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Sawant S, Nandi SS, Gohil T, Jadhav A, Samudra P, Arora M, Rudra U, Deshpande J. A multiplex SNaPshot assay for the detection of single nucleotide polymorphism associated with clinical severity of enterovirus infections. Gene 2024; 926:148618. [PMID: 38821327 DOI: 10.1016/j.gene.2024.148618] [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: 01/19/2024] [Revised: 05/14/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
Non-polio enterovirus infections are known to cause a variety of diseases and neurological complications. It is also known that the severity of these diseases largely differs among individuals with different genotypes and alleles. The Single Nucleotide Polymorphisms (SNPs) within specific genes have a considerable effect on the immune response to enteroviruses and on the outcome of disease, leading to variations in complications and infection susceptibility. Knowing the distribution of such SNPs can be valuable for individual case management and studying epidemiological parameters of enterovirus infections. In this feasibility study, a multiplex version of the primer extension-based technique called the SNaPshot Assay has been developed to examine SNPs in various relevant genes for predicting the clinical severity of enterovirus infections. It is already established that this technique is precise, consistent, scalable, and likely to exhibit high throughput. The multiplex SNaPshot can investigate multiple genetic susceptibility markers simultaneously, and the assay can be used to identify vulnerable populations, understand the epidemiology of infections, and manage the outbreaks of enteroviruses. Based on the literature, 15 SNPs were identified which are suspected for higher susceptibility to the worst outcomes after enterovirus infection and the assay was developed. Blood samples of 100 healthy volunteers were collected and tested for assay feasibility as well as to know the proportions of 15 selected SNPs. After the analysis, seven SNPs have been identified and suggested to be considered for future assays. Based on the pilot test results, it appears that positivity for any three out of the identified seven SNPs might indicate a higher risk, and future studies correlated with clinical studies among patients with and without severe diseases utilizing this assay will provide robust parameters to determine at-risk individuals more accurately.
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Affiliation(s)
- Sonali Sawant
- National Institute of Virology Mumbai Unit, Haffkine Institute Compound, AD Marg, Parel, Mumbai 400012, India.
| | - Shyam Sundar Nandi
- National Institute of Virology Mumbai Unit, Haffkine Institute Compound, AD Marg, Parel, Mumbai 400012, India.
| | - Trupti Gohil
- National Institute of Virology Mumbai Unit, Haffkine Institute Compound, AD Marg, Parel, Mumbai 400012, India.
| | - Abhijeet Jadhav
- Scientist E, National Institute of Virology, Pune 411001, India.
| | - Prasanna Samudra
- National Institute of Virology Mumbai Unit, Haffkine Institute Compound, AD Marg, Parel, Mumbai 400012, India.
| | - Meera Arora
- Dr. Babasaheb Ambedkar Memorial Hospital (Zonal) Byculla, Central Railway, Mumbai 400012, India.
| | - Ujjaini Rudra
- Dr. Balasaheb Vikhe Patil Rural Medical College, Loni 413736, India.
| | - Jagadish Deshpande
- National Institute of Virology Mumbai Unit, Haffkine Institute Compound, AD Marg, Parel, Mumbai 400012, India.
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Itani TM, Chalapa VI, Slautin VN, Bykov RO, Imangaliev BS, Starikova PK, Sergeev AG, Semenov AV. Non-Polio Enterovirus Surveillance in the Ural Federal District and Western Siberia, 2022: Is There a Need for a Vaccine? Vaccines (Basel) 2023; 11:1588. [PMID: 37896990 PMCID: PMC10610881 DOI: 10.3390/vaccines11101588] [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: 09/11/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
Human non-polio enteroviruses (NPEVs) are the etiological agents involved in most cases of hand-foot-and-mouth disease (HFMD), herpangina and aseptic meningitis. Information on the epidemiology profiles of NPEV in the Ural Federal District and Western Siberia is very limited, with no published data available. The aim of this study is to describe NPEV incidence in the Ural Federal District and Western Siberia among patients with different forms of non-polio enterovirus infections (NPEVIs) during 2022, stratified by age and clinical manifestations. A total of 265 samples that tested positive for NPEV using a polymerase chain reaction (PCR) were genotyped by semi-nested PCR for the VP1 gene. The results showed that 21 genotypes were identified among patients in this study. CVA6 was the most common genotype for HFMD. CVA6, along with CVA10, accounted for the majority of herpangina cases, while CVA9 was implicated in most meningitis cases. Sequence and phylogenetic analysis showed that nearly all of the CVA6 strains identified in this study displayed a close genetic relationship to strains identified in other cities in Russia and strains from China. NPEV surveillance allows for monitoring the circulation of clinically relevant genotypes, resulting in continuous data about NPEV epidemiology. This is important for improving case prevention, diagnosis and guiding clinical management.
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Affiliation(s)
- Tarek M. Itani
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
| | - Vladislav I. Chalapa
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
| | - Vasilii N. Slautin
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
| | - Roman O. Bykov
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
| | - Bolat S. Imangaliev
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
| | - Polina K. Starikova
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
| | - Aleksandr G. Sergeev
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
- Department of Microbiology, Virology and Immunology, Ural State Medical University, 620109 Ekaterinburg, Russia
| | - Aleksandr V. Semenov
- Laboratory of Enteric Virus Infections, Federal Budgetary Institution of Science «Federal Scientific Research Institute of Viral Infections «Virome»», Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Yekaterinburg, Russia; (V.I.C.); (V.N.S.); (R.O.B.); (B.S.I.); (P.K.S.); (A.G.S.); (A.V.S.)
- Institute of Natural Sciences and Mathematics, Ural Federal University Named after the First President of Russia B.N. Yeltsin, 620075 Ekaterinburg, Russia
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Moreni G, van Eijk H, Koen G, Johannesson N, Calitz C, Benschop K, Cremer J, Pajkrt D, Sridhar A, Wolthers K. Non-Polio Enterovirus C Replicate in Both Airway and Intestine Organotypic Cultures. Viruses 2023; 15:1823. [PMID: 37766230 PMCID: PMC10537321 DOI: 10.3390/v15091823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Non-polio enteroviruses (EV) belonging to species C, which are highly prevalent in Africa, mainly among children, are poorly characterized, and their pathogenesis is mostly unknown as they are difficult to culture. In this study, human airway and intestinal organotypic models were used to investigate tissue and cellular tropism of three EV-C genotypes, EV-C99, CVA-13, and CVA-20. Clinical isolates were obtained within the two passages of culture on Caco2 cells, and all three viruses were replicated in both the human airway and intestinal organotypic cultures. We did not observe differences in viral replication between fetal and adult tissue that could potentially explain the preferential infection of infants by EV-C genotypes. Infection of the airway and the intestinal cultures indicates that they both can serve as entry sites for non-polio EV-C. Ciliated airway cells and enterocytes are the target of infection for all three viruses, as well as enteroendocrine cells for EV-C99.
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Affiliation(s)
- Giulia Moreni
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
- OrganoVIR Labs, Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Hetty van Eijk
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
| | - Gerrit Koen
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
| | - Nina Johannesson
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
- OrganoVIR Labs, Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Carlemi Calitz
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
- OrganoVIR Labs, Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Kimberley Benschop
- National Institute for Public Health and Environment, RIVM, 3721 MA Bilthoven, The Netherlands; (K.B.); (J.C.)
| | - Jeroen Cremer
- National Institute for Public Health and Environment, RIVM, 3721 MA Bilthoven, The Netherlands; (K.B.); (J.C.)
| | - Dasja Pajkrt
- OrganoVIR Labs, Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Adithya Sridhar
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
- OrganoVIR Labs, Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Katja Wolthers
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location AMC, Amsterdam Institute for Infection and Immunity, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (H.v.E.); (G.K.); (N.J.); (C.C.); (A.S.); (K.W.)
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Itani T, Chalapa V, Semenov A, Sergeev A. Laboratory diagnosis of nonpolio enteroviruses: A review of the current literature. BIOSAFETY AND HEALTH 2022. [DOI: 10.1016/j.bsheal.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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IgA-Type Enterovirus Antibodies Are Increased among Adults and Children with Recently Diagnosed Type 1 Diabetes. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7603062. [PMID: 35958821 PMCID: PMC9357813 DOI: 10.1155/2022/7603062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
Enteroviruses (EV) are among the leading environmental triggers of childhood-onset type 1 diabetes (T1D). Our aim was to determine the prevalence of antibodies against EV and their association with T1D in different age groups (n = 62), including young adults, and to compare these data with results from HLA-matched control participants (n = 62). IgA, IgG, and IgM antibodies against EV were detected. IgA EV antibodies were present in 46.8% of participants with T1D (median level 10.9 EIU) and in 11.3% of controls (median level 3.4 EIU). IgA EV positivity and higher level of IgA EV antibodies were both significant risk factors for T1D (odds ratio (OR) 8.33; 95% confidence interval (CI) 2.52–27.6; p = 0.0005 and OR 1.04; 95% CI 1.01–1.06; p = 0.0105, respectively). Importantly, the prevalence of IgA EV antibodies in the subgroups of both children and young adults was also significantly different between participants with T1D and their matched controls (p = 0.0089 and p = 0.0055, respectively). Such differences were not seen for IgG and IgM EV antibodies. However, IgG EV antibodies were associated with 65 kDa glutamic acid decarboxylase antibodies, but not with zinc transporter 8 and protein tyrosine phosphatase IA2 antibodies. The genotype frequency of PTPN22 (rs2476601) and IFIH1 (rs1990760) was not associated with EV positivity. This study showed that EV infections may be an important disease-promoting factor of T1D not only in childhood-onset but also in adult-onset T1D. However, to further confirm this association, direct virological studies are needed in the latter T1D group.
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Seidman MA, McManus B. Myocarditis. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Korukluoglu G, Ozdemirer U, Bayrakdar F, Unal Z, Cosgun Y, Atak T, Karademirtok H, Ata I, Kara F. Detection of non-polio and polio enteroviruses in Acute Flaccid Paralysis surveillance in Turkey. Acta Microbiol Immunol Hung 2021; 68:92-98. [PMID: 33646138 DOI: 10.1556/030.2021.01353] [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: 11/23/2020] [Accepted: 01/18/2021] [Indexed: 11/19/2022]
Abstract
Poliomyelitis was a disease feared worldwide, striking suddenly and paralysing mainly children for life. Monitoring of suspected cases of poliomyelitis is carried out with Acute Flaccid Paralysis (AFP) surveillance in Turkey. This study examines national data of AFP surveillance and the epidemiology of enteroviruses (EV) in Turkey from 2000 to 2019 and gives an overview of the detected serotypes of EVs. A total of 13,640 samples collected from patients with 5216 AFP pre-diagnosed cases (2 samples from each patient) and 3,208 contacts, during a 20-year period (2000-2019) were investigated. All isolated polioviruses were tested for their wild or vaccine origin according to the WHO recommended protocol by PCR and sequencing analysis were performed. Enterovirus positivity was detected in a total of 915 cases, which were identified as 204 Sabin-like polio virus (SLPV) and 711 non-polio enterovirus (NPEV). Of the 204 SLPV, 141 (69.1%) AFP were detected in patients and 63 (30.9%) were detected in samples taken from their contacts. Of the 711 NPEVs, 516 (72.5%) were from AFP cases and 195 (27.5%) were detected in samples taken from their contacts. It is concluded that the reason for the higher detection rate of NPEV in samples from AFP pre-diagnosed cases is attributed to the polio vaccination rates reaching 97% between 2008 and 2019 in Turkey. The most frequently detected NPEV serotypes were Coxackie A24, B3, and Echo 30. This retrospective study is the first comprehensive study in Turkey to evaluate the results of the AFP surveillance in the last 20 years.
