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Song J, Lu H, Ma L, Zhu S, Yan D, Han J, Zhang Y. Molecular Characteristics of Enterovirus B83 Strain Isolated from a Patient with Acute Viral Myocarditis and Global Transmission Dynamics. Viruses 2023; 15:1360. [PMID: 37376658 DOI: 10.3390/v15061360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
This study determined the global genetic diversity and transmission dynamics of enterovirus B83 (EV-B83) and proposed future disease surveillance directions. Blood samples were collected from a patient with viral myocarditis, and viral isolation was performed. The complete genome sequence of the viral isolate was obtained using Sanger sequencing. A dataset of 15 sequences (from three continents) that had sufficient time signals for Bayesian phylogenetic analysis was set up, and the genetic diversity and transmission dynamics of global EV-B83 were analyzed using bioinformatics methods, including evolutionary dynamics, recombination event analysis, and phylogeographic analysis. Here, we report the complete genome sequence of an EV-B83 strain (S17/YN/CHN/2004) isolated from a patient with acute viral myocarditis in Yunnan Province, China. All 15 EV-B83 strains clustered together in a phylogenetic tree, confirming the classification of these isolates as a single EV type, and the predicted time for the most recent common ancestor appeared in 1998. Recombinant signals were detected in the 5'-untranslated region and 2A-3D coding regions of the S17 genome. The phylogeographic analysis revealed multiple intercontinental transmission routes of EV-B83. This study indicates that EV-B83 is globally distributed. Our findings add to the publicly available EV-B83 genomic sequence data and deepen our understanding of EV-B83 epidemiology.
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Affiliation(s)
- Juan Song
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Huanhuan Lu
- National Polio Laboratory and WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Lin Ma
- Yunnan Institute of Endemic Diseases Control and Prevention, No.5, Wenhua Road, Dali 671000, China
| | - Shuangli Zhu
- National Polio Laboratory and WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Dongmei Yan
- National Polio Laboratory and WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jun Han
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yong Zhang
- National Polio Laboratory and WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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2
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The Novel Coronavirus Infection (COVID-19) and Nervous System Involvement: Mechanisms of Neurological Disorders, Clinical Manifestations, and the Organization of Neurological Care. ACTA ACUST UNITED AC 2021; 51:147-154. [PMID: 33619413 PMCID: PMC7889305 DOI: 10.1007/s11055-021-01050-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/30/2020] [Indexed: 11/08/2022]
Abstract
The new coronavirus SARS-CoV-2 and the disease it causes COVID-19 involves not only respiratory system damage, but can also lead to disorders of the central and peripheral nervous system, as well as the muscular system. This article presents published data and our own observations on the course of neurological disorders in COVID-19 patients. There is a relationship between the severity of COVID-19 and the severity and frequency of neurological manifestations. Severe neurological disorders are mostly seen in severe cases of COVID-19 and include acute cerebrovascular accidents (aCVA), acute necrotizing encephalopathy, and Guillain–Barré syndrome. Factors potentially complicating the course of COVID-19 and increasing the development of neurological complications include arterial hypertension, diabetes mellitus, and chronic cardiac and respiratory system diseases. Questions of the possible effects of human coronaviruses on the course of chronic progressive neurological diseases are addressed using multiple sclerosis (MS) as an example. We discuss the management of patients with aCVA and MS depending on the risk of developing coronavirus infection.
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3
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Complete Heart Block Complicating Takotsubo Syndrome: Case Report and Literature Review. Case Rep Cardiol 2020; 2020:7614836. [PMID: 32923000 PMCID: PMC7453273 DOI: 10.1155/2020/7614836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/01/2020] [Accepted: 07/07/2020] [Indexed: 12/04/2022] Open
Abstract
An 81-year-old woman presents with shortness of breath resulting in a diagnosis of picornavirus and complete heart block. Troponin was elevated and there was concern about acute coronary syndrome. The final diagnosis after echocardiogram and coronary angiogram was Takotsubo syndrome in addition to the heart block which required pacemaker insertion.
