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Kolb AW, Chau VQ, Miller DL, Yannuzzi NA, Brandt CR. Phylogenetic and Recombination Analysis of Clinical Vitreous Humor-Derived Adenovirus Isolates Reveals Discordance Between Serotype and Phylogeny. Invest Ophthalmol Vis Sci 2024; 65:12. [PMID: 38319669 PMCID: PMC10854415 DOI: 10.1167/iovs.65.2.12] [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: 10/23/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose To sequence, identify, and perform phylogenetic and recombination analysis on three clinical adenovirus samples taken from the vitreous humor at the Bascom Palmer Eye Institute. Methods The PacBio Sequel II was used to sequence the genomes of the three clinical adenovirus isolates. To identify the isolates, a full genome-based multiple sequence alignment (MSA) of 722 mastadenoviruses was generated using multiple alignment using fast Fourier transform (MAFFT). MAFFT was also used to generate genome-based human adenovirus B (HAdV-B) MSAs, as well as HAdV-B fiber, hexon, and penton protein-based MSAs. To examine recombination within HAdV-B, RF-Net 2 and Bootscan software programs were used. Results In the course of classifying three new atypical ocular adenovirus samples, taken from the vitreous humor, we found that all three isolates were HAdV-B species. The three Bascom Palmer HAdV-B genomes were then combined with over 300 HAdV-B genome sequences, including nine ocular HAdV-B genome sequences. Attempts to categorize the penton, hexon, and fiber serotypes using phylogeny of the three Bascom Palmer samples were inconclusive due to incongruence between serotype and phylogeny in the dataset. Recombination analysis using a subset of HAdV-B strains to generate a hybridization network detected recombination between nonhuman primate and human-derived strains, recombination between one HAdV-B strain and the HAdV-E outgroup, and limited recombination between the B1 and B2 clades. Conclusions The discordance between serotype and phylogeny detected in this study suggests that the current classification system does not accurately describe the natural history and phylogenetic relationships among adenoviruses.
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Affiliation(s)
- Aaron W. Kolb
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Viet Q. Chau
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Darlene L. Miller
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Nicolas A. Yannuzzi
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States
| | - Curtis R. Brandt
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, United States
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
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Molecular analysis of human adenoviral keratoconjunctivitis cases: Results of a 2-year survey. MARMARA MEDICAL JOURNAL 2023. [DOI: 10.5472/marumj.1244369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objective: This study aimed to determine the adenovirus genotypes and their epidemiological features between January 2018 and
November 2019, in Istanbul, Turkey.
Material and Methods: Conjunctival swab samples were obtained from patients who were clinically diagnosed with keratoconjunctivitis.
Samples were screened with an Adeno Detector kit (Rapid Pathogen Screening, RPS Inc., South Williamsport, PA). Nucleic acid
extraction and amplification were performed with the ADENOVIRUS ELITe MGB® kit in the ELITe In Genius instrument (Elitech
Group, Torino, Italy). For subtyping of the strains, sequencing primers targeted the ‘Hypervariable Region 7’ (HVR-7) of the hexon
gene were used. DNA sequence analysis (n:72) was performed with ABI PRISM® 3100 Genetic Analyzer (Applied Biosystems, USA),
and subtyping was done by BLAST analysis.
Results: The median viral load in the samples (n: 77) was 7 log10 copies/mL (IQR: 4.5-7.4 log10 copies/mL). The clinical finding score
was found to be significantly higher in the high viral load group (Adenovirus DNA≥6 Log 10 copies/mL) than in the low viral load
group (Adenovirus DNA
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3
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Aydamirov AS, Harbiyeli II, Ozturk G, Yarkin F, Erdem E, Yagmur M. In Vitro efficacy of cyclosporine a and various antiseptics and antiviral drugs on adenovirus genotype 8, a common cause of epidemic keratoconjunctivitis. Int Ophthalmol 2022; 43:1701-1710. [PMID: 36346478 DOI: 10.1007/s10792-022-02567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 10/16/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE To evaluate the in vitro efficacy of cidofovir, ganciclovir, povidone-iodine, chlorhexidine, and cyclosporine A on adenovirus genotype 8. METHODS Conjunctival samples were collected from patients with adenoviral conjunctivitis and cultured in A549 cells. Adenovirus diagnosis was confirmed by RT-PCR. For each drug, the 50% cytotoxic concentration (CC 50 ) was determined. Subsequently, the antiviral activity was tested at concentrations below CC 50, and the 50% inhibitor concentration (IC 50 ) of drugs was determined RESULTS: While the IC 50 of cidofovir against adenovirus genotype 8 was 3.07 ± 0.8 µM, ganciclovir, povidone-iodine, chlorhexidine, and cyclosporine A were not found to be effective against adenovirus genotype 8 at concentrations below the CC 50 value. CONCLUSIONS Cidofovir was found effective and the IC 50 value was within the ranges in the literature. Ganciclovir and cyclosporine A were found to be ineffective at doses below the cytotoxic dose, povidone-iodine and chlorhexidine was found to be highly cytotoxic.
