1
|
Tejo AM, Hamasaki DT, Menezes LM, Ho YL. Severe dengue in the intensive care unit. JOURNAL OF INTENSIVE MEDICINE 2024; 4:16-33. [PMID: 38263966 PMCID: PMC10800775 DOI: 10.1016/j.jointm.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/19/2023] [Accepted: 07/24/2023] [Indexed: 01/25/2024]
Abstract
Dengue fever is considered the most prolific vector-borne disease in the world, with its transmission rate increasing more than eight times in the last two decades. While most cases present mild to moderate symptoms, 5% of patients can develop severe disease. Although the mechanisms are yet not fully comprehended, immune-mediated activation leading to excessive cytokine expression is suggested as a cause of the two main findings in critical patients: increased vascular permeability that may shock and thrombocytopenia, and coagulopathy that can induce hemorrhage. The risk factors of severe disease include previous infection by a different serotype, specific genotypes associated with more efficient replication, certain genetic polymorphisms, and comorbidities such as diabetes, obesity, and cardiovascular disease. The World Health Organization recommends careful monitoring and prompt hospitalization of patients with warning signs or propensity for severe disease to reduce mortality. This review aims to update the diagnosis and management of patients with severe dengue in the intensive care unit.
Collapse
Affiliation(s)
- Alexandre Mestre Tejo
- Intensive Care Unit, Department of Intensive Medicine of the Cancer Institute of the State of São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Debora Toshie Hamasaki
- Transfusion Medicine and Cell Therapy Department, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Letícia Mattos Menezes
- Intensive Care Unit of Infectious Disease Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Yeh-Li Ho
- Intensive Care Unit of Infectious Disease Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
2
|
Jin H, Wei W, Zhao Y, Ma A, Sun K, Lin X, Liu Q, Shou S, Zhang Y. The roles of interleukin-17A in risk stratification and prognosis of patients with sepsis-associated acute kidney injury. Kidney Res Clin Pract 2023; 42:742-750. [PMID: 37448288 DOI: 10.23876/j.krcp.22.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/01/2022] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the roles of interleukin (IL)-17A in risk stratification and prognosis of patients with sepsis-associated acute kidney injury (SAKI). METHODS We enrolled 146 sepsis patients (84 non-SAKI and 62 SAKI patients) admitted to the emergency department from November 2020 to November 2021. Patients with SAKI were differentiated based on the severity of acute kidney injury. All clinical parameters were evaluated upon admission before administering antibiotic treatment. Inflammatory cytokines were assessed using flow cytometry and the Pylon 3D automated immunoassay system (ET Healthcare). In addition, a receiver operating characteristic (ROC) curve was utilized to determine the prognostic values of IL-17A in SAKI. RESULTS The levels of creatinine, IL-2, IL-4, IL-6, IL-17A, tumor necrosis factor alpha, C-reactive protein, and procalcitonin (PCT) were significantly higher in the SAKI group than in the non-SAKI group (p < 0.05). The level of IL-17A revealed significant differences among stages 1, 2, and 3 in SAKI patients (p < 0.05). The mean levels of PCT, IL-4, and IL-17A were significantly higher in the non-survival group than in the survival group in SAKI patients (p < 0.05). In addition, the area under the ROC curve of IL-17A was 0.811. Moreover, the IL-17A cutoff for differentiating survivors from non-survivors was 4.7 pg/mL, of which the sensitivity and specificity were 77.4% and 71.0%, respectively. CONCLUSION Elevated levels of IL-17A could predict that SAKI patients are significantly prone to worsening kidney injury with higher mortality. The usefulness of IL-17A in treating SAKI requires further research.
Collapse
Affiliation(s)
- Heng Jin
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Wei
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yibo Zhao
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Ai Ma
- Department of Clinical Laboratory, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Keke Sun
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoxi Lin
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Qihui Liu
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Songtao Shou
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan Zhang
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
3
|
Bhattacharjee S, Ghosh D, Saha R, Sarkar R, Kumar S, Khokhar M, Pandey RK. Mechanism of Immune Evasion in Mosquito-Borne Diseases. Pathogens 2023; 12:pathogens12050635. [PMID: 37242305 DOI: 10.3390/pathogens12050635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
In recent decades, mosquito-borne illnesses have emerged as a major health burden in many tropical regions. These diseases, such as malaria, dengue fever, chikungunya, yellow fever, Zika virus infection, Rift Valley fever, Japanese encephalitis, and West Nile virus infection, are transmitted through the bite of infected mosquitoes. These pathogens have been shown to interfere with the host's immune system through adaptive and innate immune mechanisms, as well as the human circulatory system. Crucial immune checkpoints such as antigen presentation, T cell activation, differentiation, and proinflammatory response play a vital role in the host cell's response to pathogenic infection. Furthermore, these immune evasions have the potential to stimulate the human immune system, resulting in other associated non-communicable diseases. This review aims to advance our understanding of mosquito-borne diseases and the immune evasion mechanisms by associated pathogens. Moreover, it highlights the adverse outcomes of mosquito-borne disease.
Collapse
Affiliation(s)
| | - Debanjan Ghosh
- Department of Biotechnology, Pondicherry University, Puducherry 605014, India
| | - Rounak Saha
- Department of Biochemistry and Molecular Biology, Pondicherry University, Puducherry 605014, India
| | - Rima Sarkar
- DBT Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram 695014, India
| | - Saurav Kumar
- DBT Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram 695014, India
| | - Manoj Khokhar
- Department of Biochemistry, AIIMS, Jodhpur 342005, India
| | - Rajan Kumar Pandey
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, 171 77 Solna, Sweden
| |
Collapse
|
4
|
Rasinhas ADC, Jácome FC, Caldas GC, de Almeida ALT, de Souza DDC, Dos Santos JPR, Dias HG, Araujo EL, Mohana-Borges R, Barth OM, Dos Santos FB, Barreto-Vieira DF. Primary infection of BALB/c mice with a dengue virus type 4 strain leads to kidney injury. Mem Inst Oswaldo Cruz 2023; 118:e220255. [PMID: 37162062 PMCID: PMC10168658 DOI: 10.1590/0074-02760220255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 03/07/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Dengue is a disease caused by dengue virus (DENV-1 through -4). Among the four serotypes, DENV-4 remains the least studied. Acute kidney injury is a potential complication of dengue generally associated with severe dengue infection. OBJECTIVES The goal of this study was to investigate the alterations caused by experimental dengue infection in the kidney of adult BALB/c mice. METHODS In this study, BALB/c mice were infected through the intravenous route with a DENV-4 strain, isolated from a human patient. The kidneys of the mice were procured and subject to histopathological and ultrastructural analysis. FINDINGS The presence of the viral antigen was confirmed through immunohistochemistry. Analysis of tissue sections revealed the presence of inflammatory cell infiltrate throughout the parenchyma. Glomerular enlargement was a common find. Necrosis of tubular cells and haemorrhage were also observed. Analysis of the kidney on a transmission electron microscope allowed a closer look into the necrotic tubular cells, which presented nuclei with condensed chromatin, and loss of cytoplasm. MAIN CONCLUSIONS Even though the kidney is probably not a primary target of dengue infection in mice, the inoculation of the virus in the blood appears to damage the renal tissue through local inflammation.