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4
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Saarinen NVV, Lehtonen J, Veijola R, Lempainen J, Knip M, Hyöty H, Laitinen OH, Hytönen VP. Multiplexed High-Throughput Serological Assay for Human Enteroviruses. Microorganisms 2020; 8:microorganisms8060963. [PMID: 32604930 PMCID: PMC7355947 DOI: 10.3390/microorganisms8060963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/22/2022] Open
Abstract
Immunological assays detecting antibodies against enteroviruses typically use a single enterovirus serotype as antigen. This limits the ability of such assays to detect antibodies against different enterovirus types and to detect possible type-specific variation in antibody responses. We set out to develop a multiplexed assay for simultaneous detection of antibodies against multiple enterovirus and rhinovirus types encompassing all human infecting species. Seven recombinant VP1 proteins from enteroviruses EV-A to EV-D and rhinoviruses RV-A to RV-C species were produced. Using Meso Scale Diagnostics U-PLEX platform we were able to study antibody reactions against these proteins as well as non-structural enterovirus proteins in a single well with 140 human serum samples. Adults had on average 33-fold stronger antibody responses to these antigens (p < 10−11) compared to children, but children had less cross-reactivity between different enterovirus types. The results suggest that this new high-throughput assay offers clear benefits in the evaluation of humoral enterovirus immunity in children, giving more exact information than assays that are based on a single enterovirus type as antigen.
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Affiliation(s)
- Niila V. V. Saarinen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (N.V.V.S.); (J.L.); (H.H.); (O.H.L.)
| | - Jussi Lehtonen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (N.V.V.S.); (J.L.); (H.H.); (O.H.L.)
| | - Riitta Veijola
- Department of Paediatrics, University of Oulu, 90570 Oulu, Finland;
| | - Johanna Lempainen
- Department of Paediatrics, University of Turku, 20520 Turku, Finland;
| | - Mikael Knip
- Pediatric Research Center, Children’s Hospital, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland;
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00029 Helsinki, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (N.V.V.S.); (J.L.); (H.H.); (O.H.L.)
- Fimlab Laboratories, 33520 Tampere, Finland
| | - Olli H. Laitinen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (N.V.V.S.); (J.L.); (H.H.); (O.H.L.)
| | - Vesa P. Hytönen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (N.V.V.S.); (J.L.); (H.H.); (O.H.L.)
- Fimlab Laboratories, 33520 Tampere, Finland
- Correspondence: ; Tel.: +358-401901517
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5
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Lasrado N, Yalaka B, Reddy J. Triggers of Inflammatory Heart Disease. Front Cell Dev Biol 2020; 8:192. [PMID: 32266270 PMCID: PMC7105865 DOI: 10.3389/fcell.2020.00192] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022] Open
Abstract
Inflammatory heart disease (IHD) is a group of diseases that includes pericarditis, myocarditis, and endocarditis. Although males appear to be more commonly affected than females, IHD can be seen in any age group. While the disease can be self-limiting leading to full recovery, affected individuals can develop chronic disease, suggesting that identification of primary triggers is critical for successful therapies. Adding to this complexity, however, is the fact that IHD can be triggered by a variety of infectious and non-infectious causes that can also occur as secondary events to primary insults. In this review, we discuss the immunological insights into the development of IHD as well as a mechanistic understanding of the disease process in animal models.
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Affiliation(s)
- Ninaad Lasrado
- School of Veterinary Medicine and Biomedical Sciences, University of Nebraska–Lincoln, Lincoln, NE, United States
| | - Bharathi Yalaka
- School of Veterinary Medicine and Biomedical Sciences, University of Nebraska–Lincoln, Lincoln, NE, United States
- Bristol-Myers Squibb – Hopewell, Pennington, NJ, United States
| | - Jay Reddy
- School of Veterinary Medicine and Biomedical Sciences, University of Nebraska–Lincoln, Lincoln, NE, United States
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6
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Saarinen NVV, Stone VM, Hankaniemi MM, Mazur MA, Vuorinen T, Flodström-Tullberg M, Hyöty H, Hytönen VP, Laitinen OH. Antibody Responses against Enterovirus Proteases are Potential Markers for an Acute Infection. Viruses 2020; 12:E78. [PMID: 31936473 PMCID: PMC7020046 DOI: 10.3390/v12010078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Enteroviruses are a group of common non-enveloped RNA viruses that cause symptoms ranging from mild respiratory infections to paralysis. Due to the abundance of enterovirus infections it is hard to distinguish between on-going and previous infections using immunological assays unless the IgM fraction is studied. METHODS In this study we show using Indirect ELISA and capture IgM ELISA that an IgG antibody response against the nonstructural enteroviral proteins 2A and 3C can be used to distinguish between IgM positive (n = 22) and IgM negative (n = 20) human patients with 83% accuracy and a diagnostic odds ratio of 30. Using a mouse model, we establish that the antibody response to the proteases is short-lived compared to the antibody response to the structural proteins in. As such, the protease antibody response serves as a potential marker for an acute infection. CONCLUSIONS Antibody responses against enterovirus proteases are shorter-lived than against structural proteins and can differentiate between IgM positive and negative patients, and therefore they are a potential marker for acute infections.
