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Westphal JG, Rigopoulos AG, Bakogiannis C, Ludwig SE, Mavrogeni S, Bigalke B, Doenst T, Pauschinger M, Tschöpe C, Schulze PC, Noutsias M. The MOGE(S) classification for cardiomyopathies: current status and future outlook. Heart Fail Rev 2018; 22:743-752. [PMID: 28721466 DOI: 10.1007/s10741-017-9641-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cardiomyopathies are complex diseases of multifactorial pathogenesis and have a high morbidity and mortality. Over the past decades, several revisions of classifications and definitions of cardiomyopathies have been proposed, primarily focusing on the phenotypic characterization of cardiomyopathies. The MOGE(S) classification system published in 2013 encompasses the classification of rapidly growing knowledge on genetic mutations, acquired causes (i.e., intramyocardial inflammation, viral infections), and further conditions involved in the induction of cardiomyopathies (e.g., storage diseases, toxicity). It is based on five attributes, including morphofunctional characteristics (M), organ involvement (O), genetic or familial inheritance pattern (G), etiological annotation (E), and optional information about the heart failure functional status (S). This review summarizes the development, the cornerstones of the MOGE(S) classification, and the published data on the clinical relevance of the MOGE(S) classification. We furthermore discuss new issues which might be considered for future updates of the MOGE(S) classification of cardiomyopathies.
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Affiliation(s)
- Julian G Westphal
- Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Am Klinikum, 107747, Jena, Germany
| | - Angelos G Rigopoulos
- Department of Cardiology, Leopoldina Hospital Schweinfurt, Gustav-Adolf-Strasse, 897422, Schweinfurt, Germany.,Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Straße 40, D-06120, Halle (Saale), Germany
| | - Constantinos Bakogiannis
- 3rd Department of Cardiology, Ippokrateio Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos, 4954642, Thessaloniki, Greece
| | - Sarah E Ludwig
- Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Am Klinikum, 107747, Jena, Germany
| | - Sophie Mavrogeni
- Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, Palaeo Faliro, Athens, Greece
| | - Boris Bigalke
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm, 3012200, Berlin, Germany
| | - Torsten Doenst
- Department of Cardiothoracic Surgery, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany
| | - Matthias Pauschinger
- Department of Cardiology, Internal Medicine 8, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Carsten Tschöpe
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany.,Deutsches Zentrum für Herz Kreislaufforschung (DZHK)-Standort Berlin, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany.,Berlin Center for Regenerative Therapies (BCRT), Campus Virchow Klinikum (CVK), Berlin, Germany
| | - P Christian Schulze
- Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Am Klinikum, 107747, Jena, Germany
| | - Michel Noutsias
- Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Am Klinikum, 107747, Jena, Germany. .,Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Straße 40, D-06120, Halle (Saale), Germany.
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Birdsell DN, Özsürekci Y, Rawat A, Aycan AE, Mitchell CL, Sahl JW, Johansson A, Colman RE, Schupp JM, Ceyhan M, Keim PS, Wagner DM. Coinfections identified from metagenomic analysis of cervical lymph nodes from tularemia patients. BMC Infect Dis 2018; 18:319. [PMID: 29996780 PMCID: PMC6042416 DOI: 10.1186/s12879-018-3218-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/26/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Underlying coinfections may complicate infectious disease states but commonly go unnoticed because an a priori clinical suspicion is usually required so they can be detected via targeted diagnostic tools. Shotgun metagenomics is a broad diagnostic tool that can be useful for identifying multiple microbes simultaneously especially if coupled with lymph node aspirates, a clinical matrix known to house disparate pathogens. The objective of this study was to analyze the utility of this unconventional diagnostic approach (shotgun metagenomics) using clinical samples from human tularemia cases as a test model. Tularemia, caused by the bacterium Francisella tularensis, is an emerging infectious disease in Turkey. This disease commonly manifests as swelling of the lymph nodes nearest to the entry of infection. Because swollen cervical nodes are observed from many different types of human infections we used these clinical sample types to analyze the utility of shotgun metagenomics. METHODS We conducted an unbiased molecular survey using shotgun metagenomics sequencing of DNA extracts from fine-needle aspirates of neck lymph nodes from eight tularemia patients who displayed protracted symptoms. The resulting metagenomics data were searched for microbial sequences (bacterial and viral). RESULTS F. tularensis sequences were detected in all samples. In addition, we detected DNA of other known pathogens in three patients. Both Hepatitis B virus (HBV) and Human Parvovirus B-19 were detected in one individual and Human Parvovirus B-19 alone was detected in two other individuals. Subsequent PCR coupled with Sanger sequencing verified the metagenomics results. The HBV status was independently confirmed via serological diagnostics, despite evading notice during the initial assessment. CONCLUSION Our data highlight that shotgun metagenomics of fine-needle lymph node aspirates is a promising clinical diagnostic strategy to identify coinfections. Given the feasibility of the diagnostic approach demonstrated here, further steps to promote integration of this type of diagnostic capability into mainstream clinical practice are warranted.
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Affiliation(s)
- D N Birdsell
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA.
| | - Y Özsürekci
- Department of Pediatric Infectious Disease Unit in Ankara, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - A Rawat
- Translational Genomics Research Institute, Flagstaff, AZ, USA.,Present Address: Division of Biomedical Informatics Research, Sidra Medical & Research Center, Doha, Qatar
| | - A E Aycan
- Department of Pediatric Infectious Disease Unit in Ankara, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - C L Mitchell
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA.,Present Address: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - J W Sahl
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - A Johansson
- Department of Clinical Microbiology and Laboratory for Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - R E Colman
- Translational Genomics Research Institute, Flagstaff, AZ, USA.,Present address: Department of Medicine, University of California, San Diego, California, USA
| | - J M Schupp
- Translational Genomics Research Institute, Flagstaff, AZ, USA
| | - M Ceyhan
- Department of Pediatric Infectious Disease Unit in Ankara, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - P S Keim
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA.,Translational Genomics Research Institute, Flagstaff, AZ, USA
| | - D M Wagner
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
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53
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Ancient human parvovirus B19 in Eurasia reveals its long-term association with humans. Proc Natl Acad Sci U S A 2018; 115:7557-7562. [PMID: 29967156 DOI: 10.1073/pnas.1804921115] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Human parvovirus B19 (B19V) is a ubiquitous human pathogen associated with a number of conditions, such as fifth disease in children and arthritis and arthralgias in adults. B19V is thought to evolve exceptionally rapidly among DNA viruses, with substitution rates previously estimated to be closer to those typical of RNA viruses. On the basis of genetic sequences up to ∼70 years of age, the most recent common ancestor of all B19V has been dated to the early 1800s, and it has been suggested that genotype 1, the most common B19V genotype, only started circulating in the 1960s. Here we present 10 genomes (63.9-99.7% genome coverage) of B19V from dental and skeletal remains of individuals who lived in Eurasia and Greenland from ∼0.5 to ∼6.9 thousand years ago (kya). In a phylogenetic analysis, five of the ancient B19V sequences fall within or basal to the modern genotype 1, and five fall basal to genotype 2, showing a long-term association of B19V with humans. The most recent common ancestor of all B19V is placed ∼12.6 kya, and we find a substitution rate that is an order of magnitude lower than inferred previously. Further, we are able to date the recombination event between genotypes 1 and 3 that formed genotype 2 to ∼5.0-6.8 kya. This study emphasizes the importance of ancient viral sequences for our understanding of virus evolution and phylogenetics.
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54
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Sotiriou E, Heiner S, Jansen T, Brandt M, Schmidt KH, Kreitner KF, Emrich T, Schultheiss HP, Schulz E, Münzel T, Wenzel P. Therapeutic implications of a combined diagnostic workup including endomyocardial biopsy in an all-comer population of patients with heart failure: a retrospective analysis. ESC Heart Fail 2018; 5:630-641. [PMID: 29745463 PMCID: PMC6073026 DOI: 10.1002/ehf2.12296] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/14/2018] [Accepted: 03/29/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Aetiology of heart failure (HF) often remains obscure. We therefore evaluated the usefulness of a combined diagnostic approach including cardiac magnetic resonance imaging (CMRI) and endomyocardial biopsy (EMB) to assess the cause of unexplained cardiomyopathy underlying HF. METHODS AND RESULTS We retrospectively investigated 100 consecutive patients (36% women, mean age 53.6 ± 18.8 years) presenting with unexplained cardiomyopathy (HF with reduced ejection fraction or left ventricular hypertrophy; excluding ischaemic and valvular heart disease; left ventricular ejection fraction 31.6 ± 13.9%, Left ventricular end-diastolic pressure 18.2 ± 9.3 mmHg, heart rate 89 ± 26.6 b.p.m.; mean ± SEM) at the University Medical Center Mainz. We performed electrocardiography, echocardiography, CMRI, and cardiac catheterization with EMB analysed at a Food and Drug Administration-approved reference centre in 100%, 94%, 69%, and 100% of patients, respectively. On the basis of CMRI findings, electrocardiography, echocardiography, and medical history, the exact cause of cardiomyopathy remained uncertain in 37 of 69 cases (53.6%). In EMB, 25% of patients had viral replication, 23% had inflammation defined as lymphocytic infiltrations without active virus replication, 1% had giant cell myocarditis, and 1% had eosinophilic myocarditis. After diagnostic workup including EMB findings, the cause of cardiomyopathy remained unidentified in 14% of the cases, classified as idiopathic dilated cardiomyopathy or hypertrophic cardiomyopathy in 10% or 4%, respectively. EMB helped to discuss a causal treatment strategy of HF involving immunosuppression or antiviral treatment in 53% of patients, which was opted for in 12% of the patients. CONCLUSIONS A comprehensive workup including imaging and EMB in an all-comer population of patients with HF may help physicians to improve diagnostics of unexplained cardiomyopathy in the majority of cases.
