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Chen H, Wu S, Zhang X. COVID-19 in China: From epidemiology to treatment (Review). Exp Ther Med 2020; 20:223. [PMID: 33193837 PMCID: PMC7646693 DOI: 10.3892/etm.2020.9353] [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: 04/11/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease caused by the novel coronavirus SARS-CoV-2. It first became prevalent in Wuhan, Hubei, China in December 2019. COVID-19 was initially characterized by pneumonia of unknown etiology, accompanied by fever, dry cough and fatigue. Due to its highly infectious nature it rapidly led to widespread human infection, causing 80,924 confirmed cases and 3,140 mortalities in mainland China as of March 9, 2020. The present review highlights the prevalence of COVID-19 in China, the etiology, pathology, clinical presentation, laboratory and chest imaging tests, and treatment of this disease.
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Affiliation(s)
- Hongtao Chen
- Department of Infectious Diseases, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong 518020, P.R. China
- Key Laboratory of Pathogenic Microorganisms of Shenzhen, Shenzhen Institute of Respiratory Diseases, Shenzhen, Guangdong 518020, P.R. China
| | - Shipin Wu
- Department of Infectious Diseases, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, Guangdong 518020, P.R. China
| | - Xiaoyong Zhang
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
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Wu H, Jiang X, Gao Y, Liu W, Wang F, Gong M, Chen R, Yu X, Zhang W, Gao B, Song C, Han D. Mumps virus infection disrupts blood-testis barrier through the induction of TNF-α in Sertoli cells. FASEB J 2019; 33:12528-12540. [PMID: 31450968 DOI: 10.1096/fj.201901089r] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Mumps virus (MuV) has high tropism to the testis and may lead to male infertility. Sertoli cells are the major targets of MuV infection. However, the mechanisms by which MuV infection impairs male fertility and Sertoli cell function remain unclear. The present study elucidated the effect of MuV infection on the blood-testis barrier (BTB). The transepithelial electrical resistance of MuV-infected mouse Sertoli cells was monitored, and the expression of major proteins of the BTB was examined. We demonstrated that MuV infection disrupted the BTB by reducing the levels of occludin and zonula occludens 1. Sertoli cells derived from Tlr2-/- and Tnfa-/- mice were analyzed for mediating MuV-induced impairment. TLR2-mediated TNF-α production by Sertoli cells in response to MuV infection impaired BTB integrity. MuV-impaired BTB was not observed in Tlr2-/- and Tnfa-/- Sertoli cells. Moreover, an inhibitor of TNF-α, pomalidomide, prevents the disruption of BTB in response to MuV infection. FITC-labeled biotin tracing assay confirmed that BTB permeability and spermatogenesis were transiently impaired by MuV infection in vivo. These findings suggest that the disruption of the BTB could be one of the mechanisms underlying MuV-impaired male fertility, in which TNF-α could play a critical role.-Wu, H., Jiang, X., Gao, Y., Liu, W., Wang, F., Gong, M., Chen, R., Yu, X., Zhang, W., Gao, B., Song, C., Han, D. Mumps virus infection disrupts blood-testis barrier through the induction of TNF-α in Sertoli cells.
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Affiliation(s)
- Han Wu
- College of Animal Science and Technology, Institute of Mobilome and Genome, Yangzhou University, Yangzhou, China.,Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Xing Jiang
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China.,Guangdong Key Laboratory for Genome Stability and Disease Prevention, Shenzhen University School of Medicine, Shenzhen, China
| | - Yunxiao Gao
- Department of Andrology, China-Japan Friendship Hospital, Beijing, China
| | - Weihua Liu
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Fei Wang
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Maolei Gong
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Ran Chen
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoqin Yu
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Wenjing Zhang
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Gao
- College of Animal Science and Technology, Institute of Mobilome and Genome, Yangzhou University, Yangzhou, China
| | - Chengyi Song
- College of Animal Science and Technology, Institute of Mobilome and Genome, Yangzhou University, Yangzhou, China
| | - Daishu Han
- Institute of Basic Medical Sciences, Peking Union Medical College-Chinese Academy of Medical Sciences, Beijing, China
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Abstract
BACKGROUND Infections in the urogenital tract are accepted causes of male infertility. Epidemiologic data indicate 6-10 % of all males undergoing andrological work-up for infertility having an infectious etiology. TOPICS This review gives a comprehensive overview on the most important urogenital tract infections (prostatitis, epididymitis, orchitis, male accessory gland infection-MAGI) and the impact on fertility. In males suffering infertility, evidence is also presented regarding an infectious etiology.
