Rubella virus replication and links to teratogenicity

[The structure of replication initiation region of Pseudomonas IncP-7 streptomycin resistance plasmid Rms148]

Pseudomonads' IncP-7 plasmids make significant contribution to the environmental biodegradative potential and sometimes harbour antibiotic resistance genes. More than 30 years plasmid Rms148 is used as archetypal P-7 plasmid in microbiological incompatibility tests. However, the structure of its basic replicon was not described up to now, as well as phylogenetic relationships between all known plasmids within the IncP-7 group were not studied. In the frames of this work we have constructed two primer pairs to amplify main components of P-7 replication initiation region, and subsequent screening of repA intragenic polymorphism was made using laboratory collection of IncP-7 plasmids. Minimal replicon of Rms148 was constructed and its nucleotide sequence was determined to be identical to repA-oriVof known P-7 plasmids on 81-83% and forming separate branch on appropriate phylogenetic tree. Additionally, repA seems to be more conservative between group members compared with putative oriV region. Deduced amino acid sequence and predicted secondary and tertiary structures of Rms148 RepA protein allow us to make assumption about similar to unclassified cryptic plasmid pPS10 model of replication initiation for IncP-7 group members.

Virus factories: biogenesis and structural design

Replication and assembly of many viruses occur in specific intracellular compartments known as ‘virus factories’. Our knowledge of the biogenesis and architecture of these unique structures has increased considerably in the last 10 years, due to technical advances in cellular, molecular and structural biology. We now know that viruses build replication organelles, which recruit cell and viral components in a macrostructure in which viruses assemble and mature. Cell membranes and cytoskeleton participate in the biogenesis of these scaffolds and mitochondria are present in many factories, where they might supply energy and other essential factors. New inter‐organelle contacts have been visualized within virus factories, whose structure is very dynamic, as it changes over time. There is increasing interest in identifying the factors involved in their biogenesis and functional architecture, and new microscopy techniques are helping us to understand how these complex entities are built and work. In this review, we summarize recent findings on the cell biology, biogenesis and structure of virus factories.

Reduction in valproic acid-induced neural tube defects by maternal immune stimulation: role of apoptosis

Teratogenic deregulation of apoptosis during development is a possible mechanism for birth defects. Administration of valproic acid (VA) during first trimester of pregnancy causes neural tube defects (NTDs). Nonspecific stimulation of the mother's immune system has been shown to reduce various teratogen-induced fetal malformations including NTDs in rodents. This present study investigated the role of reduced apoptosis by maternal immune stimulation in prevention of VA-induced NTDs in CD-1 mice. Prevention of VA-induced NTDs by nonspecific maternal immune stimulation using IFNγ was employed to evaluate the role of reduced apoptosis by IFNγ in this protective mechanism. Apoptosis was quantified using flow cytometry. Terminal Transferase dUTP Nick End Labeling assay was used to localize the apoptosis. Increased apoptosis, suggesting involvement in VA teratogenicity, was observed along the neural tube in both normal and abnormal embryos from VA-exposed dams. Increased apoptosis in normal VA-exposed embryos suggests that VA may alter other cellular processes such as cell proliferation and differentiation in addition to apoptosis. Apoptotic levels in embryos with closed neural tubes from IFNγ + VA dams were similar to controls indicating resistance to VA-induced apoptosis and protection against teratogenicity of VA. In IFNγ + VA exposed embryos with open neural tubes, maternal immune stimulation failed to regulate apoptosis resulting in an NTD. Overall, these results suggest that VA alters several biological processes including apoptosis in the developing embryos to induce fetal malformations. Resistance to VA-induced apoptosis in embryos resulting from maternal immune stimulation may be involved in protective mechanism.

Characterization of cell lines stably transfected with rubella virus replicons

Rubella virus (RUBV) replicons expressing a drug resistance gene and a gene of interest were used to select cell lines uniformly harboring the replicon. Replicons expressing GFP and a virus capsid protein GFP fusion (C-GFP) were compared. Vero or BHK cells transfected with either replicon survived drug selection and grew into a monolayer. However, survival was ~9-fold greater following transfection with the C-GFP-replicon than with the GFP-expressing replicon and while the C-GFP-replicon cells grew similarly to non-transfected cells, the GFP-replicon cells grew slower. Neither was due to the ability of the CP to enhance RNA synthesis but survival during drug selection was correlated with the ability of CP to inhibit apoptosis. Additionally, C-GFP-replicon cells were not cured of the replicon in the absence of drug selection. Interferon-alpha suppressed replicon RNA and protein synthesis, but did not cure the cells, explaining in part the ability of RUBV to establish persistent infections.