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Affiliation(s)
- Efthymios Sotiriou
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Susanne Heiner
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Thomas Jansen
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Moritz Brandt
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Berlin, Germany.,Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Kai Helge Schmidt
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Karl-Friedrich Kreitner
- Clinic for Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Tilman Emrich
- Clinic for Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Heinz-Peter Schultheiss
- IKDT Institut Kardiale Diagnostik und Therapie GmbH, Moltkestraße 31, 12203, Berlin, Germany
| | - Eberhard Schulz
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Berlin, Germany
| | - Philip Wenzel
- Center for Cardiology, Cardiology 1, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Berlin, Germany.,Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
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55
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Jain A, Kant R. Genotypes of erythrovirus B19, their geographical distribution & circulation in cases with various clinical manifestations. Indian J Med Res 2018; 147:239-247. [PMID: 29923512 PMCID: PMC6022381 DOI: 10.4103/ijmr.ijmr_1816_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Indexed: 11/16/2022] Open
Abstract
Erythrovirus B19 (B19V) is one of the erythroviruses known to be pathogenic in humans. B19V is classified into three distinct genotypes; 1, 2 and 3, differing from each other by 2-13 per cent. Genotype 1 consists of the prototype B19V isolates, genotype 2 comprises the A6, LaLi and their related isolates while genotype 3 includes the V9- and V9-related isolates. The classification of genotype 1 into two subtypes (1A and 1B) and genotype 3 into two subtypes (3a and 3b) with an estimated nucleotide difference of about 5 per cent has been done. Predominance of genotype 1 across all the continents is seen followed by genotypes 2 and 3. There are no disease-specific genotypes. All the three genotypes have been found in symptomatic as well as asymptomatic individuals and have been reported from several countries across the world. The prevalence of genotype 2 in older populations and its absence from current circulation in Northern Europe has also been reported. The present review focuses on geographic distribution and association of genotypes of B19V with different clinical manifestations.
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Affiliation(s)
- Amita Jain
- Department of Microbiology, K.G. Medical University, Lucknow, India
| | - Ravi Kant
- Former Vice-Chancellor, K.G. Medical University, Lucknow, India
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56
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Immunohistochemical Demonstration of Parvovirus B19 Viral Protein 2 in Periflexural Exanthema in an Adult, Supporting Antibody-Dependent Enhancement as Means of Endothelial Uptake of the Virus. Am J Dermatopathol 2018; 40:e19-e24. [DOI: 10.1097/dad.0000000000000946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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57
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Juhl D, Hennig H. Parvovirus B19: What Is the Relevance in Transfusion Medicine? Front Med (Lausanne) 2018; 5:4. [PMID: 29450198 PMCID: PMC5799219 DOI: 10.3389/fmed.2018.00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/09/2018] [Indexed: 01/17/2023] Open
Abstract
Parvovirus B19 (B19V) has been discovered in 1975. The association with a disease was unclear in the first time after the discovery of B19V, but meanwhile, the usually droplet transmitted B19V is known as the infectious agent of the “fifth disease,” a rather harmless children’s illness. But B19V infects erythrocyte progenitor cells and thus, acute B19V infection in patients with a high erythrocyte turnover may lead to a life-threatening aplastic crisis, and acutely infected pregnant women can transmit B19V to their unborn child, resulting in a hydrops fetalis and fetal death. However, in many adults, B19V infection goes unnoticed and thus many blood donors donate blood despite the infection. The B19V infection does not impair the blood cell counts in healthy blood donors, but after the acute infection with extremely high DNA concentrations exceeding 1010 IU B19V DNA/ml plasma is resolved, B19V DNA persists in the plasma of blood donors at low levels for several years. That way, many consecutive donations that contain B19V DNA can be taken from a single donor, but the majority of blood products from donors with detectable B19V DNA seem not to be infectious for the recipients from several reasons: first, many recipients had undergone a B19V infection in the past and have formed protective antibodies. Second, B19V DNA concentration in the blood product is often too low to infect the recipient. Third, after the acute infection, the presence of B19V DNA in the donor is accompanied by presumably neutralizing antibodies which are protective also for the recipient of his blood products. Thus, transfusion-transmitted (TT-) B19V infections are very rarely reported. Moreover, in most blood donors, B19V DNA concentration is below 1,000 IU/ml plasma, and no TT-B19V infections have been found by such low-viremic donations. Cutoff for an assay for B19V DNA blood donor screening should, therefore, be approximately 1,000 IU/ml plasma, if a general screening of blood donors for single donation blood components is considered at all: for the overwhelming majority of transfusion recipients, B19V infection is not relevant as well as for the blood donors. B19V DNA screening of vulnerable patients after transfusion seems to be a more reasonable approach than general blood donor screening.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Holger Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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58
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Bustamante Rivera YY, Brütting C, Schmidt C, Volkmer I, Staege MS. Endogenous Retrovirus 3 - History, Physiology, and Pathology. Front Microbiol 2018; 8:2691. [PMID: 29379485 PMCID: PMC5775217 DOI: 10.3389/fmicb.2017.02691] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/26/2017] [Indexed: 01/05/2023] Open
Abstract
Endogenous viral elements (EVE) seem to be present in all eukaryotic genomes. The composition of EVE varies between different species. The endogenous retrovirus 3 (ERV3) is one of these elements that is present only in humans and other Catarrhini. Conservation of ERV3 in most of the investigated Catarrhini and the expression pattern in normal tissues suggest a putative physiological role of ERV3. On the other hand, ERV3 has been implicated in the pathogenesis of auto-immunity and cancer. In the present review we summarize knowledge about this interesting EVE. We propose the model that expression of ERV3 (and probably other EVE loci) under pathological conditions might be part of a metazoan SOS response.
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Affiliation(s)
| | - Christine Brütting
- Department of Paediatrics I, Martin Luther University Halle-Wittenberg, Halle, Germany.,Department of Neurology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Caroline Schmidt
- Department of Paediatrics I, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Ines Volkmer
- Department of Paediatrics I, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Martin S Staege
- Department of Paediatrics I, Martin Luther University Halle-Wittenberg, Halle, Germany
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59
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Jain A, Jain P, Kumar A, Prakash S, Khan DN, Kant R. Incidence and progression of Parvovirus B19 infection and molecular changes in circulating B19V strains in children with haematological malignancy: A follow up study. INFECTION GENETICS AND EVOLUTION 2017; 57:177-184. [PMID: 29170063 DOI: 10.1016/j.meegid.2017.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/11/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
Abstract
The present study was planned to estimate the incidence of human Parvovirus B19 infection and understand its progression in children suffering with hematological malignancy. The circulating B19V genotypes and viral mutations occurring in strains of B19V over one-year period were also studied. Children with malignancies were enrolled consecutively and were followed up for one-year period. Serum sample was collected at the time of enrolment and each follow up visit and was tested for anti B19V IgG and IgM as well as for B19V DNA. At least one B19V DNA positive sample from each patient was processed for sequencing. For patients positive for B19V DNA >1 time and at least 6 months apart, last positive sample from the same patient was also sequenced to study the nucleotide change over time. We have found very high incidence of B19V infection (100%) in the study population. All the patients tested positive for at least one B19V infection parameter (either antibodies or DNA) at least once, over one year of follow up. Cumulative percent positivity of anti B19V IgG, anti B19V IgM and B19V DNA was 85.3%, 45.2% and 72.1% respectively. Genotype 3b was reported, with occasional nucleotide change over one year period. DNA clearance was delayed in spite of appearance of IgG antibodies. Appearance of IgM class of antibodies was either delayed or absent. To conclude, children with haematological malignancies have high incidence of B19V infection with late and short lived serological response and persistence of DNA for long duration.