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Ternavasio-de la Vega HG, Boronat M, Ojeda A, García-Delgado Y, Ángel-Moreno A, Carranza-Rodríguez C, Bellini R, Francès A, Nóvoa FJ, Pérez-Arellano JL. Mumps orchitis in the post-vaccine era (1967-2009): a single-center series of 67 patients and review of clinical outcome and trends. Medicine (Baltimore) 2010; 89:96-116. [PMID: 20517181 DOI: 10.1097/md.0b013e3181d63191] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Since the introduction of the mumps vaccine, the age of appearance of mumps infection has shifted from children to adolescents and young adults, groups with a higher incidence of disease complications and sequelae. During the years 2000-2001, the Gran Canaria Island was part of an epidemic of mumps. In that period, our institution attended 67 cases of serologically confirmed acute mumps orchitis, the most serious complication of mumps infection in young postpubertal males. We conducted a descriptive and prospective study of this cohort and extensively reviewed the literature from 1967 (the year the first mumps vaccine was introduced) to 2009. Fifty-six patients were admitted because of general impairment and were treated with alpha-interferon. Sixty-six patients presented parotitis previous to orchitis (interval from parotitis to orchitis, 4.9 d). Orchitis was unilateral in 89.5% and bilateral in 10.4% of cases. More than 98% of patients had orchitis-associated fever. Nine patients had clinical and biochemical data showing acute mumps meningitis, and 11 had subclinical pancreatitis. The mean duration of symptoms was 4.6 days (range, 1-9). During the acute phase, more than 41% of the evaluated testes had a volume >25 mL. Acute hormonal disturbances were highly prevalent. These included decreased levels of testosterone and inhibin B with low or normal levels of gonadotropins in 35% of subjects, and, to our knowledge not previously reported, an atypical hormonal pattern consisting of low levels of free testosterone and inhibin B, along with increased measures of luteinizing hormone but low or normal follicle-stimulating hormone levels (11% of cases). During the follow-up period (mean, 331 d) a high incidence of sperm disturbance was found.
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Affiliation(s)
- Hugo-Guillermo Ternavasio-de la Vega
- From Internal Medicine Service II (HGTV), Hospital Universitario of Salamanca, Salamanca; Endocrinology and Nutrition Section (MB, AO, YGD, FJN), and Infectious Diseases and Tropical Medicine Unit (AF, JLPA), Internal Medicine Service, Hospital Universitario Insular of Gran Canaria, Gran Canaria; Department of Medical and Surgical Sciences (MB, AAM, CCR, RB, FJN, JLPA), Health Sciences Faculty, University of Las Palmas of Gran Canaria, Gran Canaria; and Internal Medicine Service II (AAM), Clínica Puerta de Hierro, Madrid, Spain
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Le Tortorec A, Denis H, Satie AP, Patard JJ, Ruffault A, Jégou B, Dejucq-Rainsford N. Antiviral responses of human Leydig cells to mumps virus infection or poly I:C stimulation. Hum Reprod 2008; 23:2095-103. [PMID: 18567898 PMCID: PMC2517156 DOI: 10.1093/humrep/den207] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The immuno-privileged status of the testis is essential to the maintenance of its functions, and innate immunity is likely to play a key role in limiting harmful viral infections, as demonstrated in the rat. In men mumps virus infects Leydig cells and has deleterious effects on testosterone production and spermatogenesis. The aim of this study was to test whether mumps virus infection of isolated human Leydig cells