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Affiliation(s)
| | | | - Gokhan Ozturk
- Division of Virology, Department of Microbiology, School of Medicine, Cukurova University, Adana, Turkey
| | - Fugen Yarkin
- Division of Virology, Department of Microbiology, School of Medicine, Cukurova University, Adana, Turkey
| | - Elif Erdem
- Department of Ophthalmology, School of Medicine, Cukurova University, Adana, Turkey
| | - Meltem Yagmur
- Department of Ophthalmology, School of Medicine, Cukurova University, Adana, Turkey
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4
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Seo JW, Lee SK, Hong IH, Choi SH, Lee JY, Kim HS, Kim HS. Molecular Epidemiology of Adenoviral Keratoconjunctivitis in Korea. Ann Lab Med 2022; 42:683-687. [PMID: 35765877 PMCID: PMC9277046 DOI: 10.3343/alm.2022.42.6.683] [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: 01/04/2022] [Revised: 02/21/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022] Open
Abstract
Human adenoviruses (HAdVs) are a major cause of epidemic keratoconjunctivitis. We investigated the types of adenoviruses responsible for the recent epidemic of keratoconjunctivitis in Korea. From January to November 2019, 218 conjunctival swab samples were collected from patients clinically suspected as having adenoviral keratoconjunctivitis. Genotyping targeting of adenovirus capsid hexon genes was performed using PCR and sequencing. Of the 218 samples collected, 128 (58.7%) were positive for the adenovirus genes by PCR, and 126 samples were successfully genotyped. Adenovirus type 8 (HAdV-D8) was the most common type (67.5%), followed by HAdV-D64 (11.1%), HAdV-D37 (9.5%), HAdV-B3 (5.6%), HAdV-D53 (4.0%), HAdV-E4 (1.6%), and HAdV-D56 (0.8%). Adenoviral keratoconjunctivitis cases were the most frequent in July and August 2019, which were mainly caused by type 8. Phylogenetic analyses revealed little genetic distance among adenoviruses of the same type detected in our study. Our results provide basic data for further studies of adenoviral keratoconjunctivitis.
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Affiliation(s)
- Jeong-Won Seo
- Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Su Kyung Lee
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - In Hwan Hong
- Department of Ophthalmology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Se Hyun Choi
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Joo Youn Lee
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Han-Sung Kim
- Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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Lynch JP, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment. Semin Respir Crit Care Med 2021; 42:800-821. [PMID: 34918322 DOI: 10.1055/s-0041-1733802] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The vast majority of cases are self-limited. However, the clinical spectrum is broad and fatalities may occur. Dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 100 genotypes and 52 serotypes of AdV have been identified and classified into seven species designated HAdV-A through -G. Different types display different tissue tropisms that correlate with clinical manifestations of infection. The predominant types circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been done. Cidofovir has been the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States but currently are not available to civilians.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Adriana E Kajon
- Infectious Disease Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico
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6
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Shieh WJ. Human adenovirus infections in pediatric population - an update on clinico-pathologic correlation. Biomed J 2021; 45:38-49. [PMID: 34506970 PMCID: PMC9133246 DOI: 10.1016/j.bj.2021.08.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 01/23/2023] Open
Abstract
Human adenoviruses can cause infections at any age but most commonly in pediatric population, especially in young children and infants. By the time of 10 years old, most children have had at least one episode of adenovirus infection. Adenoviruses can cause many symptoms similar to common cold, including rhinorrhea, fever, cough, and sore throat. Lower respiratory infections such as bronchitis, bronchiolitis, and pneumonia can be severe and even fatal. Other diseases such as conjunctivitis, gastroenteritis, cystitis, myocarditis, cardiomyopathy, and meningoencephalitis can also be associated with adenovirus infections. A variety of recent advancement of structural and molecular biology methods have revamped the taxonomy of adenoviruses and furthered our understanding of the diversity of related clinical diseases. Because of the wide spectrum and complexity of diseases associated with human adenovirus infections, the scope of this review is limited to basic virology and epidemiology of adenoviruses with a main focus on the clinico–pathologic correlation. Clinical manifestations and pathology of any infectious disease are always related; therefore, it is logical to review clinico–pathologic correlation within the specific disease entity caused by adenoviruses to better understand this common viral infection in pediatric population.
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Affiliation(s)
- Wun-Ju Shieh
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei, Taiwan.
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7
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Mohanty A, Mitra S, Mallick A, Barik MR, Das S, Priyadarshini S, Sahu SK. Sequelae of microsporidial keratoconjunctivitis and its management. Indian J Ophthalmol 2021; 69:1537-1543. [PMID: 34011737 PMCID: PMC8302272 DOI: 10.4103/ijo.ijo_1971_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: To characterize the sequelae of microsporidia keratoconjunctivitis (MKC) and outline its management. Methods: Retrospective analysis of microbiologically proven MKC returned with persistent disease between January 2015 and December 2019 was done. Demographics, clinical features, management, and outcome were analyzed. Results: Sixteen patients (21 eyes) of 332 treated for MKC returned with the persisting disease. The mean age of 11 males (68.7%), and 5 females was 35.1 ± 12.2 years. Three-quarter of them did not have a known predisposing risk factor and one-quarter of them were referred for chronic conjunctivitis. Past medications included topical antivirals (n = 8) and topical corticosteroid (n = 6). Three predominant presentations were persistent (>3 weeks) superficial punctate keratitis (SPKs, n = 7), sub-epithelial infiltrates (SEIs, n = 13), and uveitis (n = 2). The lesions recurred in eight eyes (SPK and SEI 4 each) after a disease-free interval of 60.4 ± 40.6 days; there were 13 episodes of recurrence. Topical low potent corticosteroids (loteprednol/fluorometholone), and tacrolimus ointment 0.03% were used in 17 (80.9%) and 8 (38%) eyes, respectively, for a mean duration of 44.8 ± 31.6 and 226.8 ± 180.5 days, respectively. At follow-up, 172.3 ± 183.6 days, visual recovery was statistically significant in persistent eyes (BCVA 0.07 ± 0.07 logMAR; P < 0.00001) but, not in recurrent eyes (BCVA 0.16 ± 0.08 logMAR; P = 0.07). Five of 21 eyes were left with residual significant scar. Conclusion: The sequelae of microsporidial keratoconjunctivitis are not uncommon. Topical 0.03% tacrolimus ointment appeared to be an effective corticosteroid-sparing agent for the treatment of SEIs and prevention of recurrence.
