1
|
Morales SV, Coelho GM, Ricciardi-Jorge T, Dorl GG, Zanluca C, Duarte Dos Santos CN. Development of a quantitative NS1 antigen enzyme-linked immunosorbent assay (ELISA) for Zika virus detection using a novel virus-specific mAb. Sci Rep 2024; 14:2544. [PMID: 38291109 PMCID: PMC10827715 DOI: 10.1038/s41598-024-52123-2] [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: 09/29/2023] [Accepted: 01/14/2024] [Indexed: 02/01/2024] Open
Abstract
Viruses from the Flaviviridae family, such as Dengue virus (DENV), Yellow fever virus (YFV), and Zika virus (ZIKV) are notorious global public health problems. ZIKV emergence in Polynesia and the Americas from 2013 to 2016 raised concerns as new distinguishing features set it apart from previous outbreaks, including its association with neurological complications and heightened disease severity. Virus detection is impaired as cross-reactivity to other closely related orthoflaviviruses is common among commercially available diagnostic kits. While non-structural protein 1 (NS1) has been used as an early marker of DENV and West Nile virus (WNV) infection, little is known about NS1 expression during ZIKV infection. In the present work, we developed a NS1 capture ELISA using a novel ZIKV-specific monoclonal antibody to study NS1 expression dynamics in vitro in mosquito and human cell lines. While detectable in culture supernatants, higher concentrations of NS1 were predominantly cell-associated. To our knowledge, this is the first report of NS1 detection in human cells despite viral clearance over time. Tests with human samples need to be conducted to validate the applicability of NS1 detection for diagnosis, but overall, the tools developed in this work are promising for specific detection of acute ZIKV infection.
Collapse
Affiliation(s)
| | - Gabriela Mattoso Coelho
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, FIOCRUZ, Curitiba, Paraná, Brazil
| | | | - Gisiane Gruber Dorl
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, FIOCRUZ, Curitiba, Paraná, Brazil
| | - Camila Zanluca
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, FIOCRUZ, Curitiba, Paraná, Brazil
| | | |
Collapse
|
2
|
The Innate Defense in the Zika-Infected Placenta. Pathogens 2022; 11:pathogens11121410. [PMID: 36558744 PMCID: PMC9787577 DOI: 10.3390/pathogens11121410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
Zika virus (ZIKV) is an arthropod-borne virus that belongs to the Flaviviridae family, genus Flavivirus and was first isolated 1947 in Uganda, Africa, from the serum of a sentinel Rhesus monkey. Since its discovery, the virus was responsible for major outbreaks in several different countries, being linked to severe complications in pregnant women, neonatal birth defects and the congenital zika syndrome. Maternal-fetal transmission of ZIKV can occur in all trimesters of pregnancy, and the role of the placenta and its cells in these cases is yet to be fully understood. The decidua basalis and chorionic villi, maternal-fetal components of the placenta, contain a rich immunological infiltrate composed by Hofbauer cells, mastocytes, dendritic cells and macrophages, primary cells of the innate immune response that have a role that still needs to be better investigated in ZIKV infection. Recent studies have already described several histopathological features and the susceptibility and permissiveness of placenta cells to infection by the Zika virus. In this review, we address some of the current knowledge on the innate immune responses against ZIKV, especially in the placenta.
Collapse
|
3
|
Salomão N, Rabelo K, Avvad-Portari E, Basílio-de-Oliveira C, Basílio-de-Oliveira R, Ferreira F, Ferreira L, de Souza TM, Nunes P, Lima M, Sales AP, Fernandes R, de Souza LJ, Dias L, Brasil P, dos Santos F, Paes M. Histopathological and immunological characteristics of placentas infected with chikungunya virus. Front Microbiol 2022; 13:1055536. [PMID: 36466642 PMCID: PMC9714605 DOI: 10.3389/fmicb.2022.1055536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/28/2022] [Indexed: 09/29/2023] Open
Abstract
Although vertical transmission of CHIKV has been reported, little is known about the role of placenta in the transmission of this virus and the effects of infection on the maternal-fetal interface. In this work we investigated five placentas from pregnant women who became infected during the gestational period. Four formalin-fixed paraffin-embedded samples of placenta (cases 1-4) were positive for CHIKV by RT-PCR. One (case 5) had no positive test of placenta, but had positive RT-PCR for CHIKV in the serum of the mother and the baby, confirming vertical transmission. The placentas were analyzed regarding histopathological and immunological aspects. The main histopathological changes were: deciduitis, villous edema, deposits, villous necrosis, dystrophic calcification, thrombosis and stem vessel obliteration. In infected placentas we noted increase of cells (CD8+ and CD163+) and pro- (IFN-γ and TNF-α) and anti-inflammatory (TGF-β and IL-10) cytokines compared to control placentas. Moreover, CHIKV antigen was detected in decidual cell, trophoblastic cells, stroma villi, Hofbauer cells, and endothelial cells. In conclusion, CHIKV infection seems to disrupt placental homeostasis leading to histopathological alterations in addition to increase in cellularity and cytokines overproduction, evidencing an altered and harmful environment to the pregnant woman and fetus.
