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Mihalić A, Železnjak J, Lisnić B, Jonjić S, Juranić Lisnić V, Brizić I. Immune surveillance of cytomegalovirus in tissues. Cell Mol Immunol 2024; 21:959-981. [PMID: 39134803 PMCID: PMC11364667 DOI: 10.1038/s41423-024-01186-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/14/2024] [Indexed: 09/01/2024] Open
Abstract
Cytomegalovirus (CMV), a representative member of the Betaherpesvirinae subfamily of herpesviruses, is common in the human population, but immunocompetent individuals are generally asymptomatic when infected with this virus. However, in immunocompromised individuals and immunologically immature fetuses and newborns, CMV can cause a wide range of often long-lasting morbidities and even death. CMV is not only widespread throughout the population but it is also widespread in its hosts, infecting and establishing latency in nearly all tissues and organs. Thus, understanding the pathogenesis of and immune responses to this virus is a prerequisite for developing effective prevention and treatment strategies. Multiple arms of the immune system are engaged to contain the infection, and general concepts of immune control of CMV are now reasonably well understood. Nonetheless, in recent years, tissue-specific immune responses have emerged as an essential factor for resolving CMV infection. As tissues differ in biology and function, so do immune responses to CMV and pathological processes during infection. This review discusses state-of-the-art knowledge of the immune response to CMV infection in tissues, with particular emphasis on several well-studied and most commonly affected organs.
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Affiliation(s)
- Andrea Mihalić
- Center for Proteomics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Jelena Železnjak
- Center for Proteomics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Berislav Lisnić
- Center for Proteomics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Stipan Jonjić
- Center for Proteomics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Department of Biomedical Sciences, Croatian Academy of Sciences and Arts, Rijeka, Croatia
| | - Vanda Juranić Lisnić
- Center for Proteomics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
| | - Ilija Brizić
- Center for Proteomics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
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Reyna RA, Littlefield KE, Shehu N, Makishima T, Maruyama J, Paessler S. The Importance of Lassa Fever and Its Disease Management in West Africa. Viruses 2024; 16:266. [PMID: 38400041 PMCID: PMC10892767 DOI: 10.3390/v16020266] [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: 12/11/2023] [Revised: 01/21/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Lassa virus (LASV) is a zoonotic pathogen endemic throughout western Africa and is responsible for a human disease known as Lassa fever (LF). Historically, LASV has been emphasized as one of the greatest public health threats in West Africa, with up to 300,000 cases and 5000 associated deaths per year. This, and the fact that the disease has been reported in travelers, has driven a rapid production of various vaccine candidates. Several of these vaccines are currently in clinical development, despite limitations in understanding the immune response to infection. Alarmingly, the host immune response has been implicated in the induction of sensorineural hearing loss in LF survivors, legitimately raising safety questions about any future vaccines as well as efficacy in preventing potential hearing loss. The objective of this article is to revisit the importance and prevalence of LF in West Africa, with focus on Nigeria, and discuss current therapeutic approaches and ongoing vaccine development. In addition, we aim to emphasize the need for more scientific studies relating to LF-associated hearing loss, and to promote critical discussion about potential risks and benefits of vaccinating the population in endemic regions of West Africa.
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Affiliation(s)
- Rachel A. Reyna
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Kirsten E. Littlefield
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Nathan Shehu
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Infectious Disease Unit, Department of Medicine, Jos University Teaching Hospital, Jos P.M.B. 2076, Nigeria
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Tawk K, Tawk A, Abouzari M. Sudden Hearing Loss Waves: The Effect of COVID-19 Infection and Vaccination on the Inner Ear. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1457:265-283. [PMID: 39283432 DOI: 10.1007/978-3-031-61939-7_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
Sudden sensorineural hearing loss (SSNHL) has emerged as a potential complication of COVID-19 infection and vaccination. Various mechanisms by which the SARS-CoV-2 virus can cause hearing loss have been reported, including direct viral invasion, neuroinflammation, blood flow disturbances, and immune-mediated response. However, the temporal relationship between COVID-19 infection and SSNHL remains unclear, with mixed findings and conflicting results reported in different studies. Similarly, while anecdotal reports have linked COVID-19 vaccination to SSNHL, evidence remains scarce. Establishing a correlation between COVID-19 vaccines and SSNHL implies a complex and multifactorial pathogenesis involving interactions between the immune system and the body's stress response. Nevertheless, it is important to consider the overwhelming evidence of the vaccines' safety and efficacy in limiting the spread of the disease and remains the primordial tool in reducing death.
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Affiliation(s)
- Karen Tawk
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, 333 City Blvd. West, Suite 525, Orange, CA, 92868, USA
| | - Anthony Tawk
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, 333 City Blvd. West, Suite 525, Orange, CA, 92868, USA
| | - Mehdi Abouzari
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, 333 City Blvd. West, Suite 525, Orange, CA, 92868, USA.
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Sudden Sensorineural Hearing Loss in the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12123139. [PMID: 36553146 PMCID: PMC9777296 DOI: 10.3390/diagnostics12123139] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Accumulating data indicate that patients with COVID-19 could be affected by sudden sensorineural hearing loss (SSNHL). The aim of the study was to analyze the epidemiological and clinical trend of SSNHL occurrence during the COVID-19 pandemic by applying a systematic review and meta-analysis approach. METHODS PubMed, Scopus, Web of Science, ScienceDirect, and Cochrane databases were searched. RESULTS The seven included studies had adequate relevance to the topic and the quality was fair. The mean age at SSNHL onset ranged from 39.23 to 62.18 years during the pandemic year period (PYP); a meta-analysis of four studies comparing these data with those of previous periods in the same institutions found a younger age during the PYP (pooled mean -0.2848). The heterogeneity was high (76.1935%) and no frank asymmetry was observed in the funnel plot. The SARS-CoV-2 positivity rate of SSNHL patients ranged from 0% to 57.53%. Standard steroid treatments were applied without significant adverse effects. Comprehensively, hearing improvement was achieved for more than half of the cases. No studies reported long-term follow-up data. CONCLUSIONS Further prospective analyses on large series and a long-term follow up on COVID-related SSNHL cases are necessary to address the open questions regarding the causative link between COVID-19 infection and SSNHL.