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Affiliation(s)
- Amita Jain
- Department of Microbiology, King George's Medical University, Lucknow, UP, India.
| | - Parul Jain
- Department of Microbiology, King George's Medical University, Lucknow, UP, India
| | - Archana Kumar
- Department of Paediatrics, King George's Medical University, Lucknow, UP, India
| | - Shantanu Prakash
- Department of Microbiology, King George's Medical University, Lucknow, UP, India
| | - Danish Nasar Khan
- Department of Microbiology, King George's Medical University, Lucknow, UP, India
| | - Ravi Kant
- Vice Chancellor (ex), King George's Medical University, Lucknow, UP, India
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60
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Söderlund-Venermo M. Clinical significance of parvovirus B19 DNA in cutaneous biopsies. Br J Dermatol 2017; 177:900-901. [DOI: 10.1111/bjd.15811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- M. Söderlund-Venermo
- Department of Virology; University of Helsinki; Haartmaninkatu 3 Helsinki 00290 Finland
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61
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Bua G, Gallinella G. How does parvovirus B19 DNA achieve lifelong persistence in human cells? Future Virol 2017. [DOI: 10.2217/fvl-2017-0079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Gloria Bua
- Department of Pharmacy & Biotechnology, University of Bologna, Bologna, Italy
| | - Giorgio Gallinella
- Department of Pharmacy & Biotechnology, University of Bologna, Bologna, Italy
- S.Orsola-Malpighi Hospital – Microbiology, Via Massarenti, 9, I-40138 Bologna, Italy
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62
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Santonja C, Santos-Briz A, Palmedo G, Kutzner H, Requena L. Detection of human parvovirus B19 DNA in 22% of 1815 cutaneous biopsies of a wide variety of dermatological conditions suggests viral persistence after primary infection and casts doubts on its pathogenic significance. Br J Dermatol 2017; 177:1060-1065. [DOI: 10.1111/bjd.15382] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 12/21/2022]
Affiliation(s)
- C. Santonja
- Department of Pathology; Hospital Universitario Fundación Jiménez Díaz; Madrid Spain
| | - A. Santos-Briz
- Departments of Pathology and Dermatology; Hospital Universitario de Salamanca; Salamanca Spain
| | - G. Palmedo
- Dermatopathologie Friedrichshafen; Friedrichshafen Germany
| | - H. Kutzner
- Dermatopathologie Friedrichshafen; Friedrichshafen Germany
| | - L. Requena
- Department of Dermatology; Hospital Universitario Fundación Jiménez Díaz/Universidad Autónoma de Madrid; Madrid Spain
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63
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McEndaffer L, Molesan A, Erb H, Kelly K. Feline Panleukopenia Virus Is Not Associated With Myocarditis or Endomyocardial Restrictive Cardiomyopathy in Cats. Vet Pathol 2017; 54:669-675. [PMID: 28622497 PMCID: PMC10956504 DOI: 10.1177/0300985817695516] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Canine parvovirus-2 (CPV-2) is nearly indistinguishable from feline panleukopenia virus (FPV) and is a well-known cause of viral myocarditis in young puppies; however, it is not known whether either FPV or CPV-2 naturally infects feline cardiomyocytes and causes myocarditis. Endomyocarditis (EMC) and left ventricular endomyocardial fibrosis (LVEF), clinically known as "endomyocardial restrictive cardiomyopathy," are important feline heart diseases suspected to have an infectious etiology. A continuum is suggested with EMC representing the acute reaction to an unknown infectious agent and LVEF the chronic manifestation of repair. The purpose of this study was to determine (1) whether there is natural parvovirus infection of the feline myocardium and (2) whether parvoviral infection is associated with feline EMC and/or LVEF. In a retrospective study, polymerase chain reaction and sequencing for the parvovirus VP1/2 gene was performed on archived heart tissue from cats with endomyocardial disease and controls. Similar methods were used prospectively on myocardial tissues from shelter-source kittens. Although 8 of 36 (22%; 95% confidence interval [CI], 11%-40%) shelter kittens had parvoviral DNA in myocardial tissue, VP1/2 DNA was not detected in 33 adult cases or 34 controls (95% CI, 0% to ∼11%). These findings were confirmed by in situ hybridization: adult cats did not have detectable parvovirus DNA, although rare intranuclear signal was confirmed in 7 of 8 shelter-source kittens. In kittens, parvovirus was not significantly associated with myocarditis, and in situ hybridization signal did not colocalize with inflammation. Although infection of cardiomyocytes was demonstrated in kittens, these data do not support a role for parvovirus in EMC-LVEF.
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Affiliation(s)
- Laura McEndaffer
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Alex Molesan
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Hollis Erb
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Kathleen Kelly
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Extinct type of human parvovirus B19 persists in tonsillar B cells. Nat Commun 2017; 8:14930. [PMID: 28374737 PMCID: PMC5382274 DOI: 10.1038/ncomms14930] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/14/2017] [Indexed: 01/06/2023] Open
Abstract
Parvovirus B19 (B19V) DNA persists lifelong in human tissues, but the cell type harbouring it remains unclear. We here explore B19V DNA distribution in B, T and monocyte cell lineages of recently excised tonsillar tissues from 77 individuals with an age range of 2–69 years. We show that B19V DNA is most frequent and abundant among B cells, and within them we find a B19V genotype that vanished from circulation >40 years ago. Since re-infection or re-activation are unlikely with this virus type, this finding supports the maintenance of pathogen-specific humoral immune responses as a consequence of B-cell long-term survival rather than continuous replenishment of the memory pool. Moreover, we demonstrate the mechanism of B19V internalization to be antibody dependent in two B-cell lines as well as in ex vivo isolated tonsillar B cells. This study provides direct evidence for a cell type accountable for B19V DNA tissue persistence. The cell type that hosts parvovirus B19 (B19V) DNA lifelong is currently unknown. Here, the authors identify tonsillar B cells as a reservoir, detect an extinct B19V type in older adults, supporting a long-term association, and show that B19V uptake into B cells is antibody dependent.
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Matthews PC, Sharp C, Simmonds P, Klenerman P. Human parvovirus 4 'PARV4' remains elusive despite a decade of study. F1000Res 2017; 6:82. [PMID: 28184291 PMCID: PMC5288687 DOI: 10.12688/f1000research.9828.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 12/16/2022] Open
Abstract
Human parvovirus 4 ('PARV4') is a small DNA tetraparvovirus, first reported in 2005. In some populations, PARV4 infection is uncommon, and evidence of exposure is found only in individuals with risk factors for parenteral infection who are infected with other blood-borne viruses. In other settings, seroprevalence studies suggest an endemic, age-associated transmission pattern, independent of any specific risk factors. The clinical impact of PARV4 infection remains uncertain, but reported disease associations include an influenza-like syndrome, encephalitis, acceleration of HIV disease, and foetal hydrops. In this review, we set out to report progress updates from the recent literature, focusing on the investigation of cohorts in different geographical settings, now including insights from Asia, the Middle East, and South America, and discussing whether attributes of viral or host populations underpin the striking differences in epidemiology. We review progress in understanding viral phylogeny and biology, approaches to diagnostics, and insights that might be gained from studies of closely related animal pathogens. Crucial questions about pathogenicity remain unanswered, but we highlight new evidence supporting a possible link between PARV4 and an encephalitis syndrome. The unequivocal evidence that PARV4 is endemic in certain populations should drive ongoing research efforts to understand risk factors and routes of transmission and to gain new insights into the impact of this virus on human health.
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Affiliation(s)
- Philippa C Matthews
- Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - Colin Sharp
- Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK
| | - Paul Klenerman
- Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK; Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK; NIHR Biomedical Research Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
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Abstract
Parvovirus B19 (B19V) and human bocavirus 1 (HBoV1), members of the large Parvoviridae family, are human pathogens responsible for a variety of diseases. For B19V in particular, host features determine disease manifestations. These viruses are prevalent worldwide and are culturable in vitro, and serological and molecular assays are available but require careful interpretation of results. Additional human parvoviruses, including HBoV2 to -4, human parvovirus 4 (PARV4), and human bufavirus (BuV) are also reviewed. The full spectrum of parvovirus disease in humans has yet to be established. Candidate recombinant B19V vaccines have been developed but may not be commercially feasible. We review relevant features of the molecular and cellular biology of these viruses, and the human immune response that they elicit, which have allowed a deep understanding of pathophysiology.