Collapse
Affiliation(s)
- Natália Salomão
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Kíssila Rabelo
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elyzabeth Avvad-Portari
- Departamento de Anatomia Patológica, Instituto da Mulher e da Criança Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Carlos Basílio-de-Oliveira
- Departamento de Anatomia Patológica, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Basílio-de-Oliveira
- Departamento de Anatomia Patológica, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fátima Ferreira
- Departamento de Neonatologia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiz Ferreira
- Departamento de Anatomia Patológica, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Thiara Manuele de Souza
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Priscila Nunes
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Monique Lima
- Laboratório Estratégico de Diagnóstico Molecular, Instituto Butantan, São Paulo, Brazil
| | - Anna Paula Sales
- Centro de Referência de Doenças Imuno-infecciosas (CRDI), Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Regina Fernandes
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro, Brazil
- Laboratório de Biotecnologia, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Luiz José de Souza
- Centro de Referência de Doenças Imuno-infecciosas (CRDI), Campos dos Goytacazes, Rio de Janeiro, Brazil
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Laura Dias
- Hospital Geral Dr. Beda, CEPLIN – Uti Neonatal Nicola Albano, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Patrícia Brasil
- Laboratório de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | - Flavia dos Santos
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marciano Paes
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|
4
|
Placental Alterations in a Chikungunya-Virus-Infected Pregnant Woman: A Case Report. Microorganisms 2022; 10:microorganisms10050872. [PMID: 35630317 PMCID: PMC9144120 DOI: 10.3390/microorganisms10050872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
Chikungunya virus (CHIKV) is an arthropod-borne virus first isolated in Tanzania, Africa. The virus has spread to Asia as well as South and Central America through infected Aedes mosquitoes. Vertical transmission may also occur, and was first documented during a chikungunya outbreak in La Réunion Island in 2005. Since then, some authors have been discussing the role of the placenta in maternal–fetal CHIKV transmission. CHIKV infection is characterized by fever, headache, rash, and arthralgia. However, atypical manifestations and clinical complications, including neurological, cardiac, renal, ocular, and dermal, may occur in some cases. In this report, we describe the case of a pregnant woman infected by CHIKV during the third trimester of gestation, who presented with severe dermatological manifestations during the epidemic in Rio de Janeiro, Brazil in 2019. CHIKV RNA and antigens were detected in the placental tissue, which presented with histopathological (deciduitis, fibrin deposition, edema, fetal vessel thickening, and chorioamnionitis) and ultrastructural alterations (cytotrophoblast with mitochondrial swelling and dilated cisterns in endoplasmic reticulum, vesicles in syncytiotrophoblasts, and thickening of the basement membrane of the endothelium).
Collapse
|
5
|
ZIKV replication is differential in explants and cells of human placental which is suppressed by HSV-2 coinfection. Virology 2022; 570:45-56. [DOI: 10.1016/j.virol.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/25/2022] [Accepted: 03/17/2022] [Indexed: 11/19/2022]
|
6
|
Alves FDAV, Oliveira LDLS, Salomão NG, Provance DW, Basilio-de-Oliveira CA, Basílio-de-Oliveira R, Moragas LJ, de Carvalho JJ, Mohana-Borges R, Rabelo K, Paes MV. Cytokines and inflammatory mediators: Markers involved in interstitial damage to the pancreas in two dengue fever cases associated with acute pancreatitis. PLoS One 2022; 17:e0262785. [PMID: 35041718 PMCID: PMC8765625 DOI: 10.1371/journal.pone.0262785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/04/2022] [Indexed: 12/15/2022] Open
Abstract
Dengue viral (DENV) infections can lead to acute pancreatitis and associated tissue damage. This study examined the pancreas from two fatal cases of DENV for histopathological changes as well as for the detection of cytokines, and other inflammatory mediators. Tissue sections were prepared for examination by ultrastructural and histopathological techniques. Sections from the pancreas of non-infected individuals were prepared in parallel as a control. The presence of viral replication in macrophages was detected by co-staining for the proteins NS3 and CD68 by immunofluorescence. Immunohistochemistry was used to detect cells that expressed cytokines and inflammatory mediators to characterize the inflammatory response. Edema, acinar necrosis and fibrosis areas associated with a mononuclear infiltrate were found in infected tissues. The major site of virus replication appeared to be macrophages based on their exclusive presentation of the viral protein NS3. Pancreatic tissues from the infected individuals also displayed increased levels of high mobility group box-1, caspase-3, gelatinase B and tumor necrosis factor alpha compared to controls. The presence of virus replicating macrophages in the pancreas was associated with multiple changes in tissue structure that included elevated levels of cytokines and inflammatory markers that may differentiate acute pancreatitis due to DENV infections from other causes.
