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Xu Y, Vertrees D, He Y, Momben-Abolfath S, Li X, Brewah YA, Scott DE, Konduru K, Rios M, Struble EB. Nanoluciferase Reporter Zika Viruses as Tools for Assessing Infection Kinetics and Antibody Potency. Viruses 2023; 15:2190. [PMID: 38005868 PMCID: PMC10674863 DOI: 10.3390/v15112190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
Zika virus (ZIKV) has become endemic in multiple tropical and subtropical regions and has the potential to become widespread in countries with limited prior exposure to this infection. One of the most concerning sequelae of ZIKV infection is the teratogenic effect on the developing fetus, with the mechanisms of viral spread to and across the placenta remaining largely unknown. Although vaccine trials and prophylactic or therapeutic treatments are being studied, there are no approved treatments or vaccines for ZIKV. Appropriate tests, including potency and in vivo assays to assess the safety and efficacy of these modalities, can greatly aid both the research of the pathophysiology of the infection and the development of anti-ZIKV therapeutics. Building on previous work, we tested reporter ZIKV variants that express nanoluciferase in cell culture and in vivo assays. We found that these variants can propagate in cells shown to be susceptible to the widely used clinical isolate PRVABC59, including Vero and human placenta cell lines. When used in neutralization assays with bioluminescence as readout, these variants gave rise to neutralization curves similar to those produced by PRVABC59, while being better suited for performing high-throughput assays. In addition, the engineered reporter variants can be useful research tools when used in other in vitro and in vivo assays, as we illustrated in transcytosis experiments and a pilot study in guinea pigs.
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Affiliation(s)
- Yanqun Xu
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Devin Vertrees
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Yong He
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Sanaz Momben-Abolfath
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Xiaohong Li
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Yambasu A. Brewah
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Dorothy E. Scott
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
| | - Krishnamurthy Konduru
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA; (K.K.); (M.R.)
| | - Maria Rios
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA; (K.K.); (M.R.)
| | - Evi B. Struble
- Laboratory of Plasma Derivatives, Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (Y.X.); (D.V.); (Y.H.); (X.L.); (Y.A.B.); (D.E.S.)
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Yang L, Han Y, Zhou T, Lacko LA, Saeed M, Tan C, Danziger R, Zhu J, Zhao Z, Cahir C, Giani AM, Li Y, Dong X, Moroziewicz D, Paull D, Chen Z, Zhong A, Noggle SA, Rice CM, Qi Q, Evans T, Chen S. Isogenic human trophectoderm cells demonstrate the role of NDUFA4 and associated variants in ZIKV infection. iScience 2023; 26:107001. [PMID: 37534130 PMCID: PMC10391681 DOI: 10.1016/j.isci.2023.107001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/17/2023] [Accepted: 05/25/2023] [Indexed: 08/04/2023] Open
Abstract
Population-based genome-wide association studies (GWAS) normally require a large sample size, which can be labor intensive and costly. Recently, we reported a human induced pluripotent stem cell (hiPSC) array-based GWAS method, identifying NDUFA4 as a host factor for Zika virus (ZIKV) infection. In this study, we extended our analysis to trophectoderm cells, which constitute one of the major routes of mother-to-fetus transmission of ZIKV during pregnancy. We differentiated hiPSCs from various donors into trophectoderm cells. We then infected cells carrying loss of function mutations in NDUFA4, harboring risk versus non-risk alleles of SNPs (rs917172 and rs12386620) or having deletions in the NDUFA4 cis-regulatory region with ZIKV. We found that loss/reduction of NDUFA4 suppressed ZIKV infection in trophectoderm cells. This study validated our published hiPSC array-based system as a useful platform for GWAS and confirmed the role of NDUFA4 as a susceptibility locus for ZIKV in disease-relevant trophectoderm cells.
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Affiliation(s)
- Liuliu Yang
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Center for Genomic Health, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Yuling Han
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Center for Genomic Health, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Ting Zhou
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Stem Cell Research Facility, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Lauretta A. Lacko
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Mohsan Saeed
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY 10065, USA
- Department of Biochemistry & Cell Biology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA
- National Emerging Infectious Diseases Laboratories (NEIDL), Boston University, Boston, MA 02118, USA
| | - Christina Tan
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Ron Danziger
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Jiajun Zhu
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Center for Genomic Health, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Zeping Zhao
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Center for Genomic Health, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Clare Cahir
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Alice Maria Giani
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Yang Li
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Xue Dong
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Dorota Moroziewicz
- The New York Stem Cell Foundation Research Institute, 619 West 54th Street, 3Road Floor, New York, NY 10019, USA
| | | | - Daniel Paull
- The New York Stem Cell Foundation Research Institute, 619 West 54th Street, 3Road Floor, New York, NY 10019, USA
| | - Zhengming Chen
- Department of Population Health Sciences, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Aaron Zhong
- Stem Cell Research Facility, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Scott A. Noggle
- The New York Stem Cell Foundation Research Institute, 619 West 54th Street, 3Road Floor, New York, NY 10019, USA
| | - Charles M. Rice
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY 10065, USA
| | - Qibin Qi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Todd Evans
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Center for Genomic Health, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Shuibing Chen
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
- Center for Genomic Health, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
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Hageman G, Nihom J. Fetuses and infants with Amyoplasia congenita in congenital Zika syndrome: The evidence of a viral cause. A narrative review of 144 cases. Eur J Paediatr Neurol 2023; 42:1-14. [PMID: 36442412 DOI: 10.1016/j.ejpn.2022.11.002] [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: 03/26/2022] [Revised: 10/09/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Amyoplasia congenita is the most frequent type of arthrogryposis causing fetal hypokinesia, leading to congenital contractures at birth. The pathogenesis is thought to be impaired blood circulation to the fetus early in pregnancy, with hypotension and hypoxia damaging the anterior horn cells. In animal studies however a prenatal infection with a poliomyelitis-like viral agent was demonstrated. Congenital Zika virus syndrome (CZVS) has recently been described in infants with severe microcephaly, and in 10-25% of cases arthrogryposis. METHODS A search in PubMed for CZVS yielded 124 studies. After a selection for arthrogryposis, 35 papers were included, describing 144 cases. The studies were divided into two categories. 1) Those (87 cases) focussing on imaging or histological data of congenital brain defects, contained insufficient information to link arthrogryposis specifically to lesions of the brain or spinal motor neuron. 2) In the other 57 cases detailed clinical data could be linked to neurophysiological, imaging or histological data. RESULTS In category 1 the most frequent brain abnormalities in imaging studies were ventriculomegaly, calcifications (subcortical, basal ganglia, cerebellum), hypoplasia of the brainstem and cerebellum, atrophy of the cerebral cortex, migration disorders and corpus callosum anomalies. In category 2, in 38 of 57 cases clinical data were indicative of Amyoplasia congenita. This diagnosis was confirmed by electromyographic findings (13 cases), by MRI (37 cases) or histology (12 cases) of the spinal cord. The latter showed small or absent lateral corticospinal tracts, and cell loss and degeneration of motor neuron cells. Zika virus-proteins and flavivirus-like particles were detected in cytoplasm of spinal neurons. CONCLUSION The phenotype of arthrogryposis in CZVS is consistent with Amyoplasia congenita. These findings warrant search for an intrauterine infection with any neurotropic viral agent with affinity to spinal motor neurons in neonates with Amyoplasia.
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Affiliation(s)
- G Hageman
- Department of Neurology, Medical Spectrum Twente, Hospital Enschede, the Netherlands.
| | - J Nihom
- Department of Neurology, Medical Spectrum Twente, Hospital Enschede, the Netherlands
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Novel Therapeutic Nutrients Molecules That Protect against Zika Virus Infection with a Special Note on Palmitoleate. Nutrients 2022; 15:nu15010124. [PMID: 36615782 PMCID: PMC9823984 DOI: 10.3390/nu15010124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/11/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Zika virus (ZIKV) is a Flavivirus from the Flaviviridae family and a positive-sense single strand RNA virus. ZIKV infection can cause a mild infection to the mother but can be vertically transmitted to the developing fetus, causing congenital anomalies. The prevalence of ZIKV infections was relatively insignificant with sporadic outbreaks in the Asian and African continents until 2006. However, recent epidemic in the Caribbean showed significant increased incidence of Congenital Zika Syndrome. ZIKV infection results in placental pathology which plays a crucial role in disease transmission from mother to fetus. Currently, there is no Food and Drug Administration (FDA) approved vaccine or therapeutic drug against ZIKV. This review article summarizes the recent advances on ZIKV transmission and diagnosis and reviews nutraceuticals which can protect against the ZIKV infection. Further, we have reviewed recent advances related to the novel therapeutic nutrient molecules that have been shown to possess activity against Zika virus infected cells. We also review the mechanism of ZIKV-induced endoplasmic reticulum and apoptosis and the protective role of palmitoleate (nutrient molecule) against ZIKV-induced ER stress and apoptosis in the placental trophoblasts.
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Watts JL, Ralston A. The fetal lineage is susceptible to Zika virus infection within days of fertilization. Development 2022; 149:276104. [PMID: 35900100 PMCID: PMC9382896 DOI: 10.1242/dev.200501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022]
Abstract
Adults contracting Zika virus (ZIKV) typically exhibit mild symptoms, yet ZIKV infection of pregnant individuals can cause miscarriage or birth defects in their offspring. Many studies have focused on maternal-to-fetal ZIKV transmission via blood and placenta. Notably, however, ZIKV is also transmitted sexually, raising the possibility that ZIKV could infect the embryo shortly after fertilization, long before the placenta is established. Here, we evaluate the consequences of ZIKV infection in mouse embryos during the first few days of embryogenesis. We show that divergent strains of ZIKV can infect the fetal lineage and can cause developmental arrest, raising concern for the developmental consequences of sexual ZIKV transmission. This article has an associated ‘The people behind the papers’ interview. Summary: Mouse preimplantation embryos are vulnerable to Zika virus-induced lethality even in the presence of the zona pellucida, highlighting a potential risk of sexually transmitted infection in early pregnancy.
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Affiliation(s)
- Jennifer L. Watts
- Molecular, Cellular and Integrative Physiology Graduate Program, Michigan State University 1 , East Lansing , MI 48824 , USA
- Michigan State University 2 Reproductive and Developmental Biology Training Program , , East Lansing , MI 48824 , USA
- Michigan State University 3 Department of Biochemistry and Molecular Biology , , East Lansing , MI 48824 , USA
| | - Amy Ralston
- Michigan State University 2 Reproductive and Developmental Biology Training Program , , East Lansing , MI 48824 , USA
- Michigan State University 3 Department of Biochemistry and Molecular Biology , , East Lansing , MI 48824 , USA
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Human Polymorphonuclear Cells Support Zika Virus to Cross Endothelial Monolayer and Access Bloodstream. Pathogens 2022; 11:pathogens11030321. [PMID: 35335645 PMCID: PMC8955922 DOI: 10.3390/pathogens11030321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022] Open
Abstract
The rapid spread of new outbreaks of human infection caused by Zika virus (ZIKV) has raised many global concerns since 2016. Despite the increasing knowledge of this virus, data on the pathogenesis of ZIKV are still missing. In particular, it is still unknown how the virus crosses the endothelial monolayer and gets access to the bloodstream. In the present work, we used human umbilical vein endothelial cells (HUVECs) as a model to study ZIKV infection in vitro. We demonstrated that HUVECs are an optimal reservoir for viral replication, as they were able to sustain ZIKV infection up to two weeks, without showing a cytopathic effect. In order to evaluate the integrity of endothelial monolayer, immunofluorescence was performed on mock-infected or ZIKV-infected cells ± peripheral blood mononuclear cells (PBMCs) or polymorphonuclear cells (PMN), 48 h p.i., by using an anti-VE-Cadherin antibody, a major adherence protein that maintains the integrity of intercellular junctions. In addition to infection, we noted that the presence of some components of the immune system, such as PMNs, played an important role in altering the endothelial monolayer in cell junctions, suggesting that presence at the site of infection probably promotes the spread of ZIKV in vivo in the bloodstream.