Neuro-invasion by a 'Trojan Horse' strategy and vasculopathy during intrauterine flavivirus infection

The central nervous system (CNS) is a major target of several important human and animal viral pathogens causing congenital infections. However, despite the importance of neuropathological outcomes, for humans in particular, the pathogenesis, including mode of neuro-invasion, remains unresolved for most congenital virus infections. Using a natural model of congenital infection with an RNA virus, bovine viral diarrhoea virus in pregnant cattle, we sought to delineate the timing and mode of virus neuro-invasion of and spread within the brain of foetuses following experimental respiratory tract infection of the dams at day 75 of pregnancy, a time of maximal risk of tissue pathology without foetal death. Virus antigen was first detected in the foetal brains 14 days postinfection of dams and was initially restricted to amoeboid microglial cells in the periventricular germinal layer. The appearance of these cells was preceded by or concurrent with vasculopathy in the same region. While the affected microvessels were negative for virus antigen, they expressed high levels of the type I interferon-stimulated protein ISG15 and eventually disappeared in parallel with the appearance of microcavitary lesions. Subsequently, the virus spread to neurons and other glial cells. Our findings suggest that the virus enters the CNS via infected microglial precursors, the amoeboid microglial cells, in a 'Trojan horse' mode of invasion and that the microcavitary lesions are associated with loss of periventricular microvasculature, perhaps as a consequence of high, unrestricted induction of interferon-regulated proteins.

The Rubella virus capsid is an anti-apoptotic protein that attenuates the pore-forming ability of Bax

Apoptosis is an important mechanism by which virus-infected cells are eliminated from the host. Accordingly, many viruses have evolved strategies to prevent or delay apoptosis in order to provide a window of opportunity in which virus replication, assembly and egress can take place. Interfering with apoptosis may also be important for establishment and/or maintenance of persistent infections. Whereas large DNA viruses have the luxury of encoding accessory proteins whose primary function is to undermine programmed cell death pathways, it is generally thought that most RNA viruses do not encode these types of proteins. Here we report that the multifunctional capsid protein of Rubella virus is a potent inhibitor of apoptosis. The main mechanism of action was specific for Bax as capsid bound Bax and prevented Bax-induced apoptosis but did not bind Bak nor inhibit Bak-induced apoptosis. Intriguingly, interaction with capsid protein resulted in activation of Bax in the absence of apoptotic stimuli, however, release of cytochrome c from mitochondria and concomitant activation of caspase 3 did not occur. Accordingly, we propose that binding of capsid to Bax induces the formation of hetero-oligomers that are incompetent for pore formation. Importantly, data from reverse genetic studies are consistent with a scenario in which the anti-apoptotic activity of capsid protein is important for virus replication. If so, this would be among the first demonstrations showing that blocking apoptosis is important for replication of an RNA virus. Finally, it is tempting to speculate that other slowly replicating RNA viruses employ similar mechanisms to avoid killing infected cells.

Among the variety of defense systems employed by mammalian cells to combat virus infection, apoptosis or programmed cell death is the most drastic response. Some large DNA viruses encode proteins whose sole function is to block apoptosis. Conversely, very little is known about whether RNA viruses encode analogous proteins. In many cases, RNA viruses are able to replicate before cell death occurs, which may be one reason why so little thought has been given to this topic. However, a number of RNA viruses, some of which are important human pathogens, have slow replication cycles and it stands to reason that they must block apoptosis during this time period. Here we show that the multifunctional capsid protein of Rubella virus is a potent inhibitor of apoptosis. Data from reverse genetic experiments suggest that the anti-apoptotic function of a virus-encoded protein is important for replication of an RNA virus. We anticipate that other slowly replicating RNA viruses may employ similar mechanisms and, as such, these studies have implications for development of novel anti-virals and vaccines.

Pregnant women in and around dhaka city: are their children at risk of developing congenital rubella syndrome?