Collapse
Affiliation(s)
- Felipe de Andrade Vieira Alves
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Lucca de Lima S. Oliveira
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Natália Gedeão Salomão
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - David William Provance
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
- Centro de Desenvolvimento Tecnológico em Saúde, Fiocruz, Rio de Janeiro, Brasil
| | | | | | - Leandro Junqueira Moragas
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Jorge José de Carvalho
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ronaldo Mohana-Borges
- Laboratório de Genômica Estrutural, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Kíssila Rabelo
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Marciano Viana Paes
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| |
Collapse
|
7
|
Martins Ronchi DC, Scaranello Malaquias MA, Rebutini PZ, Panini do Carmo LA, Neto PC, Marini ES, Prokopenko A, Nagashima S, Zanluca C, Duarte Dos Santos CN, de Noronha L. Placental Morphologic Similarities Between ZIKV-Positive and HIV-Positive Pregnant Women. Front Immunol 2021; 12:684194. [PMID: 34177930 PMCID: PMC8219962 DOI: 10.3389/fimmu.2021.684194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022] Open
Abstract
Zika virus (ZIKV) caused global concern due to Brazil's unexpected epidemic, and it was associated with congenital microcephaly and other gestational intercurrences. The study aimed to analyze the placenta morphometric changes of ZIKV-infected pregnant women (ZIKV group; n = 23) compared to placentas of HIV-infected (HIV group; n = 24) and healthy pregnant women (N-control group; n = 22). It also analyzed the relationship between the morphometric results and pathological alterations on conventional microscopy, gestational trimester of infection, and presence of the congenital Zika syndrome (CZS). There was a significant increase in area (p = 0.0172), as well as a higher number of knots (p = 0.0027), sprouts (p < 0.0001), and CD163 +Hofbauer cells (HCs) (p < 0.0001) in the ZIKV group compared to the N-control group, suggesting that villous dysmaturity and HCs hyperplasia could be associated with ZIKV infections. The HIV group had a higher area (p < 0.0001), perimeter (p = 0.0001), sprouts (p < 0.0001), and CD163 + HCs (p < 0.0001) compared to the N-control group, demonstrating that the morphometric abnormalities found in the ZIKV and HIV group are probably similar. However, when ZIKV and HIV groups are compared, it was observed a higher number of sprouts (p = 0.0066) and CD163+ HCs (p < 0.0001) in the first one, suggesting that placental ZIKV congenital changes could be more pronounced.
Collapse
Affiliation(s)
- Daiane Cristine Martins Ronchi
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Mineia Alessandra Scaranello Malaquias
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Patrícia Zadorosnei Rebutini
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Letícia Arianne Panini do Carmo
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Plínio Cézar Neto
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Emily Scaranello Marini
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Amanda Prokopenko
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Seigo Nagashima
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Camila Zanluca
- Molecular Virology Laboratory, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil
| | | | - Lúcia de Noronha
- Laboratory of Experimental Pathology, Postgraduate Program of Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| |
Collapse
|
8
|
Salomão N, Brendolin M, Rabelo K, Wakimoto M, de Filippis AM, dos Santos F, Moreira ME, Basílio-de-Oliveira CA, Avvad-Portari E, Paes M, Brasil P. Spontaneous Abortion and Chikungunya Infection: Pathological Findings. Viruses 2021; 13:v13040554. [PMID: 33806252 PMCID: PMC8067258 DOI: 10.3390/v13040554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 01/18/2023] Open
Abstract
Intrauterine transmission of the Chikungunya virus (CHIKV) during early pregnancy has rarely been reported, although vertical transmission has been observed in newborns. Here, we report four cases of spontaneous abortion in women who became infected with CHIKV between the 11th and 17th weeks of pregnancy. Laboratorial confirmation of the infection was conducted by RT-PCR on a urine sample for one case, and the other three were by detection of IgM anti-CHIKV antibodies. Hematoxylin and eosin (H&E) staining and an electron microscopy assay allowed us to find histopathological, such as inflammatory infiltrate in the decidua and chorionic villi, as well as areas of calcification, edema and the deposition of fibrinoid material, and ultrastructural changes, such as mitochondria with fewer cristae and ruptured membranes, endoplasmic reticulum with dilated cisterns, dispersed chromatin in the nuclei and the presence of an apoptotic body in case 1. In addition, by immunohistochemistry (IHC), we found a positivity for the anti-CHIKV antibody in cells of the endometrial glands, decidual cells, syncytiotrophoblasts, cytotrophoblasts, Hofbauer cells and decidual macrophages. Electron microscopy also helped in identifying virus-like particles in the aborted material with a diameter of 40–50 nm, which was consistent with the size of CHIKV particles in the literature. Our findings in this study suggest early maternal fetal transmission, adding more evidence on the role of CHIKV in fetal death.
Collapse
Affiliation(s)
- Natália Salomão
- Interdisciplinary Medical Research Laboratory Rio de Janeiro, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil;
| | - Michelle Brendolin
- Acute Febrile Diseases Laboratory, Evandro Chagas National Infectiology Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil; (M.B.); (M.W.)
| | - Kíssila Rabelo
- Ultrastructure and Tissue Biology Laboratory Rio de Janeiro, Rio de Janeiro State University, Rio de Janeiro 20551-030, Brazil;
| | - Mayumi Wakimoto
- Acute Febrile Diseases Laboratory, Evandro Chagas National Infectiology Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil; (M.B.); (M.W.)
| | - Ana Maria de Filippis
- Flaviviruses Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil;
| | - Flavia dos Santos
- Viral Immunology Laboratory, Oswaldo Cruz Institute Rio de Janeiro, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil;
| | - Maria Elizabeth Moreira
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil; (M.E.M.); (E.A.-P.)
| | - Carlos Alberto Basílio-de-Oliveira
- Pathological Anatomy, Gaffrée Guinle University Hospital Rio de Janeiro, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270-004, Brazil;
| | - Elyzabeth Avvad-Portari
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil; (M.E.M.); (E.A.-P.)
| | - Marciano Paes
- Interdisciplinary Medical Research Laboratory Rio de Janeiro, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil;
- Correspondence: (M.P.); (P.B.)
| | - Patrícia Brasil
- Acute Febrile Diseases Laboratory, Evandro Chagas National Infectiology Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil; (M.B.); (M.W.)