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Embryonic Stage of Congenital Zika Virus Infection Determines Fetal and Postnatal Outcomes in Mice. Viruses 2021; 13:v13091807. [PMID: 34578389 PMCID: PMC8473443 DOI: 10.3390/v13091807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/01/2021] [Accepted: 09/08/2021] [Indexed: 01/29/2023] Open
Abstract
Zika virus (ZIKV) infection during pregnancy causes a wide spectrum of congenital abnormalities and postnatal developmental sequelae such as fetal loss, intrauterine growth restriction (IUGR), microcephaly, or motor and neurodevelopmental disorders. Here, we investigated whether a mouse pregnancy model recapitulated a wide range of symptoms after congenital ZIKV infection, and whether the embryonic age of congenital infection changed the fetal or postnatal outcomes. Infection with ZIKV strain PRVABC59 from embryonic day 6.5 (E6.5) to E8.5, corresponding to the mid-first trimester in humans, caused fetal death, fetal resorption, or severe IUGR, whereas infection from E9.5 to E14.5, corresponding to the late-first to second trimester in humans, caused stillbirth, neonatal death, microcephaly, and postnatal growth deficiency. Furthermore, 4-week-old offspring born to dams infected at E12.5 showed abnormalities in neuropsychiatric state, motor behavior, autonomic function, or reflex and sensory function. Thus, our model recapitulated the multiple symptoms seen in human cases, and the embryonic age of congenital infection was one of the determinant factors of offspring outcomes in mice. Furthermore, maternal neutralizing antibodies protected the offspring from neonatal death after congenital infection at E9.5, suggesting that neonatal death in our model could serve as criteria for screening of vaccine candidates.
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Reis Teixeira S, Elias J, Coutinho CM, Zanon Zotin MC, Yamamoto AY, Biason de Moura Negrini SF, Mussi-Pinhata MM. Cranial US in Infants Exposed to Zika Virus: The NATZIG Cohort. Radiology 2021; 300:690-698. [PMID: 34184937 DOI: 10.1148/radiol.2021204150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Studies addressing neuroimaging findings as primary outcomes of congenital Zika virus infection are variable regarding inclusion criteria and confirmatory laboratory testing. Purpose To investigate cranial US signs of prenatal Zika virus exposure and to describe frequencies of cranial US findings in infants exposed to Zika virus compared to those in control infants. Materials and Methods In this single-center prospective cohort study, participants were enrolled during the December 2015-July 2016 outbreak of Zika virus infection in southeast Brazil (Natural History of Zika Virus Infection in Gestation cohort). Eligibility criteria were available cranial US and laboratory findings of maternal Zika virus infection during pregnancy confirmed with RNA polymerase chain reaction testing (ie, Zika virus-exposed infants). The control group was derived from the Zika in Infants and Pregnancy cohort and consisted of infants born to asymptomatic pregnant women who tested negative for Zika virus infection during pregnancy. Two radiologists who were blinded to the maternal Zika virus infection status independently reviewed cranial US scans from both groups and categorized them as normal findings, Zika virus-like pattern, or mild findings. Associations between cranial US findings and prenatal Zika virus exposure were assessed with univariable analysis. Results Two hundred twenty Zika virus-exposed infants (mean age, 53.3 days ± 71.1 [standard deviation]; 113 boys) and born to 219 mothers infected with Zika virus were included in this study and compared with 170 control infants (mean age, 45.6 days ± 45.8; 102 boys). Eleven of the 220 Zika virus-exposed infants (5%), but no control infants, had a Zika virus-like pattern at cranial US. No difference in frequency of mild findings was observed between the groups (50 of 220 infants [23%] vs 44 of 170 infants [26%], respectively; P = .35). The mild finding of lenticulostriate vasculopathy, however, was nine times more frequent in Zika virus-exposed infants (12 of 220 infants, 6%) than in control infants (one of 170 infants, 1%) (P = .01). Conclusion Lenticulostriate vasculopathy was more common after prenatal exposure to Zika virus, even in infants with normal head size, despite otherwise overall similar frequency of mild cranial US findings in Zika virus-exposed infants and in control infants. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Benson in this issue.
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Affiliation(s)
- Sara Reis Teixeira
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
| | - Jorge Elias
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
| | - Conrado Milani Coutinho
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
| | - Maria Clara Zanon Zotin
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
| | - Aparecida Yulie Yamamoto
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
| | - Silvia Fabiana Biason de Moura Negrini
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
| | - Marisa Márcia Mussi-Pinhata
- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
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- From the Departments of Medical Imaging, Hematology and Clinical Oncology (S.R.T., J.E., M.C.Z.Z.), Gynecology and Obstetrics (C.M.C.), and Pediatrics (A.Y.Y., S.F.B.d.M.N., M.M.M.P.), Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil 14049-900; and Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.R.T.)
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Martins Ronchi DC, Scaranello Malaquias MA, Rebutini PZ, Panini do Carmo LA, Neto PC, Marini ES, Prokopenko A, Nagashima S, Zanluca C, Duarte Dos Santos CN, de Noronha L. Placental Morphologic Similarities Between ZIKV-Positive and HIV-Positive Pregnant Women. Front Immunol 2021; 12:684194. [PMID: 34177930 PMCID: PMC8219962 DOI: 10.3389/fimmu.2021.684194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022] Open
Abstract
Zika virus (ZIKV) caused global concern due to Brazil's unexpected epidemic, and it was associated with congenital microcephaly and other gestational intercurrences. The study aimed to analyze the placenta morphometric changes of ZIKV-infected pregnant women (ZIKV group; n = 23) compared to placentas of HIV-infected (HIV group; n = 24) and healthy pregnant women (N-control group; n = 22). It also analyzed the relationship between the morphometric results and pathological alterations on conventional microscopy, gestational trimester of infection, and presence of the congenital Zika syndrome (CZS). There was a significant increase in area (p = 0.0172), as well as a higher number of knots (p = 0.0027), sprouts (p < 0.0001), and CD163 +Hofbauer cells (HCs) (p < 0.0001) in the ZIKV group compared to the N-control group, suggesting that villous dysmaturity and HCs hyperplasia could be associated with ZIKV infections. The HIV group had a higher area (p < 0.0001), perimeter (p = 0.0001), sprouts (p < 0.0001), and CD163 + HCs (p < 0.0001) compared to the N-control group, demonstrating that the morphometric abnormalities found in the ZIKV and HIV group are probably similar. However, when ZIKV and HIV groups are compared, it was observed a higher number of sprouts (p = 0.0066) and CD163+ HCs (p < 0.0001) in the first one, suggesting that placental ZIKV congenital changes could be more pronounced.
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Affiliation(s)
- Daiane Cristine Martins Ronchi
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Mineia Alessandra Scaranello Malaquias
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Patrícia Zadorosnei Rebutini
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Letícia Arianne Panini do Carmo
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Plínio Cézar Neto
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Emily Scaranello Marini
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Amanda Prokopenko
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Seigo Nagashima
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Camila Zanluca
- Molecular Virology Laboratory, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil
| | | | - Lúcia de Noronha
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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10
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Al Beloushi M, Kalache K, Ahmed B, Konje JC. Ultrasound diagnosis of infections in pregnancy. Eur J Obstet Gynecol Reprod Biol 2021; 262:188-197. [PMID: 34062306 DOI: 10.1016/j.ejogrb.2021.05.027] [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: 02/20/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 11/17/2022]
Abstract
Pregnancy is a unique period in which several changes occur in the mother, to ensure that the semiallograft fetus is not rejected. Some of these changes decrease the immunity of the mother to infections. As such, some infections in pregnancy which may not ordinarily cause severe symptoms can be more severe in the mother and importantly some of these infections pose a danger to the fetus either directly or indirectly. In dealing with infections in pregnancy, attention should focus on both the consequences of the infection on the mother as well as in the fetus. Over the last decade, some of these infections have significantly influenced clinical practice. This series on Infections in Pregnancy in this journal provides a comprehensive cover of this topic. Here we focus on the fetal impact of infections in pregnancy and how ultrasound scan can help in identifying some of these infections and more importantly map out pathways for managing the pregnancies including counselling and additional invasive procedures.
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Affiliation(s)
- Mariam Al Beloushi
- Senior Consultant Fetal Medicine, Womens Wellness and Research Center, Doha, Qatar and Assistant Professor Department of Obstetrics and Gynaecology, Qatar University
| | - Karim Kalache
- Division Chief Maternal-Fetal Medicine Women's Clinical Management Group Sidra Medicine, Doha, Qatar and Professor of Fetal Medicine, Weil Cornell Medicine, Doha, Qatar
| | - Badreldeen Ahmed
- Professor of Obstetrics and Gynaecology, Fetal Medicine Centre, Doha, Qatar; Department of Obstetrics and Gynaecology University of Qatar and Weil Cornell Medicine, Doha, Qatar
| | - Justin C Konje
- Emeritus Professor of Obstetrics and Gynaecology, Department of Health Sciences University of Leicester, UK.
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11
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Ginige S, Flower R, Viennet E. Neonatal Outcomes From Arboviruses in the Perinatal Period: A State-of-the-Art Review. Pediatrics 2021; 147:peds.2020-009720. [PMID: 33737375 DOI: 10.1542/peds.2020-009720] [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] [Accepted: 11/04/2020] [Indexed: 11/24/2022] Open
Abstract
Since the 2016 Zika outbreak and the understanding of the teratogenic effect of this infection, there has been a newfound interest in arbovirus infections and their effects on pregnancy, resulting in numerous publications in the last 5 years. However, limited literature focuses on arbovirus infection in different stages of pregnancy and their effect on the neonate. There is currently no consensus management of perinatal acquisition of arboviruses, and current evidence is largely anecdotal observational reports. Teratogens can have different effects on the developing fetus depending on the time of infection, so infections during pregnancy should be analyzed by trimester. A better understanding of arbovirus infection in the perinatal period is required to assist obstetric, neonatal, and pediatric clinicians in making decisions about the management of mother and neonate. Our objective was to assess the evidence of adverse neonatal outcomes for several arboviral infections when contracted during the perinatal period to guide clinicians in managing these patients. There are 8 arboviruses for which neonatal outcomes from maternal acquisition in the perinatal period have been reported, with the most data for dengue and Chikungunya virus infections. The evidence reviewed in this article supports the adoption of preventive strategies to avoid ticks and mosquitoes close to the date of delivery. For the other arbovirus infections, further community-based cohort studies during outbreaks are required to evaluate whether these infections have a similar teratogenic impact.
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12
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Zika Virus Infection Leads to Demyelination and Axonal Injury in Mature CNS Cultures. Viruses 2021; 13:v13010091. [PMID: 33440758 PMCID: PMC7827345 DOI: 10.3390/v13010091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/16/2020] [Accepted: 12/24/2020] [Indexed: 01/03/2023] Open
Abstract
Understanding how Zika virus (Flaviviridae; ZIKV) affects neural cells is paramount in comprehending pathologies associated with infection. Whilst the effects of ZIKV in neural development are well documented, impact on the adult nervous system remains obscure. Here, we investigated the effects of ZIKV infection in established mature myelinated central nervous system (CNS) cultures. Infection incurred damage to myelinated fibers, with ZIKV-positive cells appearing when myelin damage was first detected as well as axonal pathology, suggesting the latter was a consequence of oligodendroglia infection. Transcriptome analysis revealed host factors that were upregulated during ZIKV infection. One such factor, CCL5, was validated in vitro as inhibiting myelination. Transferred UV-inactivated media from infected cultures did not damage myelin and axons, suggesting that viral replication is necessary to induce the observed effects. These data show that ZIKV infection affects CNS cells even after myelination-which is critical for saltatory conduction and neuronal function-has taken place. Understanding the targets of this virus across developmental stages including the mature CNS, and the subsequent effects of infection of cell types, is necessary to understand effective time frames for therapeutic intervention.
