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Dawson KLD, Rosato G, Egloff S, Burgener C, Oevermann A, Grest P, Hilbe M, Seuberlich T. Fatal tick-borne encephalitis virus infection in Dalmatian puppy-dogs after putative vector independent transmission. Vet Q 2024; 44:1-7. [PMID: 38596900 PMCID: PMC11008312 DOI: 10.1080/01652176.2024.2338385] [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: 09/20/2023] [Accepted: 03/29/2024] [Indexed: 04/11/2024] Open
Abstract
In a retrospective metatranscriptomics study, we identified tick-borne encephalitis virus (TBEV) to be the causative agent for a fatal non-suppurative meningoencephalitis in a three-week-old Dalmatian puppy in Switzerland. Further investigations showed that the two other littermates with similar signs and pathological lesions were also positive for TBEV. By using an unbiased approach of combining high-throughput sequencing (HTS) and bioinformatics we were able to solve the etiology and discover an unusual case of TBEV in three young puppies. Based on our findings, we suggest that a vector-independent transmission of TBEV occurred and that most likely an intrauterine infection led to the severe and fulminant disease of the entire litter. We were able to demonstrate the presence of TBEV RNA by in situ hybridization (ISH) in the brain of all three puppies. Furthermore, we were able to detect TBEV by RT-qPCR in total RNA extracted from formalin-fixed and paraffin embedded (FFPE) blocks containing multiple peripheral organs. Overall, our findings shed light on alternative vector-independent transmission routes of TBEV infections in dogs and encourage veterinary practitioners to consider TBEV as an important differential diagnosis in neurological cases in dogs.
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Affiliation(s)
- Kara L. D. Dawson
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Giuliana Rosato
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Simone Egloff
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Carole Burgener
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Anna Oevermann
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Paula Grest
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Monika Hilbe
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Torsten Seuberlich
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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2
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Duarte G, Braga AR, Kreitchmann R, Menezes MLB, Miranda AEB, Travassos AGA, Melli PPDS, Nomura RMY, da Silva AL, Wender MCO. Prevention, diagnosis, and treatment protocol of dengue during pregnancy and the postpartum period. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo73. [PMID: 38994458 PMCID: PMC11239217 DOI: 10.61622/rbgo/2024rbgo73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Affiliation(s)
- Geraldo Duarte
- Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo Ribeirão PretoSP Brazil Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonio Rodrigues Braga
- Faculdade de Medicina Universidade Federal do Rio de Janeiro Rio de JaneiroRJ Brazil Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Regis Kreitchmann
- Universidade Federal de Ciências da Saúde de Porto Alegre Porto AlegreRS Brazil Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maria Luiza Bezerra Menezes
- Faculdade de Ciências Médicas Universidade de Pernambuco RecifePE Brazil Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brazil
| | - Angélica Espinosa Barbosa Miranda
- Faculdade de Medicina Universidade Federal do Espírito Santo VitóriaES Brazil Faculdade de Medicina, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Ana Gabriela Alvares Travassos
- Faculdade de Medicina Universidade do Estado da Bahia SalvadorBA Brazil Faculdade de Medicina, Universidade do Estado da Bahia, Salvador, BA, Brazil
| | - Patrícia Pereira Dos Santos Melli
- Hospital das Clínicas Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo Ribeirão PretoSP Brazil Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Roseli Mieko Yamamoto Nomura
- Escola Paulista de Medicina Universidade Federal de São Paulo São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Faculdade de Medicina Universidade de São Paulo São PauloSP Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Agnaldo Lopes da Silva
- Universidade Federal de Minas Gerais Belo HorizonteMG Brazil Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria Celeste Osório Wender
- Universidade Federal do Rio Grande do Sul Porto AlegreRS Brazil Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Xie Y, Cao J, Gan S, Xu L, Zhang D, Qian S, Xu F, Ding Q, Schoggins JW, Fan W. TRIM32 inhibits Venezuelan Equine Encephalitis Virus Infection by targeting a late step in viral entry. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.04.597282. [PMID: 38895352 PMCID: PMC11185716 DOI: 10.1101/2024.06.04.597282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Alphaviruses are mosquito borne RNA viruses that are a reemerging public health threat. Alphaviruses have a broad host range, and can cause diverse disease outcomes like arthritis, and encephalitis. The host ubiquitin proteasome system (UPS) plays critical roles in regulating cellular processes to control the infections with various viruses, including alphaviruses. Previous studies suggest alphaviruses hijack UPS for virus infection, but the molecular mechanisms remain poorly characterized. In addition, whether certain E3 ubiquitin ligases or deubiquitinases act as alphavirus restriction factors remains poorly understood. Here, we employed a cDNA expression screen to identify E3 ubiquitin ligase TRIM32 as a novel intrinsic restriction factor against alphavirus infection, including VEEV-TC83, SINV, and ONNV. Ectopic expression of TRIM32 reduces alphavirus infection, whereas depletion of TRIM32 with CRISPR-Cas9 increases infection. We demonstrate that TRIM32 inhibits alphaviruses through a mechanism that is independent of the TRIM32-STING-IFN axis. Combining reverse genetics and biochemical assays, we found that TRIM32 interferes with genome translation after membrane fusion, prior to replication of the incoming viral genome. Furthermore, our data indicate that the monoubiquitination of TRIM32 is important for its antiviral activity. Notably, we also show two TRIM32 pathogenic mutants R394H and D487N, related to Limb-girdle muscular dystrophy (LGMD), have a loss of antiviral activity against VEEV-TC83. Collectively, these results reveal that TRIM32 acts as a novel intrinsic restriction factor suppressing alphavirus infection and provides insights into the interaction between alphaviruses and the host UPS.
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Affiliation(s)
- Yifan Xie
- Zhejiang Provincial Key Laboratory for Cancer Molecular Cell Biology, Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Jie Cao
- Zhejiang Provincial Key Laboratory for Cancer Molecular Cell Biology, Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Shuyi Gan
- Zhejiang Provincial Key Laboratory for Cancer Molecular Cell Biology, Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Lingdong Xu
- Laboratory Animal Center, Zhejiang University, Hangzhou, China
| | - Dongjie Zhang
- Zhejiang Provincial Key Laboratory for Cancer Molecular Cell Biology, Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Suhong Qian
- Zhejiang Provincial Key Laboratory for Cancer Molecular Cell Biology, Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Feng Xu
- Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Research Center for Life Science and Human Health, Binjiang Institute of Zhejiang University, Hangzhou, China
| | - Qiang Ding
- School of Medical Sciences, Tsinghua University, Beijing, China
| | - John W. Schoggins
- Department of Microbiology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Wenchun Fan
- Zhejiang Provincial Key Laboratory for Cancer Molecular Cell Biology, Life Sciences Institute, Zhejiang University, Hangzhou, China
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Hcini N, Lambert V, Picone O, Carod JF, Carles G, Pomar L, Epelboin L, Nacher M. Arboviruses and pregnancy: are the threats visible or hidden? Trop Dis Travel Med Vaccines 2024; 10:4. [PMID: 38355934 PMCID: PMC10868105 DOI: 10.1186/s40794-023-00213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/22/2023] [Indexed: 02/16/2024] Open
Abstract
Mosquito-borne arboviral diseases are a global concern and can have severe consequences on maternal, neonatal, and child health. Their impact on pregnancy tends to be neglected in developing countries. Despite hundreds of millions of infections, 90% pregnancies being exposed, scientific data on pregnant women is poor and sometimes non-existent. Recently and since the 2016 Zika virus outbreak, there has been a newfound interest in these diseases. Through various neuropathogenic, visceral, placental, and teratogenic mechanisms, these arbovirus infections can lead to fetal losses, obstetrical complications, and a wide range of congenital abnormalities, resulting in long-term neurological and sensory impairments. Climate change, growing urbanization, worldwide interconnectivity, and ease of mobility allow arboviruses to spread to other territories and impact populations that had never been in contact with these emerging agents before. Pregnant travelers are also at risk of infection with potential subsequent complications. Beyond that, these pathologies show the inequalities of access to care on a global scale in a context of demographic growth and increasing urbanization. It is essential to promote research, diagnostic tools, treatments, and vaccine development to address this emerging threat.Background The vulnerability of pregnant women and fetuses to emergent and re-emergent pathogens has been notably illustrated by the outbreaks of Zika virus. Our comprehension of the complete scope and consequences of these infections during pregnancy remains limited, particularly among those involved in perinatal healthcare, such as obstetricians and midwives. This review aims to provide the latest information and recommendations regarding the various risks, management, and prevention for pregnant women exposed to arboviral infections.
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Affiliation(s)
- Najeh Hcini
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.
- CIC Inserm 1424 and DFR Santé Université Guyane, Cayenne, French Guiana, France.
| | - Véronique Lambert
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Olivier Picone
- Department of Obstetrics and Gynecology, Hôpital Louis Mourier, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique : Hôpitaux de Paris, Université Paris Diderot, CEDEX, Colombes, France
| | - Jean-Francois Carod
- Department of Biology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Gabriel Carles
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Department "Woman-Mother-Child", Lausanne University Hospital, Lausanne, Switzerland
| | - Loïc Epelboin
- Department of Infectious and Tropical Diseases, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
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5
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Ogwuche J, Chang CA, Ige O, Sagay AS, Chaplin B, Kahansim ML, Paul M, Elujoba M, Imade G, Kweashi G, Dai YC, Hsieh SC, Wang WK, Hamel DJ, Kanki PJ. Arbovirus surveillance in pregnant women in north-central Nigeria, 2019-2022. J Clin Virol 2023; 169:105616. [PMID: 37944259 PMCID: PMC10841754 DOI: 10.1016/j.jcv.2023.105616] [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: 09/06/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The adverse impact of Zika (ZIKV), dengue (DENV), and chikungunya (CHIKV) virus infection in pregnancy has been recognized in Latin America and Asia but is not well studied in Africa. Although originally discovered in sub-Saharan Africa the non-specific clinical presentation of arbovirus infection may have hampered our detection of adverse clinical outcomes and outbreak. OBJECTIVE This prospective study of arbovirus infection in pregnant women in north-central Nigeria sought to characterize the prevalence of acute arbovirus infection and determine the impact on pregnancy and infant outcomes. METHODS In Nigeria, we screened 1006 pregnant women for ZIKV, DENV and CHIKV IgM/IgG by rapid test (2019-2022). Women with acute infection were recruited for prospective study and infants were examined for any abnormalities from delivery through six months. A subset of rapid test-reactive samples were confirmed using virus-specific ELISAs and neutralization assays. RESULTS The prevalence of acute infection (IgM+) was 3.8 %, 9.9 % and 11.8 % for ZIKV, DENV and CHIKV, respectively; co-infections represented 24.5 % of all infections. The prevalence in asymptomatic women was twice the level of symptomatic infection. We found a significant association between acute maternal ZIKV/DENV/CHIKV infection and any gross abnormal birth outcome (p = 0.014). CONCLUSIONS Over three rainy seasons, regular acute infection with ZIKV, DENV, and CHIKV was observed with significantly higher rates in pregnant women without symptoms. The potential association arbovirus infection with abnormal birth outcome warrants further prospective study to ascertain the clinical significance of these endemic arboviruses in Africa.