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Affiliation(s)
- Niila V. V. Saarinen
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
| | - Virginia M. Stone
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
- Karolinska Institutet, The Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska University Hospital, 14152 Stockholm, Sweden;
| | - Minna M. Hankaniemi
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
| | - Magdalena A. Mazur
- Karolinska Institutet, The Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska University Hospital, 14152 Stockholm, Sweden;
| | - Tytti Vuorinen
- Turku University Hospital, Clinical Microbiology and University of Turku, Institute of Biomedicine, 20520 Turku, Finland;
| | - Malin Flodström-Tullberg
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
- Karolinska Institutet, The Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska University Hospital, 14152 Stockholm, Sweden;
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
| | - Vesa P. Hytönen
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
| | - Olli H. Laitinen
- Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland; (N.V.V.S.); (V.M.S.); (M.M.H.); (M.F.-T.); (H.H.); (V.P.H.)
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7
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Gusev E, Martynov M, Boyko A, Voznyuk I, Latsh N, Sivertseva S, Spirin N, Shamalov N. Novel coronavirus infection (COVID-19) and nervous system involvement: pathogenesis, clinical manifestations, organization of neurological care. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:7-16. [DOI: 10.17116/jnevro20201200617] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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8
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Pellegrinelli L, Bubba L, Primache V, Pariani E, Battistone A, Delogu R, Fiore S, Binda S. Surveillance of poliomyelitis in Northern Italy: Results of acute flaccid paralysis surveillance and environmental surveillance, 2012-2015. Hum Vaccin Immunother 2017; 13:332-338. [PMID: 27929744 PMCID: PMC5328214 DOI: 10.1080/21645515.2017.1264726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Although in the last years poliovirus (PV) transmission has been reported at the lowest levels ever recorded, the spread of virus from endemic countries endures; the high levels of immigration flows across the Mediterranean Sea jeopardize Italy for PV reintroduction. The World Health Organization (WHO) strategic plan for global poliomyelitis (polio) eradication indicates the nationwide surveillance of Acute Flaccid Paralysis (AFP) as the gold standard for detecting cases of polio. In addition, the Environmental Surveillance (ES), seeking the presence of PV and Non-Polio Enterovirus (NPEV) in sewage, is recognized as a powerful tool to confirm PV circulation in absence of AFP cases, especially in polio-free countries. Here we report the results of AFP surveillance (AFPS) and ES in Lombardy (Northern Italy) from 2012 to 2015. Forty-eight AFP cases were identified during the study period. No AFP case was caused by PV infection. NPEVs were identified in 6.3% (3/48) of AFP cases. The annual AFP incidence rate was 0.87/100'000 children <15 y in 2012, 1.42/100'000 in 2013, 1.02/100'000 in 2014, and 0.47/100'000 in 2015; according to WHO indicators, the sensitivity of AFPS was adequate in 2013 and 2014. Completeness of case investigation raised progressively during the study period to achieve the WHO standards in 2014 (92.3%) and 2015 (100%). Completeness of follow-up increased from 72.7% in 2012 to 100% in 2014. In the framework of the ES conducted in Milan, 268 wastewater samples were collected from 2012 to 2015 and no PVs were isolated. In contrast, NPEVs were detected in 65.3% (175/268) of samples. All NPEVs characterized belonged to enterovirus species B: echovirus type 11, 6 and 3 were the most frequently detected viruses, representing 29.1% (41/141), 20.6% (29/141) and 9.2% (13/141) of genotyped NPEVs, respectively. Keeping strong and encouraging both AFPS and ES is crucial to ensure that PV will not return unnoticed in Italy - as well as in other polio-free countries - and, as a final point, to achieve the global polio eradication goal.