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13
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Cavalcanti AFC, Aguiar YPC, Arruda TDD, Melo ASDO, Cavalcanti AL, d’Ávila S. Quality of Life of Mothers of Brazilian Children with Congenital Zika Virus Syndrome and Associated Factors. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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14
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Freitas DA, Souza-Santos R, Carvalho LMA, Barros WB, Neves LM, Brasil P, Wakimoto MD. Congenital Zika syndrome: A systematic review. PLoS One 2020; 15:e0242367. [PMID: 33320867 PMCID: PMC7737899 DOI: 10.1371/journal.pone.0242367] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The signs and symptoms of Zika virus infection are usually mild and self-limited. However, the disease has been linked to neurological complications such as Guillain-Barré syndrome and peripheral nerve involvement, and also to abortion and fetal deaths due to vertical transmission, resulting in various congenital malformations in newborns, including microcephaly. This review aimed to describe the o signs and symptoms that characterize the congenital Zika syndrome. METHODS AND FINDINGS A systematic review was performed with a protocol and described according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search strategy yielded 2,048 studies. After the exclusion of duplicates and application of inclusion criteria, 46 studies were included. The main signs and symptoms associated with the congenital Zika syndrome were microcephaly, parenchymal or cerebellar calcifications, ventriculomegaly, central nervous system hypoplasia or atrophy, arthrogryposis, ocular findings in the posterior and anterior segments, abnormal visual function and low birthweight for gestational age. CONCLUSIONS Zika virus infection during pregnancy can cause a series of changes in the growth and development of children, while impacting the healthcare system due to the severity of cases. Our findings outline the disease profile in newborns and infants and may contribute to the development and updating of more specific clinical protocols.
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Affiliation(s)
- Danielle A. Freitas
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Reinaldo Souza-Santos
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Liege M. A. Carvalho
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Wagner B. Barros
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Luiza M. Neves
- Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Patrícia Brasil
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Mayumi D. Wakimoto
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
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15
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Molecular dynamics simulation of zika virus NS5 RNA dependent RNA polymerase with selected novel non-nucleoside inhibitors. J Mol Struct 2020. [DOI: 10.1016/j.molstruc.2019.127428] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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The Spectrum of Developmental Disability with Zika Exposure: What Is Known, What Is Unknown, and Implications for Clinicians. J Dev Behav Pediatr 2019; 40:387-395. [PMID: 30921103 PMCID: PMC7713528 DOI: 10.1097/dbp.0000000000000665] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Clinicians who treat children with neurodevelopmental disabilities may encounter infants with congenital Zika syndrome or those exposed to Zika virus (ZIKV), either in utero or postnatally, in their practice and may have questions about diagnosis, management, and prognosis. In this special report, we reviewed the current literature to provide a comprehensive understanding of the findings and needs of children exposed to ZIKV in utero and postnatally. The current literature is sparse, and thus, this review is preliminary. We found that infants and children exposed to ZIKV in utero have a variety of health and developmental outcomes that suggest a wide range of lifelong physical and developmental needs. Postnatal exposure does not seem to have significant long-lasting health or developmental effects. We provide a comprehensive examination of the current knowledge on health and developmental care needs in children exposed to Zika in utero and postnatally. This can serve as a guide for health care professionals on the management and public health implications of this newly recognized population.
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17
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Zika virus infection induces RNAi-mediated antiviral immunity in human neural progenitors and brain organoids. Cell Res 2019; 29:265-273. [PMID: 30814679 DOI: 10.1038/s41422-019-0152-9] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/29/2019] [Indexed: 12/27/2022] Open
Abstract
The re-emergence of Zika virus (ZIKV) in the Western Hemisphere has resulted in global public health crisis since 2015. ZIKV preferentially infects and targets human neural progenitor cells (hNPCs) and causes fetal microcephaly upon maternal infection. hNPCs not only play critical roles during fetal brain development, but also persist in adult brain throughout life. Yet the mechanism of innate antiviral immunity in hNPCs remains largely unknown. Here, we show that ZIKV infection triggers the abundant production of virus-derived small interfering RNAs in hNPCs, but not in the more differentiated progenies or somatic cells. Ablation of key RNAi machinery components significantly enhances ZIKV replication in hNPCs. Furthermore, enoxacin, a broad-spectrum antibiotic that is known as an RNAi enhancer, exerts potent anti-ZIKV activity in hNPCs and other RNAi-competent cells. Strikingly, enoxacin treatment completely prevents ZIKV infection and circumvents ZIKV-induced microcephalic phenotypes in brain organoid models that recapitulate human fetal brain development. Our findings highlight the physiological importance of RNAi-mediated antiviral immunity during the early stage of human brain development, uncovering a novel strategy to combat human congenital viral infections through enhancing RNAi.
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18
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Gorshkov K, Shiryaev SA, Fertel S, Lin YW, Huang CT, Pinto A, Farhy C, Strongin AY, Zheng W, Terskikh AV. Zika Virus: Origins, Pathological Action, and Treatment Strategies. Front Microbiol 2019; 9:3252. [PMID: 30666246 PMCID: PMC6330993 DOI: 10.3389/fmicb.2018.03252] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/14/2018] [Indexed: 01/05/2023] Open
Abstract
The Zika virus (ZIKV) global epidemic prompted the World Health Organization to declare it a 2016 Public Health Emergency of International Concern. The overwhelming experience over the past several years teaches us that ZIKV and the associated neurological complications represent a long-term world-wide challenge to public health. Although the number of ZIKV cases in the Western Hemisphere has dropped since 2016, the need for basic research and anti-ZIKV drug development remains strong. Re-emerging viruses like ZIKV are an ever-present threat in the 21st century where fast transcontinental travel lends itself to viral epidemics. Here, we first present the origin story for ZIKV and review the rapid progress researchers have made toward understanding of the ZIKV pathology and in the design, re-purposing, and testing–particularly in vivo–drug candidates for ZIKV prophylaxis and therapy ZIKV. Quite remarkably, a short, but intensive, drug-repurposing effort has already resulted in several readily available FDA-approved drugs that are capable of effectively combating the virus in infected adult mouse models and, most importantly, in both preventing maternal-fetal transmission and severe microcephaly in newborns in pregnant mouse models.
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Affiliation(s)
- Kirill Gorshkov
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, United States
| | - Sergey A Shiryaev
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Sophie Fertel
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Yi-Wen Lin
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Chun-Teng Huang
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Antonella Pinto
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Chen Farhy
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Alex Y Strongin
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Wei Zheng
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, United States
| | - Alexey V Terskikh
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
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19
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Gharbaran R, Somenarain L. Putative Cellular and Molecular Roles of Zika Virus in Fetal and Pediatric Neuropathologies. Pediatr Dev Pathol 2019; 22:5-21. [PMID: 30149771 DOI: 10.1177/1093526618790742] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although the World Health Organization declared an end to the recent Zika virus (ZIKV) outbreak and its association with adverse fetal and pediatric outcome, on November 18, 2016, the virus still remains a severe public health threat. Laboratory experiments thus far supported the suspicions that ZIKV is a teratogenic agent. Evidence indicated that ZIKV infection cripples the host cells' innate immune responses, allowing productive replication and potential dissemination of the virus. In addition, studies suggest potential transplacental passage of the virus and subsequent selective targeting of neural progenitor cells (NPCs). Depletion of NPCs by ZIKV is associated with restricted brain growth. And while microcephaly can result from infection at any gestational stages, the risk is greater during the first trimester. Although a number of recent studies revealed some of specific molecular and cellular roles of ZIKV proteins of this mosquito-borne flavivirus, the mechanisms by which it produces it suspected pathophysiological effects are not completely understood. Thus, this review highlights the cellular and molecular evidence that implicate ZIKV in fetal and pediatric neuropathologies.
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Affiliation(s)
- Rajendra Gharbaran
- 1 Department of Biological Sciences, Bronx Community College, The City University of New York, Bronx, New York
| | - Latchman Somenarain
- 1 Department of Biological Sciences, Bronx Community College, The City University of New York, Bronx, New York
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20
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Soares-Marangoni DDA, Tedesco NM, Nascimento AL, Almeida PRD, Santos Pereira CND. General movements and motor outcomes in two infants exposed to Zika virus: brief report. Dev Neurorehabil 2019; 22:71-74. [PMID: 29452026 DOI: 10.1080/17518423.2018.1437843] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We described the general movements (GMs) in the fidgety period and the motor performance of two infants who were exposed to Zika virus (ZIKV) during distinct trimesters of gestation. METHODS Infants were assessed at 4 and 12 months of age. Prechtl's GM assessment and the Alberta Infant Motor Scale were used. RESULTS In Case 1, the mother presented confirmed ZIKV infection in the 10th week of gestation and the infant was born full-term with brain abnormalities and microcephaly. Fidgety movements were absent at 16 weeks after term and motor development was severely impaired at 12 months of age. In Case 2, the mother presented confirmed ZIKV infection in the 34th week of gestation and the infant was born full-term with no signs of brain changes or microcephaly. Fidgety movements at 13 weeks were normal in presentation and motor outcome was typical at 12 months. CONCLUSION GM assessment can be useful for ZIKV-exposed infants. These findings represent the first information on GMs and long-term motor outcomes in ZIKV-exposed infants.
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Affiliation(s)
| | - Natália Matos Tedesco
- b Program of Post-Graduation in Health and Development , Faculty of Medicine, UFMS , Campo Grande , Brazil
| | - Andressa Lagoa Nascimento
- b Program of Post-Graduation in Health and Development , Faculty of Medicine, UFMS , Campo Grande , Brazil
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21
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Mulkey SB, Bulas DI, Vezina G, Fourzali Y, Morales A, Arroyave-Wessel M, Swisher CB, Cristante C, Russo SM, Encinales L, Pacheco N, Kousa YA, Lanciotti RS, Cure C, DeBiasi RL, du Plessis AJ. Sequential Neuroimaging of the Fetus and Newborn With In Utero Zika Virus Exposure. JAMA Pediatr 2019; 173:52-59. [PMID: 30476967 PMCID: PMC6583436 DOI: 10.1001/jamapediatrics.2018.4138] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The evolution of fetal brain injury by Zika virus (ZIKV) infection is not well described. OBJECTIVES To perform longitudinal neuroimaging of fetuses and infants exposed to in utero maternal ZIKV infection using concomitant magnetic resonance imaging (MRI) and ultrasonography (US), as well as to determine the duration of viremia in pregnant women with ZIKV infection and whether the duration of viremia correlated with fetal and/or infant brain abnormalities. DESIGN, SETTING, AND PARTICIPANTS A cohort of 82 pregnant women with clinical criteria for probable ZIKV infection in Barranquilla, Colombia, and Washington, DC, were enrolled from June 15, 2016, through June 27, 2017, with Colombian women identified by community recruitment and physician referral and travel-related cases of American women recruited from a Congenital Zika Program. INTERVENTIONS AND EXPOSURES Women received 1 or more MRI and US examinations during the second and/or third trimesters. Postnatally, infants underwent brain MRI and cranial US. Blood samples were tested for ZIKV. MAIN OUTCOMES AND MEASURES The neuroimaging studies were evaluated for brain injury and cerebral biometry. RESULTS Of the 82 women, 80 were from Colombia and 2 were from the United States. In 3 of 82 cases (4%), fetal MRI demonstrated abnormalities consistent with congenital ZIKV infection. Two cases had heterotopias and malformations in cortical development and 1 case had a parietal encephalocele, Chiari II malformation, and microcephaly. In 1 case, US results remained normal despite fetal abnormalities detected on MRI. Prolonged maternal polymerase chain reaction positivity was present in 1 case. Of the remaining 79 cases with normal results of prenatal imaging, postnatal brain MRI was acquired in 53 infants and demonstrated mild abnormalities in 7 (13%). Fifty-seven infants underwent postnatal cranial US, which detected changes of lenticulostriate vasculopathy, choroid plexus cysts, germinolytic/subependymal cysts, and/or calcification in 21 infants (37%). CONCLUSIONS AND RELEVANCE In a cohort of pregnant women with ZIKV infection, prenatal US examination appeared to detect all but 1 abnormal fetal case. Postnatal neuroimaging in infants who had normal prenatal imaging revealed new mild abnormalities. For most patients, prenatal and postnatal US may identify ZIKV-related brain injury.
