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Jiang D, Zhang J, Shen W, Sun Y, Wang Z, Wang J, Zhang J, Zhang G, Zhang G, Wang Y, Cai S, Zhang J, Wang Y, Liu R, Bai T, Sun Y, Yang S, Ma Z, Li Z, Li J, Ma C, Cheng L, Sun B, Yang K. DNA Vaccines Encoding HTNV GP-Derived Th Epitopes Benefited from a LAMP-Targeting Strategy and Established Cellular Immunoprotection. Vaccines (Basel) 2024; 12:928. [PMID: 39204051 PMCID: PMC11359959 DOI: 10.3390/vaccines12080928] [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: 06/23/2024] [Revised: 08/06/2024] [Accepted: 08/14/2024] [Indexed: 09/03/2024] Open
Abstract
Vaccines has long been the focus of antiviral immunotherapy research. Viral epitopes are thought to be useful biomarkers for immunotherapy (both antibody-based and cellular). In this study, we designed a novel vaccine molecule, the Hantaan virus (HTNV) glycoprotein (GP) tandem Th epitope molecule (named the Gnc molecule), in silico. Subsequently, computer analysis was used to conduct a comprehensive and in-depth study of the various properties of the molecule and its effects as a vaccine molecule in the body. The Gnc molecule was designed for DNA vaccines and optimized with a lysosomal-targeting membrane protein (LAMP) strategy. The effects of GP-derived Th epitopes and multiepitope vaccines were initially verified in animals. Our research has resulted in the design of two vaccines based on effective antiviral immune targets. The effectiveness of molecular therapies has also been preliminarily demonstrated in silico and in laboratory animals, which lays a foundation for the application of a vaccines strategy in the field of antivirals.
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Affiliation(s)
- Dongbo Jiang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
- Department of Microbiology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China;
| | - Junqi Zhang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Wenyang Shen
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Yubo Sun
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Zhenjie Wang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Jiawei Wang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Jinpeng Zhang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Guanwen Zhang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Gefei Zhang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Yueyue Wang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Sirui Cai
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Jiaxing Zhang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Yongkai Wang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Ruibo Liu
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Tianyuan Bai
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Yuanjie Sun
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Shuya Yang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Zilu Ma
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Zhikui Li
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Jijin Li
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Chenjin Ma
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
| | - Linfeng Cheng
- Department of Microbiology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China;
| | - Baozeng Sun
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
- Yingtan Detachment, Jiangxi General Hospital, Chinese People’s Armed Police Force, Nanchang 330001, China
| | - Kun Yang
- Department of Immunology, The Key Laboratory of Bio-Hazard Damage and Prevention Medicine, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi’an 710032, China; (D.J.); (J.Z.); (W.S.); (Y.S.); (Z.W.); (J.W.); (J.Z.); (G.Z.); (G.Z.); (Y.W.); (S.C.); (J.Z.); (Y.W.); (R.L.); (T.B.); (Y.S.); (S.Y.); (Z.M.); (Z.L.); (J.L.); (C.M.)
