1
|
Radoi CL, Zlatian O, Balasoiu M, Dragomir TL, Sorop MI, Bagiu IC, Boeriu E, Susan M, Sorop B, Oprisoni LA, Iliescu DG. Seroprevalence of Anti-Cytomegalovirus Antibodies in Pregnant Women from South-West Romania. Microorganisms 2024; 12:268. [PMID: 38399672 PMCID: PMC10893531 DOI: 10.3390/microorganisms12020268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Cytomegalovirus (CMV), in addition to other agents, is part of the TORCH complex (Toxoplasma gondii, Rubella virus, Cytomegalovirus, Herpes simplex viruses, and other agents). CMV infection is the most frequent cause of congenital malformations. This study aimed to establish the variation of prevalence of anti-CMV antibodies in pregnant women from the South-West region of Romania, according to demographic factors, such as age and area of residence, in two separate time periods (2013-2016 and 2019-2022). We collected from the hospital records the age, place of residence, and anti-CMV antibody test results using immune electrochemiluminescence and chemiluminescence. This study found that the seroprevalence of anti-CMV IgM antibodies increased slightly from 2013-2016 to 2019-2022, from 1.92% to 2.26%, and for IgG antibodies from 93.68% to 94.96%. In both groups was observed a descending trend of anti-CMV IgM seroprevalence with an increase in age, showing a decrease in seroprevalence from 3.57% to 1.09% in pregnant women from rural areas in the 31-35 years age group, while in urban areas, we observed a decrease in seroprevalence from 11.11% to 3.06% in the <20 years age group. The IgG seroprevalence showed an increase both in rural areas (from 93.97% to 95.52%) and urban areas (from 93.52% to 94.27%). In both groups, seroprevalence was higher in rural areas compared to urban regions. These results show a high rate of immunization against CMV in pregnant women in South-West Romania, which led to a low risk of acquiring the primary infection during pregnancy. However, the increase in the rate of primary CMV infections in pregnancy suggests the need for prioritizing screening programs and improving the existing protocols to enhance maternal and child healthcare.
Collapse
Affiliation(s)
- Cristiana Luiza Radoi
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Ovidiu Zlatian
- Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania; (O.Z.); (M.B.)
- Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Balasoiu
- Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania; (O.Z.); (M.B.)
- Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Tiberiu-Liviu Dragomir
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Madalina Ioana Sorop
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Iulia Cristina Bagiu
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Estera Boeriu
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Monica Susan
- Department of Internal Medicine I, Centre for Preventive Medicine,”Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania;
| | - Bogdan Sorop
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Licinia Andrada Oprisoni
- Department of Pediatrics, Discipline of Pediatric Oncology and Hematology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Dominic Gabriel Iliescu
- Obstetrics and Gynecology Department, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania;
- Obstetrics and Gynecology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| |
Collapse
|
2
|
Greye H, Henning S, Freese K, Köhn A, Lux A, Radusch A, Redlich A, Schleef D, Seeger S, Thäle V, Rissmann A. Cross-sectional study to assess awareness of cytomegalovirus infection among pregnant women in Germany. BMC Pregnancy Childbirth 2022; 22:964. [PMID: 36566184 PMCID: PMC9789651 DOI: 10.1186/s12884-022-05312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Study aimed to assess awareness of congenital cytomegalovirus (CMV) infection and its determinants in pregnancy. METHODS Cross-sectional survey was conducted in five hospital-based maternity units in Germany. Pregnant women attending the maternity departments completed interviewer/self-administered survey questionnaire. High-risk group was defined according to contact with children under five years of age (at home or at work). Quantitative analyses using multivariable logistic regression were performed. RESULTS One thousand two hundred thirty-three pregnant women were included. 48.5% (n = 598) of women reported any knowledge about risk of CMV infection during pregnancy. CMV infection was less known than other infections or diseases (education about toxoplasmosis 95.5% (n = 1,177), listeriosis 60.5% (n = 746). 38% (n = 468) of participants received education about CMV. CMV awareness was associated with the level of education and employment in childcare or medical care. Only 32% (n = 394) of the women made use of serological screening for CMV during pregnancy (individual health service). 40.8% (n = 503) of pregnant women were classified as high-risk group. They had significantly higher knowledge and education about CMV, and msignificantlycant more often use of the serological screening. CONCLUSIONS Less than half of pregnant women surveyed were aware of potential risk associated with CMV infection during pregnancy. In our study,one-third third of pregnant women made use of the serological screening for CMV. Regarding the lack of current consensus on the role of serological CMV screening for pregnant women, hygiene preventive measures are the only evidence-based recommendation for pregnant women and knowledge increase could potentially have major public health impact.
Collapse
Affiliation(s)
- Hannah Greye
- grid.5807.a0000 0001 1018 4307Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-Von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Stine Henning
- grid.5807.a0000 0001 1018 4307Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-Von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Kristina Freese
- Department of Obstetrics and Gynaecology, St. Marienstift Hospital Magdeburg, Harsdorfer Straße 30, 39110 Magdeburg, Germany
| | - Andrea Köhn
- grid.5807.a0000 0001 1018 4307Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-Von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Anke Lux
- grid.5807.a0000 0001 1018 4307Institute for Biometrics and Medical Informatics, Medical Faculty, Otto-Von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Anja Radusch
- Department of Gynaecology and Obstetrics, Perinatal Centre, St. Elisabeth and St. Barbara Halle, Mauerstraße 5, 06110 Halle (Saale), Germany
| | - Anke Redlich
- grid.5807.a0000 0001 1018 4307Department of Obstetrics and Gynaecology, Otto-Von-Guericke-University Magdeburg, Gerhart-Hauptmann-Straße 35, 39108 Magdeburg, Germany
| | - Daniela Schleef
- Department of Obstetrics and Gynecology, Hospital Magdeburg GmbH, Birkenallee 34, 39130 Magdeburg, Germany
| | - Sven Seeger
- Department of Gynaecology and Obstetrics, Perinatal Centre, St. Elisabeth and St. Barbara Halle, Mauerstraße 5, 06110 Halle (Saale), Germany
| | - Volker Thäle
- grid.9018.00000 0001 0679 2801Department of Obstetrics and Fetal Medicine, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Anke Rissmann
- grid.5807.a0000 0001 1018 4307Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-Von-Guericke-University Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany
| |
Collapse
|
3
|
Hill M, Obeng-Gyasi E. The Association of Cytomegalovirus IgM and Allostatic Load. Diseases 2022; 10:diseases10040070. [PMID: 36278569 PMCID: PMC9590072 DOI: 10.3390/diseases10040070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cytomegalovirus (CMV) is a deoxyribonucleic acid virus that affects a significant proportion of the worldwide population; after primary infection, it goes into a latent state and can be reactivated, primarily after a reduction in host immune defenses. Methods: This study evaluated the association of acute cytomegalovirus infection (CMV IgM) and Allostatic Load (AL) by sociodemographic factors using data from the National Health and Nutrition Examination Survey (NHANES) 2001–2004 among participants (aged 20–49 years). CMV infection was determined by the level of CMV IgM antibody in serum samples. AL was assessed as a combination of 10 biomarkers from the cardiovascular, inflammatory, and metabolic systems. The evaluation of the association between CMV infection and AL included descriptive statistics and logistic regression models, which were adjusted for demographic and behavioral covariates. Results: AL was more elevated among those who were older, male, those with lower education, those performing limited physical activity, and smokers. CMV was more elevated in females than males among those who consumed alcohol and cigarette smokers. In Pearson’s correlation analysis, there was a slight positive correlation between CMV IgM and AL, with triglycerides and Body Mass Index (BMI) the most strongly correlated with AL. Binary logistic regression showed no significant relationship between high AL and positive CMV IgM but did show a significant relationship between high AL and age (OR = 1.0592, 95% CI 1.0215–1.0983, p = 0.00715). The findings of this study provide insight into the relationship between CMV and AL and provide awareness of factors that affect their relationship.
Collapse
Affiliation(s)
- Matthew Hill
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
- Correspondence: ; Tel.: +1-336-285-3132
| |
Collapse
|
4
|
Bopp L, Kreuter A, von Stebut E, Fabri M. [Virus-induced exanthems in returning travellers]. Hautarzt 2022; 73:462-474. [PMID: 35554622 PMCID: PMC9100320 DOI: 10.1007/s00105-022-05001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/25/2022]
Abstract
Dermatological diseases are among the most common travel-associated diseases. In particular, viral infections not only with tropical and subtropical pathogens, but also with viruses common in Germany, which are often accompanied by skin rashes and general symptoms, are of great importance. In addition to an accurate travel history and possible risk exposures, epidemiological information on country-specific risks in combination with molecular and serological analyses is helpful in making the correct diagnosis. This article provides an overview of important virus-induced exanthems in returned travellers.