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Affiliation(s)
- Amrita Mohanty
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Sanchita Mitra
- Ocular Microbiology Service, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Aparajita Mallick
- Ocular Microbiology Service, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Manas Ranjan Barik
- Ocular Microbiology Service, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Sujata Das
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Smrutirekha Priyadarshini
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Srikant K Sahu
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India
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8
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Fukuda M, Nakamura J, Ito S, Kawazoe K, Miyanaga Y, Teshigawara T, Okuda K, Mizuki N, Shimada M. Vaccination inhibits the human adenoviral transduction in a mouse keratoconjunctivitis model. Vaccine 2021; 39:3498-3508. [PMID: 34016474 DOI: 10.1016/j.vaccine.2021.05.010] [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: 01/03/2021] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
Adenovirus infections are a major cause of epidemic keratoconjunctivitis (EKC), which can lead to corneal subepithelial infiltrates and multifocal corneal opacity. In the current study, we investigated the use of an E1/E3-deleted adenovirus serotype 5 (Ad5) vector as a vaccine administered intramuscularly (IM) or intranasally (IN) against subsequent challenges with a luciferase-expressing Ad5 (Ad5-Luci) vector via eyedrop. We evaluated the adaptive immune response to Ad5 vector vaccination and confirmed a robust polyfunctional CD8 T cell response in splenic cells. Neutralizing Ad5 antibodies were also measured in the sera of vaccinated mice as well as Ad5 antibody in the eye wash solutions. Upon challenge with Ad5-Luci vector 8 weeks post the primary immunization, transduction was significantly reduced by > 70% in the vaccinated mice, which was slightly better in IM- vs. that in IN-vaccinated animals. Resistance to subsequent challenge was observed 10 months post primary IM vaccination, with sustained reduction up to 60% in the Ad5-Luci vector transduction. Passive immunization of naive mice with antisera from IM to vaccinated mice subsequently challenged with the Ad5-Luci vector resulted in approximately 40% loss in transduction efficiency. Furthermore, the mice that received IM immunization with or without CD8 T cell depletion showed > 40% and 70% reductions, respectively, in Ad8 genomic copies after Ad8 topical challenge. We conclude that Ad-vector vaccination successfully induced an adaptive immune response that prevented subsequent Ad transduction in the cornea and conjunctiva-associated tissues in a mouse model of adenovirus keratoconjunctivitis, and that both cellular and humoral immunity play an important role in preventing Ad transduction.
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Affiliation(s)
- Michiko Fukuda
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Jutaro Nakamura
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Saori Ito
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | | | | | - Takeshi Teshigawara
- Department of Ophthalmology, Yokosuka Chuoh Eye Clinic, Yokosuka 238-0008, Japan
| | - Kenji Okuda
- Department of Molecular Biodefense Research, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Masaru Shimada
- Department of Molecular Biodefense Research, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan.
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9
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Direct costs and clinical impact of adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit. Infect Control Hosp Epidemiol 2020; 42:142-148. [PMID: 32900393 DOI: 10.1017/ice.2020.404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To report a conjunctivitis outbreak in a neonatology intensive care unit (NICU) and determine the associated economic impact. DESIGN Prospective observational study. SETTING Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, a private, tertiary-care healthcare institution in Buenos Aires, Argentina. PARTICIPANTS The study included 52 NICU neonates and 59 NICU-related healthcare workers (HCWs) from CEMIC hospital. METHODS Neonates and HCWs were swabbed for real-time polymerase chain reaction (PCR) testing, viral culture, and typing by sequencing. Infection control measures, structural and logistic changes were implemented. Billing records were analyzed to determine costs. RESULTS From January 30 to April 28, 2018, 52 neonates were hospitalized in the NICU. Among them, 14 of 52 (21%) had bilateral conjunctivitis with pseudomembranes. Symptomatic neonates and HCWs were HAdV-D8 positive. Ophthalmological symptoms had a median duration of 18 days (IQR, 13-24.5). PCR positivity and infectious range had a median duration of 18.5 days. As part of containment measures, the NICU and the high-risk pregnancy unit were closed to new patients. The NICU was divided into 2 areas for symptomatic and asymptomatic patients; a new room was assigned for the general nursery, and all deliveries from the high-risk pregnancy unit were redirected to other hospitals. The outbreak cost the hospital US$205,000: implementation of a new nursery room and extra salaries cost US$30,350 and estimated productivity loss during 1 month cost US$175,000. CONCLUSIONS Laboratory diagnosis confirmed the cause of this outbreak as HAdV-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial viral spread. This outbreak represented a serious institutional problem, causing morbidity, significant economic loss, and absenteeism.
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10
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Bhargava R, Kumar P. Comparison of the safety and efficacy of topical Tacrolimus (0.03%) versus dexamethasone (0.05%) for subepithelial infiltrates after adenoviral conjunctivitis. Indian J Ophthalmol 2019; 67:594-598. [PMID: 31007215 PMCID: PMC6498921 DOI: 10.4103/ijo.ijo_1352_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: To compare the safety and efficacy of tacrolimus 0.03% ointment with dexamethasone 0.05% ointment for subepithelial infiltrates (SEIs) following adenoviral keratoconjunctivitis (AK). Methods: A randomized, double blind trial was done. Eligibility criteria was corrected distance visual acuity of 6/9 Snellen or worse for at least 4 weeks with corneal SEIs following AK. The grading of SEIs was done on a scale of 0 to 3; 0, no infiltrates, 1 mild infiltration, 2 moderate infiltration and 3, severe infiltration. Consecutive patients with SEIs following AK were randomized to receive either topical tacrolimus 0.03% or dexamethasone 0.05% ointment twice daily for 6 months. Treatment was successful if there was reduction of SEIs and improvement in vision. Results: A total of 45 patients each were assigned to the Tacro and Dexa groups, respectively. Baseline characteristics of patients did not differ significantly (P > 0.001). There was a significant change in symptoms, vision and SEIs in both the groups. However, the magnitude was greater in tacro group. Treatment was successful in 37 (92.5%) patients in Tacro and 34 (85%) patients in dexa group. In dexa group, after a period of 1.24 ± 0.24 months, 7 (15.6%) patients developed a significant rise in intraocular pressure (IOP). Three (7.5%) eyes in tacro and 6 (15%) eyes in dexa group had recurrence of SEIs after cessation of therapy. Conclusion: Tacrolimus 0.03% is an effective alternative to dexamethasone 0.05% with low recurrence rate, no significant rise in IOP but may cause burning and foreign body sensation in some patients.