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Affiliation(s)
| | - Charlotte Ajeong Chang
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Olukemi Ige
- Jos University Teaching Hospital, University of Jos, Jos, Nigeria
| | - Atiene S Sagay
- Jos University Teaching Hospital, University of Jos, Jos, Nigeria
| | - Beth Chaplin
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Michael Paul
- Jos University Teaching Hospital, University of Jos, Jos, Nigeria
| | | | - Godwin Imade
- Jos University Teaching Hospital, University of Jos, Jos, Nigeria
| | | | - Yu-Ching Dai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Szu-Chia Hsieh
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Wei-Kung Wang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Donald J Hamel
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Phyllis J Kanki
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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6
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Comes JDG, Pijlman GP, Hick TAH. Rise of the RNA machines - self-amplification in mRNA vaccine design. Trends Biotechnol 2023; 41:1417-1429. [PMID: 37328401 PMCID: PMC10266560 DOI: 10.1016/j.tibtech.2023.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 06/18/2023]
Abstract
mRNA vaccines have won the race for early COVID-19 vaccine approval, yet improvements are necessary to retain this leading role in combating infectious diseases. A next generation of self-amplifying mRNAs, also known as replicons, form an ideal vaccine platform. Replicons induce potent humoral and cellular responses with few adverse effects upon a minimal, single-dose immunization. Delivery of replicons is achieved with virus-like replicon particles (VRPs), or in nonviral vehicles such as liposomes or lipid nanoparticles. Here, we discuss innovative advances, including multivalent, mucosal, and therapeutic replicon vaccines, and highlight novelties in replicon design. As soon as essential safety evaluations have been resolved, this promising vaccine concept can transform into a widely applied clinical platform technology taking center stage in pandemic preparedness.
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Affiliation(s)
- Jerome D G Comes
- Wageningen University and Research, Laboratory of Virology, Droevendaalsesteeg 1, 6708PB, Wageningen, The Netherlands
| | - Gorben P Pijlman
- Wageningen University and Research, Laboratory of Virology, Droevendaalsesteeg 1, 6708PB, Wageningen, The Netherlands.
| | - Tessy A H Hick
- Wageningen University and Research, Laboratory of Virology, Droevendaalsesteeg 1, 6708PB, Wageningen, The Netherlands
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7
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Hcini N, Lambert V, Picone O, Carod JF, Mathieu M, Cousin R, Akli F, Carles G, Basurko C, Pomar L, Epelboin L, Nacher M. Causes and consequences of fever in Amazonian pregnant women: A large retrospective study from French Guiana. PLoS Negl Trop Dis 2023; 17:e0011721. [PMID: 37874830 PMCID: PMC10624260 DOI: 10.1371/journal.pntd.0011721] [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: 07/24/2023] [Revised: 11/03/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVE The aim of this study was to describe different causes and consequences of fever during pregnancy in Western French Guiana and along the Maroni River. STUDY DESIGN A retrospective single-center study including all patients with a history of documented fever ≥ 38°C during pregnancy at the West French Guiana Hospital for 9 years. Postpartum fever and nosocomial infections were excluded. We focused on medical history and on clinical and biological findings. Causes were characterized as confirmed or uncertain and then classified as preventable or non-preventable. RESULTS A total of 940 pregnant women who experienced at least one episode of fever were included and compared to 23,811 deliveries who occurred during the same period without documented fever. Among them, 43.7% (411/940) were in labor. About 3.7% (35/940) of febrile pregnant women had at least two episodes of fever, while 0.3% (3/940) had a coinfection at the time of diagnosis, resulting in a total of 978 febrile episodes. Among them, causes remained unknown or uncertain in 7.6% (75/978) and 0.9% (9/978) of cases, respectively. Among confirmed causes of fever throughout pregnancy (n = 483), the most common known cause was arbovirus infection (146/483, 30.2%), followed by urinary tract infection (134/483, 27.7%), chickenpox (27/483, 5.6%), and gastrointestinal (14/483, 2.9%) and pulmonary infections (10/483, 2%). Mothers with fever had a higher risk of cesarean section (19.8% vs 15.5%, aOR 1.3 [95% CI 1.14-1.6], stillbirth (5.5% versus 1.9%, aOR 2.7 [95% CI 2-3.7]), and preterm delivery < 34 weeks of gestation (7.2% vs 4.7%, aOR 1.5 [95% CI 1.2-2]. CONCLUSIONS In the Amazon region, causes of fever are diverse and often associated with epidemic waves, notably arboviruses. This must be considered when exploring possible causes of fever during pregnancy in these localities, including fetal anomalies and/or fetal loss. Physicians should consider the epidemiological context and avoid generalizations. Given the impact of emergent agents such as arboviruses on pregnancy, particular attention must be paid to the epidemiological context. This study can also help clinicians when managing fever in pregnant travelers or in their partner after having visited exposed areas. In this context, fetal abnormalities and adverse obstetric outcomes should be explored accordingly.
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Affiliation(s)
- Najeh Hcini
- Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
- INSERM CIC1424 Centre d’Investigation Clinique Antilles Guyane, Cayenne, French Guiana
| | - Véronique Lambert
- Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Olivier Picone
- Service Gynécologie Obstétrique, Hôpital Louis Mourier, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance Publique: Hôpitaux de Paris, Université Paris Diderot, Colombes CEDEX, France
| | - Jean-Francois Carod
- Department of Biology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Mérédith Mathieu
- Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Romane Cousin
- Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Ferroudja Akli
- Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Gabriel Carles
- Department of Obstetrics and Gynaecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Célia Basurko
- Centre d’Investigation Clinique Antilles-Guyane, Epidémiologie Clinique, CIC INSERM 1424, DRISP, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Léo Pomar
- Ultrasound and Fetal Medicine, Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Loïc Epelboin
- INSERM CIC1424 Centre d’Investigation Clinique Antilles Guyane, Cayenne, French Guiana
- Department of Infectious and Tropical Diseases Cayenne General Hospital French Guiana France
| | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles-Guyane, Epidémiologie Clinique, CIC INSERM 1424, DRISP, Centre hospitalier de Cayenne, Cayenne, French Guiana
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8
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Santos JD, Garcia BCC, Rocha KLS, Silva TJ, da Silva Lage SL, de Souza Macedo M, Teixeira RA, Rocha-Vieira E, de Oliveira DB. Seroprevalence of Dengue, Chikungunya, and Zika viruses antibodies in a cohort of asymptomatic pregnant women in a low-income region of Minas Gerais, Brazil, 2018-2019. Braz J Microbiol 2023; 54:1853-1858. [PMID: 37454038 PMCID: PMC10484836 DOI: 10.1007/s42770-023-01054-7] [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: 02/15/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Dengue, Chikungunya, and Zika viruses are arthropod-borne viruses (arboviruses) that infect millions of individuals in tropical and subtropical regions. In the Americas, arboviruses represent a major public health problem, especially among vulnerable groups such as the elderly, children, and pregnant women. In this study, the seroprevalence of IgM or IgG against these arboviruses in pregnant, young women in the city of Diamantina, Minas Gerais, Brazil, and the influence of sociodemographic factors on the incidence/prevalence of infection in this group were investigated. A cross-sectional investigation was conducted on a total of 135 pregnant women for Dengue and Chikungunya IgM and 88 pregnant women for Zika IgG. Dengue IgM was found on the serum of twenty participants (14.8%) and only one woman (0.7%) tested positive for Chikungunya IgM. Zika IgG was found in three (3.4%) participants and 2 women who tested positive for Zika virus were also positive for Dengue virus IgM. Although the arboviruses seroprevalence was higher frequency among young (20-25 years old), brown and high school women, with a monthly income of 1-3 minimum wages, no association between these sociodemographic factors and arboviruses seroprevalence was found.
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Affiliation(s)
- Juliane Duarte Santos
- Programa Multicêntrico de Pós-Graduação Em Ciências Fisiológicas, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil
| | - Bruna Caroline Chaves Garcia
- Programa Multicêntrico de Pós-Graduação Em Ciências Fisiológicas, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil
| | - Kamila Lorene Soares Rocha
- Programa de Pós-Graduação Em Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thyago José Silva
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil
| | - Sanny Lara da Silva Lage
- Programa Multicêntrico de Pós-Graduação Em Ciências Fisiológicas, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil
| | - Mariana de Souza Macedo
- Departamento de Nutrição, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil
| | - Romero Alves Teixeira
- Departamento de Nutrição, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil
| | - Etel Rocha-Vieira
- Programa Multicêntrico de Pós-Graduação Em Ciências Fisiológicas, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil.
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil.
| | - Danilo Bretas de Oliveira
- Programa Multicêntrico de Pós-Graduação Em Ciências Fisiológicas, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil.
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil.
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9
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Zhang Y, Sheng Z, Chen Q, Zhou A, Cao J, Xue F, Ye Y, Wu N, Gao N, Fan D, Liu L, Li Y, Wang P, Liang L, Zhou D, Zhang F, Li F, An J. Neutrophil infiltration leads to fetal growth restriction by impairing the placental vasculature in DENV-infected pregnant mice. EBioMedicine 2023; 95:104739. [PMID: 37544202 PMCID: PMC10432184 DOI: 10.1016/j.ebiom.2023.104739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/22/2023] [Accepted: 07/18/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Dengue virus (DENV) infection during pregnancy increases the risk of adverse fetal outcomes, which has become a new clinical challenge. However, the underlying mechanism remains unknown. METHODS The effect of DENV-2 infection on fetuses was investigated using pregnant interferon α/β receptor-deficient (Ifnar1-/-) mice. The histopathological changes in the placentas were analyzed by morphological techniques. A mouse inflammation array was used to detect the cytokine and chemokine profiles in the serum and placenta. The infiltration characteristics of inflammatory cells in the placentas were evaluated by single-cell RNA sequencing. FINDINGS Fetal growth restriction observed in DENV-2 infection was mainly caused by the destruction of the placental vasculature rather than direct damage from the virus in our mouse model. After infection, neutrophil infiltration into the placenta disrupts the expression profile of matrix metalloproteinases, which leads to placental dysvascularization and insufficiency. Notably, similar histopathological changes were observed in the placentas from DENV-infected puerperae. INTERPRETATION Neutrophils play key roles in placental histopathological damage during DENV infection, which indicates that interfering with aberrant neutrophil infiltration into the placenta may be an important therapeutic target for adverse pregnancy outcomes in DENV infection. FUNDING The National Key Research and Development Plans of China (2021YFC2300200-02 to J.A., 2019YFC0121905 to Q.Z.C.), the National Natural Science Foundation of China (NSFC) (U1902210 and 81972979 to J. A., 81902048 to Z. Y. S., and 82172266 to P.G.W.), and the Support Project of High-level Teachers in Beijing Municipal Universities in the Period of 13th Five-year Plan, China (IDHT20190510 to J. A.).
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Affiliation(s)
- Yingying Zhang
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China; Department of Blood Transfusion, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ziyang Sheng
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China.
| | - Qiaozhu Chen
- Department of Ob&Gyn, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Anni Zhou
- Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiaying Cao
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Feiyang Xue
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Yanzhen Ye
- Department of Obstetrics and Gynecology, People's Hospital of Nanhai District, Foshan City, 528200, Guangdong, China
| | - Na Wu
- Laboratory Animal Center, Capital Medical University, Beijing, 100069, China
| | - Na Gao
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Dongying Fan
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Libo Liu
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Yuetong Li
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Peigang Wang
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Li Liang
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Deshan Zhou
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Fuchun Zhang
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fang Li
- Department of Ob&Gyn, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China; Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
| | - Jing An
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China.
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10
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Hills SL, Wong JM, Staples JE. Arboviral vaccines for use in pregnant travelers. Travel Med Infect Dis 2023; 55:102624. [PMID: 37517630 DOI: 10.1016/j.tmaid.2023.102624] [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: 05/12/2023] [Revised: 06/20/2023] [Accepted: 07/26/2023] [Indexed: 08/01/2023]
Abstract
Pregnant women traveling abroad can be exposed to a variety of arboviruses, primarily spread by mosquitoes or ticks. Some arboviral infections can be of particular concern for pregnant women or their fetuses. Vaccination is one preventive measure that can reduce the risk for infection. Several arboviral vaccines have been licensed for many years and can be used to prevent infection in travelers, namely Japanese encephalitis, yellow fever, and tick-borne encephalitis vaccines. Recommendations on use of these vaccines in pregnancy vary. Other arboviral vaccines have been licensed but are not indicated for use in pregnant travelers (e.g., dengue vaccines) or are in development (e.g., chikungunya, Zika vaccines). This review describes arboviral vaccines for travelers, focusing on women who are pregnant and those planning travel during pregnancy.