Rubella Virus (RUBV) is a common cause of childhood rash and fever in non-immunized populations, and its public health importance relates to teratogenic effects of primary rubella infection in women with early pregnancy. Infection of the fetus may lead to congenital rubella syndrome (CRS). This work aimed to assess the degree of risk associated in acquiring rubella virus infection by the women during pregnancy and developing CRS among their children in Bangladesh. The study population (n = 275) included pregnant mothers (15-38 years) from various socioeconomic backgrounds attending a women health care based hospital. All subjects were personally interviewed, clinically examined and a standardized questionnaire was filled up for each of them. From each participant 3 ml blood was taken and serum was separated. Commercially available ELISA kit was used for the qualitative and quantitative determination of IgM and IgG class antibodies against RUBV in collected serum samples. 209 women were found to contain detectable level of antiRUBV IgG antibodies, but did not possess IgM antibodies against rubella. Only 9% participants were vaccinated previously against rubella virus among the whole antenatal population studied. Ninety-two percent of these vaccinated pregnant women contained serum anti-rubella IgG antibody which was significantly (P = 0.05) higher than that of the nonvaccinated study population (75%). Pregnant women from lower middle and poor socioeconomic class had significantly (P = 0.05) more intra uterine growth retardation (IUGR) of fetus than the upper middle class. 20% of the women of child bearing age examined in this work were not yet exposed to RUBV and at risk of acquiring this virus during pregnancy and subsequently transmitting the virus to the fetus. Our work demonstrates rubella attack rate among antenatal population in Bangladesh as 14.5 in 1000 during pregnancy. A proper and reliable vaccination policy against rubella virus is not yet adopted at the national level in many developing countries including Bangladesh. This work identifies the requirement of detailed study for the identification of intrauterine rubella infection and its related influence on perinatal morbidity and mortality. Thorough epidemiological studies are also considered necessary prior to the development and acceptance of national immunization program against rubella virus in Bangladesh.

An audit of rubella IgG antibody status in antenatal women in a NHS Trust over 5 years (2005-2009)

Rubella, a vaccine-preventable infection. This study examined the antibody status of 11 987 pregnant women during 2005-2009. Results showed a non-significant decrease in those with antibody levels of <4·0 IU/ml from 29/2312 (1·3%) in 2005 to 21/2447 (0·9%) in 2009 (χ² for linear trend=0·279, P=0·56) but a significant increase in those with levels of <10 IU/ml from 88/2312 (3·8%) in 2005 to 124/2447 (5·1%) in 2009 (χ² for linear trend=10·27, P=0·001). In women born before 1983 (pre-pubertal vaccination) the proportion of first pregnancies with titres <4 IU was 1·1% (21/2002) compared to 3·4% (69/2022) in those born after 1983 (χ²=25·176, P<0·0001) and 2·2% (44/2002) for titres <10 IU compared to 14·0% (282/2022) for those born after 1983 (χ²=171·43, P<0·0001). The potential impact of the increase is difficult to determine, requiring further monitoring. This paper discusses the effect of changing immunization programmes on rubella susceptibility in pregnant women.

Infection: a hypothesis on active susceptibility and species immunity with implications for AIDS prevention

There is no fundamental difference in contagiousness or pathogenicity between the normal and pathogenic microfloras: both are contagious, and both may either cause illness or persist in the body of a healthy carrier. The contagiousness of the normal microflora is determined by its positive function in the host. In addition to the normal microflora, endogenous retrovirus genes are also useful for a macroorganism: they have been found to be integral elements of many animal and plant genomes and participate in vital functions, such as genome activity control, antiviral defense, and formation of the placenta; dysfunction of some endogenous retrovirus genes causes pathology. Components of bacterial cells cause protective effects with respect to noninfectious somatic diseases. Therefore, it is reasonable to assume that natural susceptibility to both "normal" and "pathogenic" microfloras results from vital necessity for a macroorganism to interact with them. The necessity to interact with specific microorganisms and, hence, susceptibility to them is the cause of their infectivity. In this connection, studies on the positive functions of specific "pathogenic" microflora in a macroorganism with the use of SPF animals would be of interest. Even more interesting would be experiments with transfer of specific microbial genes into the genomes of susceptible species, which may help to understand the causes and mechanisms of susceptibility/insusceptibility as a basis of species immunity and develop fundamentally new and more natural methods for preventing and treating infectious diseases.

Congenital rubella syndrome: pattern and presentation in a southern Nigerian tertiary hospital

BACKGROUND

Congenital rubella syndrome (CRS) resulting from maternal rubella infection can result in miscarriages, still birth and rubella infection of the infant. The aim of this study was to evaluate the pattern and presentation of CRS over an 8-year period as seen in the University of Port-Harcourt Teaching Hospital (UPTH), Nigeria.

METHODS

The medical records of all cases of CRS presenting to the Pediatric Department of UPTH from January 2000 to December 2007 were reviewed.

