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Wang W, Wang Z, Chen Z, Liang M, Zhang A, Sheng H, Ni M, Yang J. Construction of an early differentiation diagnosis model for patients with severe fever with thrombocytopenia syndrome and hemorrhagic fever with renal syndrome. J Med Virol 2024; 96:e29626. [PMID: 38654664 DOI: 10.1002/jmv.29626] [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: 12/29/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with a high mortality rate. Differentiating between SFTS and hemorrhagic fever with renal syndrome (HFRS) is difficult and inefficient. Retrospective analysis of the medical records of individuals with SFTS and HFRS was performed. Clinical and laboratory data were compared, and a diagnostic model was developed based on multivariate logistic regression analyzes. Receiver operating characteristic curve analysis was used to evaluate the diagnostic model. Among the 189 patients, 113 with SFTS and 76 with HFRS were enrolled. Univariate analysis revealed that more than 20 variables were significantly associated with SFTS. Multivariate logistic regression analysis revealed that gender, especially female gender (odds ratio [OR]: 4.299; 95% confidence interval [CI]: 1.163-15.887; p = 0.029), age ≥65 years (OR: 16.386; 95% CI: 3.043-88.245; p = 0.001), neurological symptoms (OR: 12.312; 95% CI: 1.638-92.530; p = 0.015), leukopenia (<4.0 × 109/L) (OR: 17.355; 95% CI: 3.920-76.839; p < 0.001), and normal Cr (OR: 97.678; 95% CI: 15.483-616.226; p < 0.001) were significantly associated with SFTS but not with HFRS. The area under the curve of the differential diagnostic model was 0.960 (95% CI: 0.936-0.984), which was significantly better than that of each single factor. In addition, the model exhibited very excellent sensitivity and specificity (92.9% and 85.5%, respectively). In cases where HFRS and SFTS are endemic, a diagnostic model based on five parameters, such as gender, age ≥65 years, neurological symptoms, leukopenia and normal Cr, will facilitate the differential diagnosis of SFTS and HFRS in medical institutions, especially in primary care settings.
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Affiliation(s)
- Wenjie Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zijian Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zumin Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Manman Liang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Aiping Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Haoyu Sheng
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Mingyue Ni
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jianghua Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Pan J, Yang Z, Xu W, Tian S, Liu X, Guo C. Effect of fasting plasma glucose level in severe fever and thrombocytopenia syndrome patients without diabetes. PLoS Negl Trop Dis 2024; 18:e0012125. [PMID: 38626191 PMCID: PMC11051581 DOI: 10.1371/journal.pntd.0012125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/26/2024] [Accepted: 04/01/2024] [Indexed: 04/18/2024] Open
Abstract
Hyperglycemia is correlated with worse in-hospital outcomes in acute infectious diseases such as coronavirus disease 2019 (COVID-19) and severe fever with thrombocytopenia syndrome (SFTS). This study assessed the relationship between fasting plasma glucose (FPG) levels and in-hospital mortality, disease type, and secondary infections among individuals with SFTS without preexisting diabetes. The clinical data and laboratory results upon admission of 560 patients with SFTS without preexisting diabetes meeting the inclusion criteria at Wuhan Union Hospital were collected. FPG levels in surviving patients with SFTS subjects were significantly lower than those in patients with SFTS who had died (P<0.0001). In multivariate Cox regression, high FPG level (≥11.1 mmol/L) was a risk factor independently associated with the in-hospital death of patients with SFTS without preexisting diabetes. Similarly, the FPG levels in general patients with SFTS were significantly lower than those in patients with severe SFTS (P<0.0001). Multivariate logistic regression identified high FPG level (7.0-11.1 mmol/L) as a risk factor independently associated with SFTS severity. While FPG levels were comparable between patients with SFTS with and without secondary infection (P = 0.5521), logistic regression analysis revealed that high FPG levels were not a risk factor for secondary infection in patients with SFTS without preexisting diabetes. High FPG level on admission was an independent predictor of in-hospital death and severe disease in individuals with SFTS without preexisting diabetes. FPG screening upon admission and glycemic control are effective methods for improving the prognosis of patients with SFTS.
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Affiliation(s)
- Jun Pan
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Zhihao Yang
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Wen Xu
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Shan Tian
- Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaobo Liu
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Chunxia Guo
- Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhang S, Wang J, Zhang Q, Pan Y, Zhang Z, Geng Y, Jia B, Li Y, Xiong Y, Yan X, Li J, Wang H, Wu C, Huang R. Association of liver function and prognosis in patients with severe fever with thrombocytopenia syndrome. PLoS Negl Trop Dis 2024; 18:e0012068. [PMID: 38626222 PMCID: PMC11051684 DOI: 10.1371/journal.pntd.0012068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/26/2024] [Accepted: 03/12/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVES Severe fever with thrombocytopenia syndrome (SFTS) is an epidemic emerging infectious disease with high mortality rate. We investigated the association between liver injury and clinical outcomes in patients with SFTS. METHODS A total of 291 hospitalized SFTS patients were retrospectively included. Cox proportional hazards model was adopted to identify risk factors of fatal outcome and Kaplan-Meier curves were used to estimate cumulative risks. RESULTS 60.1% of patients had liver injury at admission, and the median alanine transaminase, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBil) levels were 76.4 U/L, 152.3 U/L, 69.8 U/L and 9.9 μmol/L, respectively. Compared to survivors, non-survivors had higher levels of AST (253.0 U/L vs. 131.1 U/L, P < 0.001) and ALP (86.2 U/L vs. 67.9 U/L, P = 0.006), higher proportion of elevated ALP (20.0% vs. 4.4%, P < 0.001) and liver injury (78.5% vs. 54.9%, P = 0.001) at admission. The presence of liver injury (HR 2.049, P = 0.033) at admission was an independent risk factor of fatal outcome. CONCLUSIONS Liver injury was a common complication and was strongly associated with poor prognosis in SFTS patients. Liver function indicators should be closely monitored for SFTS patients.
