for severe hand, foot, and mouth disease (HFMD) are currently either inconsequent or deficient in evidence. We retrospectively surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. HFMD is staged from I to V according to clinical severity. Severe HFMD is defined as a case involving the central nervous system (CNS). We analyzed risk factors for fatality of severe cases and compared the efficiency and outcome of some therapies by binary logistic regression. The overall HFMD cases included 637 (1.26%) severe cases and 38 fatalities (0.075%). Analyses indicate that age (<3 years), enterovirus 71 (+), autonomic nervous system dysregulation, pulmonary edema/hemorrhage, C-reactive protein (CRP) (>40 mg/L), and cardiac troponin I (>0.04 ng/ml) are risk factors for fatality (all P < 0.05). Intravenous immunoglobulin (IVIG) and mechanical ventilation applied only in early stage IV significantly improved HFMD progression (both P < 0.05) with odds ratios of 0.24 (95% CI: 0.10-0.57) and 0.01 (95% CI: 0.00-0.10), respectively. Neither methylprednisolone nor milrinone administered in any stage made any significant difference on mortality (all P > 0.05). Precise recognition of the severe HFMD cases in early stage IV and prompt IVIG and mechanical ventilation application may reduce mortality. Mechanical ventilation training programs and dispatch of specialists to hospitals where there is no chance of transferring critical cases to the severe HFMD designated hospitals are two key measures to reduce fatality.
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Affiliation(s)
- Jian Liu
- Department of Pediatrics, The Second School of Clinical Medicine, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, Guangzhou, China.,Department of Pediatrics, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jing Qi
- Department of Neurology, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, Guangzhou, China
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Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China. Epidemiol Infect 2019; 147:e327. [PMID: 31884976 PMCID: PMC7006018 DOI: 10.1017/s0950268819002139] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This study attempts to figure out the seasonality of the transmissibility of hand, foot and mouth disease (HFMD). A mathematical model was established to calculate the transmissibility based on the reported data for HFMD in Xiamen City, China from 2014 to 2018. The transmissibility was measured by effective reproduction number (Reff) in order to evaluate the seasonal characteristics of HFMD. A total of 43 659 HFMD cases were reported in Xiamen, for the period 2014 to 2018. The median of annual incidence was 221.87 per 100 000 persons (range: 167.98/100,000–283.34/100 000). The reported data had a great fitting effect with the model (R2 = 0.9212, P < 0.0001), it has been shown that there are two epidemic peaks of HFMD in Xiamen every year. Both incidence and effective reproduction number had seasonal characteristics. The peak of incidence, 1–2 months later than the effective reproduction number, occurred in Summer and Autumn, that is, June and October each year. Both the incidence and transmissibility of HFMD have obvious seasonal characteristics, and two annual epidemic peaks as well. The peak of incidence is 1–2 months later than Reff.
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A method for hand-foot-mouth disease prediction using GeoDetector and LSTM model in Guangxi, China. Sci Rep 2019; 9:17928. [PMID: 31784625 PMCID: PMC6884467 DOI: 10.1038/s41598-019-54495-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/14/2019] [Indexed: 12/14/2022] Open
Abstract
Hand-foot-mouth disease (HFMD) is a common infectious disease in children and is particularly severe in Guangxi, China. Meteorological conditions are known to play a pivotal role in the HFMD. Previous studies have reported numerous models to predict the incidence of HFMD. In this study, we proposed a new method for the HFMD prediction using GeoDetector and a Long Short-Term Memory neural network (LSTM). The daily meteorological factors and HFMD records in Guangxi during 2014–2015 were adopted. First, potential risk factors for the occurrence of HFMD were identified based on the GeoDetector. Then, region-specific prediction models were developed in 14 administrative regions of Guangxi, China using an optimized three-layer LSTM model. Prediction results (the R-square ranges from 0.39 to 0.71) showed that the model proposed in this study had a good performance in HFMD predictions. This model could provide support for the prevention and control of HFMD. Moreover, this model could also be extended to the time series prediction of other infectious diseases.