was associated with an inhibition of their innate antiviral defences. METHODS Leydig cell production of mRNA and protein for interferons (IFNs) and of three antiviral proteins—2′5′ oligoadenylate synthetase (2′5′OAS), double-stranded RNA-activated protein kinase (PKR) and MxA—was investigated, in the absence or presence of mumps virus or viral stimuli including poly I:C, a mimetic of RNA viruses replication product. RESULTS Stimulated or not, human Leydig cells appeared unable to produce routinely detectable IFNs α, β and γ. Although the level of PKR remained unchanged after stimulation, the expression of 2′5′OAS and MxA was enhanced following either mumps virus or poly I:C exposure (P < 0.05 versus control). CONCLUSIONS Overall, our results demonstrate that mumps virus replication in human Leydig cells is not associated with a specific inhibition of IFNs or 2′5′OAS, MxA and PKR production and that these cells display relatively weak endogenous antiviral abilities, as opposed to their rat counterparts.
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Affiliation(s)
- A. Le Tortorec
- Inserm, U625, Rennes, France
- Univ Rennes I, Campus de Beaulieu, IFR-140, Groupe d'Etude de la Reproduction chez l'Homme et les Mammifères, Rennes, F-35042, France
| | - H. Denis
- Inserm, U625, Rennes, France
- Univ Rennes I, Campus de Beaulieu, IFR-140, Groupe d'Etude de la Reproduction chez l'Homme et les Mammifères, Rennes, F-35042, France
| | - A-P. Satie
- Inserm, U625, Rennes, France
- Univ Rennes I, Campus de Beaulieu, IFR-140, Groupe d'Etude de la Reproduction chez l'Homme et les Mammifères, Rennes, F-35042, France
| | - J-J. Patard
- Service d'Urologie, Centre Hospitalier Universitaire Régional Pontchaillou, Rennes, France
| | - A. Ruffault
- Unité de Rétrovirologie, Centre Hospitalier Universitaire Régional Pontchaillou, Rennes, France
| | - B. Jégou
- Inserm, U625, Rennes, France
- Univ Rennes I, Campus de Beaulieu, IFR-140, Groupe d'Etude de la Reproduction chez l'Homme et les Mammifères, Rennes, F-35042, France
| | - N. Dejucq-Rainsford
- Inserm, U625, Rennes, France
- Univ Rennes I, Campus de Beaulieu, IFR-140, Groupe d'Etude de la Reproduction chez l'Homme et les Mammifères, Rennes, F-35042, France
- Correspondence address. Tel: +33-2-23-23-50-69; Fax: +33-2-23-23-50-55; E-mail:
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Affiliation(s)
- Jae Won Lee
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Tchun Yong Lee
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Hong Yong Choi
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
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Jalal H, Bahadur G, Knowles W, Jin L, Brink N. Mumps epididymo-orchitis with prolonged detection of virus in semen and the development of anti-sperm antibodies. J Med Virol 2004; 73:147-50. [PMID: 15042662 DOI: 10.1002/jmv.10544] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Epididymo-orchitis is the most common complication of mumps in post-pubertal men. A case of MMR vaccine failure, in whom mumps and mumps-associated unilateral epididymo-orchitis developed, is presented in this article. Mumps virus was isolated from the semen 14 days after onset and mumps RNA was detected in semen for up to 40 days using RT-PCR. Epididymo-orchitis was associated with transient but significant reduction in sperm count and severe abnormalities in sperm morphology. It also led to the appearance of anti-sperm antibodies, which may have potential long-term adverse effects on the patient's fertility. Sequencing of the SH gene of the virus showed this to be a new mumps genotype distinct from the virus circulating currently in the UK.