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Affiliation(s)
- Gulay Korukluoglu
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Umit Ozdemirer
- 2Ministry of Health, General Directorate of Public Health, Vaccine Preventable Diseases Department, Ankara, Turkey
| | - Fatma Bayrakdar
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Zehra Unal
- 3Izmir Public Health Laboratory, Provincial Health Directorate, Izmir, Turkey
| | - Yasemin Cosgun
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Tunca Atak
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Hulya Karademirtok
- 1Ministry of Health, General Directorate of Public Health, Virology Reference and Research Laboratory, Ankara, Turkey
| | - Isil Ata
- 2Ministry of Health, General Directorate of Public Health, Vaccine Preventable Diseases Department, Ankara, Turkey
| | - Fatih Kara
- 4Ministry of Health, General Directorate of Public Health, Ankara, Turkey
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Hedrera-Fernandez A, Cancho-Candela R, Arribas-Arceredillo M, Garrido-Barbero M, Conejo-Moreno D, Sariego-Jamardo A, Perez-Poyato MS, Rodriguez-Fernandez C, Del Villar-Guerra P, Bermejo-Arnedo I, Peña-Valenceja A, Maldonado-Ruiz E, Ortiz-Madinaveitia S, Camina-Gutierrez AB, Blanco-Lago R, Malaga I. Outbreak of Enterovirus Infection with Neurological Presentations in a Pediatric Population in Northern Spain: A Clinical Observational Study. Neuropediatrics 2021; 52:192-200. [PMID: 33657631 DOI: 10.1055/s-0041-1725008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The study aimed to describe the cases of neurological disease related to the outbreak of enterovirus (EV) in three regions in Northern Spain during 2016. MATERIALS AND METHODS Multicenter retrospective observational study. Clinical, radiological, and microbiological data were analyzed from patients younger than 15 years with confirmed EV-associated neurological disease admitted to 10 hospitals of Asturias, Cantabria, and Castile and Leon between January 1 and December 31, 2016. RESULTS Fifty-five patients were included. Median age was 24 months (interquartile range = 18.5 months). Fifteen patients were classified as aseptic meningitis (27.3%). In total, 37 cases presented brainstem encephalitis (67.3%), 25 of them due to EV-A71 with excellent prognosis (84.6% asymptomatic 2 months following the onset). Three cases of acute flaccid myelitis (5.5%) by EV-D68 were reported and presented persistent paresis 2 months following the onset. Microbiological diagnosis by reverse transcriptase polymerase chain reaction was performed in all cases, finding EV in cerebrospinal fluid in meningitis, but not in brainstem encephalitis and acute flaccid myelitis, where EV was found in respiratory or rectal samples. Step therapy was administrated with intravenous immunoglobulin (IVIG; 32.7%), methylprednisolone (10%), and plasmapheresis (3.6%). Four patients received fluoxetine (7.3%). Twenty patients needed to be admitted to pediatric intensive care unit (36.4%). CONCLUSION Clinical, microbiological, and radiological diagnosis is essential in outbreaks of EV neurological disease, taking into account that it can be difficult to identify EV-A71 and EV-D68 in CSF, requiring throat or rectal samples. There is not specific treatment to these conditions and the efficacy and understanding of the mechanism of action of immune-modulatory treatment (IVIG, corticosteroids, and plasmapheresis) is limited.
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Affiliation(s)
- Antonio Hedrera-Fernandez
- Paediatric Neurology Unit, Hospital Universitario Rio Hortega, Valladolid, Spain.,Paediatric Neurology Unit, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ramon Cancho-Candela
- Paediatric Neurology Unit, Hospital Universitario Rio Hortega, Valladolid, Spain
| | | | | | | | - Andrea Sariego-Jamardo
- Paediatric Neurology Unit, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | | | | | | | | | | | | | | | | | - Raquel Blanco-Lago
- Paediatric Neurology Unit, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ignacio Malaga
- Paediatric Neurology Unit, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Alhazmi A, Nekoua MP, Michaux H, Sane F, Halouani A, Engelmann I, Alidjinou EK, Martens H, Jaidane H, Geenen V, Hober D. Effect of Coxsackievirus B4 Infection on the Thymus: Elucidating Its Role in the Pathogenesis of Type 1 Diabetes. Microorganisms 2021; 9:microorganisms9061177. [PMID: 34072590 PMCID: PMC8229779 DOI: 10.3390/microorganisms9061177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/12/2021] [Accepted: 05/26/2021] [Indexed: 12/19/2022] Open
Abstract
The thymus gland is a primary lymphoid organ for T-cell development. Various viral infections can result in disturbance of thymic functions. Medullary thymic epithelial cells (mTECs) are important for the negative selection of self-reactive T-cells to ensure central tolerance. Insulin-like growth factor 2 (IGF2) is the dominant self-peptide of the insulin family expressed in mTECs and plays a crucial role in the intra-thymic programing of central tolerance to insulin-secreting islet β-cells. Coxsackievirus B4 (CVB4) can infect and persist in the thymus of humans and mice, thus hampering the T-cell maturation and differentiation process. The modulation of IGF2 expression and protein synthesis during a CVB4 infection has been observed in vitro and in vivo in mouse models. The effect of CVB4 infections on human and mouse fetal thymus has been studied in vitro. Moreover, following the inoculation of CVB4 in pregnant mice, the thymic function in the fetus and offspring was disturbed. A defect in the intra-thymic expression of self-peptides by mTECs may be triggered by CVB4. The effects of viral infections, especially CVB4 infection, on thymic cells and functions and their possible role in the pathogenesis of type 1 diabetes (T1D) are presented.
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Affiliation(s)
- Abdulaziz Alhazmi
- Laboratoire de Virologie ULR3610, Université de Lille, CHU Lille, F-59000 Lille, France; (A.A.); (M.P.N.); (F.S.); (I.E.); (E.K.A.)
- Microbiology and Parasitology Department, College of Medicine, Jazan University, Jazan 82911, Saudi Arabia
| | - Magloire Pandoua Nekoua
- Laboratoire de Virologie ULR3610, Université de Lille, CHU Lille, F-59000 Lille, France; (A.A.); (M.P.N.); (F.S.); (I.E.); (E.K.A.)
| | - Hélène Michaux
- GIGA-I3 Center of Immunoendocrinology, GIGA Research Institute, University of Liège, 4000 Liège, Belgium; (H.M.); (H.M.); (V.G.)
| | - Famara Sane
- Laboratoire de Virologie ULR3610, Université de Lille, CHU Lille, F-59000 Lille, France; (A.A.); (M.P.N.); (F.S.); (I.E.); (E.K.A.)
| | - Aymen Halouani
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Université de Monastir, 5000 Monastir, Tunisia; (A.H.); (H.J.)
| | - Ilka Engelmann
- Laboratoire de Virologie ULR3610, Université de Lille, CHU Lille, F-59000 Lille, France; (A.A.); (M.P.N.); (F.S.); (I.E.); (E.K.A.)
| | - Enagnon Kazali Alidjinou
- Laboratoire de Virologie ULR3610, Université de Lille, CHU Lille, F-59000 Lille, France; (A.A.); (M.P.N.); (F.S.); (I.E.); (E.K.A.)
| | - Henri Martens
- GIGA-I3 Center of Immunoendocrinology, GIGA Research Institute, University of Liège, 4000 Liège, Belgium; (H.M.); (H.M.); (V.G.)
| | - Hela Jaidane
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Université de Monastir, 5000 Monastir, Tunisia; (A.H.); (H.J.)
| | - Vincent Geenen
- GIGA-I3 Center of Immunoendocrinology, GIGA Research Institute, University of Liège, 4000 Liège, Belgium; (H.M.); (H.M.); (V.G.)
| | - Didier Hober
- Laboratoire de Virologie ULR3610, Université de Lille, CHU Lille, F-59000 Lille, France; (A.A.); (M.P.N.); (F.S.); (I.E.); (E.K.A.)
- Correspondence: ; Tel.: +33-(0)3-20-44-66-88
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Perez VA, Melnick LE, Whittier S, Dayan PS, Garzon MC, Morel KD, Levin LE, Lauren CT. The use of respiratory pathogen panel nasal polymerase chain reaction testing in predicting cutaneous enteroviral infections in the pediatric population. Pediatr Dermatol 2021; 38:602-605. [PMID: 33724504 DOI: 10.1111/pde.14567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/02/2021] [Accepted: 02/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVE To characterize the relationship between the presence of enteroviral skin infection, defined as a positive skin polymerase chain reaction (PCR) test, and the nasopharyngeal (NP) respiratory pathogen panel (RPP) PCR test which includes enterovirus/rhinovirus as an analyte. METHODS A retrospective chart review was performed on 543 subjects, age 18 years or younger, who had enterovirus (EV) skin swabs performed at an academic medical center in New York City between September 2014 and November 2019. Those patients with positive EV skin PCR were considered to have an enteroviral skin infection, and those with a negative EV skin PCR were considered not to have an enteroviral skin infection. Of those 543 children who had EV skin PCR, 170 also had an NP swab RPP performed. These NP swab RPP results were characterized as positive or negative, and if positive, it was noted if the patient was positive or negative for enterovirus/rhinovirus. The positive predictive value (PPV), negative predictive value (NPV), specificity, and sensitivity of a NP swab RPP for enteroviral skin infection were then calculated. RESULTS An enterovirus/rhinovirus NP swab RPP had a NPV of 95%, PPV of 43%, sensitivity of 90%, and specificity of 62% for cutaneous enterovirus infection. CONCLUSION The enteroviral skin PCR test is an assay that was validated at this institution. In clinically suspicious cases of EV, a positive NP swab RPP for enterovirus/rhinovirus is a sensitive test. A negative test is highly predictive of not having EV on the skin. Although further data are needed, given that NP swab RPP is readily available, these data may suggest that an NP swab RPP, when appropriately utilized, can support or exclude a clinical diagnosis of cutaneous enterovirus in the pediatric population.
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Affiliation(s)
- Victoria A Perez
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Laura E Melnick
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Susan Whittier
- Departments of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - Peter S Dayan
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Maria C Garzon
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Kimberly D Morel
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Laura E Levin
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Christine T Lauren
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
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11
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Dolskiy AA, Grishchenko IV, Yudkin DV. Cell Cultures for Virology: Usability, Advantages, and Prospects. Int J Mol Sci 2020; 21:ijms21217978. [PMID: 33121109 PMCID: PMC7662242 DOI: 10.3390/ijms21217978] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022] Open
Abstract
Virus detection in natural and clinical samples is a complicated problem in research and diagnostics. There are different approaches for virus isolation and identification, including PCR, CRISPR/Cas technology, NGS, immunoassays, and cell-based assays. Following the development of genetic engineering methods, approaches that utilize cell cultures have become useful and informative. Molecular biology methods allow increases in the sensitivity and specificity of cell cultures for certain viruses and can be used to generate reporter cell lines. These cell lines express specific reporter proteins (e.g., GFP, luciferase, and CAT) in response to virus infection that can be detected in a laboratory setting. The development of genome editing and synthetic biology methods has given rise to new perspectives regarding the design of virus reporter systems in cell cultures. This review is aimed at describing both virology methods in general and examples of the development of cell-based methods that exist today.