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Affiliation(s)
- S L Hills
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
| | - J M Wong
- Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA
| | - J E Staples
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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11
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Recaioglu H, Kolk SM. Developing brain under renewed attack: viral infection during pregnancy. Front Neurosci 2023; 17:1119943. [PMID: 37700750 PMCID: PMC10493316 DOI: 10.3389/fnins.2023.1119943] [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: 12/09/2022] [Accepted: 04/26/2023] [Indexed: 09/14/2023] Open
Abstract
Living in a globalized world, viral infections such as CHIKV, SARS-COV-2, and ZIKV have become inevitable to also infect the most vulnerable groups in our society. That poses a danger to these populations including pregnant women since the developing brain is sensitive to maternal stressors including viral infections. Upon maternal infection, the viruses can gain access to the fetus via the maternofetal barrier and even to the fetal brain during which factors such as viral receptor expression, time of infection, and the balance between antiviral immune responses and pro-viral mechanisms contribute to mother-to-fetus transmission and fetal infection. Both the direct pro-viral mechanisms and the resulting dysregulated immune response can cause multi-level impairment in the maternofetal and brain barriers and the developing brain itself leading to dysfunction or even loss of several cell populations. Thus, maternal viral infections can disturb brain development and even predispose to neurodevelopmental disorders. In this review, we discuss the potential contribution of maternal viral infections of three relevant relative recent players in the field: Zika, Chikungunya, and Severe Acute Respiratory Syndrome Coronavirus-2, to the impairment of brain development throughout the entire route.
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Affiliation(s)
| | - Sharon M. Kolk
- Faculty of Science, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
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12
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Sagay AS, Hsieh SC, Dai YC, Chang CA, Ogwuche J, Ige OO, Kahansim ML, Chaplin B, Imade G, Elujoba M, Paul M, Hamel DJ, Furuya H, Khoury R, Boaventura VS, de Moraes L, Kanki PJ, Wang WK. Chikungunya virus antepartum transmission and abnormal infant outcomes in Nigeria. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.05.23293675. [PMID: 37609297 PMCID: PMC10441498 DOI: 10.1101/2023.08.05.23293675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Chikungunya virus (CHIKV) has become a global public health concern since the reemergence of the Indian Ocean lineage and expansion of the Asian genotype. CHIKV infection causes acute febrile illness, rash, and arthralgia and during pregnancy may affect both mothers and infants. The mother-to-child transmission (MTCT) of CHIKV in Africa remains understudied. We screened 1006 pregnant women at two clinics in Nigeria between 2019 and 2022 and investigated the prevalence and MTCT of CHIKV. Of the 1006, 119 tested positive for CHIKV IgM, of which 36 underwent detailed laboratory tests. While none of the IgM reactive samples were RT-PCR positive, 14 symptomatic pregnant women were confirmed by CHIKV neutralization test. Twelve babies were followed with 8 normal and 4 abnormal outcomes, including stillbirth, cleft lip/palate with microcephaly, preterm delivery, polydactyly with sepsis and jaundice. CHIKV IgM testing identified 3 antepartum transmissions, further studies will determine its impact in antepartum infection.
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13
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Ogwuche J, Chang CA, Ige O, Sagay AS, Chaplin B, Kahansim ML, Paul M, Elujoba M, Imade G, Kweashi G, Dai YC, Hsieh SC, Wang WK, Hamel DJ, Kanki PJ. Arbovirus surveillance in pregnant women in north-central Nigeria, 2019-2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.04.23293671. [PMID: 37609234 PMCID: PMC10441490 DOI: 10.1101/2023.08.04.23293671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The adverse impact of Zika (ZIKV), dengue (DENV), and chikungunya (CHIKV) virus infection in pregnancy has been recognized in Latin America and Asia but is not well studied in Africa. In Nigeria, we screened 1006 pregnant women for ZIKV, DENV and CHIKV IgM/IgG by rapid test (2019-2022). Women with acute infection were recruited for prospective study and infants were examined for any abnormalities from delivery through six months. A subset of rapid test-reactive samples were confirmed using virus-specific ELISAs and neutralization assays. Prevalence of acute infection (IgM+) was 3.8%, 9.9% and 11.8% for ZIKV, DENV and CHIKV, respectively; co-infections represented 24.5% of all infections. Prevalence in asymptomatic women was twice the level of symptomatic infection. We found a significant association between acute maternal ZIKV/DENV/CHIKV infection and any gross abnormal birth outcome (p=0.014). Further prospective studies will contribute to our understanding of the clinical significance of these endemic arboviruses in Africa.
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14
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Beltrami S, Rizzo S, Schiuma G, Speltri G, Di Luca D, Rizzo R, Bortolotti D. Gestational Viral Infections: Role of Host Immune System. Microorganisms 2023; 11:1637. [PMID: 37512810 PMCID: PMC10383666 DOI: 10.3390/microorganisms11071637] [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: 05/11/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Viral infections in pregnancy are major causes of maternal and fetal morbidity and mortality. Infections can develop in the neonate transplacentally, perinatally, or postnatally (from breast milk or other sources) and lead to different clinical manifestations, depending on the viral agent and the gestational age at exposure. Viewing the peculiar tolerogenic status which characterizes pregnancy, viruses could exploit this peculiar immunological status to spread or affect the maternal immune system, adopting several evasion strategies. In fact, both DNA and RNA virus might have a deep impact on both innate and acquired immune systems. For this reason, investigating the interaction with these pathogens and the host's immune system during pregnancy is crucial not only for the development of most effective therapies and diagnosis but mostly for prevention. In this review, we will analyze some of the most important DNA and RNA viruses related to gestational infections.
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Affiliation(s)
- Silvia Beltrami
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Sabrina Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Giovanna Schiuma
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Giorgia Speltri
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Dario Di Luca
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Roberta Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Daria Bortolotti
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
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15
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Farias-Jofre M, Romero R, Xu Y, Levenson D, Tao L, Kanninen T, Galaz J, Arenas-Hernandez M, Liu Z, Miller D, Bhatti G, Seyerle M, Tarca AL, Gomez-Lopez N. Differential immunophenotype of circulating monocytes from pregnant women in response to viral ligands. BMC Pregnancy Childbirth 2023; 23:323. [PMID: 37149573 PMCID: PMC10163583 DOI: 10.1186/s12884-023-05562-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/30/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Viral infections during pregnancy can have deleterious effects on mothers and their offspring. Monocytes participate in the maternal host defense against invading viruses; however, whether pregnancy alters monocyte responses is still under investigation. Herein, we undertook a comprehensive in vitro study of peripheral monocytes to characterize the differences in phenotype and interferon release driven by viral ligands between pregnant and non-pregnant women. METHODS Peripheral blood was collected from third-trimester pregnant (n = 20) or non-pregnant (n = 20, controls) women. Peripheral blood mononuclear cells were isolated and exposed to R848 (TLR7/TLR8 agonist), Gardiquimod (TLR7 agonist), Poly(I:C) (HMW) VacciGrade™ (TLR3 agonist), Poly(I:C) (HMW) LyoVec™ (RIG-I/MDA-5 agonist), or ODN2216 (TLR9 agonist) for 24 h. Cells and supernatants were collected for monocyte phenotyping and immunoassays to detect specific interferons, respectively. RESULTS The proportions of classical (CD14hiCD16-), intermediate (CD14hiCD16+), non-classical (CD14loCD16+), and CD14loCD16- monocytes were differentially affected between pregnant and non-pregnant women in response to TLR3 stimulation. The proportions of pregnancy-derived monocytes expressing adhesion molecules (Basigin and PSGL-1) or the chemokine receptors CCR5 and CCR2 were diminished in response to TLR7/TLR8 stimulation, while the proportions of CCR5- monocytes were increased. Such differences were found to be primarily driven by TLR8 signaling, rather than TLR7. Moreover, the proportions of monocytes expressing the chemokine receptor CXCR1 were increased during pregnancy in response to poly(I:C) stimulation through TLR3, but not RIG-I/MDA-5. By contrast, pregnancy-specific changes in the monocyte response to TLR9 stimulation were not observed. Notably, the soluble interferon response to viral stimulation by mononuclear cells was not diminished in pregnancy. CONCLUSIONS Our data provide insight into the differential responsiveness of pregnancy-derived monocytes to ssRNA and dsRNA, mainly driven by TLR8 and membrane-bound TLR3, which may help to explain the increased susceptibility of pregnant women to adverse outcomes resulting from viral infection as observed during recent and historic pandemics.
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Affiliation(s)
- Marcelo Farias-Jofre
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
- Division of Obstetrics and Gynecology, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024, Santiago, Chile
| | - Roberto Romero
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, 48824, USA
| | - Yi Xu
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Dustyn Levenson
- Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Li Tao
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Tomi Kanninen
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Jose Galaz
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
- Division of Obstetrics and Gynecology, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024, Santiago, Chile
| | - Marcia Arenas-Hernandez
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Zhenjie Liu
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Derek Miller
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Gaurav Bhatti
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
| | - Megan Seyerle
- Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Adi L Tarca
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA
- Department of Computer Science, Wayne State University College of Engineering, Detroit, MI, 48202, USA
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, 48201, USA
| | - Nardhy Gomez-Lopez
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Detroit, MI, 48201, USA.
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA.
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, 48201, USA.
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
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16
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Schulz J, Schilling E, Fabian C, Zenclussen AC, Stojanovska V, Claus C. Dissecting Rubella Placental Infection in an In Vitro Trophoblast Model. Int J Mol Sci 2023; 24:ijms24097894. [PMID: 37175600 PMCID: PMC10178045 DOI: 10.3390/ijms24097894] [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: 03/11/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/15/2023] Open
Abstract
Vertical transmission of rubella virus (RuV) occurs at a high rate during the first trimester of pregnancy. The modes of vertical transmission including the response of trophoblasts to RuV are not well understood. Here, RuV-trophoblast interaction was studied in the BeWo trophoblast cell line. Analysis included early and late time-point kinetics of virus infection rate and the antiviral innate immune response at mRNA and protein level. BeWo characteristics were addressed through metabolic activity by extracellular flux analysis and syncytiotrophoblast formation through incubation with forskolin. We found that RuV infection of BeWo led to profuse type III interferon (IFN) production. Transfecting trophoblast cells with dsRNA analog induced an increase in the production of type I IFN-β and type III IFNs; however, this did not occur in RuV-infected BeWo trophoblasts. IFN-β and to a lesser extent type III IFN-λ1 were inhibitory to RuV. While no significant metabolic alteration was detected, RuV infection reduced the cell number in the monolayer culture in comparison to the mock control and resulted in detached and floating cells. Syncytia formation restricted RuV infection. The use of BeWo as a relevant cell culture model for infection of trophoblasts highlights cytopathogenicity in the absence of a type I IFN response as a pathogenic alteration by RuV.
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Affiliation(s)
- Juliane Schulz
- Institute of Medical Microbiology and Virology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
- Institute of Biochemistry and Biotechnology, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Erik Schilling
- Rheumatology Unit, Department of Internal Medicine III, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Claire Fabian
- Department of Vaccines and Infection Models, Fraunhofer Institute for Cell Therapy and Immunology, 04103 Leipzig, Germany
- Medical Department II, University Cancer Center Leipzig (UCCL), University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Ana Claudia Zenclussen
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, 04318 Leipzig, Germany
- Perinatal Immunology Research Group, Saxonian Incubator for Clinical Translation, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Violeta Stojanovska
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research, 04318 Leipzig, Germany
| | - Claudia Claus
- Institute of Medical Microbiology and Virology, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
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17
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Velay A, Janssen-Langenstein R, Kremer S, Laugel E, Lutz M, Pierson AL, Wendling MJ, Schneider F, Fafi-Kremer S. Tick-Borne Encephalitis in Pregnant Woman and Long-Term Sequelae. Emerg Infect Dis 2023; 29:669-671. [PMID: 36823716 PMCID: PMC9973690 DOI: 10.3201/eid2903.221328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
We report a case of severe tick-borne encephalitis in a pregnant woman, leading to a prolonged stay in the intensive care unit. She showed minor clinical improvement >6 months after her presumed infection. The patient was not vaccinated, although an effective vaccine is available and not contraindicated during pregnancy.
