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Steininger P, Korn K, Hackstein H, Strasser EF. Validation of a Parvovirus B19 NAT Assay for Screening of Umbilical Cord Blood for Allogenic Hematopoietic Stem Cell Donation. Transfus Med Hemother 2024; 51:48-51. [PMID: 38314242 PMCID: PMC10836944 DOI: 10.1159/000532073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/17/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Parvovirus B19 transmitted by umbilical cord blood (UCB) products may cause severe disease in allogenic hematopoietic stem cell transplant recipients. Thus, commercially available nucleic acid test (NAT) assays for highly sensitive detection of parvovirus B19 DNA validated for the specimen cord blood plasma (CBP) are required to avoid parvovirus B19 transmission by umbilical hematopoietic stem cell preparations. Methods The multiplex cobas DPX NAT assay was validated for detection of parvovirus B19 DNA in CBP derived from citrate anticoagulated UCB units which have been processed by the Rubinstein method. In total, 363 retained CBP samples pretested negative for parvovirus B19 DNA were prepared for analyzing sensitivity, specificity, and interference of that NAT assay. The 3rd WHO International Standard for parvovirus B19 DNA was used for determining the 95% limit of detection (LOD95) by probit analysis. Results The validation of the parvovirus B19 NAT assay for CBP demonstrated high sensitivity, specificity, intra- and inter-assay precision. Dilution series and replicate analyses showed a high linearity of the assay with a coefficient of determination above 0.99 and revealed a LOD95 of 17 International Units (IU)/mL (95% confidence interval, 14-44 IU/mL) for parvovirus B19 DNA in CBP samples. Conclusion The validation of a commercially available parvovirus B19 NAT assay for the specimen CBP demonstrated a high assay performance fulfilling German guidelines and international regulations.
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Affiliation(s)
- Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Korn
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Holger Hackstein
- Department of Transfusion Medicine and Haemostaseology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Erwin F Strasser
- Division of Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, LMU Munich, Munich, Germany
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Sánchez-Moguel I, Coffeen CF, Bustos-Jaimes I. On-column refolding and off-column assembly of parvovirus B19 virus-like particles from bacteria-expressed protein. Appl Microbiol Biotechnol 2024; 108:160. [PMID: 38252281 PMCID: PMC10803429 DOI: 10.1007/s00253-024-13004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024]
Abstract
Virus-like particles (VLPs) are nanometric structures composed of structural components of virions, keeping most of the cellular recognition and internalization properties, but are non-infective as they are deprived of their genetic material. VLPs have been a versatile platform for developing vaccines by carrying their own or heterologous antigenic epitopes. Moreover, VLPs can also be used as nanovessels for encapsulating molecules with therapeutic applications, like enzymes, nucleic acids, and drugs. Parvovirus B19 (B19V) VLPs can be self-assembled in vitro from the denatured major viral particle protein VP2 by equilibrium dialysis. Despite its fair productivity, this process is currently a time-consuming task. Affinity chromatography is used as an efficient step for concentration and purification, but it is only sometimes seen as a method that facilitates the oligomerization of proteins. In this research, we report a novel approach for the in vitro assembly of B19V VLPs through the immobilization of the denatured VP2 into an immobilized metal affinity chromatography (IMAC) column, followed by the on-column folding and the final VLP assembly upon protein elution. This method is suitable for the fast production of B19V VLPs. KEY POINTS: • Biotechnological applications for inclusion bodies • Efficient single-step purification and immobilization strategies • Rapid VLP assembly strategy.
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Affiliation(s)
- Ignacio Sánchez-Moguel
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510, Mexico City, Mexico
| | - Carlos Francisco Coffeen
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510, Mexico City, Mexico
| | - Ismael Bustos-Jaimes
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510, Mexico City, Mexico.
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Ravel-Chapuis R, Mottin L, Souissi M, Lahary A, Bobée V. [Hemolytic anemia in a two-year-old child: A case of multiple red blood cell abnormalities]. Ann Biol Clin (Paris) 2023; 81:abc.2023.1843. [PMID: 38018827 DOI: 10.1684/abc.2023.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
The discovery of hemolytic anemia requires a meticulous investigation to determine its etiology. Among patients of African origin, it is not uncommon to find multiple constitutional red blood cell abnormalities, which can complicate diagnosis. We herein describe the case of a two-year-old child presenting with acute hemolytic anemia. A G6PD deficiency, hereditary spherocytosis, and a sickle cell trait A/S were simultaneously identified, all within the context of a primary infection with Parvovirus B19. This virus commonly triggers acute anemia in children exhibiting constitutional red blood cell abnormalities and need to be considered in such cases.
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Singh V, Dogra PM, Singh P, Singh SK, Ghosh I, Sreenivasa S, Singhal G, Arya R. Parvovirus B19 infection after kidney transplantation: A single centre experience. Med J Armed Forces India 2023; 79:665-671. [PMID: 37981933 PMCID: PMC10654353 DOI: 10.1016/j.mjafi.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/06/2023] [Indexed: 11/21/2023] Open
Abstract
Background Parvovirus B19 is an uncommon cause of anaemia in kidney transplant recipients (KTRs). The study aims to determine the incidence, clinical presentation, laboratory findings and outcome of parvovirus B19-related anaemia in KTR. Method We conducted a 12-year retrospective, single-centre study describing the clinical profile of KTRs with parvovirus B19-related anaemia. Result Amongst the 714 patients who underwent kidney transplantation between January 2011 and January 2023, (cumulative follow-up: 1287 patient-years), six females and one male, developed parvovirus B19-related anaemia. The incidence proportion (risk) is 0.98% with an incidence rate of 5.43 cases per 1000 patient-year. The median duration from transplant to development of anaemia was 6 weeks (range: 4-40 weeks). The mean fall in haemoglobin was 2.88 ± 1.55 gm/dl; concomitant leukopenia and thrombocytopenia were observed in 57.1 and 28.6% of patients. Three patients responded to a reduction in immunosuppression, the four non-responders required the administration of low-dose intravenous immunoglobulin. The mean duration from initiation of therapy to a sustained rise in haemoglobin was 7.71 ± 2.62 weeks. None of the patients had a relapse of the infection. Conclusions Parvovirus B19 infection is an uncommon cause of post-transplant refractory anaemia. The key to successfully managing such patients includes a high index of suspicion, early diagnosis and reduction of immunosuppression with or without administration of intravenous immunoglobulin.
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Affiliation(s)
- Vishal Singh
- Professor & Head (Nephrology), Army Hospital (R&R), Delhi Cantt, India
| | - Pavitra Manu Dogra
- Senior Advisor (Medicine) & Nephrologist, Army Hospital (R&R), Delhi Cantt, India
| | - Pulkit Singh
- Department of Medicine, MS Ramaiah Medical College, Bangalore, India
| | | | - Indranil Ghosh
- Senior Advisor (Medicine) & Nephrologist, Army Hospital (R&R), Delhi Cantt, India
| | - S. Sreenivasa
- Senior Advisor (Medicine) & Nephrologist, Army Hospital (R&R), Delhi Cantt, India
| | - Gaurav Singhal
- Resident (Nephrology), Army Hospital (R&R), Delhi Cantt, India
| | - Rohan Arya
- Resident (Nephrology), Army Hospital (R&R), Delhi Cantt, India
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Kloc A, Campbell KS, Espinoza YAU. Detection of Parvovirus B19 genome in human heart tissue samples. BMC Res Notes 2023; 16:239. [PMID: 37775826 PMCID: PMC10542668 DOI: 10.1186/s13104-023-06527-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE Identifying viral genomes in human heart tissues is critical for disease diagnosis and assessment of cardiovascular damage. Human heart tissue samples obtained during a biopsy procedure are routinely used to test for the presence of viruses, as guided by clinical manifestations and prognosis. Furthermore, heart tissue samples obtained post-mortem or during a cardiac transplant procedure serve as a valuable research tool, as they allow for an in-depth assessment of cardiac pathology that can aid in our understanding of molecular pathways associated with disease. Because viral nucleic acid constitutes only a small portion of each sample's genetic material, appropriate methods are necessary for positive viral genome identification. RESULTS Snap-frozen heart tissue samples obtained either post-mortem or during a cardiac transplant procedure were used to develop conditions for detection of Parvovirus B19. Briefly, total DNA was isolated from the heart tissue under varying conditions. A PCR-based assay with Parvovirus B19 specific primers was implemented to detect the presence of the viral genome, followed by Sanger Sequencing. The mechanical disruption of the heart tissue, as well as the cardiac tissue processing methods, had a significant effect on the DNA quality and the ability to detect the Parvovirus B19 genome.
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Affiliation(s)
- Anna Kloc
- Department of Biology and Environmental Science, University of New Haven, West Haven, CT, USA.
| | - Kenneth S Campbell
- Saha Cardiovascular Research Center, University of Kentucky College of Medicine, Lexington, KY, USA
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Aronson ST, Celiker MY, Guarini L, Agha R. Intravenous immunoglobulin treatment of congenital parvovirus B19 induced anemia - a case report. Matern Health Neonatol Perinatol 2023; 9:10. [PMID: 37544998 PMCID: PMC10405454 DOI: 10.1186/s40748-023-00164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Parvovirus is a common childhood infection that could be very dangerous to the fetus, if pregnant women become infected. The spectrum of effects range from pure red blood cell aplasia with hydrops fetalis to meningoencephalitis, with many symptoms in between. Severe anemia in the setting of pure red blood cell aplasia is one of the more common effects that neonatal experience (if infected intrapartum), with the current gold standard treatment being intrauterine or postnatal packed red blood cell (PRBC) transfusions, yet intravenous immunoglobulin (IVIG) may be a superior treatment option. CASE PRESENTATION A preterm infant was born at 26th week of gestational age via emergency Cesarean section due to hydrops fetalis, with parvovirus B19 exposure one month prior. The infant tested positive for IgM antibodies against parvovirus B19. Among many other serious complications of both hydrops fetalis and premature delivery, the infant had severe unremitting anemia, and received many PRBC transfusion over the course of his 71-day-long neonatal intensive care unit stay. During a follow up appointments as outpatient, his blood tests showed persistent high copies of parvovirus B19. He was then supported with PRBC transfusions and treated with IVIG. After three doses of IVIG, the infant's parvovirus B19 viral copy numbers have dramatically reduced and the infant did not require any more PRBC transfusions. CONCLUSIONS IVIG infusion effectively treated the parvovirus B19 infection and restored erythropoiesis making the child transfusion independent. Furthermore, since IVIG is safe and readily crosses the placenta, further studies are needed to determine if IVIG should be considered as an alternative prenatal treatment for congenital parvovirus B19 infection.
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Affiliation(s)
- Stephanie T Aronson
- Department of Pediatrics, Maimonides Children's Hospital, 4802 10th Avenue, 11219, Brooklyn, NY, USA
| | - Mahmut Y Celiker
- Division of Pediatric Hematology/Oncology Department of Pediatrics, Maimonides Children's Hospital, 4802 10th Avenue, 11219, Brooklyn, NY, USA.
| | - Ludovico Guarini
- Division of Pediatric Hematology/Oncology Department of Pediatrics, Maimonides Children's Hospital, 4802 10th Avenue, 11219, Brooklyn, NY, USA
| | - Rabia Agha
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Maimonides Children's Hospital, 4802 10th Avenue, 11219, Brooklyn, NY, USA
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Kalavari F, Tanzifi P, Yousefi T, Lotfi M, Nazar E. Investigation of Parvovirus B19, Cytomegalovirus, Herpes Simplex Virus Types 1 and 2, Human Papillomavirus Types 16 and 18 in Papillary Thyroid Carcinoma. Iran J Pathol 2023; 18:370-375. [PMID: 37942204 PMCID: PMC10628384 DOI: 10.30699/ijp.2023.1982745.3032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/05/2023] [Indexed: 11/10/2023]
Abstract
Background & Objective Viral infections are associated with the pathogenesis and progression of human malignancies. Several studies have suggested the role of viral infections in papillary thyroid carcinoma (PTC). However, the results are still conflicting, and the potential role of viruses in PTC tumorigenesis remains to be elucidated. In the present study, we aimed to investigate the presence of parvovirus B19, cytomegalovirus (CMV), herpes simplex virus types 1 and 2 (HSV-1/HSV-2), and human papillomavirus (HPV) types 16 and 18 in PTC. Methods In this cross-sectional study, paraffin-embedded tissue blocks of 40 patients with PTC were used. Tissue blocks were studied for the presence of the virus genome using real-time polymerase chain reaction (PCR). Results Of the 40 patients with PTC, there was 1 positive case of HPV (2.5%), while 6 cases were positive for parvovirus B19. HSV and CMV DNAs were not detected in any cases. Conclusion Correlations among HSV, CMV, and PTC are unexpected in our patient population. But parvovirus B19 and, to a lesser extent, HPV DNA genomes were detected in PTC using real-time PCR.