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12
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Alhazmi A, Sane F, Lazrek M, Nekoua MP, Badia-Boungou F, Engelmann I, Alidjinou EK, Hober D. Enteroviruses and Type 1 Diabetes Mellitus: An Overlooked Relationship in Some Regions. Microorganisms 2020; 8:microorganisms8101458. [PMID: 32977495 PMCID: PMC7598226 DOI: 10.3390/microorganisms8101458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023] Open
Abstract
Enteroviruses (EVs) infect millions of people annually. EV infections can be asymptomatic or symptomatic with conditions ranging from mild illnesses to serious diseases such as dilated cardiomyopathy. A causal relationship between EV infections and type 1 diabetes mellitus (T1DM) has been heavily debated, with some studies suggesting that this relationship is not yet conclusive and requires additional evidence, whereas others strongly argue for this correlation. While this relationship is well investigated in some developed countries like the USA and Finland, it is understudied or neglected in other countries like Russia for many reasons such as the low incidence of T1DM. Although the Middle East and North Africa (MENA) are highly affected by T1DM, the role of EVs in the disease in MENA has not been investigated extensively. Therefore, we aimed to address the relationship between T1DM and EVs in MENA and other regions globally.
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Affiliation(s)
- Abdulaziz Alhazmi
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
- Microbiology and Parasitology Department, College of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Famara Sane
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Mouna Lazrek
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Magloire Pandoua Nekoua
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
- Laboratoire de Biologie et Physiologie Cellulaires, Institut des Sciences Biomédicales Appliquées (ISBA), Faculté des Sciences et Techniques (FAST), Université d’Abomey-Calavi, 01 BP 526 Cotonou, Benin
| | - Francis Badia-Boungou
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Ilka Engelmann
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Enagnon Kazali Alidjinou
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Didier Hober
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
- Correspondence: ; Tel.: +33-3-20-44-66-88
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13
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Alhazmi A, Lazrek M, Alidjinou EK, Engelmann I, Schuffenecker I, Dubos F, Hober D. Repeated viral meningitis in a newborn. J Neurovirol 2020; 26:449-451. [PMID: 32026339 DOI: 10.1007/s13365-020-00829-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/18/2019] [Accepted: 01/23/2020] [Indexed: 11/28/2022]
Abstract
Human enteroviruses (EV) are the most common cause of viral meningitis in children. Human parechoviruses (HPeV) are increasingly being recognized as a cause of central nervous system (CNS) infections and sepsis-like disease in children. Both viruses belong to Picornaviridae family. The clinical picture in EV and HPeV infections is usually nonspecific. Therefore, molecular detection of both viruses is needed for etiological diagnosis. In this case report, we describe and discuss clinical and laboratory findings of two consecutive episodes of viral meningitis caused by EV and HPeV, respectively, occurring in the first month of a newborn's life.
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Affiliation(s)
- Abdulaziz Alhazmi
- Univ Lille, CHU Lille, Laboratoire de Virologie EA3610, F-59037, Lille, France.,Univ Jazan, Microbiology Department, Jazan, Saudi Arabia
| | - Mouna Lazrek
- Univ Lille, CHU Lille, Laboratoire de Virologie EA3610, F-59037, Lille, France
| | | | - Ilka Engelmann
- Univ Lille, CHU Lille, Laboratoire de Virologie EA3610, F-59037, Lille, France
| | | | - Francois Dubos
- Univ Lille, CHU Lille, Urgences Pédiatriques et Maladies Infectieuses, F-59037, Lille, France
| | - Didier Hober
- Univ Lille, CHU Lille, Laboratoire de Virologie EA3610, F-59037, Lille, France.
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14
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Hudson JA, Broad J, Martin NG, Sadarangani M, Galal U, Kelly DF, Pollard AJ, Kadambari S. Outcomes beyond hospital discharge in infants and children with viral meningitis: A systematic review. Rev Med Virol 2019; 30:e2083. [PMID: 31524309 DOI: 10.1002/rmv.2083] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/18/2019] [Accepted: 08/27/2019] [Indexed: 12/27/2022]
Abstract
Viruses are the commonest cause of childhood meningitis, but outcomes beyond hospital discharge are poorly described. We undertook a systematic literature review of long-term outcomes following paediatric viral meningitis. A search was carried out using MEDLINE, Embase, and Cochrane Review for studies from 1 January 1990 to 31 December 2018. Studies were included where specific outcome measures were available beyond hospital discharge for children <16 years old with viral meningitis. In total, 3588 papers were identified of which 14 were eligible for inclusion. Four studies reported outcomes in children with nonenterovirus 71 meningitis. A US study of 16 cases demonstrated subtle language difficulties at 3-year follow-up in infants in contrast to an Australian study, which revealed no impairment in language. A Fijian study showed that two out of eight cases had sensorineural hearing loss compared with none in a UK cohort of 668 infants. Three studies evaluated outcomes of enterovirus 71 meningitis in China and Taiwan, two showed cases recovered without sequelae, while one demonstrated an increased risk of attention deficit hyperactivity disorder. Two studies including 141 cases of human parechovirus revealed no evidence of neurodevelopmental sequelae. Conversely, an Australian study demonstrated neurodevelopmental sequelae in 11 out of 77 infants with parechovirus meningitis. Most studies identified in this review demonstrated a high proportion of good clinical outcomes following viral meningitis. However, the data are limited, so robustly conducted neurodevelopmental studies are warranted to inform the evidence-based management of viral meningitis beyond hospital discharge.
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Affiliation(s)
- Jessica A Hudson
- Department of Public Health, John Radcliffe Hospital, Oxford, UK
| | - Jonathan Broad
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Natalie G Martin
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Ushma Galal
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Dominic F Kelly
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Seilesh Kadambari
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
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15
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Ko Y, Jeon W, Chae MK, Yang H, Lee J. Clinical characteristics of enteroviral meningitis without pleocytosis in children: a retrospective single center observational study in the Republic of Korea. BMC Pediatr 2019; 19:335. [PMID: 31521164 PMCID: PMC6744706 DOI: 10.1186/s12887-019-1714-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/09/2019] [Indexed: 12/02/2022] Open
Abstract
Background We aimed to study the prevalence of enterovirus (EV) meningitis without the presence of cerebrospinal fluid (CSF) pleocytosis and identify patient factors and clinical features associated with it. Methods This was a retrospective analysis of patients aged < 18 years old who were diagnosed with EV meningitis by CSF reverse-transcriptase polymerase chain reaction (RT-PCR) testing between January 2015 and December 2016. Clinical variables were compared with regard to the presence of CSF pleocytosis. Results A total of 305 patients were enrolled in study; 169 (55.4%) had no pleocytosis. Patients without pleocytosis were younger (median age 2 months vs. 67.0 months, p < 0.01) and had lower white blood cell (WBC) count (median, 8600/mm3 vs. 10,300/mm3, p < 0.01). Also absolute neutrophil (ANC) count were lower than pleocytosis group (median, 4674/mm3 vs. 7600/mm3, p < 0.01). Comparing three age groups, CSF apleocytosis was present in 106 of 128 patients (82.8%) aged ≤3 months, 7 of 13 patients (53.8%) aged 3 months–3 years and 56 of 164 patients (34.1%) aged > 3 years. Younger age groups had higher prevalence of CSF apleocytosis (p < 0.01). In patients aged ≤3 months, 94.5% underwent lumbar puncture within 24 h of symptom onset. The frequency of not having pleocytosis was higher than the frequency of having pleocytosis during peak EV infection prevalent months (summer and fall) (p < 0.01). Conclusion This study shows that EV meningitis in young infants, with early lumbar puncture, or occurring during peak EV meningitis prevalent seasons cannot be solely excluded by pleocytosis. Also, a confirmation test for EV meningitis should be performed using RT-PCR.
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Affiliation(s)
- Yura Ko
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Woochan Jeon
- Department of Emergency Medicine, Inje University, Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Minjung Kathy Chae
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Heewon Yang
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jisook Lee
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
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16
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de Crom SC. Enterovirus and parechovirus infections in children: differences in clinical presentation, mechanisms for meningitis without pleocytosis and mechanisms involved in the neurological outcome. Minerva Pediatr 2018; 71:150-158. [PMID: 30511561 DOI: 10.23736/s0026-4946.18.05449-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Enterovirus (EV) and Parechovirus (HPeV) are a frequent cause of infection in children. This review gives an overview of possible causes for differences in clinical presentation. EV and HPeV can cause a meningitis with or without pleocytosis. Different possible mechanisms for meningitis without pleocytosis are given. Little is known about the prognosis and long-term effects of EV and HPeV meningitis in children. Only some studies with a small number of children with EV or HPeV meningitis are reported. The different possible mechanisms involved in the neurological outcome after EV or HPeV meningitis will be discussed.
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17
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Micafungin is a novel anti-viral agent of chikungunya virus through multiple mechanisms. Antiviral Res 2018; 159:134-142. [DOI: 10.1016/j.antiviral.2018.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/23/2018] [Accepted: 10/05/2018] [Indexed: 12/31/2022]
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18
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Song JY, Nam SO, Kim YA, Kim KM, Lyu SY, Ko A, Kim YM, Yeon GM, Lee YJ. Cerebrospinal fluid non-pleocytosis in pediatric enteroviral meningitis: Large-scale review. Pediatr Int 2018; 60:855-861. [PMID: 29998580 DOI: 10.1111/ped.13658] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 06/26/2018] [Accepted: 07/10/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Lack of cerebrospinal fluid (CSF) pleocytosis has been reported in some children with enteroviral meningitis (EVM). The aim of this paper was to investigate the clinical spectrum and related factors in EVM with CSF non-pleocytosis. METHODS The databases of children diagnosed with EVM on CSF polymerase chain reaction between 2011 and 2014 were retrospectively reviewed. CSF pleocytosis was defined at each age using the criteria. Clinical and laboratory variables were compared between patients with CSF pleocytosis and non-pleocytosis. RESULTS Of the 802 children of EVM, 25.4% (204/802) had CSF non-pleocytosis. In particular, CSF non-pleocytosis was found in 63.3% of the neonates versus in 22.2% of the children aged ≥1 year old, indicating that the ratio of CSF non-pleocytosis had a negative correlation with age (P < 0.001). As the main symptoms, fever (91.8% vs 86.8%, P = 0.038), headache (80.3% vs 63.7%, P < 0.001), and vomiting (75.9% vs 61.8%, P < 0.001) were significantly more frequent in CSF pleocytosis than in CSF non-pleocytosis. Patients with CSF non-pleocytosis had much lower peripheral leukocytosis (10 656 ± 3,662 vs 12 403 ± 4,207/mm3 , P = 0.014) and C-reactive protein (0.7±0.8 vs 1.2±1.5 mg/dL, P < 0.001), and earlier lumbar puncture <24 h after onset (42.6% vs 21.4%, p<0.001). No significant difference during the summer and autumn months was seen between the two groups (76.9% vs 81.9%, P = 0.169). CONCLUSION CSF non-pleocytosis in childhood EVM was frequently observed, especially in young infants, regardless of season. We propose that CSF PCR testing for enterovirus can be helpful to recognize EVM in children with CSF non-pleocytosis.