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Affiliation(s)
- Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Qun Zhang
- Department of Infectious Diseases, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu, China
| | - Yifan Pan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yu Geng
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Bei Jia
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yuanyuan Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yali Xiong
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaomin Yan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Huali Wang
- Department of General Practice, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Chang M, Min YQ, Xu Z, Deng F, Wang H, Ning YJ. Host factor MxA restricts Dabie bandavirus infection by targeting the viral NP protein to inhibit NP-RdRp interaction and ribonucleoprotein activity. J Virol 2024; 98:e0156823. [PMID: 38054738 PMCID: PMC10805036 DOI: 10.1128/jvi.01568-23] [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: 10/08/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high case mortality rates, which is caused by Dabie bandavirus (DBV), a novel pathogen also termed as SFTS virus (SFTSV). Currently, no specific therapeutic drugs or vaccines are available for SFTS. Myxovirus resistance protein A (MxA) has been shown to inhibit multiple viral pathogens; however, the role of MxA in DBV infection is unknown. Here, we demonstrated that DBV stimulates MxA expression which, in turn, restricts DBV infection. Mechanistic target analysis revealed that MxA specifically interacts with the viral nucleocapsid protein (NP) in a manner independent of RNA. Minigenome reporter assay showed that in agreement with its targeting of NP, MxA inhibits DBV ribonucleoprotein (RNP) activity. In detail, MxA interacts with the NP N-terminal and disrupts the interaction of NP with the viral RNA-dependent RNA polymerase (RdRp) but not NP multimerization, the critical activities of NP for RNP formation and function. Furthermore, MxA N-terminal domain was identified as the functional domain inhibiting DBV infection, and, consistently, then was shown to interact with NP and obstruct the NP-RdRp interaction. Additionally, threonine 103 within the N-terminal domain is important for MxA inhibition to DBV, and its mutation (T103A) attenuates MxA binding to NP and obstruction of the NP-RdRp interaction. This study uncovers MxA inhibition of DBV with a series of functional and mechanistical analyses, providing insights into the virus-host interactions and probably helping inform the development of antiviral agents in the future.IMPORTANCEDBV/SFTSV is an emerging high-pathogenic virus. Since its first identification in China in 2009, cases of DBV infection have been reported in many other countries, posing a significant threat to public health. Uncovering the mechanisms of DBV-host interactions is necessary to understand the viral pathogenesis and host response and may advance the development of antiviral therapeutics. Here, we found that host factor MxA whose expression is induced by DBV restricts the virus infection. Mechanistically, MxA specifically interacts with the viral NP and blocks the NP-RdRp interaction, inhibiting the viral RNP activity. Further studies identified the key domain and amino acid residue required for MxA inhibition to DBV. Consistently, they were then shown to be important for MxA targeting of NP and obstruction of the NP-RdRp association. These findings unravel the restrictive role of MxA in DBV infection and the underlying mechanism, expanding our knowledge of the virus-host interactions.
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Affiliation(s)
- Meng Chang
- Key Laboratory of Virology and Biosafety and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yuan-Qin Min
- Key Laboratory of Virology and Biosafety and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- State Key Laboratory of Virology and Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Zhao Xu
- Key Laboratory of Virology and Biosafety and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Fei Deng
- Key Laboratory of Virology and Biosafety and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- State Key Laboratory of Virology and Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Hualin Wang
- Key Laboratory of Virology and Biosafety and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- State Key Laboratory of Virology and Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Yun-Jia Ning
- Key Laboratory of Virology and Biosafety and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- State Key Laboratory of Virology and Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
- Hubei Jiangxia Laboratory, Wuhan, China
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Liu S, Su Y, Lu Z, Zou X, Xu L, Teng Y, Wang Z, Wang T. The SFTSV Nonstructural Proteins Induce Autophagy to Promote Viral Replication via Interaction with Vimentin. J Virol 2023; 97:e0030223. [PMID: 37039677 PMCID: PMC10134822 DOI: 10.1128/jvi.00302-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/25/2023] [Accepted: 03/20/2023] [Indexed: 04/12/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly identified phlebovirus associated with severe hemorrhagic fever in humans. Studies have shown that SFTSV nucleoprotein (N) induces BECN1-dependent autophagy to promote viral assembly and release. However, the function of other SFTSV proteins in regulating autophagy has not been reported. In this study, we identify SFTSV NSs, a nonstructural protein that forms viroplasm-like structures in the cytoplasm of infected cells as the virus component mediating SFTSV-induced autophagy. We found that SFTSV NSs-induced autophagy was inclusion body independent, and most phenuivirus NSs had autophagy-inducing effects. Unlike N protein-induced autophagy, SFTSV NSs was key in regulating autophagy by interacting with the host's vimentin in an inclusion body-independent manner. NSs interacted with vimentin and induced vimentin degradation through the K48-linked ubiquitin-proteasome pathway. This negatively regulating Beclin1-vimentin complex formed and promoted autophagy. Furthermore, we identified the NSs-binding domain of vimentin and found that overexpression of wild-type vimentin antagonized the induced effect of NSs on autophagy and inhibited viral replication, suggesting that vimentin is a potential antiviral target. The present study shows a novel mechanism through which SFTSV nonstructural protein activates autophagy, which provides new insights into the role of NSs in SFTSV infection and pathogenesis. IMPORTANCE Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly emerging tick-borne pathogen that causes multifunctional organ failure and even death in humans. As a housekeeping mechanism for cells to maintain steady state, autophagy plays a dual role in viral infection and the host's immune response. However, the relationship between SFTSV infection and autophagy has not been described in detail yet. Here, we demonstrated that SFTSV infection induced complete autophagic flux and facilitated viral proliferation. We also identified a key mechanism underlying NSs-induced autophagy, in which NSs interacted with vimentin to inhibit the formation of the Beclin1-vimentin complex and induced vimentin degradation through K48-linked ubiquitination modification. These findings may help us understand the new functions and mechanisms of NSs and may aid in the identification of new antiviral targets.