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Brisse M, Fernández-Alarcón C, Huang Q, Kirk N, Schleiss MR, Liang Y, Ly H. Hearing loss in outbred Hartley guinea pigs experimentally infected with Pichinde virus as a surrogate model of human mammarenaviral hemorrhagic fevers. Virulence 2022; 13:1049-1061. [PMID: 35758052 PMCID: PMC9794012 DOI: 10.1080/21505594.2022.2087948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Lassa fever (LF) is a neglected tropical disease that is caused by Lassa virus (LASV), a human hemorrhagic fever-causing mammarenavirus. A notable sequela of LF is sensorineural hearing loss (SNHL) that can develop in about 33% of the patients. Animal models of LF-associated SNHL have been limited in size and scope because LASV is a biosafety level 4 (BSL4) pathogen that requires its handling in a high biocontainment laboratory. In this report, we describe the development of an alternative arenavirus hearing loss model by infecting outbred Hartley guinea pigs with a virulent strain (rP18) of the Pichinde virus (PICV), which is a guinea pig-adapted mammarenavirus that has been used as a surrogate model of mammarenaviral hemorrhagic fevers in a conventional (BSL2) laboratory. By measuring auditory brainstem response (ABR) throughout the course of the virulent rP18 PICV infection, we noticed that some of the animals experienced an acute but transient level of hearing loss. Cochleae of hearing-impaired animals, but not of controls, had demonstrable viral RNA by quantitative RT-PCR, indicating the presence of virus in the affected inner ear with no overt histopathological changes. In contrast, neither the outbred Hartley guinea pigs infected with a known avirulent strain (rP2) of PICV nor those that were mock-infected showed any evidence of hearing loss or viral infection of the inner ear. This is the first report of an immunocompetent small animal model of mammarenavirus-induced hearing loss that can be used to evaluate potential therapeutics against virus-induced hearing impairment under a conventional laboratory setting.
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Affiliation(s)
- Morgan Brisse
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | | | - Qinfeng Huang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Natalie Kirk
- Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Mark R. Schleiss
- Department of Pediatrics, School of Medicine University of Minnesota, Twin Cities, Minnesota, USA
| | - Yuying Liang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Hinh Ly
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA,CONTACT Hinh Ly
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Li M, Wu L, Chen M, Dong Y, Zheng L, Chen D, Qiao Y, Ke Z, Shi X. Co-activation of Caspase-1 and Caspase-8 in CMV-induced SGN death by inflammasome-associated pyroptosis and apoptosis. Int Immunopharmacol 2022; 113:109305. [DOI: 10.1016/j.intimp.2022.109305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/15/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
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Hakim A, Hool SL, Yassa N, Breiding PS, Pastore-Wapp M, Caversaccio M, Anschuetz L, Wagner F. Signal Alteration of the Inner Ear on High-Resolution Three-Dimensional Constructive Interference in Steady State Sequence in Patients with Ménière's Disease and Labyrinthitis. Audiol Neurootol 2022; 27:449-457. [PMID: 36037798 PMCID: PMC9808646 DOI: 10.1159/000525419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 06/06/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The aim of this study is to evaluate signal alteration in the inner ear using three-dimensional (3D)-constructive interference in steady state (CISS) sequence in patients with Ménière's disease and labyrinthitis and its correlation with clinical and audiological parameters. METHODS The medical records of the department of otorhinolaryngology were searched for patients with Ménière's disease or labyrinthitis who underwent MRI with 3D-CISS sequence. Blinded analysis of these patients and of MRI from control subjects without middle or inner ear symptoms was performed to detect any signal asymmetry of the inner ear structures. The results were correlated with clinical symptoms and results of audiological and vestibular tests. RESULTS Fifty-eight patients with definite Ménière's disease and 5 patients with labyrinthitis as well as 41 control exams were included. A separate analysis was performed for patients with probable Ménière's disease (n = 68). A total of 172 3D-CISS sequences were analyzed by 2 blinded independent neuroradiologists. A CISS-hypointense signal of the inner ear structures was found in 3 patients with definite Ménière's disease (5.2%), in 4 patients with probable Ménière's disease (5.9%), and 2 patients with labyrinthitis (40%). No CISS hypointensity was found in the control group. Although no significant difference in symptoms or audiological test results was found between patients with and without this signal change, the side of hypointensity was frequently correlated with the symptomatic side and with hearing impairment. DISCUSSION/CONCLUSION CISS hypointensity of the inner ear structures was evident in patients with clinical conditions other than vestibular schwannoma - more frequently in labyrinthitis than in Ménière's disease. This signal alteration was frequently encountered on the same symptomatic side as that of the pathological audiology tests, but it is not a predictor for hearing or vestibular impairment.
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Affiliation(s)
- Arsany Hakim
- University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland,*Arsany Hakim,
| | - Sara-Lynn Hool
- Department of Otorhinolaryngology and Head & Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Nabil Yassa
- University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland,Praxis für Neurochirurgie, Wilhelmshaven, Germany
| | - Philipe Sebastian Breiding
- University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Manuela Pastore-Wapp
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland,Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology and Head & Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Lukas Anschuetz
- Department of Otorhinolaryngology and Head & Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Franca Wagner
- University Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
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Reyna RA, Maruyama J, Mantlo EK, Manning JT, Taniguchi S, Makishima T, Lukashevich IS, Paessler S. Depletion of CD4 and CD8 T Cells Reduces Acute Disease and Is Not Associated with Hearing Loss in ML29-Infected STAT1-/- Mice. Biomedicines 2022; 10:2433. [PMID: 36289695 PMCID: PMC9598517 DOI: 10.3390/biomedicines10102433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Abstract
Lassa virus (LASV) is a zoonotic virus endemic to western Africa that can cause a potentially lethal and hemorrhagic disease, Lassa fever (LF). Survivors suffer a myriad of sequelae, most notably sudden onset sensorineural hearing loss (SNHL), the mechanism of which remains unclear. Unfortunately, studies aiming to identify the mechanism of these sequelae are limited due to the biosafety level 4 (BSL4) requirements of LASV itself. ML29, a reassortant virus proposed as an experimental vaccine candidate against LASV, is potentially an ideal surrogate model of LF in STAT1-/- mice due to similar phenotype in these animals. We intended to better characterize ML29 pathogenesis and potential sequelae in this animal model. Our results indicate that while both CD4 and CD8 T cells are responsible for acute disease in ML29 infection, ML29 induces significant hearing loss in a mechanism independent of either CD4 or CD8 T cells. We believe that this model could provide valuable information for viral-associated hearing loss in general.