Collapse
Affiliation(s)
- Arthur da Costa Rasinhas
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunologia Viral, Rio de Janeiro, RJ, Brasil
| | - Fernanda Cunha Jácome
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunologia Viral, Rio de Janeiro, RJ, Brasil
| | - Gabriela Cardoso Caldas
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Patologia, Rio de Janeiro, RJ, Brasil
| | - Ana Luisa Teixeira de Almeida
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
| | - Daniel Dias Coutinho de Souza
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
| | | | - Helver Gonçalves Dias
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunologia Viral, Rio de Janeiro, RJ, Brasil
| | - Eduarda Lima Araujo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
| | - Ronaldo Mohana-Borges
- Universidade Federal do Rio de Janeiro, Instituto de Biofísica Carlos Chagas Filho, Laboratório de Biotecnologia e Bioengenharia Estrutural, Rio de Janeiro, RJ, Brasil
| | - Ortrud Monika Barth
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
| | - Flavia Barreto Dos Santos
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunologia Viral, Rio de Janeiro, RJ, Brasil
| | - Debora Ferreira Barreto-Vieira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Morfologia e Morfogênese Viral, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
5
|
Virus-Associated Nephropathies: A Narrative Review. Int J Mol Sci 2022; 23:ijms231912014. [PMID: 36233315 PMCID: PMC9569621 DOI: 10.3390/ijms231912014] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 12/13/2022] Open
Abstract
While most viral infections cause mild symptoms and a spontaneous favorable resolution, some can lead to severe or protracted manifestations, specifically in immunocompromised hosts. Kidney injuries related to viral infections may have multiple causes related to the infection severity, drug toxicity or direct or indirect viral-associated nephropathy. We review here the described virus-associated nephropathies in order to guide diagnosis strategies and treatments in cases of acute kidney injury (AKI) occurring concomitantly with a viral infection. The occurrence of virus-associated nephropathy depends on multiple factors: the local epidemiology of the virus, its ability to infect renal cells and the patient's underlying immune response, which varies with the state of immunosuppression. Clear comprehension of pathophysiological mechanisms associated with a summary of described direct and indirect injuries should help physicians to diagnose and treat viral associated nephropathies.
Collapse
|
6
|
Emergence of New Immunopathogenic Factors in Human Yellow Fever: Polarisation of the M1/M2 Macrophage Response in the Renal Parenchyma. Viruses 2022; 14:v14081725. [PMID: 36016347 PMCID: PMC9416648 DOI: 10.3390/v14081725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 12/04/2022] Open
Abstract
Macrophages in the kidney play a pathogenic role in inflammation and fibrosis. Our study aimed to understand the polarisation of the M1 and M2 phenotypic profiles of macrophages in injured kidney tissue retrieved from fatal cases of yellow fever virus (YFV). A total of 11 renal tissue biopsies obtained from patients who died of yellow fever (YF) were analysed. To detect antibodies that promote the classical and alternative pathways of macrophage activation, immunohistochemical analysis was performed to detect CD163, CD68, inducible nitric oxide synthase (iNOS), arginase 1, interleukin (IL)-4, IL-10, interferon (IFN)-γ, IFN-β, tumour necrosis factor (TNF)-α, IL-13, and transforming growth factor (TGF)-β. There was a difference in the marker expression between fatal cases of YFV and control samples, with increased expression in the cortical region of the renal parenchyma. The immunoexpression of CD68 and CD163 receptors suggests the presence of activated macrophages migrating to infectious foci. The rise in IL-10, IL-4, and IL-13 indicated their potential role in the inactivation of the inflammatory macrophage response and phenotypic modulation of M2 macrophages. The altered expression of IFN-γ and IFN-β demonstrates the importance of the innate immune response in combating microorganisms. Our findings indicate that the polarisation of M1 and M2 macrophages plays a vital role in the renal immune response to YFV.
Collapse
|
7
|
Gholamipoor Z, Rahimzadeh M, Montazerghaem H, Naderi N. RORC gene polymorphism is associated with acute kidney injury following cardiac surgery. Acta Anaesthesiol Scand 2021; 65:1397-1403. [PMID: 34252205 DOI: 10.1111/aas.13949] [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: 04/23/2021] [Revised: 06/19/2021] [Accepted: 06/22/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Acute kidney injury (AKI) is a common complication of cardiopulmonary bypass (CPB), associated with increased mortality in surgical patients. It is well-proven that Th17 and its hallmark cytokine, IL-17, contribute to AKI development. Since the RAR-related orphan receptor C (RORC) gene is a master regulator of the Th17 differentiation, we aimed to evaluate the association between its polymorphisms, CPB-AKI and plasma IL-17 levels among Iranian patients undergoing CPB. METHOD Totally, 138 patients undergoing CPB in Bandar Abbas, Iran, were enrolled. The allele and genotype frequencies of the selected SNPs were determined using PCR-SSP. IL-17 serum level was determined using an enzyme-linked immunosorbent assay. RESULTS Rs9017 GG genotype and G allele were associated with increased risk of CPB-AKI (OR = 3, 95% CI = 1.4-6.6 and OR = 2.3, 95% CI = 1.3-3.9, respectively) while A allele was protective against the disease (OR = 0.4, 95% CI = 0.3-0.7, p = .02). There was not a statistically significant interaction between the three genotypes of rs9017 and AKI disease with IL-17 serum level before (p = .9) and after (p = .6) the operation. The IL-17 serum level before surgery was significantly higher in patients carrying GG genotype compared to GA genotype (p = .017). CONCLUSION Our results showed that the rs9017 GG genotype was associated with an increased level of IL-17 and risk of CBP-AKI in the Iranian population. Our current results suggest that the rs9017 GG genotype could be a probable predictor of AKI after cardiac surgery.
