Pathology of Rotavirus-driven Multiple Organ Failure in a 16-month-old Boy

Epidemiological Impact of GII.17 Human Noroviruses Associated With Attachment to Enterocytes

For the last 30 years, molecular surveys have shown that human norovirus (HuNoV), predominantly the GII.4 genotype, is one of the main causative agents of gastroenteritis. However, epidemiological surveys have revealed the worldwide emergence of GII.17 HuNoVs. Genetic analysis confirmed that GII.17 strains are distributed into three variants (i.e., Kawasaki 308, Kawasaki 323, and CS-E1). Here, virus-like particles (VLPs) were baculovirus-expressed from these variants to study putative interactions with HBGA. Qualitative analysis of the HBGA binding profile of each variant showed that the most recent and predominant GII.17 variant, Kawasaki 308, possesses a larger binding spectrum. The retrospective study of GII.17 strains documented before the emergence of the dominant Kawasaki 308 variant showed that the emergence of a new GII.17 variant could be related to an increased binding capacity toward HBGA. The use of duodenal histological sections confirmed that recognition of enterocytes involved HBGA for the three GII.17 variants. Finally, we observed that the relative affinity of recent GII.17 VLPs for HBGA remains lower than that of the GII.4-2012 variant. These observations suggest a model whereby a combination of virological factors, such as polymerase fidelity and increased affinity for HBGA, and immunological factors was responsible for the incomplete and non-persistent replacement of GII.4 by new GII.17 variants.

CLINICAL AND IMMUNOLOGICAL FEATURES OF ROTAVIRUS INFECTION IN CHILDREN INFECTED WITH EPSTEIN-BARR VIRUS

OBJECTIVE

The aim: To identify clinical and immunological features of acute rotavirus gastroenteritis occurring against the background of Epstein-Barr virus infection.

PATIENTS AND METHODS

Materials and methods: The study involved examination of 56 children. Of them, 33 children (1 group) did not have a background infection and 23 patients (2 group) suffered from rotavirus infection on the background of the latent form of Epstein-Barr virus infection. Children in these groups were compared by gender, age, severity of the disease and other parameters. Quantitative data were presented as mean and standard deviation (M±SD). Differences at p <0.05 were considered statistically significant.

RESULTS

Results: The data suggest that the presence of background Epstein-Barr virus in children with rotavirus infection leads to later hospitalization, lower temperature response rates, lower frequency of vomiting at the onset of the disease, and longer duration of fever and diarrhea. At the same time, in children infected with Epstein-Barr virus, the relative content of CD8+ T lymphocytes dominated both in the acute period of the disease and in the period of convalescence against the background of reduced relative content of CD16+, CD22+ T lymphocytes and IgM in the period of early convalescence.

CONCLUSION

Conclusions: The study allowed to reveal the influence of latent EBV infection on the clinical and immunological parameters of rotavirus gastroenteritis.

Relationship between myocardial enzyme levels, hepatic function and metabolic acidosis in children with rotavirus infection diarrhea

Objective:

To investigate the relationship between myocardial enzymes, liver function and metabolic acidosis in children with rotavirus infection diarrhea.

Methods:

The data of 70 children with infectious diarrhea treated in Baoding Children’s Hospital, China, from October 2017 to April 2018 were retrospectively studied. The antigen of rotavirus in feces was positive by colloidal gold method. According to the clinical features of biochemical indicators and mental status, the patients were divided into four groups, an acidosis-free group, a mild acidosis group, a moderate acidosis group and a severe acidosis group, in line with acidosis severity. In addition to detecting the hepatic functions of the pediatric patients in the four groups, including aspartate aminotransferase (AST), alanine aminotransfer (ALT) levels, and myocardial enzyme levels (e.g., creatine kinase, or CK, and creatine kinase isoenzyme, or CK-MB), the relationships of hepatic function, myocardial enzyme levels and acidosis severity of the patients with infectious diarrhea caused by rotavirus infection were also analyzed.

Results:

There was no significant difference in sex and age among the four groups (P>0.05). However, there was a significant difference in the frequency of diarrhea and vomiting (p<0.05). In addition, there were significant differences in creatine kinase, CK-MB, AST and ALT levels in children with metabolic acidosis of different severities.

Conclusion:

With the aggravation of metabolic acidosis, infectious diarrhea caused by rotavirus is characterized by the aggravation of hepatic function and myocardial cells.