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Brisse E, Verweyen EL, De Visscher A, Kessel C, Wouters CH, Matthys P. Murine Models of Secondary Cytokine Storm Syndromes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1448:497-522. [PMID: 39117836 DOI: 10.1007/978-3-031-59815-9_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) comprises a broad spectrum of life-threatening cytokine storm syndromes, classified into primary (genetic) or secondary (acquired) HLH. The latter occurs in a variety of medical conditions, including infections, malignancies, autoimmune and autoinflammatory diseases, acquired immunodeficiency, and metabolic disorders. Despite recent advances in the field, the pathogenesis of secondary HLH remains incompletely understood. Considering the heterogeneity of triggering factors and underlying diseases in secondary HLH, a large diversity of animal models has been developed to explore pivotal disease mechanisms. To date, over 20 animal models have been described that each recapitulates certain aspects of secondary HLH. This review provides a comprehensive overview of the existing models, highlighting relevant findings, discussing the involvement of different cell types and cytokines in disease development and progression, and considering points of interest toward future therapeutic strategies.
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Affiliation(s)
- Ellen Brisse
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Emely L Verweyen
- Translational Inflammation Research, Department of Pediatric Rheumatology & Immunology, WWU Medical Center (UKM), Muenster, Germany
| | - Amber De Visscher
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Christoph Kessel
- Translational Inflammation Research, Department of Pediatric Rheumatology & Immunology, WWU Medical Center (UKM), Muenster, Germany
| | - Carine H Wouters
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium
- Pediatric Rheumatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Patrick Matthys
- Laboratory of Immunobiology, Rega Institute, KU Leuven, Leuven, Belgium.
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Cheng W, Wang L, Gao X, Duan L, Shu Y, Qiu H. Prognostic value of lipid profile in adult hemophagocytic lymphohistiocytosis. Front Oncol 2023; 13:1083088. [PMID: 36895490 PMCID: PMC9988898 DOI: 10.3389/fonc.2023.1083088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/08/2023] [Indexed: 02/23/2023] Open
Abstract
Background Adult secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare clinical syndrome with a high mortality rate. Currently, there are no feasible prognostic factors to clinically predict untreated sHLH patients' prognosis. Our objective was to characterize the lipid profile of adult sHLH patients and to determine the relationship with overall survival. Methods We retrospectively analyzed 247 patients with newly diagnosed sHLH from January 2017 to January 2022 according to the HLH-2004 criteria. Multivariate Cox regression analyses and restricted cubic splines were conducted to evaluate the prognostic value of the lipid profile. Results The median age of all patients was 52 years, and the commonest cause of sHLH in our cohort was malignancy. During a median follow-up of 88 (interquartile ranges, 22-490) days, 154 deaths occurred. The univariate analysis confirmed total cholesterol (TC) ≤ 3 mmol/L, triglycerides (TG) > 3.08 mmol/L, high-density lipoprotein cholesterol (HDL-c) ≤ 0.52 mmol/L, and low-density lipoprotein cholesterol (LDL-c) ≤ 2.17 mmol/L were associated with an inferior survival. In a multivariate model, HDL-c, hemoglobin, platelet, fibrinogen, and soluble interleukin-2 receptor were considered as independent factors. Additionally, the restricted cubic spline analyses indicated an inverse linear association between HDL-c and the risk of mortality in sHLH. Conclusion Lipid profiles, which were low-cost and readily available promising biomarkers, were strongly associated with the overall survival in adult sHLH patients.
