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Hönemann M, Scharfenberg E, Dietze N, Claus C, Jochmann C, Liebert UG. Rubella virus-associated uveitis at a tertiary care hospital in Germany between 2013 and 2019. BMC Ophthalmol 2023; 23:447. [PMID: 37932668 PMCID: PMC10629089 DOI: 10.1186/s12886-023-03182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
Uveitis is a process of intraocular inflammation that may involve different sections of the uveal tract. Apart from systemic or localized immune-mediated diseases, infections are key players in the etiology of uveitis and entail different treatment strategies. Rubella virus (RuV) is a recognized causative agent for the development of Fuchs uveitis, representing a major cause of virus-associated intraocular inflammation. A cohort of 159 patients diagnosed with different forms of uveitis between 2013 and 2019 was subjected to diagnostic antibody testing of the aqueous or vitreous humor. The diagnostic panel included RuV, cytomegalovirus, herpes simplex virus, varicella-zoster virus, and toxoplasmosis. Within this cohort, 38 RuV-associated uveitis (RAU) patients were identified based on a pathologic Goldman-Witmer coefficient indicative of an underlying RuV infection. With a mean age of 45.9 years, the RAU patients were younger than the non-RAU patients (56.3, p < 0.001). The evaluation of clinical parameters revealed a predominance of anterior uveitis and late sequalae such as cataract and glaucoma among the RAU patients. In 15 of the patients a history of prior RuV infections could be confirmed. The study underlines the importance of long-term surveillance of RuV associated diseases that originate from infections before the introduction of RuV vaccination programs.
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Affiliation(s)
- Mario Hönemann
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany.
| | - Elizabeth Scharfenberg
- Department of Ophthalmology, University Hospital Leipzig, Leipzig University, Liebigstrasse 21, 04103, Leipzig, Germany
| | - Nadine Dietze
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
| | - Claudia Claus
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
| | - Claudia Jochmann
- Department of Ophthalmology, University Hospital Leipzig, Leipzig University, Liebigstrasse 21, 04103, Leipzig, Germany
| | - Uwe Gerd Liebert
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
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Schulz J, Schilling E, Fabian C, Zenclussen AC, Stojanovska V, Claus C. Dissecting Rubella Placental Infection in an In Vitro Trophoblast Model. Int J Mol Sci 2023; 24:ijms24097894. [PMID: 37175600 PMCID: PMC10178045 DOI: 10.3390/ijms24097894] [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: 03/11/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/15/2023] Open
Abstract
Vertical transmission of rubella virus (RuV) occurs at a high rate during the first trimester of pregnancy. The modes of vertical transmission including the response of trophoblasts to RuV are not well understood. Here, RuV-trophoblast interaction was studied in the BeWo trophoblast cell line. Analysis included early and late time-point kinetics of virus infection rate and the antiviral innate immune response at mRNA and protein level. BeWo characteristics were addressed through metabolic activity by extracellular flux analysis and syncytiotrophoblast formation through incubation with forskolin. We found that RuV infection of BeWo led to profuse type III interferon (IFN) production. Transfecting trophoblast cells with dsRNA analog induced an increase in the production of type I IFN-β and type III IFNs; however, this did not occur in RuV-infected BeWo trophoblasts. IFN-β and to a lesser extent type III IFN-λ1 were inhibitory to RuV. While no significant metabolic alteration was detected, RuV infection reduced the cell number in the monolayer culture in comparison to the mock control and resulted in detached and floating cells. Syncytia formation restricted RuV infection. The use of BeWo as a relevant cell culture model for infection of trophoblasts highlights cytopathogenicity in the absence of a type I IFN response as a pathogenic alteration by RuV.