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Affiliation(s)
- Rahul Bhargava
- Department of Ophthalmology, Laser Eye Clinic, Noida, UP, India
| | - Prachi Kumar
- Department of Ophthalmology, Laser Eye Clinic, Noida, UP, India
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11
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Chandra N, Frängsmyr L, Imhof S, Caraballo R, Elofsson M, Arnberg N. Sialic Acid-Containing Glycans as Cellular Receptors for Ocular Human Adenoviruses: Implications for Tropism and Treatment. Viruses 2019; 11:v11050395. [PMID: 31035532 PMCID: PMC6563162 DOI: 10.3390/v11050395] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/15/2019] [Accepted: 04/26/2019] [Indexed: 02/04/2023] Open
Abstract
Human adenoviruses (HAdV) are the most common cause of ocular infections. Species B human adenovirus type 3 (HAdV-B3) causes pharyngoconjunctival fever (PCF), whereas HAdV-D8, -D37, and -D64 cause epidemic keratoconjunctivitis (EKC). Recently, HAdV-D53, -D54, and -D56 emerged as new EKC-causing agents. HAdV-E4 is associated with both PCF and EKC. We have previously demonstrated that HAdV-D37 uses sialic acid (SA)-containing glycans as cellular receptors on human corneal epithelial (HCE) cells, and the virus interaction with SA is mediated by the knob domain of the viral fiber protein. Here, by means of cell-based assays and using neuraminidase (a SA-cleaving enzyme), we investigated whether ocular HAdVs other than HAdV-D37 also use SA-containing glycans as receptors on HCE cells. We found that HAdV-E4 and -D56 infect HCE cells independent of SAs, whereas HAdV-D53 and -D64 use SAs as cellular receptors. HAdV-D8 and -D54 fiber knobs also bound to cell-surface SAs. Surprisingly, HCE cells were found resistant to HAdV-B3 infection. We also demonstrated that the SA-based molecule i.e., ME0462, designed to bind to SA-binding sites on the HAdV-D37 fiber knob, efficiently prevents binding and infection of several EKC-causing HAdVs. Surface plasmon resonance analysis confirmed a direct interaction between ME0462 and fiber knobs. Altogether, we demonstrate that SA-containing glycans serve as receptors for multiple EKC-causing HAdVs, and, that SA-based compound function as a broad-spectrum antiviral against known and emerging EKC-causing HAdVs.
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Affiliation(s)
- Naresh Chandra
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE-90185 Umeå, Sweden.
| | - Lars Frängsmyr
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE-90185 Umeå, Sweden.
| | - Sophie Imhof
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE-90185 Umeå, Sweden.
| | - Rémi Caraballo
- Department of Chemistry, Umeå University, SE-90187 Umeå, Sweden.
| | - Mikael Elofsson
- Department of Chemistry, Umeå University, SE-90187 Umeå, Sweden.
| | - Niklas Arnberg
- Section of Virology, Department of Clinical Microbiology, Umeå University, SE-90185 Umeå, Sweden.
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12
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Proenca-Modena JL, de Souza Cardoso R, Criado MF, Milanez GP, de Souza WM, Parise PL, Bertol JW, de Jesus BLS, Prates MCM, Silva ML, Buzatto GP, Demarco RC, Valera FCP, Tamashiro E, Anselmo-Lima WT, Arruda E. Human adenovirus replication and persistence in hypertrophic adenoids and palatine tonsils in children. J Med Virol 2019; 91:1250-1262. [PMID: 30815882 PMCID: PMC7166372 DOI: 10.1002/jmv.25441] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 12/31/2022]
Abstract
The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well established. However, the relationships, if any, of HAdV persistence and reactivation in the development of the chronic adenotonsillar disease is not fully understood. The present paper reports a 3-year cross-sectional hospital-based study aimed at detecting and quantifying HAdV DNA and mRNA of the HAdV hexon gene in adenoid and palatine tonsil tissues and nasopharyngeal secretions (NPS) from patients with adenotonsillar hypertrophy or recurrent adenotonsillitis. HAdV C, B, and E were detectable in nearly 50% of the patients, with no association with the severity of airway obstruction, nor with the presence of recurrent tonsillitis, sleep apnea or otitis media with effusion (OME). Despite the higher rates of respiratory viral coinfections in patients with HAdV, the presence of other viruses, including DNA and RNA viruses, had no association with HAdV replication or shedding in secretions. Higher HAdV loads in adenoids showed a significant positive correlation with the presence of sleep apnea and the absence of OME. Although this study indicates that a significant proportion (~85%) of individuals with chronic adenotonsillar diseases have persistent nonproductive HAdV infection, including those by HAdV C, B, and E, epithelial and subepithelial cells in tonsils seem to be critical for HAdV C production and shedding in NPS in some patients, since viral antigen was detected in these regions by immunohistochemistry in four patients, all of which were also positive for HAdV mRNA detection.