RESULTS

There were 16 394 babies delivered in UPTH from January 2000 to December 2007. Of these babies, 19 were clinically diagnosed as having CRS, but none had laboratory confirmation. They had a mean age of 5.1 +/-3.2 months (range: 1-11 months). Seventy-five percent of their mothers had presumed rubella infection during the first trimester of pregnancy. Cataract was noticed to be the most prominent systemic manifestation in 18 of the 19 babies. Other common manifestations included hearing impairment (n=14), microcephaly (n=13), patent ductus arteriosus (n=11), and low birth weight (n=10). A surge was observed in the number of babies with CRS from 2004 to 2007; however, this was not statistically significant (chi (2)=8.68, P=0.28). Unfortunately, long-term outcome of the 19 babies was not available.

CONCLUSION

CRS is commonly diagnosed at our center. Thus, mounting effective surveillance for CRS and considering the inclusion of rubella vaccine in Nigeria are of extreme importance.

Rubella seroprevalence among primary and pre- primary school pupils at Moi's Bridge location, Uasin Gishu District, Kenya

BACKGROUND

Rubella is an infectious and generally mild childhood viral disease. The disease is of public health importance because infection acquired during early pregnancy often results in foetal abnormalities that are classified as congenital rubella syndrome (CRS). The burden of rubella infection in most developing countries in not well documented because of limited epidemiological data. However, availability of an effective vaccine has made it necessary to have all the countries with no routine vaccination schedule to evaluate the burden of disease in order to make informed decisions on rubella vaccination and strategy. To address this gap we conducted a study to determine age-specific rubella seroprevalence rates and related risk factors among primary and pre-primary school children in Uasin Gishu district, Moi's Bridge location of Kenya.

METHODS

Subjects of the study were 498 pupils from seven primary schools aged 4-20 years. Questionnaire surveys with blood sampling were conducted between January to July 2005. Samples were tested for rubella specific IgG antibody using ELISA test kit (Enzygnost Behring, Germany).

RESULTS

Overall, rubella seropositivity rate was 80% and it increased with age from 59% (among ages 4-6 years) to 94% (ages 14-20 years). Multivariate logistic regression analysis model, showed that age of child and ownership of a television set which is a proxy measure of socio-economic status of family were significantly associated with rubella seropositivity. The odds of rubella seropositivity in a child older than 13 years was more than that in children younger than 7 years (OR = 3.8 95% CI 2.56-5.78). The odds of rubella seropositivity in a child whose family did not own a television set was 3 times higher than that of child whose family owned a set (OR 3.06, 95% CI 1.17-7.97).

CONCLUSION

The study provides important and highly useful information on rubella age specific seroprevalence rates in Kenya. Advancing age was found to be associated with increased risk of rubella. Low socio-economic factors suggest an increased risk of infection in certain categories of society, and control measures need to target this. Overall, the findings can also be used by policy makers to model introduction of routine rubella vaccination in the country and also other developing countries facing similar challenges. More than half of the children got infected in pre-primary and efforts to control rubella should target pre-school children. These data provides pre-vaccination information that can be used to guide immunization strategy as well as to determine success of an immunization programme.

Analysis of gene expression in fetal and adult cells infected with rubella virus

Congenital infection with rubella virus (RUB) leads to persistent infection and congenital defects and we showed previously that primary human fetal fibroblasts did not undergo apoptosis when infected with RUB, which could promote fetal virus persistence [Adamo, P., Asís, L., Silveyra, P., Cuffini, C., Pedranti, M., Zapata, M., 2004. Rubella virus does not induce apoptosis in primary human embryo fibroblasts cultures: a possible way of viral persistence in congenital infection. Viral Immunol. 17, 87-100]. To extend this observation, gene chip analysis was performed on a line of primary human fetal fibroblasts (10 weeks gestation) and a line of human adult lung fibroblasts (which underwent apoptosis in response to RUB infection) to compare gene expression in infected and uninfected cells. A total of 632 and 516 genes were upregulated or downregulated in the infected fetal and adult cells respectively in comparison to uninfected cells, however only 52 genes were regulated in both cell types. Although the regulated genes were different, across functional gene categories the patterns of gene regulation were similar. In general, regulation of pro- and anti-apoptotic genes following infection appeared to favor apoptosis in the adult cells and lack of apoptosis in the fetal cells, however there was a greater relative expression of anti-apoptotic genes and reduced expression of pro-apoptotic genes in uninfected fetal cells versus uninfected adult cells and thus the lack of apoptosis in fetal cells following RUB infection was also due to the prevailing background of gene expression that is antagonistic to apoptosis. In support of this hypothesis, it was found that of a battery of five chemicals known to induce apoptosis, two induced apoptosis in the adult cells, but not in fetal cells, and two induced apoptosis more rapidly in the adult cells than in fetal cells (the fifth did not induce apoptosis in either). A robust interferon-stimulated gene response was induced following infection of both fetal and adult cells and many of the genes upregulated in both cell types were those involved in establishment of an antiviral state; this is the first demonstration of an interferon response at this early stage of human embryonic development. In both fetal and adult cells, interferon controlled but did not eliminate virus spread and apoptosis was not induced in infected fetal cells in the absence of interferon. In addition to the interferon response, chemokines were induced in both infected fetal and adult cells. Thus, it is possible that fetal damage following congenital RUB infection, which involves cell proliferation and differentiation, could be due to induction of the innate immune response as well as frank virus infection.