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Affiliation(s)
- Sihua Liu
- School of Life Sciences, Tianjin University, Tianjin, China
| | - Yazhi Su
- School of Life Sciences, Tianjin University, Tianjin, China
| | - Zhuozhuang Lu
- National Institute for Viral Disease Control and Prevention, CDC, Beijing, China
| | - Xiaohui Zou
- National Institute for Viral Disease Control and Prevention, CDC, Beijing, China
| | - Leling Xu
- School of Life Sciences, Tianjin University, Tianjin, China
| | - Yue Teng
- State Key Laboratory of Pathogen and Biosecurity Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Zhiyun Wang
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Tao Wang
- School of Life Sciences, Tianjin University, Tianjin, China
- Institute of Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, Tianjin, China
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Chung H, Kim E, Kwon B, Cho YG, Bae S, Jung J, Kim MJ, Chong YP, Kim SH, Lee SO, Choi SH, Kim YS. Kinetics of Glycoprotein-Specific Antibody Response in Patients with Severe Fever with Thrombocytopenia Syndrome. Viruses 2022; 14:v14020256. [PMID: 35215849 PMCID: PMC8880780 DOI: 10.3390/v14020256] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/14/2022] [Accepted: 01/25/2022] [Indexed: 01/10/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne disease in East Asia that is causing high mortality. The Gn glycoprotein of the SFTS virus (SFTSV) has been considered to be an essential target for virus neutralization. However, data on anti-Gn glycoprotein antibody kinetics are limited. Therefore, we investigated the kinetics of Gn-specific antibodies compared to those of nucleocapsid protein (NP)-specific antibodies. A multicenter prospective study was performed in South Korea from January 2018 to September 2021. Adult patients with SFTS were enrolled. Anti-Gn-specific IgM and IgG were measured using an enzyme-linked immunosorbent assay. A total of 111 samples from 34 patients with confirmed SFTS were analyzed. Anti-Gn-specific IgM was detected at days 5–9 and peaked at day 15–19 from symptom onset, whereas the anti-NP-specific IgM titers peaked at days 5–9. Median seroconversion times of both anti-Gn- and NP-specific IgG were 7.0 days. High anti-Gn-specific IgG titers were maintained until 35–39 months after symptom onset. Only one patient lost their anti-Gn-specific antibodies at 41 days after symptom onset. Our data suggested that the anti-Gn-specific IgM titer peaked later than anti-NP-specific IgM, and that anti-Gn-specific IgG remain for at least 3 years from symptom onset.
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Affiliation(s)
- Hyemin Chung
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Eunsil Kim
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.K.); (Y.-G.C.)
| | - Bomin Kwon
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Yeong-Geon Cho
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.K.); (Y.-G.C.)
| | - Seongman Bae
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Jiwon Jung
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Min-Jae Kim
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Yong-Pil Chong
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Sung-Han Kim
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Sang-Oh Lee
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Sang-Ho Choi
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
| | - Yang-Soo Kim
- Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.C.); (B.K.); (S.B.); (J.J.); (M.-J.K.); (Y.-P.C.); (S.-H.K.); (S.-O.L.); (S.-H.C.)
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (E.K.); (Y.-G.C.)
- Correspondence:
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Kwon JS, Jin S, Kim JY, Ra SH, Kim T, Park SY, Kim MC, Park SY, Kim D, Cha HH, Lee HJ, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Lee KH, Kee SH, Kim SH. Viral and Immunologic Factors Associated with Fatal Outcome of Patients with Severe Fever with Thrombocytopenia Syndrome in Korea. Viruses 2021; 13:v13122351. [PMID: 34960620 PMCID: PMC8703577 DOI: 10.3390/v13122351] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/11/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022] Open
Abstract
Significant progress has been made on the molecular biology of the severe fever with thrombopenia virus (SFTSV); however, many parts of the pathophysiological mechanisms of mortality in SFTS remain unclear. In this study, we investigated virologic and immunologic factors for fatal outcomes of patients with SFTS. We prospectively enrolled SFTS patients admitted from July 2015 to October 2020. Plasma samples were subjected to SFTSV RNA RT-PCR, multiplex microbead immunoassay for 17 cytokines, and IFA assay. A total of 44 SFTS patients were enrolled, including 37 (84.1%) survivors and 7 (15.9%) non-survivors. Non-survivors had a 2.5 times higher plasma SFTSV load than survivors at admission (p < 0.001), and the viral load in non-survivors increased progressively during hospitalization. In addition, non-survivors did not develop adequate anti-SFTSV IgG, whereas survivors exhibited anti-SFTSV IgG during hospitalization. IFN-α, IL-10, IP-10, IFN-γ, IL-6, IL-8, MCP-1, MIP-1α, and G-CSF were significantly elevated in non-survivors compared to survivors and did not revert to normal ranges during hospitalization (p < 0.05). Severe signs of inflammation such as a high plasma concentration of IFN-α, IL-10, IP-10, IFN-γ, IL-6, IL-8, MCP-1, MIP-1α, and G-CSF, poor viral control, and inadequate antibody response during the disease course were associated with mortality in SFTS patients.
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Affiliation(s)
- Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Sol Jin
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Ji-Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Sang-Hyun Ra
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Taeeun Kim
- Division of Infectious Diseases, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju 52727, Korea;
| | - Se-Yoon Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea;
| | - Min-Chul Kim
- Division of Infectious Diseases, Chung-Ang University Hospital, Seoul 06973, Korea;
| | - Seong-Yeon Park
- Department of Infectious Diseases, Dongguk University Ilsan Hospital, Goyang 10326, Korea;
| | - Dasarang Kim
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul 02841, Korea; (D.K.); (S.-H.K.)
| | - Hye-Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Hyun-Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Min-Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Yong-Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Yang-Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
| | - Keun-Hwa Lee
- Department of Microbiology, College of Medicine, Hanyang University, Seoul 04763, Korea;
| | - Sun-Ho Kee
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul 02841, Korea; (D.K.); (S.-H.K.)
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-S.K.); (S.J.); (J.-Y.K.); (S.-H.R.); (H.-H.C.); (H.-J.L.); (M.-J.K.); (Y.-P.C.); (S.-O.L.); (S.-H.C.); (Y.-S.K.)
