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Fazeli MM, Heydari Sirat S, Shatizadeh Malekshahi S. Novel Human Polyomaviruses Discovered From 2007 to the Present: An Update of Current Knowledge. Rev Med Virol 2025; 35:e70017. [PMID: 40000590 DOI: 10.1002/rmv.70017] [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: 09/30/2024] [Revised: 12/26/2024] [Accepted: 01/21/2025] [Indexed: 02/27/2025]
Abstract
Human polyomaviruses (HPyVs) are a diverse group of viruses that typically establish asymptomatic persistent infections in healthy individuals. However, they can lead to severe diseases in immunocompromised patients. The past 15 years have witnessed significant advancements in understanding HPyVs, leading to the discovery of several novel and highly divergent strains. This surge in knowledge raises critical questions about their evolution, tropism, and potential contributions to various diseases. Although HPyVs are generally benign, certain strains can lead to significant health issues under immunocompromised conditions. Since 2007, several novel PyVs have been isolated from humans: Karolinska Institute Polyomavirus (KIPyV), Washington University Polyomavirus (WUPyV), Merkel cell Polyomavirus (MCPyV), HPyV6, HPyV7, Trichodisplasia spinulosa polyomavirus (TSPyV), HPyV9, HPyV10, Saint Louis polyomavirus (STLPyV), HPyV12, New Jersey Polyomavirus (NJPyV), Lyon IARC polyomavirus (LIPyV), HPyV16 and Quebec polyomavirus (QPyV). This review summarises the available data regarding the biology, tissue tropism, epidemiology, and associated diseases of novel HPyVs discovered from 2007 to the present. While some HPyVs are well-characterised with clear associations to specific diseases, others remain enigmatic, warranting additional investigation into their biology and clinical implications.
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Affiliation(s)
- Mohammad Mehdi Fazeli
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sara Heydari Sirat
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Khalili AA, Maciagowski E, Nguyen K, Watters KA. Trichodysplasia Spinulosa. Sultan Qaboos Univ Med J 2024; 24:131-134. [PMID: 38434466 PMCID: PMC10906767 DOI: 10.18295/squmj.5.2023.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 03/05/2024] Open
Abstract
Trichodysplasia spinulosa (TS) is a unique, rare clinical and histological dermatologic entity described mainly in a setting of immunosuppression. It is caused by a novel human polymoavirus, TS-associated polyomavirus. Reduction of immunosuppression and/or anti-viral therapy is the main therapeutic strategies used to treat such cases. We report a biopsy-proven case of TS in a male renal transplant patient who presented to a dermatology outpatient clinic in Montreal, Canada, in 2015. He was managed with valgancyclovir with no obvious response. Subsequently, a trial of topical imiquimod was commenced. Awareness of TS can prompt early diagnosis and management to prevent possible complications.
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Affiliation(s)
- Ayida Al Khalili
- Dermatology Unit, Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Elsa Maciagowski
- Department of Dermatology, McGill University Health Center, Montreal, Canada
| | - Khue Nguyen
- Department of Dermatology, McGill University Health Center, Montreal, Canada
| | - Kevin A. Watters
- Department of Pathology, McGill University Health Center, Montreal, Canada
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3
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Bartley BR, Moore SA, Doan HQ, Rady PL, Tyring SK. Current treatments and emerging therapies of human polyomavirus-associated skin diseases: a comprehensive review. Int J Dermatol 2023; 62:387-396. [PMID: 36577746 DOI: 10.1111/ijd.16534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022]
Abstract
Since Merkel cell polyomavirus (MCPyV) was linked as the predominant etiology of Merkel cell carcinoma (MCC) in 2008, three additional human polyomaviruses (HPyV) have been definitively linked to cutaneous diseases-trichodysplasia spinulosa virus (TSPyV) and human polyomavirus 6 and 7 (HPyV6, HPyV7). TSPyV contributes to the development of trichodysplasia spinulosa (TS), and HPyV6/7 is associated closely with the eruption of pruritic and dyskeratotic dermatoses (PDD). Clinically, MCC is treated with surgical excision and radiation with adjuvant chemotherapy, although newer treatment options include immune checkpoint inhibition. These novel immunotherapies hold promise for the treatment of metastatic MCC, but resistance and side effects prevent a significant proportion of patients from realizing their benefits. Based on previous case reports, the standard of care for the less deadly but disfiguring cutaneous disease TS include immunosuppressant (IS) reduction, the use of antivirals such as cidofovir (CDV) or valganciclovir (VGCV), or a combination of these treatments. Similar treatments were attempted for PDD, but oral acitretin was found to be most effective. As MCC, TS, and PDD are rare diseases, further research is required for effective treatments. In this review, we summarize clinical trials, preclinical studies, and case reports that present outcomes and side effects of current and emerging treatments for HPyV-associated cutaneous diseases, offering a comprehensive resource for clinical application and prospective clinical trials.