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Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Andrea Battistone
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Delogu
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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9
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Kwon OH, Kim MN, Kim SA, Seok HY, Park SM, Kim BJ, Kim CH, Shim WJ, Shim JS, Lee MG. Fulminant lymphocytic myocarditis associated with orbital myositis and diaphragmatic paralysis. Cardiovasc Pathol 2015; 25:55-8. [PMID: 26481055 DOI: 10.1016/j.carpath.2015.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/11/2015] [Accepted: 08/15/2015] [Indexed: 10/23/2022] Open
Abstract
Although the clinical presentation of myocarditis is very diverse, ranging from mild dyspnea to hemodynamic collapse, myocarditis accompanied with extracardiac myositis is extremely rare. We report a single case of fulminant myocarditis associated with orbital myositis and diaphragmatic paralysis in a 40-year-old man, which was successfully managed by immunosuppressive therapy with steroid.
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Affiliation(s)
- Oh Hong Kwon
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Mi-Na Kim
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Su-A Kim
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Hung Youl Seok
- Dept. of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Seong-Mi Park
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Byung-Jo Kim
- Dept. of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Chul-Hwan Kim
- Dept. of Pathology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Wan-Joo Shim
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ju Sung Shim
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Min-Gu Lee
- Dept of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
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10
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Biesbroek PS, Beek AM, Germans T, Niessen HWM, van Rossum AC. Diagnosis of myocarditis: Current state and future perspectives. Int J Cardiol 2015; 191:211-9. [PMID: 25974197 DOI: 10.1016/j.ijcard.2015.05.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 05/01/2015] [Accepted: 05/05/2015] [Indexed: 01/17/2023]
Abstract
Myocarditis, i.e. inflammation of the myocardium, is one of the leading causes of sudden cardiac death (SCD) and dilated cardiomyopathy (DCM) in young adults, and is an important cause of symptoms such as chest pain, dyspnea and palpitations. The pathophysiological process of disease progression leading to DCM involves an ongoing inflammation as a result of a viral-induced auto-immune response or a persisting viral infection. It is therefore crucial to detect the disease early in its course and prevent persisting inflammation that may lead to DCM and end-stage heart failure. Because of the highly variable clinical presentation, ranging from mild symptoms to severe heart failure, and the limited available diagnostic tools, the evaluation of patients with suspected myocarditis represents an important clinical dilemma in cardiology. New approaches for the diagnosis of myocarditis are needed in order to improve recognition, to help unravel its pathophysiology, and to develop new therapeutic strategies to treat the disease. In this review, we give a comprehensive overview of the current diagnostic strategies for patients with suspected myocarditis, and demonstrate several new techniques that may help to improve the diagnostic work-up.
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Affiliation(s)
- P Stefan Biesbroek
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands.