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36
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Huang L, Yue J. The interplay of autophagy and enterovirus. Semin Cell Dev Biol 2019; 101:12-19. [PMID: 31563390 PMCID: PMC7102577 DOI: 10.1016/j.semcdb.2019.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 12/19/2022]
Abstract
Autophagy, an evolutional conserved lysosomal degradation process, has been implicated to play an important role in cellular defense against a variety of microbial infection. Interestingly, numerous studies found that some pathogens, especially positive-single-strand RNA viruses, actually hijacked autophagy machinery to promote virus infection within host cells, facilitating different stages of viral life cycle, from replication, assembly to egress. Enterovirus, a genus of positive-strand RNA virus, can cause various human diseases and is one of main public health threat globally, yet no effective clinical intervention is available for enterovirus infection. Here we summarized recent literature on how enteroviruses regulate and utilize autophagy process to facilitate their propagation in the host cells. The studies on the interplay between enterovirus and autophagy not only shed light on the molecular mechanisms underlying how enterovirus hijacks cellular components and pathway for its own benefits, but also provide therapeutic option against enterovirus infection.
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Affiliation(s)
- Lihong Huang
- City University of Hong Kong ShenZhen Research Institute, ShenZhen, China
| | - Jianbo Yue
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China.
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Lizasoain A, Piegas S, Victoria M, Da Silva EE, Colina R. Hand-foot-and-mouth disease in uruguay: Coxsackievirus A6 identified as causative of an outbreak in a rural childcare center. J Med Virol 2019; 92:167-173. [PMID: 31502682 DOI: 10.1002/jmv.25590] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/03/2019] [Indexed: 02/02/2023]
Abstract
To know the epidemiological context of hand-foot-and-mouth disease (HFMD) in a region of Uruguay and to identify the Enterovirus responsible for an outbreak in a rural childcare center in 2018. Swab samples from skin lesions and/or stools samples were collected from children suffering HFMD during an outbreak in a rural childcare center. Samples were subject to viral RNA extraction and reverse-transcription polymerase chain reaction towards VP1 coding segment, to identify the Enterovirus type by sequencing and phylogenetic analysis. Total of 149 cases of HFMD affecting 98 boys and 51 girls were reported in Salto Province-Uruguay in 2018. Total 60% of the cases were originated from outbreaks, which occurred in ten educative and childcare institutions from both urban and rural areas. Coxsackievirus-6 (CV-A6) was identified as responsible for one of the rural outbreaks. Uruguayan strains were more related to strains reported in Russia, Turkey, and Germany (2014-2017) than to strains reported in Brazil and Argentina from 2015 to 2016. This is the first report of CV-A6-associated HFMD in Uruguay, evidencing a wide geographic range of the virus in the Latin American region. Our report also warns about CV-A6-associated HFMD during winter, contrarily to most reports that register HFMD during summer and fall seasons.
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Affiliation(s)
- Andrés Lizasoain
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, Universidad de la República, Salto, Salto, Uruguay
| | - Sofia Piegas
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, Universidad de la República, Salto, Salto, Uruguay
| | - Matías Victoria
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, Universidad de la República, Salto, Salto, Uruguay
| | - Edson E Da Silva
- Laboratório de Enterovírus, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Rodney Colina
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, Universidad de la República, Salto, Salto, Uruguay
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Sun Y, Feng L, Li J, Xu H, Mei X, Feng L, Sun H, Gao J, Zhang X. miR-545 promoted enterovirus 71 replication via directly targeting phosphatase and tensin homolog and tumor necrosis factor receptor-associated factor 6. J Cell Physiol 2019; 234:15686-15697. [PMID: 30697739 DOI: 10.1002/jcp.28222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/10/2019] [Accepted: 01/15/2019] [Indexed: 01/24/2023]
Abstract