Collapse
Affiliation(s)
- Zeynab Gholamipoor
- Molecular Medicine Research Center Hormozgan Health InstituteHormozgan University of Medical Sciences Bandar Abbas Iran
- Department of Biochemistry Faculty of Medicine Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Mahsa Rahimzadeh
- Molecular Medicine Research Center Hormozgan Health InstituteHormozgan University of Medical Sciences Bandar Abbas Iran
- Department of Biochemistry Faculty of Medicine Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Hossein Montazerghaem
- Cardiovascular Research Center Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Nadereh Naderi
- Department of Immunology Faculty of Medicine Hormozgan University of Medical Sciences Bandar Abbas Iran
| |
Collapse
|
8
|
Brazilian Dengue Virus Type 2-Associated Renal Involvement in a Murine Model: Outcomes after Infection by Two Lineages of the Asian/American Genotype. Pathogens 2021; 10:pathogens10091084. [PMID: 34578117 PMCID: PMC8467194 DOI: 10.3390/pathogens10091084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/25/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022] Open
Abstract
Dengue virus type 2 (DENV-2) is, traditionally, the most studied serotype due to its association with explosive outbreaks and severe cases. In Brazil, almost 20 years after the first introduction in the 1990s, a new lineage (Lineage II) of the DENV-2 Asian/American genotype emerged and caused an epidemic with severe cases and hospitalizations. Severe dengue includes multiple organ failure, and renal involvement can be potentially related to increased mortality. In order to better understand the role of DENV infection in renal injury, here we aimed to investigate the outcomes of infection with two distinct lineages of DENV-2 Asian/American genotype in the kidney of a murine model. BALB/c mice were infected with Lineages I and II and tissues were submitted to histopathology, immunohistochemistry, histomorphometry and ultrastructural analysis. Blood urea nitrogen (BUN) was detected in blood sample accessed by cardiac puncture. A tendency in kidney weight increase was observed in mice infected with both lineages, but urea levels, on average, were increased only in mice infected with Lineage II. The DENV antigen was detected in the tissue of mice infected with Lineage II and morphological changes were similar to those observed in human dengue cases. Furthermore, the parameters such as organ weight, urea levels and morphometric analysis, showed significant differences between the two lineages in the infected BALB/c, which was demonstrated to be a suitable experimental model for dengue pathophysiology studies in kidneys.
Collapse
|
9
|
Aguilar-Briseño JA, Moser J, Rodenhuis-Zybert IA. Understanding immunopathology of severe dengue: lessons learnt from sepsis. Curr Opin Virol 2020; 43:41-49. [PMID: 32896675 DOI: 10.1016/j.coviro.2020.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
Endothelial dysfunction leading to vascular permeability and plasma leakage are characteristic features of severe dengue and sepsis. However, the mechanisms underlying these immune-pathologies remain unclear. The risk of severe dengue and sepsis development depend on patient-related and pathogen-related factors. Additionally, comorbidities increase the risk of severe disease and their incidence hampers correct diagnosis and treatments. To date, there is no efficient therapy to combat severe dengue and sepsis. Here, we discuss the differences and similarities between the pathogenesis of severe dengue and that of bacterial sepsis. We identify gaps in knowledge that need to be better understood in order to move towards the rational development and/or usage of therapeutic strategies to ameliorate severe dengue disease.
Collapse
Affiliation(s)
- José A Aguilar-Briseño
- Department of Medical Microbiology and Infection Prevention, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Jill Moser
- Departments of Critical Care, Pathology & Medical Biology, Medical Biology Section, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Izabela A Rodenhuis-Zybert
- Department of Medical Microbiology and Infection Prevention, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
| |
Collapse
|
10
|
Characterization of the Th17 profile immune response in cases of human rabies transmitted by dogs and its interference in the disease pathogenesis. J Neuroimmunol 2020; 344:577263. [PMID: 32416557 DOI: 10.1016/j.jneuroim.2020.577263] [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: 01/20/2020] [Revised: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 11/20/2022]
Abstract
The Th17 profile immune response is influenced by the presence of cytokines such as IL-1, IL-6, TGF-β, IL-17, and IL-23. We sought to characterize the Th17 profile in CNS samples from human rabies cases transmitted by dogs and examine its possible influence on disease pathogenesis. We observed a high expression of TGF-β, followed by IL-23, IL-17 and IL-6, and a low expression of IL-1β and IFN-γ. Those results suggest the participation of Th17 in rabies virus neuroinfection transmitted by dogs. IL-23 probably plays a role in maintaining the Th17 profile, but it can also interfere with the establishment of the Th1 profile and viral clearance.
Collapse
|
11
|
Meneses GC, da Silva GB, Tôrres PPBF, de Castro VQ, Lopes RL, Martins AMC, Daher EDF. Novel kidney injury biomarkers in tropical infections: a review of the literature. Rev Inst Med Trop Sao Paulo 2020; 62:e14. [PMID: 32074217 PMCID: PMC7032010 DOI: 10.1590/s1678-9946202062014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/21/2020] [Indexed: 12/29/2022] Open
Abstract
Tropical diseases are mainly found in the tropical regions of Asia, Africa and Latin America. They are a major Public Health problem in these regions, most of them are considered neglected diseases and remain as important contributors to the development of AKI (Acute Kidney Injury), which is associated with increased patients' morbidity and mortality. In most countries, kidney disease associated to tropical diseases is attended at health services with poor infrastructure and inadequate preventive measures. The long-term impacts of these infections on kidney tissue may be a main cause of future kidney disease in these patients. Therefore, the investigation of novel kidney injury biomarkers in these tropical diseases is of utmost importance to explain the mechanisms of kidney injury, to improve their diagnosis and prognosis, as well as the assessment to health systems by these patients. Since 2011, our group has been studying renal biomarkers in visceral and cutaneous leishmaniasis, schistosomiasis, leptospirosis and leprosy. This study has increased the knowledge on the pathophysiology of kidney disease in the presence of these infections and has contributed to the early diagnosis of kidney injury, pointing to glomerular, endothelial and inflammatory involvement as the main causes of the mechanisms leading to nephropathy and clinical complications. Future perspectives comprise establishing long-term cohort groups to assess the development of kidney disease and the patients' survival, as well as the use of new biomarkers such as urinary exosomes to detect risk groups and to understand the progression of kidney injuries.