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Affiliation(s)
- Juliane Schulz
- Institute of Medical Microbiology and Virology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
- Institute of Biochemistry and Biotechnology, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Erik Schilling
- Rheumatology Unit, Department of Internal Medicine III, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Claire Fabian
- Department of Vaccines and Infection Models, Fraunhofer Institute for Cell Therapy and Immunology, 04103 Leipzig, Germany
- Medical Department II, University Cancer Center Leipzig (UCCL), University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Ana Claudia Zenclussen
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, 04318 Leipzig, Germany
- Perinatal Immunology Research Group, Saxonian Incubator for Clinical Translation, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Violeta Stojanovska
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, 04318 Leipzig, Germany
| | - Claudia Claus
- Institute of Medical Microbiology and Virology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
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Kanbayashi D, Kurata T, Kaida A, Kubo H, Yamamoto SP, Egawa K, Hirai Y, Okada K, Kaida Y, Ikemori R, Yumisashi T, Ito A, Saito T, Yamaji Y, Nishino Y, Omori R, Mori H, Motomura K, Ikuta K. Shedding of rubella virus in postsymptomatic individuals; viral RNA load is a potential indicator to estimate candidate patients excreting infectious rubella virus. J Clin Virol 2023; 160:105377. [PMID: 36682339 DOI: 10.1016/j.jcv.2022.105377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/25/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Since the first isolation of rubella virus (RuV) in 1962, comprehensive data regarding the quantitative evaluation of RuV shedding remain unavailable. In this study, we evaluated the shedding of viral RNA and infectious virus in patients with acute RuV infection. STUDY DESIGN We analyzed 767 specimens, including serum/plasma, peripheral blood mononuclear cells (PBMCs), throat swabs, and urine, obtained from 251 patients with rubella. The viral RNA load and the presence of infectious RuV were determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and virus isolation. RESULTS Virus excretion peaked 0-2 days after rash onset and decreased over time. The median viral RNA load dropped to an undetectable level on day 3 after rash onset in serum/plasma, day 2 in PBMCs, days 10-13 in throat swabs, and days 6-7 in urine. Infectious virus could be isolated for up to day 2 after rash onset in serum/plasma, day 1 in PBMCs, days 8-9 in throat swabs, and days 4-5 in urine. The minimum viral RNA load that allowed virus isolation was 961 copies/mL in serum/plasma, 784 copies/mL in PBMCs, 650 copies/mL in throat swabs, and 304 copies/mL in urine. A higher viral RNA load indicated a higher likelihood of the presence of infectious virus. CONCLUSION These findings would contribute to improve algorithms for rubella surveillance and diagnosis. In addition, this study indicates that the results of RT-qPCR enable efficient rubella control by estimating candidate patients excreting infectious virus, which could help prevent viral transmission at an early stage and eliminate rubella ultimately.
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Affiliation(s)
- Daiki Kanbayashi
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan.
| | - Takako Kurata
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Atsushi Kaida
- Division of Microbiology, Osaka Institute of Public Health, Osaka, 543-0026, Japan
| | - Hideyuki Kubo
- Division of Microbiology, Osaka Institute of Public Health, Osaka, 543-0026, Japan
| | - Seiji P Yamamoto
- Division of Microbiology, Osaka Institute of Public Health, Osaka, 543-0026, Japan
| | - Kazutaka Egawa
- Division of Microbiology, Osaka Institute of Public Health, Osaka, 543-0026, Japan
| | - Yuki Hirai
- Division of Microbiology, Osaka Institute of Public Health, Osaka, 543-0026, Japan
| | - Kazuma Okada
- Division of Microbiology, Osaka Institute of Public Health, Osaka, 543-0026, Japan
| | - Yuko Kaida
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Ryo Ikemori
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Takahiro Yumisashi
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Ayami Ito
- Osaka City Public Health Bureau, Osaka City Health Center, Osaka, 545-0051, Japan
| | - Takeshi Saito
- Osaka City Public Health Bureau, Osaka City Health Center, Osaka, 545-0051, Japan
| | - Yoshihiko Yamaji
- Department of Public Health and Medical Affairs, Osaka Prefectural Government, Osaka, 540-8570, Japan
| | - Yuka Nishino