Collapse
Affiliation(s)
- Luisa Bopp
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Oberhausen, Deutschland
| | - Esther von Stebut
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Mario Fabri
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| |
Collapse
|
5
|
Seroprevalence of Cytomegalovirus in Haemodialysis Patients. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cytomegalovirus (CMV) is prevalent worldwide. It belongs to the β-herpesvirinae subfamily of Herpesviridae and comprises a double-stranded linear DNA genome and capsid, surrounded by an envelope. CMV infection is most prominently found in patients with kidney failure caused by various possible reasons such as urinary tract infection or systemic disease and are undergoing dialysis. The present study was conducted during the period of March 2020 to April 2021. It included 96 patients with chronic kidney disease undergoing hemodialysis (44 of patients were women and 52 men) within the age range of 11-70 years. Five-mL of the venous blood sample was drawn from each patient to conduct the rapid antibody test for the presence of CMV-specific antibodies (both IgG, and IgM). This study showed that the seroprevalence of CMV infection among haemodialysis patients was 75%. The seropositivity for CMV-IgG was 72.9% which was significantly higher than that for CMV-IgM (2.1%) for both sexes. The present study further demonstrated that the prevalence of positive CMV-IgG in males was higher than that in females (38.5% and 34.4%, respectively). In addition, the positivity of CMV-IgM was highest in the age group 61–70 years old (2.1%), while the positivity of CMV-IgG was highest in patients age groups 41–50 years (24%). The present study revealed a high seroprevalence of CMV infection among haemodialysis patients in Basrah City. The elevated seroprevalence could be related to many factors, including the endemicity of the virus, public health, patient immunity, environmental factors, and geographical location. CMV infection increases with age, and the infection rate in men was higher than that in women. The seroprevalence rate of CMV-IgG antibodies was higher than that of CMV-IgM antibodies, indicating a previous infection or reactivation of CMV virus among haemodialysis patients, leading to a high risk of CMV infection.
Collapse
|
6
|
Fractalkine/CX3CL1 in Neoplastic Processes. Int J Mol Sci 2020; 21:ijms21103723. [PMID: 32466280 PMCID: PMC7279446 DOI: 10.3390/ijms21103723] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
Fractalkine/CX3C chemokine ligand 1 (CX3CL1) is a chemokine involved in the anticancer function of lymphocytes-mainly NK cells, T cells and dendritic cells. Its increased levels in tumors improve the prognosis for cancer patients, although it is also associated with a poorer prognosis in some types of cancers, such as pancreatic ductal adenocarcinoma. This work focuses on the 'hallmarks of cancer' involving CX3CL1 and its receptor CX3CR1. First, we describe signal transduction from CX3CR1 and the role of epidermal growth factor receptor (EGFR) in this process. Next, we present the role of CX3CL1 in the context of cancer, with the focus on angiogenesis, apoptosis resistance and migration and invasion of cancer cells. In particular, we discuss perineural invasion, spinal metastasis and bone metastasis of cancers such as breast cancer, pancreatic cancer and prostate cancer. We extensively discuss the importance of CX3CL1 in the interaction with different cells in the tumor niche: tumor-associated macrophages (TAM), myeloid-derived suppressor cells (MDSC) and microglia. We present the role of CX3CL1 in the development of active human cytomegalovirus (HCMV) infection in glioblastoma multiforme (GBM) brain tumors. Finally, we discuss the possible use of CX3CL1 in immunotherapy.
Collapse
|
7
|
Hoehl S, Berger A, Ciesek S, Rabenau HF. Thirty years of CMV seroprevalence-a longitudinal analysis in a German university hospital. Eur J Clin Microbiol Infect Dis 2020; 39:1095-1102. [PMID: 31989374 PMCID: PMC7225192 DOI: 10.1007/s10096-020-03814-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/12/2020] [Indexed: 01/20/2023]
Abstract
Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality in patient groups at risk. We have previously shown that the anti-CMV IgG seroprevalence in an urban region of Germany has changed over the last decades. Overall, a decline from 63.7 to 57.25% had been observed between 1988–1997 and 1998–2008 (p < 0,001). Here, we continuously follow the trends to the most recent decade 2009 to 2018. In a retrospective analysis, we determined the seroprevalence of CMV IgG antibodies in our patient cohort, stratified by gender and selected groups at risk (e.g., patients with HIV infection; women of childbearing age). The overall prevalence of anti-CMV IgG non-significantly declined further from 57.25% in 1998–2008 to 56.48% in 2009–2018 (p = 0.881). Looking at gender differences, overall CMV seroprevalence in males declined to 52.82% (from 55.54% in 1998–2008; p = 0.0254), while it non-significantly increased in females to 59.80%. The high seroprevalence in patients with a known HIV infection further increased from 87.46% in 1998–2008 to 92.93% in the current period (p = 0.9999). In women of childbearing age, no significant changes over the last three decades could be observed. The CMV seroprevalence in oncological patients was determined to be 60.64%. Overall, the former significant decline of CMV seroprevalence between the decades 1988–1997 and 1998–2008 in this urban region of Germany slowed down to a non-significant decrease of 0.77% (1998–2008 vs. 2009–2018). This might be an indicator that CMV seroprevalence has reached a plateau.
Collapse
Affiliation(s)
- Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany.
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Paul-Ehrlich-Straße 40, 60496, Frankfurt am Main, Germany.
| |
Collapse
|
8
|
Wei-Lu, Chen SJ, Huang SF, Chan YJ, Wang FD, Chen HP. Clinical significance of human cytomegalovirus viruria and the effect of antiviral therapy in hematopoietic stem cell transplant recipients. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2019; 52:402-408. [PMID: 29126804 DOI: 10.1016/j.jmii.2017.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/10/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) causes life-threatening infections in immunocompromised host. The clinical significance of asymptomatic CMV viruria in patients receiving hematopoietic stem cell transplantation (HSCT) remains unclear. This study aims to clarify whether antiviral therapy is associated with a favorable clinical outcome. METHODS HSCT recipients whose urine was culture-positive for CMV were retrospectively reviewed and followed. Viruria episodes were divided according to whether or not antiviral therapy was used. Mortality and the estimated glomerular filtration rate (eGFR) in 2 years following CMV viruria were compared between patients with and without antiviral therapy. RESULTS Sixty-two episodes of culture-proven asymptomatic CMV viruria were identified in 28 HSCT recipients. Antiviral therapy was used in 35 (56.5%) and spared in 27 (43.5%) viruric episodes. Compared with the baselines, there were no significant difference in the decrements of eGFR between the two groups at the end the 1st year (4.78 vs 5.02 mL/min/1.73 m2, p = 0.968) and the 2nd year (1.13 vs 7.66 mL/min/1.73 m2, p = 0.276). Antiviral therapy for asymptomatic CMV viruria was also not associated with a favorable survival (p = 0.288). On the other hand, presence of CMV viremia correlated with a poorer survival (2-year mortality rate 60% vs 13.33%, p < 0.001). CONCLUSION Antiviral therapy for asymptomatic CMV viruria is not associated with a clear clinical benefit in HSCT recipients. Further studies may be needed to identify if specific patient populations may benefit from antiviral therapy in CMV viruria.
Collapse
Affiliation(s)
- Wei-Lu
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Internal Medicine, Department of Medicine, Cardinal Tien Hospital, Xindian Dist., New Taipei City, Taiwan
| | - Su-Jung Chen
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shiang-Fen Huang
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Jiun Chan
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fu-Der Wang
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Pai Chen
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
9
|
Berger A, Doerr HW. Preventing vertical virus infections: the role of serologic screening of pregnant women. Med Microbiol Immunol 2018; 207:249-253. [PMID: 29971491 DOI: 10.1007/s00430-018-0549-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/29/2018] [Indexed: 12/28/2022]
Abstract
Several virus infections affect the pregnancy itself as well as the foetal development (rubella, PVB19, VZV, HSV, HCMV, HBV, HIV). Prevention can be established by vaccination or an assessment of the immunity status as well as by chemotherapy. The following review provides an update to current aspects focusing on the role of serologic screening.
Collapse
Affiliation(s)
- Annemarie Berger
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt, Goethe Universität, Paul Ehrlich Str. 40, 60596, Frankfurt, Germany.
| | - Hans Wilhelm Doerr
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt, Goethe Universität, Paul Ehrlich Str. 40, 60596, Frankfurt, Germany
| |
Collapse
|
10
|
Korbecki J, Gutowska I, Kojder I, Jeżewski D, Goschorska M, Łukomska A, Lubkowska A, Chlubek D, Baranowska-Bosiacka I. New extracellular factors in glioblastoma multiforme development: neurotensin, growth differentiation factor-15, sphingosine-1-phosphate and cytomegalovirus infection. Oncotarget 2018; 9:7219-7270. [PMID: 29467963 PMCID: PMC5805549 DOI: 10.18632/oncotarget.24102] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/02/2018] [Indexed: 11/25/2022] Open
Abstract
Recent years have seen considerable progress in understanding the biochemistry of cancer. For example, more significance is now assigned to the tumor microenvironment, especially with regard to intercellular signaling in the tumor niche which depends on many factors secreted by tumor cells. In addition, great progress has been made in understanding the influence of factors such as neurotensin, growth differentiation factor-15 (GDF-15), sphingosine-1-phosphate (S1P), and infection with cytomegalovirus (CMV) on the 'hallmarks of cancer' in glioblastoma multiforme. Therefore, in the present work we describe the influence of these factors on the proliferation and apoptosis of neoplastic cells, cancer stem cells, angiogenesis, migration and invasion, and cancer immune evasion in a glioblastoma multiforme tumor. In particular, we discuss the effect of neurotensin, GDF-15, S1P (including the drug FTY720), and infection with CMV on tumor-associated macrophages (TAM), microglial cells, neutrophil and regulatory T cells (Treg), on the tumor microenvironment. In order to better understand the role of the aforementioned factors in tumoral processes, we outline the latest models of intratumoral heterogeneity in glioblastoma multiforme. Based on the most recent reports, we discuss the problems of multi-drug therapy in treating glioblastoma multiforme.