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Affiliation(s)
- Fakhriyeh Kalavari
- Department of Pathology, Guilan University of Medical Sciences, Razi Hospital, Rasht, Iran
| | - Parin Tanzifi
- Department of Pathology, Douglass Hanly Moir Pathology, New South Wales, Australia
| | - Tahereh Yousefi
- Department of Pathology, Amir-Alam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Lotfi
- Department of Pathology, Amir-Alam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Nazar
- Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Bertazza Partigiani N, Negrisolo S, Carraro A, Marzenta D, Manaresi E, Gallinella G, Barzon L, Benetti E. Pre-Existing Intrarenal Parvovirus B19 Infection May Relate to Antibody-Mediated Rejection in Pediatric Kidney Transplant Patients. Int J Mol Sci 2023; 24:ijms24119147. [PMID: 37298109 DOI: 10.3390/ijms24119147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/01/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
Viral infections can lead to transplant dysfunction, and their possible role in rejection is described. In total, 218 protocol biopsies performed in 106 children at 6, 12 and 24 months after transplantation were analyzed according to Banff '15. RT-PCR for cytomegalovirus, Epstein-Barr virus, BK virus and Parvovirus B19 was performed on blood and bioptic samples at the time of transplant and each protocol biopsy. The prevalence of intrarenal viral infection increases between 6 and 12 months after transplantation (24% vs. 44%, p = 0.007). Intrarenal Parvovirus B19 infection is also associated with antibody-mediated rejection (ABMR) (50% ABMR vs. 19% T-cell-mediated rejection, p = 0.04). Moreover, Parvovirus infection is higher at 12 months of follow-up and it decreases at 48 months (40.4% vs. 14%, p = 0.02), while in 24% of grafts, Parvovirus is already detectable at the moment of transplantation. Intrarenal Parvovirus B19 infection seems to be related to ABMR in pediatric kidney recipients. The graft itself may be the way of transmission for Parvovirus, so performance of a PCR test for Parvovirus B19 should be considered to identify high-risk patients. Intrarenal Parvovirus infection presents mainly during the first-year post-transplantation; thus, we recommend an active surveillance of donor-specific antibodies (DSA) in patients with intrarenal Parvovirus B19 infection during this period. Indeed, it should be considered a treatment with intravenous immunoglobulins in patients with intrarenal Parvovirus B19 infection and DSA positivity, even in the absence of ABMR criteria for kidney biopsy.
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Affiliation(s)
- Nicola Bertazza Partigiani
- Pediatric Nephrology, Department of Women's and Children's Health, University Hospital of Padua, 35128 Padua, Italy
- Department of Women's and Children's Health, University of Padua, 35128 Padua, Italy
| | - Susanna Negrisolo
- Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women's and Children's Health, University of Padova, 35127 Padua, Italy
- Pediatric Research Institute "IRP Città della Speranza", 35127 Padua, Italy
| | - Andrea Carraro
- Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women's and Children's Health, University of Padova, 35127 Padua, Italy
| | - Diana Marzenta
- Pediatric Nephrology, Department of Women's and Children's Health, University Hospital of Padua, 35128 Padua, Italy
- Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women's and Children's Health, University of Padova, 35127 Padua, Italy
| | - Elisabetta Manaresi
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Giorgio Gallinella
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padua, 35121 Padua, Italy
| | - Elisa Benetti
- Pediatric Nephrology, Department of Women's and Children's Health, University Hospital of Padua, 35128 Padua, Italy
- Laboratory of Immunopathology and Molecular Biology of the Kidney, Department of Women's and Children's Health, University of Padova, 35127 Padua, Italy
- Pediatric Research Institute "IRP Città della Speranza", 35127 Padua, Italy
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Mendes-de-Almeida DP, Bokel JPB, Alves ADR, Vizzoni AG, Tavares ICF, Silva MST, Netto JDSB, Grinsztejn BGJ, Amado Leon LA. Clinical Presentation of Parvovirus B19 Infection in Adults Living with HIV/AIDS: A Case Series. Viruses 2023; 15:v15051124. [PMID: 37243210 DOI: 10.3390/v15051124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
Parvovirus B19 (B19V) infection varies clinically depending on the host's immune status. Due to red blood cell precursors tropism, B19V can cause chronic anemia and transient aplastic crisis in patients with immunosuppression or chronic hemolysis. We report three rare cases of Brazilian adults living with human immunodeficiency virus (HIV) with B19V infection. All cases presented severe anemia and required red blood cell transfusions. The first patient had low CD4+ counts and was treated with intravenous immunoglobulin (IVIG). As he remained poorly adherent to antiretroviral therapy (ART), B19V detection persisted. The second patient had sudden pancytopenia despite being on ART with an undetectable HIV viral load. He had historically low CD4+ counts, fully responded to IVIG, and had undiagnosed hereditary spherocytosis. The third individual was recently diagnosed with HIV and tuberculosis (TB). One month after ART initiation, he was hospitalized with anemia aggravation and cholestatic hepatitis. An analysis of his serum revealed B19V DNA and anti-B19V IgG, corroborating bone marrow findings and a persistent B19V infection. The symptoms resolved and B19V became undetectable. In all cases, real time PCR was essential for diagnosing B19V. Our findings showed that adherence to ART was crucial to B19V clearance in HIV-patients and highlighted the importance of the early recognition of B19V disease in unexplained cytopenias.
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Affiliation(s)
- Daniela P Mendes-de-Almeida
- Hematology Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
- Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20220-430, RJ, Brazil
- Department of Medical Affairs, Clinical Studies, and Post-Registration Surveillance (DEAME), Institute of Technology in Immunobiologicals/Bio-Manguinhos, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Joanna Paes Barreto Bokel
- Hematology Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
- Onco-Hematology Unit, Clínica São Vicente, Rio de Janeiro 22451-100, RJ, Brazil
| | - Arthur Daniel Rocha Alves
- Laboratory of Technological Development in Virology, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Alexandre G Vizzoni
- Hematology Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Isabel Cristina Ferreira Tavares
- Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Mayara Secco Torres Silva
- Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Juliana Dos Santos Barbosa Netto
- Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Beatriz Gilda Jegerhorn Grinsztejn
- Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
| | - Luciane Almeida Amado Leon
- Laboratory of Technological Development in Virology, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-360, RJ, Brazil
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Bichicchi F, Guglietta N, Rocha Alves AD, Fasano E, Manaresi E, Bua G, Gallinella G. Next Generation Sequencing for the Analysis of Parvovirus B19 Genomic Diversity. Viruses 2023; 15:217. [PMID: 36680257 PMCID: PMC9863757 DOI: 10.3390/v15010217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/02/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
Parvovirus B19 (B19V) is a ssDNA human virus, responsible for an ample range of clinical manifestations. Sequencing of B19V DNA from clinical samples is frequently reported in the literature to assign genotype (genotypes 1-3) and for finer molecular epidemiological tracing. The increasing availability of Next Generation Sequencing (NGS) with its depth of coverage potentially yields information on intrinsic sequence heterogeneity; however, integration of this information in analysis of sequence variation is not routinely obtained. The present work investigated genomic sequence heterogeneity within and between B19V isolates by application of NGS techniques, and by the development of a novel dedicated bioinformatic tool and analysis pipeline, yielding information on two newly defined parameters. The first, α-diversity, is a measure of the amount and distribution of position-specific, normalised Shannon Entropy, as a measure of intra-sample sequence heterogeneity. The second, σ-diversity, is a measure of the amount of inter-sample sequence heterogeneity, also incorporating information on α-diversity. Based on these indexes, further cluster analysis can be performed. A set of 24 high-titre viraemic samples was investigated. Of these, 23 samples were genotype 1 and one sample was genotype 2. Genotype 1 isolates showed low α-diversity values, with only a few samples showing distinct position-specific polymorphisms; a few genetically related clusters emerged when analysing inter-sample distances, correlated to the year of isolation; the single genotype 2 isolate showed the highest α-diversity, even if not presenting polymorphisms, and was an evident outlier when analysing inter-sample distance. In conclusion, NGS analysis and the bioinformatic tool and pipeline developed and used in the present work can be considered effective tools for investigating sequence diversity, an observable parameter that can be incorporated into the quasispecies theory framework to yield a better insight into viral evolution dynamics.
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Affiliation(s)
- Federica Bichicchi
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Niccolò Guglietta
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Arthur Daniel Rocha Alves
- Laboratory of Technological Development in Virology, Oswaldo Cruz Foundation/FIOCRUZ, Brasil Avenue 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Erika Fasano
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Elisabetta Manaresi
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Gloria Bua
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
| | - Giorgio Gallinella
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy
- Microbiology Section, IRCCS Sant’Orsola Hospital, 40138 Bologna, Italy
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Bonczarowska JH, Susat J, Mühlemann B, Jasch-Boley I, Brather S, Höke B, Brather-Walter S, Schoenenberg V, Scheschkewitz J, Graenert G, Krausse D, Francken M, Jones TC, Wahl J, Nebel A, Krause-Kyora B. Pathogen genomics study of an early medieval community in Germany reveals extensive co-infections. Genome Biol 2022; 23:250. [PMID: 36510283 PMCID: PMC9746117 DOI: 10.1186/s13059-022-02806-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The pathogen landscape in the Early European Middle Ages remains largely unexplored. Here, we perform a systematic pathogen screening of the rural community Lauchheim "Mittelhofen," in present-day Germany, dated to the Merovingian period, between fifth and eighth century CE. Skeletal remains of individuals were subjected to an ancient DNA metagenomic analysis. Genomes of the detected pathogens were reconstructed and analyzed phylogenetically. RESULTS Over 30% of the individuals exhibit molecular signs of infection with hepatitis B virus (HBV), parvovirus B19, variola virus (VARV), and Mycobacterium leprae. Seven double and one triple infection were detected. We reconstructed four HBV genomes and one genome each of B19, VARV, and M. leprae. All HBV genomes are of genotype D4 which is rare in Europe today. The VARV strain exhibits a unique pattern of gene loss indicating that viruses with different gene compositions were circulating in the Early Middle Ages. The M. leprae strain clustered in branch 3 together with the oldest to-date genome from the UK. CONCLUSIONS The high burden of infectious disease, together with osteological markers of physiological stress, reflect a poor health status of the community. This could have been an indirect result of the climate decline in Europe at the time, caused by the Late Antique Little Ice Age (LALIA). Our findings suggest that LALIA may have created an ecological context in which persistent outbreaks set the stage for major epidemics of severe diseases such as leprosy and smallpox hundreds of years later.
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Affiliation(s)
- Joanna H. Bonczarowska
- grid.9764.c0000 0001 2153 9986Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
| | - Julian Susat
- grid.9764.c0000 0001 2153 9986Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
| | - Barbara Mühlemann
- grid.7468.d0000 0001 2248 7639Institute of Virology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany ,grid.452463.2German Centre for Infection Research (DZIF), partner site Charité, 10117 Berlin, Germany
| | - Isabelle Jasch-Boley
- grid.10392.390000 0001 2190 1447Institute for Archaeological Sciences, Palaeoanthropology Working Group, University of Tübingen, Rümelinstrasse 23, 72070 Tübingen, Germany
| | - Sebastian Brather
- grid.5963.9Institute of Archaeology, Freiburg University, Belfortstraße 22, 79085 Freiburg, Germany
| | - Benjamin Höke
- grid.461756.70000 0001 2323 9995Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Berliner Straße 12, 73728 Esslingen, Germany
| | - Susanne Brather-Walter
- grid.5963.9Institute of Archaeology, Freiburg University, Belfortstraße 22, 79085 Freiburg, Germany
| | | | - Jonathan Scheschkewitz
- grid.461756.70000 0001 2323 9995Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Berliner Straße 12, 73728 Esslingen, Germany
| | - Gabriele Graenert
- grid.461756.70000 0001 2323 9995Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Berliner Straße 12, 73728 Esslingen, Germany
| | - Dirk Krausse
- grid.461756.70000 0001 2323 9995Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Berliner Straße 12, 73728 Esslingen, Germany
| | - Michael Francken
- grid.461756.70000 0001 2323 9995Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Konstanz, Germany
| | - Terry C. Jones
- grid.7468.d0000 0001 2248 7639Institute of Virology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany ,grid.5335.00000000121885934Center for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ UK
| | - Joachim Wahl
- grid.10392.390000 0001 2190 1447Institute for Archaeological Sciences, Palaeoanthropology Working Group, University of Tübingen, Rümelinstrasse 23, 72070 Tübingen, Germany
| | - Almut Nebel
- grid.9764.c0000 0001 2153 9986Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
| | - Ben Krause-Kyora
- grid.9764.c0000 0001 2153 9986Institute of Clinical Molecular Biology, Kiel University, 24105 Kiel, Germany
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12
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Simunov B, Mrzljak A, Jurekovic Z, Zidovec Lepej S, Bainrauch A, Pavicic Saric J, Hruskar Z, Radmanic L, Vilibic-Cavlek T. Parvovirus B19 status in liver, kidney and pancreas transplant candidates: A single center experience. World J Transplant 2022; 12:378-387. [PMID: 36437842 PMCID: PMC9693899 DOI: 10.5500/wjt.v12.i11.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/05/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Parvovirus B19 (B19V) is associated with a wide range of clinical manifestations. The major presentation is erythema infectiosum. However, a persistent infection may cause pure red cell aplasia and chronic anemia in immunocompromized patients. The B19V seroprevalence varies with age and geographical location.