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Affiliation(s)
- Jianming Qiu
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Neal S Young
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Molenaar-de Backer M, Russcher A, Kroes A, Koppelman M, Lanfermeijer M, Zaaijer H. Detection of parvovirus B19 DNA in blood: Viruses or DNA remnants? J Clin Virol 2016; 84:19-23. [DOI: 10.1016/j.jcv.2016.09.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/02/2016] [Accepted: 09/12/2016] [Indexed: 02/02/2023]
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Jia J, Ma Y, Zhao X, Huangfu C, Zhong Y, Fang C, Fan R, Lv M, Zhang J. Existence of various human parvovirus B19 genotypes in Chinese plasma pools: genotype 1, genotype 3, putative intergenotypic recombinant variants and new genotypes. Virol J 2016; 13:155. [PMID: 27639978 PMCID: PMC5027099 DOI: 10.1186/s12985-016-0611-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/09/2016] [Indexed: 12/31/2022] Open
Abstract
Background Human parvovirus B19 (B19V) is a frequent contaminant of blood and plasma-derived medicinal products. Three distinct genotypes of B19V have been identified. The distribution of the three B19V genotypes has been investigated in various regions or countries. However, in China, data on the existence of different B19V genotypes are limited. Methods One hundred and eighteen B19V-DNA positive source plasma pool samples collected from three Chinese blood products manufacturers were analyzed. The subgenomic NS1/VP1u region junction of B19V was amplified by nested PCR. These amplified products were then cloned and subsequently sequenced. For genotyping, their phylogenetic inferences were constructed based on the NS1/VP1-unique region. Then putative recombination events were analyzed and identified. Results Phylogenetic analysis of 118 B19V sequences attributed 61.86 % to genotype 1a, 10.17 % to genotype 1b, and 17.80 % to genotype 3b. All the genotype 3b sequences obtained in this study grouped as a specific, closely related cluster with B19V strain D91.1. Four 1a/3b recombinants and 5 new atypical B19V variants with no recombination events were identified. Conclusions There were at least 3 subtypes (1a, 1b and 3b) of B19V circulating in China. Furthermore, putative B19V 1a/3b recombinants and unclassified strains were identified as well. Such recombinant and unclassified strains may contribute to the genetic diversity of B19V and consequently complicate the B19V infection diagnosis and NAT screening. Further studies will be required to elucidate the biological significance of the recombinant and unclassified strains. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0611-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Junting Jia
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Yuyuan Ma
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China.
| | - Xiong Zhao
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Chaoji Huangfu
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Yadi Zhong
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Chi Fang
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Rui Fan
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Maomin Lv
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China
| | - Jingang Zhang
- Laboratory for Viral Safety of National Centre of Biomedical Analysis, Beijing Institute of Transfusion Medicine, No. 27 Taiping road, Haidian District, Beijing, 100850, China.
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Hokynar K, Sormunen JJ, Vesterinen EJ, Partio EK, Lilley T, Timonen V, Panelius J, Ranki A, Puolakkainen M. Chlamydia-Like Organisms (CLOs) in Finnish Ixodes ricinus Ticks and Human Skin. Microorganisms 2016; 4:E28. [PMID: 27681922 PMCID: PMC5039588 DOI: 10.3390/microorganisms4030028] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 01/16/2023] Open
Abstract
Ticks carry several human pathogenic microbes including Borreliae and Flavivirus causing tick-born encephalitis. Ticks can also carry DNA of Chlamydia-like organisms (CLOs). The purpose of this study was to investigate the occurrence of CLOs in ticks and skin biopsies taken from individuals with suspected tick bite. DNA from CLOs was detected by pan-Chlamydiales-PCR in 40% of adult ticks from southwestern Finland. The estimated minimal infection rate for nymphs and larvae (studied in pools) was 6% and 2%, respectively. For the first time, we show CLO DNA also in human skin as 68% of all skin biopsies studied contained CLO DNA as determined through pan-Chlamydiales-PCR. Sequence analyses based on the 16S rRNA gene fragment indicated that the sequences detected in ticks were heterogeneous, representing various CLO families; whereas the majority of the sequences from human skin remained "unclassified Chlamydiales" and might represent a new family-level lineage. CLO sequences detected in four skin biopsies were most closely related to "uncultured Chlamydial bacterium clones from Ixodes ricinus ticks" and two of them were very similar to CLO sequences from Finnish ticks. These results suggest that CLO DNA is present in human skin; ticks carry CLOs and could potentially transmit CLOs to humans.
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Affiliation(s)
- Kati Hokynar
- Department of Virology, Hartman institute, University of Helsinki, Helsinki 00014, Finland.
| | - Jani J Sormunen
- Department of Biology, University of Turku, Turku 20014, Finland.
| | - Eero J Vesterinen
- Department of Biology, University of Turku, Turku 20014, Finland.
- Department of Agricultural Sciences, University of Helsinki, Helsinki 00014, Finland.
| | - Esa K Partio
- Medical Center Söder, Söderkulla 01150, Finland.
| | - Thomas Lilley
- Biology Department, Bucknell University, Lewisburg, PA 17837, USA.
| | - Veera Timonen
- Department of Virology, Hartman institute, University of Helsinki, Helsinki 00014, Finland.
| | - Jaana Panelius
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00250, Finland.
| | - Annamari Ranki
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00250, Finland.
| | - Mirja Puolakkainen
- Department of Virology, Hartman institute, University of Helsinki, Helsinki 00014, Finland.
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Ivanova SK, Mihneva ZG, Toshev AK, Kovaleva VP, Andonova LG, Muller CP, Hübschen JM. Insights into epidemiology of human parvovirus B19 and detection of an unusual genotype 2 variant, Bulgaria, 2004 to 2013. ACTA ACUST UNITED AC 2016; 21:30116. [PMID: 26847955 DOI: 10.2807/1560-7917.es.2016.21.4.30116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 11/12/2015] [Indexed: 11/20/2022]
Abstract
The present study aimed to determine the role of human parvovirus В19 (B19V) as an aetiological agent in measles and rubella negative fever/rash patients from Bulgaria between 2004 and 2013. A total of 1,266 sera from all over the country were tested for B19V IgM antibodies and all positives were further investigated by polymerase chain reaction (PCR). Overall, 280 sera (22%) were B19V IgM positive and 227 of these (81%) were also PCR positive. The highest number of IgM positives was found among five to nine year-old children (27%). Eight infected women gave birth to healthy children; one fetus was aborted with hydrops fetalis. Of the 55 genetic sequences obtained, 54 belonged to genotype 1a and one grouped as a genotype 2 outlier. Phylogenetic analysis of all available genotype 2 sequences covering the 994 nucleotide non-structural protein 1(NS1)/capsid viral protein 1 (VP1) unique region junction, showed that only one other sequence grouped with the outlier strain, forming a clearly distinct and well-supported cluster of genotype 2 (between-group genetic distance: 3.32%). In accordance with B19V nomenclature, this cluster may represent a new subgenotype 2b. The study showed that B19V infections may be falsely identified as rubella or measles in ca 22% of cases, emphasising the need for laboratory confirmation.
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Affiliation(s)
- Stefka Krumova Ivanova
- National Center of Infectious and Parasitic Diseases, Department Virology, National Reference Laboratory of Measles, Mumps and Rubella, Sofia, Bulgaria
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Phan TG, Dreno B, da Costa AC, Li L, Orlandi P, Deng X, Kapusinszky B, Siqueira J, Knol AC, Halary F, Dantal J, Alexander KA, Pesavento PA, Delwart E. A new protoparvovirus in human fecal samples and cutaneous T cell lymphomas (mycosis fungoides). Virology 2016; 496:299-305. [PMID: 27393975 DOI: 10.1016/j.virol.2016.06.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 02/07/2023]
Abstract
We genetically characterized seven nearly complete genomes in the protoparvovirus genus from the feces of children with diarrhea. The viruses, provisionally named cutaviruses (CutaV), varied by 1-6% nucleotides and shared ~76% and ~82% amino acid identity with the NS1 and VP1 of human bufaviruses, their closest relatives. Using PCR, cutavirus DNA was found in 1.6% (4/245) and 1% (1/100) of diarrhea samples from Brazil and Botswana respectively. In silico analysis of pre-existing metagenomics datasets then revealed closely related parvovirus genomes in skin biopsies from patients with epidermotropic cutaneous T-cell lymphoma (CTCL or mycosis fungoides). PCR of skin biopsies yielded cutavirus DNA in 4/17 CTCL, 0/10 skin carcinoma, and 0/21 normal or noncancerous skin biopsies. In situ hybridization of CTCL skin biopsies detected viral genome within rare individual cells in regions of neoplastic infiltrations. The influence of cutavirus infection on human enteric functions and possible oncolytic role in CTCL progression remain to be determined.
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Affiliation(s)
- Tung G Phan
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Brigitte Dreno
- Department of Dermatology, Nantes University Hospital, INSERM U 892, Nantes, France.
| | - Antonio Charlys da Costa
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Institute of Tropical Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Linlin Li
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California at San Francisco, San Francisco, CA, USA
| | | | - Xutao Deng
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Beatrix Kapusinszky
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Juliana Siqueira
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Anne-Chantal Knol
- Department of Dermatology, Nantes University Hospital, INSERM U 892, Nantes, France
| | - Franck Halary
- Institute for Transplantation/Urology and Nephrology, Nantes University Hospital, Nantes F44093, France; INSERM, UMR 1064-Center for Research in Transplantation and Immunology, Nantes F44093, France; University of Nantes, Nantes F44093, France
| | - Jacques Dantal
- Department of Nephrology, Clinical Immunology, Transplantation, Nantes University Hospital, Nantes, France
| | - Kathleen A Alexander
- Department of Fisheries and Wildlife Conservation, Virginia Tech, Blacksburg, VA, USA; CARACAL, Centre for African Resources: Animals, Communities, and Land Use, Kasane, Botswana
| | - Patricia A Pesavento
- Department of Pathology, Microbiology and Immunology, University of California, Davis, CA, USA
| | - Eric Delwart
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California at San Francisco, San Francisco, CA, USA.