Collapse
Affiliation(s)
- Jan Korbecki
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.,Department of Biochemistry and Molecular Biology, Faculty of Health Sciences, University of Bielsko-Biała, 43-309 Bielsko-Biała, Poland
| | - Izabela Gutowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
| | - Ireneusz Kojder
- Department of Applied Neurocognitivistics, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland.,Department of Neurosurgery, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
| | - Dariusz Jeżewski
- Department of Applied Neurocognitivistics, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland.,Department of Neurosurgery, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
| | - Marta Goschorska
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Agnieszka Łukomska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Irena Baranowska-Bosiacka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| |
Collapse
|
11
|
Development of a Bead-Based Multiplex Assay for the Analysis of the Serological Response against the Six Pathogens HAV, HBV, HCV, CMV, T. gondii, and H. pylori. High Throughput 2017; 6:ht6040014. [PMID: 29855458 PMCID: PMC5748593 DOI: 10.3390/ht6040014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/17/2017] [Accepted: 10/26/2017] [Indexed: 02/06/2023] Open
Abstract
The spread of infectious diseases and vaccination history are common subjects of epidemiological and immunological research studies. Multiplexed serological assays are useful tools for assessing both current and previous infections as well as vaccination efficacy. We developed a serological multi-pathogen assay for hepatitis A, B and C virus, cytomegalovirus (CMV), Toxoplasma gondii, and Helicobacter pylori using a bead-based multiplex assay format. The multi-pathogen assay consisting of 15 antigens was utilized for the analysis of the serological response in elderly individuals of an influenza vaccination study (n = 34). The technical assay validation revealed a mean intra-assay precision of coefficient of variation (CV) = 3.2 ± 1.5% and a mean inter-assay precision of CV = 8.2 ± 5.3% across all 15 antigens and all tested samples, indicating a robust test system. Furthermore, the assay shows high sensitivities (ranging between 94% and 100%) and specificities (ranging between 93% and 100%) for the different pathogens. The highest seroprevalence rates in our cohort were observed for hepatitis A virus (HAV; 73.5%), followed by CMV (70.6%), T. gondii (67.6%) and H. pylori (32.4%). Seroprevalences for hepatitis B virus (HBV, 8.8%) and hepatitis C virus (HCV, 0%) were low. The seroprevalences observed in our study were similar to those from other population-based studies in Germany. In summary, we conclude that our multiplex serological assay represents a suitable tool for epidemiological studies.
Collapse
|
12
|
Ye B, Zhao H. Early abnormal liver enzyme levels may increase the prevalence of human cytomegalovirus antigenaemia after hematopoietic stem cell transplantation. J Int Med Res 2017; 45:673-679. [PMID: 28415934 PMCID: PMC5536655 DOI: 10.1177/0300060516689013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Human cytomegalovirus (HCMV) infection is common after bone marrow transplantation (BMT), and it increases morbidity and mortality for transplant recipients. HCMV infection may cause hepatitis and elevate the liver enzymes aspartate transferase (AST) and alanine transferase (ALT). This study aimed to analyse the associations between liver enzyme levels and infection with HCMV antigenaemia after BMT. Methods Data from 30 patients after BMT were collected at different time points (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 4.0, 5.0, and 6.0 months post-transplantation). The patients were divided into the HCMV antigenaemia-positive and HCMV antigenaemia-negative groups according to a peripheral blood pp65 antigen assay. Immunohistochemistry was used to identify HCMV pp65 antigen and conventional methods were used to detect liver enzyme levels. Results Twelve patients were pp65 antigenaemia-positive and 10 patients were positive in the first 3 months post-transplant. Liver enzyme levels were increased after positivity for HCMV antigenaemia (p = 0.034 and p = 0.018 for ALT and AST, respectively). One month before antigenaemia, AST levels were higher in the HCMV antigenaemia-positive group compared with the negative group (p = 0.006). Conclusion HCMV antigenaemia mostly occurs in the early stage of post-BMT and early abnormal liver enzyme levels may increase the chance of HCMV antigenaemia after BMT.
Collapse
Affiliation(s)
- Baning Ye
- 1 Department of Intensive Care Unit, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Hong Zhao
- 2 Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
13
|
Abstract
Cytomegalovirus (CMV) infection remains the leading cause of congenital virus infection in developed countries. Measuring the national prevalence of this infection, especially among women of childbearing age, is of great value to estimate the risk of congenital CMV infection, as well as to identify risk groups that should be targeted for behavioural interventions and/or vaccination once a CMV vaccine finally becomes available. In order to fulfil these objectives, a seroprevalence survey was conducted in 2010, using a nationally representative, population-based sample of 2536 people aged between 15 and 49 years, living in metropolitan France and attending private microbiological laboratories for blood testing. All blood samples were analysed in the same laboratory and screened for CMV-specific IgG using an enzyme-linked immunoassay technique (Elisa PKS Medac Enzyme immunoassay). The overall point estimate of CMV infection seroprevalence for individuals aged 15-49 years was 41.9%. The estimates were higher in women than in men (respectively 45.6% and 39.3%), and people born in a non-Western country were more likely to be CMV seropositive than those born in France or in another Western country (93.7% vs. 37.7%). Our results showed that a substantial percentage of women of childbearing age in France are CMV seronegative and therefore at risk of primary CMV infection during pregnancy. Educational measures and future vaccine are key issues to prevent infection in pregnant women and congenital CMV disease.
Collapse
|
14
|
Ibrahim S, Siddiqui AA, Siddiqui AR, Ahmed W, Moss PAH, Lalani ENMA. Sociodemographic factors associated with IgG and IgM seroprevalence for human cytomegalovirus infection in adult populations of Pakistan: a seroprevalence survey. BMC Public Health 2016; 16:1112. [PMID: 27770770 PMCID: PMC5075404 DOI: 10.1186/s12889-016-3772-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/13/2016] [Indexed: 11/16/2022] Open
Abstract
Background The seroprevalence of human cytomegalovirus (HCMV) infection ranges from 30 to 90 % in developed countries. Reliable estimates of HCMV seroprevalence are not available for Pakistan. This study determined the seroprevalence and sociodemographic factors associated with HCMV infection in adult populations of Karachi, Pakistan. Methods A seroprevalence survey was conducted on 1000 adults, including residents of two semi-urban communities, and visitors to a government and a private hospital. Questionnaire-based interviews were conducted. Sera were analysed for HCMV-specific IgG and IgM. Chi-square or Fisher’s exact test was used for comparing sociodemographic variables against seropositivity of HCMV-IgG or IgM. Multiple logistic regression modeling was performed for IgG seroprevalence and adjusted odds ratios were computed. Results The seroprevalence of HCMV-IgG and IgM was 93.2 and 4.3 % respectively. 95.3 % of individuals who were IgM seropositive were also seropositive for IgG. Around 6 % (15/250) of women of childbearing age remained uninfected and were therefore susceptible to primary infection. HCMV-IgG seroprevalence was associated with being female (p = 0.001), increasing age (p = 0.002) and crowding index (p = 0.003) and also with lower levels of both education (p < 0.001) and income (p = 0.008). Seroprevalence also differed significantly by marital status (p = 0.008) and sampling location (p < 0.001). A logistic regression model for HCMV-IgG seroprevalence showed associations with being female (OR = 1.89; 95 % CI: 1.10–3.25), increasing age (OR = 3.95; 95 % CI: 1.79–8.71) and decreasing income (OR = 0.72; 95 % CI: 0.54–0.96). A strong association was observed between increased seroprevalence of HCMV-IgM and decreasing household size (p = 0.008). Conclusions Seroprevalence of HCMV is very high in Pakistan, although 6 % of women of childbearing age remain at risk of primary infection. The IgM seropositivity observed in some individuals living in small household size (1–3 individuals) with persistent HCMV infection could have resulted from a recurrent HCMV infection. Future longitudinal research in pregnant women and neonates is required to study the trends in HCMV seroprevalence over time in Pakistan for the development of a potential HCMV prevention and vaccination programme.
Collapse
Affiliation(s)
- Saira Ibrahim
- Department of Biological and Biomedical Sciences, Aga Khan University, PO Box 3500, Stadium Road, Karachi, 74800, Pakistan
| | - Anwar A Siddiqui
- Department of Biological and Biomedical Sciences, Aga Khan University, PO Box 3500, Stadium Road, Karachi, 74800, Pakistan
| | - Amna R Siddiqui
- Department of Community Health Sciences, Aga Khan University, PO Box 3500, Stadium Road, Karachi, 74800, Pakistan
| | - Waquaruddin Ahmed
- Pakistan Medical Research Council, Research Centre, Jinnah Postgraduate Medical Centre, Rafique Shaheed Road, Karachi, Pakistan
| | - Paul A H Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
| | - El-Nasir M A Lalani
- Department of Pathology and Laboratory Medicine, Aga Khan University, PO Box 3500, Stadium Road, Karachi, 74800, Pakistan.
| |
Collapse
|
15
|
Stranzinger J, Kindel J, Henning M, Wendeler D, Nienhaus A. Prevalence of CMV infection among staff in a metropolitan children's hospital - occupational health screening findings. GMS HYGIENE AND INFECTION CONTROL 2016; 11:Doc20. [PMID: 27730028 PMCID: PMC5039315 DOI: 10.3205/dgkh000280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: Staff in children’s hospitals may run an increased risk of cytomegalovirus (CMV) contact infection leading to a congenital CMV fetopathy during pregnancy. The main risk factor is close contact with inapparent carriers of CMV among infants (<3 years). We therefore examined CMV seroprevalence (SP) and possible risk factors for CMV infection among staff at a children’s hospital. Method: In 2014, staff at a metropolitan children’s hospital were offered a CMV antibody test in the context of occupational health screening. Besides of anti-CMV immunoglobulin G (anti-CMV IgG) gender, age, profession, number of children and migration background were assessed and used as independent variables in multiple logistic regression. Women without a migration background (MIG) were considered as a separate group. Results: The study included 219 employees. Women showed a significant higher risk than men of being CMV-positive (adjusted odds ratio [aOR] 3.0; 95% CI 1.1–7.8). The risk among age groups of 30 and over was double that of the under-30s (aOR 2.0; 95% CI 1.0–3.9); among those aged 40-plus it was aOR 2.3 (95% CI 1.1–4.7). Staff with an MIG tested more often positive than those without an MIG (95.5% versus 45.7%). CMV SP was 47.7% among women without an MIG. In this subgroup the probability of CMV infection increased with age (p=0.08) as well. Conclusion: In the staff group as a whole there was a significant correlation between CMV SP, country of origin and age. We found no significant differences between occupational groups; perhaps our random sample was too small. Given the low CMV SP particularly in those without MIG, women who want to have children in particular must be protected from CMV infection. Follow-up studies should be undertaken to test whether good workplace hygiene offers sufficient protection for pregnant women and could be an alternative to prohibiting certain activities.