- Correspondence: ; Tel.: +82-2-3010-3305
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Ando T, Nabeshima T, Inoue S, Tun MMN, Obata M, Hu W, Shimoda H, Kurihara S, Izumikawa K, Morita K, Hayasaka D. Severe Fever with Thrombocytopenia Syndrome in Cats and Its Prevalence among Veterinarian Staff Members in Nagasaki, Japan. Viruses 2021; 13:v13061142. [PMID: 34198717 PMCID: PMC8232257 DOI: 10.3390/v13061142] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/26/2021] [Accepted: 06/09/2021] [Indexed: 01/30/2023] Open
Abstract
In this study, we investigated severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) infection in cats in Nagasaki, Japan. In total, 44 of 133 (33.1%) cats with suspected SFTS were confirmed to be infected with SFTSV. Phylogenetic analyses of SFTSV isolates from cats indicated that the main genotype in Nagasaki was J1 and that unique reassortant strains with J2 (S segment) and unclassified genotypes (M and L segments) were also present. There were no significant differences in virus growth in cell cultures or fatality in SFTSV-infected mice between the SFTSV strains that were isolated from recovered and fatal cat cases. Remarkably, SFTSV RNAs were detected in the swabs from cats, indicating that the body fluids contain SFTSV. To evaluate the risk of SFTSV infection when providing animal care, we further examined the seroprevalence of SFTSV infection in veterinarian staff members; 3 of 71 (4.2%) were seropositive for SFTSV-specific antibodies. Our results provide useful information on the possibility of using cats as sentinel animals and raised concerns of the zoonotic risk of catching SFTSV from animals.
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Affiliation(s)
- Tsuyoshi Ando
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (T.A.); (T.N.); (S.I.); (M.M.N.T.); (K.M.)
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Takeshi Nabeshima
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (T.A.); (T.N.); (S.I.); (M.M.N.T.); (K.M.)
| | - Shingo Inoue
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (T.A.); (T.N.); (S.I.); (M.M.N.T.); (K.M.)
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (T.A.); (T.N.); (S.I.); (M.M.N.T.); (K.M.)
| | - Miho Obata
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8511, Japan; (M.O.); (W.H.); (H.S.)
| | - Weiyin Hu
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8511, Japan; (M.O.); (W.H.); (H.S.)
| | - Hiroshi Shimoda
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8511, Japan; (M.O.); (W.H.); (H.S.)
| | - Shintaro Kurihara
- Department of Medical Safety, Nagasaki University Hospital, Nagasaki University, Nagasaki 852-8501, Japan;
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki University, Nagasaki 852-8501, Japan;
- Department of Infectious Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (T.A.); (T.N.); (S.I.); (M.M.N.T.); (K.M.)
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Daisuke Hayasaka
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8511, Japan; (M.O.); (W.H.); (H.S.)
- Correspondence: ; Tel.: +81-83-933-5887
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9
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Abstract
The genus Bandavirus consists of seven tick-borne bunyaviruses, among which four are known to infect humans. Dabie bandavirus, severe fever with thrombocytopenia syndrome virus (SFTSV), poses serious threats to public health worldwide. SFTSV is a tick-borne virus mainly reported in China, South Korea, and Japan with a mortality rate of up to 30%. To date, most immunology-related studies focused on the antagonistic role of SFTSV non-structural protein (NSs) in sequestering RIG-I-like-receptors (RLRs)-mediated type I interferon (IFN) induction and type I IFN mediated signaling pathway. It is still elusive whether the interaction of SFTSV and other conserved innate immune responses exists. As of now, no specific vaccines or therapeutics are approved for SFTSV prevention or treatments respectively, in part due to a lack of comprehensive understanding of the molecular interactions occurring between SFTSV and hosts. Hence, it is necessary to fully understand the host-virus interactions including antiviral responses and viral evasion mechanisms. In this review, we highlight the recent progress in understanding the pathogenesis of SFTS and speculate underlying novel mechanisms in response to SFTSV infection.
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Affiliation(s)
- Chuan-min Zhou
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xue-jie Yu
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
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10
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Xu S, Jiang N, Nawaz W, Liu B, Zhang F, Liu Y, Wu X, Wu Z. Infection of humanized mice with a novel phlebovirus presented pathogenic features of severe fever with thrombocytopenia syndrome. PLoS Pathog 2021; 17:e1009587. [PMID: 33974679 PMCID: PMC8139491 DOI: 10.1371/journal.ppat.1009587] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 05/21/2021] [Accepted: 04/26/2021] [Indexed: 12/02/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is a tick-borne emerging phlebovirus with high mortality rates of 6.0 to 30%. SFTSV infection is characterized by high fever, thrombocytopenia, leukopenia, hemorrhage and multiple organ failures. Currently, specific therapies and vaccines remain elusive. Suitable small animal models are urgently needed to elucidate the pathogenesis and evaluate the potential drug and vaccine for SFTSV infection. Previous models presented only mild or no pathogenesis of SFTS, limiting their applications in SFTSV infection. Therefore, it is an urgent need to develop a small animal model for the investigation of SFTSV pathogenesis and evaluation of therapeutics. In the current report, we developed a SFTSV infection model based on the HuPBL-NCG mice that recapitulates many pathological characteristics of SFTSV infection in humans. Virus-induced histopathological changes were identified in spleen, lung, kidney, and liver. SFTSV was colocalized with macrophages in the spleen and liver, suggesting that the macrophages in the spleen and liver could be the principle target cells of SFTSV. In addition, histological analysis showed that the vascular endothelium integrity was severely disrupted upon viral infection along with depletion of platelets. In vitro cellular assays further revealed that SFTSV infection increased the vascular permeability of endothelial cells by promoting tyrosine phosphorylation and internalization of the adhesion molecule vascular endothelial (VE)–cadherin, a critical component of endothelial integrity. In addition, we found that both virus infection and pathogen-induced exuberant cytokine release dramatically contributed to the vascular endothelial injury. We elucidated the pathogenic mechanisms of hemorrhage syndrome and developed a humanized mouse model for SFTSV infection, which should be helpful for anti-SFTSV therapy and pathogenesis study. SFTSV is a novel bunyavirus that was identified in 2010 and endemic in China, Korea, Japan and Vietnam with expanding spatial incidents. SFTS is characterized by high case-fatality rates and currently has no effective therapeutics or vaccines. In previous study, models presented only mild or no pathogenesis of SFTS, limiting their applications in SFTSV infection. In the current study, we developed a humanized NCG mouse model for the study of SFTSV infection and elucidated the pathogenic mechanisms of hemorrhage syndrome with respect to apoptosis, membrane protein endocytosis and cytokine stimulation. The HuPBL-NCG model presented multiple organ pathologies that resemble those of human infection, which will be helpful for anti-SFTSV therapy and pathogenesis study.