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Affiliation(s)
- Ji Yeon Song
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Ook Nam
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young A Kim
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kyung Min Kim
- Department of Pediatrics, Good Gang-An Hospital, Busan, Korea
| | - Soo Young Lyu
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Ara Ko
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Mi Kim
- Department of Pediatrics, Pusan National University Hospital, Busan, Korea
| | - Gyu Min Yeon
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University, Busan, Korea
| | - Yun-Jin Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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19
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Hung TH, Chen VCH, Yang YH, Tsai CS, Lu ML, McIntyre RS, Lee Y, Huang KY. Association between enterovirus infection and speech and language impairments: A nationwide population-based study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 77:76-86. [PMID: 29705533 DOI: 10.1016/j.ridd.2018.04.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND AIMS Delay and impairment in Speech and language are common developmental problems in younger populations. Hitherto, there has been minimal study of the association between common childhood infections (e.g. enterovirus [EV]) and speech and language. The impetus for evaluating this association is provided by evidence linking inflammation to neurodevelopmental disorders. Herein we sought to determine whether an association exists between EV infection and subsequent diagnoses of speech and language impairments in a nationwide population-based sample in Taiwan. METHODS Our study acquired data from the Taiwan National Health Insurance Research Database. The sample was comprised of individuals under 18 years of age with newly diagnosed EV infection during the period from January 1998 to December 2011. 39669 eligible cases were compared to matched controls and assessed during the study period for incident cases of speech and language impairments. Cox regression analyses were applied, adjusting for sex, age and other physical and mental problems. RESULTS In the fully adjusted Cox regression model for hazard ratios, EV infection as positively associated with speech and language impairments (HR = 1.14, 95% CI: 1.06-1.22) after adjusting for age, sex and other confounds. Compared to the control group, the hazard ratio for speech and language impairments was 1.12 (95% CI: 1.03-1.21) amongst the group of EV infection without hospitalization, and 1.26 (95% CI: 1.10-1.45) amongst the group of EV infection with hospitalization. CONCLUSIONS EV infection is temporally associated with incident speech and language impairments. Our findings herein provide rationale for educating families that EV infection may be associated with subsequent speech and language problems in susceptible individuals and that monitoring for such a presentation would be warranted. WHAT THIS PAPER ADDS?: Speech and language impairments associated with central nervous system infections have been reported in the literature. EV are medically important human pathogens and associated with select neuropsychiatric diseases. Notwithstanding, relatively few reports have mentioned the effects of EV infection on speech and language problems. Our study used a nationwide longitudinal dataset and identified that children with EV infection have a greater risk for speech and language impairments as compared with control group. Infected children combined other comorbidities or risk factors might have greater possibility to develop speech problems. Clinicians should be vigilant for the onset of language developmental abnormalities of preschool children with EV infection.
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Affiliation(s)
- Tai-Hsin Hung
- Department of Psychiatry, Chang Gung Memorial Hospital and University, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital and University, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Hsu Yang
- Department for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Ching-Shu Tsai
- Department of Psychiatry, Chang Gung Memorial Hospital and University, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan-Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Kuo-You Huang
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University and Hospital, Taichung, Taiwan.
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Lee K, Kim DE, Jang KS, Kim SJ, Cho S, Kim C. Gemcitabine, a broad-spectrum antiviral drug, suppresses enterovirus infections through innate immunity induced by the inhibition of pyrimidine biosynthesis and nucleotide depletion. Oncotarget 2017; 8:115315-115325. [PMID: 29383162 PMCID: PMC5777774 DOI: 10.18632/oncotarget.23258] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 12/05/2017] [Indexed: 11/25/2022] Open
Abstract
Gemcitabine, an anti-cancer chemotherapy drug, has additionally shown the antiviral activity against a broad range of viruses and we also have previously reported its synergistic antiviral activity with ribavirin against enteroviruses. As a cytidine analog, gemcitabine has been reported to have an inhibitory activity on the pyrimidine biosynthesis. In addition, a few inhibitors of the pyrimidine biosynthesis have shown to induce the innate immunity in a yet-to-be-determined manner and inhibit the virus infection. Thus, we also investigated whether the anti-enteroviral activity of gemcitabine is mediated by innate immunity, induction of which is related with the inhibition of the pyrimidine synthesis. In this study, we found that the addition of exogenous cytidine, uridine and uridine mono-phosphate (UMP) effectively reversed the antiviral activity of gemcitabine in enterovirus-infected as well as enteroviral replicon-harboring cells, demonstrating gemcitabine's targeting of the salvage pathway. Moreover, the expression of several interferon (IFN)-stimulated genes (ISGs) was significantly induced by the treatment of gemcitabine, which was also suppressed by the co-treatment with cytidine. These results suggest that the antiviral activity of gemcitabine involves ISGs induced by the inhibition of the pyrimidine biosynthesis.
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Affiliation(s)
- Kyungjin Lee
- Center for Convergent Research of Emerging Virus Infection, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Dong-Eun Kim
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea
| | - Kyoung-Soon Jang
- Biomedical Omics Group, Korea Basic Science Institute, Cheongju, South Korea
| | - Seong-Jun Kim
- Center for Convergent Research of Emerging Virus Infection, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Sungchan Cho
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea.,Department of Biomolecular Science, KRIBB School of Bioscience, Korea University of Science and Technology, Daejeon, South Korea
| | - Chonsaeng Kim
- Center for Convergent Research of Emerging Virus Infection, Korea Research Institute of Chemical Technology, Daejeon, South Korea.,Department of Medicinal and Pharmaceutical Chemistry, Korea University of Science and Technology, Daejeon, South Korea
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21
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Abstract
Enteroviral encephalitis in children has been rarely described from Western India. We describe a 5½-year-old child with Coxsackie encephalitis.
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Affiliation(s)
- Ira Shah
- Department of Pediatrics, B. J. Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Hemant Ambulkar
- Department of Pediatrics, B. J. Wadia Hospital for Children, Mumbai, Maharashtra, India
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Sullivan KE, Bassiri H, Bousfiha AA, Costa-Carvalho BT, Freeman AF, Hagin D, Lau YL, Lionakis MS, Moreira I, Pinto JA, de Moraes-Pinto MI, Rawat A, Reda SM, Reyes SOL, Seppänen M, Tang MLK. Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies. J Clin Immunol 2017; 37:650-692. [PMID: 28786026 PMCID: PMC5693703 DOI: 10.1007/s10875-017-0426-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/21/2017] [Indexed: 12/18/2022]
Abstract
In today's global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.
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Affiliation(s)
- Kathleen E Sullivan
- Division of Allergy and Immunology, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Hamid Bassiri
- Division of Infectious Diseases and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3501 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Ahmed A Bousfiha
- Clinical Immunology Unit, Infectious Department, Hopital d'Enfant Abderrahim Harouchi, CHU Ibn Rochd, Laboratoire d'Immunologie Clinique, d'Inflammation et d'Allergie LICIA, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Morocco
| | - Beatriz T Costa-Carvalho
- Department of Pediatrics, Federal University of São Paulo, Rua dos Otonis, 725, São Paulo, SP, 04025-002, Brazil
| | - Alexandra F Freeman
- NIAID, NIH, Building 10 Room 12C103, 9000 Rockville, Pike, Bethesda, MD, 20892, USA
| | - David Hagin
- Division of Allergy and Immunology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, 6 Weizmann St, 64239, Tel Aviv, Israel
| | - Yu L Lau
- Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Rm 106, 1/F New Clinical Building, Pok Fu Lam, Hong Kong.,Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong
| | - Michail S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy & Infectious Diseases (NIAID), National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 11C102, Bethesda, MD, 20892, USA
| | - Ileana Moreira
- Immunology Unit, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, 1425, Buenos Aires, Argentina
| | - Jorge A Pinto
- Division of Immunology, Department of Pediatrics, Federal University of Minas Gerais, Av. Alfredo Balena 190, room # 161, Belo Horizonte, MG, 30130-100, Brazil
| | - M Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Federal University of São Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil
| | - Amit Rawat
- Pediatric Allergy and Immunology, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shereen M Reda
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Saul Oswaldo Lugo Reyes
- Immunodeficiencies Research Unit, National Institute of Pediatrics, Av Iman 1, Torre de Investigacion, Piso 9, Coyoacan, 04530, Mexico City, Mexico
| | - Mikko Seppänen
- Harvinaissairauksien yksikkö (HAKE), Rare Disease Center, Helsinki University Hospital (HUH), Helsinki, Finland
| | - Mimi L K Tang
- Murdoch Children's Research Institute, The Royal Children's Hospital, University of Melbourne, Melbourne, Australia
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Wang CR. Role and evolution trend of multiple enteroviruses in epidemic of hand, foot and mouth disease. Shijie Huaren Xiaohua Zazhi 2016; 24:4029-4039. [DOI: 10.11569/wcjd.v24.i29.4029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There are a variety of enteroviruses (EV) that can cause hand, foot and mouth disease (HFMD), and the major pathogens include enterovirus 71 (EV71) and coxasckievirus A16 (CVA16). EV71 and CVA16 have attracted much attention for their high prevalence and pathogenicity, and disease surveillance and vaccine development are mainly concentrated on them. EV71 can cause serious harm to children with HFMD, especially the damage to the nervous system such as aseptic meningitis, brain stem encephalitis and paralytic disease, or even lead to death. However, in recent years, due to the epidemic of EV71 and CVA16, people have established an immune barrier through natural infection in a certain degree. Although there is no cross protection between types, the immune protection against the relevant type can persist for a long time. Thus, the number of HFMD cases caused by EV71 and CVA16 shows a decreasing trend, while the epidemic of HFMD caused by other EV exhibits an upward trend. Further studies found that non-EV71 and non-CVA16 EV are very complex, and there are also differences in EV prevalence each year, which makes the development, evolution and control of HFMD become complicated. At present, there is no enough attention paid to the sporadic virus in the HFMD epidemic, and a complete research system for non-EV71 and non-CVA16 EV has not formed. Therefore, it is necessary to strengthen the monitoring of multiple non-EV71 and non-CVA16 EV, further investigate their pathogenicity and genetic characteristics, and evaluate the relative frequency and biological hazard of infection. In this review, we summarize a variety of EV changes, molecular evolution, as well as typical epidemics, which may provide clues to the development of antiviral drugs and vaccines, and prevention and control of HFMD.
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24
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Fout GS, Cashdollar JL. EPA Method 1615. Measurement of Enterovirus and Norovirus Occurrence in Water by Culture and RT-qPCR. II. Total Culturable Virus Assay. J Vis Exp 2016:52437. [PMID: 27684193 PMCID: PMC5092008 DOI: 10.3791/52437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A standardized method is required when national studies on virus occurrence in environmental and drinking waters utilize multiple analytical laboratories. The U.S Environmental Protection Agency's (USEPA) Method 1615 was developed with the goal of providing such a standard for measuring Enterovirus and Norovirus in these waters. Virus is concentrated from water using an electropositive filter, eluted from the filter surface with beef extract, and then concentrated further using organic flocculation. Herein we present the protocol from Method 1615 for filter elution, secondary concentration, and measurement of total culturable viruses. A portion of the concentrated eluate from each sample is inoculated onto ten replicate flasks of Buffalo Green Monkey kidney cells. The number of flasks demonstrating cytopathic effects is used to quantify the most probable number (MPN) of infectious units per liter. The method uses a number of quality controls to increase data quality and to reduce interlaboratory and intralaboratory variation. Laboratories must meet defined performance standards. Method 1615 was evaluated by examining virus recovery from reagent-grade and ground waters seeded with Sabin poliovirus type 3. Mean poliovirus recoveries with the total culturable assay were 111% in reagent grade water and 58% in groundwaters.
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Affiliation(s)
- G Shay Fout
- National Exposure Research Laboratory, U.S. Environmental Protection Agency;
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25
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de Crom SCM, Rossen JWA, van Furth AM, Obihara CC. Enterovirus and parechovirus infection in children: a brief overview. Eur J Pediatr 2016; 175:1023-9. [PMID: 27156106 PMCID: PMC4930465 DOI: 10.1007/s00431-016-2725-7] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/25/2016] [Accepted: 04/18/2016] [Indexed: 02/07/2023]
Abstract
UNLABELLED Enterovirus and parechovirus are a frequent cause of infection in children. This review is an overview of what is known from enterovirus and parechovirus infection in children and contains information about the epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of enterovirus and parechovirus infection in children. CONCLUSIONS EV and HPeV infections are a frequent cause of infection in childhood. The clinical presentation is diverse. RT-qPCR is the best way to detect an EV or HPeV. Cerebrospinal fluid, blood and feces have the highest sensitivity for detecting an EV or HPeV. There is no treatment for EV and HPeV infections. Two vaccines against EV 71 are just licensed in China and will be available on the private market. Little is known about the prognosis of EV and HPeV infections. WHAT IS KNOWN •EV and HPeV are a frequent cause of infection in children. What is new: •This review gives a brief overview over EV and HPeV infection in children.