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18
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Arthropod-Borne Flaviviruses in Pregnancy. Microorganisms 2023; 11:microorganisms11020433. [PMID: 36838398 PMCID: PMC9959669 DOI: 10.3390/microorganisms11020433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Flaviviruses are a diverse group of enveloped RNA viruses that cause significant clinical manifestations in the pregnancy and postpartum periods. This review highlights the epidemiology, pathophysiology, clinical features, diagnosis, and prevention of the key arthropod-borne flaviviruses of concern in pregnancy and the neonatal period-Zika, Dengue, Japanese encephalitis, West Nile, and Yellow fever viruses. Increased disease severity during pregnancy, risk of congenital malformations, and manifestations of postnatal infection vary widely amongst this virus family and may be quite marked. Laboratory confirmation of infection is complex, especially due to the reliance on serology for which flavivirus cross-reactivity challenges diagnostic specificity. As such, a thorough clinical history including relevant geographic exposures and prior vaccinations is paramount for accurate diagnosis. Novel vaccines are eagerly anticipated to ameliorate the impact of these flaviviruses, particularly neuroinvasive disease manifestations and congenital infection, with consideration of vaccine safety in pregnant women and children pivotal. Moving forward, the geographical spread of flaviviruses, as for other zoonoses, will be heavily influenced by climate change due to the potential expansion of vector and reservoir host habitats. Ongoing 'One Health' engagement across the human-animal-environment interface is critical to detect and responding to emergent flavivirus epidemics.
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19
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Watanabe S, Vasudevan SG. Clinical and experimental evidence for transplacental vertical transmission of flaviviruses. Antiviral Res 2023; 210:105512. [PMID: 36572192 DOI: 10.1016/j.antiviral.2022.105512] [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: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
The Zika virus (ZIKV) epidemic outbreak in Americas in 2016 attracted global attention because of the association of the virus infection with severe birth defects such as microcephaly, mediated through transplacental virus transmission during pregnancy. Less well-known, but also reported is the increasing evidence that prenatal vertical transmission can be caused by other flaviviruses such as dengue virus (DENV). Currently, the mechanism(s) that cause the vertical transmission of flaviviruses is understudied. Here we review the published reports of clinical evidence of intrauterine transmission of ZIKV and other flaviviruses. We also discuss the animal models for flavivirus infection during pregnancy that have been developed to study the mechanisms underlying the transplacental transmission of flaviviruses in order to develop potential countermeasures for its prevention.
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Affiliation(s)
- Satoru Watanabe
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road, 169857, Singapore.
| | - Subhash G Vasudevan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road, 169857, Singapore
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Webb E, Michelen M, Rigby I, Dagens A, Dahmash D, Cheng V, Joseph R, Lipworth S, Harriss E, Cai E, Nartowski R, Januraga PP, Gedela K, Sukmaningrum E, Cevik M, Groves H, Hart P, Fletcher T, Blumberg L, Horby PW, Jacob ST, Sigfrid L. An evaluation of global Chikungunya clinical management guidelines: A systematic review. EClinicalMedicine 2022; 54:101672. [PMID: 36193172 PMCID: PMC9526181 DOI: 10.1016/j.eclinm.2022.101672] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) has expanded its geographical reach in recent decades and is an emerging global health threat. CHIKV can cause significant morbidity and lead to chronic, debilitating arthritis/arthralgia in up to 40% of infected individuals. Prevention, early identification, and clinical management are key for improving outcomes. The aim of this review is to evaluate the quality, availability, inclusivity, and scope of evidence-based clinical management guidelines (CMG) for CHIKV globally. METHODS We conducted a systematic review. Six databases were searched from Jan 1, 1989, to 14 Oct 2021 and grey literature until Sept 16, 2021, for CHIKV guidelines providing supportive care and treatment recommendations. Quality was assessed using the appraisal of Guidelines for Research and Evaluation tool. Findings are presented in a narrative synthesis. PROSPERO registration: CRD42020167361. FINDINGS 28 CMGs were included; 54% (15/28) were produced more than 5 years ago, and most were of low-quality (median score 2 out of 7 (range 1-7)). There were variations in the CMGs' guidance on the management of different at-risk populations, long-term sequelae, and the prevention of disease transmission. While 54% (15/28) of CMGs recommended hospitalisation for severe cases, only 39% (11/28) provided guidance for severe disease management. Further, 46% (13/28) advocated for steroids in the chronic phase, but 18% (5/28) advised against its use. INTERPRETATION There was a lack of high-quality CMGs that provided supportive care and treatment guidance, which may impact patient care and outcomes. It is essential that existing guidelines are updated and adapted to provide detailed evidence-based treatment guidelines for different at-risk populations. This study also highlights a need for more research into the management of the acute and chronic phases of CHIKV infection to inform evidence-based care. FUNDING The UK Foreign, Commonwealth and Development Office, Wellcome Trust [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135].
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Affiliation(s)
- Eika Webb
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UK
| | - Melina Michelen
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Ishmeala Rigby
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Andrew Dagens
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Dania Dahmash
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Vincent Cheng
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Samuel Lipworth
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Erhui Cai
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Robert Nartowski
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | | | | | - Evi Sukmaningrum
- Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
- HIV AIDS Research Centre-HPSI, AJCU, Jakarta, Indonesia
| | - Muge Cevik
- Department of Global Health and Infection Research, School of Medicine, University of St Andrews, Fife, Scotland, UK
| | | | | | - Tom Fletcher
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UK
| | - Lucille Blumberg
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Peter W. Horby
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Shevin T. Jacob
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, UK
| | - Louise Sigfrid
- International Severe Acute Respiratory and emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Oxford, UK
- Corresponding author.
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21
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Giménez-Richarte Á, Ortiz de Salazar MI, Giménez-Richarte MP, Collado M, Fernández PL, Clavijo C, Navarro L, Arbona C, Marco P, Ramos-Rincon JM. Transfusion-transmitted arboviruses: Update and systematic review. PLoS Negl Trop Dis 2022; 16:e0010843. [PMID: 36201547 PMCID: PMC9578600 DOI: 10.1371/journal.pntd.0010843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/18/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background The detection of the first cases of transfusion-transmitted West Nile virus in 2002 posed a new challenge for transfusion safety. Institutions like the World Health Organization have stated that blood transfusion centers need to know the epidemiology of the different emerging infectious agents and their impact on blood transfusion. The aim of the study is to review the published cases of arbovirus transmission through transfusion of blood or blood components and to analyze their main clinical and epidemiological characteristics. Material and methods Systematic literature searches were conducted in MEDLINE, Embase and Scopus. Pairs of review authors selected a variety of scientific publications reporting cases of transfusion-transmitted arboviruses. Main clinical and epidemiological characteristics were reviewed of the cases described. The study protocol was registered in PROSPERO CRD42021270355. Results A total of 74 cases of transfusion-transmitted infections were identified from 10 arboviruses: West Nile virus (n = 42), dengue virus (n = 18), Zika virus (n = 3), yellow fever vaccine virus (n = 3), tick-borne encephalitis virus (n = 2), Japanese encephalitis virus (n = 2), Powassan virus (n = 1), St. Louis encephalitis virus (n = 1), Ross River virus (n = 1) and Colorado tick fever virus (n = 1). The blood component most commonly involved was red blood cells (N = 35, 47.3%; 95% confidence interval [CI] 35.9% to 58.7%). In 54.1% (N = 40; 95% CI: 42.7%-65.47%) of the cases, the recipient was immunosuppressed. Transmission resulted in death in 18.9% (N = 14; 95% CI: 10.0%-27.8%) of the recipients. In addition, 18 additional arboviruses were identified with a potential threat to transfusion safety. Discussion In the last 20 years, the number of published cases of transfusion-transmitted arboviruses increased notably, implicating new arboviruses. In addition, a significant number of arboviruses that may pose a threat to transfusion safety were detected. In the coming years, it is expected that transmission of arboviruses will continue to expand globally. It is therefore essential that all responsible agencies prepare for this potential threat to transfusion safety. The transfusion of blood and blood components entails some risks and potential complications, chief among them the transmission of infectious agents. Organizations like the American Association of Blood Banks have warned of the risks posed by emerging and re-emerging viruses for transfusion safety and have classified transmission of several arboviruses as a high or very high risk to the transfusion of blood and blood components. Following recommendations by the World Health Organization (WHO), this study aims to enable safe blood transfusion services, by making available the latest updated information of transfusion-transmitted arboviruses and comprehensive knowledge of the current epidemiology of reported cases. Research revealed case reports of transfusion transmission of 10 arboviruses, with West Nile virus and dengue virus as the most prevalent. Main clinical characteristics of reported cases were collected, including the type of blood component transfused and the state of immunosuppression of the recipient. Research also revealed 18 additional arboviruses with potential risk of transmission through other direct transmission routes. This systematic review provides an updated overview of the clinical characteristics of reported cases of transfusion-transmitted arboviruses. It is the most complete record published to date that assesses the risk posed by arboviruses to blood transfusion.
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Affiliation(s)
| | | | | | - Miriam Collado
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | | | - Carlos Clavijo
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Laura Navarro
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Cristina Arbona
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Pascual Marco
- Service of Hematology, General- University Hospital of Alicante-ISABIAL. Alicante, Spain
- Clinical Medicine Department, Miguel Hernandez University of Elche, Alicante, Spain
| | - Jose-Manuel Ramos-Rincon
- Clinical Medicine Department, Miguel Hernandez University of Elche, Alicante, Spain
- * E-mail: (AG-R); (J-MR-R)
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22
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Gizzi G, Mazzeschi C, Delvecchio E, Beccari T, Albi E. Possible Stress-Neuroendocrine System-Psychological Symptoms Relationship in Pregnant Women during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11497. [PMID: 36141770 PMCID: PMC9517650 DOI: 10.3390/ijerph191811497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic induced long-term damages that weigh on the national health systems of various countries in terms of support and care. This review aimed to highlight the mental health impact of the COVID-19 pandemic in pregnant women. We first report data on the immune system physiopathology and the main viral infections in pregnancy, including COVID-19. Then, the attention is focused on the main factors that affect the mental health of pregnant women during the COVID-19 pandemic, such as (1) the fear of being infected and transmitting the infection to the fetus, (2) the cancellation of checkups and pre-child courses, and (3) confinement and the inability to have close friends or a partner at the time of delivery or in the first days after delivery, as well as family tensions. Because of all this, pregnant women find themselves in a stressful condition independent of the pregnancy, and thus experience anxiety, depression, insomnia, hostility, delirium, and an alteration of the mother-baby relationship. Several studies have shown an involvement of the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-thyroid axis in response to the pandemic. We propose a possible involvement of the neuroendocrine system as a mediator of the psychological symptoms of pregnant women induced by COVID-19-related stress.
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Affiliation(s)
- Giulia Gizzi
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06123 Perugia, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06123 Perugia, Italy
| | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06123 Perugia, Italy
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy
| | - Elisabetta Albi
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy
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23
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Bjonholm E, Soderholm S, Stephansson O, Askling H. Tick-borne encephalitis in pregnant women – a mini narrative review. New Microbes New Infect 2022; 48:101017. [PMID: 36176540 PMCID: PMC9513166 DOI: 10.1016/j.nmni.2022.101017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/20/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022] Open
Abstract
Tick-borne encephalitis (TBE) incidence has been increasing in Europe the last decades, but very few cases in pregnant women have been described. We present two cases and describe the serology of both mother and infant at the time of diagnosis and delivery, as well as at months 3, 6, 9, and 12 of follow-up. In both cases, pregnancies and infants developed normally. The mothers had moderate-to severe symptoms of TBE and were positive for IgM and IgG at the time of diagnosis, and throughout the follow up period whilst both infants were PCR- and IgM-negative and positive for IgG during their first months in life. Declining IgG titres were seen in the infants during follow-up until they became negative at the age of nine months. TBE IgG was vertically transmitted in these two cases of infants born to TBE-infected mothers.