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Affiliation(s)
- Rachel A. Reyna
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Emily K. Mantlo
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - John T. Manning
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Satoshi Taniguchi
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Igor S. Lukashevich
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40292, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Lo TH, Lin PH, Hsu WC, Tsao PN, Liu TC, Yang TH, Hsu CJ, Huang LM, Lu CY, Wu CC. Prognostic determinants of hearing outcomes in children with congenital cytomegalovirus infection. Sci Rep 2022; 12:5219. [PMID: 35338167 PMCID: PMC8956567 DOI: 10.1038/s41598-022-08392-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 02/24/2022] [Indexed: 12/20/2022] Open
Abstract
Congenital cytomegalovirus (cCMV) infection is the most prevalent cause of non-genetic sensorineural hearing loss (SNHL) in children. However, the prognostic determinants of SNHL remain unclear. Children with cCMV infection in a tertiary hospital were enrolled. The presence of cCMV-related symptoms at birth, the newborn hearing screening (NHS) results, and the blood viral loads were ascertained. Audiologic outcomes and initial blood viral loads were compared between different groups. Of the 39 children enrolled, 16 developed SNHL. SNHL developed in 60% of children who were initially symptomatic, and in 34.5% of those who were initially asymptomatic with normal hearing or isolated hearing loss, respectively. Failuire in NHS was a reliable tool for early detection of SNHL. The initial viral loads were higher in children who were symptomatic at birth, those who failed NHS, and those who developed SNHL. We observed SNHL deterioration in a patient after CMV DNAemia clearance was achieved, and in another patient with the flare-up of viral load. The presence of cCMV-related symptoms at birth, failure in NHS, and blood viral load might be the prognostic factors for hearing outcomes. Regular audiologic examinations are necessary in all children with cCMV infection even after CMV DNAemia clearance.
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Affiliation(s)
- Ta-Hsuan Lo
- Department of Otolaryngology, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC.,Department of Otolaryngology, National Taiwan University Biomedical Park Hospital, Hsinchu, Taiwan
| | - Pei-Hsuan Lin
- Department of Otolaryngology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Wei-Chung Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC
| | - Po-Nien Tsao
- Department of Pediatrics, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC
| | - Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Taichung Tzu-Chi Hospital, Taichung, Taiwan
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC.
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Address: 7, Chung-Shan S. Rd., 10002, Taipei, Taiwan, ROC. .,Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan. .,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. .,Department of Medical Research, National Taiwan University Biomedical Park Hospital, Hsinchu, Taiwan.
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Otsuka KS, Nielson C, Firpo MA, Park AH, Beaudin AE. Early Life Inflammation and the Developing Hematopoietic and Immune Systems: The Cochlea as a Sensitive Indicator of Disruption. Cells 2021; 10:cells10123596. [PMID: 34944105 PMCID: PMC8700005 DOI: 10.3390/cells10123596] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/02/2021] [Accepted: 12/13/2021] [Indexed: 12/22/2022] Open
Abstract
Emerging evidence indicates that perinatal infection and inflammation can influence the developing immune system and may ultimately affect long-term health and disease outcomes in offspring by perturbing tissue and immune homeostasis. We posit that perinatal inflammation influences immune outcomes in offspring by perturbing (1) the development and function of fetal-derived immune cells that regulate tissue development and homeostasis, and (2) the establishment and function of developing hematopoietic stem cells (HSCs) that continually generate immune cells across the lifespan. To disentangle the complexities of these interlinked systems, we propose the cochlea as an ideal model tissue to investigate how perinatal infection affects immune, tissue, and stem cell development. The cochlea contains complex tissue architecture and a rich immune milieu that is established during early life. A wide range of congenital infections cause cochlea dysfunction and sensorineural hearing loss (SNHL), likely attributable to early life inflammation. Furthermore, we show that both immune cells and bone marrow hematopoietic progenitors can be simultaneously analyzed within neonatal cochlear samples. Future work investigating the pathogenesis of SNHL in the context of congenital infection will therefore provide critical information on how perinatal inflammation drives disease susceptibility in offspring.
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Affiliation(s)
- Kelly S. Otsuka
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84112, USA;
| | - Christopher Nielson
- Division of Otolaryngology—Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (C.N.); (A.H.P.)
| | - Matthew A. Firpo
- Department of Surgery, University of Utah, Salt Lake City, UT 84112, USA;
| | - Albert H. Park
- Division of Otolaryngology—Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; (C.N.); (A.H.P.)