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Affiliation(s)
- Sarah B. Mulkey
- Division of Fetal and Transitional Medicine, Children’s National Health System, Washington, DC,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC,Department of Neurology, School of Medicine and Health Sciences, The George Washington University, Washington, DC
| | - Dorothy I. Bulas
- Division of Radiology, Children’s National Health System, Washington, DC
| | - Gilbert Vezina
- Division of Radiology, Children’s National Health System, Washington, DC
| | | | | | | | - Christopher B. Swisher
- Division of Fetal and Transitional Medicine, Children’s National Health System, Washington, DC
| | - Caitlin Cristante
- Division of Fetal and Transitional Medicine, Children’s National Health System, Washington, DC
| | - Stephanie M. Russo
- Division of Fetal and Transitional Medicine, Children’s National Health System, Washington, DC
| | | | | | - Youssef A. Kousa
- Division of Neurology, Children’s National Health System, Washington, DC
| | - Robert S. Lanciotti
- Arbovirus Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Roberta L. DeBiasi
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC,Division of Infectious Diseases, Children’s National Health System, Washington, DC,Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC
| | - Adre J. du Plessis
- Division of Fetal and Transitional Medicine, Children’s National Health System, Washington, DC,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC,Department of Neurology, School of Medicine and Health Sciences, The George Washington University, Washington, DC
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22
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Kirkham FJ, Zafeiriou D, Howe D, Czarpran P, Harris A, Gunny R, Vollmer B. Fetal stroke and cerebrovascular disease: Advances in understanding from lenticulostriate and venous imaging, alloimmune thrombocytopaenia and monochorionic twins. Eur J Paediatr Neurol 2018; 22:989-1005. [PMID: 30467085 DOI: 10.1016/j.ejpn.2018.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/17/2022]
Abstract
Fetal stroke is an important cause of cerebral palsy but is difficult to diagnose unless imaging is undertaken in pregnancies at risk because of known maternal or fetal disorders. Fetal ultrasound or magnetic resonance imaging may show haemorrhage or ischaemic lesions including multicystic encephalomalacia and focal porencephaly. Serial imaging has shown the development of malformations including schizencephaly and polymicrogyra after ischaemic and haemorrhagic stroke. Recognised causes of haemorrhagic fetal stroke include alloimmune and autoimmune thrombocytopaenia, maternal and fetal clotting disorders and trauma but these are relatively rare. It is likely that a significant proportion of periventricular and intraventricular haemorrhages are of venous origin. Recent evidence highlights the importance of arterial endothelial dysfunction, rather than thrombocytopaenia, in the intraparenchymal haemorrhage of alloimmune thrombocytopaenia. In the context of placental anastomoses, monochorionic diamniotic twins are at risk of twin twin transfusion syndrome (TTTS), or partial forms including Twin Oligohydramnios Polyhydramnios Sequence (TOPS), differences in estimated weight (selective Intrauterine growth Retardation; sIUGR), or in fetal haemoglobin (Twin Anaemia Polycythaemia Sequence; TAPS). There is a very wide range of ischaemic and haemorrhagic injury in a focal as well as a global distribution. Acute twin twin transfusion may account for intraventricular haemorrhage in recipients and periventricular leukomalacia in donors but there are additional risk factors for focal embolism and cerebrovascular disease. The recipient has circulatory overload, with effects on systemic and pulmonary circulations which probably lead to systemic and pulmonary hypertension and even right ventricular outflow tract obstruction as well as the polycythaemia which is a risk factor for thrombosis and vasculopathy. The donor is hypovolaemic and has a reticulocytosis in response to the anaemia while maternal hypertension and diabetes may influence stroke risk. Understanding of the mechanisms, including the role of vasculopathy, in well studied conditions such as alloimmune thrombocytopaenia and monochorionic diamniotic twinning may lead to reduction of the burden of antenatally sustained cerebral palsy.
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Affiliation(s)
- Fenella J Kirkham
- Developmental Neurosciences Section and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom; Departments of Child Health, Obstetrics and Gynaecology and Radiology, University Hospital Southampton, United Kingdom; Clinical and Experimental Sciences, University of Southampton, United Kingdom.
| | - Dimitrios Zafeiriou
- 1st Department of Pediatrics, "Hippokratio' General Hospital, Aristotle University, Thessaloniki, Greece
| | - David Howe
- Departments of Child Health, Obstetrics and Gynaecology and Radiology, University Hospital Southampton, United Kingdom; Clinical and Experimental Sciences, University of Southampton, United Kingdom
| | - Philippa Czarpran
- Departments of Child Health, Obstetrics and Gynaecology and Radiology, University Hospital Southampton, United Kingdom
| | - Ashley Harris
- Departments of Child Health, Obstetrics and Gynaecology and Radiology, University Hospital Southampton, United Kingdom
| | - Roxanna Gunny
- Developmental Neurosciences Section and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom; Department of Radiology, St George's hospital, London, United Kingdom
| | - Brigitte Vollmer
- Departments of Child Health, Obstetrics and Gynaecology and Radiology, University Hospital Southampton, United Kingdom; Clinical and Experimental Sciences, University of Southampton, United Kingdom
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23
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Preliminary Studies on Immune Response and Viral Pathogenesis of Zika Virus in Rhesus Macaques. Pathogens 2018; 7:pathogens7030070. [PMID: 30127237 PMCID: PMC6160936 DOI: 10.3390/pathogens7030070] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/18/2018] [Accepted: 08/10/2018] [Indexed: 01/08/2023] Open
Abstract
Zika Virus (ZIKV) is primarily transmitted through mosquito bites. It can also be transmitted during sexual intercourse and in utero from mother to fetus. To gain preliminary insight into ZIKV pathology and immune responses on route of transmission, rhesus macaques (RMs) were inoculated with ZIKV (PRVABC59) via intravaginal (IVAG) (n = 3) or subcutaneous (sub Q) (n = 2) routes. Systemic ZIKV infection was observed in all RMs, regardless of the route of inoculation. After 9 days postinfection (dpi), ZIKV was not detected in the plasma of IVAG- and sub-Q-inoculated RMs. Importantly, RMs harbored ZIKV up to 60 dpi in various anatomical locations. Of note, ZIKV was also present in several regions of the brain, including the caudate nucleus, parietal lobe, cortex, and amygdala. These observations appear to indicate that ZIKV infection may be systemic and persistent regardless of route of inoculation. In addition, we observed changes in key immune cell populations in response to ZIKV infection. Importantly, IVAG ZIKV infection of RMs is associated with increased depletion of CD11C hi myeloid cells, reduced PD-1 expression in NK cells, and elevated frequencies of Ki67+ CD8+ central memory cells as compared to sub Q ZIKV-infected RMs. These results need to interpreted with caution due to the small number of animals utilized in this study. Future studies involving large groups of animals that have been inoculated through both routes of transmission are needed to confirm our findings.
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Brito CAA, Henriques-Souza A, Soares CRP, Castanha PMS, Machado LC, Pereira MR, Sobral MCM, Lucena-Araujo AR, Wallau GL, Franca RFO. Persistent detection of Zika virus RNA from an infant with severe microcephaly - a case report. BMC Infect Dis 2018; 18:388. [PMID: 30097025 PMCID: PMC6086026 DOI: 10.1186/s12879-018-3313-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/03/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Zika virus (ZIKV) is a recently emerged arbovirus, which infection during pregnancy is associated with a series of congenital malformations, collectively denominated Congenital Zika Syndrome (CZS). Following infection, ZIKV RNA has a median duration period of 10 days in plasma and up to 6 months in semen in immunocompetent adult individuals. Moreover, ZIKV is able to replicate and persist in fetal brains and placentas, consequently, infection is associated with pregnancy loss, albeit the pathogenic mechanisms are still unknown. CASE PRESENTATION Here we report a CZS case of an infant born during the ZIKV outbreak in northeast Brazil, the child presented recurrent episodes of seizures with prolonged presence of ZIKV RNA on the central nervous system (CNS) and blood. ZIKV RNA was identified and partially sequenced from a sample of cerebrospinal fluid (CSF) obtained from the infant with 6 months of life, and later from another sample after the infant completed 17 months of life. Commonly congenital infections were discarded based on STORCH (syphilis, toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus) negative laboratory results. Presence of specific ZIKV antibodies on both mother and children confirmed the association of severe microcephaly and ZIKV infection, diagnosed after birth. CONCLUSIONS Altogether, our data raise the possibility that CZS cases may result in prolonged viral presence, these findings could be useful for therapy and diagnostic recommendations.