Rubella

Rubella is associated with an 80% risk of congenital abnormalities if acquired in the first 12 weeks of pregnancy. Reinfection in early pregnancy presents a much smaller risk. Prenatal diagnosis may be useful to assess the risk to the fetus. Congenital rubella is a progressive disease and some abnormalities will not be present at birth. Rubella and congenital rubella are usually diagnosed by detection of rubella-specific IgM; it may be difficult to confirm a diagnosis of congenital rubella in children over 3 months of age. Rubella vaccines are usually combined with measles and mumps vaccines. Their use has enabled some industrialised countries to eliminate rubella and congenital rubella. Countries should ensure that susceptible women of child-bearing age and health care workers are offered a rubella-containing vaccine. Rubella vaccine is contraindicated during pregnancy, but if a pregnant woman is inadvertently vaccinated it is not an indication for termination or prenatal diagnosis.

Modifications of nuclear envelope during differentiation and depolyploidization of rat trophoblast cells

An increased activity of membranes of the nuclear envelope (NE) was observed electron microscopically in the trophoblast cells of the rat placenta. The activity of the membranes was manifested as formation of various NE derivatives, such as the annulate lamellae (AL), the intranuclear tubules, and the concentric membranous structures. At the period of terminal differentiation of the secondary giant trophoblast cells (SGTC) the NE derivatives play active role in subdivision of the initial highly polyploid nuclei into the numerous low-ploidy fragments. (3)H-thymidine labeling showed that attenuation of the DNA replication precedes the nuclear fragmentation. In the course of the nuclear fragmentation the narrow deep NE invaginations subdivide the nucleus into the separate lobes that subsequently are detached from the initial nucleus. By the beginning of the fragmentation, the accumulated membranous structures, i.e. the intranuclear AL, tubules, clusters of pore complexes, etc., seem to be the source of the reserve material that is necessary for formation of the great amount of the NE membranes of the newly formed nuclear fragments. Thus, the intranuclear membranous structures that seem to increase the active surface of the growing endopolyploid nucleus at the earlier stage of differentiation then take part in genome isolation that results in formation of a multinucleate cell with diploid and low-polyploid nuclei. The outer NE membrane of the initial nucleus plays an active role in compartmentalization of cytoplasmic areas around the nuclear fragments within the giant polykaryocyte. Apart from the membranous structures the bundles of intermediate filaments (IF) located in the cytoplasm perinuclear zones seem to participate in the nuclear fragmentation. These processes are likely to provide formation of the giant polykaryocytes incapable for further proliferation.

Synthesis and biological evaluation of 4-alkylamino-6-(2-hydroxyethyl)-2-methylthiopyrimidines as new rubella virus inhibitors

In the search for new chemotherapeutic agents useful against Rubella virus (RV) infections, a solution-phase parallel approach for the synthesis of a small library of 4-alkylamino-6-(2-hydroxyethyl)-2-methylthiopyrimidines has been set up, based on previous results from our research group. Biological evaluation of the newly synthesized compounds pointed out their interesting properties as anti-RV agents with IC(50) values in the micromolar range.

Duodenal stenosis, a new finding on congenital rubella syndrome: Case description and literature review

Congenital rubella syndrome (CRS) continues to represent a public healthcare problem although an effective vaccination program. Gastrointestinal involvement is rather infrequent and the association of CRS with duodenal stenosis has been never reported. In this study a case of CRS with duodenal diaphragm is reported and the gastrointestinal diseases described in association with CRS are reviewed. A 10-month-old child affected by CRS with congenital hearth disease, perceptive deafness and microcephaly, was admitted because of vomiting and failure to thrive. An upper endoscopy demonstrated dilated proximal duodenum and a perforated diaphragm in the second segment of the duodenum. Endoscopic membranectomy was therefore performed. Two months later the patient was submitted to a further endoscopic evaluation that showed a partial diaphragm persistence and a second excision was performed. Follow-up one year after the first treatment showed good clinical conditions, reasonable physical growth and disappearance of vomiting. In conclusion we report the first case of CRS in association with duodenal stenosis. Duodenal stenosis in the absence of other intestinal localizations may be due to rubella capacity of infecting only small numbers of fetal cells but we cannot exclude that the duodenal stenosis in our patient be only a casual association.