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Späth MR, Hoyer-Allo KJR, Seufert L, Höhne M, Lucas C, Bock T, Isermann L, Brodesser S, Lackmann JW, Kiefer K, Koehler FC, Bohl K, Ignarski M, Schiller P, Johnsen M, Kubacki T, Grundmann F, Benzing T, Trifunovic A, Krüger M, Schermer B, Burst V, Müller RU. Organ Protection by Caloric Restriction Depends on Activation of the De Novo NAD+ Synthesis Pathway. J Am Soc Nephrol 2023; 34:772-792. [PMID: 36758124 PMCID: PMC10125653 DOI: 10.1681/asn.0000000000000087] [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: 03/20/2022] [Accepted: 01/10/2023] [Indexed: 02/11/2023] Open
Abstract
SIGNIFICANCE STATEMENT AKI is a major clinical complication leading to high mortality, but intensive research over the past decades has not led to targeted preventive or therapeutic measures. In rodent models, caloric restriction (CR) and transient hypoxia significantly prevent AKI and a recent comparative transcriptome analysis of murine kidneys identified kynureninase (KYNU) as a shared downstream target. The present work shows that KYNU strongly contributes to CR-mediated protection as a key player in the de novo nicotinamide adenine dinucleotide biosynthesis pathway. Importantly, the link between CR and NAD+ biosynthesis could be recapitulated in a human cohort. BACKGROUND Clinical practice lacks strategies to treat AKI. Interestingly, preconditioning by hypoxia and caloric restriction (CR) is highly protective in rodent AKI models. However, the underlying molecular mechanisms of this process are unknown. METHODS Kynureninase (KYNU) knockout mice were generated by Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and comparative transcriptome, proteome and metabolite analyses of murine kidneys pre- and post-ischemia-reperfusion injury in the context of CR or ad libitum diet were performed. In addition, acetyl-lysin enrichment and mass spectrometry were used to assess protein acetylation. RESULTS We identified KYNU as a downstream target of CR and show that KYNU strongly contributes to the protective effect of CR. The KYNU-dependent de novo nicotinamide adenine dinucleotide (NAD+) biosynthesis pathway is necessary for CR-associated maintenance of NAD+ levels. This finding is associated with reduced protein acetylation in CR-treated animals, specifically affecting enzymes in energy metabolism. Importantly, the effect of CR on de novo NAD+ biosynthesis pathway metabolites can be recapitulated in humans. CONCLUSIONS CR induces the de novo NAD+ synthesis pathway in the context of IRI and is essential for its full nephroprotective potential. Differential protein acetylation may be the molecular mechanism underlying the relationship of NAD+, CR, and nephroprotection.
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Affiliation(s)
- Martin R. Späth
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - K. Johanna R. Hoyer-Allo
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Seufert
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Höhne
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christina Lucas
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Theresa Bock
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Genetics, University of Cologne, Cologne, Germany
| | - Lea Isermann
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Medical Faculty, Institute for Mitochondrial Diseases and Aging, University of Cologne, Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, Cologne, Germany
| | - Susanne Brodesser
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan-Wilm Lackmann
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katharina Kiefer
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Felix C. Koehler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katrin Bohl
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Ignarski
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Petra Schiller
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Marc Johnsen
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Torsten Kubacki
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Franziska Grundmann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thomas Benzing
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Aleksandra Trifunovic
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Medical Faculty, Institute for Mitochondrial Diseases and Aging, University of Cologne, Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, Cologne, Germany
| | - Marcus Krüger
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Genetics, University of Cologne, Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, Cologne, Germany
| | - Bernhard Schermer
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Volker Burst
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Emergency Department, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- CECAD, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Koehler FC, Di Cristanziano V, Späth MR, Hoyer-Allo KJR, Wanken M, Müller RU, Burst V. OUP accepted manuscript. Clin Kidney J 2022; 15:1231-1252. [PMID: 35756741 PMCID: PMC9217627 DOI: 10.1093/ckj/sfac008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Indexed: 01/18/2023] Open
Abstract
Hantavirus-induced diseases are emerging zoonoses with endemic appearances and frequent outbreaks in different parts of the world. In humans, hantaviral pathology is characterized by the disruption of the endothelial cell barrier followed by increased capillary permeability, thrombocytopenia due to platelet activation/depletion and an overactive immune response. Genetic vulnerability due to certain human leukocyte antigen haplotypes is associated with disease severity. Typically, two different hantavirus-caused clinical syndromes have been reported: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). The primarily affected vascular beds differ in these two entities: renal medullary capillaries in HFRS caused by Old World hantaviruses and pulmonary capillaries in HCPS caused by New World hantaviruses. Disease severity in HFRS ranges from mild, e.g. Puumala virus-associated nephropathia epidemica, to moderate, e.g. Hantaan or Dobrava virus infections. HCPS leads to a severe acute respiratory distress syndrome with high mortality rates. Due to novel insights into organ tropism, hantavirus-associated pathophysiology and overlapping clinical features, HFRS and HCPS are believed to be interconnected syndromes frequently involving the kidneys. As there are no specific antiviral treatments or vaccines approved in Europe or the USA, only preventive measures and public awareness may minimize the risk of hantavirus infection. Treatment remains primarily supportive and, depending on disease severity, more invasive measures (e.g., renal replacement therapy, mechanical ventilation and extracorporeal membrane oxygenation) are needed.
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Affiliation(s)
- Felix C Koehler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Veronica Di Cristanziano
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Martin R Späth
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - K Johanna R Hoyer-Allo
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Manuel Wanken
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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