Collapse
Affiliation(s)
- Gdayllon Cavalcante Meneses
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento
de Medicina Clínica, Programa de Pós-Graduação em Ciências Médicas, Fortaleza,
Ceará, Brazil
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e
Enfermagem, Laboratório de Nefrologia e Doenças Tropicais, Fortaleza, Ceará,
Brazil
| | - Geraldo Bezerra da Silva
- Universidade de Fortaleza, Centro de Ciências da Saúde, Curso de
Medicina, Programa de Pós-Graduação em Saúde Coletiva e Ciências Médicas, Fortaleza,
Ceará, Brazil
- Universidade Federal do Ceará,Faculdade de Farmácia, Odontologia e
Enfermagem, Programa de Pós-Graduação em Ciências Farmacêuticas, Fortaleza, Ceará,
Brazil
| | - Paulo Pacelli Bezerra Filizola Tôrres
- Universidade Federal do Ceará,Faculdade de Farmácia, Odontologia e
Enfermagem, Programa de Pós-Graduação em Ciências Farmacêuticas, Fortaleza, Ceará,
Brazil
| | - Valeska Queiroz de Castro
- Universidade Federal do Ceará,Faculdade de Farmácia, Odontologia e
Enfermagem, Programa de Pós-Graduação em Ciências Farmacêuticas, Fortaleza, Ceará,
Brazil
| | - Renata Lima Lopes
- Universidade de Fortaleza, Centro de Ciências da Saúde, Curso de
Medicina, Programa de Pós-Graduação em Saúde Coletiva e Ciências Médicas, Fortaleza,
Ceará, Brazil
| | - Alice Maria Costa Martins
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e
Enfermagem, Laboratório de Nefrologia e Doenças Tropicais, Fortaleza, Ceará,
Brazil
- Universidade Federal do Ceará,Faculdade de Farmácia, Odontologia e
Enfermagem, Programa de Pós-Graduação em Ciências Farmacêuticas, Fortaleza, Ceará,
Brazil
| | - Elizabeth De Francesco Daher
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento
de Medicina Clínica, Programa de Pós-Graduação em Ciências Médicas, Fortaleza,
Ceará, Brazil
| |
Collapse
|
12
|
Vitoria WO, Thomé LS, Kanashiro-Galo L, Carvalho LVD, Penny R, Santos WLC, Vasconcelos PFDC, Sotto MN, Duarte MIS, Quaresma JAS, Pagliari C. Upregulation of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 in renal tissue in severe dengue in humans: Effects on endothelial activation/dysfunction. Rev Soc Bras Med Trop 2019; 52:e20180353. [PMID: 31778418 DOI: 10.1590/0037-8682-0353-2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/20/2019] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Dengue is an important mosquito-borne disease in tropical and subtropical regions. Adhesion molecules have not been systematically characterized in the renal tissue of patients with severe dengue (SD). The objective of this study was to detect viral antigens in samples from patients that evolved with SD, correlating with the expression of ICAM-1, VCAM-1, VE-cadherin, and E-selectin to contribute to a better understanding of the pathophysiology of SD. METHODS Kidney specimens from patients with SD were selected according to clinical and laboratorial data and submitted to histological and immunohistochemistry analysis. A semiquantitative evaluation was performed considering positive immunostaining in 20 glomeruli. RESULTS Viral antigens were mainly detected in distal tubules. The intense immunostaining of VCAM-1 and ICAM-1 was observed. The expression of E-selectin was discrete, and VE-cadherin expression varied from mild to moderate. VCAM-1 was slightly intense in the glomerular capsule; the expression of ICAM-1 was diffuse. E-selectin was diffuse, and VE-cadherin varied from mild to moderate. The most frequent histological findings were glomerular congestion, mild glomerulitis, acute renal injury, and glomerular atrophy. CONCLUSIONS The results appear to demonstrate an imbalance between vascular endothelial permeability regulating events in renal lesions in SD. The increase in the expression of ICAM-1 and VCAM-1 is an in-situ indicator of higher permeability with a consequent influx of cells favoring the inflammation of the endothelium. These molecules are important in the pathophysiology of the disease and provide the possibility of developing new markers for the evaluation, clinical follow-up, and therapeutic response of patients with SD.
Collapse
Affiliation(s)
- Webster Oliveira Vitoria
- Universidade de São Paulo, Faculdade de Medicina, Laboratório da Disciplina de Patologia de Moléstias Transmissíveis, São Paulo, SP, Brasil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, SP, Brasil
| | - Letícia Silva Thomé
- Universidade de São Paulo, Faculdade de Medicina, Laboratório da Disciplina de Patologia de Moléstias Transmissíveis, São Paulo, SP, Brasil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, SP, Brasil
| | - Luciane Kanashiro-Galo
- Universidade de São Paulo, Faculdade de Medicina, Laboratório da Disciplina de Patologia de Moléstias Transmissíveis, São Paulo, SP, Brasil
| | | | | | | | | | - Mirian Nacagami Sotto
- Universidade de São Paulo, Faculdade de Medicina, Laboratório da Disciplina de Patologia de Moléstias Transmissíveis, São Paulo, SP, Brasil
| | - Maria Irma Seixas Duarte
- Universidade de São Paulo, Faculdade de Medicina, Laboratório da Disciplina de Patologia de Moléstias Transmissíveis, São Paulo, SP, Brasil
| | | | - Carla Pagliari
- Universidade de São Paulo, Faculdade de Medicina, Laboratório da Disciplina de Patologia de Moléstias Transmissíveis, São Paulo, SP, Brasil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, SP, Brasil
| |
Collapse
|
13
|
Nunes PCG, Rioja LDS, Coelho JMCDO, Salomão NG, Rabelo K, José CC, Rodrigues FDCDC, de Azeredo EL, Basílio-de-Oliveira CA, Basílio-de-Oliveira R, Nogueira RMR, Sánchez-Arcila JC, dos Santos FB, Paes MV. Renal Injury in DENV-4 Fatal Cases: Viremia, Immune Response and Cytokine Profile. Pathogens 2019; 8:pathogens8040223. [PMID: 31703246 PMCID: PMC6963280 DOI: 10.3390/pathogens8040223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/14/2019] [Accepted: 10/19/2019] [Indexed: 01/06/2023] Open
Abstract
Dengue virus (DENV) infections may result in asymptomatic cases or evolve into a severe disease, which involves multiple organ failure. Renal involvement in dengue can be potentially related to an increased mortality. Aiming to better understand the role of DENV in renal injury observed in human fatal cases, post-mortem investigations were performed in four DENV-4 renal autopsies during dengue epidemics in Brazil. Tissues were submitted to histopathology, immunohistochemistry, viral quantification, and characterization of cytokines and inflammatory mediators. Probably due the high viral load, several lesions were observed in the renal tissue, such as diffuse mononuclear infiltration around the glomerulus in the cortical region and in the medullary vessels, hyalinosis arteriolar, lymphocytic infiltrate, increased capsular fibrosis, proximal convoluted tubule (PCT) damage, edema, PCT debris formation, and thickening of the basal vessel membrane. These changes were associated with DENV-4 infection, as confirmed by the presence of DENV-specific NS3 protein, indicative of viral replication. The exacerbated presence of mononuclear cells at several renal tissue sites culminated in the secretion of proinflammatory cytokines and chemokines. Moreover, it can be suggested that the renal tissue injury observed here may have been due to the combination of both high viral load and exacerbated host immune response.
Collapse
Affiliation(s)
- Priscila Conrado Guerra Nunes
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro-RJ 21040900, Brazil; (E.L.d.A.); (F.B.d.S.)