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Affiliation(s)
- Brooke R Bartley
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Stephen A Moore
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Hung Q Doan
- Department of Dermatology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Stephen K Tyring
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
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Zanella MC, Pastor D, Feltkamp MCW, Hadaya K, Cordey S, Toutous Trellu L. Sustained Trichodysplasia Spinulosa Polyomavirus Viremia Illustrating a Primary Disseminated Infection in a Kidney Transplant Recipient. Microorganisms 2021; 9:microorganisms9112298. [PMID: 34835424 PMCID: PMC8624465 DOI: 10.3390/microorganisms9112298] [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: 10/15/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 01/08/2023] Open
Abstract
Novel human polyomaviruses (HPyV) have been recently identified in solid organ transplant recipients. Trichodysplasia spinulosa (TS) is a rare disease associated with immunosuppression and induced by a polyomavirus (TSPyV). We report here a case of primary and disseminated TSPyV infection after kidney transplantation with extensive skin lesions, sustained viremia, and high viral loads in urine specimens, anal, nasal and throat swabs, assessed via specific real-time PCR for TSPyV during a follow-up period of 32 months after transplantation. The detection of TSPyV with a high viral load in respiratory and anal swab samples is compatible with viral replication and thus may suggest potential respiratory and oro-fecal routes of transmission.
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Affiliation(s)
- Marie-Céline Zanella
- Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Laboratory of Virology, Division of Infectious Diseases and Division of Laboratory Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
- Correspondence:
| | - Damien Pastor
- Department of Dermatology, Geneva University Hospitals, 1205 Geneva, Switzerland; (D.P.); (L.T.T.)
| | - Mariet C. W. Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Karine Hadaya
- Department of Nephrology and Hypertension, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Samuel Cordey
- Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Laboratory of Virology, Division of Infectious Diseases and Division of Laboratory Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
| | - Laurence Toutous Trellu
- Department of Dermatology, Geneva University Hospitals, 1205 Geneva, Switzerland; (D.P.); (L.T.T.)
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Curman P, Näsman A, Brauner H. Trichodysplasia spinulosa: a comprehensive review of the disease and its treatment. J Eur Acad Dermatol Venereol 2021; 35:1067-1076. [PMID: 33559344 PMCID: PMC8247895 DOI: 10.1111/jdv.17081] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/16/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Trichodysplasia spinulosa (TS) is a rare dermatological disease caused by TS‐associated polyomavirus (TSPyV) in immunosuppressed patients. The seroprevalence of TSPyV in immunocompetent adults is high and the number of immunosuppressed patients developing TS remains low, suggesting that TS is underdiagnosed and/or that additional unknown factors are needed in order to develop TS. There is no well‐established treatment for TS, and to date a majority of reported cases have consequently received ineffective therapies, likely due to the unavailability of reviews and recommendations of treatments for TS. The few treatments reported in case reports to be effective include topical cidofovir 3%, reduction of immunosuppression and oral valganciclovir. In this comprehensive review, we present all published cases to date, together with a summary of all treatments for TS categorized by overall clinical efficacy, thus addressing this rare disease and what appears to be its clinically efficacious treatment.