- Correspondence: (M.P.); (P.B.)
| |
Collapse
|
9
|
Histopathologic Changes in Placental Tissue Associated With Vertical Transmission of Zika Virus. Int J Gynecol Pathol 2020; 39:157-162. [PMID: 30789499 DOI: 10.1097/pgp.0000000000000586] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Zika virus (ZIKV) is highly neurotropic after crossing the placenta, inducing teratogenic effects that result in delayed development and microcephaly in infants. The available evidence for vertical transmission of this infection is based on placental studies showing alterations in trophoblastic tissue. However, complete characterization of ZIKV-infected placenta and involved pathways has yet to be fully clarified. This case report of placental ZIKV infection describes morphologic and molecular changes in the placenta. Hyperplasia of placental Hofbauer cells in chorionic villi and numerous histiocyte-like cells in the decidua were observed. The decidua, fibroblasts, and chorion, as well as circulating cells in the intravascular compartment stained positive for ZIKV envelop protein. Deciduitis was present on the maternal surface of the placenta, with a prevalence of lymphocytes associated with vasculitis. A high level of uncommitted CD3 T lymphocytes were present, in addition to CD4 and CD8 cells. Elevated expression of the apoptosis inhibitor, Bcl-2, was observed in syncytiotrophoblasts. These parameters may promote the persistence of ZIKV in placental tissue and transmission to the fetus.
Collapse
|
10
|
Puerta-Guardo H, Tabata T, Petitt M, Dimitrova M, Glasner DR, Pereira L, Harris E. Zika Virus Nonstructural Protein 1 Disrupts Glycosaminoglycans and Causes Permeability in Developing Human Placentas. J Infect Dis 2020; 221:313-324. [PMID: 31250000 DOI: 10.1093/infdis/jiz331] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/26/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND During pregnancy, the Zika flavivirus (ZIKV) infects human placentas, inducing defects in the developing fetus. The flavivirus nonstructural protein 1 (NS1) alters glycosaminoglycans on the endothelium, causing hyperpermeability in vitro and vascular leakage in vivo in a tissue-dependent manner. The contribution of ZIKV NS1 to placental dysfunction during ZIKV infection remains unknown. METHODS We examined the effect of ZIKV NS1 on expression and release of heparan sulfate (HS), hyaluronic acid (HA), and sialic acid on human trophoblast cell lines and anchoring villous explants from first-trimester placentas infected with ZIKV ex vivo. We measured changes in permeability in trophoblasts and stromal cores using a dextran-based fluorescence assay and changes in HA receptor expression using immunofluorescent microscopy. RESULTS ZIKV NS1 in the presence and absence of ZIKV increased the permeability of anchoring villous explants. ZIKV NS1 induced shedding of HA and HS and altered expression of CD44 and lymphatic endothelial cell HA receptor-1, HA receptors on stromal fibroblasts and Hofbauer macrophages in villous cores. Hyaluronidase was also stimulated in NS1-treated trophoblasts. CONCLUSIONS These findings suggest that ZIKV NS1 contributes to placental dysfunction via modulation of glycosaminoglycans on trophoblasts and chorionic villi, resulting in increased permeability of human placentas.
Collapse
Affiliation(s)
- Henry Puerta-Guardo
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | - Takako Tabata
- Department of Cell and Tissue Biology, School of Dentistry, University of California San Francisco
| | - Matthew Petitt
- Department of Cell and Tissue Biology, School of Dentistry, University of California San Francisco
| | - Milena Dimitrova
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | - Dustin R Glasner
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | - Lenore Pereira
- Department of Cell and Tissue Biology, School of Dentistry, University of California San Francisco
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| |
Collapse
|
11
|
Rodrigues de Sousa J, Azevedo RDSDS, Quaresma JAS, Vasconcelos PFDC. The innate immune response in Zika virus infection. Rev Med Virol 2020; 31:e2166. [PMID: 32926478 DOI: 10.1002/rmv.2166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/20/2020] [Accepted: 08/22/2020] [Indexed: 11/06/2022]
Abstract
Zika virus (ZIKV; Flaviviridae, Flavivirus) was discovered in 1947 in Uganda, Africa, from the serum of a sentinel Rhesus monkey (Macaca mulatta). It is an enveloped, positive-sense, single-stranded RNA virus, which encodes a single polyprotein that is cleaved into 10 individual proteins. In 2015, the Zika-epidemic in Brazil was marked mainly by the exponential growth of microcephaly cases and other congenital defects. With regard to host-pathogen relationships, understanding the role of the immune response in the pathogenesis ZIKV infection is challenging. The innate immune response is the first-line immunological defence, in which pathogen-associated molecular patterns are recognized by pattern-recognition receptors that trigger macrophages, dendritic cells, natural killer cells and endothelial cells to produce several mediators, which modulate viral replication and immune evasion. In this review, we have summarized current knowledge on the innate immune response against ZIKV.