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Affiliation(s)
- Shijie Xu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Na Jiang
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Waqas Nawaz
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Bingxin Liu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Fang Zhang
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Ye Liu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Xilin Wu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
- * E-mail: (XW); (ZW)
| | - Zhiwei Wu
- School of Life Sciences, Ningxia University, Yinchuan, P.R. China
- State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
- * E-mail: (XW); (ZW)
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11
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Urata S, Yasuda J, Iwasaki M. Loperamide Inhibits Replication of Severe Fever with Thrombocytopenia Syndrome Virus. Viruses 2021; 13:v13050869. [PMID: 34068464 PMCID: PMC8150324 DOI: 10.3390/v13050869] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). SFTS is mainly prevalent in East Asia. It has a mortality rate of up to 30%, and there is no approved treatment against the disease. In this study, we evaluated the effect of loperamide, an antidiarrheal and antihyperalgesic agent, on the propagation of SFTSV in a cell culture system. METHODS SFTSV-infected human cell lines were exposed to loperamide, and viral titers were evaluated. To clarify the mode of action of loperamide, several chemical compounds having shared targets with loperamide were used. Calcium imaging was also performed to understand whether loperamide treatment affected calcium influx. RESULTS Loperamide inhibited SFTSV propagation in several cell lines. It inhibited SFTSV in the post-entry step and restricted calcium influx into the cell. Furthermore, nifedipine, a calcium channel inhibitor, also blocked post-entry step of SFTSV infection. CONCLUSIONS Loperamide inhibits SFTSV propagation mainly by restraining calcium influx into the cytoplasm. This indicates that loperamide, a Food and Drug Administration (FDA)-approved drug, has the potential for being used as a treatment option against SFTS.
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Affiliation(s)
- Shuzo Urata
- National Research Center for the Control and Prevention of Infectious Diseases (CCPID), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
- Correspondence: ; Tel.: +81-95-819-7970
| | - Jiro Yasuda
- National Research Center for the Control and Prevention of Infectious Diseases (CCPID), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
- Department of Emerging Infectious Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Masaharu Iwasaki
- Laboratory of Emerging Viral Diseases, International Research Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Osaka 565-0871, Japan;
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12
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Casel MA, Park SJ, Choi YK. Severe fever with thrombocytopenia syndrome virus: emerging novel phlebovirus and their control strategy. Exp Mol Med 2021; 53:713-722. [PMID: 33953322 PMCID: PMC8178303 DOI: 10.1038/s12276-021-00610-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/23/2020] [Accepted: 01/11/2021] [Indexed: 02/03/2023] Open
Abstract
An emerging infectious disease first identified in central China in 2009, severe fever with thrombocytopenia syndrome (SFTS) was found to be caused by a novel phlebovirus. Since SFTSV was first identified, epidemics have occurred in several East Asian countries. With the escalating incidence of SFTS and the rapid, worldwide spread of SFTSV vector, it is clear this virus has pandemic potential and presents an impending global public health threat. In this review, we concisely summarize the latest findings regarding SFTSV, including vector and virus transmission, genotype diversity and epidemiology, probable pathogenic mechanism, and clinical presentation of human SFTS. Ticks most likely transmit SFTSV to animals including humans; however, human-to-human transmission has been reported. The majority of arbovirus transmission cycle includes vertebrate hosts, and potential reservoirs include a variety of both domestic and wild animals. Reports of the seroprevalence of SFTSV in both wild and domestic animals raises the probability that domestic animals act as amplifying hosts for the virus. Major clinical manifestation of human SFTS infection is high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, and a high case-fatality rate. Several animal models were developed to further understand the pathogenesis of the virus and aid in the discovery of therapeutics and preventive measures.
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Affiliation(s)
- Mark Anthony Casel
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Su Jin Park
- Research Institute of Life Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Young Ki Choi
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea.
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13
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Fang X, Hu J, Peng Z, Dai Q, Liu W, Liang S, Li Z, Zhang N, Bao C. Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome bunyavirus human-to-human transmission. PLoS Negl Trop Dis 2021; 15:e0009037. [PMID: 33930022 PMCID: PMC8087050 DOI: 10.1371/journal.pntd.0009037] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) was listed as one of the most severe infectious disease by world health organization in 2017. It can mostly be transmitted by tick bite, while human-to-human transmission has occurred on multiple occasions. This study aimed to explore the epidemiological and clinical characteristics and make risk analysis of SFTS human-to-human transmission. METHODS Descriptive and spatial methods were employed to illustrate the epidemiological and clinical characteristics of SFTS human-to-human transmission. The risk of SFTS human-to-human transmission was accessed through secondary attack rate (SAR) and basic reproductive number (R0). Logistic regression analysis was used to identify the associated risk factors. RESULTS A total of 27 clusters of SFTS human-to-human transmission were reported in China and South Korea during 1996-2019. It mainly occurred among elder people in May, June and October in central and eastern China. The secondary cases developed milder clinical manifestation and better outcome than the index cases. The incubation period was 10.0 days (IQR:8.0-12.0), SAR was 1.72%-55.00%, and the average R0 to be 0.13 (95%CI:0.11-0.16). Being blood relatives of the index case, direct blood/bloody secretion contact and bloody droplet contact had more risk of infection (OR = 6.35(95%CI:3.26-12.37), 38.01 (95%CI,19.73-73.23), 2.27 (95%CI,1.01-5.19)). CONCLUSIONS SFTS human-to-human transmission in China and South Korea during 1996-2019 had obvious spatio-temporal distinction. Ongoing assessment of this transmission risk is crucial for public health authorities though it continues to be low now.