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Affiliation(s)
- José Luiz Proenca-Modena
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Ricardo de Souza Cardoso
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Miriã Ferreira Criado
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Guilherme Paier Milanez
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - William Marciel de Souza
- Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Pierina Lorencini Parise
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Jéssica Wildgrube Bertol
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Bruna Lais Santos de Jesus
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Maria Lúcia Silva
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Guilherme Pietrucci Buzatto
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo Cassiano Demarco
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Hanaoka N, Ito S, Konagaya M, Nojiri N, Yasuda M, Fujimoto T, Deguchi T. Infectious human adenoviruses are shed in urine even after disappearance of urethral symptoms. PLoS One 2019; 14:e0212434. [PMID: 30840641 PMCID: PMC6402629 DOI: 10.1371/journal.pone.0212434] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 02/02/2019] [Indexed: 11/24/2022] Open
Abstract
Background Urethritis is a common sexually transmitted disease, and human adenoviruses (HAdVs) have been found to be associated with nonchlamydial nongonococcal urethritis. However, the level and viability of HAdV in the urine of patients with urethritis remain unclear. Methods Male patients with urethritis and an asymptomatic group were screened using their First-void urine (FVU) for urethritis-related pathogens to identify those with HAdV DNA. FVU and gargle fluid were collected from all patients including from those in the asymptomatic group. A swab of eye discharge was also collected from patients with eye symptoms. The pharyngeal and/ or ocular fluid was also screened only in cases in which FVU was positive for HAdV DNA. HAdVs were isolated using A549 cell lines and typed by sequencing, and viral shedding during 2 years was quantified using real-time PCR. The prevalence of HAdV was assessed in the urethritis and asymptomatic groups, and viral load, isolated HAdV types, and urethral symptoms were compared between the groups. Results The positive detection rate of HAdV DNA was significantly higher in the urethritis group than in the asymptomatic group. Of 398 patients with urethritis, HAdV was isolated in all 32 cases (23 cases in which only HAdV DNA was detected with a mean of 2 × 109 copies/mL in urine samples). Of 124 control cases, one had HAdV monoinfection. The most frequently detected HAdV type was 56, followed by types 37 and 64. Regarding the relationship between symptoms and isolated HAdVs, the virus was isolated for up to 12 days after urethritis symptoms disappeared. Conclusions HAdVs were significantly detected and isolated from the FVU of patients with urethritis. Furthermore, high levels of infectious HAdVs are excreted in urine for a long period even after urethritis symptoms disappear.
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Affiliation(s)
- Nozomu Hanaoka
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
| | | | - Masami Konagaya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naomi Nojiri
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mitsuru Yasuda
- Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Tsuguto Fujimoto
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takashi Deguchi
- Department of Urology, Kizawa Memorial Hospital, Minokamo, Gifu, Japan
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Clinical case: severe course of adenoviral conjunctivitis with a hemorrhagic component complicated by a toxic-allergic reaction against a pregnancy. КЛИНИЧЕСКАЯ ПРАКТИКА 2018. [DOI: 10.17816/clinpract09176-81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
One of the manifestations of adenovirus keratoconjunctivitis – extensive subconjunctival hemorrhages – is the characteristic of rather rare hemorrhagic form of conjunctivitis of severe course. Patients, especially pregnant women, with clinical manifestations of adenoviral conjunctivitis of severe course with a hemorrhagic component complicated by a toxic-allergic reaction, require close attention not only from ophthalmologists. It is necessary to conduct a comprehensive examination, including: general blood test, coagulogram, consultation of the therapist. Clinical signs of deterioration, in the early days of the disease, against the backdrop of treatment, is a clinical feature of the course of adenovirus infection, which should be informed to the patient. The use of a complex approach using the domestic non-toxic inducer of interferon formation of Poludan (polyA:polyU complex) in instillations and injections, supplemented by scraping-massage with a glass rod of the tarsal conjunctiva, facilitating the elimination of adenovirus from conjunctival follicles, quickly and effectively reversed the phenomenon of severe AVC. The appointment of corticosteroid therapy, regardless of the severity of the toxic-allergic reaction, is shown no earlier than 7 days after the manifestation of the disease.
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Haque E, Banik U, Monowar T, Anthony L, Adhikary AK. Worldwide increased prevalence of human adenovirus type 3 (HAdV-3) respiratory infections is well correlated with heterogeneous hypervariable regions (HVRs) of hexon. PLoS One 2018; 13:e0194516. [PMID: 29590206 PMCID: PMC5874027 DOI: 10.1371/journal.pone.0194516] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/05/2018] [Indexed: 12/21/2022] Open
Abstract
Human adenovirus type 3 (HAdV-3) respiratory infections occurs worldwide in both children and adults, leading to severe morbidity and mortality, particularly in the paediatric age group and especially in neonates. During HAdV infection, neutralizing antibodies are formed against the epitopes located in the hyper variable regions (HVRs) of the hexon protein. These neutralizing antibodies provide protection against reinfection by viruses of the same type. Therefore it is reasonable to speculate that variations of HAdV-3 in the HVRs could impair the immunity acquired by previous infection with a different strain with variation in its HVRs. HAdV-3 has recently become the major agent of acute respiratory infection worldwide, being responsible for 15% to 87% of all adenoviral respiratory infections. However, despite the increased prevalence of HAdV-3 as respiratory pathogen, the diversity of hexon proteins in circulating strains remains unexplored. This study was designed to explore the variation in HVRs of hexon among globally distributed strains of HAdV-3 as well as to discover possible relationship among them, thus possibly shedding light on the cause for the increased prevalence of HAdV-3. In this study, for the first time we analysed the hexon proteins of all 248 available strains of HAdV-3 from the NCBI database and compared them with those of the HAdV-3 prototype (GB stain). We found that the HVRs of HAdV-3 strains circulating worldwide were highly heterogeneous and have been mutating continuously since -their original isolation. Based on their immense heterogeneity, the strains can be categorized into 25 hexon variants (3Hv-1 to 3Hv-25), 4 of which (3Hv-1 to 3Hv-4) comprises 80% of the strains. This heterogeneity may explain why HAdV-3 has become the most prevalent HAdVs type worldwide. The heterogeneity of hexon proteins also shows that the development of a vaccine against HAdV-3 might be challenging. The data on hexon variants provided here may be useful for the future epidemiological study of HAdV-3 infection.