- Correspondence: (P.C.G.N.); (M.V.P.)
| | - Lilimar da Silveira Rioja
- Departamento de Patologia e Laboratórios, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro-RJ 20550170, Brazil;
| | - Janice Mery Chicarino de Oliveira Coelho
- Laboratório de Anatomia Patológica, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro-RJ 21040900, Brazil; (J.M.C.d.O.C.); (F.d.C.d.C.R.)
| | - Natália Gedeão Salomão
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro-RJ 21040900, Brazil; (N.G.S.); (C.C.J.)
| | - Kíssila Rabelo
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro/UERJ, Rio de Janeiro- RJ 20550170, Brazil;
| | - Carollina Ceia José
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro-RJ 21040900, Brazil; (N.G.S.); (C.C.J.)
| | - Francisco das Chagas de Carvalho Rodrigues
- Laboratório de Anatomia Patológica, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro-RJ 21040900, Brazil; (J.M.C.d.O.C.); (F.d.C.d.C.R.)
| | - Elzinandes Leal de Azeredo
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro-RJ 21040900, Brazil; (E.L.d.A.); (F.B.d.S.)
| | | | - Rodrigo Basílio-de-Oliveira
- Anatomia Patológica, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro-RJ 20270004, Brazil; (C.A.B.-d.-O.); (R.B.-d.-O.)
| | - Rita Maria Ribeiro Nogueira
- Laboratório de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ Rio de Janeiro-RJ 21040900, Brazil;
| | | | - Flávia Barreto dos Santos
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro-RJ 21040900, Brazil; (E.L.d.A.); (F.B.d.S.)
| | - Marciano Viana Paes
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro-RJ 21040900, Brazil; (N.G.S.); (C.C.J.)
- Correspondence: (P.C.G.N.); (M.V.P.)
| |
Collapse
|
14
|
Kuczera D, Assolini JP, Tomiotto-Pellissier F, Pavanelli WR, Silveira GF. Highlights for Dengue Immunopathogenesis: Antibody-Dependent Enhancement, Cytokine Storm, and Beyond. J Interferon Cytokine Res 2019; 38:69-80. [PMID: 29443656 DOI: 10.1089/jir.2017.0037] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Infection with dengue virus (DENV) can lead to a wide spectrum of clinical presentations, ranging from asymptomatic infection to death. It is estimated that the disease manifests only in 90 million cases out of the total 390 million yearly infections. Even though research has not yet elucidated which are the precise pathophysiological mechanisms that trigger severe forms of dengue, the infection elicits a critical immune response significant for dengue pathogenesis development. Understanding how the immune response to DENV is established and how it can resolve the infection or turn into an immunopathology is of great importance in DENV research. Currently, studies have extensively debated 2 hypotheses involving immune response: antibody-dependent enhancement and cytokine storm. However, despite its undeniable importance in severe forms of the disease, these 2 hypotheses are based on a primed immune status resulting from previous heterologous infection, abstaining them from explaining the severe forms of dengue in naive immune subjects, for example. Thus, it seems that a more intricate arrangement of causes and conditions must be achieved to severe dengue to occur. Among them, the cytokine network signature elicited, in association with viral aspects deserves special attention regarding the establishment of infection and evolution to pathogenesis. In this work, we intend to shed light on how those elements contribute to severe dengue development.
Collapse
Affiliation(s)
- Diogo Kuczera
- 1 Laboratório de Virologia Molecular, Instituto Carlos Chagas , ICC/Fiocruz/PR, Curitiba, Brazil
| | - João Paulo Assolini
- 2 Departamento de Ciências Patológicas, Centro de Ciências Biológicas , Universidade Estadual de Londrina, Londrina, Brazil
| | - Fernanda Tomiotto-Pellissier
- 2 Departamento de Ciências Patológicas, Centro de Ciências Biológicas , Universidade Estadual de Londrina, Londrina, Brazil
| | - Wander Rogério Pavanelli
- 2 Departamento de Ciências Patológicas, Centro de Ciências Biológicas , Universidade Estadual de Londrina, Londrina, Brazil
| | | |
Collapse
|
15
|
Burdmann EA. Flaviviruses and Kidney Diseases. Adv Chronic Kidney Dis 2019; 26:198-206. [PMID: 31202392 DOI: 10.1053/j.ackd.2019.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 12/17/2022]
Abstract
The genus Flavivirus comprises approximately 73 viruses, which share several common aspects, such as dimension, structure, nucleic acid properties, and shape in electronic microscopy. Global incidence of flavivirus infection increased dramatically over the last decades, causing large outbreaks in several areas of the world. These viruses are expanding from endemic tropical and subtropical areas to previously nonendemic areas, affecting and causing diseases in millions of individuals worldwide and posing a formidable challenge to public health in several countries. The majority of clinically significant flavivirus-associated infections are mosquito borne (arboviruses-acronym for ARthropod-BOrne VIRUSES), such as dengue, yellow fever, Japanese encephalitis, Zika, and West Nile fever. Most diseases caused by flaviviruses are asymptomatic or manifest as self-limited, mild, undifferentiated febrile diseases. In a limited number of cases, these diseases may evolve to severe inflammatory, multisystem diseases, causing high morbidity and mortality. Some flaviviruses have been consistently identified in kidney tissue and urine and have been clinically associated with kidney diseases. In this review, we will provide an overview of the epidemiology, risk factors, kidney pathology, etiopathogenesis, and outcomes of acute and chronic kidney syndromes associated with dengue, yellow fever, Zika, and West Nile virus disease.
Collapse
|
16
|
Zika Virus Epidemic in Brazil. II. Post-Mortem Analyses of Neonates with Microcephaly, Stillbirths, and Miscarriage. J Clin Med 2018; 7:jcm7120496. [PMID: 30487475 PMCID: PMC6306831 DOI: 10.3390/jcm7120496] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction: The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barré syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection. Methods: Twelve fatal cases of neonates, whose mothers were infected with ZIKV during pregnancy, were examined; cases included nine neonatal deaths due to microcephaly, one miscarriage, and two stillbirths. Tissue samples were obtained from all cases at necropsy and were submitted for virological investigation (RT-qPCR and virus isolation) and/or histopathology (hematoxylin and eosin staining) and immunohistochemical assay for the detection of ZIKV antigens. Results: ZIKV antigens and/or ZIKV RNA were detected in tissue samples of all 12 cases examined. ZIKV was recovered in one case. Results of the virological and immunohistochemical analyses, as well as the anatomic abnormalities and histopathologic changes observed at necropsy on the 12 fatal cases, are presented. Conclusions: Data from these 12 cases provide strong evidence of the causal relationship between ZIKV and congenital disease in fetuses of women who were infected with the virus during pregnancy.