Enterovirus 71 (EV71) is a small, nonenveloped icosahedral RNA virus and is the predominant causative pathogen of hand-foot-and-mouth disease. Recently, microRNAs (miRNAs) are reported to play important roles in the pathogenesis of EV71 replication. This study investigated the role of miR-545 in the EV71 replication and explored the underlying molecular mechanisms. We showed that miR-545 was upregulated in the EV71-infected human embryonic kidney (HEK) 293 cells and rhabdomyosarcoma (RD) cells. Overexpression of miR-545 promoted the viral replication of EV71 and attenuated the inhibitory effects of EV71 on cell viability in HEK293 and RD cells; while knockdown of miR-545 significantly suppressed the EV71 replication in these two cell lines. Bioinformatics analysis and luciferase reporter assay showed that miR-545 directly targeted the 3'untranslated region of phosphatase and tensin homolog (PTEN) and tumor necrosis factor receptor-associated factor 6 (TRAF6) in HEK293 cells. Furthermore, miR-545 negatively regulated the messenger RNA (mRNA) and protein expression of PTEN and TRAF6. The mRNA and protein expression of PTEN and TRAF6 was also suppressed by EV71 infection, which was attenuated by miR-545 knockdown in HEK293 cells. Overexpression of PTEN and TRAF6 both suppressed the EV71 replication in HKE293 cells, and also attenuated the enhanced effects of miR-545 overexpression on the EV71 replication in HEK293 cells. Collectively, our study for the first time showed that miR-545 had an enhanced effect on the EV71 replication in HEK293 and RD cells. Further mechanistic results indicated that miR-545 promoted EV71 replication at least partly via targeting PTEN and TRAF6.
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Affiliation(s)
- Ying Sun
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China.,Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, China.,Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Long Feng
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jiansheng Li
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, China.,Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Huaming Xu
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xue Mei
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Lingyan Feng
- Medical College, Jianghan University, Wuhan, Hubei, China
| | - Huijuan Sun
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jianfeng Gao
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xiaoli Zhang
- Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou, Henan, China
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Smith C, Scott J. Necrotising fasciitis complicating hand, foot and mouth disease. BMJ Case Rep 2019; 12:12/8/e228581. [PMID: 31434667 DOI: 10.1136/bcr-2018-228581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A literature search confirmed no previous cases of necrotising fasciitis (NF) complicating hand,foot and mouth disease (HFMD). This report explores the case of a previously well 55-week-old Caucasian boy who attended accident and emergency with an acutely swollen right hand and atypical viral rash affecting the hands and face. He was admitted under plastic surgery and treated with intravenous antibiotics and fluid resuscitation for sepsis secondary to cellulitis. Following dermatological review of the rash, a clinical diagnosis of atypical HFMD was made. He deteriorated over the first 12 hours with progression of cellulitis despite intervention. Emergency exploration and debridement were performed for suspected NF. NF was subsequently confirmed by laboratory testing. He required 5 days in paediatric intensive care but made a full recovery. Recent reports highlight an increase in atypical cases of HFMD. Clinicians should be aware of the potential for superadded necrotising infection in cases of atypical HFMD.
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Affiliation(s)
- Clara Smith
- Plastic Surgery, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - John Scott
- Canniesburn Plastic Surgery Unit, NHS Greater Glasgow and Clyde, Glasgow, UK
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40
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Recombinant lactococcus lactis secreting viral protein 1 of enterovirus 71 and its immunogenicity in mice. Biotechnol Lett 2019; 41:867-872. [PMID: 31119429 DOI: 10.1007/s10529-019-02695-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To construct recombinant Lactococcus lactis (L. lactis) expressing viral protein 1 (VP1) of enterovirus 71 (EV71) and evaluate its immunogenicity to be used as an oral vaccine in BALB/c mice. RESULTS Recombinant L. lactis competent in secreting VP1 (~ 30 kDa) into the extracellular environment with the aid of the signal peptide Usp45 was produced. Enzyme-linked immunosorbent assay showed that significant VP1-specific antibody response including the production of both serum IgG and fecal IgA (p < 0.05) was elicited in BALB/c mice upon oral immunization with recombinant L. lactis. Moreover, in contrast to negative control, recombinant L. lactis induced adequate neutralizing antibodies in mouse sera (p < 0.05) as demonstrated in virus neutralization assay, whereas the presence of neutralizing antibodies in fecal samples was obvious but not significant (p > 0.05). CONCLUSIONS Recombinant L. lactis expressing VP1 of EV71 has the potential to be used as an oral vaccine candidate. The findings may provide some preliminary evidences for further development of effective and needle-free EV71 vaccines.