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Affiliation(s)
- Xinyu Fang
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Jianli Hu
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qigang Dai
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Wendong Liu
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Shuyi Liang
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Zhifeng Li
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Nan Zhang
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
- NHC Key laboratory of Enteric Pathogenic Microbiology, Nanjing, China
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Kirino Y, Ishijima K, Miura M, Nomachi T, Mazimpaka E, Sudaryatma PE, Yamanaka A, Maeda K, Sugimoto T, Saito A, Mekata H, Okabayashi T. Seroprevalence of Severe Fever with Thrombocytopenia Syndrome Virus in Small-Animal Veterinarians and Nurses in the Japanese Prefecture with the Highest Case Load. Viruses 2021; 13:v13020229. [PMID: 33540629 PMCID: PMC7912989 DOI: 10.3390/v13020229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is the causative agent of SFTS, an emerging tick-borne disease in East Asia, and is maintained in enzootic cycles involving ticks and a range of wild animal hosts. Direct transmission of SFTSV from cats and dogs to humans has been identified in Japan, suggesting that veterinarians and veterinary nurses involved in small-animal practice are at occupational risk of SFTSV infection. To characterize this risk, we performed a sero-epidemiological survey in small-animal-practice workers and healthy blood donors in Miyazaki prefecture, which is the prefecture with the highest per capita number of recorded cases of SFTS in Japan. Three small-animal-practice workers were identified as seropositive by ELISA, but one had a negative neutralization-test result and so was finally determined to be seronegative, giving a seropositive rate of 2.2% (2 of 90), which was significantly higher than that in healthy blood donors (0%, 0 of 1000; p < 0.05). The seroprevalence identified here in small-animal-practice workers was slightly higher than that previously reported in other high-risk workers engaged in agriculture and forestry in Japan. Thus, enhancement of small-animal-practice workers’ awareness of biosafety at animal hospitals is necessary for control of SFTSV.
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Affiliation(s)
- Yumi Kirino
- Center for Animal Disease Control, University of Miyazaki, Miyazaki 889-2192, Japan; (Y.K.); (A.S.); (H.M.)
- Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Keita Ishijima
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo 162-8640, Japan; (K.I.); (K.M.)
| | - Miho Miura
- Department of Microbiology, Miyazaki Prefectural Institute for Public Health and Environment, Miyazaki 889-2155, Japan; (M.M.); (T.S.)
| | - Taro Nomachi
- Miyazaki Prefectural Miyakonojo Inspection Center, Miyazaki 885-0021, Japan;
| | - Eugene Mazimpaka
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki 889-2192, Japan; (E.M.); (P.E.S.)
| | - Putu Eka Sudaryatma
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki 889-2192, Japan; (E.M.); (P.E.S.)
| | - Atsushi Yamanaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki 880-8510, Japan;
| | - Ken Maeda
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo 162-8640, Japan; (K.I.); (K.M.)
| | - Takayuki Sugimoto
- Department of Microbiology, Miyazaki Prefectural Institute for Public Health and Environment, Miyazaki 889-2155, Japan; (M.M.); (T.S.)
| | - Akatsuki Saito
- Center for Animal Disease Control, University of Miyazaki, Miyazaki 889-2192, Japan; (Y.K.); (A.S.); (H.M.)
- Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki 889-2192, Japan; (E.M.); (P.E.S.)
| | - Hirohisa Mekata
- Center for Animal Disease Control, University of Miyazaki, Miyazaki 889-2192, Japan; (Y.K.); (A.S.); (H.M.)
| | - Tamaki Okabayashi
- Center for Animal Disease Control, University of Miyazaki, Miyazaki 889-2192, Japan; (Y.K.); (A.S.); (H.M.)
- Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki 889-2192, Japan; (E.M.); (P.E.S.)
- Correspondence: ; Tel./Fax: +81-985-58-7575
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15
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Park ES, Fujita O, Kimura M, Hotta A, Imaoka K, Shimojima M, Saijo M, Maeda K, Morikawa S. Diagnostic system for the detection of severe fever with thrombocytopenia syndrome virus RNA from suspected infected animals. PLoS One 2021; 16:e0238671. [PMID: 33507990 PMCID: PMC7842937 DOI: 10.1371/journal.pone.0238671] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/04/2020] [Indexed: 12/02/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome virus (SFTSV) causes severe hemorrhagic fever in humans and cats. Clinical symptoms of SFTS-infected cats resemble those of SFTS patients, whereas SFTS-contracted cats have high levels of viral RNA loads in the serum and body fluids. Due to the risk of direct infection from SFTS-infected cats to human, it is important to diagnose SFTS-suspected animals. In this study, a reverse transcription polymerase chain reaction (RT-PCR) was newly developed to diagnose SFTS-suspected animals without non-specific reactions. Methodology/principle findings Four primer sets were newly designed from consensus sequences constructed from 108 strains of SFTSV. A RT-PCR with these four primer sets successfully and specifically detected four clades of SFTSV. Their limits of detection are 1–10 copies/reaction. Using this RT-PCR, 5 cat cases among 56 SFTS-suspected animal cases were diagnosed as SFTS. From these cats, IgM or IgG against SFTSV were detected by enzyme-linked immunosorbent assay (ELISA), but not neutralizing antibodies by plaque reduction neutralization titer (PRNT) test. This phenomenon is similar to those of fatal SFTS patients. Conclusion/significance This newly developed RT-PCR could detect SFTSV RNA of several clades and from SFTS-suspected animals. In addition to ELISA and PRNT test, the useful laboratory diagnosis systems of SFTS-suspected animals has been made in this study.