Collapse
Affiliation(s)
- Jorge Rodrigues de Sousa
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Brazil.,Universidade do Estado do Pará, Belém, Brazil
| | | | - Juarez Antônio Simões Quaresma
- Universidade do Estado do Pará, Belém, Brazil.,Departamento de Patologia, Instituto Evandro Chagas, Ananindeua, Brazil.,Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Pedro Fernando da Costa Vasconcelos
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Brazil.,Universidade do Estado do Pará, Belém, Brazil
| |
Collapse
|
12
|
Rabelo K, de Souza LJ, Salomão NG, Machado LN, Pereira PG, Portari EA, Basílio-de-Oliveira R, Dos Santos FB, Neves LD, Morgade LF, Provance DW, Higa LM, Tanuri A, de Carvalho JJ, Paes MV. Zika Induces Human Placental Damage and Inflammation. Front Immunol 2020; 11:2146. [PMID: 32983175 PMCID: PMC7490298 DOI: 10.3389/fimmu.2020.02146] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/07/2020] [Indexed: 12/18/2022] Open
Abstract
In Brazil, an epidemic of Zika virus (ZIKV) infections was declared in 2015 that coincided with alarming reports of microcephaly in newborns associated with mother infection. Although the virus has placental tropism, changes in the tissue morphology and immunity of infected patients have not yet been elucidated. Here, we investigated the histopathological and ultrastructural changes along with the immunological profile and the BDNF expression in rare placental material. Tissues were obtained in the 2015–2016 Brazilian epidemic, of ten ZIKV-infected patients during pregnancy, five resulting in cases of fetal microcephaly and five non-microcephaly, compared to five non-infected control placentae. Viral antigens were only detected in samples from the ZIKV infected patients. Infected placentae presented histopathological severe damage, while the ultrastructural evaluation showed abnormal organelles, such as clusters of virus-like particles consistent with the ZIKV dimensions. Increased infiltration of CD68+ and TCD8+ cells, expression of MMPs, cytokines (IFN-γ and TNF-α) and other immunological mediators (RANTES/CCL5 and VEGFR-2) confirmed excessive inflammation and vascular permeability dysfunction. An evaluation of BDNF showed a decrease that could modulate neuronal damage in the developing fetus. The placental changes caused by ZIKV are not pathognomonic, however, the data provide evidence that this infection leads to severe placental injury.
Collapse
Affiliation(s)
- Kíssila Rabelo
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Natália Gedeão Salomão
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | | | - Priscila Gomes Pereira
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Laura Dias Neves
- Hospital Geral Dr. Beda, CEPLIN - Uti Neonatal Nicola Albano, Rio de Janeiro, Brazil
| | - Luciana Faes Morgade
- Hospital Geral Dr. Beda, CEPLIN - Uti Neonatal Nicola Albano, Rio de Janeiro, Brazil
| | - David William Provance
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil.,Centro de Desenvolvimento Tecnológico em Saúde, Fiocruz, Rio de Janeiro, Brazil
| | - Luiza Mendonça Higa
- Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge José de Carvalho
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marciano Viana Paes
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| |
Collapse
|
13
|
Venceslau EM, Guida JP, Amaral E, Modena JLP, Costa ML. Characterization of Placental Infection by Zika Virus in Humans: A Review of the Literature. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:577-585. [PMID: 32559805 PMCID: PMC10309222 DOI: 10.1055/s-0040-1712126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE The aim of the current review is to present a systematic evaluation of reported human placental findings in cases of zika virus (ZIKV) infection. DATA SOURCES We reviewed the EMBASE, PUBMED, and SCIELO databases until June 2019, without language restrictions. SELECTION OF STUDIES The search terms placenta AND zika virus were used. The inclusion criteria of the studies were studies that reported placental findings in humans. Experimental studies, reviews, notes or editorials were excluded. A total of 436 studies were retrieved; after duplicate exclusion, 243 articles had their titles screened, and 128 had their abstract read; of those, 32 were included in the final analysis (18 case reports, 10 case series, and 4 cohorts) DATA COLLECTION: We collected data concerning the author, year of publication, study design, number of participants, number of placental samples, onset of symptoms, perinatal outcomes, and main findings on histological analysis. DATA SYNTHESIS The placental pathologic findings were described as mild and nonspecific, similar to those of other placental infections, including chronic placentitis, chronic villitis, increased Hofbauer cells, irregular fibrin deposits, increased mononuclear cells in the villus stroma, villous immaturity, edema, hypervascularization, stromal fibrosis, calcification, and focal necrosis of syncytiotrophoblasts. CONCLUSION Zika infection presents unspecific placental findings, similar to other infections in the toxoplasmosis, other agents, rubella, cytomegalovirus, and herpes (TORCH)group. Characterizing and standardizing placental findings after zika virus infection is key to understanding the mechanisms of congenital diseases.