AIM To determine the B19V serological status and DNAemia in kidney, liver, and pancreas transplant candidates.
METHODS Patients who underwent kidney, liver, or simultaneous kidney and pancreas/liver transplantation between January 2021 and May 2022 were included in the study. The serum samples were collected before transplantation. For detection of B19V DNA, a LightMix Kit B19V EC (TIB MOLBIOL, Berlin, Germany) was used. B19V IgM and IgG antibodies were detected using a commercial ELISA test (Euroimmun, Lübeck, Germany).
RESULTS One hundred and thirty-one transplant candidates were included in the study, 71.0% male, with an average age of 53.27 years ± 12.71 years. There were 68.7% liver, 27.5% kidney, 3.0% simultaneous pancreas/kidney transplant (SPKT), and 0.8% simultaneous liver/kidney transplant recipients. No patients had detectable B19V DNA. B19V IgG seroprevalence was 77.1%. No acute or recent infections were detected (IgM antibodies). There was no difference in the mean age of seronegative and seropositive patients (51.8 years ± 12.9 years vs 53.7 years ± 12.7 years, t = -0.603; P = 0.548). Although seropositivity was lower in patients aged less than 30 years (66.6%) compared to the patients aged 30-59 years and > 60 years (80.4% and 78.1%, respectively), this difference was not significant. In addition, there was no difference in seropositivity between male and female transplant candidates, 76.3% and 78.9% (χ2 = 0.104; P = 0.748). The seroprevalence did not differ among organ recipients, with 77.8%, 80.6%, and 50.0% for liver, kidney, and SPKT, respectively, (χ2 = 5.297; P = 0.151). No significant difference was found in the seroprevalence in kidney transplant patients according to dialysis modality. Seroprevalence was 71.1% in hemodialysis patients, and 100% in peritoneal dialysis patients (χ2 = 0.799; P = 0.372).
CONCLUSION The B19V seroprevalence is expectedly high among kidney, liver, and pancreas transplant candidates, but there are still 22.9% of seronegative individuals who remain at risk for primary disease and severe manifestations. Further research should elucidate the necessity of B19V screening in peri-transplant management.
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Affiliation(s)
- Bojana Simunov
- Department of Nephrology, Merkur University Hospital, Zagreb 10000, Croatia
| | - Anna Mrzljak
- Department of Gastroenterology and Hepatology, University Clinical Hospital Zagreb, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Zeljka Jurekovic
- Department of Nephrology, Merkur University Hospital, Zagreb 10000, Croatia
| | - Snjezana Zidovec Lepej
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Zagreb 10000, Croatia
| | - Ana Bainrauch
- Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia
| | | | - Zeljka Hruskar
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
| | - Leona Radmanic
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, Zagreb 10000, Croatia
| | - Tatjana Vilibic-Cavlek
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
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13
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Calcaterra V, Cavalli R, Croci GA, Fiori L, Fabiano A, Lunardon L, Avanzini MA, Berti E, Zuccotti G. Type D lymphomatoid papulosis with pityriasis lichenoides et varioliformis acuta-like features in a child with parvovirus infection: a controversial diagnosis in the spectrum of lymphoid proliferations: case report and literature review. Ital J Pediatr 2022; 48:183. [PMID: 36307824 PMCID: PMC9616621 DOI: 10.1186/s13052-022-01371-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background Lymphomatoid papulosis (LyP) is a rare condition in pediatrics; LyP histological type D has been reported in only 7 children. The differential diagnosis of LyP in the spectrum of lymphoid proliferation remains controversial. Case presentation A 6-year-old boy presented to Emergency Department with a 3-week history of an erythematous papulo-vesicular itchy eruption over the submandibular regions, trunk and extremities. History, symptoms and laboratory tests were unremarkable. SARS-CoV-2 antigen was negative. The clinical suspicion of pityriasis lichenoides et varioliformis acuta (PLEVA) was posed, and topical steroids were introduced. One week after, he returned with an extensive painful scaly papulo-erythematous rash, with some ulcerated and necrotic lesions, and fever; therefore the child was hospitalized. Biochemical results were within reference limits, except for high level of C-reactive protein, aspartate aminotransferase, alanine transaminase and bilirubin. Due to a persistently high fever, systemic corticosteroid treatment was administered, with a good clinical response and an improvement of the skin lesions. Anti-PVB-19 Immunoglobulin M was detected. Elevated levels of IL-6, IL-10 and IFN-γ were also recorded. Five days post-admission, most of the lesions had cleared, and the child was discharged. Methotrexate was started, with a positive response. At skin biopsy a “PLEVA-like” pattern was apparent, with a dense, wedge shaped lymphoid infiltrate featuring epidermotropism and morphologically comprising pleomorphic and blastic cells. The pattern of infiltration was highlighted by immunohistochemical stains, which prove the process to feature a CD8+/CD30 + phenotype, the latter being intense on larger cells, with antigenic loss. Polymerase chain reaction for T-cell receptor gamma (TCRG) chain clonality assessment documented a monoclonal peak. A diagnosis of LyP type D was favored. Conclusion The reported case encompasses most of the critical features of two separated entities—PLEVA and LyP—thus providing further support to the concept of them representing declinations within a sole spectrum of disease. Studying the role of infectious agents as trigger potential in lymphoproliferative cutaneous disorders and detecting novel markers of disease, such as cytokines, could have a crucial impact on pathogenic disease mechanisms and perspective therapies.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine, University of Pavia, 27100, Pavia, Italy.,Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Riccardo Cavalli
- Pediatric Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Giorgio A Croci
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Laura Fiori
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Antonella Fabiano
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Luisa Lunardon
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Maria Antonietta Avanzini
- Cell Factory, Pediatric Hematology Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Emilio Berti
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy. .,Department of Biomedical and Clinical Science, University of Milan, 20157, Milan, Italy.
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14
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Suzuki H, Noguchi T, Matsugu N, Suzuki A, Kimura S, Onishi M, Kosaka M, Miyazato P, Morita E, Ebina H. Safety and immunogenicity of parvovirus B19 virus-like particle vaccine lacking phospholipase A2 activity. Vaccine 2022; 40:6100-6106. [PMID: 36114131 DOI: 10.1016/j.vaccine.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/14/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
Parvovirus B19 (B19) belongs to the Erythroparvovirus genus and is known to cause the fifth disease in children. Primary infection of pregnant women is associated with a high risk of hydrops fetalis and stillbirth due to severe fetal anemia. Virus-like particle (VLP) vaccine candidates for B19 have been developed, although none have been approved so far. The B19 phospholipase A2 domain (B19 PLA2), located in the VP1 unique region, is believed to be associated with adverse inflammatory reactions, and previous effective attempts to improve this vaccine modality inserted a mutation to impair the PLA2 activity of VLPs. In this study, we designed VLPs with a deletion mutant of PLA2 (⊿PLA2 B19 VLP), devoid of PLA2 activity, and confirmed their immunogenicity and safe use in vivo. These results were supported by the lack of histological inflammatory reactions at the site of immunization or the production of IL-6 in ⊿PLA2 B19 VLP-immunized mice, that were observed in mice immunized with B19 VLPs. CD4+ T cells from mice vaccinated with VLPs and B19-seropositive human samples were not activated by B19 PLA2 stimulation, suggesting that the B19 PLA2 domain does not constitute a major CD4+ T cell epitope. Most importantly, the ⊿PLA2 B19 VLPs induced neutralizing antibodies against B19, in levels similar to those found in B19-seropositive human samples, indicating that they could be used as a safe and effective vaccine candidate against B19.
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Affiliation(s)
- Hidehiko Suzuki
- Virus vaccine group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Takafumi Noguchi
- Virus vaccine group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Noriko Matsugu
- The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Akio Suzuki
- The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Sakika Kimura
- Department of Biochemistry and Molecular Biology, Faculty of Agriculture and Life Science, Hirosaki University, Hirosaki, Aomori, Japan
| | - Misa Onishi
- The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Mitsuyo Kosaka
- Virus vaccine group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Paola Miyazato
- Virus vaccine group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Eiji Morita
- Department of Biochemistry and Molecular Biology, Faculty of Agriculture and Life Science, Hirosaki University, Hirosaki, Aomori, Japan
| | - Hirotaka Ebina
- Virus vaccine group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan; Virus vaccine group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.
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15
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Faure EE, Noriega L, Seminara C, Carranza G, Herrero M, Mukdsi JH. A rare cause of full-house membranous glomerulopathy in an infant: Answers. Pediatr Nephrol 2022; 37:2357-2359. [PMID: 35445973 DOI: 10.1007/s00467-022-05538-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Erica Elizabeth Faure
- Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Reforma, esq. Haya de la Torre, 5000, Cordoba, Argentina.
| | - Leonela Noriega
- Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Reforma, esq. Haya de la Torre, 5000, Cordoba, Argentina.,Instituto de Investigaciones en Ciencias de La Salud (INICSA), Consejo Nacional de Investigaciones Científicas Y Técnicas, Cordoba, Argentina
| | - Claudia Seminara
- Servicio de Nefrología, Hospital de Niños de La Santísima Trinidad, Cordoba, Argentina
| | - Gisella Carranza
- Servicio de Anatomía Patológica, Hospital de Niños de La Santísima Trinidad, Cordoba, Argentina
| | - Mónica Herrero
- Servicio de Anatomía Patológica, Hospital Córdoba, Cordoba, Argentina
| | - Jorge Humberto Mukdsi
- Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Reforma, esq. Haya de la Torre, 5000, Cordoba, Argentina.,Instituto de Investigaciones en Ciencias de La Salud (INICSA), Consejo Nacional de Investigaciones Científicas Y Técnicas, Cordoba, Argentina
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16
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Mendes Dos Santos MA, Dias LS, Ramirez Pavon JA, Viniski AE, Campos Souza CL, Pepato MA, Correa de Azevedo V, Teixeira Nunes MR, Slhessarenko RD. Regional mutations in CHIKV-ECSA genomes and detection of other viruses in the serum of acute febrile patients by a metagenomic approach in Mato Grosso, Central-Western Brazil, 2018. Virology 2022; 576:18-29. [PMID: 36126430 DOI: 10.1016/j.virol.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022]
Abstract
Mato Grosso (MT) State is part of central western Brazil and has a tropical permissive environment that favors arbovirus outbreaks. A metagenomic approach was used to identify viral genomes in seven pools of serum from patients (n=65) with acute febrile disease. Seven chikungunya virus (CHIKV) genomes were determined, showing four amino acid changes found only in CHIKV genomes obtained in MT since 2018: nsP2:T31I, nsP3: A388V, E3:T201I and E3:H57R, in addition to other mutations in E1, nsP2 and nsP4. Six parvovirus B19 (B19V) genotype I genomes (4771-5131 nt) showed four aa alterations (NS1:N473D, R579Q; VP1:I716T; and 11 kDa:V44A) compared to most similar B19V from the USA. Coinfection between CHIKV and B19V was evidenced in 22/65 (33.8%) patients by RT‒PCR and PCR, respectively. Other viruses found in these pools include human pegivirus C, torque teno virus 3, an unclassified TTV and torque teno mini virus. Metagenomics represents a useful approach to detect viruses in the serum of acute febrile patients suspected of arbovirus disease.
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Affiliation(s)
- Marcelo Adriano Mendes Dos Santos
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil; Faculdade de Medicina, Universidade do Estado de Mato Grosso, Cáceres, MT, Brazil
| | - Lucas Silva Dias
- Curso de Graduação em Medicina, Faculdade de Medicina, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil
| | - Janeth Aracely Ramirez Pavon
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil
| | - Ana Elisa Viniski
- Laboratório Central do Estado de Mato Grosso, Secretaria Estadoual de Saúde, Cuiabá, MT, Brazil
| | | | - Marco Andrey Pepato
- Laboratório Central do Estado de Mato Grosso, Secretaria Estadoual de Saúde, Cuiabá, MT, Brazil; Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil
| | | | | | - Renata Dezengrini Slhessarenko
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil.
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17
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Jacquot R, Gerfaud-Valentin M, Mekki Y, Billaud G, Jamilloux Y, Sève P. [ Parvovirus B19 infections in adults]. Rev Med Interne 2022; 43:713-726. [PMID: 36088203 DOI: 10.1016/j.revmed.2022.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 08/21/2022] [Indexed: 12/11/2022]
Abstract
Acute Parvovirus B19 (PVB19) infection is responsible for erythema infectiosum in children and non-specific polyarthralgias in immunocompetent adults associated with skin lesions and rarer manifestations (hepatic, neurological, cardiac or nephrological). In immunocompromised patients, cytopenias are more frequent and in some cases, viremia persists and is responsible for PVB19 chronic infection. PVB19 is responsible for pure red cell aplasia during chronic hemolytic diseases. Acute PVB19 infection is a differential diagnosis of some autoimmune diseases and has been suspected to be a trigger for some autoimmune diseases because of its ability to promote the emergence of autoimmune markers. Mechanisms of molecular mimicry, induction of apoptosis and activation of enzymes have been demonstrated, explaining in part the production of autoantibodies during infection. However, the demonstration of a causal relationship in the triggering of autoimmune disease remains to be done. This review provides a synthesis of the PVB19 infection clinical data in adults with a particular focus on these links with autoimmunity.