Rubéola: el nuevo escenario de una vieja enfermedad

World Health Organization has the target by the year 2010 of reducing congenital rubella syndrome to less than 1/100,000 live births, being necessary the control of the virus circulation. Rubella is currently a low-incidence disease, that affected to children in the pre-vaccine era. The excellent measles-mumps-rubella vaccine coverage in children, together with the vaccination campaigns in childbearing age women, leads to get very high protection. Until recently, susceptible individuals were grouped in a reduced fraction of young men, born after the decline of wild virus circulation and that did not receive the vaccine, due to its age. The new demographic situation derived from the immigration is causing important changes in the susceptibility pattern. Many immigrants came to Spain from regions where rubella vaccine is not (or until recently was not) administered; as result, it can emerge an accumulation of susceptible individuals (especially among adults) allowing the re-circulation of the virus.

The contribution of HLA class I antigens in immune status following two doses of rubella vaccination

The variability of humoral and cellular immune responses modulated by human leukocyte antigen (HLA) genes is a significant factor in the protective effect of rubella vaccines. We performed HLA class I typing in a group of 346 healthy schoolchildren and young adults who previously received two doses of measles-mumps-rubella-II vaccine. Rubella virus-specific humoral (serum antibody) immunity and cell-mediated immunity (lymphocyte proliferation) were assessed. Median values for antibody levels and stimulation indices (SI) were 38.63 IU/ml and 2.29 IU/ml, respectively. The alleles that provided suggestive, but not conclusive, evidence of HLA association with rubella seropositivity were HLA-B*2705 (median, 24.68 IU/ml; p = 0.160), B*4501 (median, 61.22 IU/ml; p = 0.098), Cw*0303 (median, 30.34 IU/ml; p = 0.102) and Cw*0704 (median, 26.58 IU/ml; p = 0.144). These alleles approach, but do not achieve, statistical significance. Of all the alleles analyzed, HLA-B*3503 (median SI, 3.00; p = 0.031) and HLA-Cw*1502 (median SI, 3.19; p = 0.035) were positively associated with lymphoproliferative responses to rubella virus antigens, whereas the HLA-B*3901 (SI, 1.34; p = 0.066) allele was negatively associated. This suggests that class I HLA alleles may have limited associations with humoral and cellular immune responses to rubella vaccine. These data may facilitate our understanding of immune response variation in a genetically outbred heterogeneous population.

Effects of endocytosis inhibitory drugs on rubella virus entry into VeroE6 cells

It has been suggested that infectious entry of rubella virus (RV) is conducted by receptor mediated endocytosis. To explore the cellular entry mechanism of RV, inhibitory effects of drugs affecting various endocytic pathways on RV entry into VeroE6 cells were analyzed. Results showed that RV infectious entry into VeroE6 cells is mediated by clathrin-dependent endocytosis and not by caveolae-mediated endocytosis. Moreover, chemical inhibition of macropinocytosis such as treatments of amiloride, actin and microtubule-disrupting drug significantly reduced RV infection. Considering that macropinocytosis is inducible endocytosis by cellular stimulations, clathrin-mediated endocytosis is likely to be a major route of RV infectious entry.

Virus factories: associations of cell organelles for viral replication and morphogenesis

Genome replication and assembly of viruses often takes place in specific intracellular compartments where viral components concentrate, thereby increasing the efficiency of the processes. For a number of viruses the formation of 'factories' has been described, which consist of perinuclear or cytoplasmic foci that mostly exclude host proteins and organelles but recruit specific cell organelles, building a unique structure. The formation of the viral factory involves a number of complex interactions and signalling events between viral and cell factors. Mitochondria, cytoplasmic membranes and cytoskeletal components frequently participate in the formation of viral factories, supplying basic and common needs for key steps in the viral replication cycle.

Monitoring congenital rubella embryopathy

BACKGROUND

Currently, all developed countries include rubella vaccination in their immunization programs, targeting the complete elimination of congenital rubella syndrome (CRS). In the underdeveloped world, where this severely disabling condition still exists, only a few countries have implemented vaccination policies, and almost no data on their effectiveness or on prevalence rates are available. The aims of the present work were to search for the best phenotype to be used as a sentinel for CRS in a large series of malformed newborns and to propose a CRS surveillance system, based only on clinical data.