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Affiliation(s)
- Eun-sil Park
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Osamu Fujita
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masanobu Kimura
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Akitoyo Hotta
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Koichi Imaoka
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masayuki Shimojima
- Department of Virology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Ken Maeda
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
- Laboratory of Veterinary Microbiology, Yamaguchi University, Yamaguchi, Japan
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
- Department of Microbiology, Faculty of Veterinary Medicine, Okayama University of Science, Imabari, Ehime, Japan
- * E-mail:
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16
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Ikemori R, Aoyama I, Sasaki T, Takabayashi H, Morisada K, Kinoshita M, Ikuta K, Yumisashi T, Motomura K. Two Different Strains of Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) in North and South Osaka by Phylogenetic Analysis of Evolutionary Lineage: Evidence for Independent SFTSV Transmission. Viruses 2021; 13:v13020177. [PMID: 33504090 PMCID: PMC7911098 DOI: 10.3390/v13020177] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 11/24/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a novel tick-borne infectious disease, therefore, the information on the whole genome of the SFTS virus (SFTSV) is still limited. This study demonstrates a nearly whole genome of the SFTSV identified in Osaka in 2017 and 2018 by next-generation sequencing (NGS). The evolutionary lineage of two genotypes, C5 and J1, was identified in Osaka. The first case in Osaka belongs to suspect reassortment (L:C5, M:C5, S:C4), the other is genotype J1 (L: J1, M: J1, S: J1) according to the classification by a Japanese group. C5 was identified in China, indicating that C5 identified in this study may be transmitted by birds between China and Japan. This study revealed that different SFTSV genotypes were distributed in two local areas, suggesting the separate or focal transmission patterns in Osaka.
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Affiliation(s)
- Ryo Ikemori
- Virology Section, Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.I.); (I.A.); (T.S.); (K.I.); (T.Y.)
| | - Ikuko Aoyama
- Virology Section, Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.I.); (I.A.); (T.S.); (K.I.); (T.Y.)
| | - Tadahiro Sasaki
- Virology Section, Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.I.); (I.A.); (T.S.); (K.I.); (T.Y.)
- Research Institute of Microbial Diseases, Osaka University, Suita, Osaka 565-0781, Japan
| | - Hirono Takabayashi
- Fujiidera Public Health Center, Fujiidera, Osaka 583-0024, Japan;
- Ikeda Public Health Center, Ikeda, Osaka 563-0041, Japan
| | | | - Masaru Kinoshita
- Department of Health and Medical Care, Osaka Prefectural Government, Osaka 540-8570, Japan;
| | - Kazuyoshi Ikuta
- Virology Section, Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.I.); (I.A.); (T.S.); (K.I.); (T.Y.)
| | - Takahiro Yumisashi
- Virology Section, Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.I.); (I.A.); (T.S.); (K.I.); (T.Y.)
| | - Kazushi Motomura
- Virology Section, Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.I.); (I.A.); (T.S.); (K.I.); (T.Y.)
- Correspondence: ; Tel.: +81-6-6972-1321
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17
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Ra SH, Kim MJ, Kim MC, Park SY, Park SY, Chong YP, Lee SO, Choi SH, Kim YS, Lee KH, Kim SH, Kee SH. Kinetics of Serological Response in Patients with Severe Fever with Thrombocytopenia Syndrome. Viruses 2020; 13:v13010006. [PMID: 33375753 PMCID: PMC7823500 DOI: 10.3390/v13010006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 11/17/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is caused by SFTS virus (SFTSV). We investigated the detailed kinetics of serologic response in patients with SFTS. Twenty-eight patients aged ≥18 years were enrolled between July 2015 and October 2018. SFTS was confirmed by detecting SFTSV RNA in their plasma using reverse transcription polymerase chain reaction. SFTSV-specific IgG and IgM were measured using immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA). We found that SFTSV-specific IgG was detected at days 5–9 after symptom onset, and its titer was rising during the course of disease. SFTSV-specific IgM titer peaked at around week 2–3 from symptom onset. The SFTSV-specific seropositive rates for days 5–9, 10–14, 15–19, and 20–24 from symptom onset using IFA and ELISA were 63%, 76%, 90%, and 100%, and 58%, 86%, 100%, and 100%, respectively, for IgG, whereas they were 32%, 62%, 80%, and 100%, and 53%, 62%, 70%, and 100%, respectively, for IgM. The delayed IgM response could be attributed to the low sensitivity of SFTSV-specific IgM IFA or ELISA and/or impaired immune responses. The IgM test using IFA or ELISA that we used in this study is, therefore, insufficient for the early diagnosis of SFTS.
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Affiliation(s)
- Sang Hyun Ra
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Min-Chul Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Dongjak-gu, Seoul 06973, Korea;
| | - Se Yoon Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University College of Medicine, Yongsan-gu, Seoul 04401, Korea;
| | - Seong Yeon Park
- Department of Infectious Diseases, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Ilsandong-gu, Goyang-si 10326, Korea;
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Keun Hwa Lee
- Department of Microbiology, Hanyang University College of Medicine, Seongdong-gu, Seoul 04763, Korea
- Correspondence: (K.H.L.); (S.-H.K.)
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Korea; (S.H.R.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
- Correspondence: (K.H.L.); (S.-H.K.)
| | - Sun-Ho Kee
- Department of Microbiology, Korea University College of Medicine, Seongbuk-gu, Seoul 02841, Korea;
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18
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Kim M, Heo ST, Oh H, Oh S, Lee KH, Yoo JR. Prognostic Factors of Severe Fever with Thrombocytopenia Syndrome in South Korea. Viruses 2020; 13:v13010010. [PMID: 33374620 PMCID: PMC7822455 DOI: 10.3390/v13010010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), a tick-borne infectious disease, is difficult to differentiate from other common febrile diseases. Clinically distinctive features and climate variates associated with tick growth can be useful predictors for SFTS. This retrospective study (2013–2019) demonstrated the role of climatic factors as predictors of SFTS and developed a clinical scoring system for SFTS using climate variables and clinical characteristics. The presence of the SFTS virus was confirmed using reverse transcription polymerase chain reaction (RT-PCR) tests. In the univariate analysis, the SFTS-positive group was significantly associated with higher mean ambient temperature and humidity compared with the SFTS-negative group (22.5 °C vs. 18.9 °C; 77.9% vs. 70.7%, all p < 0.001). In the multivariate analysis, poor oral intake (Odds ratio [OR] 5.87, 95% CI: 2.42–8.25), lymphadenopathy (OR 7.20, 95% CI: 6.24–11.76), mean ambient temperature ≥ 20 °C (OR 4.62, 95% CI: 1.46–10.28), absolute neutrophil count ≤ 2000 cells/μL (OR 8.95, 95% CI: 2.30–21.25), C-reactive protein level ≤ 1.2 mg/dL (OR 6.42, 95% CI: 4.02–24.21), and creatinine kinase level ≥ 200 IU/L (OR 5.94, 95% CI: 1.42–24.92) were significantly associated with the SFTS-positive group. This study presents the risk factors, including ambient temperature and clinical characteristics, that physicians should consider when suspecting SFTS.