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Affiliation(s)
- R Jacquot
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France.
| | - M Gerfaud-Valentin
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France
| | - Y Mekki
- Université de Lyon, Lyon, France
| | | | - Y Jamilloux
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France
| | - P Sève
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), Inserm U1290, Lyon, France; Laboratoire de virologie, hospices civils de Lyon, centre de biologie et de pathologie, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France
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18
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Huang Q, Wang Y, Chen R, Zhao Y, Wang H, Ma X, Li D, Liu Q, Chen X, He L, Zhang M, Li M. Parvovirus B19 infection in kidney transplant recipients: A prospective study in a teaching hospital in Shanghai, China. Transpl Immunol 2022; 74:101667. [PMID: 35835294 DOI: 10.1016/j.trim.2022.101667] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND There is a lack of epidemiological studies on the course and clinical characteristics of Parvovirus B19 (B19V) infections in kidney transplant (KT) recipients. This study was undertaken to provide recommendations for clinical B19V infection diagnosis and treatment. METHODS Serum samples of KT recipients were regularly collected and tested for B19V-DNA copies, B19V-IgG/IgM levels, as well as hematological parameters and functions of kidney and liver. The course of B19V infection was described according to the results of serology and DNA testing, and the clinical and epidemiological data were combined for analysis. RESULTS 75% B19V infections occurred within 2 weeks after KT(n = 9). The infection rate of B19V in KT recipients was high, namely 10.17% (n = 12). The number of 10 patients IgM antibodies against B19V (IgM+) and theDNA B19V (DNA+), whereas 2 patients were IgM negative (IgM-) but DNA+. The B19V infected KT patients showed several symptoms, including anemia (100%), reduction of platelets (8.33%), and damage to liver (75%) and kidney function (16.67%) Patients with progressive anemia in the first two weeks after KT, which combined with the decrease of reticulocytes, are more likely to have B19V infection. Associations of four main therapeutic risk factors for B19V infections in KT patients have been analyzed. B19V infection was associated with use of basiliximab (OR = 1.19; 95%- CI: 1.08-1.32; P = 0.003) and use of thymoglobulins (OR = 0.84; 95%-CI: 0.76-0.93; P = 0.003). CONCLUSIONS Doctors should be alert to B19V infection, especially in the immunodeficient patients within the first two weeks after transplantation.
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Affiliation(s)
- Qian Huang
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Yanan Wang
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Ruoyang Chen
- Department of Urology, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Yanan Zhao
- Faculty of medical laboratory science, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Hua Wang
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Xiaowei Ma
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Dawei Li
- Department of Urology, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Qian Liu
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Xiaoying Chen
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Lei He
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Ming Zhang
- Department of Urology, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
| | - Min Li
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China; Faculty of medical laboratory science, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
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Esmel-Vilomara R, Dolader P, Izquierdo-Blasco J, Balcells J, Sorlí M, Escudero F, Vera E, Gran F. Parvovirus B19 myocarditis in children: a diagnostic and therapeutic approach. Eur J Pediatr 2022; 181:2045-2053. [PMID: 35138467 DOI: 10.1007/s00431-022-04406-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
UNLABELLED Parvovirus B19 is one of the most frequent causes of pediatric myocarditis, associating high mortality rates or need for cardiac transplantation. The aim of this study is to describe the clinical course of Parvovirus B19 myocarditis in children with emphasis on the role of endomyocardial biopsy and cardiac magnetic resonance, and the use of an innovative therapeutic strategy. Eleven patients and 12 episodes of polymerase chain reaction (PCR)-confirmed Parvovirus B19 myocarditis were prospectively collected for 14 years. Diagnosis was confirmed either histopathologically or by magnetic resonance. A life-threatening clinical presentation is described, similar to previous series, but with 83.3% overall survival without transplantation. We also present a case of recurrent myocarditis, which is extraordinarily rare. Electrocardiographic patterns presented chiefly peaked p waves, low QRS voltages, and negative T waves on inferior or lateral leads. Endomyocardial biopsy is the gold standard diagnostic test; alternatively magnetic resonance could be a useful diagnostic tool. A good concordance between myocardial and blood PCRs was observed. Seven patients received treatment with corticosteroids and beta interferon and all underwent a significant cardiac function improvement. CONCLUSION A severe clinical presentation is reported, similar to previous reports but with better outcomes. Endomyocardial biopsy is the gold standard diagnostic test; alternatively magnetic resonance may be used. Both blood and myocardium PCR can be used in children to establish the microbiological etiology. Steroids with IFNß could be a useful therapeutic option, although further multicenter studies are needed to confirm these results. WHAT IS KNOWN • Parvovirus B19 is one of the most frequent causes of myocarditis in children. It is associated with a fulminant clinical presentation. • Endomyocardial biopsy is the gold standard diagnostic test but it is an invasive procedure. WHAT IS NEW • Myocarditis may recur in pediatrics, even it is extraordinarily rare. • IFNβ with steroids may be a useful therapeutic option to improve the outcomes.
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Affiliation(s)
- Roger Esmel-Vilomara
- Pediatric Cardiology, Vall d'Hebron Hospital Campus, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain. .,Pediatric Cardiology, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.
| | - Paola Dolader
- Pediatric Cardiology, Vall d'Hebron Hospital Campus, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | | | - Joan Balcells
- Pediatric Critical Care, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Moisés Sorlí
- Pediatric Cardiology, Hospital Virgen de La Arrixaca, Murcia, Spain
| | | | - Elena Vera
- Pediatric Cardiology, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - Ferran Gran
- Pediatric Cardiology, Vall d'Hebron Hospital Campus, Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
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20
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Zhou X, Jiang P, Gao L, Yang J, Cai Y, Tong Y, Qiu H, Huang C, Zhou K, Xu X, Niu J, Xia X, Zhang Y, Shen C, Wei Y, Shao J, Song X, Wan L. Immune reconstitution and survival of patients with parvovirus B19 related pure red cell aplasia after haplo-PBSCT. Ann Hematol 2022; 101:1333-1342. [PMID: 35396950 PMCID: PMC9072482 DOI: 10.1007/s00277-022-04831-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/29/2022] [Indexed: 11/24/2022]
Abstract
Parvovirus B19 (PvB19) infection and PvB19 related pure red cell aplasia (PRCA) in recipients with allogeneic hematopoietic stem cell transplantation have been reported sporadically. However, clinical studies with large sample sizes are lacking, especially in patients undergoing HLA-haploidentical peripheral blood stem cell transplantation (haplo-PBSCT). In addition, clinical features, immune reconstitution, and outcomes of these patients are not clear. We conducted a retrospective analysis of 164 patients who received haplo-PBSCT with low-dose anti-thymocyte globulin (ATG) plus low-dose posttransplant cyclophosphamide (PTCy)-based regimen as graft-versus-host disease (GVHD) prophylaxis. We analyzed the incidence of PvB19 related PRCA and compared the clinical characteristics, immune reconstitution, incidence of GVHD, relapse rate, and survival between patients with and without PvB19 related PRCA. A total of 14 (8.5%) recipients developed PvB19 related PRCA after a median of 5.3 months after haplo-PBSCT. These patients with PvB19 related PRCA had slower immune reconstitution, but similar incidences of GVHD, relapse rate, and overall survival compared with recipients without PvB19 related PRCA. PvB19 related PRCA indicated relative delayed and poor immune reconstitution of the recipients early after haplo-PBSCT. PvB19 related PRCA had no effects on GVHD, relapse, and survival.
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Affiliation(s)
- Xiao Zhou
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Peiyao Jiang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Lu Gao
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Jun Yang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Yu Cai
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Yin Tong
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Huiying Qiu
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Chongmei Huang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Kun Zhou
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Xiaowei Xu
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Jiahua Niu
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Xinxin Xia
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Ying Zhang
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Chang Shen
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Yu Wei
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Jie Shao
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China
| | - Xianmin Song
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China. .,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China.
| | - Liping Wan
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China. .,Engineering Technology Research Center of Cell Therapy and Clinical Translation, Shanghai Science and Technology Committee (STCSM), No. 100 Haining Road, Shanghai, 200080, China.
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21
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Sirkeci O, Sirkeci EE, Kucukciloglu Y. Spontaneous recovery of pancytopenia in an immunosuppres- sed patient infected with Parvovirus B19. Clin Ter 2022; 173:104-106. [PMID: 35385031 DOI: 10.7417/ct.2022.2402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Parvovirus B19 infection can be associated with a wide spec-trum of clinical manifestations that mainly depends on the clinical background of the patient. Infection causes severe aplastic effects on bone marrow in immunosuppressive patients. Our patient was using Azathioprine for Crohn Disease when she admitted with malaise and fatigue laboratory tests revealed pancytopenia due to Parvovirus B19 infection . But contrary to expectations patients pancytopenia improved spontaneously without any treatment. Although intravenous immuno-globulin treatment is a safe approach waiting spontaneous recovery of bone marrow may be risky but another option.
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Affiliation(s)
- O Sirkeci
- Suleyman Demirel University Medicine Faculty, Department of Gastroenterology, Isparta
| | - E E Sirkeci
- Near East University Hospital Emergency Department, Nicosia, Cyprus
| | - Y Kucukciloglu
- Near East University Hospital Radiology Department, Nicosia, Cyprus
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22
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Mitsiakos G, Gavras C, Katsaras GN, Chatziioannidis I, Mouravas V, Mitsiakou C, Lampropoulos V, Nikolaidis N. Parvovirus B19 Intrauterine Infection and Eventration of the Diaphragm. Prague Med Rep 2022; 123:48-55. [PMID: 35248165 DOI: 10.14712/23362936.2022.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Parvovirus B19 infection in pregnancy may have a poor outcome for the fetus. Ocular anomalies, brain damage with hydrocephalus and central nervous system (CNS) scarring, cleft lip and hypospadias, as well myocarditis and congenital heart disease have been reported. We present a case of a preterm female neonate born with ascites, hydrothorax and congenital diaphragmatic eventration (CDE), with a prenatal diagnosis of congenital diaphragmatic hernia (CDH). The neonate was born prematurely at 32 weeks gestation with caesarean section due to a previous caesarean delivery. She was immediately intubated in the delivery room, transferred in the Neonatal Intensive Care Unit (NICU) and supported with high frequency oscillatory ventilation (HFOV). The diagnosis of CDH was sonographically estimated from the 20th week of gestation and surgical correction was decided. During surgery CDE was diagnosed instead of CDH and despite postoperatively care the neonate developed disseminated intravascular coagulation and finally died in the 40th hour of life. Along with the identification of parvovirus B19 in the pleural fluid by PCR, the biopsy of the diaphragm revealed connective tissue, full of vasculature and absence muscle tissue. Although only cytomegalovirus, rubella, and toxoplasmosis were considered to be associated with CDE, parvovirus B19 might also be related to this congenital diaphragmatic malformation. In CDE, the function of the lungs can be compromised as a consequence of the compression applied by the abdominal organs. The neonatologists should include this condition in their differential diagnosis for a more direct and effective management.
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Affiliation(s)
- Georgios Mitsiakos
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece.
| | - Christoforos Gavras
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Georgios N Katsaras
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Ilias Chatziioannidis
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vasilios Mouravas
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Christina Mitsiakou
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vasilios Lampropoulos
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Nikolaos Nikolaidis
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Thessaloniki, Greece
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23
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Heidari Z, Valinezhad M. High prevalence of parvovirus B19 infection in patients with thyroid nodules: A case-control study. Am J Otolaryngol 2022; 43:103345. [PMID: 34995966 DOI: 10.1016/j.amjoto.2021.103345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND The incidence of thyroid nodules has increased dramatically in recent decades. Although this increase has been attributed to improved imaging modalities, the question arises as to whether other environmental factors, such as infectious agents are influential. METHODS Adult patients with newly diagnosed papillary thyroid carcinoma, benign thyroid nodules, and healthy euthyroid controls without nodules; were recruited. Various clinical and biochemical parameters including thyroid function tests and serum Parvovirus B19 Ab (IgG) were assessed and compared between groups. RESULTS In this study, data from 364 patients with papillary thyroid carcinoma, 370 patients with benign thyroid nodules, and 360 healthy euthyroid individuals without nodules were analyzed as a control group. The prevalence of parvovirus B19 infection in papillary thyroid carcinoma patients was 58.8% that was significantly higher than the two groups of benign thyroid nodules (49.2%) and the control group (45.0%). In the papillary thyroid carcinoma group, a significant positive correlation was found between tumor size and TSH (r = 0.129, p = 0.014), and between tumor size and B19-Ab (r = 0.176, p = 0.001). CONCLUSION The rate of parvovirus B19 infection was higher in patients with papillary thyroid carcinoma and benign thyroid nodules than in the control group. Also, patients with papillary thyroid carcinoma had significantly higher rates of B19 infection than those with benign thyroid nodules.