Collapse
Affiliation(s)
- Johanna Stranzinger
- BGW, Basics of Prevention and Rehabilitation, Occupational Medicine and Health Sciences Division, Hamburg, Germany
| | - Jutta Kindel
- Practising Specialist in Occupational Medicine, Hamburg, Germany
| | - Melanie Henning
- BGW, Basics of Prevention and Rehabilitation, Occupational Medicine and Health Sciences Division, Hamburg, Germany
| | - Dana Wendeler
- BGW, Basics of Prevention and Rehabilitation, Occupational Medicine and Health Sciences Division, Hamburg, Germany
| | - Albert Nienhaus
- BGW, Basics of Prevention and Rehabilitation, Occupational Medicine and Health Sciences Division, Hamburg, Germany; Center of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| |
Collapse
|
16
|
Vilibic-Cavlek T, Kolaric B, Beader N, Vrtar I, Tabain I, Mlinaric-Galinovic G. Seroepidemiology of cytomegalovirus infections in Croatia. Wien Klin Wochenschr 2016; 129:129-135. [PMID: 27599701 DOI: 10.1007/s00508-016-1069-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 07/29/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) is endemic worldwide, with marked differences in the seroprevalence rates between countries. The aim of this study was to analyze the seroprevalence of CMV infections in Croatia. METHODS During a 3-year period (2013-2015) 2438 consecutive serum samples collected from Croatian residents were tested for the presence of CMV IgM and IgG antibodies using enzyme-linked immunoassay. The IgM/IgG positive samples were further tested for IgG avidity. RESULTS The overall seroprevalence rates for CMV IgG and IgM antibodies were 74.4 % and 4.3 %, respectively. The IgG seroprevalence showed significant differences between population groups: children/adolescents 54.6 %, general adult population 77.2 %, hemodialysis patients 91.4 % (p < 0.001). Seropositivity of CMV was strongly age-dependent with prevalences ranging from 53.0 % in children less than 10 years old to 93.8 % in persons above 60 years (p < 0.001). There was no difference in the prevalence rate between women with normal pregnancy and women with poor obstetric history. Gender and place of residence were not associated with CMV seropositivity. Using IgG avidity, current/recent primary CMV infection was confirmed by a low/borderline avidity index (AI) in 46.7 % participants, while in 53.3 % a high AI indicated CMV reactivation or reinfection. Primary infections were detected mainly in children and adolescents (83.2 % and 70.5 %, respectively), while reactivation/reinfection was common in persons older than 40 (77.0-100 %). Reactivation/reinfection was most commonly detected in hemodialysis patients (92.3 %). Logistic regression showed that older age and being on hemodialysis were significant predictors of CMV seropositivity. CONCLUSION Infections with CMV are widespread in the Croatian population. Older age and being on hemodialysis appear to be the main risk factors for CMV infection.
Collapse
Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian National Institute of Public Health, Rockefellerova 12, 10000, Zagreb, Croatia.
- School of Medicine University of Zagreb, Zagreb, Croatia.
| | - Branko Kolaric
- Department of Epidemiology, Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
- School of Medicine University of Rijeka, Rijeka, Croatia
| | - Natasa Beader
- School of Medicine University of Zagreb, Zagreb, Croatia
- Clinical Hospital Centre, Zagreb, Croatia
| | - Izabela Vrtar
- Department of Virology, Croatian National Institute of Public Health, Rockefellerova 12, 10000, Zagreb, Croatia
| | - Irena Tabain
- Department of Virology, Croatian National Institute of Public Health, Rockefellerova 12, 10000, Zagreb, Croatia
| | - Gordana Mlinaric-Galinovic
- Department of Virology, Croatian National Institute of Public Health, Rockefellerova 12, 10000, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
| |
Collapse
|
17
|
Nemeckova S, Sroller V, Stastna-Markova M. Evolution of human cytomegalovirus-seronegative donor/-seropositive recipient high-risk combination frequency in allogeneic hematopoietic stem cell transplantations at Institute of Hematology and Blood Transfusion during 1995-2014. Transpl Infect Dis 2016; 18:297-301. [DOI: 10.1111/tid.12508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/05/2015] [Indexed: 11/26/2022]
Affiliation(s)
- S. Nemeckova
- Department of Immunology; Institute of Hematology and Blood Transfusion; Prague Czech Republic
| | - V. Sroller
- Department of Immunology; Institute of Hematology and Blood Transfusion; Prague Czech Republic
| | - M. Stastna-Markova
- Transplantation Ward; Institute of Hematology and Blood Transfusion; Prague Czech Republic
| |
Collapse
|
18
|
Voigt S, Schaffrath Rosario A, Mankertz A. Cytomegalovirus Seroprevalence Among Children and Adolescents in Germany: Data From the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), 2003-2006. Open Forum Infect Dis 2015; 3:ofv193. [PMID: 26817022 PMCID: PMC4724754 DOI: 10.1093/ofid/ofv193] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/01/2015] [Indexed: 11/13/2022] Open
Abstract
CMV seroprevalence increases with age and is significantly associated with migration background, country of origin, and place of birth. We identified the birth order of siblings, breastfeeding, early day care attendance and living in East Germany as further risk factors. Background. Congenital cytomegalovirus (CMV) infection can cause severe birth defects. The majority of children with congenital CMV are born to CMV-seropositive women; however, transmission from mother to fetus and resulting defects are more likely to occur when mothers experience seroconversion during pregnancy. The objective of this study was to provide a population-based estimate of CMV seropositivity and to identify factors that correlate with the detection of CMV-immunoglobulin (Ig)G antibodies. Methods. Cytomegalovirus-specific IgG antibodies were determined by enzyme-linked immunosorbent assay in 13 876 serum samples from children and adolescents (aged 1–17 years). Cytomegalovirus seroprevalence was correlated with children's age, gender, migration background, country of origin, place of birth, socioeconomic status, breast feeding, daycare attendance, order and number of siblings, and residence in East versus West Germany. Results. Age-adjusted seroprevalence was 27.4% (95% confidence interval, 25.8–29.0). Cytomegalovirus seroprevalence increased with age (21.5% at ages 1–2; 32.0% at ages 14–17). Cytomegalovirus seropositivity was significantly associated with migration background, country of origin and place of birth, and (among migrants only) with low socioeconomic status. Risk factors for CMV acquisition included the birth order of siblings, breastfeeding, early daycare attendance, and living in East Germany. Conclusions. In Germany, CMV seroprevalence increases with age, irrespective of gender. These data highlight risk factors associated with seroprevalence and help to identify a target age for the application of a CMV vaccine.
Collapse
Affiliation(s)
- Sebastian Voigt
- Departments of Infectious Diseases; Department of Pediatric Oncology/Hematology/SCT, Charité-Universitätsmedizin, Berlin, Germany
| | | | | |
Collapse
|
19
|
Reitter A, Buxmann H, Haberl AE, Schlösser R, Kreibich M, Keppler OT, Berger A. Incidence of CMV co-infection in HIV-positive women and their neonates in a tertiary referral centre: a cohort study. Med Microbiol Immunol 2015; 205:63-71. [PMID: 26155982 DOI: 10.1007/s00430-015-0427-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 06/29/2015] [Indexed: 01/21/2023]
Abstract
Co-infection with CMV in HIV-positive pregnant women is associated with perinatal mother-to-child transmission (MTCT) of both viruses. This retrospective study reports on the incidence of maternal and neonatal CMV (presence of anti-CMV IgG and IgM, CMV DNA PCR and/or CMV virus isolation) in high-risk pregnancies due to maternal HIV infection, MTCT of HIV and/or CMV. One hundred and eleven maternal samples and 75 matched neonatal samples were available for HIV and subsequent CMV testing. In this cohort of HIV-positive pregnant women, 96 (86.5 %) serum samples were anti-CMV IgG positive. In nine (9.4 %) of these, anti-CMV IgM was detected, and in none of them a maternal primary CMV infection was suspected. Fifty-seven (51.8 %) maternal serum samples were tested retrospectively by CMV DNA PCR; one sample was positive (0.9 %). All matched neonates were tested for HIV by PCR in the first month of life; HIV transmission was detected in one case. In 74 (67.2 %) of neonates, CMV testing was performed. Sixty-six of these serum samples were tested retrospectively by CMV DNA PCR. Two newborns (2.7 %) showed laboratory markers for CMV infection (one by detection of CMV DNA in plasma, and one by isolation of CMV from a urine sample). In the follow-up, neither of these two showed clinical signs for active CMV disease. We discussed these findings in the light of the national official guidelines. All CMV transmissions occurred due to maternal reinfection or endogenous reactivation. This suggests the success of highly active antiretroviral therapy in preventing MTCT of HIV and CMV disease and highlights the importance of adequate care and follow-up.