Collapse
|
17
|
Immunomodulatory effect of 1, 25 dihydroxy vitamin D 3 on the expression of RNA sensing pattern recognition receptor genes and cytokine response in dengue virus infected U937-DC-SIGN cells and THP-1 macrophages. Int Immunopharmacol 2018; 62:237-243. [PMID: 30032048 DOI: 10.1016/j.intimp.2018.07.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 12/30/2022]
Abstract
Dengue virus (DENV) infections are straining public health systems worldwide. Vitamin D, a secosteroid hormone, is currently being investigated for its immunomodulatory effects in DENV infections. The objectives of the present study was to study the effect of 1, 25 dihydroxy vitamin D3 (1,25(OH)2D3) on the expression of genes coding for RNA sensing pattern recognition receptors, downstream signaling components including oligoadenylate synthetases (OAS) and interferon stimulated gene 15 (ISG15) and T helper (Th)1, Th2 and Th17 cytokine response in DENV infected U937-DC-SIGN cells and THP-1 macrophages. U937-DC-SIGN RNA was investigated for the expression of TLR3, DDX58, IFIH1, OAS1, OAS2, OAS3, CAMP and ISG15 genes using gene expression assays. Interleukin (IL)-12p70, IL-10, IL-4 and IL-17A levels were assessed in the THP-1 macrophage culture supernatants. The results revealed that 1,25(OH)2D3 increased the expression of DDX58, OAS1, OAS2 and OAS3 at 0.1 μM while higher concentration had diminishing effect. 1,25(OH)2D3 enhanced the expression of ISG15 and CAMP genes. 1,25(OH)2D3 suppressed the levels of IL-4 and IL-17A. Lower concentration of 1,25(OH)2D3 suppressed IL-12p70 and IL-10 levels while a higher concentration enhanced the levels. The results suggest that 1,25(OH)2D3 may have concentration dependent immunomodulatory effects. Higher dose of 1,25(OH)2D3 might have an immunoregulatory role in ameliorating inflammation during dengue infections. Further studies are needed to evaluate the efficacy of different doses of 1,25(OH)2D3 in preventing severe dengue.
Collapse
|
18
|
Renal manifestations of dengue virus infections. J Clin Virol 2018; 101:1-6. [DOI: 10.1016/j.jcv.2018.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 12/04/2017] [Accepted: 01/04/2018] [Indexed: 11/17/2022]
|
19
|
Cangussu ASR, Mariúba LAM, Lalwani P, Pereira KDES, Astolphi-Filho S, Orlandi PP, Epiphanio S, Viana KF, Ribeiro MFB, Silva HM, Marinho CRF, Nogueira PA. A hybrid protein containing MSP1a repeats and Omp7, Omp8 and Omp9 epitopes protect immunized BALB/c mice against anaplasmosis. Vet Res 2018; 49:6. [PMID: 29351812 PMCID: PMC5775529 DOI: 10.1186/s13567-018-0503-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/20/2017] [Indexed: 12/23/2022] Open
Abstract
Anaplasma marginale (A. marginale) has a remarkable impact on livestock production, and an effective vaccine is not currently available due to the inexistence of a small animal model. Recently, BALB/c mice were successfully infected with A. marginale, resulting in an acute and persistent anaplasmosis infection. Here, we designed a hybrid protein containing repeats of polypeptide 1a from major surface protein-1 complex (MSP1a) repeats and common epitopes of outer membrane proteins (OMPs) OMP7, OMP8 and OMP9 expressed in Escherichia coli. Our proof-of-concept assessed vaccinal effectiveness against a challenge with live bacteria. The MSP1a/OMP7/8/9 immunized BALB/C mice exhibited a strong reduction in rickettsemia and had no signs of anaplasmosis or hepatic lesions. In contrast, the non-immunized mice exhibited signs of anaplasmosis and a body weight loss associated with increases in monocyte and neutrophil counts. Furthermore, the non-immunized mice displayed atrophies with chronic inflammatory infiltrates in the spleen and increased binucleation and hydropic degeneration in the hepatocytes. Our findings demonstrated that immunization with our hybrid protein induced a strong reduction in rickettsemia and conferred protection against anaplasmosis. Therefore, given the strong evidence of the protective effect against anaplasmosis, hybrid protein designs are potential candidates for the rational design of vaccinal subunits.
Collapse
Affiliation(s)
- Alex Sander R Cangussu
- Universidade Federal do Amazonas-Programa de pós-graduação em Rede de Biodiversidade e Biotecnologia da Amazônia Legal, Manaus, AM/Brasil, Brazil. .,Universidade Federal do Tocantins-Engenharia de Bioprocessos e Biotecnologia, Gurupi, TO/Brazil, Brazil.
| | - Luis André M Mariúba
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| | - Pritesh Lalwani
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| | | | - Spartaco Astolphi-Filho
- Universidade Federal do Amazonas-Programa de pós-graduação em Rede de Biodiversidade e Biotecnologia da Amazônia Legal, Manaus, AM/Brasil, Brazil
| | - Patricia P Orlandi
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| | - Sabrina Epiphanio
- Departamento de Análises Clínicas e Toxicológicas da Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, São Paulo/Brazil, Brazil
| | - Kelvison F Viana
- Universidade Federal do Tocantins-Engenharia de Bioprocessos e Biotecnologia, Gurupi, TO/Brazil, Brazil
| | - Mucio Flavio B Ribeiro
- Departamento de Parasitologia do Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais/Brazil, Brazil
| | - Hidelberto M Silva
- Faculdade de Medicina, Centro Universitário Unirg, Gurupi, Tocantins/Brazil, Brazil
| | - Claudio R F Marinho
- Departamento de Parasitologia do Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo A Nogueira
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| |
Collapse
|
20
|
Luo X, Zhang X, Wu X, Yang X, Han C, Wang Z, Du Q, Zhao X, Liu SL, Tong D, Huang Y. Brucella Downregulates Tumor Necrosis Factor-α to Promote Intracellular Survival via Omp25 Regulation of Different MicroRNAs in Porcine and Murine Macrophages. Front Immunol 2018; 8:2013. [PMID: 29387067 PMCID: PMC5776175 DOI: 10.3389/fimmu.2017.02013] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/28/2017] [Indexed: 01/18/2023] Open
Abstract
Brucella spp. impedes the production of pro-inflammatory cytokines by its outer membrane protein Omp25 in order to promote survival and immune evasion. However, how Omp25 regulates tumor necrosis factor (TNF-α) expression in different mammalian macrophages remains unclear. In this study, we investigated the potential mechanisms by which Omp25 regulates TNF-α expression and found that Omp25-deficient mutant of B. suis exhibited an enhanced TNF-α expression compared with wild-type (WT) B. suis, whereas ectopic expression of Omp25 suppressed LPS-induced TNF-α production at both protein and mRNA levels in porcine alveolar macrophages (PAMs) and murine macrophage RAW264.7 cells. We observed that Omp25 protein as well as WT B. suis upregulated miR-146a, -181a, -181b, and -301a-3p and downregulated TRAF6 and IRAK1 in both PAMs and RAW264.7 cells, but separately upregulates miR-130a-3p in PAMs and miR-351-5p in RAW264.7. The upregulation of miR-146a or miR-351-5p attenuated TNF-α transcription by targeting TRAF6 and IRAK1 at the 3' untranslated region (UTR), resulting in inhibition of NF-kB pathway, while upregulation of miR-130a-3p, -181a, or -301a-3p correlated temporally with decreased TNF-α by targeting its 3'UTR in PAMs or RAW264.7 cells. In contrast, inhibition of miR-130a-3p, -146a, -181a, and -301a-3p attenuated the inhibitory effects of Omp25 on LPS-induced TNF-α in PAMs, while inhibition of miR-146a, -181a, -301a-3p, and -351-5p attenuated the inhibitory effects of Omp25 in RAW264.7, resulting in an increased TNF-α production and decreased intracellular bacteria in both cells. Taken together, our results demonstrate that Brucella downregulates TNF-α to promote intracellular survival via Omp25 regulation of different microRNAs in porcine and murine macrophages.