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Affiliation(s)
- S C M de Crom
- Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands.
- Department of Pediatrics, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
| | - J W A Rossen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A M van Furth
- Department of Pediatric Infectious Diseases Immunology and Rheumatology, VU Medical Centre, Amsterdam, The Netherlands
| | - C C Obihara
- Department of Pediatrics, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
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Kim C, Kang H, Kim DE, Song JH, Choi M, Kang M, Lee K, Kim HS, Shin JS, Jeong H, Jung S, Han SB, Kim JH, Ko HJ, Lee CK, Kim M, Cho S. Antiviral activity of micafungin against enterovirus 71. Virol J 2016; 13:99. [PMID: 27296985 PMCID: PMC4907259 DOI: 10.1186/s12985-016-0557-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/07/2016] [Indexed: 12/30/2022] Open
Abstract
Background Enterovirus 71 (EV71) is a major causative agent of hand-foot-mouth disease (HFMD) and also causes severe neurological complications, leading to fatality in young children. However, no effective therapy is currently available for the treatment of this infection. Methods We identified small-molecule inhibitors of EV71 from a screen of 968 Food and Drug Administration (FDA)-approved drugs, with which clinical application for EV71-associated diseases would be more feasible, using EV71 subgenomic replicon system. Primary hits were extensively evaluated for their antiviral activities in EV71-infected cells. Results We identified micafungin, an echinocandin antifungal drug, as a novel inhibitor of EV71. Micafungin potently inhibits the proliferation of EV71 as well as the replication of EV71 replicon in cells with a low micromolar IC50 (~5 μM). The strong antiviral effect of micafungin on EV71 replicon and the result from time-of-addition experiment demonstrated a targeting of micafungin on virion-independent intracellular process(es) during EV71 infection. Moreover, an extensive analysis excluded the involvement of 2C and 3A proteins, IRES-dependent translation, and also that of polyprotein processing in the antiviral effect of micafungin. Conclusions Our research revealed a new indication of micafungin as an effective inhibitor of EV71, which is the first case reporting antiviral activity of micafungin, an antifungal drug. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0557-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chonsaeng Kim
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, South Korea
| | - Hyunju Kang
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea.,College of Pharmacy, Chungbuk National University, 1 Chungdae-ro Seowon-gu, Cheongju-si, Chungcheongbuk-do, 28644, South Korea
| | - Dong-Eun Kim
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea.,College of Pharmacy, Chungbuk National University, 1 Chungdae-ro Seowon-gu, Cheongju-si, Chungcheongbuk-do, 28644, South Korea
| | - Jae-Hyoung Song
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do, 24341, South Korea
| | - Miri Choi
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea
| | - Mingu Kang
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea
| | - Kyungjin Lee
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, South Korea
| | - Hae Soo Kim
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, South Korea
| | - Jin Soo Shin
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, South Korea
| | - Hyejeong Jeong
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea
| | - Sunhee Jung
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea
| | - Sang-Bae Han
- College of Pharmacy, Chungbuk National University, 1 Chungdae-ro Seowon-gu, Cheongju-si, Chungcheongbuk-do, 28644, South Korea
| | - Jong Heon Kim
- Cancer Cell and Molecular Biology Branch, Research Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, South Korea
| | - Hyun-Jeong Ko
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do, 24341, South Korea
| | - Chong-Kyo Lee
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, South Korea
| | - Meehyein Kim
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, South Korea
| | - Sungchan Cho
- Anticancer Agent Research Center, Korea Research Institute of Bioscience & Biotechnology, 30 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, 28116, South Korea. .,Department of Biomolecular Science, Korea University of Science and Technology, 217 Gajeong-ro, Daejeon, 34113, South Korea.
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Tsai CS, Yang YH, Huang KY, Lee Y, McIntyre RS, Chen VCH. Association of Tic Disorders and Enterovirus Infection: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3347. [PMID: 27082591 PMCID: PMC4839835 DOI: 10.1097/md.0000000000003347] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
There has been growing interest in the association between infectious disease and mental disorders, but an association between enterovirus (EV) infection and tic disorders has not been sufficiently explored. Herein, we aim to investigate the association between EV infection and incidence of tic disorders in a nationwide population-based sample using Taiwan's National Health Insurance Research Database. We identified individuals aged ≤18 years prior to 2005 with an inpatient diagnosis of EV infection and/or history of EV infection. Tic disorder was operationalized using International Classification of Disease, Revision 9, Clinical Modification (ICD-9-CM) codes 307.20-307.23. A total of 47,998 individuals with history of EV infection were compared to 47,998 sex-, age-, and urbanization-matched controls on incidence of tic disorders. The mean ± standard deviation follow-up period for all subjects was 9.7 ± 3.6 years; the mean latency period between initial EV infection and incident diagnosis of tic disorder diagnosis was 5.4 ± 2.8 years. EV infection was significantly associated with greater incidence of tic disorders (hazard ratio [HR] = 1.24, 95% CI: 1.07-1.45). When subgrouped on the basis of central nervous system (CNS) involvement, EV infection with CNS involvement was not significantly associated with greater incidence of tic disorders when compared to controls (HR = 1.25, 95% CI: 0.64-2.43); EV infection without CNS involvement was significantly associated greater incidence of tic disorders when compared to controls (HR = 1.24, 95% CI: 1.07-1.45). In addition, hospitalization for an EV infection did not increase the hazard for greater incidence of tic disorders (HR = 1.32, 95% CI: 1.04-1.67 with hospitalization and 1.22, 95% CI: 1.04-1.44 without hospitalization). EV infection is temporally associated with incidence of tic disorders. Our observations add to the growing body of literature implicating immune-inflammatory system in the pathoetiology of brain disorders in a subpopulation of individuals and serve as a clarion call for surveillance of symptoms suggestive of tic disorders in individuals with history of EV infection.
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Affiliation(s)
- Ching-Shu Tsai
- From the Department of Psychiatry, Chang Gung Memorial Hospital and University, Chiayi (C-ST, VC-HC); Graduate Institute of Clinical Medical Sciences, Chang Gung University (C-ST, VC-HC); Chang Gung Institute of Technology, Taoyuan (C-ST); Department for Traditional Chinese Medicine (Y-HY); Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi (Y-HY); Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei (Y-HY), Department of Speech, Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan (K-YH); and Department of Psychiatry, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network (YL, RSM), Toronto, Ontario, Canada
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28
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Balasubramanian H, Wagh D, Rao S, Keil AD, McMichael J. Developmental outcomes in cerebrospinal fluid proven enteroviral meningitis in neonates > 32 weeks of gestation. J Paediatr Child Health 2016; 52:327-32. [PMID: 27124842 DOI: 10.1111/jpc.13083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 08/16/2015] [Accepted: 08/31/2015] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study is to assess the short-term and long-term (1 year) outcomes of cerebrospinal fluid (CSF) confirmed enteroviral meningitis in neonates > 32 weeks of gestation. METHODS A retrospective audit of neonates admitted between 1 July 2002 to 30 June 2012. RESULTS Thirty-three neonates were diagnosed with enteroviral meningitis based on a positive CSF enteroviral PCR. Physical growth and neurodevelopmental outcomes at 1 year corrected for prematurity were available for 24 infants. All infants were alive at 1 year. The median weight, length and head circumference at 1 year were in the 72nd, 62nd and 78th centile and were comparable with the birth parameters. The mean general quotient (GQ) was 98.5 (SD 7.1) and was not significantly different from the population mean of 100.2 (P = 0.27). None of the infants had a GQ > 2SD below the population mean. Neurological recovery was complete in the 24 neonates assessed except one, who developed cerebral palsy, epilepsy and progressive hydrocephalus requiring ventriculoperitoneal shunt at 1 year. CONCLUSION Neonatal enteroviral meningitis was associated with optimal growth and neurodevelopment in the majority of the infants at 1 year corrected for prematurity. Longer term studies are needed to better define developmental outcomes.
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Affiliation(s)
- Haribalakrishna Balasubramanian
- Department of Neonatology, Princess Margaret Hospital for Children, Perth, Australia.,Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Australia
| | - Deepika Wagh
- Department of Neonatology, Princess Margaret Hospital for Children, Perth, Australia.,Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Australia.,Centre for Neonatal Research and Education, School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Shripada Rao
- Department of Neonatology, Princess Margaret Hospital for Children, Perth, Australia.,Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Australia.,Centre for Neonatal Research and Education, School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Anthony D Keil
- PathWest Laboratory Medicine WA, Princess Margaret Hospital for Children
| | - Judy McMichael
- Department of Neonatology, Princess Margaret Hospital for Children, Perth, Australia.,Child Development, Princess Margaret Hospital for Children, Perth, Australia.,Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Australia
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30
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Kang H, Kim C, Kim DE, Song JH, Choi M, Choi K, Kang M, Lee K, Kim HS, Shin JS, Kim J, Han SB, Lee MY, Lee SU, Lee CK, Kim M, Ko HJ, van Kuppeveld FJM, Cho S. Synergistic antiviral activity of gemcitabine and ribavirin against enteroviruses. Antiviral Res 2015; 124:1-10. [PMID: 26526589 DOI: 10.1016/j.antiviral.2015.10.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/25/2015] [Accepted: 10/10/2015] [Indexed: 12/21/2022]
Abstract
Enteroviruses are major causative agents of various human diseases, and some of them are currently considered to be an enormous threat to public health. However, no effective therapy is currently available for the treatment of these infections. We identified gemcitabine, a nucleoside-analog drug used for cancer treatment, from a screen of bioactive chemicals as a novel inhibitor of coxsackievirus B3 (CVB3) and enterovirus 71 (EV71). Gemcitabine potently inhibited the proliferation of CVB3 and EV71, as well as the replication of CVB3 and EV71 replicons, in cells with a low micromolar IC50 (1-5 μM). Its strong inhibitory effect was also observed in cells infected with human rhinoviruses, demonstrating broad-spectrum antiviral effects on enteroviruses. Mechanistically, an extensive analysis excluded the involvement of 2C, 3A, IRES-dependent translation, and also that of polyprotein processing in the antiviral effects of gemcitabine. Importantly, gemcitabine in combination with ribavirin, an antiviral drug currently being used against a few RNA viruses, exhibited a synergistic antiviral effect on the replication of CVB3 and EV71 replicons. Consequently, our results clearly demonstrate a new indication for gemcitabine as an effective broad-spectrum inhibitor of enteroviruses and strongly suggest a new therapeutic strategy using gemcitabine alone or in combination with ribavirin for the treatment of various diseases associated with enterovirus infection.
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Affiliation(s)
- Hyunju Kang
- Incurable Diseases Therapeutics Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea; College of Pharmacy, Chungbuk National University, Cheongju, South Korea
| | - Chonsaeng Kim
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Dong-eun Kim
- Incurable Diseases Therapeutics Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea; College of Pharmacy, Chungbuk National University, Cheongju, South Korea
| | - Jae-Hyoung Song
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
| | - Miri Choi
- Incurable Diseases Therapeutics Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea; College of Pharmacy, Chungbuk National University, Cheongju, South Korea
| | - Kwangman Choi
- Incurable Diseases Therapeutics Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea; Department of Medical Science, Soonchunhyang University, Asan, South Korea
| | - Mingu Kang
- Incurable Diseases Therapeutics Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea
| | - Kyungjin Lee
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Hae Soo Kim
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Jin Soo Shin
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Janghwan Kim
- Stem Cell Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon, South Korea
| | - Sang-Bae Han
- College of Pharmacy, Chungbuk National University, Cheongju, South Korea
| | - Mi-Young Lee
- Department of Medical Science, Soonchunhyang University, Asan, South Korea
| | - Su Ui Lee
- Natural Medicine Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea
| | - Chong-Kyo Lee
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Meehyein Kim
- Virus Research and Testing Center, Korea Research Institute of Chemical Technology, Daejeon, South Korea
| | - Hyun-Jeong Ko
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
| | - Frank J M van Kuppeveld
- Section of Virology, Department Infectious Diseases & Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Sungchan Cho
- Incurable Diseases Therapeutics Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheongju, South Korea; Department of Biomolecular Science, Korea University of Science and Technology, Daejeon, South Korea.