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Affiliation(s)
- Wanying Cheng
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Lingling Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Department of Hematology, Wuxi People's Hospital, Wuxi, China
| | - Xin Gao
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Limin Duan
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yongqian Shu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Hongxia Qiu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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Páez-Guillán EM, Campos-Franco J, Alende R, Garitaonaindía Y, González-Quintela A. Transient hypertriglyceridemia: a common finding during Epstein-Barr virus-induced infectious mononucleosis. Lipids Health Dis 2021; 20:177. [PMID: 34895245 PMCID: PMC8667370 DOI: 10.1186/s12944-021-01603-9] [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] [Received: 10/25/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hypertriglyceridemia can occur in lymphoproliferative disorders. Infectious mononucleosis is a self-limiting, benign lymphoproliferative disorder. This study aimed to investigate the serum triglyceride concentrations and their change over time in patients with infectious mononucleosis. Methods We evaluated an adult patient with severe hypertriglyceridemia (>1000 mg/dL) during infectious mononucleosis and reviewed the records of 360 patients admitted to our hospital because of infectious mononucleosis (median age, 19 years; range, 15-87 years; 51.4% male). We compared the serum triglyceride concentrations with those of a control sample from the general population (n=75). A second triglyceride measurement, obtained during convalescence (median of 30 days after the initial determination), was available for 160 patients. Results The triglyceride concentrations in the acute phase (median: 156 mg/dL) were significantly higher than those of the controls (median, 76 mg/dL; P<0.001). A total of 194 (53.9%) patients presented with hypertriglyceridemia (>150 mg/dL), which was more common in the patients older than 30 years than in the younger patients (78.6% vs. 50.6%; P<0.001). A significant correlation (P<0.005) was observed between the triglyceride levels and white blood cell counts, total cholesterol levels, and liver damage markers. The triglyceride concentrations decreased during convalescence (P<0.001) and were lower than the initial measurement in 83.7% of the cases. Conversely, the total cholesterol concentrations during the acute phase were lower than those of the controls and increased during convalescence (P<0.001). Conclusions Patients with severe infectious mononucleosis frequently show mild, transient hypertriglyceridemia. Further studies are needed to elucidate the mechanisms underlying this finding.
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Affiliation(s)
- Emilio-Manuel Páez-Guillán
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Joaquín Campos-Franco
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rosario Alende
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Yago Garitaonaindía
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Arturo González-Quintela
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
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Meeting report: Eleventh International Conference on Hantaviruses. Antiviral Res 2020; 176:104733. [PMID: 32068071 DOI: 10.1016/j.antiviral.2020.104733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 12/24/2022]
Abstract
The 2019 11th International Conference on Hantaviruses (ICH 2019) was organized by the International Society for Hantaviruses (ISH), and held on September 1-4, 2019, at the Irish College, in Leuven, Belgium. These ICHs have been held every three years since 1989. ICH 2019 was attended by 158 participants from 33 countries. The current report summarizes research presented on all aspects of hantavirology: ecology; pathogenesis and immune responses; virus phylogeny, replication and morphogenesis; epidemiology; vaccines, therapeutics and prevention; and clinical aspects and diagnosis.
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Shastri B, Kofman A, Hennenfent A, Klena JD, Nicol S, Graziano JC, Morales-Betoulle M, Cannon D, Maradiaga A, Tran A, Ramdeen SK. Domestically Acquired Seoul Virus Causing Hemophagocytic Lymphohistiocytosis-Washington, DC, 2018. Open Forum Infect Dis 2019; 6:ofz404. [PMID: 31660366 PMCID: PMC6790396 DOI: 10.1093/ofid/ofz404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/10/2019] [Indexed: 11/18/2022] Open
Abstract
Seoul orthohantavirus (SEOV) infections, uncommonly reported in the United States, often result in mild illness. We report a case of hemophagocytic lymphohistiocytosis secondary to SEOV infection that was domestically acquired in Washington, DC.