Collapse
Affiliation(s)
| | - José Paulo Guida
- Departament of Gynecology and Obstetrics, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Eliana Amaral
- Departament of Gynecology and Obstetrics, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - José Luis Proença Modena
- Departament of Genetics, Evolution and Bioagents, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Maria Laura Costa
- Departament of Gynecology and Obstetrics, Universidade Estadual de Campinas, Campinas, SP, Brazil
| |
Collapse
|
14
|
Rabelo K, Gonçalves AJDS, de Souza LJ, Sales AP, de Lima SMB, Trindade GF, Ciambarella BT, Amorim Tasmo NR, Diaz BL, de Carvalho JJ, Duarte MPDO, Paes MV. Zika Virus Infects Human Placental Mast Cells and the HMC-1 Cell Line, and Triggers Degranulation, Cytokine Release and Ultrastructural Changes. Cells 2020; 9:cells9040975. [PMID: 32316163 PMCID: PMC7227014 DOI: 10.3390/cells9040975] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 12/22/2022] Open
Abstract
Zika virus (ZIKV) is an emergent arthropod-borne virus whose outbreak in Brazil has brought major public health problems. Infected individuals have different symptoms, including rash and pruritus, which can be relieved by the administration of antiallergics. In the case of pregnant women, ZIKV can cross the placenta and infect the fetus leading to congenital defects. We have identified that mast cells in the placentae of patients who had Zika during pregnancy can be infected. This led to our investigation on the possible role of mast cells during a ZIKV infection, using the HMC-1 cell line. We analyzed their permissiveness to infection, release of mediators and ultrastructural changes. Flow cytometry detection of ZIKV-NS1 expression 24 h post infection in 45.3% of cells showed that HMC-1 cells are permissive to ZIKV infection. Following infection, β-hexosaminidase was measured in the supernatant of the cells with a notable release at 30 min. In addition, an increase in TNF-α, IL-6, IL-10 and VEGF levels were measured at 6 h and 24 h post infection. Lastly, different intracellular changes were observed in an ultrastructural analysis of infected cells. Our findings suggest that mast cells may represent an important source of mediators that can activate other immune cell types during a ZIKV infection, which has the potential to be a major contributor in the spread of the virus in cases of vertical transmission.
Collapse
Affiliation(s)
- Kíssila Rabelo
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil; (B.T.C.); (J.J.d.C.)
- Correspondence: (K.R.); (M.P.d.O.D.); (M.V.P); Tel.: +55-21-25621038 (M.V.P.)
| | | | - Luiz José de Souza
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro 28035-581, Brazil; (L.J.d.S.); (A.P.S.)
| | - Anna Paula Sales
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro 28035-581, Brazil; (L.J.d.S.); (A.P.S.)
| | | | - Gisela Freitas Trindade
- Laboratório de Tecnologia Virológica, Biomanguinhos, Rio de Janeiro 21040-900, Brazil; (S.M.B.d.L.); (G.F.T.)
| | - Bianca Torres Ciambarella
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil; (B.T.C.); (J.J.d.C.)
| | - Natália Recardo Amorim Tasmo
- Laboratório de Inflamação, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (N.R.A.T.); (B.L.D.)
| | - Bruno Lourenço Diaz
- Laboratório de Inflamação, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (N.R.A.T.); (B.L.D.)
| | - Jorge José de Carvalho
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil; (B.T.C.); (J.J.d.C.)
| | - Márcia Pereira de Oliveira Duarte
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil;
- Correspondence: (K.R.); (M.P.d.O.D.); (M.V.P); Tel.: +55-21-25621038 (M.V.P.)
| | - Marciano Viana Paes
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil;
- Correspondence: (K.R.); (M.P.d.O.D.); (M.V.P); Tel.: +55-21-25621038 (M.V.P.)
| |
Collapse
|
15
|
Steinbach RJ, Haese NN, Smith JL, Colgin LMA, MacAllister RP, Greene JM, Parkins CJ, Kempton JB, Porsov E, Wang X, Renner LM, McGill TJ, Dozier BL, Kreklywich CN, Andoh TF, Grafe MR, Pecoraro HL, Hodge T, Friedman RM, Houser LA, Morgan TK, Stenzel P, Lindner JR, Schelonka RL, Sacha JB, Roberts VHJ, Neuringer M, Brigande JV, Kroenke CD, Frias AE, Lewis AD, Kelleher MA, Hirsch AJ, Streblow DN. A neonatal nonhuman primate model of gestational Zika virus infection with evidence of microencephaly, seizures and cardiomyopathy. PLoS One 2020; 15:e0227676. [PMID: 31935257 PMCID: PMC6959612 DOI: 10.1371/journal.pone.0227676] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022] Open
Abstract
Zika virus infection during pregnancy is associated with miscarriage and with a broad spectrum of fetal and neonatal developmental abnormalities collectively known as congenital Zika syndrome (CZS). Symptomology of CZS includes malformations of the brain and skull, neurodevelopmental delay, seizures, joint contractures, hearing loss and visual impairment. Previous studies of Zika virus in pregnant rhesus macaques (Macaca mulatta) have described injury to the developing fetus and pregnancy loss, but neonatal outcomes following fetal Zika virus exposure have yet to be characterized in nonhuman primates. Herein we describe the presentation of rhesus macaque neonates with a spectrum of clinical outcomes, including one infant with CZS-like symptoms including cardiomyopathy, motor delay and seizure activity following maternal infection with Zika virus during the first trimester of pregnancy. Further characterization of this neonatal nonhuman primate model of gestational Zika virus infection will provide opportunities to evaluate the efficacy of pre- and postnatal therapeutics for gestational Zika virus infection and CZS.