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Affiliation(s)
- P Curman
- Dermatology and Venereology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - A Näsman
- Department of Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology (OnkPat), Karolinska Institutet, Stockholm, Sweden
| | - H Brauner
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden.,Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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Beyond Cytomegalovirus and Epstein-Barr Virus: a Review of Viruses Composing the Blood Virome of Solid Organ Transplant and Hematopoietic Stem Cell Transplant Recipients. Clin Microbiol Rev 2020; 33:33/4/e00027-20. [PMID: 32847820 DOI: 10.1128/cmr.00027-20] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Viral primary infections and reactivations are common complications in patients after solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) and are associated with high morbidity and mortality. Among these patients, viral infections are frequently associated with viremia. Beyond the usual well-known viruses that are part of the routine clinical management of transplant recipients, numerous other viral signatures or genomes can be identified in the blood of these patients. The identification of novel viral species and variants by metagenomic next-generation sequencing has opened up a new field of investigation and new paradigms. Thus, there is a need to thoroughly describe the state of knowledge in this field with a review of all viral infections that should be scrutinized in high-risk populations. Here, we review the eukaryotic DNA and RNA viruses identified in blood, plasma, or serum samples of pediatric and adult SOT/HSCT recipients and the prevalence of their detection, with a particular focus on recently identified viruses and those for which their potential association with disease remains to be investigated, such as members of the Polyomaviridae, Anelloviridae, Flaviviridae, and Astroviridae families. Current knowledge of the clinical significance of these viral infections with associated viremia among transplant recipients is also discussed. To ensure a comprehensive description in these two populations, individuals described as healthy (mostly blood donors) are considered for comparative purposes. The list of viruses that should be on the clinicians' radar is certainly incomplete and will expand, but the challenge is to identify those of possible clinical significance.
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Narayanan D, Rady PL, Tyring SK. Recent developments in trichodysplasia spinulosa disease. Transpl Infect Dis 2020; 22:e13434. [PMID: 32748541 DOI: 10.1111/tid.13434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
Abstract
Trichodysplasia Spinulosa (TS) is a rare proliferative skin disease that occurs primarily in immunocompromised patients, specifically organ transplant recipients. TS is characterized by uncontrolled inner root sheath cell proliferation and folliculocentric papular eruption that can progress to disfiguring leonine facies when left untreated. TS presents with distinct histological features including the presence of large eosinophilic, trichohyaline granules within hyperproliferating inner root sheath cells of the hair bulb. The discovery of the Trichodysplasia Spinulosa Polyomavirus (TSPyV) and recent studies highlighting the role of TSPyV tumor antigens in cell proliferation pathways have provided new insight into the mechanisms of TS development. In this review, we discuss the expansion of our understanding of TS, specifically over the past 5 years. We summarize novel cases of TS and recent developments in the mechanisms underlying TSPyV-mediated disease progression. We also evaluate advancements in diagnostic methods and treatment options. As the incidence of TS continues to rise, it is becoming critical for clinicians to understand the clinical features of TS and emerging research regarding pathogenesis and therapeutics for early treatment of this potentially disfiguring disease.
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Affiliation(s)
- Deepika Narayanan
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Stephen K Tyring
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
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Jose A, Dad T, Strand A, Tse JY, Plotnikova N, Boucher HW, Sarnak MJ, Gilbert SJ, Goyal N. Trichodysplasia spinulosa: Case reports and review of literature. Transpl Infect Dis 2020; 22:e13342. [PMID: 32475005 DOI: 10.1111/tid.13342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/13/2020] [Indexed: 11/29/2022]
Abstract
Trichodysplasia spinulosa (TS) is a rare skin condition caused by trichodysplasia spinulosa-associated polyomavirus (TSPyV). It affects immunosuppressed patients, and <50 cases have been reported. The majority of these cases are seen in solid organ transplant recipients. TS often poses a diagnostic and therapeutic challenge because of its rarity and resemblance with other skin conditions. Several forms of treatment are usually tried prior to establishing a definitive diagnosis. Oral valganciclovir and topical cidofovir have been found to give the best results and hence are the most commonly used agents once the diagnosis is established. Here, we present two cases with a review of literature of TS in solid organ transplant recipients, focusing on time to develop the condition post-transplant, immunosuppression regimen used, and treatment initiated both before and after a definitive diagnosis.
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Affiliation(s)
- Aju Jose
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Taimur Dad
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Andrew Strand
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
| | - Julie Y Tse
- Pathology and Laboratory Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Natalia Plotnikova
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Helen W Boucher
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
| | - Mark J Sarnak
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Scott J Gilbert
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Nitender Goyal
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
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