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41
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Lv Y, Wang X. Interleukin-37 Inhibits the Imbalance Between T Helper 17 Cells and Regulatory T Cells in Hand, Foot, and Mouth Disease. J Interferon Cytokine Res 2019; 39:421-427. [PMID: 31090483 DOI: 10.1089/jir.2019.0005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The aim of this study was to explore the role of interleukin-37 (IL-37) in imbalance of T helper (Th)17/regulatory T cells (Tregs) in hand, foot, and mouth disease (HFMD). The proportions of CD4+ IL-17A+ Th17 cells and CD4+ CD25+Foxp3+ Tregs in peripheral blood or peripheral blood mononuclear cells (PBMCs) from HFMD patients and healthy controls were measured by fluorescence activated cell sorter. The level of IL-37, IL-10, IL-17A, IL-23, and transforming growth factor β1 (TGF-β1) in serum or PBMCs of HFMD patients and control subjects were detected using enzyme-linked immunosorbent assay. Results showed that Th17 cells proportion and IL-17A and IL-23 levels were highly increased, whereas Tregs proportion and IL-10 and TGF-β1 levels were significantly decreased in HFMD patients. Moreover, IL-37 stimulation elevated Tregs proportion but reduced Th17 cell proportion in subjects with HFMD. On the contrary, we found methylprednisolone pulse therapy/methylprednisolone combinated with intravenous gamma globulin inhibits Th17/Treg imbalance through upregulation of IL-37 in HFMD. In conclusion, IL-37 inhibits the imbalance of Th17/Tregs in HFMD.
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Affiliation(s)
- Yong Lv
- Department of Pediatric, The First Affiliated Hospital of University of Science and Technology of China (USTC), Hefei, China
| | - Xuesong Wang
- Department of Pediatric, The First Affiliated Hospital of University of Science and Technology of China (USTC), Hefei, China
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42
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Zhou H, Guo S, Sun Y, Wang H, Zhang M, Li Y. Screening the Action Targets of Enterovirus 71 in Human SH-SY5Y Cells Using RNA Sequencing Data. Viral Immunol 2019; 32:170-178. [PMID: 31063043 DOI: 10.1089/vim.2018.0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common infection for children younger than the age of five. HFMD is mainly induced by coxsackievirus A16 and enterovirus 71 (EV71). EV71-associated HFMD often has serious neurological disease complications. The purpose of this study was to reveal the mechanisms of action of EV71 on neurons. SH-SY5Y cells transfected or untransfected with EV71 were sequenced. After data preprocessing, differentially expressed genes (DEGs) were screened using the limma package in R, and clustering analysis was then performed using the ComplexHeatmap package in R. The DAVID tool was used for EDG enrichment analysis. Protein-protein interactions (PPIs) were predicted using the STRING database and PPI networks were then constructed using Cytoscape software. After pathways involved in the key PPI network nodes were enriched, pathway deviation scores were calculated. Clustering analysis was also conducted for these pathways. There were 978 DEGs in the transfected samples. Upregulated TNF was enriched in NF-kappa B signaling pathway. Among the top 20 nodes in the PPI network, CDK1, STAT3, CCND1, TNF, and MYC had the highest degrees. A total of 28 pathways were enriched for the top 20 nodes, including Epstein-Barr virus infection (p = 3.78E-06), proteoglycans in cancer (p = 4.96E-06), and melanoma (p = 1.99E-05). In addition, clustering analysis showed that these pathways could clearly differentiate the two groups of samples. EV71 may affect neurons by mediating CDK1, STAT3, CCND1, TNF, and MYC, indicating that these genes are promising targets for preventing the neuronal complications of HFMD.