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24
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Al-Fahad D, Majeed K, Al-Naqshbandi A, Al-Amery A, Fahad Alharbi B. The Cytokines Responses against Parvovirus B19 in Miscarriage Women and the Susceptibility of their RhD Blood Type to Contract Parvovirus B19 in South of Iraq. Rep Biochem Mol Biol 2021; 10:462-70. [PMID: 34981024 DOI: 10.52547/rbmb.10.3.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/18/2021] [Indexed: 11/18/2022]
Abstract
Background Parvovirus B19 (B19) infection is linked with various diseases. Cytokines play critical roles in cellular response to viral infection. It has also been reported that's susceptibility of the ABO blood type people to several viral infection. In this study, we evaluated interleukin 6 (IL-6), interleukin 8(IL-8), and interferon gamma (IFN-γ) levels in aborted women infected with parvovirus B19 (B19+/Abr+) and uninfected with B19(B19-/Abr+) in comparison with healthy women (B12-/Abr-) and susceptibility of their RhD blood type to contract B19. Methods B19+/Abr+ were diagnosed using IgM and IgG antibodies against B19, and the concentrations of IL-6, IL-8, and IFN-γ were determined using enzyme-linked immunosorbent assay (ELISA) test in both B19+/Abr+, B19-/Abr+, and B19-/Abr-. Here, we also collected blood groups, number of abortion, and gestational ages from 200 B19+/Abr+ along with the same number ofB19-/Abr+ and B19-/Abr-. Results The levels of IFN-γ were higher in serum of B19-/Abr+andB19+/Abr+ group in comparison to B19-/Abr-, while the serum levels of IL-6, IL-8were increased in B19+/Abr+ group in comparisontoB19-/Abr+ and B19-/Abr-. Our analyzed data also showed that aborted women with RhD+ are more susceptible to contract s B19 than people with RhD- blood type. Conclusion B19 infection may differently modulate the amount of cytokines in the plasma of aborted women. So, it can be suggested that IL-6, IL-8, and IFN-γ potentially useful as markers for inflammation intrauterine. The susceptibility/protection of aborted women against B19 might be determined based on RhD blood type.
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25
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Steffen CJ, Koch N, Eckardt KU, Amann K, Seelow E, Schreiber A. Hemophagocytic lymphohistiocytosis and thrombotic microangiopathy after parvovirus B19 infection and renal transplantation: a case report. BMC Nephrol 2021; 22:337. [PMID: 34641801 DOI: 10.1186/s12882-021-02538-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/22/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening disease characterized by hyperactivation of the immune system that causes hypercytokinemia and potentially multi organ failure. HLH can occur in patients with underlying rheumatic or autoinflammatory disorders. Additionally, HLH can develop in patients during infections or malignancies without a known genetic predisposition. CASE PRESENTATION We herein report a patient, who presented with fever, both acute kidney and liver injury, anemia, thrombocytopenia and HSV stomatitis. HLH was diagnosed based on clinical criteria and qPCR revealed an acute parvovirus B19 infection as potential underlying infectious trigger. Treatment was started with both IVIG and dexamethasone. Subsequently, kidney biopsy demonstrated TMA. CONCLUSIONS In rare cases both HLH and aHUS can occur simultaneously in a patient as a consequence of viral infections. Insights from this unusual case might help physicians understand this complex symptom constellation.
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26
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Heidari Z, Jami M. Parvovirus B19 Infection Is Associated with Autoimmune Thyroid Disease in Adults. Int J Endocrinol Metab 2021; 19:e115592. [PMID: 35069751 PMCID: PMC8762377 DOI: 10.5812/ijem.115592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/28/2021] [Accepted: 08/29/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Autoimmune thyroid diseases are the most frequent autoimmune disorders, with a global prevalence of about 10%. Several mechanisms have been proposed to induce autoimmune thyroid responses by infectious agents. In this study, we aimed to evaluate the association between parvovirus B19 infection and autoimmune thyroid disorders. METHODS Adult patients with newly diagnosed Graves' disease (GD) and Hashimoto's thyroiditis (HT) and healthy euthyroid controls were recruited. Various clinical and biochemical parameters, including thyroid function tests and serum parvovirus B19 antibody level (IgG), were assessed and compared between the groups. RESULTS In this study, data from 404 cases with HT, 248 cases with GD, and 480 healthy individuals as a control group were analyzed. The prevalence of parvovirus B19 infection in patients with HT and GD and controls was 61.1%, 58.9%, and 47.1%, respectively. In the group of patients with HT, there was a significant positive correlation between the B19 IgG and TPOAb (r = 0.764, P < 0.001) and TgAb (r = 0.533, P < 0.001). Also, in patients with GD, the B19 IgG had a significant positive correlation with TPOAb (r = 0.779, P < 0.001) and TgAb (r = 0.467, P < 0.001). CONCLUSIONS Parvovirus B19 infection is commonly seen in patients with autoimmune thyroid disorders.
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Affiliation(s)
- Zahra Heidari
- Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran
- Corresponding Author: Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Maede Jami
- Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran
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27
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Khatami A, Razizadeh MH, Ghadirali M, Yazdani S, Bahadory S, Soleimani A. Association of parvovirus B19 and myocarditis/dilated cardiomyopathy: A systematic review and meta-analysis. Microb Pathog 2021; 162:105207. [PMID: 34563612 DOI: 10.1016/j.micpath.2021.105207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The potential association between Parvovirus B19 and heart disease has been controversial. The aim of the present study was to report the prevalence of B19 in myocarditis and dilated cardiomyopathy (DCM) as well as measure the statistical association between them. METHODS Our systematic search was carried out to retrieve published articles between January 2000 and March 2021 using three major databases: PubMed, Scopus, and Web of Science, as well as the Google Scholar search engine. The overall prevalence of HAV, pooled odds ratio, and heterogeneity were estimated by comprehensive meta-analysis (V2.2, Biostat) software. RESULTS The overall prevalence results in myocarditis and DCM were 23.7% (95% CI: 18.7%-29.5%) and 34.1% (95% CI: 23.8%-46.1%) respectively; in addition, the overall OR for B19 and myocarditis was 4.317 (95% CI, 1.831-10.180) versus 1.163 (95% CI: 0.706-1.916) for B19 and DCM. CONCLUSION Our findings have shown a significant association between Parvovirus B19 and myocarditis with a high prevalence. In the case of DCM, no significant association was found while the prevalence of the virus was relatively high.
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Affiliation(s)
- Alireza Khatami
- Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | | | - Monire Ghadirali
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Iran
| | - Shahrooz Yazdani
- Department of Cardiology, School of Medicine, Alborz University of Medical Sciences, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Alireza Soleimani
- Department of Infectious Diseases, School of Medicine, Alborz University of Medical Sciences, Iran
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28
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Jiménez-Chávez ÁDJ, Nava-García BK, Bustos-Jaimes I, Moreno-Fierros L. B19-VLPs as an effective delivery system for tumour antigens to induce humoral and cellular immune responses against triple negative breast cancer. Immunol Lett 2021; 239:77-87. [PMID: 34508790 DOI: 10.1016/j.imlet.2021.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/25/2021] [Accepted: 09/03/2021] [Indexed: 01/16/2023]
Abstract
Cancer immunotherapy is emerging as a viable treatment option for several types of cancer. Active immunotherapy aims for the induction of specific antitumor immune responses; this goal requires strategies capable of increasing the immunogenicity of tumour antigens. Parvovirus B19 virus-like particles (B19-VLPs) formed of VP2 protein had been shown to be an effective multi-neoepitope delivery system capable of inducing specific cellular responses towards coupled antigens and reducing tumour growth and lung metastases in triple negative breast cancer mouse model. These findings encouraged us to further characterise these VP2 B19-VLPs by testing their capacity to simultaneously induce cellular and humoral responses towards other tumour-associated antigens, as this had not yet been evaluated. Here, we designed and evaluated in the 4T1 breast cancer model the prophylactic and therapeutic effect of VP2 B19-VLPs decorated with cellular (P53) and humoral (MUC1) epitopes. Balb/c mice were immunised with chimaeric VLPs, vehicle, or VLPs plus adjuvant. Tumour establishment and growth, lung metastasis, and cellular and humoral immune responses were evaluated. The prophylactic administration of chimaeric VLPs without adjuvant prevented the establishment of the tumour, while by therapeutic administration, chimaeric VLPs induced smaller tumour growth and decreased the number of metastases in the lung compared to wild-type VLPs. chimaeric VLPs induced high antibody titres towards the MUC1 epitope, as well as specific cellular responses towards P53 epitopes in lymph nodes local to the tumour. Our results reinforce and extend the utility of VP2 B19-VLPs as an encouraging tumour antigen delivery system in cancer immunotherapy able to improve tumour immunity in TNBC by inducing cellular and humoral immune responses.
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Affiliation(s)
- Ángel de Jesús Jiménez-Chávez
- Biomedicine Research Unit, Faculty of Higher Studies Iztacala, National Autonomous University of Mexico. Avenida de los Barrios 1, Los Reyes Iztacala, Tlalnepantla, Estado de México, 54090, México
| | - Brenda Katherine Nava-García
- Biomedicine Research Unit, Faculty of Higher Studies Iztacala, National Autonomous University of Mexico. Avenida de los Barrios 1, Los Reyes Iztacala, Tlalnepantla, Estado de México, 54090, México
| | - Ismael Bustos-Jaimes
- Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico
| | - Leticia Moreno-Fierros
- Biomedicine Research Unit, Faculty of Higher Studies Iztacala, National Autonomous University of Mexico. Avenida de los Barrios 1, Los Reyes Iztacala, Tlalnepantla, Estado de México, 54090, México.
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Gigi CE, Anumba DOC. Parvovirus b19 infection in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol 2021; 264:358-362. [PMID: 34391051 DOI: 10.1016/j.ejogrb.2021.07.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/20/2021] [Accepted: 07/25/2021] [Indexed: 11/30/2022]
Abstract
Parvovirus B19 (B19V) is a widespread infection that may affect 1-5% of pregnant women, mainly with normal pregnancy outcome. Vertical transmission occurs in 33-51% of cases of maternal infection. B19V infection is an important cause of fetal morbidity (fetal anaemia and non-immune hydrops) and mortality, predominantly in the second trimester. Diagnosis of B19V infection requires a multi-method approach using mainly serology and PCR techniques. Severe fetal anaemia is managed with intrauterine transfusion with perinatal survival rates following intrauterine transfusion ranging from 67% to 85%. If fetal anaemia is mild, and considering that hydrops can spontaneously resolve, invasive therapy is not recommended and B19V complicated pregnancy may be non-invasively monitored by serial ultrasound examination and MCV-PSV measurements. As an alternative, intrauterine IVIG therapy has been described with successful treatment of fetal hydrops. No specific antiviral therapy or vaccine is presently available for B19V infection but efforts in the search for compounds inhibiting B19V replication are now being pursued. New virus-like-particle based parvovirus B19 vaccine candidates, produced by co-expressing VP2 and either wild-type VP1 or phospholipase-negative VP1 in a regulated ratio from a single plasmid inSaccharomyces cerevisiae have been developed and show sufficient promise to test in humans.
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Affiliation(s)
- Charles E Gigi
- Department of Obstetrics and Gynaecology, Sheffield Teaching Hospital, 8 Beech Hill Road, Sheffield, South Yorkshire S10 2SB, UK.
| | - Dilly O C Anumba
- Sheffield Teaching Hospital, 8 Beech Hill Road, Sheffield, South Yorkshire S10 2SB, UK.
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Suzuki H, Noguchi T, Ogawa K, Miyazato P, Hatakeyama Y, Morita E, Ebina H. Fusion of parvovirus B19 receptor-binding domain and pneumococcal surface protein A induces protective immunity against parvovirus B19 and Streptococcus pneumoniae. Vaccine 2021; 39:5146-52. [PMID: 34340860 DOI: 10.1016/j.vaccine.2021.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Parvovirus B19 (B19) is a well-known cause of fifth disease in children, but infection during pregnancy may cause hydrops fetalis and stillbirth. The receptor-binding domain (RBD) of the VP1 unique capsid plays a pivotal role in infection. Here, we aimed to improve the immunogenicity of an RBD-based vaccine by genetically fusing it with Streptococcus pneumoniae surface protein A (PspA). METHODS Mice were intramuscularly injected with RBD-based vaccines. Antigen-specific antibodies and neutralizing activity against B19 were measured. Protective immunity against S. pneumoniae was evaluated by monitoring the survival of mice nasally challenged with bacteria and determining antigen-specific T cell activation in splenic cells. RESULTS RBD alone failed to generate neutralizing antibodies against B19, but fusion with PspA induced higher levels of neutralizing IgG compared to B19 virus-like particles. Furthermore, a comparable level of PspA-specific IgG was induced by RBD-PspA and PspA alone, which was sufficient to protect mice against pneumococcal infection. Stimulation with PspA, but not RBD, induced cytokine production in splenic cells from mice immunized with RBD-PspA, suggesting that PspA-specific T cells supported immunoglobulin class switching of both RBD- and PspA-specific B cells. CONCLUSIONS RBD-PspA should be an effective bivalent vaccine against B19 and S. pneumoniae infections.