Collapse
Affiliation(s)
- A Reitter
- Department of Obstetrics and Gynaecology, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
| | - H Buxmann
- Division of Neonatology, Department of Pediatrics, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - A E Haberl
- Department of Infectious Diseases, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - R Schlösser
- Division of Neonatology, Department of Pediatrics, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - M Kreibich
- Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany
| | - O T Keppler
- Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany
| | - A Berger
- Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany
| |
Collapse
|
20
|
Heybar H, Alavi SM, Farashahi Nejad M, Latifi M. Cytomegalovirus infection and atherosclerosis in candidate of coronary artery bypass graft. Jundishapur J Microbiol 2015; 8:e15476. [PMID: 25834719 PMCID: PMC4377172 DOI: 10.5812/jjm.15476] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/12/2013] [Accepted: 12/28/2013] [Indexed: 11/24/2022] Open
Abstract
Background: Although there is enough evidence that infectious agents such as Chlamydia pneumonia and Helicobacter pylori may play a pathogenic role in atherosclerosis, this role for cytomegalovirus (CMV) is yet controversial. Objectives: The aim of the present study was to detect CMV-DNA in atherosclerotic plaques in patients who underwent coronary artery bypass graft (CABG). Patients and Methods: In this case-control study, candidates for CABG (cases) and patients with valvular or congenital malformation but without atherosclerotic plaques (controls) were studied from 2012 to 2013 at Golestan hospital, Ahvaz, IR Iran. Demographic and laboratory data were collected. Atherosclerotic and histological samples were obtained from visible plaques and from aorta by the surgeon. All the samples were examined for the presence of CMV-DNA by polymerase chain reaction (PCR) method using a commercial kit (SinaClon, Tehran, IR Iran). Results: The mean ages in case and control groups were 60.8 ± 6.8 and 57.5 ± 11.5 years, respectively, with no significant difference (P = 0.09). Thirty patients (54.5%) in case and 32 (58.2%) in control groups were male with no significant difference (P = 0.7). CMV-DNA was present in 8 (14.5%) of the cases and 2 (4%) of the controls. CMV-DNA was associated with higher risk of atherosclerosis (OR: 7.7, 95% CI = 1.1-51.4, P = 0.03). Of the total normal aortic samples (55 in cases and 55 in controls), there was no individual with simultaneous positive CMV-DNA among aortic atherosclerotic and normal tissue samples. Conclusions: The presence of CMV-DNA in aortic plaques is associated with increased risk of atherosclerosis. CMV infection may be considered as an independent risk factor for this event.
Collapse
Affiliation(s)
- Habib Heybar
- Cardiology Department, Medical College, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Seyed Mohammad Alavi
- Health Research Institute, Jundishapur Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Seyed Mohammad Alavi, Health Research Institute, Jundishapur Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6133387724, E-mail:
| | - Mehdi Farashahi Nejad
- Infectious Diseases Department, Medical College, Razi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Mahmood Latifi
- Health College, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| |
Collapse
|
21
|
HCMV seroprevalence in couples under infertility treatment. Arch Gynecol Obstet 2015; 292:439-43. [PMID: 25649040 DOI: 10.1007/s00404-015-3640-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE Congenital HCMV infection affects about 0.5-0.9 % of newborns in Europe. Primary prevention could effectively be implemented in screening programmes for couples treated for infertility. By supplying epidemiological data, the proportion of women susceptible to primary HCMV infection is estimated. METHODS Retrospective evaluation of HCMV IgG of couples with recurrent implantation failure in German IVF programmes referred to a tertiary immunological centre for lymphocyte immunotherapy in 2002 (727 couples) and 2012 (294 male partners only). RESULTS HCMV seroprevalence was 45 % in women and 33 % in men of childbearing age in 2002 and has not declined any further in the male group (34 %) in 2012. It was higher in women (39.8 %) than in males (28.0 %) of German descent (p < 0.00001). Most couples were concordantly seropositive (20.5 %) or negative (41.8 %). Discordant partnerships comprised of seropositive women with negative partners (24.6 %) and seronegative women with positive partners (13.1 %). CONCLUSIONS More than 50 % of the women are HCMV seronegative and may benefit from primary prevention. About one fourth of them live with a seropositive partner. Risks to contract HCMV via the sexual route in a long-term discordant partnership may be very low, and the advice of protective safer sex methods in this group of prospective parents is critical since it leads to a conflict of interests.
Collapse
|
22
|
Thomas S, Rouilly V, Patin E, Alanio C, Dubois A, Delval C, Marquier LG, Fauchoux N, Sayegrih S, Vray M, Duffy D, Quintana-Murci L, Albert ML. The Milieu Intérieur study - an integrative approach for study of human immunological variance. Clin Immunol 2015; 157:277-93. [PMID: 25562703 DOI: 10.1016/j.clim.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/21/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
Abstract
The Milieu Intérieur Consortium has established a 1000-person healthy population-based study (stratified according to sex and age), creating an unparalleled opportunity for assessing the determinants of human immunologic variance. Herein, we define the criteria utilized for participant enrollment, and highlight the key data that were collected for correlative studies. In this report, we analyzed biological correlates of sex, age, smoking-habits, metabolic score and CMV infection. We characterized and identified unique risk factors among healthy donors, as compared to studies that have focused on the general population or disease cohorts. Finally, we highlight sex-bias in the thresholds used for metabolic score determination and recommend a deeper examination of current guidelines. In sum, our clinical design, standardized sample collection strategies, and epidemiological data analyses have established the foundation for defining variability within human immune responses.
Collapse
Affiliation(s)
- Stéphanie Thomas
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France
| | - Vincent Rouilly
- Center for Human Immunology, Institut Pasteur, Paris, France; Center for Bioinformatics, Institut Pasteur, Paris, France
| | - Etienne Patin
- Laboratory of Human Evolutionary Genetics, Department of Genomes & Genetics, Institut Pasteur, Paris, France; CNRS URA3012, France
| | - Cécile Alanio
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France
| | | | | | | | | | | | - Muriel Vray
- Unit of Emerging Diseases Epidemiology, Institut Pasteur, Paris, France
| | - Darragh Duffy
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France
| | - Lluis Quintana-Murci
- Laboratory of Human Evolutionary Genetics, Department of Genomes & Genetics, Institut Pasteur, Paris, France; CNRS URA3012, France.
| | - Matthew L Albert
- Center for Human Immunology, Institut Pasteur, Paris, France; Laboratory of Dendritic Cell Immunobiology, Department of Immunology, Institut Pasteur, Paris, France; INSERM U818, France; INSERM UMS20, France.
| | | |
Collapse
|
23
|
Matheï C, Adriaensen W, Vaes B, Van Pottelbergh G, Wallemacq P, Degryse J. No relation between CMV infection and mortality in the oldest old: results from the Belfrail study. Age Ageing 2015; 44:130-5. [PMID: 25026957 DOI: 10.1093/ageing/afu094] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE previous studies have demonstrated an association between cytomegalovirus (CMV) infection and mortality in adults. In this prospective study, it was investigated whether these findings could be confirmed in the oldest old. METHODOLOGY data obtained from a prospective observational cohort study (2008-2012) of 549 community-dwelling persons in Belgium aged 80 and older. RESULTS seventy-six percent were anti-CMV seropositive of whom 37.5% had an anti-CMV IgG titre in the highest tertile (>250 IU/ml). After a median time of follow-up of 1,049 days, 127 deaths occurred. Cox proportional hazard models failed to show an association between CMV serostatus and all-cause mortality. Among persons seropositive for CMV, after adjusting for multiple confounders an anti-CMV in the highest tertile was statistically significantly associated with all-cause mortality (hazard ratio: 1.64, 95% confidence interval: 1.08, 2.48). CONCLUSION in contrast to previous findings, a positive CMV serostatus was not associated with an increased risk for all-cause mortality in this cohort of very old people. This is probably the result of a survival effect. CMV seropositive subjects with high anti-CMV titres were at higher risk for all-cause mortality compared with other individuals. This may reflect CMV infection reactivation to be more common in the end stages of life.