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Affiliation(s)
- E. Bjonholm
- Department of Infectious Diseases, Mälarsjukhuset, Eskilstuna, Sweden
| | | | - O. Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
| | - H.H. Askling
- Department of Medicine, Division of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden
- Corresponding author: Helena Hervius Askling, Institutionen för medicin Solna (MedS), Karolinska Universitetssjukhuset Solna NB6:02, 17176 Stockholm, Sweden.
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24
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Watanabe S, Chan KWK, Tan NWW, Mahid MBA, Chowdhury A, Chang KTE, Vasudevan SG. Experimental evidence for a high rate of maternal-fetal transmission of dengue virus in the presence of antibodies in immunocompromised mice. EBioMedicine 2022; 77:103930. [PMID: 35290828 PMCID: PMC8921544 DOI: 10.1016/j.ebiom.2022.103930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Congenital disorders associated with prenatal vertical transmission of Zika virus (ZIKV) is well established since the 2016 outbreak in the Americas. However, despite clinical reports of similar mode of transmission for other flaviviruses such as dengue virus (DENV), the phenomenon has not been experimentally explored. Methods Pregnant AG129 mice were infected with DENV1 in the presence or absence of enhancing antibodies at different gestational time points. ZIKV was used for comparison. We quantified viral load in fetus and placentas and performed comprehensive gene expression profiling in the maternal (decidua) and fetal portion of placenta separately. Findings We demonstrate in a laboratory experimental setting that DENV can be transmitted vertically in a gestation stage-dependent manner similar to ZIKV, and this incidence drastically increases in the presence of enhancing antibodies. Interestingly, a high rate of DENV fetal infection occurs even though the placental viral load is significantly lower than that found in ZIKV-infected dams. Comprehensive gene expression profiling revealed DENV infection modulates a variety of inflammation-associated genes comparable to ZIKV in decidua and fetal placenta in early pregnancy. Interpretation Our findings suggest that the virus-induced modulation of host gene expression may facilitate DENV to cross the placental barrier in spite of lower viral burden compared to ZIKV. This mouse model may serve to identify the host determinants required for the vertical transmission of flaviviruses and develop appropriate countermeasures. Funding National Medical Research Council/Open Fund Individual Research Grant MOH-000524 (SW), MOH-000086 and OFIRG20nov-0017 (SGV).
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Affiliation(s)
- Satoru Watanabe
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore.
| | - Kitti Wing Ki Chan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore
| | - Nicole Wei Wen Tan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore
| | | | - Avisha Chowdhury
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore
| | - Kenneth Tou En Chang
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore; Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road 229899, Singapore
| | - Subhash G Vasudevan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 8-College Road 169857, Singapore; Institute for Glycomics, Griffith University, Gold Coast Campus, Queensland 4222, Australia.
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25
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Klein RS. Encephalitic Arboviruses of Africa: Emergence, Clinical Presentation and Neuropathogenesis. Front Immunol 2022; 12:769942. [PMID: 35003087 PMCID: PMC8733932 DOI: 10.3389/fimmu.2021.769942] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Many mosquito-borne viruses (arboviruses) are endemic in Africa, contributing to systemic and neurological infections in various geographical locations on the continent. While most arboviral infections do not lead to neuroinvasive diseases of the central nervous system, neurologic diseases caused by arboviruses include flaccid paralysis, meningitis, encephalitis, myelitis, encephalomyelitis, neuritis, and post-infectious autoimmune or memory disorders. Here we review endemic members of the Flaviviridae and Togaviridae families that cause neurologic infections, their neuropathogenesis and host neuroimmunological responses in Africa. We also discuss the potential for neuroimmune responses to aide in the development of new diagnostics and therapeutics, and current knowledge gaps to be addressed by arbovirus research.
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Affiliation(s)
- Robyn S Klein
- Center for Neuroimmunology & Neuroinfectious Diseases, Departments of Medicine, Neuroscience, and Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States
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26
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Ahmed U, Aman A. Intraoperative Post Partum Hemorrhage in a Patient with Dengue Fever. Pak J Med Sci 2022; 38:326-328. [PMID: 35035449 PMCID: PMC8713201 DOI: 10.12669/pjms.38.1.4519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 11/15/2022] Open
Abstract
A 33 year old obstetric patient with mild fever of undiagnosed etiology underwent emergency caesarean section under general anesthesia. She had platelet count of 98,000 per microliter and increased APTT of 37.8 s at the time of surgery. After uneventful anesthetic induction and delivery of fetus, slow and oozing type of bleeding led to massive hemorrhage. Patient remained vitally stable throughout perioperative phase and was extubated. Next day, patient's dengue IgM antibody was reported positive. Neonate was well and his dengue test was negative. Pregnant women are at high risk of developing severe complications of dengue fever with unclear mechanisms related to impaired coagulation. Regional anesthesia may not have safe outcome due to dengue infection.
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Affiliation(s)
- Usama Ahmed
- Dr. Usama Ahmed, Fellow Pain Medicine, Department of Anaesthesiology, The Aga Khan University, Karachi, Pakistan
| | - Asiyah Aman
- Dr. Asiyah Aman, Assistant Professor, Department of Anaesthesiology, The Aga Khan University, Karachi, Pakistan
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27
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Ruiz-Burga E, Bruijning-Verhagen P, Palmer P, Sandcroft A, Fernandes G, de Hoog M, Bryan L, Pierre R, Bailey H, Giaquinto C, Thorne C, Christie CDC. The ZIKApp for detection of potential arbovirus infections and pregnancy complications in pregnant women in Jamaica: a pilot study (Preprint). JMIR Form Res 2021; 6:e34423. [PMID: 35896029 PMCID: PMC9377438 DOI: 10.2196/34423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elisa Ruiz-Burga
- Population, Policy & Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Patricia Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Paulette Palmer
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
| | - Annalisa Sandcroft
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
| | - Georgina Fernandes
- Population, Policy & Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Marieke de Hoog
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lenroy Bryan
- Department of Obstetrics and Gynaecology, University of the West Indies, Kingston, Jamaica
| | - Russell Pierre
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
| | - Heather Bailey
- Institute for Global Health, University College London, London, United Kingdom
| | - Carlo Giaquinto
- Dipartimento di Salute della Donna e del Bambino, Università degli Studi di Padova, Padova, Italy
| | - Claire Thorne
- Population, Policy & Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Celia D C Christie
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
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Maternal and perinatal outcomes during a Chikungunya outbreak in Kassala, eastern Sudan. Arch Gynecol Obstet 2021; 305:855-858. [PMID: 34448947 DOI: 10.1007/s00404-021-06204-6] [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: 02/05/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Arboviruses (dengue, Zika, and chikungunya) have recently emerged as an important public health issue and can lead to adverse obstetrics outcomes. The current study was conducted to assess maternal and perinatal outcomes following chikungunya fever/infection and to compare adverse pregnancy outcomes with data from the community collected in a previous study. METHODS This study was performed during a chikungunya infection epidemic in Kassala, Sudan by recruiting all pregnant women with a confirmed chikungunya fever diagnosis by using antibodies/detection viral RNA using reverse transcriptase-polymerase chain reaction. RESULTS Ninety-three pregnant women with confirmed chikungunya infection were enrolled. Their mean (standard deviation) age and parity were 31.6 (3.4) years and 3.5 (1.4), respectively. Of the 93 women, 58 (62.4%) delivered a live infant at term and 18 (19.4%), 13 (13.9%), and 4 (4.3%) women experienced miscarriage, preterm birth, and stillbirth, respectively. In the logistic regression model, severe thrombocytopenia (platelets < 50,000 cells/mm3 (odds ratio [OR] = 5.1; confidence interval [CI] 1.8-14; P = 0.001) and leukopenia (OR = 4.5; CI 2.2-8.8; P < 0.001) were predictors for poor obstetric outcomes in pregnant women with chikungunya fever. The rates of miscarriage (18/93 [19.3%] vs. 1/71 [1.4%], P < 0.001) and preterm birth (13/93 [13.9%] vs. 2/71 [2.8%], P = 0.003) were significantly higher in the current study compared with the rate in the community. CONCLUSION Chikungunya infections during pregnancy were associated with miscarriage and preterm birth. Women with severe thrombocytopenia and leukopenia were at higher risk of poor obstetric outcomes. Women with severe thrombocytopenia and leukopenia were at higher risk of poor obstetric outcomes.
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29
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Fontoura MA, Rocha RF, Marques RE. Neutrophil Recruitment and Participation in Severe Diseases Caused by Flavivirus Infection. Life (Basel) 2021; 11:717. [PMID: 34357089 PMCID: PMC8304117 DOI: 10.3390/life11070717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/21/2022] Open
Abstract
Neutrophils are first-line responders to infections and are recruited to target tissues through the action of chemoattractant molecules, such as chemokines. Neutrophils are crucial for the control of bacterial and fungal infections, but their role in the context of viral infections has been understudied. Flaviviruses are important human viral pathogens transmitted by arthropods. Infection with a flavivirus may result in a variety of complex disease manifestations, including hemorrhagic fever, encephalitis or congenital malformations. Our understanding of flaviviral diseases is incomplete, and so is the role of neutrophils in such diseases. Here we present a comprehensive overview on the participation of neutrophils in severe disease forms evolving from flavivirus infection, focusing on the role of chemokines and their receptors as main drivers of neutrophil function. Neutrophil activation during viral infection was shown to interfere in viral replication through effector functions, but the resulting inflammation is significant and may be detrimental to the host. For congenital infections in humans, neutrophil recruitment mediated by CXCL8 would be catastrophic. Evidence suggests that control of neutrophil recruitment to flavivirus-infected tissues may reduce immunopathology in experimental models and patients, with minimal loss to viral clearance. Further investigation on the roles of neutrophils in flaviviral infections may reveal unappreciated functions of this leukocyte population while increasing our understanding of flaviviral disease pathogenesis in its multiple forms.
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Affiliation(s)
- Marina Alves Fontoura
- Brazilian Biosciences National Laboratory—LNBio, Brazilian Center for Research in Energy and Materials—CNPEM, Campinas 13083-100, Brazil; (M.A.F.); (R.F.R.)
- Cellular and Structural Biology Graduate Program, Institute of Biology, University of Campinas (UNICAMP), Campinas 13083-865, Brazil
| | - Rebeca Fróes Rocha
- Brazilian Biosciences National Laboratory—LNBio, Brazilian Center for Research in Energy and Materials—CNPEM, Campinas 13083-100, Brazil; (M.A.F.); (R.F.R.)
- Genetics and Molecular Biology Graduate Program, Institute of Biology, University of Campinas (UNICAMP), Campinas 13083-970, Brazil
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Rafael Elias Marques
- Brazilian Biosciences National Laboratory—LNBio, Brazilian Center for Research in Energy and Materials—CNPEM, Campinas 13083-100, Brazil; (M.A.F.); (R.F.R.)
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30
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de St Maurice A, Ervin E, Chu A. Ebola, Dengue, Chikungunya, and Zika Infections in Neonates and Infants. Clin Perinatol 2021; 48:311-329. [PMID: 34030816 DOI: 10.1016/j.clp.2021.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Emerging infectious diseases, including Ebola, chikungunya, Zika, and dengue, may have significant impacts on maternal-fetal dyads and neonatal outcomes. Pregnant women infected with Ebola demonstrate high mortality and very low evidence of neonatal survival. Maternal chikungunya infection can result in high rates of perinatal transmission, and infected neonates demonstrate variable disease severity. Dengue can be transmitted to neonates via vertical transmission or perinatal transmission. Zika is characterized by mild disease in pregnant women, but congenital infection can be severe. Treatment largely is supportive for these diseases, and vaccine development remains under way, with promising recent advances, notably for Ebola.
