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Ramos CL, Nascimento-Carvalho EC, Nascimento-Carvalho GC, VanDuijn MM, Vilas-Boas AL, Moreno-Carvalho OA, Carvalho LP, Zeneyedpour L, Ferwerda G, de Groot R, Luider TM, Nascimento-Carvalho CM. Cell adhesion proteins in the cerebrospinal fluid of neonates prenatally exposed to Zika virus: A case-control study. Eur J Neurosci 2022; 56:6258-6268. [PMID: 36300719 DOI: 10.1111/ejn.15851] [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: 01/19/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 12/29/2022]
Abstract
To compare cell adhesion molecules levels in cerebrospinal fluid (CSF) between Zika virus (ZIKV)-exposed neonates with/without microcephaly (cases) and controls, 16 neonates (cases), 8 (50%) with and 8 (50%) without microcephaly, who underwent lumbar puncture (LP) during the ZIKV epidemic (2015-2016) were included. All mothers reported ZIKV clinical symptoms during gestation, all neonates presented with congenital infection findings, and other congenital infections were ruled out. Fourteen control neonates underwent LP in the same laboratory (2017-2018). Five cell adhesion proteins were measured in the CSF using mass spectrometry. Neurexin-1 (3.50 [2.00-4.00] vs. 7.5 [5.00-10.25], P = 0.001), neurexin-3 (0.00 [0.00-0.00] vs. 3.00 [1.50-4.00], P = 0.001) and neural cell adhesion molecule 2 (NCAM2) (0.00 [0.00-0.75] vs. 1.00 [1.00-2.00], P = 0.001) were significantly lower in microcephalic and non-microcephalic cases than in controls. When these two sub-groups of prenatally ZIKA-exposed children were compared to controls separately, the same results were found. When cases with and without microcephaly were compared, no difference was found. Neurexin-3 (18.8% vs. 78.6%, P = 0.001) and NCAM2 (25.0% vs. 85.7%, P = 0.001) were less frequently found among the cases. A positive correlation was found between cephalic perimeter and levels of these two proteins. Neurexin-2 and neurexin-2b presented no significant differences. Levels of three cell adhesion proteins were significantly lower in CSF of neonates exposed to ZIKV before birth than in controls, irrespective of presence of congenital microcephaly. Moreover, the smaller the cephalic perimeter, the lower CSF cell adhesion protein levels. These findings suggest that low CSF levels of neurexin-1, neurexin-3 and NCAM2 may reflect the effects of ZIKV on foetal brain development.
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Affiliation(s)
- Clara L Ramos
- Bahiana Foundation for Science Development, Bahiana School of Medicine, Salvador, Brazil
| | | | | | | | - Ana-Luisa Vilas-Boas
- Bahiana Foundation for Science Development, Bahiana School of Medicine, Salvador, Brazil
| | | | - Lucas P Carvalho
- Laboratory of Clinical Research, LAPEC, Gonçalo Moniz Institute, Salvador, Brazil
| | | | - Gerben Ferwerda
- Section of Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud Centre for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ronald de Groot
- Section of Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud Centre for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Theo M Luider
- Department of Neurology, Erasmus MC, Rotterdam, Netherlands
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Nascimento-Carvalho GC, Nascimento-Carvalho EC, Ramos CL, Vilas-Boas AL, Moreno-Carvalho OA, Vinhaes CL, Barreto-Duarte B, Queiroz ATL, Andrade BB, Nascimento-Carvalho CM. Zika-exposed microcephalic neonates exhibit higher degree of inflammatory imbalance in cerebrospinal fluid. Sci Rep 2021; 11:8474. [PMID: 33875756 PMCID: PMC8055905 DOI: 10.1038/s41598-021-87895-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 04/05/2021] [Indexed: 11/09/2022] Open
Abstract
Not every neonate with congenital Zika virus (ZIKV) infection (CZI) is born with microcephaly. We compared inflammation mediators in CSF (cerebrospinal fluid obtained from lumbar puncture) between ZIKV-exposed neonates with/without microcephaly (cases) and controls. In Brazil, in the same laboratory, we identified 14 ZIKV-exposed neonates during the ZIKV epidemic (2015-2016), 7(50%) with and 7(50%) without microcephaly, without any other congenital infection, and 14 neonates (2017-2018) eligible to be controls and to match cases. 29 inflammation mediators were measured using Luminex immunoassay and multidimensional analyses were employed. Neonates with ZIKV-associated microcephaly presented substantially higher degree of inflammatory perturbation, associated with uncoupled inflammatory response and decreased correlations between concentrations of inflammatory biomarkers. The groups of microcephalic and non-microcephalic ZIKV-exposed neonates were distinguished from the control group (area under curve [AUC] = 1; P < 0.0001). Between controls and those non-microcephalic exposed to ZIKV, IL-1β, IL-3, IL-4, IL-7 and EOTAXIN were the top CSF markers. By comparing the microcephalic cases with controls, the top discriminant scores were for IL-1β, IL-3, EOTAXIN and IL-12p70. The degree of inflammatory imbalance may be associated with microcephaly in CZI and it may aid additional investigations in experimental pre-clinical models testing immune modulators in preventing extensive damage of the Central Nervous System.