- Department of Public Health and Medical Affairs, Osaka Prefectural Government, Osaka, 540-8570, Japan
| | - Ryosuke Omori
- International Institute for Zoonosis Control, Hokkaido University, Hokkaido, 001-0020, Japan
| | - Haruyo Mori
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Kazushi Motomura
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Kazuyoshi Ikuta
- Division of Virology, Osaka Institute of Public Health, Osaka, 537-0025, Japan; Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan; BioAcademia Inc., Osaka, 565-0871, Japan
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Interferon Signaling-Dependent Contribution of Glycolysis to Rubella Virus Infection. Pathogens 2022; 11:pathogens11050537. [PMID: 35631058 PMCID: PMC9146913 DOI: 10.3390/pathogens11050537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Interferons (IFNs) are an essential part of innate immunity and contribute to adaptive immune responses. Here, we employed a loss-of-function analysis with human A549 respiratory epithelial cells with a knockout (KO) of the type I IFN receptor (IFNAR KO), either solely or together with the receptor of type III IFN (IFNAR/IFNLR1 KO). The course of rubella virus (RuV) infection on the IFNAR KO A549 cells was comparable to the control A549. However, on the IFNAR/IFNLR1 KO A549 cells, both genome replication and the synthesis of viral proteins were significantly enhanced. The generation of IFN β during RuV infection was influenced by type III IFN signaling. In contrast to IFNAR KO A549, extracellular IFN β was not detected on IFNAR/IFNLR1 KO A549. The bioenergetic profile of RuV-infected IFNAR/IFNLR1 KO A549 cells generated by extracellular flux analysis revealed a significant increase in glycolysis, whereas mitochondrial respiration was comparable between all three cell types. Moreover, the application of the glucose analogue 2-deoxy-D-glucose (2-DG) significantly increased viral protein synthesis in control A549 cells, while no effect was noted on IFNAR/IFNLR KO A549. In conclusion, we identified a positive signaling circuit of type III IFN signaling on the generation of IFN β during RuV infection and an IFN signaling-dependent contribution of glycolysis to RuV infection. This study on epithelial A549 cells emphasizes the interaction between glycolysis and antiviral IFN signaling and notably, the antiviral activity of type III IFNs against RuV infection, especially in the absence of both type I and III IFN signaling, the RuV replication cycle was enhanced.
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Schulz H, Neale M, Zubach V, Severini A, Hiebert J. Development of a rapid, internally controlled, two target, real-time RT-PCR for detection of rubella virus. J Virol Methods 2022; 303:114500. [PMID: 35217102 DOI: 10.1016/j.jviromet.2022.114500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 11/19/2022]
Abstract
Rubella surveillance in elimination setting relies on rapid molecular detection of the virus. In this study a multiplex real-time RT-PCR assay for the detection of rubella virus was validated. The assay includes three independent probes with unique reporter dyes for the simultaneous detection of the rubella viral coding regions for envelope glycoprotein E1 and non-structural p150 protein, and an endogenous control (human RNaseP). Using dilution series of synthetic RNAs, the limits of detection were determined to be at least 50 copies of rubella RNA. The assay is reproducible with low intra-assay and inter-assay coefficients of variation for both the E1 and the p150 targets. After testing 62 confirmed rubella positive and 165 rubella negative archival clinical samples, the sensitivity and specificity of the multiplex assay were 98.4 and 100%, respectively. No cross reactivity was identified with clinical specimens positive for eleven other viruses. This multiplex assay successfully detected nine viral genotypes including the predominant genotypes 1E, 1 G, 1 J, and 2B as well as the 1a vaccine genotype.
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Affiliation(s)
- Helene Schulz
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg, Manitoba, Postal Code R3E 3L5, Canada.
| | - Mackenzie Neale
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg, Manitoba, Postal Code R3E 3L5, Canada.
| | - Vanessa Zubach
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg, Manitoba, Postal Code R3E 3L5, Canada.
| | - Alberto Severini
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg, Manitoba, Postal Code R3E 3L5, Canada; Department of Medical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Joanne Hiebert
- Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada, JC Wilt Infectious Diseases Research Centre, 745 Logan Avenue, Winnipeg, Manitoba, Postal Code R3E 3L5, Canada.