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Affiliation(s)
- Carlos A. A. Brito
- Department of Clinical Medicine, Federal University of Pernambuco – UFPE, Recife, 50670-901 Brazil
| | | | - Cynthia R. P. Soares
- Department of Virology and Experimental Therapy, Aggeu Magalhães Institute, Oswaldo Cruz Foundation – FIOCRUZ, Avenida Professor Moraes Rego s/n, Recife, PE 50740-465 Brazil
| | - Priscila M. S. Castanha
- Department of Virology and Experimental Therapy, Aggeu Magalhães Institute, Oswaldo Cruz Foundation – FIOCRUZ, Avenida Professor Moraes Rego s/n, Recife, PE 50740-465 Brazil
| | - Laís C. Machado
- Department of Entomology, Oswaldo Cruz Foundation - FIOCRUZ, Aggeu Magalhães Institute, Recife, 50740-465 Brazil
| | - Mylena R. Pereira
- Department Veterinary Medicine, Federal Rural University of Pernambuco – UFRPE, Recife, 52171-900 Brazil
| | - Mariana C. M. Sobral
- Department of Entomology, Oswaldo Cruz Foundation - FIOCRUZ, Aggeu Magalhães Institute, Recife, 50740-465 Brazil
| | | | - Gabriel L. Wallau
- Department of Entomology, Oswaldo Cruz Foundation - FIOCRUZ, Aggeu Magalhães Institute, Recife, 50740-465 Brazil
| | - Rafael F. O. Franca
- Department of Virology and Experimental Therapy, Aggeu Magalhães Institute, Oswaldo Cruz Foundation – FIOCRUZ, Avenida Professor Moraes Rego s/n, Recife, PE 50740-465 Brazil
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25
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Rasmussen SA, Meaney-Delman DM, Petersen LR, Jamieson DJ. Studying the effects of emerging infections on the fetus: Experience with West Nile and Zika viruses. Birth Defects Res 2018; 109:363-371. [PMID: 28398684 PMCID: PMC7161891 DOI: 10.1002/bdr2.1006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 12/14/2022]
Abstract
Emerging infections have the potential to produce adverse effects on the pregnant woman or her fetus; however, studying these effects is often challenging. We review our experiences with investigating the prenatal effects of two mosquito‐borne infections that emerged in the past 2 decades, West Nile virus (WNV) and Zika virus. Concerns regarding teratogenicity were raised about both viruses; Zika virus has been confirmed to be teratogenic, while WNV appears not to increase the risk for adverse outcomes, although teratogenicity has not been excluded. Study designs used to examine the effects of both viruses include case reports and series, pregnancy registries, and cohort studies. Case–control studies and birth defects surveillance systems are being used to study the effects during pregnancy of Zika virus, but not the effects of WNV, because a specific phenotype was observed among infants with congenital Zika infection, but not among infants with congenital WNV infection. Experimental data that demonstrated that Zika virus was neurotropic have also been useful because they provided biologic plausibility for Zika virus's teratogenic effects: these findings were consistent with observations in congenitally infected infants. Challenges encountered with studies to evaluate the effects of these infections include the broad range of possible adverse outcomes, the inability to include all infected pregnant women in studies because many infections are asymptomatic, and the difficulty with interpretation of diagnostic testing of infants (WNV and Zika) and pregnant women (Zika). This review might be helpful to guide future studies of the effects of emerging infections during pregnancy. Birth Defects Research 109:363–371, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | - Lyle R Petersen
- Centers for Disease Control and Prevention, Atlanta, Georgia
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26
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Nogueira ML, Nery Júnior NRR, Estofolete CF, Bernardes Terzian AC, Guimarães GF, Zini N, Alves da Silva R, Dutra Silva GC, Junqueira Franco LC, Rahal P, Bittar C, Carneiro B, Vasconcelos PFC, Freitas Henriques D, Barbosa DMU, Lopes Rombola P, de Grande L, Negri Reis AF, Palomares SA, Wakai Catelan M, Cruz LEAA, Necchi SH, Mendonça RCV, Penha Dos Santos IN, Alavarse Caron SB, Costa F, Bozza FA, Soares de Souza A, Brandão de Mattos CC, de Mattos LC, Vasilakis N, Oliani AH, Vaz Oliani DCM, Ko AI. Adverse birth outcomes associated with Zika virus exposure during pregnancy in São José do Rio Preto, Brazil. Clin Microbiol Infect 2018; 24:646-652. [PMID: 29133154 DOI: 10.1016/j.cmi.2017.11.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 10/29/2017] [Accepted: 11/02/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We aimed to report the first 54 cases of pregnant women infected by Zika virus (ZIKV) and their virologic and clinical outcomes, as well as their newborns' outcomes, in 2016, after the emergence of ZIKV in dengue-endemic areas of São Paulo, Brazil. METHODS This descriptive study was performed from February to October 2016 on 54 quantitative real-time PCR ZIKV-positive pregnant women identified by the public health authority of São José do Rio Preto, São Paulo, Brazil. The women were followed and had clinical and epidemiologic data collected before and after birth. Adverse outcomes in newborns were analysed and reported. Urine or blood samples from newborns were collected to identify ZIKV infection by reverse transcription PCR (RT-PCR). RESULTS A total of 216 acute Zika-suspected pregnant women were identified, and 54 had the diagnosis confirmed by RT-PCR. None of the 54 women miscarried. Among the 54 newborns, 15 exhibited adverse outcomes at birth. The highest number of ZIKV infections occurred during the second and third trimesters. No cases of microcephaly were reported, though a broad clinical spectrum of outcomes, including lenticulostriate vasculopathy, subependymal cysts, and auditory and ophthalmologic disorders, were identified. ZIKV RNA was detected in 18 of 51 newborns tested and in eight of 15 newborns with adverse outcomes. CONCLUSIONS Although other studies have associated many newborn outcomes to ZIKV infection during pregnancy, these same adverse outcomes were rare or nonexistent in this study. The clinical presentation the newborns we studied was mild compared to other reports, suggesting that there is significant heterogeneity in congenital Zika infection.
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Affiliation(s)
- M L Nogueira
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil.
| | - N R R Nery Júnior
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - C F Estofolete
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | | | - G F Guimarães
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - N Zini
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - R Alves da Silva
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - G C Dutra Silva
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - L C Junqueira Franco
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - P Rahal
- São Paulo State University, São José do Rio Preto, São Paulo, Brazil
| | - C Bittar
- São Paulo State University, São José do Rio Preto, São Paulo, Brazil
| | - B Carneiro
- São Paulo State University, São José do Rio Preto, São Paulo, Brazil
| | | | | | - D M U Barbosa
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - P Lopes Rombola
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - L de Grande
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - A F Negri Reis
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - S A Palomares
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - M Wakai Catelan
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - L E A A Cruz
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - S H Necchi
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | - R C V Mendonça
- Health Secretariat, São José do Rio Preto, São Paulo, Brazil
| | | | | | - F Costa
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Federal University of Bahia, Salvador, Bahia, Brazil; Yale School of Public Health, New Haven, CT, USA
| | - F A Bozza
- Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - A Soares de Souza
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | | | - L C de Mattos
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - N Vasilakis
- University of Texas Medical Branch (UTMB), Galveston, TX, USA
| | - A H Oliani
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - D C M Vaz Oliani
- São José do Rio Preto School of Medicine, São José do Rio Preto, São Paulo, Brazil
| | - A I Ko
- Yale School of Public Health, New Haven, CT, USA
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27
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Regadas VC, Silva MDCE, Abud LG, Labadessa LMPL, Oliveira RGGD, Miyake CH, Queiroz RM. Microcephaly caused by congenital Zika virus infection and viral detection in maternal urine during pregnancy. ACTA ACUST UNITED AC 2018; 64:11-14. [PMID: 29561936 DOI: 10.1590/1806-9282.64.01.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/07/2017] [Indexed: 11/22/2022]
Abstract
Currently Latin America is undergoing a major epidemic of Zika virus, which is transmitted by Aedes mosquitoes. Concern for Zika virus infection has been increasing as it is suspected of causing brain defects in newborns such as microcephaly and, more recently, potential neurological and autoimmune complications including Guillian-Barré syndrome and acute disseminated encephalomyelitis. We describe a case of virus infection in a 25-year-old woman during the first trimester of her pregnancy, confirmed by laboratory tests only for the detection of viral particles in maternal urine, with imaging studies demonstrating the progression of cranial and encephalic changes in the fetus and later in the newborn, such as head circumference reduction, cerebral calcifications and ventriculomegaly.
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Affiliation(s)
- Vanessa Couras Regadas
- Department of Radiology and Medical Imaging, Documenta - Hospital Materno Infantil Sinhá Junqueira, Ribeirão Preto, SP, Brazil.,Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
| | - Márcio de Castro E Silva
- Department of Radiology and Medical Imaging, Documenta - Hospital Materno Infantil Sinhá Junqueira, Ribeirão Preto, SP, Brazil.,Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
| | - Lucas Giansante Abud
- Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
| | - Luiz Mario Pereira Lopes Labadessa
- Department of Radiology and Medical Imaging, Documenta - Hospital Materno Infantil Sinhá Junqueira, Ribeirão Preto, SP, Brazil.,Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
| | - Rafael Gouvêa Gomes de Oliveira
- Department of Radiology and Medical Imaging, Documenta - Hospital Materno Infantil Sinhá Junqueira, Ribeirão Preto, SP, Brazil.,Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
| | - Cecília Hissae Miyake
- Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
| | - Rodolfo Mendes Queiroz
- Department of Radiology and Medical Imaging, Documenta - Hospital Materno Infantil Sinhá Junqueira, Ribeirão Preto, SP, Brazil.,Department of Radiology and Medical Imaging, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil
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28
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Neuberger I, Garcia J, Meyers ML, Feygin T, Bulas DI, Mirsky DM. Imaging of congenital central nervous system infections. Pediatr Radiol 2018; 48:513-523. [PMID: 29550865 DOI: 10.1007/s00247-018-4092-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/08/2018] [Accepted: 01/19/2018] [Indexed: 10/17/2022]
Abstract
Congenital central nervous system (CNS) infections are a cause of significant morbidity and mortality. The recent Zika virus outbreak raised awareness of congenital CNS infections. Imaging can be effective in diagnosing the presence and severity of infection. In this paper we review the clinical presentations and imaging characteristics of several common and less common congenital CNS infections.
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Affiliation(s)
- Ilana Neuberger
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E. 16th Ave., Box B125, Aurora, CO, 80045, USA
| | - Jacquelyn Garcia
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E. 16th Ave., Box B125, Aurora, CO, 80045, USA
| | - Mariana L Meyers
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E. 16th Ave., Box B125, Aurora, CO, 80045, USA
| | - Tamara Feygin
- Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Dorothy I Bulas
- Department of Radiology, Children's National Health System, George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - David M Mirsky
- Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E. 16th Ave., Box B125, Aurora, CO, 80045, USA.
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29
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Epelboin S, Dulioust E, Epelboin L, Benachi A, Merlet F, Patrat C. Zika virus and reproduction: facts, questions and current management. Hum Reprod Update 2018; 23:629-645. [PMID: 28961800 DOI: 10.1093/humupd/dmx024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/02/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) is an arthropod-borne virus of the family Flaviviridae, genus Flavivirus. ZIKV is currently the focus of an ongoing pandemic and worldwide public health emergency. Although originally isolated in 1947, its pathogenesis was poorly known and very few documented infections were published until recently. Its route of transmission and its impact on reproduction and pregnancy have only recently begun to be disclosed. OBJECTIVE AND RATIONALE This review summarizes the most recent knowledge about ZIKV infection and pathogenesis and focuses on its impacts on male and female genital tracts, including the risks of sexual transmission and to pregnancy. The consequences of ZIKV infection for pregnancy planning and ART are also discussed. SEARCH METHODS The PubMed and EMBASE databases were inter-rogated using specific terms, such as 'ZIKV', 'transmission', 'male', 'female', fertility', 'pregnancy, 'semen', 'testis', 'ovary' and 'genital tract', up to 17 March 2017. OUTCOMES ZIKV has long been considered a harmless virus, but increasing evidence suggests that it has adverse effects on the neurological system and on pregnancy outcomes. In mice, ZIKV slows foetal growth and damages the foetal brain. In humans, the virus is able to cross the placental barrier and to induce foetal death and major anomalies, such as microcephaly, brain defects and long-term neurologic sequelae, i.e. the 'congenital Zika syndrome'. In addition to its transmission by mosquitoes, ZIKV may be transmitted sexually. Currently available data indicate that ZIKV RNA can remain detectable in semen for several months, whereas shedding in the female genital tract appears to be rare and of short duration. Current guidance on preventing the sexual transmission of ZIKV is based on the assumption that transmission occurs from a male partner to a receptive partner. Furthermore, in mouse models, the virus can actively replicate in male genital organs and induce severe orchitis, which raises concerns about its possible impact on human male fertility. WIDER IMPLICATIONS These new and relevant findings have led many countries and institutions to release updated and regular guidance for preconception counselling and ART to prevent the sexual transmission of ZIKV. Progress in understanding the sexual transmission of ZIKV and its dissemination to genital systems would also help to better anticipate and control outbreaks of potentially sexually transmissible infectious agents.
