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Nurmukanova V, Matsvay A, Gordukova M, Shipulin G. Square the Circle: Diversity of Viral Pathogens Causing Neuro-Infectious Diseases. Viruses 2024; 16:787. [PMID: 38793668 PMCID: PMC11126052 DOI: 10.3390/v16050787] [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: 03/27/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Neuroinfections rank among the top ten leading causes of child mortality globally, even in high-income countries. The crucial determinants for successful treatment lie in the timing and swiftness of diagnosis. Although viruses constitute the majority of infectious neuropathologies, diagnosing and treating viral neuroinfections remains challenging. Despite technological advancements, the etiology of the disease remains undetermined in over half of cases. The identification of the pathogen becomes more difficult when the infection is caused by atypical pathogens or multiple pathogens simultaneously. Furthermore, the modern surge in global passenger traffic has led to an increase in cases of infections caused by pathogens not endemic to local areas. This review aims to systematize and summarize information on neuroinvasive viral pathogens, encompassing their geographic distribution and transmission routes. Emphasis is placed on rare pathogens and cases involving atypical pathogens, aiming to offer a comprehensive and structured catalog of viral agents with neurovirulence potential.
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Affiliation(s)
- Varvara Nurmukanova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, 119121 Moscow, Russia
| | - Alina Matsvay
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, 119121 Moscow, Russia
| | - Maria Gordukova
- G. Speransky Children’s Hospital No. 9, 123317 Moscow, Russia
| | - German Shipulin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, 119121 Moscow, Russia
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Jeyachandran AV, Irudayam JI, Dubey S, Chakravarty N, Konda B, Shah A, Su B, Wang C, Cui Q, Williams KJ, Srikanth S, Shi Y, Deb A, Damoiseaux R, Stripp BR, Ramaiah A, Arumugaswami V. Comparative Analysis of Molecular Pathogenic Mechanisms and Antiviral Development Targeting Old and New World Hantaviruses. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.04.552083. [PMID: 37577539 PMCID: PMC10418258 DOI: 10.1101/2023.08.04.552083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background Hantaviruses - dichotomized into New World (i.e. Andes virus, ANDV; Sin Nombre virus, SNV) and Old-World viruses (i.e. Hantaan virus, HTNV) - are zoonotic viruses transmitted from rodents to humans. Currently, no FDA-approved vaccines against hantaviruses exist. Given the recent breakthrough to human-human transmission by the ANDV, an essential step is to establish an effective pandemic preparedness infrastructure to rapidly identify cell tropism, infective potential, and effective therapeutic agents through systematic investigation. Methods We established human cell model systems in lung (airway and distal lung epithelial cells), heart (pluripotent stem cell-derived (PSC-) cardiomyocytes), and brain (PSC-astrocytes) cell types and subsequently evaluated ANDV, HTNV and SNV tropisms. Transcriptomic, lipidomic and bioinformatic data analyses were performed to identify the molecular pathogenic mechanisms of viruses in different cell types. This cell-based infection system was utilized to establish a drug testing platform and pharmacogenomic comparisons. Results ANDV showed broad tropism for all cell types assessed. HTNV replication was predominantly observed in heart and brain cells. ANDV efficiently replicated in human and mouse 3D distal lung organoids. Transcriptomic analysis showed that ANDV infection resulted in pronounced inflammatory response and downregulation of cholesterol biosynthesis pathway in lung cells. Lipidomic profiling revealed that ANDV-infected cells showed reduced level of cholesterol esters and triglycerides. Further analysis of pathway-based molecular signatures showed that, compared to SNV and HTNV, ANDV infection caused drastic lung cell injury responses. A selective drug screening identified STING agonists, nucleoside analogues and plant-derived compounds that inhibited ANDV viral infection and rescued cellular metabolism. In line with experimental results, transcriptome data shows that the least number of total and unique differentially expressed genes were identified in urolithin B- and favipiravir-treated cells, confirming the higher efficiency of these two drugs in inhibiting ANDV, resulting in host cell ability to balance gene expression to establish proper cell functioning. Conclusions Overall, our study describes advanced human PSC-derived model systems and systems-level transcriptomics and lipidomic data to better understand Old and New World hantaviral tropism, as well as drug candidates that can be further assessed for potential rapid deployment in the event of a pandemic.