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Affiliation(s)
- Hong Zhou
- 1 The Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shuzhen Guo
- 2 The Respiratory Medicine, The Center for Disease Control and Prevention of Harbin, Harbin, China
| | - Yu Sun
- 1 The Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hui Wang
- 1 The Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Meiling Zhang
- 1 The Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yanjun Li
- 1 The Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Dai W, Xiong P, Zhang X, Liu Z, Chen J, Zhou Y, Ye X, Zhang C. Recombinant virus-like particle presenting a newly identified coxsackievirus A10 neutralization epitope induces protective immunity in mice. Antiviral Res 2019; 164:139-146. [PMID: 30817941 DOI: 10.1016/j.antiviral.2019.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 02/17/2019] [Accepted: 02/24/2019] [Indexed: 02/06/2023]
Abstract
Coxsackievirus A10 (CVA10) has emerged as one of the major pathogens of hand, foot, and mouth disease in recent years. However, there are no approved vaccines or effective drugs against CVA10. Several experimental CVA10 vaccines have been shown to elicit neutralizing antibodies that could confer protection against viral infection. However, neutralizing antigenic sites on CVA10 capsid have not been well characterized. Here, we report the characterization of linear neutralization epitopes of CVA10 and the development of a CVA10 vaccine based on the identified epitopes. We showed that peptide VP2-P28, corresponding to residues 136 to 150 of VP2, were recognized by anti-inactivated CVA10 sera and effectively inhibited anti-CVA10 sera-mediated neutralization, suggesting that this peptide contains neutralizing epitopes. Insertion of VP2-P28 into hepatitis B core antigen (HBc) resulted in a chimeric virus-like particle (VLP; designated HBc-P28) with the CVA10 epitope exposed on the particle surface. HBc-P28 VLP elicited strong antibody responses against VP2-P28 in mice. Anti-HBc-P28 sera could neutralize both CVA10 clinical isolates and prototype strain, consistent with the fact that the VP2-P28 sequence is highly conserved among CVA10 strains. In addition, anti-HBc-P28 sera failed to cross-neutralize other HFMD-causing enteroviruses, indicating that neutralizing antibodies elicited by HBc-P28 VLP were CVA10-specific. Importantly, anti-HBc-P28 sera were able to provide efficient protection against lethal CVA10 infection in recipient mice. Collectively, these data show that peptide VP2-P28 represents a CVA10-specific linear neutralizing antigenic site and chimeric VLP displaying this peptide is a promising epitope-based CVA10 vaccine candidate.
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Affiliation(s)
- Wenlong Dai
- Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Pei Xiong
- Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Xueyang Zhang
- Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Zhi Liu
- Biological Imaging and Instrumental Analysis Center, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Jinhuan Chen
- National Center for Protein Science Shanghai, State Key Laboratory of Molecular Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Yu Zhou
- Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Xiaohua Ye
- Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China
| | - Chao Zhang
- Vaccine Research Center, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China; Joint Center for Infection and Immunity, Guangzhou Institute of Pediatrics, Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
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Xu T, Lin Z, Wang C, Li Y, Xia Y, Zhao M, Hua L, Chen Y, Guo M, Zhu B. Heat shock protein 70 as a supplementary receptor facilitates enterovirus 71 infections in vitro. Microb Pathog 2018; 128:106-111. [PMID: 30579945 DOI: 10.1016/j.micpath.2018.12.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 11/22/2018] [Accepted: 12/17/2018] [Indexed: 02/08/2023]
Abstract
As one of the major causative agents of hand, foot and mouth disease (HFMD), enterovirus 71 (EV71) is a small, non-enveloped positive stranded RNA virus. Children suffering EV71 infection may cause severe symptoms including neurological complications, pulmonary edema and aseptic meningitis. EV71 is a neurotropic virus and it can cause the damage of nervous cells, cytokine storm and toxic substance. Identifying the factors that mediate viral binding or entry to host cells is important to uncover the mechanisms which viruses utilize to cause diseases in human body. Heat shock protein 70 (HSP70) is induced during virus infection and facilitates proper protein folding during viral propagation. The role that HSP70 plays during EV71 infection is still unclear. In this study, siRNA interference technique and transgenic technique were used to investigate the interaction between HSP70 and EV71 virus. The result demonstrated that the cell surface HSP70 is not essential for EV71 infection but helps the initial binding of virus to host cells and that multiple receptors are involved during EV71 infection. In addition, HSP70 was upregulated in human neuroblastoma cells (SK-N-SH) infected with EV71.