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Affiliation(s)
- Sylvie Epelboin
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service de Gynécologie, Obstétrique et Reproduction, 46 rue Henri Huchard, 75018 Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, France
| | - Emmanuel Dulioust
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Centre d'Etudes et de Conservation des Ovocytes et du Sperme, 27 rue du Faubourg Saint Jacques, 75014 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, France
| | - Loïc Epelboin
- Hôpital Andrée Rosemon, Avenue des Flamboyants, Cayenne 97300, France.,Université de Guyane, Equipe EA 3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Cayenne, Guyane Française
| | - Alexandra Benachi
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service de Gynécologie-Obstétrique, 147 rue de la Porte de Trivaux, 92140 Clamart, France.,Université Paris Sud, Clamart, France
| | - Françoise Merlet
- Agence de la Biomédecine, 1 Avenue du Stade de France, 93212 La Plaine Saint Denis, France
| | - Catherine Patrat
- Université Paris Diderot, Sorbonne Paris Cité, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service de Biologie de la Reproduction, 46 rue Henri Huchard, 75018 Paris, France
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30
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Halai UA, Nielsen-Saines K, Moreira ML, de Sequeira PC, Junior JPP, de Araujo Zin A, Cherry J, Gabaglia CR, Gaw SL, Adachi K, Tsui I, Pilotto JH, Nogueira RR, de Filippis AMB, Brasil P. Maternal Zika Virus Disease Severity, Virus Load, Prior Dengue Antibodies, and Their Relationship to Birth Outcomes. Clin Infect Dis 2018; 65:877-883. [PMID: 28535184 DOI: 10.1093/cid/cix472] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/17/2017] [Indexed: 11/13/2022] Open
Abstract
Background Congenital Zika virus (ZIKV) syndrome is a newly identified condition resulting from infection during pregnancy. We analyzed outcome data from a mother-infant cohort in Rio de Janeiro in order to assess whether clinical severity of maternal ZIKV infection was associated with maternal virus load, prior dengue antibodies, or abnormal pregnancy/infant outcomes. Methods A clinical severity assessment tool was developed based on duration of fever, severity of rash, multisystem involvement, and duration of symptoms during ZIKV infection. ZIKV-RNA load was quantified by polymerase chain reaction (PCR) cycles in blood/ urine. Dengue immunoglobulin G (IgG) antibodies were measured at baseline. Adverse outcomes were defined as fetal loss or a live infant with grossly abnormal clinical or brain imaging findings. Regression models were used to study potential associations. Results 131 ZIKV-PCR positive pregnant women were scored for clinical disease severity, 6 (4.6%) had mild disease, 98 (74.8%) had moderate disease, and 27 (20.6%) severe manifestations of ZIKV infection. There were 58 (46.4%) abnormal outcomes with 9 fetal losses (7.2%) in 125 pregnancies. No associations were found between: disease severity and abnormal outcomes (P = .961; odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.796-1.270); disease severity and viral load (P = .994); viral load and adverse outcomes (P = .667; OR: 1.02; 95% CI: 0.922-1.135); or existence of prior dengue antibodies (88% subjects) with severity score, ZIKV-RNA load or adverse outcomes (P = .667; OR: 0.78; 95% CI: 0.255-2.397). Conclusions Congenital ZIKV syndrome does not appear to be associated with maternal disease severity, ZIKV-RNA load at time of infection or existence of prior dengue antibodies.
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Affiliation(s)
- Umme-Aiman Halai
- David Geffen School of Medicine, University of California, Los Angeles
| | | | | | | | | | | | - James Cherry
- David Geffen School of Medicine, University of California, Los Angeles
| | | | | | - Kristina Adachi
- David Geffen School of Medicine, University of California, Los Angeles
| | - Irena Tsui
- David Geffen School of Medicine, University of California, Los Angeles
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31
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Counotte MJ, Egli-Gany D, Riesen M, Abraha M, Porgo TV, Wang J, Low N. Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: From systematic review to living systematic review. F1000Res 2018; 7:196. [PMID: 30631437 PMCID: PMC6290976 DOI: 10.12688/f1000research.13704.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 01/16/2023] Open
Abstract
Background. The Zika virus (ZIKV) outbreak in the Americas has caused international concern due to neurological sequelae linked to the infection, such as microcephaly and Guillain-Barré syndrome (GBS). The World Health Organization stated that there is “sufficient evidence to conclude that Zika virus is a cause of congenital abnormalities and is a trigger of GBS”. This conclusion was based on a systematic review of the evidence published until 30.05.2016. Since then, the body of evidence has grown substantially, leading to this update of that systematic review with new evidence published from 30.05.2016 – 18.01.2017, update 1. Methods. We review evidence on the causal link between ZIKV infection and adverse congenital outcomes and the causal link between ZIKV infection and GBS or immune-mediated thrombocytopaenia purpura. We also describe the transition of the review into a living systematic review, a review that is continually updated. Results. Between 30.05.2016 and 18.01.2017, we identified 2413 publications, of which 101 publications were included. The evidence added in this update confirms the conclusion of a causal association between ZIKV and adverse congenital outcomes. New findings expand the evidence base in the dimensions of biological plausibility, strength of association, animal experiments and specificity. For GBS, the body of evidence has grown during the search period for update 1, but only for dimensions that were already populated in the previous version. There is still a limited understanding of the biological pathways that potentially cause the occurrence of autoimmune disease following ZIKV infection. Conclusions. This systematic review confirms previous conclusions that ZIKV is a cause of congenital abnormalities, including microcephaly, and is a trigger of GBS. The transition to living systematic review techniques and methodology provides a proof of concept for the use of these methods to synthesise evidence about an emerging pathogen such as ZIKV.
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Affiliation(s)
| | - Dianne Egli-Gany
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Maurane Riesen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Million Abraha
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Jingying Wang
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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32
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Azeredo EL, Dos Santos FB, Barbosa LS, Souza TMA, Badolato-Corrêa J, Sánchez-Arcila JC, Nunes PCG, de-Oliveira-Pinto LM, de Filippis AM, Dal Fabbro M, Hoscher Romanholi I, Venancio da Cunha R. Clinical and Laboratory Profile of Zika and Dengue Infected Patients: Lessons Learned From the Co-circulation of Dengue, Zika and Chikungunya in Brazil. PLOS CURRENTS 2018; 10. [PMID: 29588874 PMCID: PMC5843488 DOI: 10.1371/currents.outbreaks.0bf6aeb4d30824de63c4d5d745b217f5] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: The current triple epidemic caused by dengue, zika and chikungunya constitutes a serious health problem in Brazil. The aim of this study was to investigate acute samples (up to the 7 days of symptoms) from patients presenting acute fever syndrome suspected as arboviral infection and characterize the clinical and laboratorial profile during the co-circulation of dengue, zika and chikungunya in Campo Grande, Mato Grosso do Sul (MS), midwest region of Brazil. Methods: All suspected cases (n=134) were tested by using serological and molecular diagnostic tests including DENV, ZIKV and CHIKV RT-PCR, Dengue nonstructural protein 1 (NS1) antigen capture ELISA, anti- DENV IgM ELISA and anti-CHIKV IgM ELISA. In addition, clinical, hematological and biochemical parameters of infected patients were analyzed. Results: It was observed that 79.1% of the blood samples were confirmed for ZIKV and/or DENV infection Of those, 38.0% patients were DENV monoinfected, 26.8% were ZIKV monoinfected and 13.4% were DENV/ZIKV co-infected. Seven patients presented Chikungunya IgM antibodies indicating a previous CHIKV infection. Common symptoms included fever, rash, arthralgia, myalgia, prostration, headache and conjunctivitis. Statistical analysis showed that pruritus and edema were associated with ZIKV infection while prostration and vomiting were more associated with dengue. Additionally, total protein and ALT levels were significantly different in DENV patients compared to ZIKV ones. Some DENV infected patients as well as co-infected needed hospitalization and venous hydration. Otherwise, most ZIKV infected patients presented mild clinical course. Among the pregnant women studied (n=11), three were ZIKV monoinfected while four were DENV monoinfected and two were DENV-1/ZIKV coinfected. In general, normal birth outcomes were observed except for the death due to respiratory insufficiency of one baby born to a mother coinfected with DENV-1/ZIKV. Conclusions: Herein, we provide evidence of the co-circulation of DENV, ZIKV and CHIKV infections in the Campo Grande, MS, Brazil, with a high frequency of DENV-1/ZIKV coinfection. Laboratorial diagnosis poses a challenge where those arboviruses are endemic and differential diagnosis proved to imperative for cases characterization. The knowledge about disease severity during arbovirus coinfections is still scarce and there are several issues emphasizing the importance of adequate management of patients at risk areas.
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Affiliation(s)
| | | | - Luciana Santos Barbosa
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil; UFRJ- Federal University of Rio de Janeiro, Laboratory of Genetics, IPPMG - Martagão Gesteira Child Care and Pediatrics Institute, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Márcia Dal Fabbro
- Medical Clinic Department, Federal University of Mato Grosso do Sul, Campo,Grande, MS, Brazil
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33
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Majumder MS, Hess R, Ross R, Piontkivska H. Seasonality of birth defects in West Africa: could congenital Zika syndrome be to blame? F1000Res 2018; 7:159. [PMID: 30079237 PMCID: PMC6058464 DOI: 10.12688/f1000research.13858.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2018] [Indexed: 01/12/2023] Open
Abstract
The link between Zika virus infection during pregnancy and microcephaly and other neurodevelopmental defects in infants, referred to as congenital Zika syndrome (CZS), was recently discovered. One key question that remains is whether such neurodevelopmental abnormalities are limited to the recently evolved Asiatic ZIKV strains or if they can also be induced by endemic African strains. Thus, we examined birth registries from one particular hospital from a country in West Africa, where ZIKV is endemic. Results showed a seasonal pattern of birth defects that is consistent with potential CZS, which corresponds to a range of presumed maternal infection that encompasses both the peak of the warm, rainy season as well as the months immediately following it, when mosquito activity is likely high. While we refrain from definitively linking ZIKV infection and birth defects in West Africa at this time, in part due to scant data available from the region, we hope that this report will initiate broader surveillance efforts that may help shed light onto mechanisms underlying CZS.
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Affiliation(s)
- Maimuna S Majumder
- Computational Epidemiology Group, Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, 02115, USA.,Engineering Systems Division, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA
| | - Rosanna Hess
- Research for Health, Inc., Cuyahoga Falls, OH, 44223, USA
| | - Ratchneewan Ross
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, 27408, USA
| | - Helen Piontkivska
- 241 Cunningham Hall, Department of Biological Sciences & School of Biomedical Sciences, Kent State University, Kent, OH, 44242, USA
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34
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Wheeler AC. Development of Infants With Congenital Zika Syndrome: What Do We Know and What Can We Expect? Pediatrics 2018; 141:S154-S160. [PMID: 29437048 PMCID: PMC5795516 DOI: 10.1542/peds.2017-2038d] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 01/10/2023] Open
Abstract
The association between Zika virus infection during pregnancy and severe birth defects in infants has led to worldwide attention focused on the mechanisms of the disease and the prevention of future exposure. Surveillance efforts around the world continue with the goal of identifying and monitoring all potentially exposed women and their newborns. For infants who were born with congenital Zika syndrome (CZS) and their families, an uncertain future awaits. As infants who were born with CZS during the most recent outbreak enter their second year of life, new developments in the outcomes of the condition continue to unfold, providing some insight into the likely long-term sequalae. In this article, I review the literature on emerging findings regarding the impact of CZS on the developing infant and provide some predictions regarding the long-term outcomes and lifetime needs of these children and their families.