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31
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Sin J, Mangale V, Thienphrapa W, Gottlieb RA, Feuer R. Recent progress in understanding coxsackievirus replication, dissemination, and pathogenesis. Virology 2015; 484:288-304. [PMID: 26142496 DOI: 10.1016/j.virol.2015.06.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/23/2015] [Accepted: 06/03/2015] [Indexed: 01/01/2023]
Abstract
Coxsackieviruses (CVs) are relatively common viruses associated with a number of serious human diseases, including myocarditis and meningo-encephalitis. These viruses are considered cytolytic yet can persist for extended periods of time within certain host tissues requiring evasion from the host immune response and a greatly reduced rate of replication. A member of Picornaviridae family, CVs have been historically considered non-enveloped viruses - although recent evidence suggest that CV and other picornaviruses hijack host membranes and acquire an envelope. Acquisition of an envelope might provide distinct benefits to CV virions, such as resistance to neutralizing antibodies and efficient nonlytic viral spread. CV exhibits a unique tropism for progenitor cells in the host which may help to explain the susceptibility of the young host to infection and the establishment of chronic disease in adults. CVs have also been shown to exploit autophagy to maximize viral replication and assist in unconventional release from target cells. In this article, we review recent progress in clarifying virus replication and dissemination within the host cell, identifying determinants of tropism, and defining strategies utilized by the virus to evade the host immune response. Also, we will highlight unanswered questions and provide future perspectives regarding the potential mechanisms of CV pathogenesis.
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Affiliation(s)
- Jon Sin
- Cedars-Sinai Heart Institute, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Vrushali Mangale
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA 92182-4614, USA
| | - Wdee Thienphrapa
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA 92182-4614, USA
| | - Roberta A Gottlieb
- Cedars-Sinai Heart Institute, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Ralph Feuer
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA 92182-4614, USA.
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Gaensbauer JT, Lindsey NP, Messacar K, Staples JE, Fischer M. Neuroinvasive arboviral disease in the United States: 2003 to 2012. Pediatrics 2014; 134:e642-50. [PMID: 25113294 PMCID: PMC5662468 DOI: 10.1542/peds.2014-0498] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To describe the epidemiologic and clinical syndromes associated with pediatric neuroinvasive arboviral infections among children in the United States from 2003 through 2012. METHODS We reviewed data reported by state health departments to ArboNET, the national arboviral surveillance system, for 2003 through 2012. Children (<18 years) with neuroinvasive arboviral infections (eg, meningitis, encephalitis, or acute flaccid paralysis) were included. Demographic, clinical syndrome, outcome, geographic, and temporal data were analyzed for all cases. RESULTS During the study period, 1217 cases and 22 deaths due to pediatric neuroinvasive arboviral infection were reported from the 48 contiguous states. La Crosse virus (665 cases; 55%) and West Nile virus (505 cases; 41%) were the most common etiologies identified. Although less common, Eastern equine encephalitis virus (30 cases; 2%) resulted in 10 pediatric deaths. La Crosse virus primarily affected younger children, whereas West Nile virus was more common in older children and adolescents. West Nile virus disease cases occurred throughout the country, whereas La Crosse and the other arboviruses were more focally distributed. CONCLUSIONS Neuroinvasive arboviral infections were an important cause of pediatric disease from 2003 through 2012. Differences in the epidemiology and clinical disease result from complex interactions among virus, vector, host, and the environment. Decreasing the morbidity and mortality from these agents depends on vector control, personal protection to reduce mosquito and tick bites, and blood donor screening. Effective surveillance is critical to inform clinicians and public health officials about the epidemiologic features of these diseases and to direct prevention efforts.
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Affiliation(s)
- James T. Gaensbauer
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Nicole P. Lindsey
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Kevin Messacar
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - J. Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Marc Fischer
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
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Marques F, Brito MJ, Conde M, Pinto M, Moreira A. Autism spectrum disorder secondary to enterovirus encephalitis. J Child Neurol 2014; 29:708-14. [PMID: 24782421 DOI: 10.1177/0883073813508314] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Millions of children are infected by enteroviruses each year, usually exhibiting only mild symptoms. Nevertheless, these viruses are also associated with severe and life-threatening infections, such as meningitis and encephalitis. We describe a 32-month-old patient with enteroviral encephalitis confirmed by polymerase chain reaction in cerebrospinal fluid, with unfavorable clinical course with marked developmental regression, autistic features, persistent stereotypes and aphasia. She experienced slow clinical improvement, with mild residual neurologic and developmental deficits at follow-up. Viral central nervous system infections in early childhood have been associated with autism spectrum disorders but the underlying mechanisms are still poorly understood. This case report is significant in presenting a case of developmental regression with autistic features and loss of language improving on follow-up. To our knowledge, this is the first published report of enterovirus encephalitis leading to an autism spectrum disorder.
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Affiliation(s)
- Filipa Marques
- 1Infectious Diseases Unit, Hospital Dona Estefânia, Centro Hospitalar Lisboa Central-EPE, Lisbon, Portugal
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Coxsackievirus B exits the host cell in shed microvesicles displaying autophagosomal markers. PLoS Pathog 2014; 10:e1004045. [PMID: 24722773 PMCID: PMC3983045 DOI: 10.1371/journal.ppat.1004045] [Citation(s) in RCA: 234] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 02/17/2014] [Indexed: 01/08/2023] Open
Abstract
Coxsackievirus B3 (CVB3), a member of the picornavirus family and enterovirus genus, causes viral myocarditis, aseptic meningitis, and pancreatitis in humans. We genetically engineered a unique molecular marker, “fluorescent timer” protein, within our infectious CVB3 clone and isolated a high-titer recombinant viral stock (Timer-CVB3) following transfection in HeLa cells. “Fluorescent timer” protein undergoes slow conversion of fluorescence from green to red over time, and Timer-CVB3 can be utilized to track virus infection and dissemination in real time. Upon infection with Timer-CVB3, HeLa cells, neural progenitor and stem cells (NPSCs), and C2C12 myoblast cells slowly changed fluorescence from green to red over 72 hours as determined by fluorescence microscopy or flow cytometric analysis. The conversion of “fluorescent timer” protein in HeLa cells infected with Timer-CVB3 could be interrupted by fixation, suggesting that the fluorophore was stabilized by formaldehyde cross-linking reactions. Induction of a type I interferon response or ribavirin treatment reduced the progression of cell-to-cell virus spread in HeLa cells or NPSCs infected with Timer-CVB3. Time lapse photography of partially differentiated NPSCs infected with Timer-CVB3 revealed substantial intracellular membrane remodeling and the assembly of discrete virus replication organelles which changed fluorescence color in an asynchronous fashion within the cell. “Fluorescent timer” protein colocalized closely with viral 3A protein within virus replication organelles. Intriguingly, infection of partially differentiated NPSCs or C2C12 myoblast cells induced the release of abundant extracellular microvesicles (EMVs) containing matured “fluorescent timer” protein and infectious virus representing a novel route of virus dissemination. CVB3 virions were readily observed within purified EMVs by transmission electron microscopy, and infectious virus was identified within low-density isopycnic iodixanol gradient fractions consistent with membrane association. The preferential detection of the lipidated form of LC3 protein (LC3 II) in released EMVs harboring infectious virus suggests that the autophagy pathway plays a crucial role in microvesicle shedding and virus release, similar to a process previously described as autophagosome-mediated exit without lysis (AWOL) observed during poliovirus replication. Through the use of this novel recombinant virus which provides more dynamic information from static fluorescent images, we hope to gain a better understanding of CVB3 tropism, intracellular membrane reorganization, and virus-associated microvesicle dissemination within the host. Enteroviruses are significant human pathogens, causing myocarditis, aseptic meningitis and encephalitis. The mechanisms of enterovirus dissemination in the host and cell-to-cell spread may be critical factors influencing viral pathogenesis. Here, we have generated a recombinant coxsackievirus expressing “fluorescence timer” protein (Timer-CVB3) which assists in following the progression of infection within the host. Unexpectedly, we observed the shedding of microvesicles containing virus in partially-differentiated progenitor cells infected with Timer-CVB3. These extracellular microvesicles (EMVs) were released in high levels following cellular differentiation, and may play a role in virus dissemination. Timer-CVB3 will be a valuable tool in monitoring virus spread in the infected host.
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Badoe E, Wilmshurst JM. An overview of the effect and epidemiology of viral central nervous system infections in African children. Semin Pediatr Neurol 2014; 21:26-9. [PMID: 24655401 DOI: 10.1016/j.spen.2014.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Viral infections in Africa are common. Polio still persists in the continent despite vaccination campaigns. Many of the common viral infections, such as by the nonpolio enteroviruses, lack effective therapies and leave devastating sequelae to infected neonates and infants. Rarer conditions, such as by West Nile virus, have generated a fascinating conundrum as to how the virus spread to other parts of the world, such as the United States of America. This infection illustrates that these conditions should not be considered isolated to Africa alone but that they represent examples of potentially lethal infections which, although predominantly found in Africa, have the capacity to spread wider afield.
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Affiliation(s)
- Eben Badoe
- Department of Child Health, University of Ghana Medical School, Accra, Ghana.
| | - Jo M Wilmshurst
- Department of Pediatric Neurology, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, South Africa
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Puccini JM, Ruller CM, Robinson SM, Knopp KA, Buchmeier MJ, Doran KS, Feuer R. Distinct neural stem cell tropism, early immune activation, and choroid plexus pathology following coxsackievirus infection in the neonatal central nervous system. J Transl Med 2014; 94:161-81. [PMID: 24378643 DOI: 10.1038/labinvest.2013.138] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 09/25/2013] [Accepted: 10/18/2013] [Indexed: 12/21/2022] Open
Abstract
Coxsackievirus B3 (CVB3) and lymphocytic choriomeningitis virus (LCMV) are both neurotropic RNA viruses, which can establish a persistent infection and cause meningitis and encephalitis in the neonatal host. Utilizing our neonatal mouse model of infection, we evaluated the consequences of early viral infection upon the host central nervous system (CNS) by comparing CVB3 and LCMV infection. Both viruses expressed high levels of viral protein in the choroid plexus and subventricular zone (SVZ), a region of neurogenesis. LCMV infected a greater number of cells in the SVZ and targeted both nestin(+) (neural progenitor cell marker) and olig2(+) (glial progenitor marker) cells at a relatively equal proportion. In contrast, CVB3 preferentially infected nestin(+) cells within the SVZ. Microarray analysis revealed differential kinetics and unique host gene expression changes for each infection. MHC class I gene expression, several developmental-related Hox genes, and transthyretin (TTR), a protein secreted in the cerebrospinal fluid by the choroid plexus, were specifically downregulated following CVB3 infection. Also, we identified severe pathology in the choroid plexus of CVB3-infected animals at 48 h post infection accompanied by a decrease in the level of TTR and carbonic anhydrase II. These results demonstrate broader neural progenitor and stem cell (NPSC) tropism for LCMV in the neonatal CNS, whereas CVB3 targeted a more specific subset of NPSCs, stimulated a distinct early immune response, and induced significant acute damage in the choroid plexus.