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Affiliation(s)
- Misun Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.K.); (S.T.H.); (H.O.); (S.O.)
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.K.); (S.T.H.); (H.O.); (S.O.)
- Department of Internal Medicine, College of Medicine and Graduate School of Medicine, Jeju National University, Jeju 63241, Korea
| | - Hyunjoo Oh
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.K.); (S.T.H.); (H.O.); (S.O.)
| | - Suhyun Oh
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.K.); (S.T.H.); (H.O.); (S.O.)
| | - Keun Hwa Lee
- Department of Microbiology, College of Medicine, Hanyang University, Seoul 04763, Korea;
| | - Jeong Rae Yoo
- Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea; (M.K.); (S.T.H.); (H.O.); (S.O.)
- Department of Internal Medicine, College of Medicine and Graduate School of Medicine, Jeju National University, Jeju 63241, Korea
- Correspondence: ; Tel.: +82-64-717-2833
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19
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Li XK, Dai K, Yang ZD, Yuan C, Cui N, Zhang SF, Hu YY, Wang ZB, Miao D, Zhang PH, Li H, Zhang XA, Huang YQ, Chen WW, Zhang JS, Lu QB, Liu W. Correlation between thrombocytopenia and host response in severe fever with thrombocytopenia syndrome. PLoS Negl Trop Dis 2020; 14:e0008801. [PMID: 33119592 PMCID: PMC7595704 DOI: 10.1371/journal.pntd.0008801] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 08/14/2020] [Indexed: 12/13/2022] Open
Abstract
Severe Fever with Thrombocytopenia Syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus, SFTS virus (SFTSV), with fatal outcome developed in approximately 17% of the cases. Thrombocytopenia is a hallmark feature of SFTS, and associated with a higher risk of fatal outcome, however, the pathophysiological involvement of platelet in the clinical outcome of SFTS remained under-investigated. In the current study, by retrospectively analyzing 1538 confirmed SFTS patients, we observed that thrombocytopenia was associated with enhanced activation of the cytokine network and the vascular endothelium, also with a disturbed coagulation response. The platelet phenotypes were also extensively altered in the process of thrombocytopenia development of SFTS patients. More importantly, all these disturbed host responses were related to the severity of thrombocytopenia, thus were considered to play in a synergistic way to influence the disease outcome. Moreover, the clinical effect of platelet transfusion was assessed by comparing two groups of patients with or without receiving this therapy. As a result, we observed no therapy effect in altering frequencies of fatal outcome, clinical bleeding development, or dynamic change of platelet count during the hospitalization. It’s suggested that platelet supplementation alone acted a minor role in improving disease outcome, therefore new therapeutic intervention to regulate host response should be proposed. The current results revealed some evidence of interrelationship between platelet count and clinical outcome of SFTS disease from the perspective of activation of the cytokine network, the vascular endothelium, and the coagulation/fibrinolysis system. These evaluations might help to attain a better understanding of the pathogenesis and therapy choice in SFTS. Thrombocytopenia in SFTSV is a multifactor-process involving a combination of platelet size or morphology alterations, fibrinolysis activation and coagulation abnormalities, increased inflammatory response and endothelial injury. Platelet supplementation alone shows minor role in improving disease, therefore new therapeutic intervention to regulate host response should be proposed.
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Affiliation(s)
- Xiao-Kun Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Ke Dai
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Zhen-Dong Yang
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Shihe District, Xinyang, P. R. China
| | - Chun Yuan
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Shihe District, Xinyang, P. R. China
| | - Ning Cui
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Shihe District, Xinyang, P. R. China
| | - Shao-Fei Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Yuan-Yuan Hu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Zhi-Bo Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Dong Miao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Pan-He Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Yan-Qin Huang
- The Shangcheng Center for Disease Control and Prevention, Shangcheng County, Xinyang, P. R. China
| | - Wei-Wei Chen
- Treatment and Research Center for Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Fengtai District, Beijing, P. R. China
| | - Jiu-Song Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Haidian District, Beijing, P. R. China
- * E-mail: (Q-BL); , (WL)
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
- Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing, People’s Republic of China
- * E-mail: (Q-BL); , (WL)
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20
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Huang XY, He ZQ, Wang BH, Hu K, Li Y, Guo WS. Severe fever with thrombocytopenia syndrome virus: a systematic review and meta-analysis of transmission mode. Epidemiol Infect 2020; 148:e239. [PMID: 32993819 PMCID: PMC7584033 DOI: 10.1017/s0950268820002290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a disease with a high case-fatality rate that is caused by infection with the SFTS virus (SFTSV). Five electronic databases were systematically searched to identify relevant articles published from 1 January 2011 to 1 December 2019. The pooled rates with 95% confidence interval (CI) were calculated by a fixed-effect or random-effect model analysis. The results showed that 92 articles were included in this meta-analysis. For the confirmed SFTS cases, the case-fatality rate was 0.15 (95% CI 0.11, 0.18). Two hundred and ninety-six of 1384 SFTS patients indicated that they had been bitten by ticks and the biting rate was 0.21 (95% CI 0.16, 0.26). The overall pooled seroprevalence of SFTSV antibodies among the healthy population was 0.04 (95% CI 0.03, 0.05). For the overall seroprevalence of SFTSV in animals, the seroprevalence of SFTSV was 0.25 (95% CI 0.20, 0.29). The infection rate of SFTSV in ticks was 0.08 (95% CI 0.05, 0.11). In conclusion, ticks can serve as transmitting vectors of SFTSVs and reservoir hosts. Animals can be infected by tick bites, and as a reservoir host, SFTSV circulates continuously between animals and ticks in nature. Humans are infected by tick bites and direct contact with patient secretions.
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Affiliation(s)
- X. Y. Huang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Z. Q. He
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - B. H. Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - K. Hu
- Henan Academy of Medical Sciences, Zhengzhou, China
| | - Y. Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - W. S. Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
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