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Affiliation(s)
- Annabelle de St Maurice
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Los Angeles, 924 Westwood Boulevard, Suite 900, CA 90095, USA.
| | - Elizabeth Ervin
- Post-baccalaureate Premedical Program, University of Michigan, Office of Graduate and Postdoctoral Studies, 2960 Taubman Health Science Library, 1135 Catherine Street, Ann Arbor, MI 48109, USA
| | - Alison Chu
- Division of Neonatology and Developmental Biology, Department of Pediatrics, 10833 Le Conte Avenue, MDCC B2-411, Los Angeles, CA 90095, USA
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31
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Duarte G, Miranda AE, Bermudez XPD, Saraceni V, Martinez-Espinosa FE. Brazilian Protocol for Sexually Transmitted Infections 2020: Zika virus infection. Rev Soc Bras Med Trop 2021; 54:e2020609. [PMID: 34008724 PMCID: PMC8210481 DOI: 10.1590/0037-8682-609-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 11/22/2022] Open
Abstract
This article addresses the vector, sexual and vertical transmissions of the Zika virus, a topic covered in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Although in Brazil Zika virus is transmitted more predominantly by Aedes aegypti, the vertical and sexual transmission routes are of significant importance for reproductive health. Sexual transmission demands specific prophylactic interventions, including the use of male or female condoms, especially among couples in a risk situation and planning pregnancy. Vertical transmission is linked to severe structural abnormalities of the central nervous system, and there is still no vaccine or known pharmacological resources that can prevent it. As the disease is predominantly asymptomatic, failure to comply with the basic principles of care and guidelines associated with the spread of the infection transcends the severity of the disease's symptoms. Although in Brazil Zika virus is predominantly transmitted by the Aedes aegypti mosquito, vertical and sexual transmission routes are important for reproductive health. Vertical transmission causes severe central nervous system structural abnormalities.
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Affiliation(s)
- Geraldo Duarte
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
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Sié A, Hanefeld J, Chaponda M, Chico RM, LeDoare K, Mayaud P, Drexler JF, Jaenisch T. Congenital malformations in sub-Saharan Africa-warnings of a silent epidemic? THE LANCET. INFECTIOUS DISEASES 2021; 21:594-596. [PMID: 33773619 PMCID: PMC9760594 DOI: 10.1016/s1473-3099(21)00061-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/27/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Ali Sié
- National Institute of Public Health, Burkina Faso
| | - Johanna Hanefeld
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK,Zentrum Internationaler Gesundheitsschutz, Robert Koch Institute, Berlin 14195, Germany
| | | | - R Matthew Chico
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Kirsty LeDoare
- Paediatric Infectious Diseases Research Group, St George's Medical School, London, UK
| | - Philippe Mayaud
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Jan Felix Drexler
- Charité-Universitätsmedizin Berlin Universität Berlin, Humbolt-Universität zu Berlin, Berlin, Germany,Institute of Virology, Berlin, Germany
| | - Thomas Jaenisch
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany,Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
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Fajardo TCG, Gazeta RE, Catalan DT, Mello AS, da Silva ACB, Bertozzi APAP, Santos GRD, Pinto CAL, Monteiro CO, Machado RRG, Oliveira DBL, Durigon EL, Passos SD. Neonatal consequences of maternal exposure to the chikungunya virus: Case reports. Medicine (Baltimore) 2021; 100:e25695. [PMID: 33907147 PMCID: PMC8084008 DOI: 10.1097/md.0000000000025695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
RATIONALE The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Cairo Oliveira Monteiro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Saulo Duarte Passos
- Laboratory of Paediatric Infectology, Jundiaí School of Medicine
- Department of Paediatric, Jundiaí School of Medicine
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Vertical transmission of chikungunya virus: A systematic review. PLoS One 2021; 16:e0249166. [PMID: 33891622 PMCID: PMC8064608 DOI: 10.1371/journal.pone.0249166] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/13/2021] [Indexed: 01/23/2023] Open
Abstract
Objectives To describe and estimate the frequency of pregnancy outcomes, clinical and laboratory characteristics of vertical transmission of CHIKV in the neonate. Study design We performed a systematic review evaluating the clinical presentation of perinatally-acquired CHIKV infection in neonates. The search was performed using Medline (via PubMed), LILACS, Web of Science, Scielo, Google Scholar and Open grey to identify studies assessing vertical transmission of CHIKV up to November 3, 2020. There were no search restrictions regarding the study type, the publication date or language. Studies with no documented evidence of CHIKV infection in neonates (negative RT-PCR or absence of IgM) were excluded. Results From the 227 studies initially identified, 42 were selected as follows: 28 case reports, 7 case series, 2 cross-sectional studies and 5 cohort studies, for a total of 266 CHIKV infected neonates confirmed by serological and/or molecular tests. The vertical transmission rate was 50% in the Reunion Island outbreak, which was the subject of the majority of the studies; the premature delivery were reported in 19 (45.2%) studies; the rate of fetal distress was 19.6% of infected babies and fetal loss occurred in 2% of the cases. Approximately 68.7% of newborns were diagnosed with encephalopathy or encephalitis after perinatally acquired CHIKV. Most of the infected neonates were born healthy, developing CHIKV sepsis clinical syndrome within the first week of life. Conclusions We alert neonatologists to the late manifestations of neonatal CHIKV infection, relevant to the management and reduction of morbidity. A limitation of our review was that it was not possible to carry out meta-analysis due to differences in study design and the small number of participants.
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Jacques IJAA, Katz L, Sena MA, Guimarães ABG, Silva YL, Albuquerque GDM, Pereira RO, de Albuquerque CAMC, Silva MAL, Oliveira PAS, Albuquerque MDFPM, Cordeiro MT, Marques ETA, França RFO, Martelli CMT, Castanha PMS, Braga C. High Incidence of Zika or Chikungunya Infection among Pregnant Women Hospitalized Due to Obstetrical Complications in Northeastern Brazil-Implications for Laboratory Screening in Arbovirus Endemic Area. Viruses 2021; 13:v13050744. [PMID: 33922819 PMCID: PMC8145990 DOI: 10.3390/v13050744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/11/2021] [Accepted: 04/20/2021] [Indexed: 12/16/2022] Open
Abstract
The diagnostic of arbovirus-related obstetric complications in high-risk pregnancy and childbirth care is challenging, especially in endemic areas. We conducted a prospective study to track active or recent Zika (ZIKV), dengue (DENV), or chikungunya (CHIKV) virus infection among hospitalized pregnant women (PW) with obstetric complications in a hospital at the epicenter of Zika outbreak and ZIKV-related microcephaly in Brazil. Clinical data and blood samples were collected at enrollment and 10 days after the admission of study participants, between October 2018 and May 2019. Further clinical data were extracted from medical records. Samples were screened by molecular and serological tests. Out of 780 participants, 93.1% (95% CI: 91.1–94.7%) presented previous DENV exposure (IgG). ZIKV, CHIKV, and/or DENV laboratory markers of recent or active infection were detected in 130 PW, yielding a prevalence of 16.6% (95% CI: 14.2–19.5%); 9.4% (95% CI: 7.4–11.7%), 7.4% (95% CI: 5.7–9.7%), and 0.38% (95% CI: 0.1–1.2%) of CHIKV, ZIKV, and DENV infections, respectively. Most ZIKV infections were detected by molecular assays (89.6%), while CHIKV infections were detected by serology (95.9%). Our findings highlight the need for arbovirus infections screening in PW with obstetrical complications, potentially associated to these infections in endemic areas regardless of the signs or symptoms suggestive of arboviral disease.
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Affiliation(s)
- Iracema J. A. A. Jacques
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Leila Katz
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife CEP 50070-550, PE, Brazil; (L.K.); (G.D.M.A.); (R.O.P.); (C.A.M.C.d.A.)
| | - Marília A. Sena
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Ana B. G. Guimarães
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Yasmim L. Silva
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Gabriela D. M. Albuquerque
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife CEP 50070-550, PE, Brazil; (L.K.); (G.D.M.A.); (R.O.P.); (C.A.M.C.d.A.)
| | - Raisa O. Pereira
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife CEP 50070-550, PE, Brazil; (L.K.); (G.D.M.A.); (R.O.P.); (C.A.M.C.d.A.)
| | - Camila A. M. C. de Albuquerque
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife CEP 50070-550, PE, Brazil; (L.K.); (G.D.M.A.); (R.O.P.); (C.A.M.C.d.A.)
| | - Maria Almerice L. Silva
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Paula A. S. Oliveira
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Maria de Fátima P. M. Albuquerque
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Marli T. Cordeiro
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Ernesto T. A. Marques
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (E.T.A.M.J.); (P.M.S.C.)
| | - Rafael F. O. França
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Celina M. T. Martelli
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
| | - Priscila M. S. Castanha
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (E.T.A.M.J.); (P.M.S.C.)
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife CEP 50100-130, PE, Brazil
| | - Cynthia Braga
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz Pernambuco, Recife CEP 50740-465, PE, Brazil; (I.J.A.A.J.); (M.A.S.); (A.B.G.G.); (Y.L.S.); (M.A.L.S.); (P.A.S.O.); (M.d.F.P.M.A.); (M.T.C.); (R.F.O.F.); (C.M.T.M.)
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife CEP 50070-550, PE, Brazil; (L.K.); (G.D.M.A.); (R.O.P.); (C.A.M.C.d.A.)
- Correspondence: ; Tel.: +55-81-2101-2577
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Saavedra LPJ, Prates KV, Gonçalves GD, Piovan S, Matafome P, Mathias PCDF. COVID-19 During Development: A Matter of Concern. Front Cell Dev Biol 2021; 9:659032. [PMID: 33898461 PMCID: PMC8058409 DOI: 10.3389/fcell.2021.659032] [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] [Received: 01/26/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
A new infectious disease, COVID-19, has spread around the world. The most common symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are cough and fever, but severe cases can develop acute respiratory distress syndrome. The main receptor for SARS-CoV-2 in human tissue is angiotensin-converting enzyme 2, and the lungs, heart, and kidneys are the most affected organs. Besides the inflammatory process and tissue damage, the presence of a cytokine "storm" has been related to a higher mortality rate. Other infectious viral diseases, such as Zika, chikungunya, and influenza, were associated with complications in pregnant women, such as growth restriction, malformation, preterm birth, low birth weight, miscarriage, and death, although they can also cause developmental disorders in infants and adolescents. Evidence points out that stressors during pregnancy and infancy may lead to the development of obesity, diabetes, and cardiovascular disease. Therefore, we hypothesize that COVID-19 infection during the critical phases of development can program the individual to chronic diseases in adulthood. It is important that COVID-19 patients receive proper monitoring as a way to avoid expensive costs to public health in the future.
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Affiliation(s)
- Lucas Paulo Jacinto Saavedra
- Laboratory of Secretion Cell Biology, Department of Biotechnology, Genetics and Cell Biology, State University of Maringa, Maringa, Brazil
| | - Kelly Valério Prates
- Laboratory of Secretion Cell Biology, Department of Biotechnology, Genetics and Cell Biology, State University of Maringa, Maringa, Brazil
| | - Gessica Dutra Gonçalves
- Laboratory of Secretion Cell Biology, Department of Biotechnology, Genetics and Cell Biology, State University of Maringa, Maringa, Brazil
| | - Silvano Piovan
- Laboratory of Secretion Cell Biology, Department of Biotechnology, Genetics and Cell Biology, State University of Maringa, Maringa, Brazil
| | - Paulo Matafome
- Institute of Physiology and Institute of Clinical and Biomedical Research, Faculty of Medicine and Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Coimbra Health School, ESTeSC, Instituto Politécnico de Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Paulo Cezar de Freitas Mathias
- Laboratory of Secretion Cell Biology, Department of Biotechnology, Genetics and Cell Biology, State University of Maringa, Maringa, Brazil
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Ginige S, Flower R, Viennet E. Neonatal Outcomes From Arboviruses in the Perinatal Period: A State-of-the-Art Review. Pediatrics 2021; 147:peds.2020-009720. [PMID: 33737375 DOI: 10.1542/peds.2020-009720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/24/2022] Open
Abstract
Since the 2016 Zika outbreak and the understanding of the teratogenic effect of this infection, there has been a newfound interest in arbovirus infections and their effects on pregnancy, resulting in numerous publications in the last 5 years. However, limited literature focuses on arbovirus infection in different stages of pregnancy and their effect on the neonate. There is currently no consensus management of perinatal acquisition of arboviruses, and current evidence is largely anecdotal observational reports. Teratogens can have different effects on the developing fetus depending on the time of infection, so infections during pregnancy should be analyzed by trimester. A better understanding of arbovirus infection in the perinatal period is required to assist obstetric, neonatal, and pediatric clinicians in making decisions about the management of mother and neonate. Our objective was to assess the evidence of adverse neonatal outcomes for several arboviral infections when contracted during the perinatal period to guide clinicians in managing these patients. There are 8 arboviruses for which neonatal outcomes from maternal acquisition in the perinatal period have been reported, with the most data for dengue and Chikungunya virus infections. The evidence reviewed in this article supports the adoption of preventive strategies to avoid ticks and mosquitoes close to the date of delivery. For the other arbovirus infections, further community-based cohort studies during outbreaks are required to evaluate whether these infections have a similar teratogenic impact.