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Affiliation(s)
- Ezazul Haque
- Unit of Microbiology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Urmila Banik
- Unit of Pathology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Tahmina Monowar
- Unit of Microbiology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Leela Anthony
- Unit of Community Medicine, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
| | - Arun Kumar Adhikary
- Unit of Microbiology, AIMST University, Faculty of Medicine, Jalan Bedong Semeling, Bedong, Kedah, Malaysia
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Lee CS, Lee AY, Akileswaran L, Stroman D, Najafi-Tagol K, Kleiboeker S, Chodosh J, Magaret A, Wald A, Van Gelder RN. Determinants of Outcomes of Adenoviral Keratoconjunctivitis. Ophthalmology 2018; 125:1344-1353. [PMID: 29602567 DOI: 10.1016/j.ophtha.2018.02.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/07/2018] [Accepted: 02/12/2018] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To determine host and pathogen factors predictive of outcomes in a large clinical cohort with keratoconjunctivitis. DESIGN Retrospective analyses of the clinical and molecular data from a randomized, controlled, masked trial for auricloscene for keratoconjunctivitis (NVC-422 phase IIB, NovaBay; clinicaltrials.gov identifier, NCT01877694). PARTICIPANTS Five hundred participants from United States, India, Brazil, and Sri Lanka with clinical diagnosis of keratoconjunctivitis and positive rapid test results for adenovirus. METHODS Clinical signs and symptoms and bilateral conjunctival swabs were obtained on days 1, 3, 6, 11, and 18. Polymerase chain reaction (PCR) analysis was performed to detect and quantify adenovirus in all samples. Regression models were used to evaluate the association of various variables with keratoconjunctivitis outcomes. Time to resolution of each symptom or sign was assessed by adenoviral species with Cox regression. MAIN OUTCOME MEASURES The difference in composite scores of clinical signs between days 1 and 18, mean visual acuity change between days 1 and 18, and time to resolution of each symptom or sign. RESULTS Of 500 participants, 390 (78%) showed evidence of adenovirus by PCR. Among adenovirus-positive participants, adenovirus D species was most common (63% of total cases), but a total of 4 species and 21 different types of adenovirus were detected. Adenovirus D was associated with more severe signs and symptoms, a higher rate of subepithelial infiltrate development, and a slower decline in viral load compared with all other adenovirus species. The clinical courses of all patients with non-adenovirus D species infection and adenovirus-negative keratoconjunctivitis were similar. Mean change in visual acuity between days 1 and 18 was a gain of 1.9 letters; worse visual outcome was associated with older age. CONCLUSIONS A substantial proportion of keratoconjunctivitis is not associated with a detectable adenovirus. The clinical course of those with adenovirus D keratoconjunctivitis is significantly more severe than those with non-adenovirus D species infections or adenovirus-negative keratoconjunctivitis; high viral load at presentation and non-United States origin of participants is associated with poorer clinical outcome.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, Washington.
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | | | - David Stroman
- NovaBay Pharmaceuticals, Inc., Emeryville, California
| | | | | | - James Chodosh
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Amalia Magaret
- Department of Biostatistics, University of Washington, Seattle, Washington; Department of Laboratory Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anna Wald
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington; Department of Epidemiology, University of Washington, Seattle, Washington
| | - Russell N Van Gelder
- Department of Ophthalmology, University of Washington, Seattle, Washington; Departments of Biological Structure and Pathology, University of Washington, Seattle, Washington
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Lei Z, Zhu Z, wang BMC, mei H, Li H, ga DZG, jie G, chi MMB, Zhang S, Ma C, Xu W. Outbreaks of epidemic keratoconjunctivitis caused by human adenovirus type 8 in the Tibet Autonomous Region of China in 2016. PLoS One 2017; 12:e0185048. [PMID: 28915257 PMCID: PMC5600394 DOI: 10.1371/journal.pone.0185048] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/04/2017] [Indexed: 11/26/2022] Open
Abstract
From April to November 2016, two outbreaks of epidemic keratoconjunctivitis (EKC) occurred successively at primary and middle schools in the Tibet Autonomous Region of China, and a total of 197 clinically diagnosed cases were reported. Real-time PCR analyses confirmed that human adenovirus (HAdV) infection was related to these outbreaks. Further studies involving sequence determination and phylogenetic analysis based on the penton base, hexon, and fiber genes indicated that human adenovirus type 8 (HAdV-8), belonging to species D, was responsible for the outbreaks. This is the first report of a HAdV-8 associated EKC outbreak in mainland of China, and the results of this study are expected to provide support for future research into HAdV-8 in China.
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Affiliation(s)
- Zhenqiang Lei
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang city, Shaanxi province, People’s Republic of China
| | - Zhen Zhu
- WHO WPRO Regional Reference Measles/Rubella laboratory and Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing City, People’s Republic of China
| | - Bai ma ci wang
- Department of Infectious Diseases, Tibet Center for Disease Control and Prevention, Lhasa city, Tibet Autonomous Region, People’s Republic of China
| | - Hong mei
- Department of Health Inspection, Tibet Center for Disease Control and Prevention, Lhasa city, Tibet Autonomous Region, People’s Republic of China
| | - Hong Li
- Department of Pathogenic Biology, Medical School, Anhui University of Science and Technology, Huainan City, Anhui Province, People’s Republic of China
| | - Dan zeng gong ga
- Department of Infectious Diseases, Tibet Center for Disease Control and Prevention, Lhasa city, Tibet Autonomous Region, People’s Republic of China
| | - Guo jie
- Gongbujiangda County Center for Disease Control and Prevention, Linzhi City, Tibet Autonomous Region, People’s Republic of China
| | - Mi ma bu chi
- Department of Infectious Diseases, Rikaze Prefecture Center for Disease Control and Prevention, Rikaze City, Tibet Autonomous Region, People’s Republic of China
| | - Sheng Zhang
- WHO WPRO Regional Reference Measles/Rubella laboratory and Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing City, People’s Republic of China
| | - Chaofeng Ma
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang city, Shaanxi province, People’s Republic of China
- Xi'an Center for Disease Control and Prevention, Xi’an City, Shaanxi Province, People’s Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Reference Measles/Rubella laboratory and Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing City, People’s Republic of China
- Department of Pathogenic Biology, Medical School, Anhui University of Science and Technology, Huainan City, Anhui Province, People’s Republic of China
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Assadian F, Kamel W, Laurell G, Svensson C, Punga T, Akusjärvi G. Expression profile of Epstein-Barr virus and human adenovirus small RNAs in tonsillar B and T lymphocytes. PLoS One 2017; 12:e0177275. [PMID: 28542273 PMCID: PMC5444648 DOI: 10.1371/journal.pone.0177275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/25/2017] [Indexed: 12/24/2022] Open
Abstract
We have used high-throughput small RNA sequencing to characterize viral small RNA expression in purified tonsillar B and T lymphocytes isolated from patients tested positive for Epstein-Barr virus (EBV) or human adenovirus (HAdV) infections, respectively. In the small set of patients analyzed, the expression profile of EBV and HAdV miRNAs could not distinguish between patients diagnosed with tonsillar hypertrophy or chronic/recurrent tonsillitis. The EBV miR-BART expression profile among the patients diagnosed with tonsillar diseases resembles most closely the pattern seen in EBV+ tumors (Latency II/I). The miR-BARTs that appear to be absent in normal EBV infected cells are essentially all detectable in the diseased tonsillar B lymphocytes. In the EBV+ B cells we detected 44 EBV miR-BARTs derived from the proposed BART precursor hairpins whereof five are not annotated in miRBase v21. One previously undetected miRNA, BART16b-5p, originates from the miR-BART16 precursor hairpin as an alternative 5´ miR-BART16 located precisely upstream of the annotated miR-BART16-5p. Further, our analysis revealed an extensive sequence variation among the EBV miRNAs with isomiRs having a constant 5´ end but alternative 3´ ends. A range of small RNAs was also detected from the terminal stem of the EBER RNAs and the 3´ part of v-snoRNA1. During a lytic HAdV infection in established cell lines the terminal stem of the viral non-coding VA RNAs are processed to highly abundant viral miRNAs (mivaRNAs). In contrast, mivaRNA expression in HAdV positive tonsillar T lymphocytes was very low. The small RNA profile further showed that the 5´ mivaRNA from VA RNAI and the 3´ mivaRNA from VA RNAII were as predicted, whereas the 3´ mivaRNA from VA RNAI showed an aberrant processing upstream of the expected Dicer cleavage site.