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Schilling E, Grahnert A, Pfeiffer L, Koehl U, Claus C, Hauschildt S. The Impact of Rubella Virus Infection on a Secondary Inflammatory Response in Polarized Human Macrophages. Front Immunol 2021; 12:772595. [PMID: 34975859 PMCID: PMC8716696 DOI: 10.3389/fimmu.2021.772595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022] Open
Abstract
Macrophages (MΦ) are known to exhibit distinct responses to viral and bacterial infection, but how they react when exposed to the pathogens in succession is less well understood. Accordingly, we determined the effect of a rubella virus (RV)-induced infection followed by an LPS-induced challenge on cytokine production, signal transduction and metabolic pathways in human GM (M1-like)- and M (M2-like)-MΦ. We found that infection of both subsets with RV resulted in a low TNF-α and a high interferon (IFN, type I and type III) release whereby M-MΦ produced far more IFNs than GM-MΦ. Thus, TNF-α production in contrast to IFN production is not a dominant feature of RV infection in these cells. Upon addition of LPS to RV-infected MΦ compared to the addition of LPS to the uninfected cells the TNF-α response only slightly increased, whereas the IFN-response of both subtypes was greatly enhanced. The subset specific cytokine expression pattern remained unchanged under these assay conditions. The priming effect of RV was also observed when replacing RV by IFN-β one putative priming stimulus induced by RV. Small amounts of IFN-β were sufficient for phosphorylation of Stat1 and to induce IFN-production in response to LPS. Analysis of signal transduction pathways activated by successive exposure of MΦ to RV and LPS revealed an increased phosphorylation of NFκB (M-MΦ), but different to uninfected MΦ a reduced phosphorylation of ERK1/2 (both subtypes). Furthermore, metabolic pathways were affected; the LPS-induced increase in glycolysis was dampened in both subtypes after RV infection. In conclusion, we show that RV infection and exogenously added IFN-β can prime MΦ to produce high amounts of IFNs in response to LPS and that changes in glycolysis and signal transduction are associated with the priming effect. These findings will help to understand to what extent MΦ defense to viral infection is modulated by a following exposure to a bacterial infection.
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Affiliation(s)
- Erik Schilling
- Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Anja Grahnert
- Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Lukas Pfeiffer
- Institute of Medical Microbiology and Virology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Ulrike Koehl
- Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany
- Fraunhofer Institute for Cellular Therapeutics and Immunology, Leipzig, Germany
- Institute for Cellular Therapeutics, Hannover Medical School, Hannover, Germany
| | - Claudia Claus
- Institute of Medical Microbiology and Virology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sunna Hauschildt
- Institute of Biology, University of Leipzig, Leipzig, Germany
- *Correspondence: Sunna Hauschildt,
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Wan Y, Gupta V, Bird C, Pullagurla SR, Fahey P, Forster A, Volkin DB, Joshi SB. Formulation Development and Improved Stability of a Combination Measles and Rubella Live-Viral Vaccine Dried for Use in the Nanopatch TM Microneedle Delivery System. Hum Vaccin Immunother 2021; 17:2501-2516. [PMID: 33957843 PMCID: PMC8475600 DOI: 10.1080/21645515.2021.1887692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/18/2021] [Accepted: 02/03/2021] [Indexed: 12/27/2022] Open
Abstract
Measles (Me) and rubella (Ru) viral diseases are targeted for elimination by ensuring a high level of vaccination coverage worldwide. Less costly, more convenient MeRu vaccine delivery systems should improve global vaccine coverage, especially in low - and middle - income countries (LMICs). In this work, we examine formulating a live, attenuated Me and Ru combination viral vaccine with Nanopatch™, a solid polymer micro-projection array for intradermal delivery. First, high throughput, qPCR-based viral infectivity and genome assays were established to enable formulation development to stabilize Me and Ru in a scaled-down, custom-built evaporative drying system to mimic the Nanopatch™ vaccine coating process. Second, excipient screening and optimization studies identified virus stabilizers for use during the drying process and upon storage in the dried state. Finally, a series of real-time and accelerated stability studies identified eight candidate formulations that met a target thermal stability criterion for live vaccines (<1 log10 loss after 1 week storage at 37°C). Compared to -80°C control samples, the top candidate formulations resulted in minimal viral infectivity titer losses after storage at 2-8°C for 6 months (i.e., <0.1 log10 for Me, and ~0.4 log10 for Ru). After storage at 25°C over 6 months, ~0.3-0.5 and ~1.0-1.4 log10 titer losses were observed for Me and Ru, respectively, enabling the rank-ordering of the stability of candidate formulations. These results are discussed in the context of future formulation challenges for developing microneedle-based dosage forms containing stabilized live, attenuated viral vaccines for use in LMICs.