| | - Anna E. Beaudin
- Division of Hematology and Hematologic Malignancies, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
- Correspondence:
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Dror AA, Kassis-Karayanni N, Oved A, Daoud A, Eisenbach N, Mizrachi M, Rayan D, Francis S, Layous E, Gutkovich YE, Taiber S, Srouji S, Chordekar S, Goldenstein S, Ziv Y, Ronen O, Gruber M, Avraham KB, Sela E. Auditory Performance in Recovered SARS-COV-2 Patients. Otol Neurotol 2021; 42:666-670. [PMID: 33967243 PMCID: PMC8115428 DOI: 10.1097/mao.0000000000003037] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE While COVID-19 symptoms impact rhinology (anosmia) and laryngology (airways), two major disciplines of the otolaryngology armamentarium, the virus has seemed to spare the auditory system. A recent study, however, reported changes in otoacoustic emission (OAE) signals measured in SARS-COV-2 positive patients. We sought to assess the effect of COVID-19 infection on auditory performance in a cohort of recovered SARS-COV-2 patients and controls. To avoid a potential bias of previous audiological dysfunction not related to SARS-COV-2 infection, the study encompasses patients with normal auditory history. We hypothesized that if SARS-COV-2 infection predisposes to hearing loss, we would observe subtle and early audiometric deficits in our cohort in the form of subclinical auditory changes. STUDY DESIGN Cross-sectional study. SETTING Tertiary referral center. PATIENTS The Institutional Review Board approved the study and we recruited participants who had been positive for SARS-COV-2 infection, according to an Reverse Transcription Polymerase Chain Reaction (RT-PCR) test on two nasopharyngeal swabs. The patients included in this study were asymptomatic for the SARS-COV-2 infection and were evaluated following recovery, confirmed by repeated swab testing. The control group comprised healthy individuals matched for age and sex, and with a normal auditory and otologic history. INTERVENTIONS The eligibility to participate in this study included a normal audiogram, no previous auditory symptoms, normal otoscopy examination with an intact tympanic membrane, and bilateral tympanometry type A. None of our volunteers reported any new auditory symptoms following SARS-COV-2 infection. Ototacoustic emissions (OAE) and auditory brainstem response (ABR) measurements were used to evaluate the auditory function. MAIN OUTCOME MEASURES OAE and ABR measurements. RESULTS We have found no significant differences between recovered asymptomatic SARS-COV-2 patients and controls in any of transitory evoked otoacoustic emission (TEOAE), distortion product otoacoustic emissions (DPOAE), or ABR responses. CONCLUSIONS There is no cochlear dysfunction represented by ABR, TEOAE, and DPOAE responses in recovered COVID-19 asymptomatic patients. Retrocochlear function was also preserved as evident by the ABR responses. A long-term evaluation of a larger cohort of SARS-COV-2 patients will help to identify a possible contribution of SARS-COV-2 infection to recently published anecdotal auditory symptoms associated with COVID-19.
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Affiliation(s)
- Amiel A. Dror
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Najla Kassis-Karayanni
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Adi Oved
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Amani Daoud
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Netanel Eisenbach
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Matti Mizrachi
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Doaa Rayan
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Shawky Francis
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Eli Layous
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Yoni Evgeni Gutkovich
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute, Haifa
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Shahar Taiber
- Department of Human Molecular Genetics & Biochemistry
| | - Samer Srouji
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Oral and Maxillofacial Department
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Shai Chordekar
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
- Speech & Hearing Center, Hadassah University Medical Center, Jerusalem, Israel
| | - Sonia Goldenstein
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Yael Ziv
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Ohad Ronen
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Maayan Gruber
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | | | - Eyal Sela
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
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12
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Karimi-Boroujeni M, Zahedi-Amiri A, Coombs KM. Embryonic Origins of Virus-Induced Hearing Loss: Overview of Molecular Etiology. Viruses 2021; 13:71. [PMID: 33419104 PMCID: PMC7825458 DOI: 10.3390/v13010071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022] Open
Abstract
Hearing loss, one of the most prevalent chronic health conditions, affects around half a billion people worldwide, including 34 million children. The World Health Organization estimates that the prevalence of disabling hearing loss will increase to over 900 million people by 2050. Many cases of congenital hearing loss are triggered by viral infections during different stages of pregnancy. However, the molecular mechanisms by which viruses induce hearing loss are not sufficiently explored, especially cases that are of embryonic origins. The present review first describes the cellular and molecular characteristics of the auditory system development at early stages of embryogenesis. These developmental hallmarks, which initiate upon axial specification of the otic placode as the primary root of the inner ear morphogenesis, involve the stage-specific regulation of several molecules and pathways, such as retinoic acid signaling, Sonic hedgehog, and Wnt. Different RNA and DNA viruses contributing to congenital and acquired hearing loss are then discussed in terms of their potential effects on the expression of molecules that control the formation of the auditory and vestibular compartments following otic vesicle differentiation. Among these viruses, cytomegalovirus and herpes simplex virus appear to have the most effect upon initial molecular determinants of inner ear development. Moreover, of the molecules governing the inner ear development at initial stages, SOX2, FGFR3, and CDKN1B are more affected by viruses causing either congenital or acquired hearing loss. Abnormalities in the function or expression of these molecules influence processes like cochlear development and production of inner ear hair and supporting cells. Nevertheless, because most of such virus-host interactions were studied in unrelated tissues, further validations are needed to confirm whether these viruses can mediate the same effects in physiologically relevant models simulating otic vesicle specification and growth.
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Affiliation(s)
- Maryam Karimi-Boroujeni
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Ali Zahedi-Amiri
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
| | - Kevin M. Coombs
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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13
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Yee KT, Neupane B, Bai F, Vetter DE. Zika virus infection causes widespread damage to the inner ear. Hear Res 2020; 395:108000. [PMID: 32623238 DOI: 10.1016/j.heares.2020.108000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/07/2020] [Accepted: 05/20/2020] [Indexed: 12/20/2022]
Abstract
Zika virus (ZIKV) has been recently recognized as a causative agent of newborn microcephaly, as well as other neurological consequences. A less well recognized comorbidity of prenatal ZIKV infection is hearing loss, but cases of hearing impairment following adult ZIKV infection have also been recognized. Diminished hearing following prenatal ZIKV infection in a mouse model has been reported, but no cellular consequences were observed. We examined the effects of ZIKV infection on inner ear cellular integrity and expression levels of various proteins important for cochlear function in type I interferon receptor null (Ifnar1-/-) mice following infection at 5-6 weeks of age. We show that ZIKV antigens are present in cells within the cochlear epithelium, lateral wall, spiral limbus and spiral ganglion. Here we show that ZIKV infection alters cochlear expression of genes that signal cell damage (S100B), transport fluids (AQP1), are gaseous transmitters (eNOs) and modulate immune response (F4/80). Morphological analyses shows that not only are cochlear structures compromised by ZIKV infection, but damage also occurs in vestibular end organs. ZIKV produces a graded distribution of cellular damage in the cochlea, with greatest damage in the apex similar to that reported for cytomegalovirus (CMV) infection. The graded distribution of damage may indicate a differential susceptibility to ZIKV along the cochlear tonotopic axis. Collectively, these data are the first to show the molecular and morphological damage to the inner ear induced by ZIKV infection in adults and suggests multiple mechanisms contributing to the hearing loss reported in the human population.