| | - Aernout M Beek
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands
| | | | - Hans W M Niessen
- Department of Pathology and Cardiac Surgery, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands
| | - Albert C van Rossum
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands
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11
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Kotani O, Iwata‐Yoshikawa N, Suzuki T, Sato Y, Nakajima N, Koike S, Iwasaki T, Sata T, Yamashita T, Minagawa H, Taguchi F, Hasegawa H, Shimizu H, Nagata N. Establishment of a panel of in-house polyclonal antibodies for the diagnosis of enterovirus infections. Neuropathology 2015; 35:107-21. [PMID: 25263613 PMCID: PMC7168124 DOI: 10.1111/neup.12171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022]
Abstract
The aim of this study was to establish a reliable method of virus detection for the diagnosis of critical enterovirus infections such as acute infective encephalitis, encephalomyelitis and myocarditis. Because histopathological and immunohistochemical analyses of paraffin-embedded tissues play an important role in recognizing infectious agents in tissue samples, six in-house polyclonal antibodies raised against three representative enteroviruses using an indirect immunofluorescence assay and immunohistochemistry were examined. This panel of polyclonal antibodies recognized three serotypes of enterovirus. Two of the polyclonal antibodies were raised against denatured virus particles from enterovirus A71, one was raised against the recombinant VP1 protein of coxsackievirus B3, and the other for poliovirus type 1 were raised against denatured virus particles, the recombinant VP1 protein and peptide 2C. Western blot analysis revealed that each of these antibodies recognized the corresponding viral antigen and none cross-reacted with non-enteroviruses within the family Picornaviridae. However, all cross-reacted to some extent with the antigens derived from other serotypes of enterovirus. Indirect immunofluorescence assay and immunohistochemistry revealed that the virus capsid and non-structural proteins were localized in the cytoplasm of affected culture cells, and skeletal muscles and neurons in neonatal mice experimentally-infected with human enterovirus. The antibodies also recognized antigens derived from recent clinical isolates of enterovirus A71, coxsackievirus B3 and poliovirus. In addition, immunohistochemistry revealed that representative antibodies tested showed the same recognition pattern according to each serotype. Thus, the panel of in-house anti-enterovirus polyclonal antibodies described herein will be an important tool for the screening and pathological diagnosis for enterovirus infections, and may be useful for the classification of different enterovirus serotypes, including coxsackieviruses A and B, echoviruses, enterovirus A71 and poliovirus.
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Affiliation(s)
- Osamu Kotani
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
- Department of Virology and Viral InfectionsFaculty of Veterinary MedicineNippon Veterinary and Life Science UniversityAichiJapan
| | | | - Tadaki Suzuki
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
| | - Yuko Sato
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
| | - Noriko Nakajima
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
| | - Satoshi Koike
- Neurovirology ProjectTokyo Metropolitan Institute of Medical ScienceAichiJapan
| | - Takuya Iwasaki
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
| | - Tetsutaro Sata
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
| | - Teruo Yamashita
- Department of Microbiology and Medical ZoologyAichi Prefectural Institute of Public HealthAichiJapan
| | - Hiroko Minagawa
- Department of Microbiology and Medical ZoologyAichi Prefectural Institute of Public HealthAichiJapan
| | - Fumihiro Taguchi
- Department of Virology and Viral InfectionsFaculty of Veterinary MedicineNippon Veterinary and Life Science UniversityAichiJapan
| | - Hideki Hasegawa
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
| | - Hiroyuki Shimizu
- Department of Virology IINational Institute of Infectious DiseasesAichiJapan
| | - Noriyo Nagata
- Department of PathologyNational Institute of Infectious DiseasesAichiJapan
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12
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Lymphocytes Infiltrate the Quadriceps Muscle in Lymphocytic Myocarditis Patients: A Potential New Diagnostic Tool. Can J Cardiol 2014; 30:1547-54. [DOI: 10.1016/j.cjca.2014.07.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/17/2014] [Accepted: 07/17/2014] [Indexed: 11/21/2022] Open
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13
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Lewek J, Kaczmarek K, Cygankiewicz I, Wranicz JK, Ptaszynski P. Inflammation and arrhythmias: potential mechanisms and clinical implications. Expert Rev Cardiovasc Ther 2014; 12:1077-85. [DOI: 10.1586/14779072.2014.942286] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Genetic diversity and molecular characterization of enteroviruses from sewage-polluted urban and rural rivers in the Philippines. Virus Genes 2012; 45:207-17. [PMID: 22743820 PMCID: PMC3448906 DOI: 10.1007/s11262-012-0776-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 06/11/2012] [Indexed: 01/26/2023]
Abstract
Despite the vast distribution and expansive diversity of enteroviruses reported globally, indicators defining a complete view of the epidemiology of enteroviruses in tropical countries such as the Philippines are yet to be established. Detection of enteroviruses in the environment has been one of the markers of circulating viruses in a community. This study aimed to bridge the gap in the epidemiology of enteroviruses in the Philippines by providing an overview of the occurrence of enteroviruses in both urban and rural rivers. Molecular detection directed at the VP1 region of the enterovirus genome was performed on 44 grab river water samples collected from April to December 2009. The majority of the enterovirus serotypes detected were clustered with human enterovirus C species (HEV-C; 21/42), followed by HEV-B (12/42) and HEV-A (9/42). Porcine enterovirus 9 was also found in 12 out of 44 water samples. Phylogenetic analysis indicated that the viruses detected were closely related, if not all forming a monophyletic clade, with those enteroviruses detected previously from acute flaccid paralysis cases in the country. The clustering of environmental and human enterovirus strains implies that the circulation of these strains were associated with river contamination. This study gives further evidence of the environmental persistence of enteroviruses once they are shed in feces and likewise, provides additional data which may help in understanding the epidemiology of enteroviruses in humans, highlighting the need for more studies on the potential public health risks linked with enteroviruses found in the environment and their eventual clinical consequences in the country.