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Affiliation(s)
- Ying Wan
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, USA
| | - Vineet Gupta
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, USA
| | - Christopher Bird
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, USA
| | - Swathi R. Pullagurla
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, USA
| | - Paul Fahey
- Vaxxas Pty Ltd, Translational Research Institute, Brisbane, QLD, Australia
| | - Angus Forster
- Vaxxas Pty Ltd, Translational Research Institute, Brisbane, QLD, Australia
| | - David B. Volkin
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, USA
| | - Sangeeta B. Joshi
- Department of Pharmaceutical Chemistry, Vaccine Analytics and Formulation Center, University of Kansas, Lawrence, KS, USA
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Zanella MC, Cordey S, Laubscher F, Docquier M, Vieille G, Van Delden C, Braunersreuther V, Ta MK, Lobrinus JA, Masouridi-Levrat S, Chalandon Y, Kaiser L, Vu DL. Unmasking viral sequences by metagenomic next-generation sequencing in adult human blood samples during steroid-refractory/dependent graft-versus-host disease. MICROBIOME 2021; 9:28. [PMID: 33487167 PMCID: PMC7831233 DOI: 10.1186/s40168-020-00953-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/06/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Viral infections are common complications following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT recipients with steroid-refractory/dependent graft-versus-host disease (GvHD) are highly immunosuppressed and are more vulnerable to infections with weakly pathogenic or commensal viruses. Here, twenty-five adult allo-HSCT recipients from 2016 to 2019 with acute or chronic steroid-refractory/dependent GvHD were enrolled in a prospective cohort at Geneva University Hospitals. We performed metagenomics next-generation sequencing (mNGS) analysis using a validated pipeline and de novo analysis on pooled routine plasma samples collected throughout the period of intensive steroid treatment or second-line GvHD therapy to identify weakly pathogenic, commensal, and unexpected viruses. RESULTS Median duration of intensive immunosuppression was 5.1 months (IQR 5.5). GvHD-related mortality rate was 36%. mNGS analysis detected viral nucleotide sequences in 24/25 patients. Sequences of ≥ 3 distinct viruses were detected in 16/25 patients; Anelloviridae (24/25) and human pegivirus-1 (9/25) were the most prevalent. In 7 patients with fatal outcomes, viral sequences not assessed by routine investigations were identified with mNGS and confirmed by RT-PCR. These cases included Usutu virus (1), rubella virus (1 vaccine strain and 1 wild-type), novel human astrovirus (HAstV) MLB2 (1), classic HAstV (1), human polyomavirus 6 and 7 (2), cutavirus (1), and bufavirus (1). CONCLUSIONS Clinically unrecognized viral infections were identified in 28% of highly immunocompromised allo-HSCT recipients with steroid-refractory/dependent GvHD in consecutive samples. These identified viruses have all been previously described in humans, but have poorly understood clinical significance. Rubella virus identification raises the possibility of re-emergence from past infections or vaccinations, or re-infection. Video abstract.
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Affiliation(s)
- M C Zanella
- Division of Infectious Diseases, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland.
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland.