Collapse
Affiliation(s)
- Xiaomao Luo
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Xiujuan Zhang
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Xingchen Wu
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Xuefeng Yang
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Cong Han
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Zhengyu Wang
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Qian Du
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Xiaomin Zhao
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH, United States.,Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH, United States.,Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, United States.,Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, United States
| | - Dewen Tong
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Yong Huang
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| |
Collapse
|
21
|
T cell immunity to Zika virus targets immunodominant epitopes that show cross-reactivity with other Flaviviruses. Sci Rep 2018; 8:672. [PMID: 29330423 PMCID: PMC5766511 DOI: 10.1038/s41598-017-18781-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/18/2017] [Indexed: 11/09/2022] Open
Abstract
Zika virus (ZIKV) Infection has several outcomes from asymptomatic exposure to rash, conjunctivitis, Guillain-Barré syndrome or congenital Zika syndrome. Analysis of ZIKV immunity is confounded by the fact that several related Flaviviruses infect humans, including Dengue virus 1-4, West Nile virus and Yellow Fever virus. HLA class II restricted T cell cross-reactivity between ZIKV and other Flaviviruses infection(s) or vaccination may contribute to protection or to enhanced immunopathology. We mapped immunodominant, HLA class II restricted, CD4 epitopes from ZIKV Envelope (Env), and Non-structural (NS) NS1, NS3 and NS5 antigens in HLA class II transgenic mice. In several cases, ZIKV primed CD4 cells responded to homologous sequences from other viruses, including DENV1-4, WNV or YFV. However, cross-reactive responses could confer immune deviation - the response to the Env DENV4 p1 epitope in HLA-DR1 resulted in IL-17A immunity, often associated with exacerbated immunopathogenesis. This conservation of recognition across Flaviviruses, may encompass protective and/or pathogenic components and poses challenges to characterization of ZIKV protective immunity.
Collapse
|
22
|
Burdmann EA, Jha V. Acute kidney injury due to tropical infectious diseases and animal venoms: a tale of 2 continents. Kidney Int 2017; 91:1033-1046. [PMID: 28088326 DOI: 10.1016/j.kint.2016.09.051] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/10/2016] [Accepted: 09/28/2016] [Indexed: 12/20/2022]
Abstract
South and Southeast Asia and Latin American together comprise 46 countries and are home to approximately 40% of the world population. The sociopolitical and economic heterogeneity, tropical climate, and malady transitions characteristic of the region strongly influence disease behavior and health care delivery. Acute kidney injury epidemiology mirrors these inequalities. In addition to hospital-acquired acute kidney injury in tertiary care centers, these countries face a large preventable burden of community-acquired acute kidney injury secondary to tropical infectious diseases or animal venoms, affecting previously healthy young individuals. This article reviews the epidemiology, clinical picture, prevention, risk factors, and pathophysiology of acute kidney injury associated with tropical diseases (malaria, dengue, leptospirosis, scrub typhus, and yellow fever) and animal venom (snakes, bees, caterpillars, spiders, and scorpions) in tropical regions of Asia and Latin America, and discusses the potential future challenges due to emerging issues.
Collapse
Affiliation(s)
- Emmanuel A Burdmann
- LIM 12, Division of Nephrology, University of São Paulo Medical School, São Paulo, Brazil.
| | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India, and University of Oxford, Oxford, UK
| |
Collapse
|
23
|
Póvoa TF, Oliveira ERA, Basílio-de-Oliveira CA, Nuovo GJ, Chagas VLA, Salomão NG, Mota EM, Paes MV. Peripheral Organs of Dengue Fatal Cases Present Strong Pro-Inflammatory Response with Participation of IFN-Gamma-, TNF-Alpha- and RANTES-Producing Cells. PLoS One 2016; 11:e0168973. [PMID: 28006034 PMCID: PMC5179082 DOI: 10.1371/journal.pone.0168973] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 12/10/2016] [Indexed: 12/26/2022] Open
Abstract
Dengue disease is an acute viral illness caused by dengue virus (DENV) that can progress to hemorrhagic stages leading to about 20000 deaths every year worldwide. Despite many clinical investigations regarding dengue, the immunopathogenic process by which infected patients evolve to the severe forms is not fully understood. Apart from differences in virulence and the antibody cross reactivity that can potentially augment virus replication, imbalanced cellular immunity is also seen as a major concern in the establishment of severe dengue. In this context, the investigation of cellular immunity and its products in dengue fatal cases may provide valuable data to help revealing dengue immunopathogenesis. Here, based in four dengue fatal cases infected by the serotype 3 in Brazil, different peripheral organs (livers, lungs and kidneys) were studied to evaluate the presence of cell infiltrates and the patterns of local cytokine response. The overall scenario of the studied cases revealed a considerable systemic involvement of infection with mononuclear cells targeted to all of the evaluated organs, as measured by immunohistochemistry (IHC). Quantification of cytokine-expressing cells in peripheral tissues was also performed to characterize the ongoing inflammatory process by the severe stage of the disease. Increased levels of IFN-γ- and TNF-α-expressing cells in liver, lung and kidney samples of post-mortem subjects evidenced a strong pro-inflammatory induction in these tissues. The presence of increased RANTES-producing cell numbers in all analyzed organs suggested a possible link between the clinical status and altered vascular permeability. Co-staining of DENV RNA and IFN-γ or TNF-α using in situ hibridization and IHC confirmed the virus-specific trigger of the pro-inflammatory response. Taken together, this work provided additional evidences that corroborated with the traditional theories regarding the “cytokine storm” and the occurrence of uneven cellular immunity in response to DENV as major reasons for progress to severe disease.