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Affiliation(s)
- Tiantian Xu
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Zhengfang Lin
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Changbing Wang
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Yinghua Li
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Yu Xia
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Mingqi Zhao
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Liang Hua
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Yi Chen
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Min Guo
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Bing Zhu
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
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45
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Taylor S, Khan M, Zaidi S, Alvi U, Fatima Y. Central serous retinopathy and hand-foot-mouth disease: coincidence or causation? Int Med Case Rep J 2018; 11:277-282. [PMID: 30425589 PMCID: PMC6202041 DOI: 10.2147/imcrj.s181088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The clinical and pathological correlation between hand–foot–mouth disease (HFMD) and ocular complications has not yet been established. However, individual case reports indicate a trend that may be the emergence of a new burden of the previous self-limiting virus. This virus is particularly prevalent in childcare centers and poses an infectious disease risk for this workplace. Objectives The primary objective of this case report is to describe an unusual clinical record of a patient who developed central serous retinopathy while unwell with HFMD. Discussion of management strategies for this workplace, its staff, and visitors is also included. Methods This was an observational case report that was identified and reported retrospectively. For comparison, a search of the literature to identify similar ocular complications of HFMD was also undertaken. Results from this search, in addition to international data and prevention and management strategies are also provided. Results A total of 13 individual case reports with ocular associations, including this clinical record, were identified in the literature worldwide. The median age was 33 years, and three patients (23%) were female. No treatment or management guidelines for ocular complications of HFMD have been identified. Conclusion Severe and potentially life-threatening complications of a seemingly harmless childhood illness are represented sporadically in the literature. The requirement for research and evaluation into this emerging occupational hazard area is necessary for improved prevention, management, and treatment strategies to be developed.
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Affiliation(s)
- Selina Taylor
- Centre for Rural and Remote Health, James Cook University, Mount Isa, QLD, Australia,
| | - Maureen Khan
- Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia
| | - Shams Zaidi
- Mackay Hospital and Health Service, Mackay, QLD, Australia
| | | | - Yaqoot Fatima
- Centre for Rural and Remote Health, James Cook University, Mount Isa, QLD, Australia,
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Increased Incidence of Obstructive Sleep Apnea in Hospitalized Children After Enterovirus Infection: A Nationwide Population-based Cohort Study. Pediatr Infect Dis J 2018; 37:872-879. [PMID: 29315158 DOI: 10.1097/inf.0000000000001892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We report the first nationwide population-based cohort study using Taiwan's National Health Insurance Research Database on the association between enterovirus (EV) infection and the incidence of sleep disorders in a pediatric population. METHODS Two matched groups of children under 18 years of age were included in the analyses for nonapneic sleep disorder and obstructive sleep apnea (OSA). Among them, 316 subjects were diagnosed with OSA during the surveillance period, including 182 in the EV infection group and 134 in the non-EV infection group. RESULTS Hospitalization because of EV infection was associated with OSA after adjusting for age, sex, urbanization atopic disease and perinatal complications (adjusted hazard ratio: 1.62, 95% confidence interval: 1.18-2.21; P = 0.003). An additional factor significantly associated with sleep apnea was allergic rhinitis (hazard ratio: 4.82, 95% confidence interval: 3.45-6.72). CONCLUSIONS Children with severe EV infection (ie, requiring hospitalization) carry a significantly higher risk of developing OSA, particularly in those with allergic rhinitis. As pediatric obstructive sleep apnea is a treatable sleep disorder, we emphasize regular follow-up and early detection in children with EV infection.