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Abstract
ABSTRACT
Primary parvovirus B19 infection is an infrequent, but serious and treatable, cause of chronic anemia in immunocompromised hosts. Many compromised hosts have preexisting antibody to B19 and are not at risk. However, upon primary infection, some patients may be able to mount a sufficient immune response to terminate active parvovirus B19 infection of erythroid precursors. The most common consequence of B19 infection in the compromised host is pure red-cell aplasia, resulting in chronic or recurrent anemia with reticulocytopenia. Anemia persists until neutralizing antibody is either produced by the host or passively administered. Parvovirus B19 should be suspected in compromised hosts with unexplained or severe anemia and reticulocytopenia, or when bone-marrow examination shows either giant pronormoblasts or absence of red-cell precursors. Diagnosis is established by detection of B19 DNA in serum in the absence of IgG antibody to B19. In some cases, IgG antibody is detected but is not neutralizing. Anti-B19 IgM may or may not be present. Therapy includes any or all of the following: red-cell transfusion, adjustment in medications to restore or improve the patient’s immune system, and administration of intravenous immunoglobulin (IVIG). Following treatment, patients should be closely monitored, especially if immunosuppression is unchanged or increased. Should hematocrit trend downward and parvovirus DNA trend upward, the therapeutic options above should be revisited. In a few instances, monthly maintenance IVIG may be indicated. Caregivers should be aware that B19 variants, though rarely encountered, can be missed or under-quantitated by some real-time polymerase-chain reaction methods.
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Dominguez F, Kühl U, Pieske B, Garcia-Pavia P, Tschöpe C. Actualización sobre miocarditis y miocardiopatía inflamatoria: el resurgir de la biopsia endomiocárdica. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.10.018] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Dominguez F, Kühl U, Pieske B, Garcia-Pavia P, Tschöpe C. Update on Myocarditis and Inflammatory Cardiomyopathy: Reemergence of Endomyocardial Biopsy. ACTA ACUST UNITED AC 2016; 69:178-87. [PMID: 26795929 DOI: 10.1016/j.rec.2015.10.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 10/14/2015] [Indexed: 12/31/2022]
Abstract
Myocarditis is defined as an inflammatory disease of the heart muscle and is an important cause of acute heart failure, sudden death, and dilated cardiomyopathy. Viruses account for most cases of myocarditis or inflammatory cardiomyopathy, which could induce an immune response causing inflammation even when the pathogen has been cleared. Other etiologic agents responsible for myocarditis include drugs, toxic substances, or autoimmune conditions. In the last few years, advances in noninvasive techniques such as cardiac magnetic resonance have been very useful in supporting diagnosis of myocarditis, but toxic, infectious-inflammatory, infiltrative, or autoimmune processes occur at a cellular level and only endomyocardial biopsy can establish the nature of the etiological agent. Furthermore, after the generalization of immunohistochemical and viral genome detection techniques, endomyocardial biopsy provides a definitive etiological diagnosis that can lead to specific treatments such as antiviral or immunosuppressive therapy. Endomyocardial biopsy is not commonly performed for the diagnosis of myocarditis due to safety reasons, but both right- and left endomyocardial biopsies have very low complication rates when performed by experienced operators. This document provides a state-of-the-art review of myocarditis and inflammatory cardiomyopathy, with special focus on the role of endomyocardial biopsy to establish specific treatments.
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Affiliation(s)
- Fernando Dominguez
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Mahadahonda, Madrid, Spain; Department of Cardiology, Charité Campus Virchow Klinikum (CVK), Berlin, Germany.
| | - Uwe Kühl
- Department of Cardiology, Charité Campus Virchow Klinikum (CVK), Berlin, Germany
| | - Burkert Pieske
- Department of Cardiology, Charité Campus Virchow Klinikum (CVK), Berlin, Germany; Department of Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Pablo Garcia-Pavia
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Mahadahonda, Madrid, Spain
| | - Carsten Tschöpe
- Department of Cardiology, Charité Campus Virchow Klinikum (CVK), Berlin, Germany; Berliner Zentrum für Regenerative Therapien (BCRT), Campus Virchow Klinikum (CVK), Berlin, Germany; Deutsches Zentrum für Herz Kreislaufforschung (DZHK), Berlin/Charité, Berlin, Germany
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Servant-Delmas A, Morinet F. Update of the human parvovirus B19 biology. Transfus Clin Biol 2016; 23:5-12. [PMID: 26778837 DOI: 10.1016/j.tracli.2015.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Indexed: 12/13/2022]
Abstract
Since its discovery, the human parvovirus B19 (B19V) has been associated with many clinical situations in addition to the prototype clinical manifestations, i.e. erythema infectiosum and erythroblastopenia crisis. The clinical significance of the viral B19V DNA persistence in sera after acute infection remains largely unknown. Such data may constitute a new clinical entity and is discussed in this manuscript. In 2002, despite the genetic diversity among B19V viruses has been reported to be very low, the description of markedly distinct sequences showed a new organization into three genotypes. The most recent common ancestor for B19V genotypes was estimated at early 1800s. B19V replication is enhanced by hypoxia and this might to explain the high viral load detected by quantitative PCR in the sera of infected patients. The minimum infectious dose necessary to transmit B19V infection by the transfusion of labile blood products remains unclear. At the opposite, the US Food and Drug Administration proposed a limit of 10(4)IU/mL of viral DNA in plasma pools used for the production of plasma derivatives. Recently, a new human parvovirus (PARV4) has been discovered. The consequences on blood transfusion of this blood-borne agent and its pathogenicity are still unknown.
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Affiliation(s)
- A Servant-Delmas
- Institut national de la transfusion sanguine (INTS), département d'études des agents transmissibles par le sang, Centre national de référence des hépatites virales B et C et du VIH en transfusion, Paris, France
| | - F Morinet
- Pôle biologie-pathologie-physiologie, CHU Saint-Louis, AP-HP, 75010 Paris, France.
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Bones hold the key to DNA virus history and epidemiology. Sci Rep 2015; 5:17226. [PMID: 26611279 PMCID: PMC4661702 DOI: 10.1038/srep17226] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 10/27/2015] [Indexed: 12/11/2022] Open
Abstract
DNA in human skeletal remains represents an important historical source of host genomic information and potentially of infecting viruses. However, little is known about viral persistence in bone. We searched ca. 70-year-old long bones of putative Finnish casualties from World War II for parvovirus B19 (B19V) DNA, and found a remarkable prevalence of 45%. The viral sequences were exclusively of genotypes 2 (n = 41), which disappeared from circulation in 1970´s, or genotype 3 (n = 2), which has never been reported in Northern Europe. Based on mitochondrial and Y-chromosome profiling, the two individuals carrying B19V genotype 3 were likely from the Soviet Red Army. The most recent common ancestor for all genotypes was estimated at early 1800s. This work demonstrates the forms of B19V that circulated in the first half of the 20th century and provides the first evidence of the suitability of bone for exploration of DNA viruses.
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Page C, François C, Goëb V, Duverlie G. Human parvovirus B19 and autoimmune diseases. Review of the literature and pathophysiological hypotheses. J Clin Virol 2015; 72:69-74. [DOI: 10.1016/j.jcv.2015.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/04/2015] [Accepted: 09/22/2015] [Indexed: 10/23/2022]
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Granzyme B mediated function of Parvovirus B19-specific CD4(+) T cells. Clin Transl Immunology 2015; 4:e39. [PMID: 26246896 PMCID: PMC4524951 DOI: 10.1038/cti.2015.13] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 12/31/2022] Open
Abstract
A novel conception of CD4(+) T cells with cytolytic potential (CD4(+) CTL) is emerging. These cells appear to have a part in controlling malignancies and chronic infections. Human parvovirus B19 can cause a persistent infection, yet no data exist on the presence of B19-specific CD4(+) CTLs. Such cells could have a role in the pathogenesis of some autoimmune disorders reported to be associated with B19. We explored the cytolytic potential of human parvovirus B19-specific T cells by stimulating peripheral blood mononuclear cell (PBMC) with recombinant B19-VP2 virus-like particles. The cytolytic potential was determined by enzyme immunoassay-based quantitation of granzyme B (GrB) and perforin from the tissue culture supernatants, by intracellular cytokine staining (ICS) and by detecting direct cytotoxicity. GrB and perforin responses with the B19 antigen were readily detectable in B19-seropositive individuals. T-cell depletion, HLA blocking and ICS experiments showed GrB and perforin to be secreted by CD4(+) T cells. CD4(+) T cells with strong GrB responses were found to exhibit direct cytotoxicity. As anticipated, ICS of B19-specific CD4(+) T cells showed expected co-expression of GrB, perforin and interferon gamma (IFN-γ). Unexpectedly, also a strong co-expression of GrB and interleukin 17 (IL-17) was detected. These cells expressed natural killer (NK) cell surface marker CD56, together with the CD4 surface marker. To our knowledge, this is the first report on virus-specific CD4(+) CTLs co-expressing CD56 antigen. Our results suggest a role for CD4(+) CTL in B19 immunity. Such cells could function within both immune regulation and triggering of autoimmune phenomena such as systemic lupus erythematosus (SLE) or rheumatoid arthritis.