Collapse
Affiliation(s)
- Catharina Matheï
- Department of Public Health and Primary Care, KULeuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Wim Adriaensen
- Department of Public Health and Primary Care, KULeuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Bert Vaes
- Department of Public Health and Primary Care, KULeuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Gijs Van Pottelbergh
- Department of Public Health and Primary Care, KULeuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Wallemacq
- Laboratory of Analytical Biochemistry, Clinique Universitaires St Luc, Brussels, Belgium
| | - Jan Degryse
- Department of Public Health and Primary Care, KULeuven, Kapucijnenvoer 33 blok J, 3000 Leuven, Belgium Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
24
|
Congenital HCMV and assisted reproduction: Why not use the chance for primary screening? Arch Gynecol Obstet 2014; 291:1205-11. [DOI: 10.1007/s00404-014-3583-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/05/2014] [Indexed: 11/25/2022]
|
25
|
Schmidt T, Schub D, Wolf M, Dirks J, Ritter M, Leyking S, Singh M, Zawada AM, Blaes-Eise AB, Samuel U, Sester U, Sester M. Comparative analysis of assays for detection of cell-mediated immunity toward cytomegalovirus and M. tuberculosis in samples from deceased organ donors. Am J Transplant 2014; 14:2159-67. [PMID: 25040687 DOI: 10.1111/ajt.12787] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/07/2014] [Accepted: 04/16/2014] [Indexed: 01/25/2023]
Abstract
Cell-mediated immunity assays could be valuable for risk assessment of organ donors, but no data exist on their feasibility in deceased donors. In this study, 105 deceased donors (52.3 ± 16.9 years) were screened at the time of organ procurement. Pathogen-specific stimulation was performed using a cytomegalovirus (CMV) lysate, tuberculin (purified protein derivative [PPD]) and soluble Mycobacterium tuberculosis-specific ESAT-6/CFP-10 proteins in combination with an in-house fluorescence-activated cell sorting (FACS) assay or commercial assay formats (QuantiFERON-CMV/TB for ELISA, T-SPOT.TB for ELISPOT). CMV-IgG antibody titers were determined as gold standard for CMV infection; 51.4% of samples were CMV seropositive. Indeterminate results were observed in 47.6% of ELISA, 12.5% of FACS and 0% of ELISPOT assays. Agreement with serology was highest for FACS (95.6%, κ = 0.91), followed by ELISPOT (84.0%, κ = 0.68) and ELISA (80.0%, κ = 0.60). Agreement between ELISA and serology increased if the CMV lysate was used as stimulus (96.7%, κ = 0.92). Among the T cell assays, agreement between ELISPOT and FACS was highest (κ = 0.70). PPD-positive results among valid samples differed between assays (26.5% for ELISA, 23.1% for FACS and 50.5% for ELISPOT); 2.0% were QuantiFERON-TB positive, 3.3% were ESAT-6/CFP-10-positive in FACS and 13.4% were positive in the T-SPOT.TB assay. In conclusion, cellular immunity may be analyzed from samples of deceased donors, although the assays differ in the rate of positivity and indeterminate results.
Collapse
Affiliation(s)
- T Schmidt
- Department of Transplant and Infection Immunology, Saarland University, Homburg, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Doerr HW, Berger A. Vaccination against infectious diseases: what is promising? Med Microbiol Immunol 2014; 203:365-71. [PMID: 25064610 DOI: 10.1007/s00430-014-0346-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/10/2014] [Indexed: 12/17/2022]
Abstract
Vaccination has proven to be one of the best weapons protecting the mankind against infectious diseases. Along with the huge progress in microbiology, numerous highly efficacious and safe vaccines have been produced by conventional technology (cultivation), by the use of molecular biology (genetic modification), or by synthetic chemistry. Sterilising prevention is achieved by the stimulation of antibody production, while the stimulation of cell-mediated immune responses may prevent the outbreak of disease in consequence of an acute or reactivated infection. From several examples, two rules are deduced to evaluate the perspectives of future vaccine developments: They are promising, if (1) the natural infectious disease induces immunity or (2) passive immunisation (transfer of antibodies, adoptive transfer of lymphocytes) is successful in preventing infection.
Collapse
Affiliation(s)
- Hans Wilhelm Doerr
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Str. 40, 60596, Frankfurt/M., Germany,
| | | |
Collapse
|
27
|
N’Diaye DS, Yazdanpanah Y, Krivine A, Andrieu T, Rozenberg F, Picone O, Tsatsaris V, Goffinet F, Launay O. Predictive factors of cytomegalovirus seropositivity among pregnant women in Paris, France. PLoS One 2014; 9:e89857. [PMID: 24587077 PMCID: PMC3933677 DOI: 10.1371/journal.pone.0089857] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/27/2014] [Indexed: 11/18/2022] Open
Abstract
Background Cytomegalovirus (CMV) is the most frequent cause of congenital infection. The objective of this study was to evaluate predictive factors for CMV seronegativity in a cohort of pregnant women in Paris, France. Methods Pregnant women enrolled in a prospective cohort during the 2009 A/H1N1 pandemic were tested for CMV IgG antibodies. Variables collected were age, geographic origin, lifestyle, work characteristics, socioeconomic status, gravidity, parity and number of children at home. A multivariate logistic regression model was used to identify independent predictive factors for CMV seropositivity. Results Among the 826 women enrolled, 389 (47.1%) were primiparous, and 552 (67.1%) had Metropolitan France as a geographic origin. Out of these, 355 (i.e. 57.0%, 95% confidence interval (CI): [53.6%–60.4%]) were CMV seropositive: 43.7% (95% CI:[39.5%–47.9%]) in those whose geographic origin was Metropolitan France and 84.1% in those with other origins (95% CI:[79.2%–88.3%]). Determinants associated with CMV seropositivity in a multivariate logistic regression model were: (i) geographic origin (p<0.001(compared with Metropolitan France, geographic origins of Africa adjusted odds ratio (aOR) 21.2, 95% CI:[9.7–46.5], French overseas departments and territories and other origin, aOR 7.5, 95% CI:[3.9–14.6], and Europe or Asia, aOR 2.2, 95% CI: [1.3–3.7]); and (ii) gravidity (p = 0.019), (compared with gravidity = 1, if gravidity≥3, aOR = 1.5, 95% CI: [1.1–2.2]; if gravidity = 2, aOR = 1.0, 95% CI: [0.7–1.4]). Work characteristics and socioeconomic status were not independently associated with CMV seropositivity. Conclusions In this cohort of pregnant women, a geographic origin of Metropolitan France and a low gravidity were predictive factors for CMV low seropositivity. Such women are therefore the likely target population for prevention of CMV infection during pregnancy in France.
Collapse
Affiliation(s)
- Dieynaba S. N’Diaye
- Infection, Antimicrobiens, Modélisation, Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Institut National de la Santé et de la Recherche Médicale (INSERM), Université (Univ) Paris Diderot, Sorbonne Paris Cité, Paris, France
- Université Pierre et Marie Curie (UPMC) Univ Paris 06, École doctorale (ED)393, Paris, France
- * E-mail:
| | - Yazdan Yazdanpanah
- Infection, Antimicrobiens, Modélisation, Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Institut National de la Santé et de la Recherche Médicale (INSERM), Université (Univ) Paris Diderot, Sorbonne Paris Cité, Paris, France
- Assistance-Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Bichat-Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine (HUPNVS), Service des Maladies Infectieuses, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Anne Krivine
- AP-HP, Groupe Hospitalier Cochin–Broca–Hôtel Dieu, Département de Virologie, Paris, France
| | - Thibaut Andrieu
- INSERM Unité (U)953, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants, Université Pierre-et-Marie-Curie, Paris, France
| | - Flore Rozenberg
- AP-HP, Groupe Hospitalier Cochin–Broca–Hôtel Dieu, Département de Virologie, Paris, France
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
| | | | - Vassilis Tsatsaris
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- AP-HP, Hôpital Cochin, Maternité, Paris, France
| | - François Goffinet
- INSERM Unité (U)953, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants, Université Pierre-et-Marie-Curie, Paris, France
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- AP-HP, Hôpital Cochin, Maternité, Paris, France
- INSERM Centre d’Investigation Clinique (CIC) P0901, Paris, France
| | - Odile Launay
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- INSERM, CIC BT505, Paris, France
- AP-HP, Hôpital Cochin, CIC de Vaccinologie Cochin-Pasteur, Paris, France
| |
Collapse
|
28
|
Salyakina D, Tsinoremas NF. Viral expression associated with gastrointestinal adenocarcinomas in TCGA high-throughput sequencing data. Hum Genomics 2013; 7:23. [PMID: 24279398 PMCID: PMC3906926 DOI: 10.1186/1479-7364-7-23] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/07/2013] [Indexed: 12/15/2022] Open
Abstract
Background Up to 20% of cancers worldwide are thought to be associated with microbial pathogens, including bacteria and viruses. The widely used methods of viral infection detection are usually limited to a few a priori suspected viruses in one cancer type. To our knowledge, there have not been many broad screening approaches to address this problem more comprehensively. Methods In this study, we performed a comprehensive screening for viruses in nine common cancers using a multistep computational approach. Tumor transcriptome and genome sequencing data were available from The Cancer Genome Atlas (TCGA). Nine hundred fifty eight primary tumors in nine common cancers with poor prognosis were screened against a non-redundant database of virus sequences. DNA sequences from normal matched tissue specimens were used as controls to test whether each virus is associated with tumors. Results We identified human papilloma virus type 18 (HPV-18) and four human herpes viruses (HHV) types 4, 5, 6B, and 8, also known as EBV, CMV, roseola virus, and KSHV, in colon, rectal, and stomach adenocarcinomas. In total, 59% of screened gastrointestinal adenocarcinomas (GIA) were positive for at least one virus: 26% for EBV, 21% for CMV, 7% for HHV-6B, and 20% for HPV-18. Over 20% of tumors were co-infected with multiple viruses. Two viruses (EBV and CMV) were statistically significantly associated with colorectal cancers when compared to the matched healthy tissues from the same individuals (p = 0.02 and 0.03, respectively). HPV-18 was not detected in DNA, and thus, no association testing was possible. Nevertheless, HPV-18 expression patterns suggest viral integration in the host genome, consistent with the potentially oncogenic nature of HPV-18 in colorectal adenocarcinomas. The estimated counts of viral copies were below one per cell for all identified viruses and approached the detection limit. Conclusions Our comprehensive screening for viruses in multiple cancer types using next-generation sequencing data clearly demonstrates the presence of viral sequences in GIA. EBV, CMV, and HPV-18 are potentially causal for GIA, although their oncogenic role is yet to be established.