Collapse
Affiliation(s)
- Rosemary J. Steinbach
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Nicole N. Haese
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Jessica L. Smith
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - Lois M. A. Colgin
- Division of Comparative Medicine, Pathology Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Rhonda P. MacAllister
- Division of Comparative Medicine, Clinical Medicine Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Justin M. Greene
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Christopher J. Parkins
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - J. Beth Kempton
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Edward Porsov
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Xiaojie Wang
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Lauren M. Renner
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Trevor J. McGill
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Brandy L. Dozier
- Division of Comparative Medicine, Clinical Medicine Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Craig N. Kreklywich
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - Takeshi F. Andoh
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - Marjorie R. Grafe
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Heidi L. Pecoraro
- Veterinary Diagnostic Services Department, North Dakota State University, Fargo, North Dakota, United States of America
| | - Travis Hodge
- Division of Comparative Medicine, Time Mated Breeding Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Robert M. Friedman
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Lisa A. Houser
- Division of Comparative Medicine, Behavioral Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Terry K. Morgan
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Peter Stenzel
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Jonathan R. Lindner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Robert L. Schelonka
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Jonah B. Sacha
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Victoria H. J. Roberts
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Martha Neuringer
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - John V. Brigande
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Christopher D. Kroenke
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Antonio E. Frias
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Anne D. Lewis
- Division of Comparative Medicine, Pathology Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Meredith A. Kelleher
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Alec J. Hirsch
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Daniel Neal Streblow
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| |
Collapse
|
16
|
Counotte MJ, Meili KW, Taghavi K, Calvet G, Sejvar J, Low N. Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review. F1000Res 2019; 8:1433. [PMID: 31754425 PMCID: PMC6852328 DOI: 10.12688/f1000research.19918.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2019] [Indexed: 01/10/2023] Open
Abstract
Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review. Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019. Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I
2=19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I
2=0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I
2=0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I
2=0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I
2=74.6%). In case-control studies, selection of controls from hospitals could have biased results. Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.
Collapse
Affiliation(s)
| | - Kaspar Walter Meili
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| | - Katayoun Taghavi
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| | - Guilherme Calvet
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - James Sejvar
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nicola Low
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| |
Collapse
|
17
|
Yamamoto L, Filho AGA, Queiroz JA, de Carvalho MHB, Rodrigues JC, Kanunfre KA, Francisco RPV, Okay TS. Performance of a Multiplex Nested Polymerase Chain Reaction in Detecting 7 Pathogens Containing DNA in Their Genomes Associated With Congenital Infections. Arch Pathol Lab Med 2019; 144:99-106. [PMID: 31219343 DOI: 10.5858/arpa.2018-0544-oa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Infections are the leading cause of perinatal and infant mortality in low-income and low-resource countries, which have a higher prevalence of infections. Definitive diagnosis of congenital and perinatal infections is largely dependent upon the results of laboratory tests. OBJECTIVE.— To develop a multiplex nested polymerase chain reaction (PCR) technique for the simultaneous detection of 7 pathogens containing DNA in their genomes in suspected cases of congenital infection. DESIGN.— Eligible participants were pregnant women with positive immunoglobulin M antibodies raised to one of the pathogens in the prenatal serologic screening, associated or not with fetal ultrasound abnormalities or positive fetal serology. Neonates whose mothers did not attend prenatal care were included when they presented with symptomatology and laboratory parameters suggestive of infection. The detection rate of the multiplex nested PCR was compared with maternal, fetal, and neonatal serology, as well as placental immunohistochemistry and noncommercial amplifications. RESULTS.— Of 161 suspected cases, the multiplex nested PCR detected 60 (37.3%), whereas the tests available in hospital laboratories detected 13 of 60 (21.7%) of the cases detected by the multiplex nested PCR, demonstrating a 4.6 times higher detection rate for the multiplex nested PCR (Fisher exact test, P < .001). Positive amplifications were to Toxoplasma gondii (32 cases), cytomegalovirus (14 cases), parvovirus B19 (5 cases), and adenovirus (5 cases). In 4 cases, 2 pathogens were simultaneously detected. All types of biological matrices were suitable for amplification. Sequencing of multiplex nested PCR products confirmed the molecular findings. CONCLUSIONS.— The multiplex nested PCR significantly increased the number of diagnosed congenital infections. Given the scarcity of DNA recovered from amniotic fluid and some neonatal samples, this multiplex nested PCR allows the simultaneous detection of 7 pathogens associated with congenital infections in a reliable, faster, cost-effective, and more sensitive way.
Collapse
Affiliation(s)
- Lidia Yamamoto
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Antonio G Amorim Filho
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Joelma A Queiroz
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Mario H B de Carvalho
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Jonatas C Rodrigues
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Kelly A Kanunfre
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Rossana P V Francisco
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Thelma Suely Okay
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| |
Collapse
|
18
|
A Stillborn Multiple Organs' Investigation from a Maternal DENV-4 Infection: Histopathological and Inflammatory Mediators Characterization. Viruses 2019; 11:v11040319. [PMID: 30986974 PMCID: PMC6521294 DOI: 10.3390/v11040319] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 12/11/2022] Open
Abstract
Dengue virus (DENV) is an emerging virus involved in outbreaks in Brazil. The association between the virus and vertical transmission, with disorders in the placenta, has raised a worldwide concern. On the 29th gestational week, a pregnant woman presented severe complications due to a DENV infection leading to maternal and fetus death. Postmortem analysis of fetal organs demonstrated the presence of DENV using reverse transcriptase polymerase chain reaction (RT-PCR) in the fetal brain and DENV non-structural protein 3 (NS3) staining in placenta and several peripheral fetal tissues, such as the brain, liver, lungs, and spleen. Histological analysis of the placenta and fetal organs revealed different types of tissue abnormalities, which included inflammation, hemorrhage, edema, and necrosis in placenta and tissue disorganization in the fetus, such as spongiform parenchyma, microglial inflammation, steatosis, hyalinose arteriolar, inflammatory cells in the alveolar septa, and disorganization of the lymphoid follicle. Increased cellularity (macrophage, Hofbauer cells and TCD8+ lymphocytes) and up-regulation of inflammatory mediators such as IFN-γ, TNF-α, RANTES/CCL5, MCP1/CCL2, and VEGF/R2 were detected in the liver, lung, spleen, brain, and placenta, supporting placental and fetus peripheral tissues inflammation. Maternal infection leading to the production of those vascular mediators may alter the vascular permeability, facilitating the virus entry and tissue and barrier dysfunction.