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Affiliation(s)
- Farzaneh Assadian
- Department of Medical Biochemistry and Microbiology, Uppsala Biomedical Center, Uppsala University, Uppsala, Sweden
| | - Wael Kamel
- Department of Medical Biochemistry and Microbiology, Uppsala Biomedical Center, Uppsala University, Uppsala, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Catharina Svensson
- Department of Medical Biochemistry and Microbiology, Uppsala Biomedical Center, Uppsala University, Uppsala, Sweden
| | - Tanel Punga
- Department of Medical Biochemistry and Microbiology, Uppsala Biomedical Center, Uppsala University, Uppsala, Sweden
| | - Göran Akusjärvi
- Department of Medical Biochemistry and Microbiology, Uppsala Biomedical Center, Uppsala University, Uppsala, Sweden
- * E-mail:
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Frings A, Geerling G, Schargus M. Red Eye: A Guide for Non-specialists. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:302-312. [PMID: 28530180 PMCID: PMC5443986 DOI: 10.3238/arztebl.2017.0302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 08/18/2016] [Accepted: 12/29/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Red eye can arise as a manifestation of many different systemic and ophthalmological diseases. The physician whom the patient first consults for this problem is often not an ophthalmologist. A correct assessment of the urgency of the situation is vitally important for the planning of further diagnostic evaluation and treatment. METHODS This review is based on pertinent publications retrieved by a selective literature search in PubMed in August 2016 as well as on the authors' own clinical and scientific experience. RESULTS Primary care physicians typically see 4-10 patients per week who complain of ocular symptoms. Most of them have red eye as the major clinical finding. A detailed history, baseline ophthalmological tests, and accompanying manifestations can narrow down the differential diagnosis. The duration and laterality of symptoms (uni- vs. bilateral) and the intensity of pain are the main criteria allowing the differentiation of non-critical changes that can be cared for by a general practitioner from diseases calling for elective referral to an ophthalmologist and eye emergencies requiring urgent ophthalmic surgery. CONCLUSION The differential diagnosis of red eye can be narrowed down rapidly with simple baseline tests and targeted questioning. Patients with ocular emergencies should be referred to an ophthalmologist at once, as should all patients whose diagnosis is in doubt.
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Affiliation(s)
- Andreas Frings
- Department of Ophthalmology, Düsseldorf University Hospital
| | - Gerd Geerling
- Department of Ophthalmology, Düsseldorf University Hospital
| | - Marc Schargus
- Department of Ophthalmology, Düsseldorf University Hospital
- Ophthalmological Medical Center Schweinfurt, Eye Hospital Schweinfurt-Gerolzhofen
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20
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Hage E, Espelage W, Eckmanns T, Lamson DM, Pantó L, Ganzenmueller T, Heim A. Molecular phylogeny of a novel human adenovirus type 8 strain causing a prolonged, multi-state keratoconjunctivitis epidemic in Germany. Sci Rep 2017; 7:40680. [PMID: 28084428 PMCID: PMC5234003 DOI: 10.1038/srep40680] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 12/09/2016] [Indexed: 12/22/2022] Open
Abstract
The German infectious disease surveillance system revealed an increase of epidemic keratoconjunctivitis (EKC) from an average of 320 cases/year (2001 to 2010) up to 2146 and 1986 cases in 2012 and 2013, respectively. From November 2011 until December 2013 (epidemic period) 85% of typed isolates were human adenovirus type 8 (HAdV-D8), whereas only low level circulation (19%) of HAdV-D8 was observed outside the epidemic period. In order to investigate whether a novel monophyletic HAdV-D8 strain prevailed during the epidemic period, complete genomic sequences of 23 HAdV-D8 isolates were generated by deep sequencing and analyzed phylogenetically. For comparison, eight HAdV-D8 isolates from outside the epidemic period were sequenced. HAdV-D8 isolates of the epidemic period had a very high sequence identity of at least 99.9% and formed a monophyletic cluster with two subclusters. A single outlier was closely related to HAdV-D8 strains isolated prior to the epidemic period. Circulation of the epidemic strain was detected as early as 2010 but not after the epidemic period in 2014. In conclusion, molecular phylogeny of complete genomic sequences proved a monophyletic HAdV-D8 epidemic. However, co-circulation of other HAdV types as well as better reporting may have contributed to the huge increase of reported cases.