METHODS

A total of 43 infants diagnosed as having CRS were obtained from 19,184 multimalformed infants, ascertained by the Latin-American Collaborative Study of Congenital Malformations, World Health Organization (WHO) Collaborating Centre for the Prevention of Birth Defects (ECLAMC), over 3,883,165 consecutive births, between 1982 and 2003. They were distributed by country and the most frequent birth defects were identified. From the 19,184 multimalformed infants, all cases presenting the birth defects identified were selected. The sensitivity, specificity, and likelihood ratio (LR) in detecting CRS were determined for these birth defects, alone and in combination. The sample size of multimalformed infants required to detect different levels of increase in the rate of CRS was determined for three sentinel phenotypes.

RESULTS

The rate of CRS was highest in Brazil. Based on the best possible combination of sensitivity, specificity, and LR, the dyad comprising eye anomalies and congenital heart defects was shown to be the most appropriate sentinel, with the lowest sample size required, to detect CRS in neonates.

CONCLUSIONS

A surveillance system for CRS, based on clinical data in newborns, is being proposed, in an attempt to monitor ongoing vaccination policies, aimed at eliminating CRS in developing countries.

Rubella virus and birth defects: Molecular insights into the viral teratogenesis at the cellular level

BACKGROUND

In utero rubella virus (RV) infection of a fetus can result in birth defects that are often collectively referred to as congenital rubella syndrome (CRS). In extreme cases, fetal death can occur. In spite of the availability of a safe and effective vaccine against rubella, recent worldwide estimates are that more than 100,000 infants are born with CRS annually.

RECENT PROGRESS

Recently, several significant findings in the field of cell biology, as well as in the RV replication and virus-cell interactions, have originated from the authors' laboratory, and other researchers have provided insights into RV teratogenesis. It has been shown that 1) an RV protein induces cell-cycle arrest by generating a subpopulation of tetraploid nuclei (i.e., 4N DNA) cells, perhaps representative of the tetraploid state following S phase in the cell cycle, due to its interaction with citron-K kinase (CK); 2) RV infection induces apoptosis in cell culture, and 3) CK functional perturbations lead to tetraploidy, followed by apoptosis, in specific cell types.

CONCLUSIONS

Based on several similarities between known RV-associated fetal and cellular manifestations and CK deficiency-associated phenotypes, it is reasonable to postulate that P90-CK interaction in RV-infected cells interferes with CK function and induces cell-cycle arrest following S phase in a subpopulation, perhaps representative of tetraploid stage, which could lead to subsequent apoptosis in RV infection. Taking all these observations to the fetal organogenesis level, it is plausible that P90-CK interaction could perhaps be one of the initial steps in RV infection-induced apoptosis-associated fetal birth defects in utero.

Structural maturation of rubella virus in the Golgi complex

Rubella virus (RUB) assembles its replication complexes (RCs) in modified organelles of endo‐lysosomal origin, known as cytopathic vacuoles (CPVs). These peculiar structures are key elements of RUB factories, where rough endoplasmic reticulum, mitochondria, and Golgi are recruited. Bicistronic RUB replicons expressing an antibiotic resistance gene either in the presence or the absence of the RUB capsid (C) gene were used to study the structure of RCs in transfected cells. Confocal microscopy showed that the RUB replicase components P90 and P150 localized to CPVs, as did double‐stranded RNA (dsRNA), a marker for RNA synthesis. Electron microscopy (EM) showed that replicons generated CPVs containing small vesicles and large vacuoles, similar to CPVs from RUB‐infected cells and that the replicase proteins were sufficient for organelle recruitment. Some of these CPVs contained straight membranes. When cross‐sectioned, these rigid membranes appeared to be sheets of closely packed proteins. Immuno‐EM revealed that these sheets, apparently in contact with the cytosol, contained both P150 and P90, as well as dsRNA, and thus could be two‐dimensional arrays of functional viral replicases. Labelling of dsRNA after streptolysin‐O permeabilization showed that replication of viral genome takes place on the cytoplasmic side of CPVs. When present, C accumulated around CPVs. Mitochondrial protein P32 was detected within modified CPVs, the first demonstration of involvement of this protein, which interacts with C, with RCs.

Evaluation of the seroprevalence of rubella in the region of Dakar (Senegal)

Data on the seroepidemiology of rubella in tropical African countries are still scarce. To determine the seroprevalence in Senegal, we conducted a 6 year retrospective survey among women of child bearing age in the urban region of Dakar, Senegal. The global seroprevalence determined with a commercial enzyme immunoassay among 3471 serological results was 90.1%. The distribution of this prevalence appeared stable with no significant difference between the years of study, age groups, and the socio-economic level of the districts of residence of the patients. Compared to seroepidemiological surveys performed in other western African countries, our data suggest an important and stable circulation of the virus in the region of Dakar. The lack of data on rubella and congenital rubella syndrome (CRS) in Senegal should encourage medical authorities to establish a national rubella surveillance network in order to develop a strategy to survey and control CRS in the country.