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Affiliation(s)
- Kathleen T Yee
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, 39202, USA
| | - Biswas Neupane
- Department of Cell and Molecular Biology, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Fengwei Bai
- Department of Cell and Molecular Biology, University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Douglas E Vetter
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, 39202, USA.
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14
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Tsuprun V, Keskin N, Schleiss MR, Schachern P, Cureoglu S. Cytomegalovirus-induced pathology in human temporal bones with congenital and acquired infection. Am J Otolaryngol 2019; 40:102270. [PMID: 31402062 DOI: 10.1016/j.amjoto.2019.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Publications on histopathology of human temporal bones with cytomegalovirus (CMV) infection are limited. We aim to determine histopathology of the inner ears and the middle ears in human temporal bones with congenital and acquired CMV infections. METHODS Temporal bones from 2 infants with congenital and 2 adults with acquired CMV infection were evaluated by light microscopy. RESULTS Two infants with congenital CMV infection showed striking pathological changes in the inner ear. There was a hypervascularization of the stria vascularis in the cochlea of the first infant, but no obvious loss of outer and inner hair cells was seen in the organ of Corti. However, cytomegalic cells and a loss of outer hair cells were found in the cochlea of the second infant. The vestibular organs of both infants showed cytomegalic cells, mostly located on dark cells. There was a loss of type I and type II hair cells in the macula of the saccule and utricle. Loss of hair cells and degeneration of nerve fibers was also seen in the semicircular canals. Both infants with congenital infection showed abundant inflammatory cells and fibrous structures in the middle ear cavity. No evidence of cytomegalic cells and hair cell loss was found in the cochlea or vestibular labyrinth in acquired CMV infection. CONCLUSIONS In two infants with congenital CMV infection, the cochlea, vestibule, and middle ear were highly affected. Temporal bones of adult donors with acquired viral infection showed histological findings similar to donors of the same age without ear disease.
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15
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Sattler RA, Maruyama J, Shehu NY, Makishima T, Paessler S. Current small animal models for LASV hearing loss. Curr Opin Virol 2019; 37:118-122. [PMID: 31479989 DOI: 10.1016/j.coviro.2019.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 11/20/2022]
Abstract
Lassa virus (LASV) is endemic in West Africa, causing an estimated 100000-300000 new infections and up to 5000-10000 deaths yearly. There are no vaccines and therapeutics are extremely limited. Typical case fatality rates are ∼1%, although a recent 2018 Nigerian outbreak featured an unprecedented 25.4% case fatality rate. Survivors of infection suffer a lifetime of sequelae with sudden onset sensorineural hearing loss (SNHL) being the most prevalent. The cause of this hearing loss remains unknown, and there is a critical need for further research on its mechanisms and potential therapeutics. The objective of this review is to outline the only currently available small animal model for LASV-induced hearing loss and to identify potential surrogate models.
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Affiliation(s)
- Rachel A Sattler
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Nathan Y Shehu
- Department of Medicine, Infectious Disease Unit, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA.
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16
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Abbas L, Rivolta MN. The use of animal models to study cell transplantation in neuropathic hearing loss. Hear Res 2019; 377:72-87. [DOI: 10.1016/j.heares.2019.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 01/29/2023]
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18
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Jackson JW, Sparer T. There Is Always Another Way! Cytomegalovirus' Multifaceted Dissemination Schemes. Viruses 2018; 10:v10070383. [PMID: 30037007 PMCID: PMC6071125 DOI: 10.3390/v10070383] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a β-herpes virus that is a significant pathogen within immune compromised populations. HCMV morbidity is induced through viral dissemination and inflammation. Typically, viral dissemination is thought to follow Fenner's hypothesis where virus replicates at the site of infection, followed by replication in the draining lymph nodes, and eventually replicating within blood filtering organs. Although CMVs somewhat follow Fenner's hypothesis, they deviate from it by spreading primarily through innate immune cells as opposed to cell-free virus. Also, in vivo CMVs infect new cells via cell-to-cell spread and disseminate directly to secondary organs through novel mechanisms. We review the historic and recent literature pointing to CMV's direct dissemination to secondary organs and the genes that it has evolved for increasing its ability to disseminate. We also highlight aspects of CMV infection for studying viral dissemination when using in vivo animal models.
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Affiliation(s)
- Joseph W Jackson
- Department of Microbiology, University of Tennessee Knoxville, Knoxville, TN 37996, USA.
| | - Tim Sparer
- Department of Microbiology, University of Tennessee Knoxville, Knoxville, TN 37996, USA.
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19
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Korver AMH, Smith RJH, Van Camp G, Schleiss MR, Bitner-Glindzicz MAK, Lustig LR, Usami SI, Boudewyns AN. Congenital hearing loss. Nat Rev Dis Primers 2017; 3:16094. [PMID: 28079113 PMCID: PMC5675031 DOI: 10.1038/nrdp.2016.94] [Citation(s) in RCA: 287] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Congenital hearing loss (hearing loss that is present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing screening programmes enable early detection; early intervention will prevent delays in speech and language development and has long-lasting beneficial effects on social and emotional development and quality of life. A diagnosis of hearing loss is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus infection, are also a common risk factor for hearing loss. Genetic causes probably account for the majority of cases in developed countries; mutations can affect any component of the hearing pathway, in particular, inner ear homeostasis (endolymph production and maintenance) and mechano-electrical transduction (the conversion of a mechanical stimulus into electrochemical activity). Once the underlying cause of hearing loss is established, it might direct therapeutic decision making and guide prevention and (genetic) counselling. Management options include specific antimicrobial therapies, surgical treatment of craniofacial abnormalities and implantable or non-implantable hearing devices. An improved understanding of the pathophysiology and molecular mechanisms that underlie hearing loss and increased awareness of recent advances in genetic testing will promote the development of new treatment and screening strategies.