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Greulich S, Kindermann I, Schumm J, Perne A, Birkmeier S, Grün S, Ong P, Schäufele T, Klingel K, Schneider S, Kandolf R, Böhm M, Sechtem U, Mahrholdt H. Predictors of outcome in patients with parvovirus B19 positive endomyocardial biopsy. Clin Res Cardiol 2015; 105:37-52. [DOI: 10.1007/s00392-015-0884-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022]
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80
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Chen MY, Hung CC, Lee KL. Detection of human parvovirus 4 viremia in the follow-up blood samples from seropositive individuals suggests the existence of persistent viral replication or reactivation of latent viral infection. Virol J 2015; 12:94. [PMID: 26088443 PMCID: PMC4480887 DOI: 10.1186/s12985-015-0326-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 06/16/2015] [Indexed: 12/31/2022] Open
Abstract
Background The transmission routes for human parvovirus 4 (PARV4) infections in areas with high seroprevalence are not known. In the work described here, persistent PARV4 viral replication was investigated by conducting a longitudinal study. Methods Ten healthcare workers each provided a blood sample at the beginning of the study (first sample) and 12 months later (second sample). The paired samples were tested for PARV4-positivity by immunoblotting analysis and nested polymerase chain reactions. Results IgG antibodies against PARV4 were detected in six participants, three of whom also had IgM antibodies against PARV4. The immunoblotting results did not vary over time. PARV4 DNA was detected in the first blood sample from one participant who had IgG antibodies against PARV4 and in the second blood samples from 2 participants who had IgG and IgM antibodies against PARV4. Conclusions Detection of PARV4 DNA in the second blood samples from two seropositive participants suggests the existence of persistent PARV4 replication or reactivation of inactive virus in the tissues. The finding of persistent or intermittent PARV4 replication in individuals with past infections provides an important clue toward unraveling the non-parenteral transmission routes of PARV4 infection in areas where the virus is endemic.
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Affiliation(s)
- Mao-Yuan Chen
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung Shan South Road, 1000, Taipei, Taiwan.
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung Shan South Road, 1000, Taipei, Taiwan.
| | - Kuang-Lun Lee
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung Shan South Road, 1000, Taipei, Taiwan.
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81
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Morris G, Berk M, Walder K, Maes M. The Putative Role of Viruses, Bacteria, and Chronic Fungal Biotoxin Exposure in the Genesis of Intractable Fatigue Accompanied by Cognitive and Physical Disability. Mol Neurobiol 2015; 53:2550-71. [PMID: 26081141 DOI: 10.1007/s12035-015-9262-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/28/2015] [Indexed: 01/08/2023]
Abstract
Patients who present with severe intractable apparently idiopathic fatigue accompanied by profound physical and or cognitive disability present a significant therapeutic challenge. The effect of psychological counseling is limited, with significant but very slight improvements in psychometric measures of fatigue and disability but no improvement on scientific measures of physical impairment compared to controls. Similarly, exercise regimes either produce significant, but practically unimportant, benefit or provoke symptom exacerbation. Many such patients are afforded the exclusionary, non-specific diagnosis of chronic fatigue syndrome if rudimentary testing fails to discover the cause of their symptoms. More sophisticated investigations often reveal the presence of a range of pathogens capable of establishing life-long infections with sophisticated immune evasion strategies, including Parvoviruses, HHV6, variants of Epstein-Barr, Cytomegalovirus, Mycoplasma, and Borrelia burgdorferi. Other patients have a history of chronic fungal or other biotoxin exposure. Herein, we explain the epigenetic factors that may render such individuals susceptible to the chronic pathology induced by such agents, how such agents induce pathology, and, indeed, how such pathology can persist and even amplify even when infections have cleared or when biotoxin exposure has ceased. The presence of active, reactivated, or even latent Herpes virus could be a potential source of intractable fatigue accompanied by profound physical and or cognitive disability in some patients, and the same may be true of persistent Parvovirus B12 and mycoplasma infection. A history of chronic mold exposure is a feasible explanation for such symptoms, as is the presence of B. burgdorferi. The complex tropism, life cycles, genetic variability, and low titer of many of these pathogens makes their detection in blood a challenge. Examination of lymphoid tissue or CSF in such circumstances may be warranted.
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Affiliation(s)
- Gerwyn Morris
- Tir Na Nog, Bryn Road seaside 87, Llanelli, SA15 2LW, Wales, UK
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry and The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - Ken Walder
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia. .,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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82
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Toppinen M, Norja P, Aaltonen LM, Wessberg S, Hedman L, Söderlund-Venermo M, Hedman K. A new quantitative PCR for human parvovirus B19 genotypes. J Virol Methods 2015; 218:40-5. [DOI: 10.1016/j.jviromet.2015.03.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/27/2015] [Accepted: 03/09/2015] [Indexed: 11/29/2022]
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83
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84
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Bonvicini F, Bua G, Manaresi E, Gallinella G. Antiviral effect of cidofovir on parvovirus B19 replication. Antiviral Res 2015; 113:11-8. [DOI: 10.1016/j.antiviral.2014.11.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 11/03/2014] [Accepted: 11/04/2014] [Indexed: 12/20/2022]
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85
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Zhang W, Li L, Deng X, Kapusinszky B, Delwart E. What is for dinner? Viral metagenomics of US store bought beef, pork, and chicken. Virology 2014; 468-470:303-310. [PMID: 25217712 PMCID: PMC4252299 DOI: 10.1016/j.virol.2014.08.025] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 08/14/2014] [Accepted: 08/22/2014] [Indexed: 12/16/2022]
Abstract
We describe here the metagenomics-derived viral sequences detected in beef, pork, and chicken purchased from stores in San Francisco. In beef we detected four previously reported viruses (two parvoviruses belonging to different genera, an anellovirus, and one circovirus-like virus) and one novel bovine polyomavirus species (BPyV2-SF) whose closest relatives infect primates. Detection of porcine hokovirus in beef indicated that this parvovirus can infect both ungulate species. In pork we detected four known parvoviruses from three genera, an anellovirus, and pig circovirus 2. Chicken meat contained numerous gyrovirus sequences including those of chicken anemia virus and of a novel gyrovirus species (GyV7-SF). Our results provide an initial characterization of some of the viruses commonly found in US store-bought meats which included a diverse group of parvoviruses and viral families with small circular DNA genomes. Whether any of these viruses can infect humans will require testing human sera for specific antibodies. Eukaryotic viral genomes in store-bought beef, pork, and chicken are identified. A novel bovine polyomavirus genome, closest to a group of viruses from primates, is sequenced. Porcine hokovirus is detected in beef samples. A small circovirus-like circular DNA genome in beef is genetically characterized. Several species of gyrovirus including a novel species are detected in chicken meat.
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Affiliation(s)
- Wen Zhang
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Microbiology, School of Medicine, Jiangsu University, Jiangsu, Zhenjiang 212013, China; Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94118, USA
| | - Linlin Li
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94118, USA
| | - Xutao Deng
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94118, USA
| | - Beatrix Kapusinszky
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94118, USA
| | - Eric Delwart
- Blood Systems Research Institute, San Francisco, CA 94118, USA; Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94118, USA.
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86
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Adamson-Small LA, Fowler LJ, Hobbs JA. Parvovirus b19 persistence in abnormal thyroid tissue of a mature cystic ovarian teratoma: a case report. Endocr Pathol 2014; 25:339-43. [PMID: 24668251 DOI: 10.1007/s12022-014-9305-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ovarian teratomas represent the most common neoplasm derived from germ cells and can contain mature ectodermal, mesodermal, and endodermal tissues. In rare cases, these teratomas can be composed predominantly or solely of thyroid tissue. These thyroid cells often function similarly to normal thyroid tissues. This laboratory and others have previously shown that parvovirus B19 (B19V) persists in primary and metastatic thyroid tissues. No reports exist on possible B19V persistence in thyroid tissues that may arise de novo outside the thyroid gland proper. In this case report, the detection of B19V (genotype 1) in the thyroid epithelial cells of a mature teratoma is reported. Nested PCR and immunohistochemistry were used to detect viral nucleic acids and proteins, respectively. Viral genomes were amplified in lesion DNA, confirming persistence of B19V. Positive immunohistochemical staining was seen for B19V capsid proteins in the thyroid epithelial cells within the mature teratoma, but not in surrounding ovarian tissue or in the non-thyroidal elements of the mature teratoma. These results demonstrate for the first time that thyroid epithelial cells, derived from non-thyroid tissue, are capable of supporting B19V infection and persistence.