Collapse
|
19
|
de Noronha L, Zanluca C, Burger M, Suzukawa AA, Azevedo M, Rebutini PZ, Novadzki IM, Tanabe LS, Presibella MM, Duarte Dos Santos CN. Zika Virus Infection at Different Pregnancy Stages: Anatomopathological Findings, Target Cells and Viral Persistence in Placental Tissues. Front Microbiol 2018; 9:2266. [PMID: 30337910 PMCID: PMC6180237 DOI: 10.3389/fmicb.2018.02266] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/05/2018] [Indexed: 12/01/2022] Open
Abstract
Zika virus (ZIKV) infection in humans has been associated with congenital malformations and other neurological disorders, such as Guillain-Barré syndrome. The mechanism(s) of ZIKV intrauterine transmission, the cell types involved, the most vulnerable period of pregnancy for severe outcomes from infection and other physiopathological aspects are not completely elucidated. In this study, we analyzed placental samples obtained at the time of delivery from a group of 24 women diagnosed with ZIKV infection during the first, second or third trimesters of pregnancy. Villous immaturity was the main histological finding in the placental tissues, although placentas without alterations were also frequently observed. Significant enhancement of the number of syncytial sprouts was observed in the placentas of women infected during the third trimester, indicating the development of placental abnormalities after ZIKV infection. Hyperplasia of Hofbauer cells (HCs) was also observed in these third-trimester placental tissues, and remarkably, HCs were the only ZIKV-positive fetal cells found in the placentas studied that persisted until birth, as revealed by immunohistochemical (IHC) analysis. Thirty-three percent of women infected during pregnancy delivered infants with congenital abnormalities, although no pattern correlating the gestational stage at infection, the IHC positivity of HCs in placental tissues and the presence of congenital malformations at birth was observed. Placental tissue analysis enabled us to confirm maternal ZIKV infection in cases where serum from the acute infection phase was not available, which reinforces the importance of this technique in identifying possible causal factors of birth defects. The results we observed in the samples from naturally infected pregnant women may contribute to the understanding of some aspects of the pathophysiology of ZIKV.
Collapse
Affiliation(s)
- Lucia de Noronha
- Laboratório de Patologia Experimental, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Camila Zanluca
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Marion Burger
- Secretaria da Saúde do Estado do Paraná, Curitiba, Brazil
| | - Andreia Akemi Suzukawa
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Marina Azevedo
- Laboratório de Patologia Experimental, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Patricia Z Rebutini
- Laboratório de Patologia Experimental, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | | | | | | |
Collapse
|
20
|
Rabelo K, Souza LJ, Salomão NG, Oliveira ERA, Sentinelli LDP, Lacerda MS, Saraquino PB, Rosman FC, Basílio-de-Oliveira R, Carvalho JJ, Paes MV. Placental Inflammation and Fetal Injury in a Rare Zika Case Associated With Guillain-Barré Syndrome and Abortion. Front Microbiol 2018; 9:1018. [PMID: 29867903 PMCID: PMC5964188 DOI: 10.3389/fmicb.2018.01018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/30/2018] [Indexed: 01/08/2023] Open
Abstract
Zika virus (ZIKV) is an emerging virus involved in recent outbreaks in Brazil. The association between the virus and Guillain-Barré syndrome (GBS) or congenital disorders has raised a worldwide concern. In this work, we investigated a rare Zika case, which was associated with GBS and spontaneous retained abortion. Using specific anti-ZIKV staining, the virus was identified in placenta (mainly in Hofbauer cells) and in several fetal tissues, such as brain, lungs, kidneys, skin and liver. Histological analyses of the placenta and fetal organs revealed different types of tissue abnormalities, which included inflammation, hemorrhage, edema and necrosis in placenta, as well as tissue disorganization in the fetus. Increased cellularity (Hofbauer cells and TCD8+ lymphocytes), expression of local pro-inflammatory cytokines such as IFN-γ and TNF-α, and other markers, such as RANTES/CCL5 and VEGFR2, supported placental inflammation and dysfunction. The commitment of the maternal-fetal link in association with fetal damage gave rise to a discussion regarding the influence of the maternal immunity toward the fetal development. Findings presented in this work may help understanding the ZIKV immunopathogenesis under the rare contexts of spontaneous abortions in association with GBS.
Collapse
Affiliation(s)
- Kíssila Rabelo
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiz J Souza
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Natália G Salomão
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Edson R A Oliveira
- Laboratório de Modelagem Molecular, Instituto de Química Orgânica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Marcelle S Lacerda
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Pedro B Saraquino
- Faculdade de Medicina de Campos, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Fernando C Rosman
- Anatomia Patológica, Hospital Municipal Jesus, Rio de Janeiro, Brazil
| | | | - Jorge J Carvalho
- Laboratório de Ultraestrutura e Biologia Tecidual, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marciano V Paes
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|