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Affiliation(s)
- Anna M H Korver
- Department of Pediatrics, St Antonius Hospital, PO BOX 2500, 3430 EM Nieuwegein, The Netherlands
| | - Richard J H Smith
- Molecular Otolaryngology and Renal Research Laboratories and the Genetics PhD Program, University of Iowa, Iowa City, Iowa, USA
| | - Guy Van Camp
- Department of Medical Genetics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Mark R Schleiss
- Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Maria A K Bitner-Glindzicz
- Genetics and Genomic Medicine Programme, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Lawrence R Lustig
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York, USA
| | - Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - An N Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
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20
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Heo J, Dogra P, Masi TJ, Pitt EA, de Kruijf P, Smit MJ, Sparer TE. Novel Human Cytomegalovirus Viral Chemokines, vCXCL-1s, Display Functional Selectivity for Neutrophil Signaling and Function. THE JOURNAL OF IMMUNOLOGY 2015; 195:227-36. [PMID: 25987741 DOI: 10.4049/jimmunol.1400291] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/27/2015] [Indexed: 12/16/2022]
Abstract
Human CMV (HCMV) uses members of the hematopoietic system including neutrophils for dissemination throughout the body. HCMV encodes a viral chemokine, vCXCL-1, that is postulated to attract neutrophils for dissemination within the host. The gene encoding vCXCL-1, UL146, is one of the most variable genes in the HCMV genome. Why HCMV has evolved this hypervariability and how this affects the virus' dissemination and pathogenesis is unknown. Because the vCXCL-1 hypervariability maps to important binding and activation domains, we hypothesized that vCXCL-1s differentially activate neutrophils, which could contribute to HCMV dissemination, pathogenesis, or both. To test whether these viral chemokines affect neutrophil function, we generated vCXCL-1 proteins from 11 different clades from clinical isolates from infants infected congenitally with HCMV. All vCXCL-1s were able to induce calcium flux at a concentration of 100 nM and integrin expression on human peripheral blood neutrophils, despite differences in affinity for the CXCR1 and CXCR2 receptors. In fact, their affinity for CXCR1 or CXCR2 did not correlate directly with chemotaxis, G protein-dependent and independent (β-arrestin-2) activation, or secondary chemokine (CCL22) expression. Our data suggest that vCXCL-1 polymorphisms affect the binding affinity, receptor usage, and differential peripheral blood neutrophil activation that could contribute to HCMV dissemination and pathogenesis.
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Affiliation(s)
- Jinho Heo
- Department of Microbiology, The University of Tennessee, Knoxville, TN 37996; and
| | - Pranay Dogra
- Department of Microbiology, The University of Tennessee, Knoxville, TN 37996; and
| | - Tom J Masi
- Department of Microbiology, The University of Tennessee, Knoxville, TN 37996; and
| | - Elisabeth A Pitt
- Department of Microbiology, The University of Tennessee, Knoxville, TN 37996; and
| | - Petra de Kruijf
- Division of Medicinal Chemistry, VU University Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Martine J Smit
- Division of Medicinal Chemistry, VU University Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Tim E Sparer
- Department of Microbiology, The University of Tennessee, Knoxville, TN 37996; and
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21
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Preservation of auditory brainstem response thresholds after cochleostomy and titanium microactuator implantation in the lateral wall of cat scala tympani. Otol Neurotol 2014; 35:730-8. [PMID: 24622027 DOI: 10.1097/mao.0000000000000281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The safety of implanting a titanium microactuator into the lateral wall of cat scala tympani was assessed by comparing preoperative and postoperative auditory brainstem response (ABR) thresholds for 1 to 3 months. BACKGROUND The safety of directly stimulating cochlear perilymph with an implantable hearing system requires maintaining preoperative hearing levels. This cat study is an essential step in the development of the next generation of fully implantable hearing devices for humans. METHODS Following GLP surgical standards, a 1-mm cochleostomy was drilled into the lateral wall of the scala tympani, and a nonfunctioning titanium anchor/microactuator assembly was inserted in 8 cats. The scala media was damaged in the 1 cat. ABR thresholds with click and 4- and 8-kHz stimuli were measured preoperatively and compared with postoperative thresholds at 1, 2, and 3 months. Nonimplanted ear thresholds were also measured to establish statistical significance for threshold shifts (>28.4 dB). Two audiologists independently interpreted thresholds. RESULTS Postoperatively, 7 cats implanted in the scala tympani demonstrated no significant ABR threshold shift for click stimulus; one shifted ABR thresholds to 4- and 8-kHz stimuli. The eighth cat, with surgical damage to the scala media, maintained stable click threshold but had a significant shift to 4- and 8-kHz stimuli. CONCLUSION This cat study provides no evidence of worsening hearing thresholds after fenestration of the scala tympani and insertion of a titanium anchor/microactuator, provided there is no surgical trauma to the scala media and the implanted device is securely anchored in the cochleostomy. These 2 issues have been resolved in the development of a fully implantable hearing system for humans. The long-term hearing stability (combined with histologic studies) reaffirm that the microactuator is well tolerated by the cat cochlea.
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22
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Weisblum Y, Panet A, Haimov-Kochman R, Wolf DG. Models of vertical cytomegalovirus (CMV) transmission and pathogenesis. Semin Immunopathol 2014; 36:615-25. [PMID: 25291972 DOI: 10.1007/s00281-014-0449-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 09/29/2014] [Indexed: 02/04/2023]
Abstract
Despite the considerable clinical impact of congenital human cytomegalovirus (HCMV) infection, the mechanisms of maternal-fetal transmission and the resultant placental and fetal damage are largely unknown. Here, we discuss animal models for the evaluation of CMV vaccines and virus-induced pathology and particularly explore surrogate human models for HCMV transmission and pathogenesis in the maternal-fetal interface. Studies in floating and anchoring placental villi and more recently, ex vivo modeling of HCMV infection in integral human decidual tissues, provide unique insights into patterns of viral tropism, spread, and injury, defining the outcome of congenital infection, and the effect of potential antiviral interventions.