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Affiliation(s)
- Anne C Wheeler
- RTI International, Research Triangle Park, North Carolina
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35
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Pessoa A, van der Linden V, Yeargin-Allsopp M, Carvalho MDCG, Ribeiro EM, Van Naarden Braun K, Durkin MS, Pastula DM, Moore JT, Moore CA. Motor Abnormalities and Epilepsy in Infants and Children With Evidence of Congenital Zika Virus Infection. Pediatrics 2018; 141:S167-S179. [PMID: 29437050 DOI: 10.1542/peds.2017-2038f] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
Initial reports of congenital Zika virus (ZIKV) infection focused on microcephaly at birth with severe brain anomalies; the phenotype has broadened to include microcephaly that develops after birth and neurodevelopmental sequelae. In this narrative review, we summarize medical literature describing motor abnormalities and epilepsy in infants with evidence of congenital ZIKV infection and provide information on the impact of these conditions. Specific scenarios are used to illustrate the complex clinical course in infants with abnormalities that are consistent with congenital Zika syndrome. A search of the English-language medical literature was done to identify motor abnormalities and epilepsy in infants with evidence of congenital ZIKV infection by using Medline and PubMed, Embase, Scientific Electronic Library Online, Scopus, the OpenGrey Repository, and the Grey Literature Report in Public Health. Search terms included "Zika" only and "Zika" in combination with any of the following terms: "epilepsy," "seizure," "motor," and "cerebral palsy." Clinical features of motor abnormalities and epilepsy in these children were reviewed. Thirty-six publications were identified; 8 were selected for further review. Among infants with clinical findings that are consistent with congenital Zika syndrome, 54% had epilepsy and 100% had motor abnormalities. In these infants, impairments that are consistent with diagnoses of cerebral palsy and epilepsy occur frequently. Pyramidal and extrapyramidal motor abnormalities were notable for their early development and co-occurrence. Prompt identification of potential disabilities enables early intervention to improve the quality of life for affected children. Long-term studies of developmental outcomes and interventions in children with congenital ZIKV infection are needed.
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Affiliation(s)
- André Pessoa
- Hospital Infantil Albert Sabin, Fortaleza, Brazil.,Department of Pediatrics and Neurology, Universidade Estadual do Ceará, Fortaleza, Brazil
| | - Vanessa van der Linden
- Association for Assistance of Disabled Children, Recife, Brazil.,Hospital Barāo de Lucena, Recife, Brazil
| | | | | | | | | | - Maureen S Durkin
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Daniel M Pastula
- Departments of Neurology, Medicine (Infectious Diseases), and Epidemiology, University of Colorado, Denver, Colorado
| | - Jazmyn T Moore
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia A Moore
- Centers for Disease Control and Prevention, Atlanta, Georgia
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36
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Zanluca C, de Noronha L, Duarte Dos Santos CN. Maternal-fetal transmission of the zika virus: An intriguing interplay. Tissue Barriers 2018; 6:e1402143. [PMID: 29370577 DOI: 10.1080/21688370.2017.1402143] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
In this review, we give an overview of aspects related to the congenital transmission of the Zika virus (ZIKV). Although we acknowledge that important advances in research on ZIKV pathogenesis have come from studies using animal models, particularly non-human primates, this review emphasizes studies using ex-vivo human cells and tissues as well as natural infections in pregnant women. The possible routes used by ZIKV to cross or breach the placental barrier and infect the fetal central nervous system are presented. Understanding the viral infection biology and ZIKV pathogenesis during pregnancy may guide the design of affordable antiviral strategies to benefit pregnant women in areas at risk.
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Affiliation(s)
- Camila Zanluca
- a Laboratório de Virologia Molecular, Instituto Carlos Chagas/Fiocruz-PR , Curitiba , PR , Brazil
| | - Lucia de Noronha
- b Laboratório de Patologia Experimental, Pontifícia Universidade Católica do Paraná , Curitiba , PR , Brazil
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37
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Deng YQ, Zhang NN, Li XF, Wang YQ, Tian M, Qiu YF, Fan JW, Hao JN, Huang XY, Dong HL, Fan H, Wang YG, Zhang FC, Tong YG, Xu Z, Qin CF. Intranasal infection and contact transmission of Zika virus in guinea pigs. Nat Commun 2017; 8:1648. [PMID: 29162827 PMCID: PMC5698318 DOI: 10.1038/s41467-017-01923-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/25/2017] [Indexed: 11/15/2022] Open
Abstract
Zika virus (ZIKV) is primarily transmitted to humans through mosquito bites or sexual contact. The excretion and persistence of contagious ZIKV in various body fluids have been well documented in ZIKV patients; however, the risk of direct contact exposure remains unclear. Here, we show that guinea pigs are susceptible to ZIKV infection via subcutaneous inoculation route; infected guinea pigs exhibit seroconversion and significant viral secretion in sera, saliva, and tears. Notably, ZIKV is efficiently transmitted from infected guinea pigs to naïve co-caged animals. In particular, intranasal inoculation of ZIKV is fully capable of establishing infection in guinea pigs, and viral antigens are detected in multiple tissues including brain and parotid glands. Cynomolgus macaques also efficiently acquire ZIKV infection via intranasal and intragastric inoculation routes. These collective results from animal models highlight the risk of exposure to ZIKV contaminants and raise the possibility of close contact transmission of ZIKV in humans.
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Affiliation(s)
- Yong-Qiang Deng
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
- State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China
| | - Na-Na Zhang
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Xiao-Feng Li
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
- State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China
| | - Ya-Qing Wang
- State Key Laboratory of Molecular Developmental Biology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Beijing, 100101, China
| | - Min Tian
- Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, 100010, China
| | - Ye-Feng Qiu
- Laboratory Animal Center, Academy of Military Medical Science, Beijing, 100071, China
| | - Jun-Wan Fan
- State Key Laboratory of Molecular Developmental Biology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jia-Nan Hao
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
- Anhui Medical University, Hefei, 230032, China
| | - Xing-Yao Huang
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Hao-Long Dong
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Hang Fan
- State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China
| | - Yu-Guang Wang
- Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, 100010, China
| | - Fu-Chun Zhang
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, 510060, China
| | - Yi-Gang Tong
- State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China
| | - Zhiheng Xu
- State Key Laboratory of Molecular Developmental Biology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China.
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Beijing, 100101, China.
| | - Cheng-Feng Qin
- Department of Virology, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China.
- State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, China.
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, 510060, China.
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38
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Replication of early and recent Zika virus isolates throughout mouse brain development. Proc Natl Acad Sci U S A 2017; 114:12273-12278. [PMID: 29087938 DOI: 10.1073/pnas.1714624114] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Fetal infection with Zika virus (ZIKV) can lead to congenital Zika virus syndrome (cZVS), which includes cortical malformations and microcephaly. The aspects of cortical development that are affected during virus infection are unknown. Using organotypic brain slice cultures generated from embryonic mice of various ages, sites of ZIKV replication including the neocortical proliferative zone and radial columns, as well as the developing midbrain, were identified. The infected radial units are surrounded by uninfected cells undergoing apoptosis, suggesting that programmed cell death may limit viral dissemination in the brain and may constrain virus-associated injury. Therefore, a critical aspect of ZIKV-induced neuropathology may be defined by death of uninfected cells. All ZIKV isolates assayed replicated efficiently in early and midgestation cultures, and two isolates examined replicated in late-gestation tissue. Alteration of neocortical cytoarchitecture, such as disruption of the highly elongated basal processes of the radial glial progenitor cells and impairment of postmitotic neuronal migration, were also observed. These data suggest that all lineages of ZIKV tested are neurotropic, and that ZIKV infection interferes with multiple aspects of neurodevelopment that contribute to the complexity of cZVS.
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39
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Gharbaran R, Somenarain L. Insights into the molecular roles of Zika virus in human reproductive complications and congenital neuropathologies. Pathology 2017; 49:707-714. [PMID: 29017720 DOI: 10.1016/j.pathol.2017.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 02/04/2023]
Abstract
The recent upsurge in the association of congenital neurological disorders and infection by the Zika virus (ZIKV) has resulted in increased research focus on the biology of this flavivirus. Studies in animal models indicate that ZIKV can breach the placental barrier and selectively infect and deplete neuroprogenitor cells (NPCs) of the developing fetus, resulting in changes of brain structures, reminiscent of human microcephaly. In vitro and ex vivo studies using human cells and tissues showed that human NPCs and placental cells are targeted by ZIKV. Also of concern is the impact of ZIKV on human reproductive structures, with the potential to cause infertility, as the virus appears to remain in the genital tract for extended periods of time. This review discusses the putative roles of ZIKV on human reproductive complications and congenital neuropathologies.
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Affiliation(s)
- Rajendra Gharbaran
- Department of Biological Sciences, Bronx Community College/The City University of New York, Bronx, NY United States.
| | - Latchman Somenarain
- Department of Biological Sciences, Bronx Community College/The City University of New York, Bronx, NY United States
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40
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The pathogenesis of microcephaly resulting from congenital infections: why is my baby’s head so small? Eur J Clin Microbiol Infect Dis 2017; 37:209-226. [DOI: 10.1007/s10096-017-3111-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 09/17/2017] [Indexed: 02/07/2023]
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41
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Dubaut JP, Agudelo Higuita NI, Quaas AM. Impact of Zika virus for infertility specialists: current literature, guidelines, and resources. J Assist Reprod Genet 2017; 34:1237-1250. [PMID: 28687969 PMCID: PMC5633575 DOI: 10.1007/s10815-017-0988-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 06/16/2017] [Indexed: 01/28/2023] Open
Abstract
In the past 2 years, Zika virus has emerged from obscurity onto the world stage-traversing and transcending clinical specialties, basic science disciplines, and public health efforts. The spread of Zika virus has serious implications for the specialty of reproductive endocrinology and infertility. Our patients, practices, and labs-worldwide and specifically in the USA-have been impacted by this teratogenic, sexually transmitted, largely asymptomatic virus. While the World Health Organization's Public Emergency of International Concern designation has lapsed as major epidemics have subsided and understanding of risks is in part clarified, the acute and long-term threat to pregnant patients is not over. The risk of wider spread in the USA is not insignificant, the subtler and long-ranging consequences beyond microcephaly are not fully known, large geographic areas of risk still contain naïve populations, and whether Zika will continue to be an intermittent risk in endemic areas is uncertain. Staying up to date with the burgeoning research on Zika virus is an important objective for the infertility specialist. Here, we review in detail the most relevant recent developments, discuss applicable guidelines, and propose strategies for contributing to a reduction in the risk and burden of Zika virus.
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Affiliation(s)
- Jamie P Dubaut
- Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, P.O. Box 26901, COMB 2400, Oklahoma City, OK, 73126-0901, USA.
| | - Nelson I Agudelo Higuita
- Section of Infectious Disease, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73014, USA
| | - Alexander M Quaas
- Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, P.O. Box 26901, COMB 2400, Oklahoma City, OK, 73126-0901, USA
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42
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Polonio CM, de Freitas CL, Zanluqui NG, Peron JPS. Zika virus congenital syndrome: experimental models and clinical aspects. J Venom Anim Toxins Incl Trop Dis 2017; 23:41. [PMID: 28932235 PMCID: PMC5602956 DOI: 10.1186/s40409-017-0131-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 09/01/2017] [Indexed: 12/24/2022] Open
Abstract
Viral infections have long been the cause of severe diseases to humans, increasing morbidity and mortality rates worldwide, either in rich or poor countries. Yellow fever virus, H1N1 virus, HIV, dengue virus, hepatitis B and C are well known threats to human health, being responsible for many million deaths annually, associated to a huge economic and social cost. In this context, a recently introduced flavivirus in South America, called Zika virus (ZIKV), led the WHO to declare in February 1st 2016 a warning on Public Health Emergency of International Concern (PHEIC). ZIKV is an arbovirus of the Flaviviridae family firstly isolated from sentinels Rhesus sp. monkeys at the Ziika forest in Uganda, Africa, in 1947. Lately, the virus has well adapted to the worldwide spread Aedes aegypti mosquito, the vector for DENV, CHIKV, YFV and many others. At first, it was not considered a threat to human health, but everything changed when a skyrocketing number of babies born with microcephaly and adults with Guillain-Barré syndrome were reported, mainly in northeastern Brazil. It is now well established that the virus is responsible for the so called congenital Zika syndrome (CZS), whose most dramatic features are microcephaly, arthrogryposis and ocular damage. Thus, in this review, we provide a brief discussion of these main clinical aspects of the CZS, correlating them with the experimental animal models described so far.