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Affiliation(s)
- Laura A Adamson-Small
- Department of Pediatrics, College of Medicine, University of Florida, 1200 Newell Road, R1-136, Gainesville, FL, 32610, USA,
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87
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Adamson-Small LA, Ignatovich IV, Laemmerhirt MG, Hobbs JA. Persistent parvovirus B19 infection in non-erythroid tissues: Possible role in the inflammatory and disease process. Virus Res 2014; 190:8-16. [DOI: 10.1016/j.virusres.2014.06.017] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 12/18/2022]
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88
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Jain P, Jain A, Prakash S, Khan DN, Singh DD, Kumar A, Moulik NR, Chandra T. Prevalence and genotypic characterization of human parvovirus B19 in children with hemato-oncological disorders in North India. J Med Virol 2014; 87:303-9. [DOI: 10.1002/jmv.24028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Parul Jain
- Department of Microbiology; King George's Medical University; Lucknow India
| | - Amita Jain
- Department of Microbiology; King George's Medical University; Lucknow India
| | - Shantanu Prakash
- Department of Microbiology; King George's Medical University; Lucknow India
| | - Danish N Khan
- Department of Microbiology; King George's Medical University; Lucknow India
| | - Desh D Singh
- Department of Microbiology; King George's Medical University; Lucknow India
| | - Archana Kumar
- Department of Paediatrics; King George's Medical University; Lucknow India
| | - Nirmalya R Moulik
- Department of Paediatrics; King George's Medical University; Lucknow India
| | - Tulika Chandra
- Department of Transfusion Medicine; King George's Medical University; Lucknow India
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89
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Sahiner F, Gümral R, Yildizoğlu Ü, Babayiğit MA, Durmaz A, Yiğit N, Saraçli MA, Kubar A. Coexistence of Epstein-Barr virus and Parvovirus B19 in tonsillar tissue samples: quantitative measurement by real-time PCR. Int J Pediatr Otorhinolaryngol 2014; 78:1288-93. [PMID: 24882454 DOI: 10.1016/j.ijporl.2014.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/03/2014] [Accepted: 05/06/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In this study, we aimed to investigate the presence and copy number of six different viruses in tonsillar tissue samples removed surgically because of chronic recurrent tonsillitis or chronic obstructive tonsillar hypertrophy. METHODS In total, 56 tissue samples (tonsillar core) collected from 44 children and 12 adults were included in this study. The presence of viruses was investigated using a new TaqMan-based quantitative real-time PCR assay. RESULTS Of the 56 tissue samples, 67.9% (38/56) were positive for at least one of the six viruses. Epstein-Barr virus was the most frequently detected virus, being found in 53.6% (30/56), followed by human Parvovirus B19 21.4% (12/56), human adenovirus 12.5% (7/56), human Cytomegalovirus 5.4% (3/56), BK polyomavirus 1.8% (1/56), and Herpes simplex virus 1.8% (1/56). Precancerous or cancerous changes were not detected in the tonsillar tissue samples by pathologic examination, whereas lymphoid hyperplasia was observed in 24 patients. In contrast to other viruses, B19 virus was present in high copy number in tonsillar tissues. The rates of EBV and B19 virus with high copy number (>500.000 copies/ml) were higher in children than in adults, and a positive relationship was also found between the presence of EBV and the presence of B19 virus with high copy number (P=0.037). CONCLUSIONS It is previously reported that some viral agents are associated with different chronic tonsillar pathologies. In the present study, the presence of B19 virus in tonsillar core samples was investigated quantitatively for the first time, and our data suggests that EBV infections could be associated with B19 virus infections or could facilitate B19 virus replication. However, further detailed studies are needed to clarify this observation.
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Affiliation(s)
- Fatih Sahiner
- Division of Medical Virology, Department of Medical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
| | - Ramazan Gümral
- Department of Medical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
| | - Üzeyir Yildizoğlu
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Ankara, Turkey.
| | | | - Abdullah Durmaz
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Ankara, Turkey.
| | - Nuri Yiğit
- Department of Medical Pathology, Gulhane Military Medical Academy, Ankara, Turkey.
| | - Mehmet Ali Saraçli
- Department of Medical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
| | - Ayhan Kubar
- Division of Medical Virology, Department of Medical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
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90
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Juhl D, Görg S, Hennig H. Persistence of Parvovirus B19 (B19V) DNA and humoral immune response in B19V-infected blood donors. Vox Sang 2014; 107:226-32. [PMID: 24916600 DOI: 10.1111/vox.12162] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/30/2014] [Accepted: 05/07/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Parvovirus B19 (B19V) DNA seems to persist in the plasma of B19V-infected blood donors. The relevance of this for recipients of single-donor blood components is yet unclear. MATERIAL AND METHODS We studied serial archive and follow-up samples from 75 B19V-infected blood donors to obtain more data about the duration and degree of viraemia and the presence of IgG and IgM anti-B19V. IgG antibodies were further characterized by Western blot analysis in 29 donors. RESULTS In 411 B19V DNA-positive samples collected, we found high concentrations (>10(6) IU B19V DNA/ml plasma) in five. B19V DNA persisted for a mean of 21·5 months (range: 2·3-52·4; 95% confidence interval, 19·1-23·9 months) in all donors. Only 15 such samples had either no or low-titre IgG anti-B19V. IgG antibodies were predominantly directed against epitopes on the minor capsid protein VP1, thus probably of neutralizing type with high avidity. IgM anti-B19V was detectable in 9/13 samples with high DNA concentrations. CONCLUSIONS The vast majority of single-donor blood components with detectable B19V DNA are probably not infectious for their recipients because DNA is at only low levels and the donors also have potentially neutralizing antibodies with high avidity. Anti-B19V IgM testing does not identify every donation with high B19V DNA concentrations, but, in addition to B19V NAT testing, donors with persistent IgG anti-B19V might be considered 'B19V-safe' for single-donor blood components.
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Affiliation(s)
- D Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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91
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Bock CT, Düchting A, Utta F, Brunner E, Sy BT, Klingel K, Lang F, Gawaz M, Felix SB, Kandolf R. Molecular phenotypes of human parvovirus B19 in patients with myocarditis. World J Cardiol 2014; 6:183-195. [PMID: 24772258 PMCID: PMC3999338 DOI: 10.4330/wjc.v6.i4.183] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/16/2014] [Accepted: 02/19/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate molecular phenotypes of myocardial B19V-infection to determine the role of B19V in myocarditis and dilated cardiomyopathy (DCM).
METHODS: Endomyocardial biopsies (EMBs) from 498 B19V-positive patients with myocarditis and DCM were analyzed using molecular methods and functional experiments. EMBs were obtained from the University Hospitals of Greifswald and Tuebingen and additionally from 36 German cardiology centers. Control tissues were obtained at autopsy from 34 victims of accidents, crime or suicide. Identification of mononuclear cell infiltrates in EMBs was performed using immunohistological staining. Anti-B19V-IgM and anti-B19V-IgG were analyzed by enzyme-linked immunosorbent assay (ELISA). B19V viral loads were determined using in-house quantitative real-time polymerase chain reaction (PCR). For B19V-genotyping a new B19V-genotype-specific restriction fragment length polymorphism (RFLP)-PCR was established. B19V-genotyping was verified by direct DNA-sequencing and sequences were aligned using BLAST and BioEdit software. B19V P6-promoter and HHV6-U94-transactivator constructs were generated for cell culture experiments. Transfection experiments were conducted using human endothelial cells 1. Luciferase reporter assays were performed to determine B19V-replication activity. Statistical analysis and graphical representation were calculated using SPSS and Prism5 software.
RESULTS: The prevalence of B19V was significantly more likely to be associated with inflammatory cardiomyopathy (iCMP) compared to uninflamed DCM (59.6% vs 35.3%) (P < 0.0001). The detection of B19V-mRNA replication intermediates proved that replication of B19V was present. RFLP-PCR assays showed that B19V-genotype 1 (57.4%) and B19V-genotype 2 (36.7%) were the most prevalent viral genotypes. B19V-genotype 2 was observed more frequently in EMBs with iCMP (65.0%) compared to DCM (35%) (P = 0.049). Although there was no significant difference in gender-specific B19V-loads, women were more frequently infected with B19V-genotype 2 (44.6%) than men (36.0%) (P = 0.0448). Coinfection with B19V and other cardiotropic viruses was found in 19.2% of tissue samples and was associated with higher B19V viral load compared to B19V-monoinfected tissue (P = 0.0012). The most frequent coinfecting virus was human herpes virus 6 (HHV6, 16.5%). B19V-coinfection with HHV6 showed higher B19V-loads compared to B19V-monoinfected EMBs (P = 0.0033), suggesting that HHV6 had transactivated B19V. In vitro experiments confirmed a 2.4-fold increased B19V P6-promoter activity by the HHV6 U94-transactivator.