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Duarte G, Miranda AE, Bermúdez XPD, Saraceni V, Martínez-Espinosa FE. [Brazilian Protocol for Sexually Transmitted Infections 2020: Zika virus infection]. ACTA ACUST UNITED AC 2021; 30:e2020609. [PMID: 33729407 DOI: 10.1590/s1679-4974202100017.esp1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023]
Abstract
This article addresses vector, sexual and vertical transmission of Zika virus, a topic covered in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Although in Brazil Zika virus is transmitted most predominantly by Aedes aegypti, the vertical and sexual transmission routes are of significant importance for reproductive health. Sexual transmission demands the use of specific prophylactic interventions, including the use of male or female condoms, especially among couples planning pregnancy. Vertical transmission is linked to severe structural abnormalities of the central nervous system and there is still no vaccine or known pharmacological resources that can prevent it. As the disease is predominantly asymptomatic, failure to comply with basic principles of care and guidelines related to the spread of infection transcends the severity of the symptoms of the disease.
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Affiliation(s)
- Geraldo Duarte
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | | | | | - Valeria Saraceni
- Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Ribeiro IM, Souto PCS, Borbely AU, Tanabe ELL, Cadavid A, Alvarez AM, Bueno J, Agudelo O, Robles RG, Ayala-Ramírez P, Sacerdoti F, Szasz T, Damiano AE, Ibarra C, Escudero C, Lima VV, Giachini FR. The limited knowledge of placental damage due to neglected infections: ongoing problems in Latin America. Syst Biol Reprod Med 2021; 66:151-169. [PMID: 32482148 DOI: 10.1080/19396368.2020.1753850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The placenta works as a selective barrier, protecting the fetus from potential infections that may affect the maternal organism during pregnancy. In this review, we will discuss several challenging infections that are common within Latin American countries and that may affect the maternal-fetal interface and pose risks to fetal development. Specifically, we will focus on emerging infectious diseases including the arboviruses, malaria, leishmaniasis, and the bacterial foodborne disease caused by Shiga toxin-producing Escherichia coli. We will also highlight some topics of interest currently being studied by research groups that comprise an international effort aimed at filling the knowledge gaps in this field. These topics address the relationship between exposure to microorganisms and placental abnormalities, congenital anomalies, and complications of pregnancy. ABBREVIATIONS ADE: antibody-dependent enhancement; CCL2: monocyte chemoattractant protein-1; CCL3: macrophage inflammatory protein-1 α; CCL5: chemokine (C-C motif) ligand 5; CHIKV: chikungunya virus; DCL: diffuse cutaneous leishmaniasis; DENV: dengue virus; Gb3: glycolipid globotriaosylceramyde; HIF: hypoxia-inducible factor; HUS: hemolytic uremic syndrome; IFN: interferon; Ig: immunoglobulins; IL: interleukin; IUGR: intrauterine growth restriction; LCL: localized cutaneous leishmaniasis; LPS: lipopolysaccharid; MCL: mucocutaneous leishmaniasis; NO: nitric oxide; PCR: polymerase chain reaction; PGF: placental growth factor; PM: placental malaria; RIVATREM: Red Iberoamericana de Alteraciones Vasculares em transtornos del Embarazo; sVEGFR: soluble vascular endothelial growth factor receptor; STEC: shiga toxin-producing Escherichia coli; stx: shiga toxin protein; TNF: tumor necrosis factor; TOAS: T cell original antigenic sin; Var2CSA: variant surface antigen 2-CSA; VEGF: vascular endothelial growth factor; VL: visceral leishmaniasis; WHO: world health organization; YFV: yellow fever virus; ZIKV: Zika virus.
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Affiliation(s)
- Isabela Moreti Ribeiro
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
| | - Paula Cristina Souza Souto
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
| | - Alexandre U Borbely
- Cell Biology Laboratory, Institute of Health and Biological Sciences, Federal University of Alagoas , Alagoas, Brazil
| | - Eloiza Lopes Lira Tanabe
- Cell Biology Laboratory, Institute of Health and Biological Sciences, Federal University of Alagoas , Alagoas, Brazil
| | - Angela Cadavid
- Grupo Reproducción, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Angela M Alvarez
- Grupo Reproducción, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Julio Bueno
- Grupo Reproducción, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Olga Agudelo
- Grupo Salud Y Comunidad, Facultad De Medicina Universidad De Antioquia , Medellin, Colombia
| | - Reggie García Robles
- Physiological Sciences Department, Faculty of Medicine, Pontificia Universidad Javeriana , Bogotá, Colombia
| | - Paola Ayala-Ramírez
- Human Genetics Institute, Facultad De Medicina, Pontificia Universidad Javeriana , Bogotá, Colombia
| | - Flavia Sacerdoti
- Laboratorio De Fisiopatogenia, Instituto De Fisiología Y Biofísica Bernardo Houssay (IFIBIO)- CONICET- Departamento De Fisiología, Facultad De Medicina, Universidad De Buenos Aires . Buenos Aires, Argentina
| | - Theodora Szasz
- Departamento of Physiology, Augusta University , Augusta, USA
| | - Alicia E Damiano
- Cátedra De Biología Celular Y Molecular, Departamento De Ciencias Biológicas, Facultad De Farmacia Y Bioquímica, Universidad De Buenos Aires . Buenos Aires, Argentina.,Laboratorio De Biología De La Reproducción, Instituto De Fisiología Y Biofísica Bernardo Houssay (IFIBIO)- CONICET- Facultad De Medicina, Universidad De Buenos Aires . Buenos Aires, Argentina
| | - Cristina Ibarra
- Cátedra De Biología Celular Y Molecular, Departamento De Ciencias Biológicas, Facultad De Farmacia Y Bioquímica, Universidad De Buenos Aires . Buenos Aires, Argentina
| | - Carlos Escudero
- Vascular Physiology Laboratory, Group of Research and Innovation in Vascular Health (GRIVAS Health), Basic Sciences Department Faculty of Sciences, Universidad Del Bio-Bio , Chillan, Chile
| | - Victor V Lima
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
| | - Fernanda R Giachini
- Laboratory of Vascular Biology and Histopathology, Institute of Health Sciences and Health, Federal University of Mato Grosso , Barra Do Garcas, Brazil
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Charlier C, Lecuit M. Maternal-fetal infections: Why do they matter? Virulence 2021; 11:398-399. [PMID: 32363994 PMCID: PMC7199755 DOI: 10.1080/21505594.2020.1759288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Caroline Charlier
- Institut Pasteur, Biology of Infection Unit, Paris, France.,Inserm U1117, Paris, France.,French National Reference Center and WHO Collaborating Center for Listeria, Institut Pasteur, Paris, France.,Necker-Enfants Malades University Hospital, Department of Infectious Diseases and Tropical Medicine, Institut Imagine, APHP.,Université de Paris, Paris, France
| | - Marc Lecuit
- Institut Pasteur, Biology of Infection Unit, Paris, France.,Inserm U1117, Paris, France.,French National Reference Center and WHO Collaborating Center for Listeria, Institut Pasteur, Paris, France.,Necker-Enfants Malades University Hospital, Department of Infectious Diseases and Tropical Medicine, Institut Imagine, APHP.,Université de Paris, Paris, France
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A Review: Aedes-Borne Arboviral Infections, Controls and Wolbachia-Based Strategies. Vaccines (Basel) 2021; 9:vaccines9010032. [PMID: 33435566 PMCID: PMC7827552 DOI: 10.3390/vaccines9010032] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 01/05/2021] [Indexed: 12/31/2022] Open
Abstract
Arthropod-borne viruses (Arboviruses) continue to generate significant health and economic burdens for people living in endemic regions. Of these viruses, some of the most important (e.g., dengue, Zika, chikungunya, and yellow fever virus), are transmitted mainly by Aedes mosquitoes. Over the years, viral infection control has targeted vector population reduction and inhibition of arboviral replication and transmission. This control includes the vector control methods which are classified into chemical, environmental, and biological methods. Some of these control methods may be largely experimental (both field and laboratory investigations) or widely practised. Perceptively, one of the biological methods of vector control, in particular, Wolbachia-based control, shows a promising control strategy for eradicating Aedes-borne arboviruses. This can either be through the artificial introduction of Wolbachia, a naturally present bacterium that impedes viral growth in mosquitoes into heterologous Aedes aegypti mosquito vectors (vectors that are not natural hosts of Wolbachia) thereby limiting arboviral transmission or via Aedes albopictus mosquitoes, which naturally harbour Wolbachia infection. These strategies are potentially undermined by the tendency of mosquitoes to lose Wolbachia infection in unfavourable weather conditions (e.g., high temperature) and the inhibitory competitive dynamics among co-circulating Wolbachia strains. The main objective of this review was to critically appraise published articles on vector control strategies and specifically highlight the use of Wolbachia-based control to suppress vector population growth or disrupt viral transmission. We retrieved studies on the control strategies for arboviral transmissions via arthropod vectors and discussed the use of Wolbachia control strategies for eradicating arboviral diseases to identify literature gaps that will be instrumental in developing models to estimate the impact of these control strategies and, in essence, the use of different Wolbachia strains and features.
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Post-Vaccination Yellow Fever Antiserum Reduces Zika Virus in Embryoid Bodies When Placental Cells are Present. Vaccines (Basel) 2020; 8:vaccines8040752. [PMID: 33322247 PMCID: PMC7768546 DOI: 10.3390/vaccines8040752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/09/2020] [Accepted: 11/29/2020] [Indexed: 11/18/2022] Open
Abstract
Zika virus (ZIKV) is a flavivirus that originated in Africa but emerged in Latin America in 2015. In this region, other flaviviruses such as Dengue (DENV), West Nile, and Yellow Fever virus (YFV) also circulate, allowing for possible antigenic cross-reactivity to impact viral infections and immune responses. Studies have found antibody-mediated enhancement between DENV and ZIKV, but the impact of YFV antibodies on ZIKV infection has not been fully explored. ZIKV infections cause congenital syndromes, such as microcephaly, necessitating further research into ZIKV vertical transmission through the placental barrier. Recent advancements in biomedical engineering have generated co-culture methods that allow for the in vitro recapitulation of the maternal–fetal interface. This study utilized a transwell assay, which was a co-culture model utilizing human placental syncytiotrophoblasts, fetal umbilical cells, and a differentiating embryoid body, to replicate the maternal–fetal axis. To determine if cross-reactive YFV vaccine antibodies impacted the pathogenesis of ZIKV across the maternal–fetal axis, syncytiotrophoblasts were inoculated with ZIKV or ZIKV incubated with YFV vaccine antisera, and the viral load was measured 72 h post-inoculation. Here, we report that BeWo and HUVEC cells were permissive to ZIKV and that the impact of YFV post-vaccination antibodies on ZIKV replication was cell line-dependent. Embryoid bodies were also permissive to ZIKV, and the presence of YFV antibodies collected 4–14 months post-vaccination reduced ZIKV infection when placental cells were present. However, when directly infected with ZIKV, the embryoid bodies displayed significantly increased viral loads in the presence of YFV antiserum taken 30 days post-vaccination. The data show that each of the cell lines and EBs have a unique response to ZIKV complexed with post-vaccination serum, suggesting there may be cell-specific mechanisms that impact congenital ZIKV infections. Since ZIKV infections can cause severe congenital syndromes, it is crucial to understand any potential enhancement or protection offered from cross-reactive, post-vaccination antibodies.