Collapse
Affiliation(s)
- Daria Salyakina
- Center for Computational Science, University of Miami, 1120 NW 14 St, Miami, FL 33136, USA.
| | | |
Collapse
|
29
|
Odland ML, Strand KM, Nordbø SA, Forsmo S, Austgulen R, Iversen AC. Changing patterns of cytomegalovirus seroprevalence among pregnant women in Norway between 1995 and 2009 examined in the Norwegian Mother and Child Cohort Study and two cohorts from Sor-Trondelag County: a cross-sectional study. BMJ Open 2013; 3:e003066. [PMID: 24078749 PMCID: PMC3787407 DOI: 10.1136/bmjopen-2013-003066] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To examine cytomegalovirus (CMV) seroprevalence and associated risk factors for CMV seropositivity in pregnant Norwegian women. DESIGN Cross-sectional study. SETTING The Norwegian Mother and Child Cohort Study (MoBa) in addition to two random samples of pregnant women from Sør-Trøndelag County in Norway. PARTICIPANTS Study group 1 were 1000 pregnant women, randomly selected among 46 127 pregnancies in the MoBa (1999-2006) at 17/18 week of gestation. Non-ethnic Norwegian women were excluded. Study groups 2 (n=1013 from 1995) and 3 (n=979 from 2009) were pregnant women at 12 weeks of gestation from Sør-Trøndelag County. OUTCOME MEASURES CMV seropositivity in blood samples from pregnant Norwegian women. RESULTS CMV-IgG antibodies were detected in 59.9% and CMV-IgM antibodies in 1.3% of pregnant Norwegian women in study group 1. Women from North Norway demonstrated a higher CMV-IgG seroprevalence (72.1%) than women from South Norway (58.5%) (OR 1.83, 95% CI 1.17 to 2.88). The CMV-IgG seroprevalence was higher among women with low education (70.5%) compared to women with higher education (OR 2.20, 95% CI 1.24 to 3.90). Between 1995 and 2009 the CMV-IgG seroprevalence increased from 63.1% to 71.4% in pregnant women from Sør-Trøndelag County (study groups 2 and 3; p<0.001). The highest CMV-IgG seroprevalence (79.0%) was observed among the youngest pregnant women (<25 years) from Sør-Trøndelag County in 2009 (study group 3). CONCLUSIONS The CMV-IgG seroprevalence of pregnant Norwegian women varies with geographic location and educational level. Additionally, the CMV-IgG seroprevalence appears to have increased over the last years, particularly among young pregnant women.
Collapse
Affiliation(s)
- Maria Lisa Odland
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kristin M Strand
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Svein Arne Nordbø
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Siri Forsmo
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Rigmor Austgulen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Centre of Molecular Inflammation Research, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ann-Charlotte Iversen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Centre of Molecular Inflammation Research, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
30
|
Kilgour AH, Firth C, Harrison R, Moss P, Bastin ME, Wardlaw JM, Deary IJ, Starr JM. Seropositivity for CMV and IL-6 levels are associated with grip strength and muscle size in the elderly. IMMUNITY & AGEING 2013; 10:33. [PMID: 23938060 PMCID: PMC3765201 DOI: 10.1186/1742-4933-10-33] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 08/12/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sarcopenia is an important cause of morbidity and mortality in older adults, with immunosenescence and inflammation being possible underlying mechanisms. We investigated the relationship between latent cytomegalovirus (CMV) infection, Interleukin 6 (IL-6) levels, muscle size and strength in a group of healthy older community-dwelling people. METHODS Participants were healthy volunteers from the Lothian Birth Cohort 1936 study. Participants had IL-6 level and CMV antibody titre measured at age 70 years and grip strength and a volumetric T1-weighted MRI brain scan (allowing measurement of neck muscle cross-sectional area (CSA)) at age 73. Markers of childhood deprivation were adjusted for in the analysis due to correlations between childhood deprivation and latent CMV infection. RESULTS 866 participants were studied; 448 men (mean age 72.48 years, sd 0.70) and 418 women (mean age 72.51 years, sd 0.72). In men, CMV seropositivity was associated with smaller neck muscle CSA (p = 0.03, partial eta squared = 0.01), even after adjustment for IL-6 levels. Neck muscle CSA was not associated with CMV seropositivity in women, or CMV antibody titre or IL-6 level in either sex. Grip strength associated negatively with IL-6 level (right grip strength p<0.00001, partial eta squared 0.032 and left grip strength p<0.00001, partial eta squared 0.027) with or without adjustment for CMV serostatus or antibody titre. CMV status and antibody titre were not significantly associated with grip strength in either hand. CONCLUSION These findings support the hypothesis that there is a relationship between markers of immunosenescence (i.e. CMV serostatus and IL6 level) and low muscle mass and strength and longitudinal studies in older cohorts are now required to investigate these relationships further.
Collapse
Affiliation(s)
- Alixe Hm Kilgour
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UK.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Simon B, Kundi M, Puchhammer-Stöckl E. Association of HCMV specific IgG subclass antibody levels with gender and age. Exp Gerontol 2013; 48:472-5. [DOI: 10.1016/j.exger.2013.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/18/2013] [Accepted: 02/11/2013] [Indexed: 11/28/2022]
|
32
|
Schuster K, Henneke P, Huzly D, Speckmann C. Zytomegalievirusinfektionen im ersten Lebensjahr. Monatsschr Kinderheilkd 2013. [DOI: 10.1007/s00112-012-2807-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
Wicker S, Friedrichs I, Rabenau HF. [Seroprevalence of antibodies against infectious pathogens relevant to pregnancy among healthcare workers]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:923-9. [PMID: 22842885 PMCID: PMC7080042 DOI: 10.1007/s00103-012-1509-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Healthcare workers (HCWs) are exposed to infectious diseases throughout the course of their work. The concerns of pregnant HCWs are considerable because certain otherwise mild infections may affect fetal development. We studied 424 pregnant HCWs at the University Hospital Frankfurt between March 2007 and July 2011. Serological tests were carried out for varicella zoster virus (VZV), measles, mumps, rubella (MMR), cytomegalovirus (CMV) and parvovirus B19. Our overall seroprevalence data with regard to VZV, MMR, CMV and parvovirus B 19 corresponded to the general population. However, physicians demonstrated lower seroprevalence towards the two non-vaccine-preventable diseases (CMV: 37.5% [KI 27.4-48.5]; parvovirus B19: 69.3% [KI 58.6-78.7]) compared with nurses (CMV: 53.4% [KI 46.1-60.6], parvovirus B19: 75.1% [68.4-81.1]). It was striking that, only one in five of the study population showed IgG antibodies against all of the six pregnant-relevant viral diseases tested, of the physicians as few as one in six. A routine exclusion from the workplace due to non-immunity would mean that it would not be possible to employ the majority of pregnant staff in healthcare and childcare.
Collapse
Affiliation(s)
- S Wicker
- Betriebsärztlicher Dienst, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
| | | | | |
Collapse
|
34
|
Enders G, Daiminger A, Lindemann L, Knotek F, Bäder U, Exler S, Enders M. Cytomegalovirus (CMV) seroprevalence in pregnant women, bone marrow donors and adolescents in Germany, 1996-2010. Med Microbiol Immunol 2012; 201:303-9. [PMID: 22398714 DOI: 10.1007/s00430-012-0232-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 02/12/2012] [Indexed: 11/25/2022]
Abstract
In Germany, studies on the IgG seroprevalence in pregnancy and in women of childbearing age are rare. Therefore, we retrospectively evaluated the CMV IgG seropositive rate in 40,324 pregnant women as well as in 31,093 female and male bone marrow donors over 15 consecutive years (1996-2010). Furthermore, the result of a study conducted in 1999 investigating 1,305 healthy adolescents with known ethnicity was included. The overall CMV IgG seroprevalence in pregnant women (15-50 years) was 42.3%. Age-dependent analysis revealed a significantly higher seropositive rate (55.6%) in young women (15-25 years) than in those aged 26-40 years (37-42%) and in women older than 40 years (48.3%). Over the study period of 15 years, the rate of seroprevalence in pregnant women declined significantly (χ(2) test < 0.01) from 44.3% in the first interval period (1996-2000), to 42.8% (2001-2005) and to 40.9% (2006-2010). The most influencing factor on CMV seropositivity appeared to be the socioeconomic status (SES), which we characterized by type of health insurance: Seroprevalence in women with low, middle and upper SES was 91.8, 46.9 and 33.7%, respectively. Female bone marrow donors of childbearing age (15-45 years) showed a significantly higher seropositive rate of 36.5% than age-matched male donors (28.6%). In adolescents aged 13-16 years, no gender-specific differences were recognized. Concerning ethnicity, youngsters with German descent had a significantly lower seroprevalence (29.9%) than those with non-German descent (67.4%).