Collapse
Affiliation(s)
- Tiago F. Póvoa
- Laboratory of Biotechnology and Physiology of Viral Infections, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Edson R. A. Oliveira
- Laboratory of Molecular Modeling, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gerard J. Nuovo
- Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Phylogeny Inc, Powell, Ohio, United States of America
| | - Vera L. A. Chagas
- Pathological Anatomy, Clementino Fraga Filho University Hospital, Rio de Janeiro, Brazil
| | - Natália G. Salomão
- Interdisciplinary Laboratory of Medical Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ester M. Mota
- Laboratory of Pathology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marciano V. Paes
- Interdisciplinary Laboratory of Medical Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- * E-mail:
| |
Collapse
|
24
|
Azevedo RSS, Araujo MT, Martins Filho AJ, Oliveira CS, Nunes BTD, Cruz ACR, Nascimento AGPAC, Medeiros RC, Caldas CAM, Araujo FC, Quaresma JAS, Vasconcelos BCB, Queiroz MGL, da Rosa EST, Henriques DF, Silva EVP, Chiang JO, Martins LC, Medeiros DBA, Lima JA, Nunes MRT, Cardoso JF, Silva SP, Shi PY, Tesh RB, Rodrigues SG, Vasconcelos PFC. Zika virus epidemic in Brazil. I. Fatal disease in adults: Clinical and laboratorial aspects. J Clin Virol 2016; 85:56-64. [PMID: 27835759 DOI: 10.1016/j.jcv.2016.10.024] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/26/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Zika virus (ZIKV) was first detected in Brazil in May 2015 and the country experienced an explosive epidemic. However, recent studies indicate that the introduction of ZIKV occurred in late 2013. Cases of microcephaly and deaths associated with ZIKV infection were identified in Brazil in November, 2015. OBJECTIVES To determine the etiology of three fatal adult cases. STUDY DESIGN Here we report three fatal adult cases of ZIKV disease. ZIKV infection in these patients was confirmed by cells culture and/or real-time reverse transcriptase polymerase chain reaction (RT-qPCR) and by antigen detection using immunohistochemical assay. Samples of brain and other selected organs taken at autopsy from three patients were also analyzed by histopathological and immunohistological examination. RESULTS The first patient, a 36-year-old man with lupus and receiving prednisone therapy, developed a fulminant ZIKV infection. At autopsy, RT-qPCR of blood and tissues was positive for ZIKV RNA, and the virus was cultured from an organ homogenate. The second patient, a previously healthy female, 16 years of age, presented classic symptoms of Zika fever, but later developed severe thrombocytopenia, anemia and hemorrhagic manifestations and died. A blood sample taken on the seventh day of her illness was positive RT-PCR for ZIKV RNA and research in the serum was positive for antinuclear factor fine speckled (1/640), suggesting Evans syndrome (hemolytic anemia an autoimmune disorder with immune thrombocytopenic purpura) secondary to ZIKV infection. The third patient was a 20-year-old woman hospitalized with fever, pneumonia and hemorrhages, who died on 13days after admission. Histopathological changes were observed in all viscera examined. ZIKV antigens were detected by immunohistochemistry in viscera specimens of patients 1 and 3. These three cases demonstrate other potential complications of ZIKV infection, in addition to microcephaly and Guillain-Barre syndrome (GBS), and they suggest that individuals with immune suppression and/or autoimmune disorders may be at higher risk of developing severe disease, if infected with ZIKV.
Collapse
Affiliation(s)
- Raimunda S S Azevedo
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil; Programa de Pós-graduação em Virologia (PPGV) do Instituto Evandro Chagas, Ananindeua, Pará, Brazil.
| | - Marialva T Araujo
- Seção de Patologia, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Arnaldo J Martins Filho
- Seção de Patologia, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Consuelo S Oliveira
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Bruno T D Nunes
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Ana C R Cruz
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil; Departamento de Patologia, Universidade do Estado do Pará, Belém, Pará, Brazil.
| | | | - Rita C Medeiros
- Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Pará, Brazil.
| | - Cezar A M Caldas
- Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Pará, Brazil.
| | - Fernando C Araujo
- Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Pará, Brazil.
| | - Juarez A S Quaresma
- Departamento de Patologia, Universidade do Estado do Pará, Belém, Pará, Brazil.
| | | | - Maria G L Queiroz
- Laboratório Central, Secretaria de Saúde Pública do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Elizabeth S Travassos da Rosa
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Daniele F Henriques
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Eliana V P Silva
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Jannifer O Chiang
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Lívia C Martins
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Daniele B A Medeiros
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Juliana A Lima
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Márcio R T Nunes
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Jedson F Cardoso
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil; Programa de Pós-graduação em Virologia (PPGV) do Instituto Evandro Chagas, Ananindeua, Pará, Brazil.
| | - Sandro P Silva
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Pei-Yong Shi
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.
| | - Robert B Tesh
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.
| | - Sueli G Rodrigues
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil.
| | - Pedro F C Vasconcelos
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil; Departamento de Patologia, Universidade do Estado do Pará, Belém, Pará, Brazil.
| |
Collapse
|
25
|
Maravitsa P, Adamopoulou M, Pistiki A, Netea MG, Louis K, Giamarellos-Bourboulis EJ. Systemic over-release of interleukin-17 in acute kidney injury after septic shock: Clinical and experimental evidence. Immunol Lett 2016; 178:68-76. [DOI: 10.1016/j.imlet.2016.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 01/13/2023]
|
26
|
Kabat-Koperska J, Kolasa-Wołosiuk A, Wojciuk B, Wojciechowska-Koszko I, Roszkowska P, Krasnodębska-Szponder B, Paczkowska E, Safranow K, Gołembiewska E, Machaliński B, Ciechanowski K. The influence of intrauterine exposure to immunosuppressive treatment on changes in the immune system in juvenile Wistar rats. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:2279-88. [PMID: 27471376 PMCID: PMC4948737 DOI: 10.2147/dddt.s102189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background In our study, we assessed the impact of immunosuppressive drug combinations on changes in the immune system of juvenile Wistar rats exposed to these drugs during pregnancy. We primarily concentrated on changes in two organs of the immune system – the thymus and the spleen. Methods The study was conducted on 40 (32+8) female Wistar rats administered full and half dose of drugs, respectively, subjected to regimens commonly used in therapy of human kidney transplant recipients ([1] cyclosporine A, mycophenolate mofetil, and prednisone; [2] tacrolimus, mycophenolate mofetil, and prednisone; [3] cyclosporine A, everolimus, and prednisone). The animals received drugs by oral gavage 2 weeks before pregnancy and during 3 weeks of pregnancy. Results There were no statistically significant differences in the weight of the thymus and spleen, but changes were found in the results of blood hematology, cytometry from the spleen, and a histologic examination of the examined immune organs of juvenile Wistar rats. In the cytokine assay, changes in the level of interleukine 17 (IL-17) after increasing amounts of concanavaline A were dose-dependent; the increase of IL-17 was blocked after administration of higher doses of immunosuppressive drugs. However, after a reduction of doses, its increase resumed. Conclusion Qualitative, quantitative, and morphological changes in the immune system of infant rats born to pharmacologically immunosuppressed females were observed. Thymus structure, spleen composition, and splenocyte IL-17 production were mostly affected in a drug regimen–dependent manner.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | | | | | | |
Collapse
|