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Affiliation(s)
- Arjit Vijey Jeyachandran
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
| | - Joseph Ignatius Irudayam
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
| | - Swati Dubey
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
| | - Nikhil Chakravarty
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - Bindu Konda
- Department of Medicine, Lung and Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aayushi Shah
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
| | - Baolong Su
- Dept. of Biological Chemistry, David Geffen School of Medicine, University of California, Los Angeles, USA
- UCLA Lipidomics Lab, University of California, Los Angeles, Los Angeles, CA, USA
| | - Cheng Wang
- Department of Neurodegenerative Diseases, Beckman Research Institute of City of Hope, CA, USA
| | - Qi Cui
- Department of Neurodegenerative Diseases, Beckman Research Institute of City of Hope, CA, USA
| | - Kevin J. Williams
- Dept. of Biological Chemistry, David Geffen School of Medicine, University of California, Los Angeles, USA
- UCLA Lipidomics Lab, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sonal Srikanth
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Yanhong Shi
- Department of Neurodegenerative Diseases, Beckman Research Institute of City of Hope, CA, USA
| | - Arjun Deb
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA, USA
| | - Robert Damoiseaux
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA, USA
- California NanoSystems Institute, UCLA, Los Angeles, CA, USA
- Department of Bioengineering, Samueli School of Engineering, UCLA, Los Angeles, CA, USA
| | - Barry R. Stripp
- Department of Medicine, Lung and Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Vaithilingaraja Arumugaswami
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA, USA
- California NanoSystems Institute, UCLA, Los Angeles, CA, USA
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Fawcett SJ, Chen JS, Fawcett RW. Acute Hantavirus Infection Presenting with Fever and Altered Mentation in the Absence of Pulmonary or Renal Manifestations. Open Forum Infect Dis 2022; 9:ofac430. [PMID: 36119963 PMCID: PMC9472660 DOI: 10.1093/ofid/ofac430] [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: 02/24/2022] [Accepted: 08/17/2022] [Indexed: 11/15/2022] Open
Abstract
Illness caused by hantaviruses is often severe and is typically characterized by diffuse pulmonary disease or renal insufficiency depending on the type of hantavirus. Here we report 2 cases of hantavirus infection that resulted in severe cognitive impairment but did not have any pulmonary or renal manifestations. These 2 cases may be indicative of previously underreported symptoms of hantavirus infection and might represent examples of hantavirus-related encephalopathy.
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Affiliation(s)
| | - Jeffrey S Chen
- Columbia Sands Medical Specialties, LLC , Redmond, OR , U.S
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Liu E, Lv S, Yi P, Feng L, Deng X, Xia H, Xu Y. Central nervous system infection with Seoul Orthohantavirus in a child after hematopoietic stem cell transplantation: a case report. Virol J 2022; 19:75. [PMID: 35459229 PMCID: PMC9034594 DOI: 10.1186/s12985-022-01766-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background Patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) are prone to complicate viral infection. Central nervous system (CNS) involvement caused by the viruses is rare but with poor prognosis. Hantavirus, which usually cause hemorrhagic fever with renal syndrome (HFRS), and none case has been reported about these infection in allo-HSCT patients. Case presentation In August 2021, a 13-year-old male child developed intermittent fever and refractory hypotension after allo-HSCT. Magnetic resonance imaging of the head revealed abnormal signal foci in the left midbrain cerebral peduncle and bilateral thalamus. His family reported traces of mouse activity in the patient’s home kitchen. HFRS was suspected, but with no significant kidney damage. The specific immunoglobulin (Ig) G and M of hantavirus were negative. The metagenomic next-generation sequencing (mNGS) detected Seoul Orthohantavirus (SEOV) sequences directly in cerebrospinal fluid and blood. Conclusions Allo-HSCT patients are a high-risk group for infection. Usually the causative agent of infection is difficult to determine, and sometimes the site of infection is concealed. This report highlights the importance of suspecting hantavirus infection in allo-HSCT patients with CNS symptoms despite the absence of renal syndromes. The mNGS is a powerful tool for detecting pathogens. CNS infection with Seoul orthohantavirus in transplant patients is rare but possible as demonstrated in this case. To the best of our knowledge, this is the first reported case employing mNGS to diagnose SEOV caused CNS infection in an allo-HSCT patient. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01766-6.