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Affiliation(s)
- Yiska Weisblum
- Clinical Virology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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23
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Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear 2014; 18:18/0/2331216514541361. [PMID: 25080364 PMCID: PMC4222184 DOI: 10.1177/2331216514541361] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A number of viral infections can cause hearing loss. Hearing loss induced by these viruses can be congenital or acquired, unilateral or bilateral. Certain viral infections can directly damage inner ear structures, others can induce inflammatory responses which then cause this damage, and still others can increase susceptibility or bacterial or fungal infection, leading to hearing loss. Typically, virus-induced hearing loss is sensorineural, although conductive and mixed hearing losses can be seen following infection with certain viruses. Occasionally, recovery of hearing after these infections can occur spontaneously. Most importantly, some of these viral infections can be prevented or treated. For many of these viruses, guidelines for their treatment or prevention have recently been revised. In this review, we outline many of the viruses that cause hearing loss, their epidemiology, course, prevention, and treatment.
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Affiliation(s)
| | - Anne Durstenfeld
- Department of Surgery, Temple University School of Medicine, Philadelphia, PA, USA
| | - Pamela C Roehm
- Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, Philadelphia, PA, USA
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24
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Gabrielli L, Bonasoni MP, Santini D, Piccirilli G, Chiereghin A, Guerra B, Landini MP, Capretti MG, Lanari M, Lazzarotto T. Human fetal inner ear involvement in congenital cytomegalovirus infection. Acta Neuropathol Commun 2013; 1:63. [PMID: 24252374 PMCID: PMC3893406 DOI: 10.1186/2051-5960-1-63] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/23/2013] [Indexed: 01/12/2023] Open
Abstract
Background Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss (SNHL). The mechanisms of pathogenesis of CMV-related SNHL are still unclear. The aim is to study congenital CMV-related damage in the fetal inner ear, in order to better understand the underlying pathophysiology behind CMV-SNHL. Results We studied inner ears and brains of 20 human fetuses, all at 21 week gestational age, with a high viral load in the amniotic fluid, with and without ultrasound (US) brain abnormalities. We evaluated histological brain damage, inner ear infection, local inflammatory response and tissue viral load. Immunohistochemistry revealed that CMV was positive in 14/20 brains (70%) and in the inner ears of 9/20 fetuses (45%). In the cases with inner ear infection, the marginal cell layer of the stria vascularis was always infected, followed by infection in the Reissner’s membrane. The highest tissue viral load was observed in the inner ear with infected Organ of Corti. Vestibular labyrinth showed CMV infection of sensory cells in the utricle and in the crista ampullaris. US cerebral anomalies were detected in 6 cases, and in all those cases, the inner ear was always involved. In the other 14 cases with normal brain scan, histological brain damage was present in 8 fetuses and 3 of them presented inner ear infection. Conclusions CMV-infection of the marginal cell layer of the stria vascularis may alter potassium and ion circulation, dissipating the endocochlear potential with consequent SNHL. Although abnormal cerebral US is highly predictive of brain and inner ear damage, normal US findings cannot exclude them either.
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25
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An attenuated cytomegalovirus vaccine with a deletion of a viral chemokine gene is protective against congenital CMV transmission in a guinea pig model. Clin Dev Immunol 2013; 2013:906948. [PMID: 24000289 PMCID: PMC3755440 DOI: 10.1155/2013/906948] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/24/2013] [Accepted: 06/05/2013] [Indexed: 01/05/2023]
Abstract
Development of a vaccine against congenital cytomegalovirus (CMV) infection is a public health priority, but CMVs encode immune evasion genes that complicate live virus vaccine design. To resolve this problem, this study employed guanosyl phosphoribosyl transferase (gpt) mutagenesis to generate a recombinant guinea pig CMV (GPCMV) with a knockout of a viral chemokine gene, GPCMV MIP (gp1). MIP deletion virus replicated with wild-type kinetics in cell culture but was attenuated in nonpregnant guinea pigs, demonstrating reduced viremia and reduced inflammation and histopathology (compared to a control virus with an intact GPCMV MIP gene) following footpad inoculation. In spite of attenuation, the vaccine was immunogenic, eliciting antibody responses comparable to those observed in natural infection. To assess its protective potential as a vaccine, either recombinant virus or placebo was used to immunize seronegative female guinea pigs. Dams were challenged in the early 3rd trimester with salivary gland-adapted GPCMV. Immunization protected against DNAemia (1/15 in vaccine group versus 12/13 in the control group, P < 0.01). Mean birth weights were significantly higher in pups born to vaccinated dams compared to controls (98.7 g versus 71.2 g, P < 0.01). Vaccination reduced pup mortality, from 35/50 (70%) in controls to 8/52 (15%) in the immunization group. Congenital GPCMV infection was also reduced, from 35/50 (70%) in controls to 9/52 (17%) in the vaccine group (P < 0.0001). We conclude that deletion of an immune modulation gene can attenuate the pathogenicity of GPCMV while resulting in a viral vaccine that retains immunogenicity and demonstrates efficacy against congenital infection and disease.
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Kato K, Otake H, Tagaya M, Takahashi Y, Ito Y, Hama A, Muramatsu H, Kojima S, Naganawa S, Nakashima T. Progressive hearing loss following acquired cytomegalovirus infection in an immunocompromised child. Am J Otolaryngol 2013; 34:89-92. [PMID: 23084431 DOI: 10.1016/j.amjoto.2012.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 09/04/2012] [Indexed: 10/27/2022]
Abstract
We report a rare case of progressive hearing loss after acquired CMV infection in a child with Langerhans cell histiocytosis (LCH). A 5-month-old female was diagnosed as having LCH. When she was 14 months old, she received an unrelated donor umbilical cord blood transfusion for the treatment of intractable LCH. CMV infection was confirmed after the blood transfusion. Because her own umbilical cord had no CMV, the CMV infection was not congenital. When she was 7 years old, mixed hearing loss was noted with bilateral otitis media with effusion. After that time, the sensorineural hearing loss progressed to bilateral profound hearing loss over 3 years. Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging with gadolinium contrast enhancement revealed a high intensity area in the inner ear that suggested bilateral labyrinthitis. This case demonstrates the possibility that, under the immunodeficiency, the acquired CMV infection causes progressive sensorineural hearing loss.