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Affiliation(s)
- Jenna M Puccini
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA, USA
| | - Chelsea M Ruller
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA, USA
| | - Scott M Robinson
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA, USA
| | - Kristeene A Knopp
- Department of Molecular Biology and Biochemistry, UC Irvine, Irvine, CA, USA
| | - Michael J Buchmeier
- Department of Molecular Biology and Biochemistry, UC Irvine, Irvine, CA, USA
| | - Kelly S Doran
- Department of Biology and Center for Microbial Sciences, San Diego State University, San Diego, CA, USA
| | - Ralph Feuer
- The Integrated Regenerative Research Institute (IRRI) at San Diego State University, Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA, USA
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37
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van der Schaar HM, Leyssen P, Thibaut HJ, de Palma A, van der Linden L, Lanke KHW, Lacroix C, Verbeken E, Conrath K, MacLeod AM, Mitchell DR, Palmer NJ, van de Poël H, Andrews M, Neyts J, van Kuppeveld FJM. A novel, broad-spectrum inhibitor of enterovirus replication that targets host cell factor phosphatidylinositol 4-kinase IIIβ. Antimicrob Agents Chemother 2013; 57:4971-81. [PMID: 23896472 PMCID: PMC3811463 DOI: 10.1128/aac.01175-13] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 07/19/2013] [Indexed: 12/22/2022] Open
Abstract
Despite their high clinical and socioeconomic impacts, there is currently no approved antiviral therapy for the prophylaxis or treatment of enterovirus infections. Here we report on a novel inhibitor of enterovirus replication, compound 1, 2-fluoro-4-(2-methyl-8-(3-(methylsulfonyl)benzylamino)imidazo[1,2-a]pyrazin-3-yl)phenol. This compound exhibited a broad spectrum of antiviral activity, as it inhibited all tested species of enteroviruses and rhinoviruses, with 50% effective concentrations ranging between 4 and 71 nM. After a lengthy resistance selection process, coxsackievirus mutants resistant to compound 1 were isolated that carried substitutions in their 3A protein. Remarkably, the same substitutions were recently shown to provide resistance to inhibitors of phosphatidylinositol 4-kinase IIIβ (PI4KIIIβ), a lipid kinase that is essential for enterovirus replication, suggesting that compound 1 may also target this host factor. Accordingly, compound 1 directly inhibited PI4KIIIβ in an in vitro kinase activity assay. Furthermore, the compound strongly reduced the PI 4-phosphate levels of the Golgi complex in cells. Rescue of coxsackievirus replication in the presence of compound 1 by a mutant PI4KIIIβ carrying a substitution in its ATP-binding pocket revealed that the compound directly binds the kinase at this site. Finally, we determined that an analogue of compound 1, 3-(3-fluoro-4-methoxyphenyl)-2-methyl-N-(pyridin-4-ylmethyl)imidazo[1,2-a]pyrazin-8-amine, is well tolerated in mice and has a dose-dependent protective activity in a coxsackievirus serotype B4-induced pancreatitis model.
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Affiliation(s)
- Hilde M. van der Schaar
- Department of Infectious Diseases and Immunology, Virology Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Pieter Leyssen
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Hendrik J. Thibaut
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Armando de Palma
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Lonneke van der Linden
- Department of Medical Microbiology, Nijmegen Centre for Molecular Life Sciences, and Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Kjerstin H. W. Lanke
- Department of Medical Microbiology, Nijmegen Centre for Molecular Life Sciences, and Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Céline Lacroix
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Erik Verbeken
- Translational Cell & Tissue Research, Department of Imaging & Pathology, University of Leuven, Leuven, Belgium
| | | | | | | | | | | | | | - Johan Neyts
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
| | - Frank J. M. van Kuppeveld
- Department of Infectious Diseases and Immunology, Virology Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Medical Microbiology, Nijmegen Centre for Molecular Life Sciences, and Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Xiao H, Guan D, Chen R, Chen P, Monagin C, Li W, Su J, Ma C, Zhang W, Ke C. Molecular characterization of echovirus 30-associated outbreak of aseptic meningitis in Guangdong in 2012. Virol J 2013; 10:263. [PMID: 23968330 PMCID: PMC4016494 DOI: 10.1186/1743-422x-10-263] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 08/20/2013] [Indexed: 11/10/2022] Open
Abstract
Background Evaluation of the primary etiologic agents that cause aseptic meningitis outbreaks may provide valuable information regarding the prevention and management of aseptic meningitis. An outbreak of aseptic meningitis occurred from May to June, 2012, in Guangdong Province, China. In order to determine the etiologic agent, CSF specimens from 121 children hospitalized for aseptic meningitis at Luoding People’s Hospital of Guangdong Province were tested for virus isolation and identification. Results Enterovirus RNA was positive in 62.0% of 121 CSF sspecimens by real-time polymerase chain reaction (RT-PCR). Amplification and sequencing of the VP1 region of enterovirus isolates revealed Echovirus 30 (E30) was the most common isolated serotype (80% of 40 enterovirus strains).For the molecular characterization of the E30 isolates, the VP1 gene sequence of 20 Luoding E30 isolates was compared pairwise using the MegAlign with reference strains from GenBank. The pairwise comparison of the nucleotide sequences of the VP1 genes demonstrated that the sequences of the strains differed from those of lineage groups C, D, E, F, and G. Reconstruction of the phylogenetic tree based on the VP1 nucleotide sequences resulted in a monophyletic tree, with seven clustered lineage groups. Most of the isolates were segregated from other lineage groups. Four E30 isolates causing this outbreak aggregated into the Lineage A cluster which was derived from E30 strains that circulated in other regions of China from 2003–2010. Conclusions This study demonstrated the Luoding strains were a distinct lineage of E30, and a probable cause of this outbreak. The study also demonstrated that different E30 variants existed in the local meningitis outbreak.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Changwen Ke
- Key Laboratory for Emergency Pathogen Detection, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China.
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Cell susceptibility to baculovirus transduction and echovirus infection is modified by protein kinase C phosphorylation and vimentin organization. J Virol 2013; 87:9822-35. [PMID: 23824807 DOI: 10.1128/jvi.01004-13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Some cell types are more susceptible to viral gene transfer or virus infection than others, irrespective of the number of viral receptors or virus binding efficacy on their surfaces. In order to characterize the cell-line-specific features contributing to efficient virus entry, we studied two cell lines (Ea.hy926 and MG-63) that are nearly nonpermissive to insect-specific baculovirus (BV) and the human enterovirus echovirus 1 (EV1) and compared their characteristics with those of a highly permissive (HepG2) cell line. All the cell lines contained high levels of viral receptors on their surfaces, and virus binding was shown to be efficient. However, in nonpermissive cells, BV and its receptor, syndecan 1, were unable to internalize in the cells and formed large aggregates near the cell surface. Accordingly, EV1 had a low infection rate in nonpermissive cells but was still able to internalize the cells, suggesting that the postinternalization step of the virus was impaired. The nonpermissive and permissive cell lines showed differential expression of syntenin, filamentous actin, vimentin, and phosphorylated protein kinase C subtype α (pPKCα). The nonpermissive nature of the cells could be modulated by the choice of culture medium. RPMI medium could partially rescue infection/transduction and concomitantly showed lower syntenin expression, a modified vimentin network, and altered activities of PKC subtypes PKCα and PKCε. The observed changes in PKCα and PKCε activation caused alterations in the vimentin organization, leading to efficient BV transduction and EV1 infection. This study identifies PKCα, PKCε, and vimentin as key factors affecting efficient infection and transduction by EV1 and BV, respectively.
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40
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Maternal and perinatal factors associated with subsequent meningococcal, Haemophilus or enteroviral meningitis in children: database study. Epidemiol Infect 2013; 142:371-8. [PMID: 23659618 DOI: 10.1017/s095026881300099x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We used a database of 248 659 births, with follow-up to subsequent disease, in the Oxford record linkage archive (1979-1999) to study the influence of family, maternal, and perinatal factors on subsequent hospital admission for meningococcal, Haemophilus, and enteroviral meningitis in the children. In this summary, we report key findings that were significant in multivariate analysis. Meningococcal meningitis was significantly associated with maternal smoking [odds ratio (OR) 2·1, 95% confidence interval (CI) 1·2-3·7]. Haemophilus meningitis was associated with having older siblings (e.g. second child compared to first-born, OR 3·3, 95% CI 2·0-5·6). Enteroviral meningitis was associated with low birth weight (OR 2·2, 95% CI 1·3-3·6) and male sex (OR 1·7, 95% CI 1·2-2·3). The mothers of six of the 312 children with enteroviral meningitis had previously had enteroviral meningitis themselves. We concluded that several maternal characteristics influence the risk of these types of meningitis.
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Cashdollar JL, Brinkman NE, Griffin SM, McMinn BR, Rhodes ER, Varughese EA, Grimm AC, Parshionikar SU, Wymer L, Fout GS. Development and evaluation of EPA method 1615 for detection of enterovirus and norovirus in water. Appl Environ Microbiol 2013; 79:215-23. [PMID: 23087037 PMCID: PMC3536115 DOI: 10.1128/aem.02270-12] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 10/15/2012] [Indexed: 11/20/2022] Open
Abstract
The U.S. EPA developed a sample concentration and preparation assay in conjunction with the total culturable virus assay for concentrating and measuring culturable viruses in source and drinking waters as part of the Information Collection Rule (ICR) promulgated in 1996. In an effort to improve upon this method, the U.S. EPA recently developed Method 1615: Measurement of Enterovirus and Norovirus Occurrence in Water by Culture and RT-qPCR. Method 1615 uses a culturable virus assay with reduced equipment and labor costs compared to the costs associated with the ICR virus method and introduces a new molecular assay for the detection of enteroviruses and noroviruses by reverse transcription-quantitative PCR. In this study, we describe the optimization of several new components of the molecular assay and examine virus recovery from ground, reagent-grade, and surface water samples seeded with poliovirus type 3 and murine norovirus. For the culturable virus and molecular assays, mean poliovirus recovery using the complete method was 58% and 20% in groundwater samples, 122% and 39% using low-titer spikes in reagent-grade water, 42% and 48% using high-titer spikes in reagent-grade water, and 11% and 10% in surface water with high turbidity, respectively. Murine norovirus recovery by the molecular assay was 30% in groundwater samples, less than 8% in both low- and high-titer spikes in reagent-grade water, and 6% in surface water with high turbidity. This study demonstrates the effectiveness of Method 1615 for use with groundwater samples and highlights the need for further research into its effectiveness with surface water.
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Affiliation(s)
- Jennifer L Cashdollar
- U.S. Environmental Protection Agency, National Exposure Research Laboratory, Cincinnati, Ohio, USA.
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El Hiar R, Haddad S, Jaïdane H, Hober D, Ben M'hadheb-Gharbi M, Gullberg M, Neji-Guediche M, Lindberg AM, Gharbi J, Aouni M. Enteroviral central nervous system infections in children of the region of monastir, Tunisia: diagnosis, laboratory findings of cerebrospinal fluid and clinical manifestations. INDIAN JOURNAL OF VIROLOGY : AN OFFICIAL ORGAN OF INDIAN VIROLOGICAL SOCIETY 2012; 23:294-302. [PMID: 24293816 DOI: 10.1007/s13337-012-0104-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 08/14/2012] [Indexed: 11/24/2022]
Abstract
Human enteroviruses (HEV) are one of the major causes of central nervous system (CNS) infections in pediatrics. A prospective study was conducted to assess the epidemiological, clinical, and laboratory characteristics of enterovirus (EV) infections of the CNS in children under 15-years-old, suspected of having viral CNS infections and admitted to the Pediatric Department of Monastir University Hospital, Tunisia. Enteroviral RNA was detected by 5' NCR nested RT-PCR assay in 33 % (20 out of 60) of cerebrospinal fluid specimens, whereas only six samples (10 %) were EV positive in cell culture. EV-positive patients were clustered according to their clinical manifestations, predominantly diagnosed as aseptic meningitis (65 %) and meningoencephalitis (20 %). Fever, headache, vomiting, and neck stiffness were the most pronounced symptoms. Pleocytosis with the predominance of lymphocytes was observed in 60 % of EV positive specimens. Although patients suffering from EV infections were encountered throughout the year, most occurred during spring and summer months. Using VP1-2A nested RT-PCR and sequence analysis, three of the 20 positive HEV were identified as Echovirus (E)-9. This is the first report of a cluster of aseptic meningitis cases caused by E-9 in Monastir.