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Affiliation(s)
- Elias Hage
- Institute of Virology, Konsiliarlabor für Adenoviren (KLA, Adenovirus Reference Laboratory); Hannover Medical School, Hannover, Germany
| | - Werner Espelage
- Department for Infectious Disease Epidemiology, Unit for Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Robert Koch Institut, Berlin, Germany
| | - Tim Eckmanns
- Department for Infectious Disease Epidemiology, Unit for Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Robert Koch Institut, Berlin, Germany
| | - Daryl M Lamson
- Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Laura Pantó
- Laboratory of Genome Sciences, Division of Bioengineering and Bioinformatics, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Tina Ganzenmueller
- Institute of Virology, Konsiliarlabor für Adenoviren (KLA, Adenovirus Reference Laboratory); Hannover Medical School, Hannover, Germany
| | - Albert Heim
- Institute of Virology, Konsiliarlabor für Adenoviren (KLA, Adenovirus Reference Laboratory); Hannover Medical School, Hannover, Germany
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Abstract
Keratoconjunctivitis caused by adenoviruses (epidemic keratoconjunctivitis, EKC, ICD-10 B30.0+) is common, can be severe and may cause significant morbidity. In the early stages of adenoviral infections it is often difficult to differentiate the clinical presentation from other causes of a red eye. Because of its highly contagious nature that can rapidly lead to epidemic outbreaks, prompt viral identification and prevention of further spread are major challenges. Even today the diagnosis is still mainly clinical, with laboratory tests only rarely contributing. New diagnostic tests, such as the Rapid Pathogen Detector (RPS, Sarasota FL) AdenoPlus detection kit, that are practical, rapid and inexpensive to use in the general practice may obviate these problems. Because of its highly resistant properties to desiccation and highly developed escape mechanisms which protect the virus from the host's immune response, long-term problems often remain. Remnants of viral proteins often persist on the corneal surface of Bowman's layer for a long time and may lead to the formation of subepithelial infiltrates. No treatment other than symptomatic eye drops is available. The major sequelae are subepithelial infiltrates, which are difficult to treat. Cyclosporin A eye drops are a good option with a low risk profile. The use of topical steroids can possibly be disadvantageous but can be discussed at all stages of the disease. As nosocomial spread of adenoviruses is relatively common, preventive measures remain a major responsibility for ophthalmologists.
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Lynch JP, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention. Semin Respir Crit Care Med 2016; 37:586-602. [PMID: 27486739 PMCID: PMC7171713 DOI: 10.1055/s-0036-1584923] [Citation(s) in RCA: 307] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The disease is more severe and dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 50 serotypes of AdV have been identified. Different serotypes display different tissue tropisms that correlate with clinical manifestations of infection. The predominant serotypes circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been conducted. Cidofovir is the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States, but currently are not available to civilians.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Adriana E Kajon
- Department of Infectious Disease, Lovelace Respiratory Research Institute, Albuquerque, New Mexico
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Distribution and Molecular Characterization of Human Adenovirus and Epstein-Barr Virus Infections in Tonsillar Lymphocytes Isolated from Patients Diagnosed with Tonsillar Diseases. PLoS One 2016; 11:e0154814. [PMID: 27136093 PMCID: PMC4852932 DOI: 10.1371/journal.pone.0154814] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/19/2016] [Indexed: 11/19/2022] Open
Abstract
Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%). The most abundant adenovirus type was HAdV-5 (68%). None of the patients were positive for HCMV. Furthermore, 43 patients (39%) showed a co-infection of HAdV and EBV. The majority of young patients diagnosed with tonsillar hypertrophy were positive for HAdV, whereas all adult patients diagnosed with chronic/recurrent tonsillitis were positive for either HAdV or EBV. Most of the tonsils from patients diagnosed with either tonsillar hypertrophy or chronic/recurrent tonsillitis showed a higher HAdV DNA copy number in T compared to B cell-enriched fraction. Interestingly, in the majority of the tonsils from patients with chronic/recurrent tonsillitis HAdV DNA was detected in T cells only, whereas hypertrophic tonsils demonstrated HAdV DNA in both T and B cell-enriched fractions. In contrast, the majority of EBV positive tonsils revealed a preference for EBV DNA accumulation in the B cell-enriched fraction compared to T cell fraction irrespective of the patients' age.
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24
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Fedaoui N, Ayed NB, Yahia AB, Hammami W, Touzi H, Triki H. Genetic variability of human adenovirus type 8 causing epidemic and sporadic cases of keratoconjunctivitis. Arch Virol 2016; 161:1469-76. [DOI: 10.1007/s00705-016-2804-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/20/2016] [Indexed: 10/22/2022]
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25
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Virology and epidemiology analyses of global adenovirus-associated conjunctivitis outbreaks, 1953-2013. Epidemiol Infect 2016; 144:1661-72. [PMID: 26732024 DOI: 10.1017/s0950268815003246] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study aimed to compare the virology and epidemiology of epidemic keratoconjunctivitis (EKC), pharyngoconjunctival fever (PCF) and acute haemorrhagic conjunctivitis (AHC) outbreaks worldwide caused by the human adenovirus (HAdV) from 1953 to 2013. Eighty-three hexon sequences from 76 conjunctivitis outbreaks were analysed and subtyped using Mega 5.05, Clustal X and SimPlot software. Epidemiology was performed for the area, age and seasonal distribution. A phylogenetic analysis indicated that all the isolates could be divided into three subgenetic lineages, without a common ancestor. The major causes of the outbreaks were Ad8, Ad7 and Ad2 co-infection with enterovirus 70 (EV70) in EKC, PCF and AHC, respectively. The epidemiological findings suggested that EKC and AHC were circulating predominantly in Asia during the early winter and spring, whereas PCF was circulating mainly in China, Australia and the United States during the summer. This study suggests that EKC, AHC and PCF outbreaks have different circulating patterns throughout the world and are caused by different adenovirus serotypes. A global surveillance system should be established to monitor conjunctivitis outbreaks in the future.
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