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Affiliation(s)
- Carolina Manganeli Polonio
- Neuroimmune Interactions Laboratory, Immunology Department – ICB IV, University of São Paulo (USP), Av. Prof. Lineu Prestes, 1730, Cidade Universitária, São Paulo, SP CEP 05508-900 Brazil
| | - Carla Longo de Freitas
- Neuroimmune Interactions Laboratory, Immunology Department – ICB IV, University of São Paulo (USP), Av. Prof. Lineu Prestes, 1730, Cidade Universitária, São Paulo, SP CEP 05508-900 Brazil
| | - Nagela Ghabdan Zanluqui
- Neuroimmune Interactions Laboratory, Immunology Department – ICB IV, University of São Paulo (USP), Av. Prof. Lineu Prestes, 1730, Cidade Universitária, São Paulo, SP CEP 05508-900 Brazil
| | - Jean Pierre Schatzmann Peron
- Neuroimmune Interactions Laboratory, Immunology Department – ICB IV, University of São Paulo (USP), Av. Prof. Lineu Prestes, 1730, Cidade Universitária, São Paulo, SP CEP 05508-900 Brazil
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Yuan S, Zhang ZW, Li ZL. Trehalose May Decrease the Transmission of Zika Virus to the Fetus by Activating Degradative Autophagy. Front Cell Infect Microbiol 2017; 7:402. [PMID: 28932709 PMCID: PMC5592200 DOI: 10.3389/fcimb.2017.00402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/25/2017] [Indexed: 01/14/2023] Open
Affiliation(s)
- Shu Yuan
- College of Resources, Sichuan Agricultural UniversityChengdu, China
| | - Zhong-Wei Zhang
- College of Resources, Sichuan Agricultural UniversityChengdu, China
| | - Zi-Lin Li
- Department of Cardiovascular Surgery, Xijing Hospital, Medical University of the Air ForceXi'an, China
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Besnard M, Dub T, Gérardin P. Outcomes for 2 Children after Peripartum Acquisition of Zika Virus Infection, French Polynesia, 2013-2014. Emerg Infect Dis 2017; 23:1421-1423. [PMID: 28514228 PMCID: PMC5547815 DOI: 10.3201/eid2308.170198] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Congenital Zika virus infection is associated with severe brain anomalies and impaired function. To determine outcomes, we followed 2 affected children for ≈30 months. For 1 who was symptomatic at birth, transient hepatitis developed. However, neurodevelopment for both children was age appropriate.
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Abstract
In less than 2 years since entry into the Americas, we have witnessed the emergent spread of Zika virus into large subsets of immunologically naïve human populations and then encountered the devastating effects of microcephaly and brain anomalies that can arise from in utero infection with the virus. Diagnostic evaluation and management of affected infants continues to evolve as our understanding of Zika virus rapidly advances. The development of a safe and effective vaccine holds the potential to attenuate the spread of infection and limit the impact of congenital infection.
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Singh MV, Weber EA, Singh VB, Stirpe NE, Maggirwar SB. Preventive and therapeutic challenges in combating Zika virus infection: are we getting any closer? J Neurovirol 2017; 23:347-357. [PMID: 28116673 PMCID: PMC5440476 DOI: 10.1007/s13365-017-0513-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/10/2017] [Indexed: 01/26/2023]
Abstract
The neuroteratogenic nature of Zika Virus (ZIKV) infection has converted what would have been a tropical disease into a global threat. Zika is transmitted vertically via infected placental cells especially in the first and second trimesters. In the developing central nervous system (CNS), ZIKV can infect and induce apoptosis of neural progenitor cells subsequently causing microcephaly as well as other neuronal complications in infants. Its ability to infect multiple cell types (placental, dermal, and neural) and increased environmental stability as compared to other flaviviruses (FVs) has broadened the transmission routes for ZIKV infection from vector-mediated to transmitted via body fluids. To further complicate the matters, it is genetically similar (about 40%) with the four serotypes of dengue virus (DENV), so much so that it can almost be called a fifth DENV serotype. This homology poses the risk of causing cross-reactive immune responses and subsequent antibody-dependent enhancement (ADE) of infection in case of secondary infections or for immunized individuals. All of these factors complicate the development of a single preventive vaccine candidate or a pharmacological intervention that will completely eliminate or cure ZIKV infection. We discuss all of these factors in detail in this review and conclude that a combinatorial approach including immunization and treatment might prove to be the winning strategy.
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Affiliation(s)
- Meera V Singh
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Emily A Weber
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, 14642, USA
| | - Vir B Singh
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, 14642, USA
| | - Nicole E Stirpe
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, 14642, USA
| | - Sanjay B Maggirwar
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, 14642, USA
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Del Campo M, Feitosa IML, Ribeiro EM, Horovitz DDG, Pessoa ALS, França GVA, García-Alix A, Doriqui MJR, Wanderley HYC, Sanseverino MVT, Neri JICF, Pina-Neto JM, Santos ES, Verçosa I, Cernach MCSP, Medeiros PFV, Kerbage SC, Silva AA, van der Linden V, Martelli CMT, Cordeiro MT, Dhalia R, Vianna FSL, Victora CG, Cavalcanti DP, Schuler-Faccini L. The phenotypic spectrum of congenital Zika syndrome. Am J Med Genet A 2017; 173:841-857. [PMID: 28328129 DOI: 10.1002/ajmg.a.38170] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 12/24/2022]
Abstract
In October 2015, Zika virus (ZIKV) outbreak the Brazilian Ministry of Health (MoH). In response, the Brazilian Society of Medical Genetics established a task force (SBGM-ZETF) to study the phenotype of infants born with microcephaly due to ZIKV congenital infection and delineate the phenotypic spectrum of this newly recognized teratogen. This study was based on the clinical evaluation and neuroimaging of 83 infants born during the period from July, 2015 to March, 2016 and registered by the SBGM-ZETF. All 83 infants had significant findings on neuroimaging consistent with ZIKV congenital infection and 12 had confirmed ZIKV IgM in CSF. A recognizable phenotype of microcephaly, anomalies of the shape of skull and redundancy of the scalp consistent with the Fetal Brain Disruption Sequence (FBDS) was present in 70% of infants, but was most often subtle. In addition, features consistent with fetal immobility, ranging from dimples (30.1%), distal hand/finger contractures (20.5%), and feet malpositions (15.7%), to generalized arthrogryposis (9.6%), were present in these infants. Some cases had milder microcephaly or even a normal head circumference (HC), and other less distinctive findings. The detailed observation of the dysmorphic and neurologic features in these infants provides insight into the mechanisms and timings of the brain disruption and the sequence of developmental anomalies that may occur after prenatal infection by the ZIKV.
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Affiliation(s)
- Miguel Del Campo
- Division of Dysmorphology and Teratology, Department of Pediatrics, UCSD, San Diego, California
| | - Ian M L Feitosa
- Departamento de Genetica, Universidade Federal de Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Dafne D G Horovitz
- Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Alfredo García-Alix
- Institut de Recerca Pediàtrica Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Maria V T Sanseverino
- SIAT-Brazilian Teratogen Information Service, Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - João M Pina-Neto
- Faculdade de Medicina de Ribeirao Preto, Departamento de Genetica, Universidade de Sao Paolo, Ribeirao Preto, Brazil
| | | | - Islane Verçosa
- Centro de Aperfeiçoamento Visual Ver a Esperança Renascer/CAVIVER, Fortaleza, Brazil
| | - Mirlene C S P Cernach
- Departamento de Genetica Medica, Universidade Federal de Sao Paolo (UNIFESP), Sao Paolo, Brazil
| | | | | | - André A Silva
- Departamento de Genetica, Universidade Federal de Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- SIAT-Brazilian Teratogen Information Service, Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- UNIVATES University, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Marli T Cordeiro
- Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Rafael Dhalia
- Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Fernanda S L Vianna
- Departamento de Genetica, Universidade Federal de Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- SIAT-Brazilian Teratogen Information Service, Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cesar G Victora
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Denise P Cavalcanti
- Departamento de Genetica Medica, Universidade de Campinas UNICAMP, Campinas, Brazil
| | - Lavinia Schuler-Faccini
- Departamento de Genetica, Universidade Federal de Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Potiguar, Natal, Brazil
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Robinson JL. Zika virus: What does a physician caring for children in Canada need to know? Paediatr Child Health 2017; 22:48-55. [PMID: 29480900 DOI: 10.1093/pch/pxx012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Zika virus (ZIKV) was recently recognized to be teratogenic. The diagnosis of congenital ZIKV syndrome should be considered in children with unexplained microcephaly, intracranial calcifications, ventriculomegaly or major structural central nervous system abnormalities. Management is evolving but suggestions are provided for children with findings compatible with congenital infection and for those born to women with potential exposure during pregnancy.
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Affiliation(s)
- Joan L Robinson
- Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Ottawa, Ontario
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Godoy AS, Lima GMA, Oliveira KIZ, Torres NU, Maluf FV, Guido RVC, Oliva G. Crystal structure of Zika virus NS5 RNA-dependent RNA polymerase. Nat Commun 2017; 8:14764. [PMID: 28345596 PMCID: PMC5378953 DOI: 10.1038/ncomms14764] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/30/2017] [Indexed: 01/05/2023] Open
Abstract
The current Zika virus (ZIKV) outbreak became a global health threat of complex epidemiology and devastating neurological impacts, therefore requiring urgent efforts towards the development of novel efficacious and safe antiviral drugs. Due to its central role in RNA viral replication, the non-structural protein 5 (NS5) RNA-dependent RNA-polymerase (RdRp) is a prime target for drug discovery. Here we describe the crystal structure of the recombinant ZIKV NS5 RdRp domain at 1.9 Å resolution as a platform for structure-based drug design strategy. The overall structure is similar to other flaviviral homologues. However, the priming loop target site, which is suitable for non-nucleoside polymerase inhibitor design, shows significant differences in comparison with the dengue virus structures, including a tighter pocket and a modified local charge distribution.
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Affiliation(s)
- Andre S Godoy
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil
| | - Gustavo M A Lima
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil
| | - Ketllyn I Z Oliveira
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil
| | - Naiara U Torres
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil.,Cellco Biotec, R. Alberto Lanzoni, 993-Parque Santa Felicia, São Carlos 13562-390, Brazil
| | - Fernando V Maluf
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil.,Cellco Biotec, R. Alberto Lanzoni, 993-Parque Santa Felicia, São Carlos 13562-390, Brazil
| | - Rafael V C Guido
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil
| | - Glaucius Oliva
- Institute of Physics of São Carlos, University of São Paulo, Av. Joao Dagnone, 1100-Jardim Santa Angelina, São Carlos 13563-120, Brazil
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50
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Yuan S, Luo Q, Zhang ZW, Li ZL. Commentary: Teratogenic effects of the Zika virus and the role of the placenta. Front Cell Infect Microbiol 2017; 7:62. [PMID: 28316955 PMCID: PMC5334333 DOI: 10.3389/fcimb.2017.00062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/20/2017] [Indexed: 01/19/2023] Open
Affiliation(s)
- Shu Yuan
- College of Resources, Sichuan Agricultural University Chengdu, China
| | - Qin Luo
- School of Biomedical Sciences, Chengdu Medical College Chengdu, China
| | - Zhong-Wei Zhang
- College of Resources, Sichuan Agricultural University Chengdu, China
| | - Zi-Lin Li
- General Hospital of Lanzhou Military Region Lanzhou, China
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