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Affiliation(s)
- Raida El Hiar
- Laboratory of Infectious Diseases and Biological Agents LR99-ES27, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
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Tabor-Godwin JM, Tsueng G, Sayen MR, Gottlieb RA, Feuer R. The role of autophagy during coxsackievirus infection of neural progenitor and stem cells. Autophagy 2012; 8:938-53. [PMID: 22751470 DOI: 10.4161/auto.19781] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Coxsackievirus B3 (CVB3) has previously been shown to utilize autophagy in an advantageous manner during the course of infection of the host cell. However, few studies have determined whether stem cells induce autophagy in a similar fashion, and whether virus-induced autophagy occurs following infection of stem cells. Therefore, we compared the induction of autophagy following CVB3 infection of neural progenitor and stem cells (NPSCs), which we have recently shown to be highly susceptible to CVB3 infection, to HL-1 cells, a transformed cardiomyocyte cell line. As previously demonstrated for other susceptible host cells, HL-1 cells showed an increase in the activity of autophagic signaling following infection with a CVB3 expressing dsRed protein (dsRed-CVB3). Furthermore, viral titers in HL-1 cells increased in the presence of an inducer of autophagy (CCPA), while viral titers decreased in the presence of an inhibitor of autophagy (3-MA). In contrast, no change in autophagic signaling was seen in NPSCs following infection with dsRed-CVB3. Also, basal levels of autophagy in NPSCs were found to be highly elevated in comparison to HL-1 cells. Autophagy could be induced in NPSCs in the presence of rapamycin without altering levels of dsRed-CVB3 replication. In differentiated NPSC precursors, autophagy was activated during the differentiation process, and a decrease in autophagic signaling was observed within all three CNS lineages following dsRed-CVB3 infection. Hence, we conclude that the role of autophagy in modulating CVB3 replication appears cell type-specific, and stem cells may uniquely regulate autophagy in response to infection.
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Affiliation(s)
- Jenna M Tabor-Godwin
- Cell & Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, CA, USA
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de Crom SCM, van Furth MAM, Peeters MF, Rossen JWA, Obihara CC. Characteristics of pediatric patients with enterovirus meningitis and no cerebral fluid pleocytosis. Eur J Pediatr 2012; 171:795-800. [PMID: 22102153 DOI: 10.1007/s00431-011-1626-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 11/08/2011] [Indexed: 11/24/2022]
Abstract
UNLABELLED Human non-polio enterovirus (EV) is the most important cause of aseptic meningitis in children. Only a few studies report the lack of cerobrospinal fluid (CSF) pleocytosis in children with confirmed EV meningitis; however, the characteristics of these children have not been well defined. This paper describes the clinical and laboratory features of EV meningitis in children with no CSF pleocytosis. Clinical, laboratory, and virological data of Dutch patients <16 years diagnosed with EV meningitis, between 2003 and 2008, were analyzed retrospectively. Data of children with and without CSF pleocytosis were compared. A total of 149 children were infected with EV. Patients presented mainly with fever (n = 113), malaise (n = 43), abdominal pain (n = 47), and irritability (n = 61). Of the 60 patients with EV meningitis, 23 had no pleocytosis. Those who lacked CSF pleocytosis were younger [odds ratio (OR) 1.00; 95% confidence interval (CI) 1.000-1.002; p = 0.001], had experienced drowsiness more (OR 9.60; 95% CI 2.24-41.15; p = 0.002), had lower white blood cell counts (OR 0.73; 95% CI 0.61-0.89; p = 0.001), and had higher C-reactive protein (OR 1.13; 95% CI 1.03-1.23; p = 0.006) than those with pleocytosis. CONCLUSION These findings show that EV meningitis occurs in the absence of CSF pleocytosis, particularly in young infants, meaning that EV meningitis in this age group cannot be solely excluded by the absence of CSF pleocytosis. They also confirm the importance of genome detection in the diagnosis of EV meningitis in young infants.
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Affiliation(s)
- Stephanie C M de Crom
- Department of Pediatrics, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 LC, Tilburg, The Netherlands.
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Šála M, Hřebabecký H, Leyssen P, Dejmek M, Dračínský M, De Palma AM, Neyts J, Nencka R. Novel substituted 9-norbornylpurines and their activities against RNA viruses. Bioorg Med Chem Lett 2012; 22:1963-8. [DOI: 10.1016/j.bmcl.2012.01.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/11/2012] [Accepted: 01/12/2012] [Indexed: 11/16/2022]
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Ouellet I, Drolet C, Thibeault R, Papenburg J. Case 2: A neonate in shock. Paediatr Child Health 2012; 17:133-5. [DOI: 10.1093/pch/17.3.133a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2011] [Indexed: 11/14/2022] Open
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Efficient synthesis and anti-enteroviral activity of 9-arylpurines. Eur J Med Chem 2012; 49:279-88. [DOI: 10.1016/j.ejmech.2012.01.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/10/2012] [Accepted: 01/11/2012] [Indexed: 11/20/2022]
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Stonehouse V, Furyk J, Norton R. Impact of polymerase chain reaction results on patient management during a viral meningitis outbreak in Tropical North Queensland. Emerg Med Australas 2012; 24:52-6. [PMID: 22313560 DOI: 10.1111/j.1742-6723.2011.01483.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Enterovirus is the most commonly isolated pathogen in viral meningitis. We report on the first outbreak of viral meningitis in Tropical Queensland and the effect of polymerase chain reaction (PCR) results on antibiotic use and hospital length of stay. METHODS Retrospective case series of consecutive patients presenting to the Townsville ED with viral meningitis were evaluated by examining hospital medical records. The study period was November 2008 to February 2009. RESULTS Forty-three patients were available for full analysis of which 17 (40%) were female and 17 (40%) had a positive enteroviral PCR. Antibiotics were commenced on 37 (86%) of patients. There was no difference in hospital length of stay in patients with a negative versus positive PCR (2.52 vs 2.72 days, P = 0.68) or duration of antibiotic therapy (2.20 vs 1.94 days, P = 0.61). CONCLUSION In our study a positive result on PCR was not associated with a shorter hospital length of stay or a shorter duration of antibiotic therapy. This contrasts with previous reports on this topic and requires further evaluation.
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Ruller CM, Tabor-Godwin JM, Van Deren DA, Robinson SM, Maciejewski S, Gluhm S, Gilbert PE, An N, Gude NA, Sussman MA, Whitton JL, Feuer R. Neural stem cell depletion and CNS developmental defects after enteroviral infection. THE AMERICAN JOURNAL OF PATHOLOGY 2011; 180:1107-1120. [PMID: 22214838 DOI: 10.1016/j.ajpath.2011.11.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 10/26/2011] [Accepted: 11/14/2011] [Indexed: 12/30/2022]
Abstract
Coxsackieviruses are significant human pathogens causing myocarditis, meningitis, and encephalitis. We previously demonstrated the ability of coxsackievirus B3 (CVB3) to persist within the neonatal central nervous system (CNS) and to target neural stem cells. Given that CVB3 is a cytolytic virus and may therefore damage target cells, we characterized the potential reduction in neurogenesis within the developing brain and the subsequent developmental defects that occurred after the loss of these essential neural stem cells. Neonatal mice were inoculated with a recombinant CVB3 expressing eGFP (eGFP-CVB3), and alterations in neurogenesis and brain development were evaluated over time. We observed a reduction in proliferating cells in CNS neurogenic regions simultaneously with the presence of nestin(+) cells undergoing apoptosis. The size of the brain appeared smaller by histology, and a permanent decrease in brain wet weight was observed after eGFP-CVB3 infection. We also observed an inverse relationship between the amount of virus material and brain wet weight up to day 30 postinfection. In addition, signs of astrogliosis and a compaction of the cortical layers were observed at 90 days postinfection. Intriguingly, partial brain wet weight recovery was observed in mice treated with the antiviral drug ribavirin during the persistent stage of infection. Hence, long-term neurological sequelae might be expected after neonatal enteroviral infections, yet antiviral treatment initiated long after the end of acute infection might limit virus-mediated neuropathology.
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Affiliation(s)
- Chelsea M Ruller
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California
| | - Jenna M Tabor-Godwin
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California
| | - Donn A Van Deren
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California
| | - Scott M Robinson
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California
| | - Sonia Maciejewski
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California
| | - Shea Gluhm
- Department of Psychology, San Diego State University, San Diego, California
| | - Paul E Gilbert
- Department of Psychology, San Diego State University, San Diego, California
| | - Naili An
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California
| | - Natalie A Gude
- SDSU Heart Institute and Department of Biology, San Diego State University, San Diego, California
| | - Mark A Sussman
- SDSU Heart Institute and Department of Biology, San Diego State University, San Diego, California
| | - J Lindsay Whitton
- Department of Immunology and Microbial Science, Scripps Research Institute, La Jolla, California
| | - Ralph Feuer
- Cell and Molecular Biology Joint Doctoral Program, Department of Biology, San Diego State University, San Diego, California.
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Concentration gradient of CXCL10 and CXCL11 between the cerebrospinal fluid and plasma in children with enteroviral aseptic meningitis. Eur J Paediatr Neurol 2011; 15:502-7. [PMID: 21703889 DOI: 10.1016/j.ejpn.2011.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 05/02/2011] [Accepted: 05/27/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Lymphocyte migration from the blood into the CNS is mediated by chemokines and chemokine receptors. Chemokines CXCL10 and CXCL11 are important for the recruitment of CXCR3-expressing Th1 lymphocytes to the site of inflammation. AIMS To determine the concentrations of CXCL10 and CXCL11 in the CSF and plasma of children with enteroviral aseptic meningitis (EV AM) and controls and the contribution of these chemokines to the chemokine concentration gradient between the periphery and the CNS. METHODS The study included 26 pediatric patients with EV AM and 16 controls in whom CNS infection is excluded by negative CSF examination. Chemokines were quantified by using enzyme immunoassay. Etiological diagnosis of EV AM was based on the detection of enteroviral RNA in the CSF using real-time PCR. RESULTS CXCL10 (median 12 725 pg/ml) and CXCL11 (median 187 pg/ml) concentrations in CSF of patients with meningitis were significantly higher compared to plasma (median 173 pg/ml and median 110 pg/ml; p < 0.001, p = 0.026 respectively). CXCL10 concentrations in the CSF (median 198 pg/ml) and plasma of controls (median 124 pg/ml) were not significantly different (p = 0.642). CXCL11 concentrations in the CSF of controls (median 89 pg/ml) were significantly lower compared with plasma (median 139 pg/ml, p = 0.004). Chemokine concentration gradient was not influenced by pleocytosis, nor dependent on cytologic CSF formula or the presence of proteinorrachia. CONCLUSION CXCL10 and CXCL11 concentration gradient between the CSF and plasma in children with EV AM suggests an important role of these chemokines in the T-cells recruitment into the CNS and local immunoreaction.
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