Characteristics and mechanisms of isolated rubella virus, strain JR23: infection of the central nervous system of BALB/c mice

OBJECTIVE

To investigate the correlation between rubella virus (RuV) antigen in peripheral lymphocytes, the immune status and RuV infection in the central nervous system (CNS).

METHODS

BALB/c mice were used as a model and treated with immunoaffecting medicines. Then, the mice were infected with RuV via the abdominal cavity, and the antigen level in peripheral lymphocytes was examined 1, 3, 7 and 14 days postinfection. RuV in the CNS was detected by immunohistochemical methods. BALB/c mice were given dexamethasone and cytoxan before infection with the RuV JR23 strain. Immune functions and RuV invasion of the CNS were assayed on day 21 postinfection via the abdominal cavity, and their relationship was analyzed.

RESULTS

The mean antigen detection rates at different times were 3.1, 4.1, 9.6 and 2.4%, respectively, in the dexamethasone group, and 14.2, 12.7, 9.9 and 3.1%, respectively, in the cytoxan group. In the group without any intervention, the detection rates were 4.63, 10.25, 6.88 and 1.75%, respectively. The antigen detection rates in peripheral lymphocytes among the three groups 24 h postinfection were significantly different (F = 0.0317, p < 0.05). Comparisons between groups showed that antigen detection rates in the cytoxan group were much higher than those in other groups, but there was no difference between the dexamethasone and control groups. The animals with persistent presence of antigen were much more susceptible to cerebral infection than those with short-term presence (p < 0.001). T cell functions of the cytoxan group were significantly lower than those of other groups (p < 0.05), as detected by the MTT method. Infection rates of the dexamethasone, cytoxan and control groups were 60, 90 and 50%, respectively. Cell immune functions of the mice with CNS infection were obviously worse than those of the mice without CNS infection (p < 0.001). RuV-specific antibodies were assayed in all groups by ELISA and the results showed that there were no significant differences among groups (p < 0.05) or between the groups with and without CNS infection.

CONCLUSION

Cytoxan can affect virus detection rates in peripheral lymphocytes. At the early phase of infection, the persistent presence of RuV in peripheral lymphocytes increases the incidence of CNS infection. RuV infection in the CNS was related to the cell immune situation before specific antibody was produced in the body.

Anticytokine therapy--new approach to the treatment of autoimmune and cytokine-disturbance diseases

We pioneered the theory (Nature, 1974) that hyperproduced interferons (cytokines) can bring autoimmune diseases (AD) and neutralizing these cytokines can be therapeutic. In 1975 we first performed successful anticytokine therapy using anti-IFN-alpha antibodies in patients with rheumatoid arthritis (RA). In 1989 we proposed also treating AD including AIDS by removing TNF-alpha and IFN-alpha. Our theory has been widely confirmed: injections of IFN-alpha and -gamma can exacerbate AD, while antibodies to IFN-alpha and -gamma and TNF-alpha can be therapeutic. Anti-IFN-gamma may be a universal treatment for Th1 AD. We had good results using anti-IFN-gamma to treat RA, multiple sclerosis (MS), transplant rejection, alopecia areata, vitiligo, psoriatic arthritis, psoriasis and others. For Th1/Th2 diseases, antagonists to cortisol could prevent the Th1-Th2 shift and allow treatment as a Th1 disease. Anticytokine therapy can also be therapeutic in many neuropsychiatric diseases. Every disturbance of homeostasis may lead to cytokine disturbance. IL-10 may restore homeostasis by inhibiting the production of certain Th1 cytokines and could be used to treat some embryonic disturbances and AD including MS.

A new and efficient synthesis of substituted 6-[(2'-dialkylamino)ethyl] pyrimidine and 4-N,N-dialkyl-6-vinyl-cytosine derivatives and evaluation of their anti-rubella activity

New 6-[(2'-dialkylamino)ethyl]-4(3H)-pyrimidinones were prepared by a multistep procedure starting from acetone dicarboxylic acid diethyl ester and urea derivatives. These compounds were used as starting materials to obtain 4-N,N-dialkyl-6-vinyl-pyrimidine derivatives by an unprecedented tandem C-6 side chain Hofmann-like elimination/C-4 pyrimidinone substitution. Among the new derivatives obtained, various compounds show anti-Rubella activity. The inhibition of HIV-1 Reverse Transcriptases (RT), from both wild type and modified viruses, is also reported.