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Affiliation(s)
- Bhagyashree Shastri
- Department of Infectious Diseases, Medstar Washington Hospital Center Atlanta, Georgia, USA, Washington, DC, USA
| | - Aaron Kofman
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrew Hennenfent
- Center for Policy, Planning and Evaluation, DC Department of Health, Washington, DC, USA
| | - John D Klena
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stuart Nicol
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James C Graziano
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria Morales-Betoulle
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Deborah Cannon
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Agueda Maradiaga
- Center for Policy, Planning and Evaluation, DC Department of Health, Washington, DC, USA
| | - Anthony Tran
- Public Health Laboratory, DC Department of Forensic Sciences, Washington, DC, USA
| | - Sheena K Ramdeen
- Department of Infectious Diseases, Medstar Washington Hospital Center Atlanta, Georgia, USA, Washington, DC, USA
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Wild Rats, Laboratory Rats, Pet Rats: Global Seoul Hantavirus Disease Revisited. Viruses 2019; 11:v11070652. [PMID: 31319534 PMCID: PMC6669632 DOI: 10.3390/v11070652] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 12/16/2022] Open
Abstract
Recent reports from Europe and the USA described Seoul orthohantavirus infection in pet rats and their breeders/owners, suggesting the potential emergence of a “new” public health problem. Wild and laboratory rat-induced Seoul infections have, however, been described since the early eighties, due to the omnipresence of the rodent reservoir, the brown rat Rattus norvegicus. Recent studies showed no fundamental differences between the pathogenicity and phylogeny of pet rat-induced Seoul orthohantaviruses and their formerly described wild or laboratory rat counterparts. The paucity of diagnosed Seoul virus-induced disease in the West is in striking contrast to the thousands of cases recorded since the 1980s in the Far East, particularly in China. This review of four continents (Asia, Europe, America, and Africa) puts this “emerging infection” into a historical perspective, concluding there is an urgent need for greater medical awareness of Seoul virus-induced human pathology in many parts of the world. Given the mostly milder and atypical clinical presentation, sometimes even with preserved normal kidney function, the importance of simple but repeated urine examination is stressed, since initial but transient proteinuria and microhematuria are rarely lacking.
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High Triglycerides Are Associated with Low Thrombocyte Counts and High VEGF in Nephropathia Epidemica. J Immunol Res 2016; 2016:8528270. [PMID: 28053993 PMCID: PMC5178363 DOI: 10.1155/2016/8528270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/24/2016] [Indexed: 01/05/2023] Open
Abstract
Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome. Several reports have demonstrated a severe alteration in lipoprotein metabolism. However, little is known about changes in circulating lipids in NE. The objectives of this study were to evaluate changes in serum total cholesterol, high density cholesterol (HDCL), and triglycerides. In addition to evaluation of serum cytokine activation associations, changes in lipid profile and cytokine activation were determined for gender, thrombocyte counts, and VEGF. Elevated levels of triglycerides and decreased HDCL were observed in NE, while total cholesterol did not differ from controls. High triglycerides were associated with both the lowest thrombocyte counts and high serum VEGF, as well as a high severity score. Additionally, there were higher levels of triglycerides in male than female NE patients. Low triglycerides were associated with upregulation of IFN-γ and IL-12, suggesting activation of Th1 helper cells. Furthermore, levels of IFN-γ and IL-12 were increased in patients with lower severity scores, suggesting that a Th1 type immune response is playing protective role in NE. These combined data advance the understanding of NE pathogenesis and indicate a role for high triglycerides in disease severity.
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Clement J, Colson P, Saegeman V, Lagrou K, Van Ranst M. Are hantavirus infections also part of the rapidly growing spectrum of an infection-triggered reactive haemophagocytic syndrome? Clin Microbiol Infect 2016; 22:745-6. [PMID: 27263030 DOI: 10.1016/j.cmi.2016.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
Affiliation(s)
- J Clement
- National Hantavirus Reference Centre, Laboratory of Clinical and Epidemiological Virology and Rega Institute for Medical Research, University of Leuven, Leuven, Belgium.
| | - P Colson
- Clinique et Maternite Sainte-Elisabeth, Emergency Department, Namur, Belgium
| | - V Saegeman
- Microbiology and Immunology & Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - K Lagrou
- Microbiology and Immunology & Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - M Van Ranst
- Microbiology and Immunology & Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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