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Callon D, Berri F, Lebreil AL, Fornès P, Andreoletti L. Coinfection of Parvovirus B19 with Influenza A/H1N1 Causes Fulminant Myocarditis and Pneumonia. An Autopsy Case Report. Pathogens 2021; 10:pathogens10080958. [PMID: 34451422 PMCID: PMC8400294 DOI: 10.3390/pathogens10080958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 01/14/2023] Open
Abstract
Parvovirus-B19 (PVB19) is a frequent causative agent of myocarditis. For unclear reasons, viral reactivation can cause acute myocarditis, a leading cause of sudden death in the young. Influenza A/H1N1(2009) virus (IAV/H1N1) is known for causing flu/pneumonia, but the heart is rarely involved. Co-infections of cardiotropic viruses are rarely reported and the mechanisms of viral interactions remain unknown. A 5-year old girl had a flu-like syndrome, when she suddenly presented with a respiratory distress and cardiac arrest. At autopsy, the lungs were found haemorrhagic. Lungs’ histology showed severe bronchiolitis, diffuse haemorrhagic necrosis, and mononuclear inflammation. In the heart, a moderate inflammation was found with no necrosis. IAV/H1N1 was detected in nasal and tracheal swabs, lungs, and the heart. The viral load was high in the lungs, but low in the heart. PVB19 was detected in the heart with a high viral load. Viral co-infection increases the risk of severe outcome but the mechanisms of interaction between viruses are poorly understood. In our case, viral loads suggested a reactivated PVB19-induced acute myocarditis during an IAV/H1N1 pneumonia. Viral interactions may involve an IAV/H1N1-induced cytokine storm, with a fulminant fatal outcome. Clinically, our case shows the importance of investigating inflammatory pathways as therapeutic targets.
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Affiliation(s)
- Domitille Callon
- Cardiovir EA-4684, Faculty of Medicine, University of Reims Champagne Ardenne, 51097 Reims, France; (F.B.); (A.-L.L.); (P.F.); (L.A.)
- Pathology Department, Academic Hospital of Reims, Robert Debré, 51097 Reims, France
- Correspondence: ; Tel.: +33-326918115
| | - Fatma Berri
- Cardiovir EA-4684, Faculty of Medicine, University of Reims Champagne Ardenne, 51097 Reims, France; (F.B.); (A.-L.L.); (P.F.); (L.A.)
| | - Anne-Laure Lebreil
- Cardiovir EA-4684, Faculty of Medicine, University of Reims Champagne Ardenne, 51097 Reims, France; (F.B.); (A.-L.L.); (P.F.); (L.A.)
| | - Paul Fornès
- Cardiovir EA-4684, Faculty of Medicine, University of Reims Champagne Ardenne, 51097 Reims, France; (F.B.); (A.-L.L.); (P.F.); (L.A.)
- Pathology Department, Academic Hospital of Reims, Robert Debré, 51097 Reims, France
| | - Laurent Andreoletti
- Cardiovir EA-4684, Faculty of Medicine, University of Reims Champagne Ardenne, 51097 Reims, France; (F.B.); (A.-L.L.); (P.F.); (L.A.)
- Virology Department, Academic Hospital of Reims, Robert Debré, 51097 Reims, France
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Alsamarai AM, Hassan HM, Alsamarai MA, Aljumaili ZK. Parvovirus B19 Seroprevalence in Women with Bad Obstetric History in Kirkuk. Antiinflamm Antiallergy Agents Med Chem 2021; 20:359-366. [PMID: 34315400 DOI: 10.2174/1871523020666210727142351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/20/2021] [Accepted: 06/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In Iraqi community, abnormal pregnancy form a major social ans psychological and health problem. The underlying etiology of this health phenomenon was varied and includes sets of infections and autoimmune diseases. Globally human parvovirus 19 infection is common and the infection attribute to bad obstetric outcomes. Global maternal parvovirus B19 remote infection rate was with a range of 13.2% to 97.9%, while the range of acute infection was 0.5% to 97.9%. In Arab countries, the IgG seroprevalence was 53.3% to 74%, while IgM seroprevalence range was 2.2% to 84%. OBJECTIVE To evaluate the role of Parvovirus B19 as an etiology of bad obstetric outcome in women in Kirkuk, Iraq. MATERIALS AND METHODS Descriptive Case Control Study. Women included in the study were recruited from Kirkuk General Hospital and their age ranged from 14 to 48 years. A 663 women were included in the study and 237 of them were none pregnant, while the pregnant were 215. Additionally, the study included 211 women with inevitable abortion. A control group (306 women) women with history of normal pregnancy (Pregnant=149; non-pregnant=157). Clinical and laboratory investigations were conducted on all patients and control groups to exclude other causes [7]. Medical and obstetric data and demographic characteristics gathered through interview according to previously designed questionnaire [7]. ELISA kits were used to determine Parvovirus B19 IgM and IgG antibodies. RESULTS The overall parvovirus seroprevalence was 93% and with no significant difference between women with normal (89.5%) and those with abnormal (93.1%) pregnancy outcomes . In addition, parvovirus IgM overall seroprevalence was 56.3%. Furthermore, current parvovirus infection was higher in women with BOH (52.6%) than that in women with normal pregnancy (49.7%) outcomes. Parvovirus IgM seroprevalence was 52.6% in women with BOH and 49.7% in women with normal pregnancy, however, the difference was not statistically significant. In contrast, the acute infection with parvovirus was significantly (X2=11.8, P=0.001) lower in women with normal pregnancy (49.7%) than in those with inevitable abortion (64.9%), While IgG seroprevalence difference was not significant between the two groups. Infection seroprevalence was more frequent in housewife, uneducated women, large family size, non-smoker, rural area, non animal exposure, repeated abortion, congenital anomalies, and anaemia. CONCLUSION Parvovirus B19 infection may be with bad obstetric outcomes if occurred during pregnancy and OR confirm a significant association of the infection with parvovirus with smoking, occupation, crowding index, education, animal exposure and number of repeated abortion.
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Van den Abeele T, Delforge ML, Boel A, Reynders M, Padalko E. Comparison of 4 commercial enzyme immunoassays for serology testing of human parvovirus B19 infection. Diagn Microbiol Infect Dis 2021; 101:115489. [PMID: 34352435 DOI: 10.1016/j.diagmicrobio.2021.115489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/25/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Parvovirus B19 is a pathogenic virus often diagnosed by serology, yet little is known about analytical performance of commercial enzyme immunoassays (EIAs). OBJECTIVE To investigate performance of 4 EIAs for parvovirus B19 IgM and IgG: Liaison, Euroimmun, Mikrogen and Virion/Serion. STUDY DESIGN To compare 4 EIAs to Biotrin's ELISA on 168 samples and determine consensus score for discordant samples using Mikrogen's confirmatory line assay. RESULTS Two thirds of results for IgM/IgG were identical for all 4 EIAs and Biotrin. Liaison shows the highest IgM sensitivity, but has low specificity. Euroimmun lacks IgM sensitivity. Mikrogen had a good overall performance, but had the lowest IgG specificity. Virion/Serion had variable performance with a low IgM specificity and the most borderline and cross-reactive results. CONCLUSIONS Liaison and Mikrogen have similar performance to Biotrin's ELISA. Euroimmun lacks sensitivity and Virion/Serion produced many borderline and cross-reactive results.
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Affiliation(s)
- Tim Van den Abeele
- Laboratory of Medical Microbiology, Ghent University Hospital, Gent, Belgium
| | - Marie-Luce Delforge
- National Reference Center for Congenital Infections, Erasme University Hospital, Brussels, Belgium
| | - An Boel
- Department of Microbiology, OLV Hospital, Aalst, Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, Sint-Jan Hospital, Bruges, Belgium
| | - Elizaveta Padalko
- Laboratory of Medical Microbiology, Ghent University Hospital, Gent, Belgium.
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Alves AD, Melgaço JG, Cássia Nc Garcia RD, Raposo JV, de Paula VS, Araújo CC, Pinto MA, Amado LA. Persistence of Parvovirus B19 in liver from transplanted patients with acute liver failure. Future Microbiol 2021; 15:307-317. [PMID: 32286103 DOI: 10.2217/fmb-2019-0224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: In this study, we investigated the presence of B19V in liver tissues from patients with acute liver failure (ALF) and evaluated the viral activity in infected liver. Methods: Serum and liver samples from 30 patients who underwent liver transplantation for ALF were investigated for B19V infection by real-time PCR, serological tests and examination of B19V mRNA (transcript) expression in the liver. Results: The serum and liver samples from seven patients were B19V DNA positive (103-105 copies/ml). Most of them presented detectable anti-B19V IgG, indicating persistent infection. B19V mRNA was detected in all patients, demonstrating intra-hepatic replication. Conclusion: B19V infection of the liver during the course of non-A-E ALF suggested a role of B19V, which produced the worst outcome in co-infected patients and in patients with cryptogenic ALF, in liver damage.
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Affiliation(s)
- Arthur Dr Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Juliana G Melgaço
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Rita de Cássia Nc Garcia
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Jessica V Raposo
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Vanessa S de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Marcelo A Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Luciane A Amado
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Auriti C, De Rose DU, Santisi A, Martini L, Piersigilli F, Bersani I, Ronchetti MP, Caforio L. Pregnancy and viral infections: Mechanisms of fetal damage, diagnosis and prevention of neonatal adverse outcomes from cytomegalovirus to SARS-CoV-2 and Zika virus. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166198. [PMID: 34118406 PMCID: PMC8883330 DOI: 10.1016/j.bbadis.2021.166198] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/07/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023]
Abstract
Some maternal infections, contracted before or during pregnancy, can be transmitted to the fetus, during gestation (congenital infection), during labor and childbirth (perinatal infection) and through breastfeeding (postnatal infection). The agents responsible for these infections can be viruses, bacteria, protozoa, fungi. Among the viruses most frequently responsible for congenital infections are Cytomegalovirus (CMV), Herpes simplex 1–2, Herpes virus 6, Varicella zoster. Moreover Hepatitis B and C virus, HIV, Parvovirus B19 and non-polio Enteroviruses when contracted during pregnancy may involve the fetus or newborn at birth. Recently, new viruses have emerged, SARS-Cov-2 and Zika virus, of which we do not yet fully know the characteristics and pathogenic power when contracted during pregnancy. Viral infections in pregnancy can damage the fetus (spontaneous abortion, fetal death, intrauterine growth retardation) or the newborn (congenital anomalies, organ diseases with sequelae of different severity). Some risk factors specifically influence the incidence of transmission to the fetus: the timing of the infection in pregnancy, the order of the infection, primary or reinfection or chronic, the duration of membrane rupture, type of delivery, socio-economic conditions and breastfeeding. Frequently infected neonates, symptomatic at birth, have worse outcomes than asymptomatic. Many asymptomatic babies develop long term neurosensory outcomes. The way in which the virus interacts with the maternal immune system, the maternal-fetal interface and the placenta explain these results and also the differences that are observed from time to time in the fetal‑neonatal outcomes of maternal infections. The maternal immune system undergoes functional adaptation during pregnancy, once thought as physiological immunosuppression. This adaptation, crucial for generating a balance between maternal immunity and fetus, is necessary to promote and support the pregnancy itself and the growth of the fetus. When this adaptation is upset by the viral infection, the balance is broken, and the infection can spread and lead to the adverse outcomes previously described. In this review we will describe the main viral harmful infections in pregnancy and the potential mechanisms of the damages on the fetus and newborn.
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Affiliation(s)
- Cinzia Auriti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Alessandra Santisi
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Ludovica Martini
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Fiammetta Piersigilli
- Department of Neonatology, St-Luc University Hospital, Catholic University of Louvain, Brussels, Belgium.
| | - Iliana Bersani
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Maria Paola Ronchetti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Leonardo Caforio
- Fetal and Perinatal Medicine and Surgery Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
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Nurmi V, Hedman L, Perdomo MF, Weseslindtner L, Hedman K. Comparison of approaches for IgG avidity calculation and a new highly sensitive and specific method with broad dynamic range. Int J Infect Dis 2021; 110:479-487. [PMID: 34044143 DOI: 10.1016/j.ijid.2021.05.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Antimicrobial IgG avidity is measured in the diagnosis of infectious disease, for dating of primary infection or immunization. It is generally determined by either of two approaches, termed here the avidity index (AI) or end-point ratio (EPR), which differ in complexity and workload. While several variants of these approaches have been introduced, little comparative information exists on their clinical utility. METHODS This study was performed to systematically compare the performances of these approaches and to design a new sensitive and specific calculation method, for easy implementation in the laboratory. The avidities obtained by AI, EPR, and the newly developed approach were compared, across parvovirus B19, cytomegalovirus, Toxoplasma gondii, rubella virus, and Epstein-Barr virus panels comprising 460 sera from individuals with a recent primary infection or long-term immunity. RESULTS With optimal IgG concentrations, all approaches performed equally, appropriately discriminating primary infections from past immunity (area under the receiver operating characteristic curve (AUC) 0.93-0.94). However, at lower IgG concentrations, the avidity status (low, borderline, high) changed in 17% of samples using AI (AUC 0.88), as opposed to 4% using EPR (AUC 0.91) and 6% using the new method (AUC 0.93). CONCLUSIONS The new method measures IgG avidity accurately, in a broad range of IgG levels, while the popular AI approach calls for a sufficiently high antibody concentration.