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Affiliation(s)
- H Jalal
- Department of Virology, Royal Free & University College Medical School, Windeyer Building, London, United Kingdom.
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Disorders at the Testicular Level. Andrology 2001. [DOI: 10.1007/978-3-662-04491-9_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ku JH, Kim YH, Jeon YS, Lee NK. The preventive effect of systemic treatment with interferon-alpha2B for infertility from mumps orchitis. BJU Int 1999; 84:839-42. [PMID: 10532982 DOI: 10.1046/j.1464-410x.1999.00273.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of interferon-alpha2B on mumps orchitis, often caused by postpubertal mumps and which can result in permanent testicular atrophy. PATIENTS AND METHODS The study included 21 patients with mumps orchitis, treated between May 1990 and June 1997. Patients were randomly assigned into two groups: in group 1, 13 patients received therapy with interferon-alpha2B (3 x 10(6) IU per day) and group 2 did not, acting as controls. All were evaluated by measurements of testis size, mumps virus titre, hormone level and semen analysis. RESULTS In group 1, the patients' symptoms resolved within 2-3 days and the volume of the testes returned to normal within 11 days; there was no testicular atrophy in any patient during the follow-up. However, asthenospermia continued to be detected in four patients (unilateral in two, bilateral in two). In group 2, the patients' symptoms resolved within 5-6 days and the volume of the testes returned to normal within 10 days; testes atrophied in three patients (unilateral in two, bilateral in one) during the follow-up. Asthenospermia continued in four patients (unilateral in two, bilateral in two). CONCLUSION These results suggest that treatment with systemic interferon-alpha2B is effective in preventing testicular atrophy when combined with standard symptomatic treatment.
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Affiliation(s)
- J H Ku
- Department of Urology, Soonchunhyang University of Medicine, Chonan, Korea
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Abstract
PURPOSE The incidence of mumps orchitis has declined dramatically since the introduction of vaccination. While in the past cases of mumps have only been seen occasionally at our institution, recently there has been a sharp increase in the number of confirmed cases. MATERIALS AND METHODS Between June 1995 and April 1996, 11 patients with severe mumps orchitis were hospitalized at our clinic. Medical history, therapeutic measures and clinical outcome were recorded for each patient. RESULTS All patients showed marked scrotal swelling with a temperature above 38.5 C. Serum C-reactive protein was significantly elevated (mean 140 mg./l.). The vaccination status of 1 of the 11 patients (9%) was unknown. Medical records from the remaining 10 patients indicated that they had not been vaccinated. Nine patients (82%) had a typical mumps parotitis preceding the orchitis. In 2 patients the clinical diagnosis of parotitis was uncertain but mumps serology was positive. None of the patients showed other manifestations of mumps. Antibodies to the mumps virus (IgG and IgM) were determined in 6 patients and positive in all cases. The average interval between parotitis and onset of orchitis was 10 days. All patients were hospitalized for an average of 6 days. Treatment included bed rest with local cooling, scrotal support and systemic treatment with nonsteroidal anti-inflammatory drugs. Ciprofloxacin or clavulanic acid/amoxicillin was administered as bacterial orchitis could not be excluded at initial presentation. The mean time to cessation of fever was 3.6 days (range 3 to 5). Antibiotics were administered for an average of 8.8 days (range 7 to 13) and anti-inflammatory drugs were given an average of 8.6 days (range 7 to 11). One patient required scrotal exploration. CONCLUSIONS Since the introduction of a vaccine against the mumps virus there is a diminished risk for mumps and its complications. However, in case of scrotal swelling mumps orchitis should still be considered. Despite vaccination mumps has not been erradicated. Therefore, continued vaccination should be considered an important step in minimizing clinical outbreaks and working towards a possible eradication of this disease in the future.
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Affiliation(s)
- R Casella
- Urologic Clinics, Department of Surgery, University Hospital, Basel, Switzerland
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