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Affiliation(s)
- Enyi Liu
- Department of Hematology, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuhe Lv
- Department of Pharmacy, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Panpan Yi
- Department of Infectious Diseases, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Feng
- Department of Neurology, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaolu Deng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Han Xia
- Department of Scientific Affaires, Hugobiotech Co., Ltd., Beijing, China
| | - Yajing Xu
- Department of Hematology, XiangYa Hospital, Central South University, Changsha, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Hunan Blood Tumor Clinical Medical Research Center, Changsha, Hunan, China.
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Hautala N, Partanen T, Kubin AM, Kauma H, Hautala T. Central Nervous System and Ocular Manifestations in Puumala Hantavirus Infection. Viruses 2021; 13:1040. [PMID: 34072819 PMCID: PMC8229408 DOI: 10.3390/v13061040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 12/21/2022] Open
Abstract
Puumala hantavirus (PUUV), carried and spread by the bank vole (Myodes glareolus), causes a mild form of hemorrhagic fever with renal syndrome (HFRS) called nephropathia epidemica (NE). Acute high fever, acute kidney injury (AKI), thrombocytopenia, and hematuria are typical features of this syndrome. In addition, headache, blurred vision, insomnia, vertigo, and nausea are commonly associated with the disease. This review explores the mechanisms and presentations of ocular and central nervous system involvement in acute NE.
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Affiliation(s)
- Nina Hautala
- Medical Research Center, PEDEGO Research Unit, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland; (N.H.); (A.-M.K.)
| | - Terhi Partanen
- Research Unit of Internal Medicine, Department of Internal Medicine, Division of Infectious Diseases, Oulu University and Oulu University Hospital, 90014 Oulu, Finland; (T.P.); (H.K.)
| | - Anna-Maria Kubin
- Medical Research Center, PEDEGO Research Unit, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland; (N.H.); (A.-M.K.)
| | - Heikki Kauma
- Research Unit of Internal Medicine, Department of Internal Medicine, Division of Infectious Diseases, Oulu University and Oulu University Hospital, 90014 Oulu, Finland; (T.P.); (H.K.)
| | - Timo Hautala
- Research Unit of Internal Medicine, Department of Internal Medicine, Division of Infectious Diseases, Oulu University and Oulu University Hospital, 90014 Oulu, Finland; (T.P.); (H.K.)
- Research Unit of Biomedicine, University of Oulu, 90029 Oulu, Finland
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Bellomo C, Alonso D, Coelho R, Iglesias A, Periolo N, Martínez V. A newborn infected by Andes virus suggests novel routes of hantavirus transmission: a case report. Clin Microbiol Infect 2020; 26:130-131. [DOI: 10.1016/j.cmi.2019.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
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Fernando R, Capone D, Elrich S, Mantovani R, Quarles L, D'Amato A, Lowe N, Malhotra A, Khoo T, Zufan S, Morales-Betoulle M, Brown SM, Cannon D, Graziano JC, Klena JD, Whitmer S, Nichol ST, Strachan P, Camins BC, Marcos LA. Infection with New York Orthohantavirus and Associated Respiratory Failure and Multiple Cerebral Complications. Emerg Infect Dis 2019; 25:1241-1243. [PMID: 30844358 PMCID: PMC6537728 DOI: 10.3201/eid2506.181966] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a case of infection with New York orthohantavirus in a woman who showed renal impairment and hemorrhage, complicated by hydrocephalus, in Long Island, New York, USA. Phylogenetic analysis showed that this virus was genetically similar to a New York orthohantavirus isolated in the same region during 1993.