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Affiliation(s)
- Visa Nurmi
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Lea Hedman
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maria F Perdomo
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Klaus Hedman
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Rostad CA, Kanwar N, Yi J, Morris CR, Bard JD, Leber A, Dunn J, Chapin KC, Blaschke AJ, Daly JA, Hueschen LA, Jones M, Ott E, Bastar J, Bourzac KM, Selvarangan R. A multicenter evaluation of viral bloodstream detections in children presenting to the Emergency Department with suspected systemic infection. BMC Pediatr 2021; 21:238. [PMID: 34006235 PMCID: PMC8129693 DOI: 10.1186/s12887-021-02699-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/26/2021] [Indexed: 11/26/2022] Open
Abstract
Background Fever is a common symptom in children presenting to the Emergency Department (ED). We aimed to describe the epidemiology of systemic viral infections and their predictive values for excluding serious bacterial infections (SBIs), including bacteremia, meningitis and urinary tract infections (UTIs) in children presenting to the ED with suspected systemic infections. Methods We enrolled children who presented to the ED with suspected systemic infections who had blood cultures obtained at seven healthcare facilities. Whole blood specimens were analyzed by an experimental multiplexed PCR test for 7 viruses. Demographic and laboratory results were abstracted. Results Of the 1114 subjects enrolled, 245 viruses were detected in 224 (20.1%) subjects. Bacteremia, meningitis and UTI frequency in viral bloodstream-positive patients was 1.3, 0 and 10.1% compared to 2.9, 1.3 and 9.7% in viral bloodstream-negative patients respectively. Although viral bloodstream detections had a high negative predictive value for bacteremia or meningitis (NPV = 98.7%), the frequency of UTIs among these subjects remained appreciable (9/89, 10.1%) (NPV = 89.9%). Screening urinalyses were positive for leukocyte esterase in 8/9 (88.9%) of these subjects, improving the ability to distinguish UTI. Conclusions Viral bloodstream detections were common in children presenting to the ED with suspected systemic infections. Although overall frequencies of SBIs among subjects with and without viral bloodstream detections did not differ significantly, combining whole blood viral testing with urinalysis provided high NPV for excluding SBI. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02699-9.
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Affiliation(s)
- Christina A Rostad
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322, USA. .,Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Neena Kanwar
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jumi Yi
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Claudia R Morris
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322, USA.,Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jennifer Dien Bard
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Amy Leber
- Nationwide Children's Hospital, Columbus, OH, USA
| | - James Dunn
- Texas Children's Hospital, Houston, TX, USA
| | | | - Anne J Blaschke
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Judy A Daly
- Primary Children's Hospital, Salt Lake City, UT, USA
| | - Leslie A Hueschen
- Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, University of Kansas School of Medicine, Kansas City, MO, USA
| | | | | | | | | | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA
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Russcher A, Verdonschot J, Molenaar-de Backer MWA, Heymans SRB, Kroes ACM, Zaaijer HL. Parvovirus B19 DNA detectable in hearts of patients with dilated cardiomyopathy, but absent or inactive in blood. ESC Heart Fail 2021; 8:2723-2730. [PMID: 33931945 PMCID: PMC8318422 DOI: 10.1002/ehf2.13341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 01/14/2023] Open
Abstract
Aims Parvovirus B19 (B19V) is often assumed to be a cause of dilated cardiomyopathy (DCM), based on the quantification of B19V DNA in endomyocardial biopsies (EMB). Whether the presence of B19V DNA correlates with active infection is still debated. Application of the enzyme endonuclease to blood samples results in degradation of B19V DNA remnants but leaves viral particles intact, which enables differentiation between active and past infection. In this study, the susceptibility to degradation by endonuclease of B19V DNA in blood was compared between DCM patients and a control group of recent B19V infections. Methods and results Twenty blood samples from 20 adult patients with DCM, who previously tested positive for B19V DNA in EMB and/or blood, were tested with B19V PCR before and after application of endonuclease to the samples. Six blood samples tested positive for B19V DNA with a mean viral load of 2.3 × 104 IU/mL. In five samples, B19V DNA became undetectable after endonuclease (100% load reduction); in one sample DNA load showed a 23% log load reduction (viral load before endonuclease: 9.1 × 104 IU/mL; after: 6.5 × 103 IU/mL). Presence of cardiac inflammation did not differ between patients with B19V DNAemia (1/4) and patients without B19V DNAemia (6/14) (P value = 1.0). In all 18 control samples of proven recent B19V infections, DNA remained detectable after application of endonuclease, showing only a mean log load reduction of 2.3% (mean viral load before endonuclease: 8.1 × 1011 IU/mL; after: 8.0 × 1011 IU/mL). Load reduction differed significantly between the DCM group and the control group; indicating the presence of intact viral particles in the control group with proven active infection and the presence of DNA remnants in the DCM group (P value = 0.000). Conclusion During recent B19V infection, viral DNA levels in blood were unaffected by endonuclease. In contrast, B19V DNA in blood in patients with DCM became undetectable or strongly reduced after application of endonuclease. Circulating viral DNA in this subset of patients with presumed parvovirus‐associated DCM does not consist of intact viral particles. Viral replicative activity cannot be assumed from demonstrating B19V DNA in cardiac tissue or in blood in DCM patients.
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Affiliation(s)
- Anne Russcher
- Department of Medical Microbiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, E4P 9600, Leiden, 2300 RC, The Netherlands
| | - Job Verdonschot
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marijke W A Molenaar-de Backer
- Department of Blood-borne Infections, Donor Medicine Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - Stephane R B Heymans
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Aloys C M Kroes
- Department of Medical Microbiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, E4P 9600, Leiden, 2300 RC, The Netherlands
| | - Hans L Zaaijer
- Department of Blood-borne Infections, Donor Medicine Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
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Rauff B, Malik A, Bhatti YA, Chudhary SA, Fatima K, Rafiq S, Tahir A, Sharif S, Qadri I. Association of Viruses in the Development of Cardiovascular Diseases. Curr Pharm Des 2021; 27:3913-3923. [PMID: 33902408 DOI: 10.2174/1381612827666210426094502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/12/2021] [Indexed: 11/22/2022]
Abstract
Cardiovascular diseases (CVD), primarily inflammatory cardiomyopathy, are characterized by the infiltration of inflammatory cells into the myocardium. It has a relatively high risk of deteriorating heart function and has heterogeneous etiologies. Inflammatory cardiomyopathy is mainly mediated by viral infections but can also be mediated by protozoa, fungal or bacterial infections. Besides that, there are a wide variety of drugs, toxic substances, and systemic immune-mediated diseases that result in the development of cardiovascular diseases (CVDs). Despite broad research, inflammatory cardiomyopathy has a poor prognosis. The roles of the pathogens, host genomic counterparts and environmental triggers in the progression of disease are still under consideration, including the role of some viruses as active inducers and others as bystanders. In this review article, we review the available evidence on the types, pathogenesis and treatment of myocarditis, inflammatory cardiomyopathy, and atherosclerosis with a particular focus on virus-associated cardiac diseases.
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Affiliation(s)
- Bisma Rauff
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW. Australia
| | - Arif Malik
- Institute of Molecular Biology and Biotechnology (IMBB), University of Lahore, Lahore. Pakistan
| | | | - Shafiq Ahmad Chudhary
- Institute of Biomedical and Allied Health Sciences (IBAHS), University of Health Sciences, Lahore. Pakistan
| | - Kaneez Fatima
- Department of Biology, University of Jeddah, Jeddah, Saudi Arabia
| | - Shafquat Rafiq
- Department of Gastrointestinal Medicine, Croydon University Hospital NHS Trust, 503 London Road, Croydon CR7 7YE. United Kingdom
| | - Aisha Tahir
- Department of Biochemistry, University of Health Sciences, Lahore. Pakistan
| | - Sumaira Sharif
- Institute of Molecular Biology and Biotechnology (IMBB), University of Lahore, Lahore. Pakistan
| | - Ishtiaq Qadri
- King Fahd Medical Research Center, King Abdul Aziz University, Jeddah, Saudi Arabia
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Jarius S, Wilken D, Haas J, Ruprecht K, Komorowski L, Wildemann B. Parvovirus B19 and mumps virus antibodies are major constituents of the intrathecal immune response in European patients with MS and increase the diagnostic sensitivity and discriminatory power of the MRZ reaction. J Neurol 2021; 268:3758-3765. [PMID: 33770235 PMCID: PMC8463395 DOI: 10.1007/s00415-021-10471-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 11/30/2022]
Abstract
Background A positive MRZ reaction, as defined by intrathecal IgG production against at least two of its constituents, measles virus (M), rubella virus (R) and varicella zoster virus (Z), is detectable in ~ 63% of patients with multiple sclerosis (MS) and is currently considered the laboratory marker with the highest specificity and positive likelihood ratio for MS. However, M, R and Z are only the most well-established constituents of a broader intrathecal humoral immune response in MS.
Objective To identify additional anti-microbial antibodies inclusion of which in the classical MRZ panel may result in increased sensitivity without compromising the marker’s high specificity for MS. Methods We determined the antibody indices (AIs) for 11 viral and bacterial agents (M, R, Z, herpes simplex virus, Epstein–Barr virus, mumps virus, cytomegalovirus, parvovirus B19, Bordetella pertussis, Corynebacterium diphtheriae, and Clostridium tetani) in paired cerebrospinal fluid and serum samples from patients with MS and disease controls. Results A positive ‘classical’ MRZ reaction was found in 17/26 (65.4%) MS patients. The five most frequently positive AIs among patients with MS were M (76.9%), Z (61.5%), R (57.7%), parvovirus B19 (42.3%), and mumps (28%). Addition of parvovirus B19 and mumps virus to the MRZ panel resulted in an increase in sensitivity in the MS group from 65.4% to 73.1%, with 22% of the initially MRZ-negative patients exhibiting a de novo-positive response. The extended MRZ panel (‘MRZplus’) distinguished sharply between MS (≥ 3 AIs in 90% of all positives) and controls (varying diagnoses, from migraine to vasculitis; 0-1 AIs; p < 0.000001). The highest median AI in the MS group was found for parvovirus B19 (3.97), followed by measles virus (2.79). Conclusion Inclusion of parvovirus B19 and mumps virus in the test panel resulted in an increase in the sensitivity and discriminatory power of MRZ. Our results provide a strong rational for prospective studies investigating the role of extended MRZ panels in the differential diagnosis of MS.
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Affiliation(s)
- S Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
| | | | - J Haas
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - K Ruprecht
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - B Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
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41
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Zanelli M, Ruggeri L, Sanguedolce F, Zizzo M, Martino G, Genua A, Ascani S. Parvovirus B19 Infection in a Patient with Common Variable Immunodeficiency. Mediterr J Hematol Infect Dis 2021; 13:e2021026. [PMID: 33747407 DOI: 10.4084/MJHID.2021.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/14/2021] [Indexed: 12/04/2022] Open
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Abstract
Parvovirus B19 infection is s new viral threat in post-kidney transplantation. It is a viral infection often acquired from the donor, occurring in young transplant patients during the first post-kidney transplantation months, and with a non-specific clinico-biological picture. The hallmark symptom is regenerative anaemia which may be severe, requiring blood transfusion. The C3 and C4 complement fractions are reduced and constitute an early and inexpensive diagnostic marker. Diagnosis is often delayed due to the non-specific clinico-biological picture. However, severe anaemia and hypocomplementemia are early and suggestive signs of parvovirus B19 infection. Levels of parvovirus B19 DNA, as determined by real time-polymerase chain reaction (RT-PCR), are often very high and tend to decrease slowly over several months. Treatment is based on adaptive reduction of immunosuppression, adequate in the forms with few symptoms, discontinuation of antiproliferative agents, or a switch to other molecules associated with intravenous immunoglobulins in the severe and highly symptomatic forms. Screening for other concomitant viral infections, particularly for cytomegalovirus, Epstein Barr virus, and BK virus is systematic. Relapses are quite frequent during the first-year post-transplantation. Clinical-biological follow-up aims to detect any recurrence of the parvovirus B19 infection, the occurrence of parvovirus B19-related glomerulopathy, and acute rejection. Parvovirus B19 infection is a new viral threat in post-kidney transplantation and requires broader and/or randomised studies to better establish the diagnostic and therapeutic approach.