| | - S Cordey
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
| | - F Laubscher
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
| | - M Docquier
- iGE3 Genomics Platform, University of Geneva, Geneva, Switzerland
- Department of Genetics and Evolution, University of Geneva, Geneva, Switzerland
| | - G Vieille
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
| | - C Van Delden
- Division of Infectious Diseases, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
| | - V Braunersreuther
- Clinical Pathology Service, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Mc Kee Ta
- Clinical Pathology Service, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - J A Lobrinus
- Clinical Pathology Service, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - S Masouridi-Levrat
- University of Geneva Medical School, Geneva, Switzerland
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Y Chalandon
- University of Geneva Medical School, Geneva, Switzerland
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - L Kaiser
- Division of Infectious Diseases, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
- Geneva Centre for Emerging Viral Diseases, Geneva, Switzerland
| | - D L Vu
- Division of Infectious Diseases, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1211, 14, Geneva, Switzerland
- University of Geneva Medical School, Geneva, Switzerland
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9
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Bilz NC, Willscher E, Binder H, Böhnke J, Stanifer ML, Hübner D, Boulant S, Liebert UG, Claus C. Teratogenic Rubella Virus Alters the Endodermal Differentiation Capacity of Human Induced Pluripotent Stem Cells. Cells 2019; 8:cells8080870. [PMID: 31405163 PMCID: PMC6721684 DOI: 10.3390/cells8080870] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 12/31/2022] Open
Abstract
The study of congenital virus infections in humans requires suitable ex vivo platforms for the species-specific events during embryonal development. A prominent example for these infections is rubella virus (RV) which most commonly leads to defects in ear, heart, and eye development. We applied teratogenic RV to human induced pluripotent stem cells (iPSCs) followed by differentiation into cells of the three embryonic lineages (ecto-, meso-, and endoderm) as a cell culture model for blastocyst- and gastrulation-like stages. In the presence of RV, lineage-specific differentiation markers were expressed, indicating that lineage identity was maintained. However, portrait analysis of the transcriptomic expression signatures of all samples revealed that mock- and RV-infected endodermal cells were less related to each other than their ecto- and mesodermal counterparts. Markers for definitive endoderm were increased during RV infection. Profound alterations of the epigenetic landscape including the expression level of components of the chromatin remodeling complexes and an induction of type III interferons were found, especially after endodermal differentiation of RV-infected iPSCs. Moreover, the eye field transcription factors RAX and SIX3 and components of the gene set vasculogenesis were identified as dysregulated transcripts. Although iPSC morphology was maintained, the formation of embryoid bodies as three-dimensional cell aggregates and as such cellular adhesion capacity was impaired during RV infection. The correlation of the molecular alterations induced by RV during differentiation of iPSCs with the clinical signs of congenital rubella syndrome suggests mechanisms of viral impairment of human development.
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Affiliation(s)
- Nicole C Bilz
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany
| | - Edith Willscher
- Interdisciplinary Center for Bioinformatics, University of Leipzig, 04107 Leipzig, Germany
| | - Hans Binder
- Interdisciplinary Center for Bioinformatics, University of Leipzig, 04107 Leipzig, Germany
| | - Janik Böhnke
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany
| | - Megan L Stanifer
- Schaller Research Group at CellNetworks, Department of Infectious Diseases, Virology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Denise Hübner
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany
| | - Steeve Boulant
- Schaller Research Group at CellNetworks, Department of Infectious Diseases, Virology, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Research Group "Cellular Polarity and Viral Infection" (F140), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Uwe G Liebert
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany
| | - Claudia Claus
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
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10
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Zobel S, Lorenz M, Frascaroli G, Böhnke J, Bilz NC, Stanifer ML, Boulant S, Bergs S, Liebert UG, Claus C. Rubella Virus Strain-Associated Differences in the Induction of Oxidative Stress Are Independent of Their Interferon Activation. Viruses 2018; 10:v10100540. [PMID: 30282907 PMCID: PMC6213305 DOI: 10.3390/v10100540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 01/16/2023] Open
Abstract
Rubella virus (RV) infection impacts cellular metabolic activity in a complex manner with strain-specific nutritional requirements. Here we addressed whether this differential metabolic influence was associated with differences in oxidative stress induction and subsequently with innate immune response activation. The low passaged clinical isolates of RV examined in this study induced oxidative stress as validated through generation of the reactive oxygen species (ROS) cytoplasmic hydrogen peroxide and mitochondrial superoxide. The addition of the cytoplasmic and mitochondrial ROS scavengers N-acetyl-l-cysteine and MitoTEMPO, respectively, reduced RV-associated cytopathogenicity and caspase activation. While the degree of oxidative stress induction varied among RV clinical isolates, the level of innate immune response and interferon-stimulated gene activation was comparable. The type III IFNs were highly upregulated in all cell culture systems tested. However, only pre-stimulation with IFN β slightly reduced RV replication indicating that RV appears to have evolved the ability to counteract innate immune response mechanisms. Through the data presented, we showed that the ability of RV to induce oxidative stress was independent of its capacity to stimulate and counteract the intrinsic innate immune response.