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Two Atypical Cases of Hantavirus Infections from Sri Lanka. Case Rep Infect Dis 2018; 2018:4069862. [PMID: 29850303 PMCID: PMC5933029 DOI: 10.1155/2018/4069862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/01/2018] [Accepted: 04/07/2018] [Indexed: 01/08/2023] Open
Abstract
There are two categories of hantaviruses resulting in two distinct illnesses. The Old World (Asia and Europe) viruses give rise to hemorrhagic fever with renal syndrome (HFRS), and the New World (Americas) viruses cause hantavirus pulmonary syndrome (HPS). Hantavirus infections have very similar clinical pictures and epidemiology to leptospirosis. Here, we present two cases of hantavirus infections from Sri Lanka (in South Asia) initially misdiagnosed as leptospirosis and later further investigated and diagnosed as hantavirus infections with serological confirmation of the diagnosis. They had clinical pictures of a combination of both HFRS and HPS as well as the involvement of the central nervous system. Hantavirus infections are rarely diagnosed in South Asia. Reports on such atypical clinical pictures of hantavirus infections are extremely rare. Having arrived at the correct diagnosis late/retrospectively, both these patients recovered notwithstanding being seriously ill, indicating adequate supportive therapy can save lives in such cases. The emergence of the hantavirus, an infection seriously affecting multiple organ systems with a high case fatality rate that is spread by aerosol and other routes, could become a serious public health issue in Sri Lanka.
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Santos RI, Bueno-Júnior LS, Ruggiero RN, Almeida MF, Silva ML, Paula FE, Correa VMA, Arruda E. Spread of Oropouche virus into the central nervous system in mouse. Viruses 2014; 6:3827-36. [PMID: 25310583 PMCID: PMC4213564 DOI: 10.3390/v6103827] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 12/25/2022] Open
Abstract
Oropouche virus (OROV) is an important cause of arboviral illness in Brazil and other Latin American countries, with most cases clinically manifested as acute febrile illness referred to as Oropouche fever, including myalgia, headache, arthralgia and malaise. However, OROV can also affect the central nervous system (CNS) with clinical neurological implications. Little is known regarding OROV pathogenesis, especially how OROV gains access to the CNS. In the present study, neonatal BALB/c mice were inoculated with OROV by the subcutaneous route and the progression of OROV spread into the CNS was evaluated. Immunohistochemistry revealed that OROV infection advances from posterior parts of the brain, including the periaqueductal gray, toward the forebrain. In the early phases of the infection OROV gains access to neural routes, reaching the spinal cord and ascending to the brain through brainstem regions, with little inflammation. Later, as infection progresses, OROV crosses the blood-brain barrier, resulting in more intense spread into the brain parenchyma, with more severe manifestations of encephalitis.
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Affiliation(s)
- Rodrigo I. Santos
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Lézio S. Bueno-Júnior
- Department of Neurology and Behavioral Sciences, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (L.S.B.-J.); (R.N.R.)
| | - Rafael N. Ruggiero
- Department of Neurology and Behavioral Sciences, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (L.S.B.-J.); (R.N.R.)
| | - Mariana F. Almeida
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Maria L. Silva
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Flávia E. Paula
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Vani M. A. Correa
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
| | - Eurico Arruda
- Department of Cell Biology, University of Sao Paulo, School of Medicine at Ribeirao Preto, Ribeirao Preto, 14049-900, Brazil; E-Mails: (R.I.S.); (M.F.A.); (M.L.S.); (F.E.P.); (V.M.A.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +55-1636023337
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Figueiredo LTM, Souza WMD, Ferrés M, Enria DA. Hantaviruses and cardiopulmonary syndrome in South America. Virus Res 2014; 187:43-54. [DOI: 10.1016/j.virusres.2014.01.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/15/2014] [Indexed: 12/12/2022]
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Abstract
Hantavirus pulmonary syndrome caused by hantaviruses in the Americas presents as a broad clinical spectrum ranging from brief febrile prodrome with only thrombocytopenia to rapidly progressive fulminant pulmonary edema and shock. This vascular leak syndrome confined almost exclusively to the lung is initiated by the noncytolytic infection of capillary endothelial cells. A number of pathogenic mechanisms have been proposed, including immune cell-mediated injury, cytokine-mediated injury and enhanced VEGF responses from intercellular junctions resulting from highly specific virus–integrin interactions. This review examines evidence for each of these potential mechanisms, with relevant references to its sister syndrome, hemorrhagic fever with renal syndrome, in Eurasia. Any mechanism or combination of mechanisms must be able to explain the massive pulmonary capillary leak at the severe extreme of the spectrum, a disease manifestation without parallel in clinical medicine.
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Affiliation(s)
- Frederick Koster
- Division of Applied Science, Lovelace Respiratory Research Institute, Albuquerque, NM, USA
| | - Erich Mackow
- Department Molecular Genetics & Microbiology, Molecular & Cellular Biology Program, Stony Brook University, Stony Brook, NY, USA
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