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Affiliation(s)
| | | | - Clara L Ramos
- Bahiana Foundation for Science Development, Bahiana School of Medicine, Salvador, Bahia, 40290-000, Brazil
| | - Ana-Luisa Vilas-Boas
- Bahiana Foundation for Science Development, Bahiana School of Medicine, Salvador, Bahia, 40290-000, Brazil
| | | | - Caian L Vinhaes
- Bahiana Foundation for Science Development, Bahiana School of Medicine, Salvador, Bahia, 40290-000, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, 40296-710, Brazil
| | - Beatriz Barreto-Duarte
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, 40296-710, Brazil
- University Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, 41820-021, Brazil
| | - Artur T L Queiroz
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, 40296-710, Brazil
| | - Bruno B Andrade
- Bahiana Foundation for Science Development, Bahiana School of Medicine, Salvador, Bahia, 40290-000, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Bahia, 40296-710, Brazil
- University Salvador (UNIFACS), Laureate Universities, Salvador, Bahia, 41820-021, Brazil
- School of Medicine, Faculdade de Tecnologia e Ciências (Uni-FTC), Salvador, Bahia, 41741-590, Brazil
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7700, South Africa
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
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Peña F, Pimentel R, Khosla S, Mehta SD, Brito MO. Zika Virus Epidemic in Pregnant Women, Dominican Republic, 2016-2017. Emerg Infect Dis 2019; 25:247-255. [PMID: 30666928 PMCID: PMC6346438 DOI: 10.3201/eid2502.181054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
During the epidemic, almost 10% of pregnancies in acute infection resulted in fetal loss; 3 cases of fetal microcephaly were reported. Zika virus infection during pregnancy may result in birth defects and pregnancy complications. We describe the Zika virus outbreak in pregnant women in the Dominican Republic during 2016–2017. We conducted multinomial logistic regression to identify factors associated with fetal losses and preterm birth. The Ministry of Health identified 1,282 pregnant women with suspected Zika virus infection, a substantial proportion during their first trimester. Fetal loss was reported for ≈10% of the reported pregnancies, and 3 cases of fetal microcephaly were reported. Women infected during the first trimester were more likely to have early fetal loss (adjusted odds ratio 5.9, 95% CI 3.5–10.0). Experiencing fever during infection was associated with increased odds of premature birth (adjusted odds ratio 1.65, 95% CI 1.03–2.65). There was widespread morbidity during the epidemic. Our findings strengthen the evidence for a broad range of adverse pregnancy outcomes resulting from Zika virus infection.
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Ramos CL, Moreno-Carvalho OA, Nascimento-Carvalho CM. Cerebrospinal fluid aspects of neonates with or without microcephaly born to mothers with gestational Zika virus clinical symptoms. J Infect 2018; 76:563-569. [PMID: 29432825 DOI: 10.1016/j.jinf.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 01/26/2018] [Accepted: 02/03/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Clara L Ramos
- Bahiana School of Medicine, Bahiana Foundation for Science Development, Salvador, 40295-050, Brazil.
| | | | - Cristiana M Nascimento-Carvalho
- Post-graduation Program in Health Sciences and Department of Paediatrics, Federal University of Bahia School of Medicine, Salvador, 40025-010, Brazil; Post-graduation Program in Health Sciences and Department of Paediatrics, Federal University of Bahia School of Medicine, Salvador, 40025-010, BrazilBrazilian Council for Scientific and Technological Development, Brazilia, Brazil
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