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Hwang JH, Chen JC, Yang SY, Wang MF, Chan YC. Expression of tumor necrosis factor-α and interleukin-1β genes in the cochlea and inferior colliculus in salicylate-induced tinnitus. J Neuroinflammation 2011; 8:30. [PMID: 21477330 PMCID: PMC3087687 DOI: 10.1186/1742-2094-8-30] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 04/09/2011] [Indexed: 01/21/2023] Open
Abstract
Background Changes in the gene expressions for tumor necrosis factor-α (TNF-α) and/or interleukin-1β (IL-1β) during tinnitus have not been previously reported. We evaluated tinnitus and mRNA expression levels of TNF-α, IL-1β, and N-methyl D-aspartate receptor subunit 2B (NR2B) genes in cochlea and inferior colliculus (IC) of mice after intraperitoneal injections of salicylate. Methods Forty-eight 3-month-old male SAMP8 mice were randomly and equally divided into two groups: salicylate-treated and saline-treated. All mice were trained to perform an active avoidance task for 5 days. Once conditioned, an active avoidance task was performed 2 hours after daily intraperitoneal injections of saline, either alone or containing 300 mg/kg sodium salicylate. Total numbers of times (tinnitus score) the mice climbed during the inter-trial silent period for 10 trials were recorded daily for 4 days (days 7 to 10), and then mice were euthanized for determination of mRNA expression levels of TNF-α, IL-1β, and NR2B genes in cochlea and IC at day 10. Results Tinnitus scores increased in response to daily salicylate treatments. The mRNA expression levels of TNF-α increased significantly for the salicylate-treated group compared to the control group in both cochlea (1.89 ± 0.22 vs. 0.87 ± 0.07, P < 0.0001) and IC (2.12 ± 0.23 vs. 1.73 ± 0.22, p = 0.0040). mRNA expression levels for the IL-1β gene also increased significantly in the salicylate group compared to the control group in both cochlea (3.50 ± 1.05 vs. 2.80 ± 0.28, p < 0.0001) and IC (2.94 ± 0.51 versus 1.24 ± 0.52, p = 0.0013). Linear regression analysis revealed a significant positive association between tinnitus scores and expression levels of TNF-α, IL-1β, and NR2B genes in cochlea and IC. In addition, expression levels of the TNF-α gene were positively correlated with those of the NR2Bgene in both cochlea and IC; whereas, the expression levels of the IL-1β gene was positively correlated with that of the NR2B gene in IC, but not in cochlea. Conclusion We conclude that salicylate treatment resulting in tinnitus augments expression of the TNF-α and IL-1β genes in cochlea and IC of mice, and we suggest that these proinflammatory cytokines might lead to tinnitus directly or via modulating the NMDA receptor.
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Affiliation(s)
- Juen-Haur Hwang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Schleiss MR, McVoy MA. Guinea Pig Cytomegalovirus (GPCMV): A Model for the Study of the Prevention and Treatment of Maternal-Fetal Transmission. Future Virol 2010; 5:207-217. [PMID: 23308078 DOI: 10.2217/fvl.10.8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A major public health challenge today is the problem of congenital cytomegalovirus (CMV) transmission. Maternal-fetal CMV infections are common, occurring in 0.5-2% of pregnancies, and these infections often lead to long-term injury of the newborn infant. In spite of the well-recognized burden that these infections place on society, there are as yet no clearly established interventions available to prevent transmission of CMV. In order to study potential interventions, such as vaccines or antiviral therapies, an animal model of congenital CMV transmission is required. The best small animal model of CMV transmission is the guinea pig cytomegalovirus (GPCMV) model. This article summarizes the GPCMV model, putting it into the larger context of how studies in this system have relevance to human health. An emphasis is placed on how the vertical transmission of GPCMV recapitulates the pathogenesis of congenital CMV in infants, making this a uniquely well-suited model for the study of potential CMV vaccines.
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Affiliation(s)
- Mark R Schleiss
- Center for Infectious Diseases and Microbiology Translational Research, University of Minnesota Medical School, 2001 6 Street SE, Minneapolis, MN 55455,
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Induction of cytomegalovirus-infected labyrinthitis in newborn mice by lipopolysaccharide: a model for hearing loss in congenital CMV infection. J Transl Med 2008; 88:722-30. [PMID: 18475257 DOI: 10.1038/labinvest.2008.39] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Congenital cytomegalovirus (CMV) infection is the most common infectious cause of sensorineural hearing loss in children. Here, we established an experimental model of hearing loss after systemic infection with murine CMV (MCMV) in newborn mice. Although almost no viral infection was observed in the inner ears and brains by intraperitoneal (i.p.) infection with MCMV in newborn mice, infection in these regions was induced in combination with intracerebral (i.c.) injection of bacterial lipopolysaccharide (LPS). The susceptibility of the inner ears was higher than that of the brains in terms of viral titer per unit weight. In the labyrinths, the viral infection was associated with the mesenchymal vessels and accompanied by inflammatory cells induced by LPS, causing hematogenous targets of infection in the labyrinths. Viral infection also spread in the perilymph regions such as the scala tympani and scala vestibuli, probably from infected brains via meningogenic and cochlear nerve routes. Viral infection was not observed in the scala media in the endolymph, including the Corti organ. However, viral infection was observed in the spiral limbus, including the stria vascularis. These results suggest that hearing loss caused by labyrinthitis after congenital CMV infection may be enhanced by inflammation caused by systemic bacterial infection in the neonatal period.
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