CONCLUSION: The finding of significantly increased B19V loads in patients with histologically proven cardiac inflammation suggests a crucial role of B19V-genotypes and reactivation of B19V-infection by HHV6-coinfection in B19V-associated iCMP. Our findings suggest that B19V-infection of the human heart can be a causative event for the development of an endothelial cell-mediated inflammatory disease and that this is related to both viral load and genotype.
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92
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Identification of past and recent parvovirus B19 infection in immunocompetent individuals by quantitative PCR and enzyme immunoassays: a dual-laboratory study. J Clin Microbiol 2014; 52:947-56. [PMID: 24403307 DOI: 10.1128/jcm.02613-13] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Parvovirus B19 (B19V) is a member of the family Parvoviridae, genus Erythrovirus. B19V-specific IgG and IgM react differently against conformational and linear epitopes of VP1 and VP2 antigens, leading to the development of IgG avidity and epitope type specificity (ETS) enzyme immunoassays (EIAs) for distinguishing past from recent infection. Additionally, B19V viral load determination (by quantitative PCR [qPCR]) is increasingly used in the staging of B19V infection. In this study, the utility of these methods is compared. A panel of 78 sera was jointly tested by the Virus Reference Department (VRD), London, United Kingdom, and the Haartman Institute (HI), Helsinki, Finland, using a number of EIAs, e.g., B19V-specific IgG and IgM, IgG avidity, and ETS EIAs. At VRD, the sera were also tested by a B19V viral load PCR (qPCR). By consensus analysis, 43 (55.1%) sera represented past infection, 28 (35.9%) sera represented recent infection, and 7 (9.0%) sera were indeterminate. Both VRD B19V qPCR and HI B19V VP2 IgM EIA gave the highest agreement with consensus interpretation for past or recent infection, with an overall agreement of 99% (95% confidence interval [CI], 92 to 100) and positive predictive value (PPV) of 100% (95% CI, 87 to 100). Nine sera designated as representing past infection by consensus analysis were B19V IgM positive by a commercial VRD B19V IgM EIA and B19V IgM negative by a new HI in-house B19V VP2 IgM EIA. A new VRD B19V IgG avidity EIA showed good (>95%) agreement (excluding equivocal results) with consensus interpretations for past or recent infection. Correct discrimination of past from recent B19V infection was achieved through application of qPCR or by appropriate selection of EIAs.
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93
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Lassner D, Rohde M, Siegismund CS, Kühl U, Gross UM, Escher F, Tschöpe C, Schultheiss HP. Myocarditis—Personalized Medicine by Expanded Endomyocardial Biopsy Diagnostics. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/wjcd.2014.46042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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94
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Adamson LA, Fowler LJ, Ewald AS, Clare-Salzler MJ, Hobbs JA. Infection and persistence of erythrovirus B19 in benign and cancerous thyroid tissues. J Med Virol 2013; 86:1614-20. [DOI: 10.1002/jmv.23852] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Laura A. Adamson
- Departments of Psychiatry and Pediatrics; University of Florida College of Medicine; Gainesville Florida
| | - Larry J. Fowler
- Department of Pathology, Immunology, and Laboratory Medicine; University of Florida College of Medicine; Gainesville Florida
| | - Amy S. Ewald
- Departments of Psychiatry and Pediatrics; University of Florida College of Medicine; Gainesville Florida
| | - Michael J. Clare-Salzler
- Department of Pathology, Immunology, and Laboratory Medicine; University of Florida College of Medicine; Gainesville Florida
| | - Jacqueline A. Hobbs
- Departments of Psychiatry and Pediatrics; University of Florida College of Medicine; Gainesville Florida
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95
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Popgeorgiev N, Temmam S, Raoult D, Desnues C. Describing the silent human virome with an emphasis on giant viruses. Intervirology 2013; 56:395-412. [PMID: 24157886 DOI: 10.1159/000354561] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Viruses are the most abundant obligate intracellular entities in our body. Until recently, they were only considered to be pathogens that caused a broad array of pathologies, ranging from mild disease to deaths in the most severe cases. However, recent advances in unbiased mass sequencing techniques as well as increasing epidemiological evidence have indicated that the human body is home to diverse viral species under non-pathological conditions. Despite these studies, the description of the presumably healthy viral flora, i.e. the normal human virome, is still in its infancy regarding viral composition and dynamics. This review summarizes our current knowledge of the human virome under non-pathological conditions.
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Affiliation(s)
- Nikolay Popgeorgiev
- URMITE UM63, CNRS 7278, IRD 198, INSERM 1095, Aix-Marseille Université, Marseille, France
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96
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Sakata H, Matsubayashi K, Ihara H, Sato S, Kato T, Wakisaka A, Tadokoro K, Yu MYW, Baylis SA, Ikeda H, Takamoto S. Impact of chemiluminescent enzyme immunoassay screening for human parvovirus B19 antigen in Japanese blood donors. Transfusion 2013; 53:2556-66. [DOI: 10.1111/j.1537-2995.2012.03949.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 09/18/2012] [Accepted: 09/18/2012] [Indexed: 12/26/2022]
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97
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Low-level DNAemia of parvovirus B19 (genotypes 1–3) in adult transplant recipients is not associated with anaemia. J Clin Virol 2013; 58:443-8. [DOI: 10.1016/j.jcv.2013.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 06/28/2013] [Accepted: 07/07/2013] [Indexed: 12/22/2022]
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98
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Keeping pace with parvovirus B19 genetic variability: a multiplex genotype-specific quantitative PCR assay. J Clin Microbiol 2013; 51:3753-9. [PMID: 24006003 DOI: 10.1128/jcm.01970-13] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Three genotypes have been identified within the parvovirus B19 species (B19V), and such genetic diversity may have significant implications for the development of molecular detection assays. In the present study, B19V genetic variability has been examined on a subset of genomic sequences available in the NCBI nucleotide database, and a quantitative PCR (qPCR) assay able to detect, differentiate, and quantify all viral variants has been established. The designed primers and probes have been used for the development of alternative detection formats, based on a combined use of intercalating dye and genotype-specific hydrolysis probes. The qPCR assay analytical performances have been determined on the 1st WHO International Reference Panel for Parvovirus B19 Genotypes. The developed qPCR protocols allow for the detection of genotypes 1 to 3 with equal accuracy, and with a limit of detection (LOD) of 200 IU/ml. A comparison of routine performance was carried out with respect to a previously established assay specifically validated on B19V genotype 1. For 130 clinical samples analyzed, 126 showed concordant results (31 positive and 97 negative), while 4 showed discordant results. Overall, the genotype-specific qPCR assay showed a sensitivity of 93.94% and a specificity of 97.94%, with an agreement rate of 96.92%. The proposed qPCR assay and the alternative protocols developed, each with robust performance, may allow choice with respect to operational systems and diagnostic requirements and might contribute to provide a more reliable diagnostic service and epidemiological surveillance of B19 virus.
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Toan NL, Sy BT, Song LH, Luong HV, Binh NT, Binh VQ, Kandolf R, Velavan TP, Kremsner PG, Bock CT. Co-infection of human parvovirus B19 with Plasmodium falciparum contributes to malaria disease severity in Gabonese patients. BMC Infect Dis 2013; 13:375. [PMID: 23945350 PMCID: PMC3765098 DOI: 10.1186/1471-2334-13-375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 08/09/2013] [Indexed: 11/29/2022] Open
Abstract
Background High seroprevalence of parvovirus B19 (B19V) coinfection with Plasmodium falciparum has been previously reported. However, the impact of B19V-infection on the clinical course of malaria is still elusive. In this study, we investigated the prevalence and clinical significance of B19V co-infection in Gabonese children with malaria. Methods B19V prevalence was analyzed in serum samples of 197 Gabonese children with P. falciparum malaria and 85 healthy controls using polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), and direct DNA-sequencing. Results B19V was detected in 29/282 (10.28%) of Gabonese children. B19V was observed more frequently in P. falciparum malaria patients (14.21%) in comparison to healthy individuals (1.17%) (P<0.001). Notably, the mild-malaria group revealed significantly lower hematocrit levels in B19V/P. falciparum co-infection than in P. falciparum mono-infection (P<0.05). Genetic analysis revealed a predominance of B19V genotype-1 (71.43%) in the studied population. However, B19V-genotype 2 was observed significantly more often in children with severe-malaria than in mild-malaria (P=0.04). Conclusion Our findings reveal that B19V-infection is frequent in Gabonese children with P. falciparum malaria and signifies a possible contribution of B19V on the clinical course of malaria in a genotype-dependent manner. B19V co-infection should be considered as a additional diagnostic measure in malaria patients with life threatening anemia.
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Affiliation(s)
- Nguyen L Toan
- Department of Molecular Pathology, Institute of Pathology and Neuropathology, University of Tuebingen, Tuebingen, Germany
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A distinct subgroup of cardiomyopathy patients characterized by transcriptionally active cardiotropic erythrovirus and altered cardiac gene expression. Basic Res Cardiol 2013; 108:372. [DOI: 10.1007/s00395-013-0372-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 07/16/2013] [Accepted: 07/18/2013] [Indexed: 01/14/2023]
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