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Khavandi A, Whitaker J, Elkington A, Probert J, Walker PR. Acute streptococcal myopericarditis mimicking myocardial infarction. Am J Emerg Med 2008; 26:638.e1-2. [PMID: 18534319 DOI: 10.1016/j.ajem.2007.10.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 10/19/2007] [Indexed: 11/17/2022] Open
Abstract
A 25-year-old man who had recurrent sore throats presented with sharp central chest pain 5 hours after starting penicillin for tonsillitis. Electrocardiogram (ECG) revealed ST-segment elevation in leads I and aVL with reciprocal ST depression in lead III (Fig. 1). Troponin I was measured as 33 microg/L (normal range, b0.1 microg/L), and C-reactive protein (CRP) was 127 (normal range b10). Echocardiogram revealed a nondilated well-contracting left ventricle, and cardiac catheterization revealed normal coronary arteries. A diagnosis of acute myopericarditis was made, and he was treated with moxifloxacin. Throat swabs grew Lancefield group A Streptococcus. Over subsequent days, his symptoms and ECG changes resolved, and he was discharged on longterm prophylactic penicillin.
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Affiliation(s)
- Ali Khavandi
- Department of Cardiology, Southmead Hospital, BS10 5NB Bristol, United Kingdom.
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Smets K, Keymeulen A, Wollants E, Lagrou K, Van Ranst M, Padalko E. Detection of enteroviral RNA on Guthrie card dried blood of a neonate with fatal Coxsackie B3 myocarditis on day 17. J Clin Virol 2008; 42:207-10. [DOI: 10.1016/j.jcv.2008.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 12/19/2007] [Accepted: 01/07/2008] [Indexed: 11/24/2022]
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Zhang H, Li Y, Peng T, Aasa M, Zhang L, Yang Y, Archard LC. Localization of enteroviral antigen in myocardium and other tissues from patients with heart muscle disease by an improved immunohistochemical technique. J Histochem Cytochem 2000; 48:579-84. [PMID: 10769041 DOI: 10.1177/002215540004800501] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The association of enterovirus infection and heart muscle diseases has been investigated extensively by detection of viral genomic RNA using nucleic acid hybridization and the reverse transcription-polymerase chain reaction. To further understand the role of enterovirus and its persistence in these diseases, an immunohistochemical technique was optimized to investigate the expression of viral capsid proteins in situ. A monoclonal antibody (5-D8/1) against an epitope in the N-terminus of capsid protein VP1, conserved in the enterovirus genus, was employed. To enhance sensitivity, the EnVison system was used to detect antigen-antibody complex. VP1 was detected in formalin-fixed, paraffin-embedded endomyocardial biopsy or postmortem myocardial tissues and in liver, spleen, lung, kidney, and pancreas from patients with myocarditis or dilated cardiomyopathy, but not from controls. VP1 was localized in cytoplasm of myofibers, often adjacent to necrosis and infiltrate in myocarditis, and was clustered or scattered in dilated cardiomyopathy. This technique can be used for a definitive laboratory diagnosis of enterovirus-associated diseases and for studying the mechanisms of virus persistence in chronic myocardial disease.
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Affiliation(s)
- H Zhang
- Molecular Pathology Section, Division of Biomedical Sciences, Imperial College of Science, Technology and Medicine, London, United Kingdom.
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