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Teo KW, Lai FY, Bandi S, Allen DJ, Tang JW. Emergence of Coxsackie A6 hand-foot-and-mouth disease and comparative severity of Coxsackie B vs. echovirus infections, 2014-2016, UK. J Infect 2018; 78:75-86. [PMID: 30134142 DOI: 10.1016/j.jinf.2018.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 08/07/2018] [Accepted: 08/11/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Kah Wee Teo
- Leicester Childrens Hospital, University Hospitals of Leicester NHS Trust (UHL), Leicester, UK
| | - Florence Yl Lai
- Cardiovascular Science, University of Leicester, Leicester, UK
| | - Srini Bandi
- Leicester Childrens Hospital, University Hospitals of Leicester NHS Trust (UHL), Leicester, UK
| | - David J Allen
- Virus Reference Department, National Infections Service, Public Health England, London, UK; Pathogen Molecular Biology Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK
| | - Julian W Tang
- Clinical Microbiology and Virology, UHL, Leicester, UK; Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
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48
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Isaacs SR, Kim KW, Cheng JX, Bull RA, Stelzer-Braid S, Luciani F, Rawlinson WD, Craig ME. Amplification and next generation sequencing of near full-length human enteroviruses for identification and characterisation from clinical samples. Sci Rep 2018; 8:11889. [PMID: 30089864 PMCID: PMC6082906 DOI: 10.1038/s41598-018-30322-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/19/2018] [Indexed: 12/16/2022] Open
Abstract
More than 100 different enterovirus (EV) genotypes infect humans and contribute to substantial morbidity. However, current methods for characterisation of full-length genomes are based on Sanger sequencing of short genomic regions, which are labour-intensive and do not enable comprehensive characterisation of viral populations. Here, we describe a simple and sensitive protocol for the amplification and sequencing of near full-length genomes of human EV species using next generation sequencing. EV genomes were amplified from 89% of samples tested, with Ct values ranging between 15.7 and 39.3. These samples included 7 EV-A genotypes (CVA2, 5–7, 10, 16 and EV71), 19 EV-B genotypes (CVA9, CVB1-6, ECHO3, 4, 6, 7, 9, 11, 16, 18, 25, 29, 30, and EV69), 3 EV-C genotypes (CVA19 and PV2, 3) and 1 EV-D genotype (EV70). We characterised 70 EVs from 58 clinical stool samples and eight reference strains, with a minimum of 100X depth. We found evidence of co-infection in four clinical specimens, each containing two distinct EV genotypes (CVB3/ECHO7, CVB3/ECHO18 and ECHO9/30). Characterisation of the complete genome provided conclusive genotyping of EVs, which can be applied to investigate the intra-host virus evolution of EVs, and allows further identification and investigation of EV outbreaks.
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Affiliation(s)
- Sonia R Isaacs
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Ki Wook Kim
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Junipearl X Cheng
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Rowena A Bull
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Systems Medicine, Inflammation and Infection Research Centre, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sacha Stelzer-Braid
- Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Fabio Luciani
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Systems Medicine, Inflammation and Infection Research Centre, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - William D Rawlinson
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.,Serology and Virology Division (SAViD), NSW Health Pathology East, Department of Microbiology, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.,School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Maria E Craig
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. .,Virology Research Laboratory, Prince of Wales Hospital, Sydney, NSW, 2031, Australia. .,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia. .,Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, 2006, Australia.
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49
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Hossain Khan MA, Anwar KS, Muraduzzaman AKM, Hossain Mollah MA, Akhter-ul-Alam SM, Munisul Islam K, Hoque SA, Nazrul Islam M, Ali MA. Emerging Hand Foot Mouth Disease in Bangladeshi Children- First Report of Rapid Appraisal on Pocket Outbreak: Clinico-epidemiological Perspective Implicating Public Health Emergency. F1000Res 2018; 7:1156. [PMID: 31372207 PMCID: PMC6662677 DOI: 10.12688/f1000research.15170.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 10/14/2023] Open
Abstract
Background: Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to gross lack of in laboratory-diagnostic facilities. Methods: Following the World Health Organization's case-definition, we conducted a rapid-appraisal of HFMD among 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols. Results: The mean age of children was 2.9±2.3 years. Age did not differ with sex (P=0.98), first sibling being more likely to (62%) belong to middle-income families. Younger children (<5 years) were more likely to suffer with moderate-to-high (38.5°C) fever (P<0.04), painful oral ulcers (P<0.03) and painful/itchy rash (P<0.01). Sex did not differ with other symptoms, but boys had less painful oral ulcers than girls (P<0.04). Fever (63%) and chicken-pox-like-rash (62%) was observed more in mid-October to mid-November than September to mid-October (P<0.01 and P<0.03, respectively). No differences in symptoms (fever, oral ulcers and extremity rash) were observed with precipitation, nor with ambient temperature. Children <5 years (85%) had quicker recovery (within 5 days) than those ≥5 years (69%), (P<0.04), with marginal differences in sex (P<0.05). Conclusions: Our findings highlight the potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable. It is particularly applicable for resource-constrained countries who lack appropriate virology laboratory equipment. Since no specific treatment or effective vaccination is available for this disease, supportive therapy and preventive measures remain the primary methods to circumvent transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent vaccine is deemed essential towards preventing HFMD.