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Affiliation(s)
- Yassamine Bentata
- Nephrology, Dialysis, and Kidney Transplantation Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research, and Public Health, Medical School, University Mohammed Premier, Oujda, Morocco
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43
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Safiyanu MB, Akande AO, Babayo A, Umar J, Abdullahi IN. Serological detection of human parvovirus B19 infection and associated risk factors among pregnant women in Jigawa State, Nigeria. J Immunoassay Immunochem 2021; 42:380-392. [PMID: 33591885 DOI: 10.1080/15321819.2021.1880435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Human Parvovirus B19 (B19 V) infection is hyperendemic in Nigeria. Pregnant women are not classically immunocompromised but maybe physiologically immunosuppressed and susceptible to viral infection. However, there is a paucity of studies on the epidemiology of B19V in Jigawa State, Northwestern Nigeria. This study aims to determine the seroprevalence, sociodemographic, and risk factors of human B19V infection among present women attending antenatal clinics of Jahun General Hospital, Nigeria. Between 2 February and 30 June 2019, blood samples were collected from 200 consented pregnant women and analyzed for anti-B19V IgM and IgG using commercially available enzyme-linked immunosorbent assay (ELISA). Sociodemographic and risk factors of subjects were collated through pre-tested structured questionnaires. Data generated were statistically analyzed for the association of anti-B19V and subjects' variables studied. Overall, the seroprevalence of anti-B19V IgM and IgG among pregnant women attending antenatal clinics of Jahun General Hospital, Nigeria was 6.0% and 22.5%, respectively. There was no significant association between the seroprevalence of anti-B19V IgM and anti-B19V IgG with all the sociodemographic variables and risk factors of pregnant women (P ˃0.05). However, pregnant women with a history of blood transfusion had a significant risk associated with seroprevalence of B19V IgM (OR = 5.95; 95% CI: 1.96-22.76; P = .009). Findings from this study revealed that a high proportion of the pregnant women were susceptible to B19V infection and anti-B19V IgG immunity decreased with age. Given the incidence of acute B19V infection, it is clinically important to continuously monitor their erythrocytes indices and screen their neonates for B19V infection and fetal complications.
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Affiliation(s)
- Mansur Bala Safiyanu
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria
| | - Azeez Oyebanji Akande
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria
| | - Adamu Babayo
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria
| | - Jamila Umar
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria
| | - Idris Nasir Abdullahi
- Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.,Department of Medical Laboratory Science, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
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Rodríguez-Espinosa D, Esforzado N, Hermida E, Cuadrado E, Broseta JJ, Diekmann F, Revuelta I. A case of recurrent anemia due to chronic parvovirus B19 infection in a kidney transplant recipient. Can everolimus make a difference? CEN Case Rep 2021; 10:388-92. [PMID: 33539009 DOI: 10.1007/s13730-021-00575-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
Parvovirus B19 (PB19) is a common infection among solid transplant recipients. Usually, it is asymptomatic, but sometimes it can become a real therapeutic challenge. We report a case of a kidney transplant recipient with relapsing pure red cell aplasia due to PB19 infection. Our patient was initially managed with standard treatment consisting of intravenous immunoglobulins and minimization of immunosuppressive treatment. However, when this approach became ineffective, conversion from tacrolimus to everolimus was done, with favorable results. This paper explores infection by PB19 in kidney transplant recipients and the potential benefits of a calcineurin inhibitor-free immunosuppression and the antiviral properties of mTOR inhibitors.
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45
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Rezahosseini O, Ekenberg C, Møller DL, Sørensen SS, Wareham NE, Perch M, Gustafsson F, Rasmussen A, Kirkby N, Reekie J, Lundgren J, Nielsen SD. Incidence and impact of parvovirus B19 infection in seronegative solid organ transplant recipients. J Infect Dis 2021; 224:865-869. [PMID: 33458766 DOI: 10.1093/infdis/jiab024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/13/2021] [Indexed: 12/22/2022] Open
Abstract
Routine monitoring of Parvovirus B19 (B19V) the first six months post-transplantation was performed in 241 seronegative solid organ transplant (SOT) recipients. Incidence rates (IR) during the 1st month and the 2nd to 6th months post-transplantation were 1.2 (95% CI, 0.33-3.2) and 0.21 (95% CI, 0.06-0.57) per 100 recipients per-month, respectively. Of the 6 SOT recipients with positive B19V PCR, 3 (50%) were admitted to hospital and 2 (33%) were treated with intravenous immunoglobulin. Thus, routine monitoring of B19V in seronegative SOT recipients may not be necessary. Targeted screening one-month post-transplantation and screening upon clinical suspicion could be an alternative strategy.
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Affiliation(s)
- Omid Rezahosseini
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christina Ekenberg
- Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Dina Leth Møller
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Søren Schwartz Sørensen
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Neval Ete Wareham
- Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Michael Perch
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Section for Lung Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Finn Gustafsson
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Allan Rasmussen
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nikolai Kirkby
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Joanne Reekie
- Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Lundgren
- Centre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Hazebroek MR, Henkens MTHM, Raafs AG, Verdonschot JAJ, Merken JJ, Dennert RM, Eurlings C, Abdul Hamid MA, Wolffs PFG, Winkens B, Brunner-La Rocca HP, Knackstedt C, van Paassen P, van Empel VPM, Heymans SRB. Intravenous immunoglobulin therapy in adult patients with idiopathic chronic cardiomyopathy and cardiac parvovirus B19 persistence: a prospective, double-blind, randomized, placebo-controlled clinical trial. Eur J Heart Fail 2021; 23:302-309. [PMID: 33347677 PMCID: PMC8048650 DOI: 10.1002/ejhf.2082] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/16/2020] [Accepted: 12/17/2020] [Indexed: 12/19/2022] Open
Abstract
AIMS Previous uncontrolled studies suggested a possible benefit of intravenous immunoglobulin (IVIg) in parvovirus B19 (B19V)-related dilated cardiomyopathy (DCM). This randomized, double-blind, placebo-controlled, single-centre trial investigated the benefits of IVIg beyond conventional therapy in idiopathic chronic DCM patients with B19V persistence. METHODS AND RESULTS Fifty patients (39 men; mean age 54 ± 11 years) with idiopathic chronic (>6 months) DCM on optimal medical therapy, left ventricular ejection fraction (LVEF) <45%, and endomyocardial biopsy (EMB) B19V load of >200 copies/µg DNA were blindly randomized to either IVIg (n = 26, 2 g/kg over 4 days) or placebo (n = 24). The primary outcome was change in LVEF at 6 months after randomization. Secondary outcomes were change in functional capacity assessed by 6-min walk test (6MWT), quality of life [Minnesota Living with Heart Failure Questionnaire (MLHFQ)], left ventricular end-diastolic volume (LVEDV), and EMB B19V load at 6 months after randomization. LVEF significantly improved in both IVIg and placebo groups (absolute mean increase 5 ± 9%, P = 0.011 and 6 ± 10%, P = 0.008, respectively), without a significant difference between groups (P = 0.609). Additionally, change in 6MWT [median (interquartile range) IVIg 36 (13;82) vs. placebo 32 (5;80) m; P = 0.573], MLHFQ [IVIg 0 (-7;5) vs. placebo -2 (-6;6), P = 0.904] and LVEDV (IVIg -16 ± 49 mL/m2 vs. placebo -29 ± 40 mL/m2 ; P = 0.334) did not significantly differ between groups. Moreover, despite increased circulating B19V antibodies upon IVIg administration, reduction in cardiac B19V did not significantly differ between groups. CONCLUSION Intravenous immunoglobulin therapy does not significantly improve cardiac systolic function or functional capacity beyond standard medical therapy in patients with idiopathic chronic DCM and cardiac B19V persistence. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov ID NCT00892112.
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Affiliation(s)
- Mark R Hazebroek
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michiel T H M Henkens
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Anne G Raafs
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Job A J Verdonschot
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jort J Merken
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert M Dennert
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Casper Eurlings
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Myrurgia A Abdul Hamid
- Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Petra F G Wolffs
- Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Hans-Peter Brunner-La Rocca
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Christian Knackstedt
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pieter van Paassen
- Department of Nephrology and Clinical Immunology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Vanessa P M van Empel
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Stephane R B Heymans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Cardiovascular Research, University of Leuven, Leuven, Belgium.,Netherlands Heart Institute (Nl-HI), Utrecht, The Netherlands
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Papadatou V, Tologos S, Deftereou TE. Congenital Parvovirus B19 infection and hydrop fetalis. Hippokratia 2021; 25:50. [PMID: 35221659 PMCID: PMC8877927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- V Papadatou
- Laboratory of Histology & Embryology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - S Tologos
- Laboratory of Histology & Embryology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - T E Deftereou
- Laboratory of Histology & Embryology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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48
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Lampejo T. Parvovirus B19 infection as a potential trigger for fat embolism syndrome in patients with sickle cell disease. J Med Virol 2020; 93:3283-3284. [PMID: 33325058 DOI: 10.1002/jmv.26734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/07/2020] [Accepted: 12/12/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Temi Lampejo
- Department of Infection, Imperial College Healthcare NHS Trust, London, United Kingdom
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49
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Soltani S, Zakeri A, Tabibzadeh A, Zandi M, Ershadi E, Akhavan Rezayat S, Khaseb S, Zakeri AM, Ashtar Nakhaei M, Afzali S, Farahani A. A literature review on the parvovirus B19 infection in sickle cell anemia and β-thalassemia patients. Trop Med Health 2020; 48:96. [PMID: 33292852 PMCID: PMC7709306 DOI: 10.1186/s41182-020-00284-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/09/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Parvovirus B19 is the causative agent for erythema infectiosum, and also as a potentially life-threatening infectious agent, it is mainly presented in high erythrocyte turnover patients. Sickle cell disease (SCD) is an inherited monogenic hematological disorder resulting from the mutations in the hemoglobin β-chain gene. Thalassemia is a hereditary hematological syndrome that happens in consequence of deficiencies in the production of one or more globin chains. We summarize current knowledge about the prevalence rates of the parvovirus B19 infection in sickle cell anemia and thalassemia patients. METHODS Several online databases were searched including, Scopus, EMBASE, Web of Science, Google Scholar, and PubMed, which were performed amidst 2009-2019 by using distinct keywords: "Thalassemia," "Parvovirus," "Anemia," "Sickle cell anemia," "parvoviridae," "parvoviridae infection," and "parvovirus B19." RESULTS Search results indicated 4 and 7 studies for the prevalence of the parvovirus B19 in β-thalassemia and SCD, respectively. Among the β-thalassemia patients, the B19V seroprevalence for IgG and IgM were ranged from 18.2-81% and 14.5-41.1%, respectively; meanwhile, B19V DNA positively results was 4-15.3%. Moreover, in the SCD group, the extent of B19V IgG was varied from 37.6 to 65.9% and that of IgM was in a range of 2.9-30%, and the DNA detection rate was 4-54%. CONCLUSION B19V seroprevalence changes in several conditions including, different epidemiological features, socio-economic status, and overpopulation. Age can expand the incidence of anti-B19V IgG/IgM in SCD and beta-thalassemia patients. Reinfection and diverse genotypes are relevant factors in the seroprevalence of B19v. The patients' immunological-hematological station and higher abundance of transfusions can affect the B19V seroprevalence in SCD and beta-thalassemia group. Further investigations in this field could be suggested to better understand the virus distribution in this susceptible population of patients.
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Affiliation(s)
- Saber Soltani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Zakeri
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Alireza Tabibzadeh
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Zandi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ershadi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Akhavan Rezayat
- Department of Health Care Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Khaseb
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Amir Mohammad Zakeri
- Pediatric Surgery Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadvala Ashtar Nakhaei
- Department of Cellular and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University G.C, Tehran, Iran
| | - Shervin Afzali
- Department of Cellular and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University G.C, Tehran, Iran
| | - Abbas Farahani
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Tsitsikas DA, Bristowe J, Abukar J. Fat Embolism Syndrome in Sickle Cell Disease. J Clin Med 2020; 9:jcm9113601. [PMID: 33171683 PMCID: PMC7695297 DOI: 10.3390/jcm9113601] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/05/2020] [Accepted: 11/07/2020] [Indexed: 12/31/2022] Open
Abstract
Fat embolism syndrome is a devastating complication of sickle cell disease resulting from extensive bone marrow necrosis and associated with high mortality rates, while survivors often suffer severe neurological sequelae. Despite that, the syndrome remains under-recognised and under-diagnosed. Paradoxically, it affects exclusively patients with mild forms of sickle cell disease, predominantly HbSC and HbSβ+. A significant number of cases occur in the context of human parvovirus B19 infection. We provide here a brief summary of the existing literature and describe our experience treating 8 patients in our institution. One patient had HbSS, 6 HbSC and 1 HbSβ+. All patients developed type I respiratory failure and neurological involvement either at presentation or within the first 72 h. The most striking laboratory abnormality was a 100-fold increase of the serum ferritin from baseline. Seven patients received emergency red cell exchange and 1 simple transfusion. Two patients (25%) died, 2 patients (25%) suffered severe neurological impairment and 1 (12%) mild neurological impairment on discharge, while 3 (38%) patients made a complete recovery. With long-term follow-up, 1 patient with severe neurological impairment and one patient with mild neurological impairment made dramatic improvements, making the long-term complete recovery or near complete recovery rate 63%. Immediate red cell exchange transfusion can be lifesaving and should be instituted as soon as the syndrome is suspected. However, as the outcomes remain unsatisfactory despite the increasing use of red cell exchange, we suggest additional therapeutic measures such as therapeutic plasma exchange and pre-emptive transfusion for high risk patients.
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Affiliation(s)
- Dimitris A. Tsitsikas
- Haemoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK;
- Correspondence:
| | - Jessica Bristowe
- Research and Innovation Department, Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK;
| | - Jibril Abukar
- Haemoglobinopathy Service, Department of Haematology, Homerton University Hospital NHS Foundation Trust, London E9 6SR, UK;
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2UP, UK
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