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Affiliation(s)
- Sarah Zobel
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
| | - Mechthild Lorenz
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
| | - Giada Frascaroli
- Leibniz Institute for Experimental Virology, Heinrich Pette Institute, 20251 Hamburg, Germany.
| | - Janik Böhnke
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
| | - Nicole C Bilz
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
| | - Megan L Stanifer
- Schaller Research Group at CellNetworks, Department of Infectious Diseases, Virology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
| | - Steeve Boulant
- Schaller Research Group at CellNetworks, Department of Infectious Diseases, Virology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
- Research Group "Cellular Polarity and Viral Infection" (F140), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Sandra Bergs
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
| | - Uwe G Liebert
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
| | - Claudia Claus
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
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11
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Kräter M, Sapudom J, Bilz NC, Pompe T, Guck J, Claus C. Alterations in Cell Mechanics by Actin Cytoskeletal Changes Correlate with Strain-Specific Rubella Virus Phenotypes for Cell Migration and Induction of Apoptosis. Cells 2018; 7:E136. [PMID: 30217036 PMCID: PMC6162683 DOI: 10.3390/cells7090136] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 02/06/2023] Open
Abstract
The cellular cytoskeleton is central for key cellular functions, and as such is a marker for diseased and infected cell states. Here we analyzed infection with rubella virus (RV) strains with respect to phenotypes in cellular mechanical properties, cell movement, and viral cytopathogenicity. Real-time deformability cytometry (RT-DC), as a high-throughput platform for the assessment of cell mechanics, revealed a correlation of an increase in cortical filamentous-actin (F-actin) with a higher cellular stiffness. The additional reduction of stress fibers noted for only some RV strains as the most severe actin rearrangement lowered cell stiffness. Furthermore, a reduced collective and single cell migration speed in a wound healing assay was detected in addition to severe changes in cell morphology. The latter was followed by activation of caspase 3/7 as a sign for induction of apoptosis. Our study emphasizes RT-DC technology as a sensitive means to characterize viral cell populations and to implicate alterations of cell mechanical properties with cell functions. These interdependent events are not only promising options to elucidate viral spread and to understand viral pathologies within the infected host. They also contribute to any diseased cell state, as exemplified by RV as a representative agent for cytoskeletal alterations involved in a cytopathological outcome.
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Affiliation(s)
- Martin Kräter
- Biotechnology Center, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, 01307 Dresden, Germany.
| | - Jiranuwat Sapudom
- Institute of Biochemistry, Leipzig University, 04103 Leipzig, Germany.
- Department of Dermatology, Venerology and Allergology, University Clinic of Leipzig, 04103 Leipzig, Germany.
| | | | - Tilo Pompe
- Institute of Biochemistry, Leipzig University, 04103 Leipzig, Germany.
| | - Jochen Guck
- Biotechnology Center, Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, 01307 Dresden, Germany.
| | - Claudia Claus
- Institute of Virology, University of Leipzig, 04103 Leipzig, Germany.
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12
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Bilz NC, Jahn K, Lorenz M, Lüdtke A, Hübschen JM, Geyer H, Mankertz A, Hübner D, Liebert UG, Claus C. Rubella Viruses Shift Cellular Bioenergetics to a More Oxidative and Glycolytic Phenotype with a Strain-Specific Requirement for Glutamine. J Virol 2018; 92:e00934-18. [PMID: 29950419 PMCID: PMC6096829 DOI: 10.1128/jvi.00934-18] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/19/2018] [Indexed: 12/21/2022] Open
Abstract
The flexible regulation of cellular metabolic pathways enables cellular adaptation to changes in energy demand under conditions of stress such as posed by a virus infection. To analyze such an impact on cellular metabolism, rubella virus (RV) was used in this study. RV replication under selected substrate supplementation with glucose, pyruvate, and glutamine as essential nutrients for mammalian cells revealed its requirement for glutamine. The assessment of the mitochondrial respiratory (based on the oxygen consumption rate) and glycolytic (based on the extracellular acidification rate) rate and capacity by respective stress tests through Seahorse technology enabled determination of the bioenergetic phenotype of RV-infected cells. Irrespective of the cellular metabolic background, RV infection induced a shift of the bioenergetic state of epithelial cells (Vero and A549) and human umbilical vein endothelial cells to a higher oxidative and glycolytic level. Interestingly there was a RV strain-specific, but genotype-independent demand for glutamine to induce a significant increase in metabolic activity. While glutaminolysis appeared to be rather negligible for RV replication, glutamine could serve as donor of its amide nitrogen in biosynthesis pathways for important metabolites. This study suggests that the capacity of RVs to induce metabolic alterations could evolve differently during natural infection. Thus, changes in cellular bioenergetics represent an important component of virus-host interactions and could complement our understanding of the viral preference for a distinct host cell population.IMPORTANCE RV pathologies, especially during embryonal development, could be connected with its impact on mitochondrial metabolism. With bioenergetic phenotyping we pursued a rather novel approach in virology. For the first time it was shown that a virus infection could shift the bioenergetics of its infected host cell to a higher energetic state. Notably, the capacity to induce such alterations varied among different RV isolates. Thus, our data add viral adaptation of cellular metabolic activity to its specific needs as a novel aspect to virus-host evolution. In addition, this study emphasizes the implementation of different viral strains in the study of virus-host interactions and the use of bioenergetic phenotyping of infected cells as a biomarker for virus-induced pathological alterations.