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Affiliation(s)
- Md. Azraf Hossain Khan
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Selim Anwar
- US-CDC’s GHSA Project, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - A. K. M. Muraduzzaman
- Department of Virology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - Md. Abid Hossain Mollah
- Department of Pediatrics, Ibrahim Medical College & Hospital, Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh
| | - S. M. Akhter-ul-Alam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Munisul Islam
- Infectious Disease Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Sheikh Ariful Hoque
- Tissue Culture Laboratory, Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md. Nazrul Islam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Md. Ahasan Ali
- Microbiology Section, Institute of Public Health (IPH), Mohakhali, Dhaka, 1212, Bangladesh
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50
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Hossain Khan MA, Anwar KS, Muraduzzaman AKM, Hossain Mollah MA, Akhter-ul-Alam SM, Munisul Islam K, Hoque SA, Nazrul Islam M, Ali MA. Emerging Hand Foot Mouth Disease in Bangladeshi Children- First Report of Rapid Appraisal on Pocket Outbreak: Clinico-epidemiological Perspective Implicating Public Health Emergency. F1000Res 2018; 7:1156. [PMID: 31372207 PMCID: PMC6662677 DOI: 10.12688/f1000research.15170.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to lack in laboratory-diagnostic facilities. Methods: Following the World Health Organization's case-definition, we conducted a rapid-appraisal of HFMD among all of the 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and extremity rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols. Results: The mean age of children was 2.9±2.3 years. There was a significant difference among the age and sex of children (P=0.98), first sibling being more belonging to middle-income families (62%). Younger children (<5 years) were more likely to suffer with moderate-to-high (38.5°C) fever (P<0.04), painful oral ulcers (P<0.03) and painful/itchy rash (P<0.01). Sex did not differ with other symptoms, but boys had less painful oral ulcers than girls (P<0.04). Fever (63%) and chicken-pox-like-rash (62%) was observed more in mid-October to mid-November than September to mid-October (P<0.01 and P<0.03, respectively). No differences in symptoms (fever, oral ulcers and extremity rash) were observed with precipitation, nor with ambient temperature. Children <5 years (85%) had quicker recovery (within 5 days) than those ≥5 years (69%), (P<0.04), with marginal differences in sex (P<0.05). Conclusions: Our findings highlight potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable, which is particularly applicable for resource-constrained countries lacking appropriate virology/essential laboratories. Since no specific treatment or effective vaccination is available for HFMD, supportive therapy and preventive measures remain the primary methods to circumvent disease-transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent-vaccine deem essential towards preventing HFMD.
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Affiliation(s)
- Md. Azraf Hossain Khan
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Selim Anwar
- US-CDC’s GHSA Project, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - A. K. M. Muraduzzaman
- Department of Virology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - Md. Abid Hossain Mollah
- Department of Pediatrics, Ibrahim Medical College & Hospital, Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh
| | - S. M. Akhter-ul-Alam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Munisul Islam
- Infectious Disease Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Sheikh Ariful Hoque
- Tissue Culture Laboratory, Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md. Nazrul Islam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Md. Ahasan Ali
- Microbiology Section, Institute of Public Health (IPH), Mohakhali, Dhaka, 1212, Bangladesh
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