Collapse
Affiliation(s)
- Gisela Enders
- Labor Enders, Prof. Dr. med. Gisela Enders & Kollegen MVZ, Medizinische Diagnostik, Institut für Virologie, Infektiologie und Epidemiologie e.V., Prof. Gisela Enders, Rosenbergstr. 85, 70193, Stuttgart, Germany.
| | | | | | | | | | | | | |
Collapse
|
35
|
Associations Between Cytomegalovirus Infection and Functional Impairment and Frailty in the BELFRAIL Cohort. J Am Geriatr Soc 2011; 59:2201-8. [DOI: 10.1111/j.1532-5415.2011.03719.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
36
|
Doerr HW, Cinatl J. Recent publications in medical microbiology and immunology: a retrospective. Med Microbiol Immunol 2011; 201:1-5. [PMID: 22033658 DOI: 10.1007/s00430-011-0219-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Indexed: 01/15/2023]
Abstract
A look back is done to some clinical and basic research activities recently published in medical microbiology and immunology. The review covers clinical experiences and in vitro experiments to understand the emergency, pathogenicity, epidemic spread, and vaccine-based prevention of avian and swine-origin flu. Some new developments and concepts in diagnosis, (molecular) epidemiology, and therapy of AIDS, viral hepatitis C, and herpesvirus-associated diseases are outlined. Regulation of immune system has been discussed in a special issue 2010 including some aspects of CNS affections (measles). Mycobacterial infection and its prevention by modern recombinant vaccines have reached new interest, as well as new concepts of vaccination and prophylaxis against several other bacteria. Adaptation to host niches enables immune escape (example brucella) and determines virulence (example N. meningitidis). Chlamydia pneumoniae, previously considered to trigger atherosclerosis, is hypothetically associated to Alzheimer disease, while CMV, another putative trigger of atherosclerosis, gains evidence of oncomodulation in CNS tumor diseases. In terms of globalization, exotic virus infections are increasingly imported from southern countries.
Collapse
Affiliation(s)
- H W Doerr
- Institute of Medical Virology, University Hospital of Frankfurt/M., Frankfurt/Main, Germany.
| | | |
Collapse
|
37
|
Chelmoński A, Jabłecki J, Szajerka T. Insidious Course of Cytomegalovirus Infection in Hand Transplant Recipient: Case Report, Diagnostics, and Treatment. Transplant Proc 2011; 43:2827-30. [DOI: 10.1016/j.transproceed.2011.06.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 05/15/2011] [Accepted: 06/03/2011] [Indexed: 11/16/2022]
|
38
|
Thiele T, Krüger W, Zimmermann K, Ittermann T, Wessel A, Steinmetz I, Dölken G, Greinacher A. Transmission of cytomegalovirus (CMV) infection by leukoreduced blood products not tested for CMV antibodies: a single-center prospective study in high-risk patients undergoing allogeneic hematopoietic stem cell transplantation (CME). Transfusion 2011; 51:2620-6. [PMID: 21645009 DOI: 10.1111/j.1537-2995.2011.03203.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Measures to prevent transfusion-transmitted cytomegalovirus (TT-CMV) infection after hematopoietic stem cell transplantation (HSCT) include transfusion of CMV antibody-negative blood units and/or transfusion of leukoreduced cellular blood products. We assessed the incidence of TT-CMV in CMV-seronegative patients receiving CMV-seronegative HSC transplants, who were transfused with leukoreduced cellular blood products not tested for anti-CMV. STUDY DESIGN AND METHODS In a prospective observational study between 1999 and 2009, all HSCT patients received leukoreduced cellular blood products not tested for anti-CMV. Patients were screened for CMV serostatus and CMV-negative recipients of CMV-negative transplants were systematically monitored for TT-CMV clinically and by CMV nucleic acid testing. Anti-CMV antibodies (immunoglobulin [Ig]G and IgM) were assessed after three time intervals (Interval 1, study inclusion to Day +30 after HSCT; Interval 2, Day +30-Day +100; Interval 3, after Day +100). RESULTS Among 142 patients treated with allogeneic HSCT, 23 CMV-negative donor-patient pairs were identified. These 23 patients received 1847 blood products from 3180 donors. All patients remained negative for CMV DNA and none developed CMV-associated clinical complications. This results in a risk for TT-CMV per donor exposure of 0% (95% confidence interval, 0.0%-0.12%). However, 17 of 23 patients seroconverted for anti-CMV IgG, but none for anti-CMV IgM. CMV IgG seroconverters received significantly more transfusions per week than nonconverters. CONCLUSION The risk of TT-CMV is low in high-risk CMV(neg/neg) HSCT patients transfused with leukoreduced blood products not tested for anti-CMV. The cause of anti-CMV IgG seroconversion is most likely passive antibody transmission by blood products.
Collapse
Affiliation(s)
- Thomas Thiele
- Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt-Universität, Greifswald, Germany
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Kalil AC, Florescu DF. Is cytomegalovirus reactivation increasing the mortality of patients with severe sepsis? Crit Care 2011; 15:138. [PMID: 21457496 PMCID: PMC3219353 DOI: 10.1186/cc10093] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cytomegalovirus (CMV) is a ubiquitous virus present in approximately two-thirds of the healthy population. This virus rarely causes an active disease in healthy individuals, but it is among the most common opportunistic infections in immunocompromised patients such as solid organ transplant recipients, patients receiving chemotherapy for cancer or patients with human immunodeficiency virus. Critically ill patients who are immunocompetent before intensive care unit admission may also become more prone to develop active CMV infection if they have prolonged hospitalizations, high disease severity, and severe sepsis. The development of active CMV infection in these critically ill patients has been associated with a significantly higher risk of death in several previous studies. The present issue of Critical Care brings a new study by Heininger and colleagues in which the authors found that patients with severe sepsis who developed active CMV infection had significantly longer intensive care unit and hospital stays, prolonged mechanical ventilation, but no changes in mortality compared to patients without CMV infection. We discuss the possible reasons for their findings (for example, selection bias and low (20%) statistical power to detect mortality endpoints), and also perform an update of our previous meta-analysis with the addition of Heininger and colleagues' study to verify whether the higher mortality rate with CMV holds. Our updated meta-analysis with approximately 1,000 patients shows that active CMV infection continues to be associated with a significant 81% higher mortality rate than that in critically ill patients without active CMV infection.
Collapse
Affiliation(s)
- Andre C Kalil
- Department of Internal Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198, USA.
| | | |
Collapse
|
40
|
Abstract
SUMMARYIn order to analyse the impact of vaccination against cytomegalovirus (CMV) on congenital infection incidence using current vaccines tested in phase II clinical trials, we simulated different scenarios by mathematical modelling, departing from the current vaccine characteristics, varying age at vaccination, immunity waning, vaccine efficacy and mixing patterns. Our results indicated that the optimal age for a single vaccination interval is from 2 to 6 months if there is no immunity waning. Congenital infection may increase if vaccine-induced immunity wanes before 20 years. Congenital disease should increase further when the mixing pattern includes transmission among children with a short duration of protection vaccine. Thus, the best vaccination strategy is a combined schedule: before age 1 year plus a second dose at 10–11 years. For CMV vaccines with low efficacy, such as the current ones, universal vaccination against CMV should be considered for infants and teenagers.
Collapse
|
41
|
Latent cytomegalovirus infection amplifies CD8 T-lymphocyte mobilisation and egress in response to exercise. Brain Behav Immun 2010; 24:1362-70. [PMID: 20638470 DOI: 10.1016/j.bbi.2010.07.239] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 07/02/2010] [Accepted: 07/11/2010] [Indexed: 12/20/2022] Open
Abstract
Exercise induces mobilisation of CD8(+) T lymphocytes (CD8TL) into the peripheral blood. This response is largely confined to effector-memory CD8TLs: antigen experienced cells which have a strong tissue-homing and effector potential. This study investigated whether effector-memory cells also account for the CD8TL egress from peripheral blood following exercise. As latent Cytomegalovirus (CMV) infection is associated with a robust expansion in the number and proportion of effector-memory CD8TLs, we also investigated if CMV serostatus was a determinant of the CD8TL responses to exercise. Fourteen males (Mean age 35, SD ± 14 yrs), half of whom were CMV seropositive (CMV(+)), ran on a treadmill for 60 min at 80% VO(2) max. Blood was collected at baseline, during the final minute of exercise, and 15 min and 60 min thereafter. CD8TL memory subsets were characterised by flow cytometry, using the cell-surface markers CD45RA, CD27, and CD28. The results confirmed that CD8TLs with an effector-memory phenotype (CD27(-)CD28(-)CD45RA(+/-)) exhibited the largest increase during exercise (+200% to +250%), and also showed the largest egress from blood 60 min post-exercise (down to 40% of baseline values). Strikingly, the mobilisation and subsequent egress of total CD8TLs was nearly twice as large in CMV(+) individuals. This effect appeared specific to CD8TLs, and was not seen for CD4(+) T lymphocytes or total lymphocytes. This effect of CMV serostatus was largely driven by the higher numbers of exercise-responsive effector-memory CD8TLs in the CMV(+) participants. This is the first study to demonstrate that infection history is a determinant of immune system responses to exercise.
Collapse
|
42
|
Rapid quantitation of cytomegalovirus DNA in whole blood by a new molecular assay based on automated sample preparation and real-time PCR. Med Microbiol Immunol 2010; 199:311-6. [DOI: 10.1007/s00430-010-0164-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Indexed: 12/17/2022]
|
43
|
Vetter M, Battegay M, Trendelenburg M. Primary cytomegalovirus infection with accompanying Pneumocystis jiroveci pneumonia in a patient with large-vessel vasculitis. Infection 2010; 38:331-4. [DOI: 10.1007/s15010-010-0024-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 03/17/2010] [Indexed: 10/19/2022]
|