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Affiliation(s)
- Nicole C Bilz
- Institute of Virology, University of Leipzig, Leipzig, Germany
| | - Kristin Jahn
- Institute of Virology, University of Leipzig, Leipzig, Germany
- Faculty of Life Sciences, University of Leipzig, Leipzig, Germany
| | | | - Anja Lüdtke
- Institute of Virology, University of Leipzig, Leipzig, Germany
- Faculty of Life Sciences, University of Leipzig, Leipzig, Germany
| | - Judith M Hübschen
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-Sur-Alzette, Grand-Duchy of Luxembourg
| | - Henriette Geyer
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Berlin, Germany
| | - Annette Mankertz
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Berlin, Germany
| | - Denise Hübner
- Institute of Virology, University of Leipzig, Leipzig, Germany
| | - Uwe G Liebert
- Institute of Virology, University of Leipzig, Leipzig, Germany
| | - Claudia Claus
- Institute of Virology, University of Leipzig, Leipzig, Germany
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13
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Hübschen JM, Bork SM, Brown KE, Mankertz A, Santibanez S, Ben Mamou M, Mulders MN, Muller CP. Challenges of measles and rubella laboratory diagnostic in the era of elimination. Clin Microbiol Infect 2017; 23:511-515. [PMID: 28412379 DOI: 10.1016/j.cmi.2017.04.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 11/26/2022]
Abstract
The Member States of the WHO European Region adopted the goal of measles and rubella elimination more than 10 years ago, but so far only 21 of 53 countries have reached this target. Laboratory investigation of suspected cases is essential to support disease elimination efforts. Therefore, WHO maintains a network of accredited laboratories providing high-quality testing. Laboratory investigation heavily relies on specific IgM serology and increasingly on virus detection by reverse transcription (RT)-PCR, but other methods such as IgG avidity testing and genetic characterization of virus strains have gained in importance. In elimination settings, often few samples from suspected cases are available for testing, but testing proficiency must be maintained. The predictive value of an IgM-positive result decreases and other rash-fever disease aetiologies become more important. In addition, cases with a rash after measles/rubella vaccination or with mild disease after waning of vaccine-induced antibodies are seen more often. Thus, it is necessary to perform comprehensive and potentially time-consuming and costly investigations of every suspected case using quality-controlled laboratory methods. At the same time rapid feedback to public health officers is required for timely interventions. The introduction of new laboratory methods for comprehensive case investigations requires training of staff under the supervision of WHO-accredited reference laboratories and the definition of appropriate test algorithms. Clinical, laboratory, and epidemiological data are essential for final case classification and investigation of chains of transmission in the endgame of measles and rubella elimination.
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Affiliation(s)
- J M Hübschen
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg
| | - S M Bork
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg
| | - K E Brown
- WHO Global Specialized Laboratory for Measles and Rubella, Virus Reference Department, Public Health England, London, UK
| | - A Mankertz
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Berlin, Germany
| | - S Santibanez
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Berlin, Germany
| | - M Ben Mamou
- Vaccine-Preventable Diseases and Immunization, WHO Regional Office for Europe, Copenhagen, Denmark
| | - M N Mulders
- Expanded Programme on Immunization, Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - C P Muller
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg.
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