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Blackmon K, Waechter R, Landon B, Noël T, Macpherson C, Donald T, Cudjoe N, Evans R, Burgen KS, Jayatilake P, Oyegunle V, Pedraza O, Abdel Baki S, Thesen T, Dlugos D, Chari G, Patel AA, Grossi-Soyster EN, Krystosik AR, LaBeaud AD. Epilepsy surveillance in normocephalic children with and without prenatal Zika virus exposure. PLoS Negl Trop Dis 2020; 14:e0008874. [PMID: 33253174 PMCID: PMC7728266 DOI: 10.1371/journal.pntd.0008874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 12/10/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022] Open
Abstract
Children with Congenital Zika Syndrome and microcephaly are at high risk for epilepsy; however, the risk is unclear in normocephalic children with prenatal Zika virus (ZIKV) exposure [Exposed Children (EC)]. In this prospective cohort study, we performed epilepsy screening in normocephalic EC alongside a parallel group of normocephalic unexposed children [Unexposed Children (UC)]. We compared the incidence rate of epilepsy among EC and UC at one year of life to global incidence rates. Pregnant women were recruited from public health centers during the ZIKV outbreak in Grenada, West Indies and assessed for prior ZIKV infection using a plasmonic-gold platform that measures IgG antibodies in serum. Normocephalic children born to mothers with positive ZIKV results during pregnancy were classified as EC and those born to mothers with negative ZIKV results during and after pregnancy were classified as UC. Epilepsy screening procedures included a pediatric epilepsy screening questionnaire and video electroencephalography (vEEG). vEEG was collected using a multi-channel microEEG® system for a minimum of 20 minutes along with video recording of participant behavior time-locked to the EEG. vEEGs were interpreted independently by two pediatric epileptologists, who were blinded to ZIKV status, via telemedicine platform. Positive screening cases were referred to a local pediatrician for an epilepsy diagnostic evaluation. Epilepsy screens were positive in 2/71 EC (IR: 0.028; 95% CI: 0.003-0.098) and 0/71 UC. In both epilepsy-positive cases, questionnaire responses and interictal vEEGs were consistent with focal, rather than generalized, seizures. Both children met criteria for a clinical diagnosis of epilepsy and good seizure control was achieved with carbamazepine. Our results indicate that epilepsy rates are modestly elevated in EC. Given our small sample size, results should be considered preliminary. They support the use of epilepsy screening procedures in larger epidemiological studies of children with congenital ZIKV exposure, even in the absence of microcephaly, and provide guidance for conducting epilepsy surveillance in resource limited settings.
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Affiliation(s)
- Karen Blackmon
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, Florida, United States of America
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
- * E-mail:
| | - Randall Waechter
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | | | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Kemi S. Burgen
- Windward Islands Research and Education Foundation, St George’s University, St George’s, Grenada, West Indies
| | - Piumi Jayatilake
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Vivian Oyegunle
- St George’s University School of Medicine, Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s, Grenada, West Indies
| | - Otto Pedraza
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, Florida, United States of America
| | - Samah Abdel Baki
- Biosignal Group Inc., Boston, Massachusetts, United States of America
| | - Thomas Thesen
- New York University School of Medicine, Department of Neurology, New York, New York, United States of America
- Department of Biomedical Sciences, University of Houston College of Medicine, USA
| | - Dennis Dlugos
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Geetha Chari
- SUNY Downstate Health Sciences University, Brooklyn, New York, United States of America
| | - Archana A. Patel
- Boston Children’s Hospital, Department of Neurology, Boston, Massachusetts, United States of America
| | - Elysse N. Grossi-Soyster
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
| | - Amy R. Krystosik
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
| | - A. Desiree LaBeaud
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California, United States of America
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44
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Saroyo YB, Sungkar A, Irwinda R, Surya R. Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome. Infect Dis Rep 2020; 12:51-60. [PMID: 33147733 PMCID: PMC7768497 DOI: 10.3390/idr12030013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/11/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Dengue fever is a major public health problem in tropical and subtropical areas. There are not many studies concerning the complications of dengue fever in pregnancy. We present four serial cases of dengue fever in pregnancy. Case illustration: Three of four cases were delivered by caesarean section; two of them died during post-caesarean care. All cases had the lowest platelet level below 50,000/µL and were given platelet transfusion during and after delivery; they also showed abnormal liver function tests. For foetal outcome, none tested positive for dengue. Discussion: Complication of dengue infection depends on a combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patients with dengue infection due to an intricate effect on the haemostatic system. The adverse foetal outcome may contribute because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy. Conclusions: The management of dengue fever in pregnancy at the tertiary hospital is still suboptimal. Dengue fever around peripartum presents a higher risk of morbidity and mortality for the mother and therefore needs a multidiscipline team approach.
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Marbán-Castro E, Arrieta GJ, Martínez MJ, González R, Bardají A, Menéndez C, Mattar S. High Seroprevalence of Antibodies against Arboviruses among Pregnant Women in Rural Caribbean Colombia in the Context of the Zika Virus Epidemic. Antibodies (Basel) 2020; 9:antib9040056. [PMID: 33096597 PMCID: PMC7709128 DOI: 10.3390/antib9040056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022] Open
Abstract
Mosquito-borne viruses such as dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV) have spread in recent decades. We aimed to assess seroprevalence of arboviral infections in pregnant women living in Cereté, Caribbean Colombia. In 2016 a cross-sectional facility-based sero-survey study was performed among pregnant women (N = 90). Most of them (66%) reported at least one symptom or sign compatible with arboviral infection over the previous 15 days. All screened women had a positive IgG for DENV, 89% for ZIKV, and 82% for CHIKV. One woman tested positive for ZIKV IgM. This study shows the high exposure among pregnant women to arboviruses in endemic areas, shown by the high seroprevalence of past arboviral infections. Given the evidence on the potential risks of these arboviral infections on pregnancy and infant outcomes, these results highlight the need for continuous epidemiological surveillance of arboviral diseases, particularly among those most of risk of their harmful consequences.
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Affiliation(s)
- Elena Marbán-Castro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain; (M.J.M.); (R.G.); (A.B.); (C.M.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-93-227-5400 (ext. 4142)
| | - Germán J. Arrieta
- Corporación Universitaria del Caribe (CECAR), Grupo de Salud Pública, Sincelejo 700001, Colombia;
- Clínica Salud Social, Sincelejo 700001, Colombia;
| | - Miguel J. Martínez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain; (M.J.M.); (R.G.); (A.B.); (C.M.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Raquel González
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain; (M.J.M.); (R.G.); (A.B.); (C.M.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Azucena Bardají
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain; (M.J.M.); (R.G.); (A.B.); (C.M.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça 1929, Mozambique
| | - Clara Menéndez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain; (M.J.M.); (R.G.); (A.B.); (C.M.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça 1929, Mozambique
| | - Salim Mattar
- Clínica Salud Social, Sincelejo 700001, Colombia;
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería 230002, Colombia
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Mahyuddin AP, Kanneganti A, Wong JJL, Dimri PS, Su LL, Biswas A, Illanes SE, Mattar CNZ, Huang RYJ, Choolani M. Mechanisms and evidence of vertical transmission of infections in pregnancy including SARS-CoV-2s. Prenat Diagn 2020; 40:1655-1670. [PMID: 32529643 PMCID: PMC7307070 DOI: 10.1002/pd.5765] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
There remain unanswered questions concerning mother‐to‐child‐transmission of SARS‐CoV‐2. Despite reports of neonatal COVID‐19, SARS‐CoV‐2 has not been consistently isolated in perinatal samples, thus definitive proof of transplacental infection is still lacking. To address these questions, we assessed investigative tools used to confirm maternal‐fetal infection and known protective mechanisms of the placental barrier that prevent transplacental pathogen migration. Forty studies of COVID‐19 pregnancies reviewed suggest a lack of consensus on diagnostic strategy for congenital infection. Although real‐time polymerase chain reaction of neonatal swabs was universally performed, a wide range of clinical samples was screened including vaginal secretions (22.5%), amniotic fluid (35%), breast milk (22.5%) and umbilical cord blood. Neonatal COVID‐19 was reported in eight studies, two of which were based on the detection of SARS‐CoV‐2 IgM in neonatal blood. Histological examination demonstrated sparse viral particles, vascular malperfusion and inflammation in the placenta from pregnant women with COVID‐19. The paucity of placental co‐expression of ACE‐2 and TMPRSS2, two receptors involved in cytoplasmic entry of SARS‐CoV‐2, may explain its relative insensitivity to transplacental infection. Viral interactions may utilise membrane receptors other than ACE‐2 thus, tissue susceptibility may be broader than currently known. Further spatial‐temporal studies are needed to determine the true potential for transplacental migration.
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Affiliation(s)
- Aniza P Mahyuddin
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Abhiram Kanneganti
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Jeslyn J L Wong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Pooja S Dimri
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Lin L Su
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Arijit Biswas
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Citra N Z Mattar
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ruby Y-J Huang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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47
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Cornish EF, Filipovic I, Åsenius F, Williams DJ, McDonnell T. Innate Immune Responses to Acute Viral Infection During Pregnancy. Front Immunol 2020; 11:572567. [PMID: 33101294 PMCID: PMC7556209 DOI: 10.3389/fimmu.2020.572567] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
Immunological adaptations in pregnancy allow maternal tolerance of the semi-allogeneic fetus but also increase maternal susceptibility to infection. At implantation, the endometrial stroma, glands, arteries and immune cells undergo anatomical and functional transformation to create the decidua, the specialized secretory endometrium of pregnancy. The maternal decidua and the invading fetal trophoblast constitute a dynamic junction that facilitates a complex immunological dialogue between the two. The decidual and peripheral immune systems together assume a pivotal role in regulating the critical balance between tolerance and defense against infection. Throughout pregnancy, this equilibrium is repeatedly subjected to microbial challenge. Acute viral infection in pregnancy is associated with a wide spectrum of adverse consequences for both mother and fetus. Vertical transmission from mother to fetus can cause developmental anomalies, growth restriction, preterm birth and stillbirth, while the mother is predisposed to heightened morbidity and maternal death. A rapid, effective response to invasive pathogens is therefore essential in order to avoid overwhelming maternal infection and consequent fetal compromise. This sentinel response is mediated by the innate immune system: a heritable, highly evolutionarily conserved system comprising physical barriers, antimicrobial peptides (AMP) and a variety of immune cells—principally neutrophils, macrophages, dendritic cells, and natural killer cells—which express pattern-receptors that detect invariant molecular signatures unique to pathogenic micro-organisms. Recognition of these signatures during acute infection triggers signaling cascades that enhance antimicrobial properties such as phagocytosis, secretion of pro-inflammatory cytokines and activation of the complement system. As well as coordinating the initial immune response, macrophages and dendritic cells present microbial antigens to lymphocytes, initiating and influencing the development of specific, long-lasting adaptive immunity. Despite extensive progress in unraveling the immunological adaptations of pregnancy, pregnant women remain particularly susceptible to certain acute viral infections and continue to experience mortality rates equivalent to those observed in pandemics several decades ago. Here, we focus specifically on the pregnancy-induced vulnerabilities in innate immunity that contribute to the disproportionately high maternal mortality observed in the following acute viral infections: Lassa fever, Ebola virus disease (EVD), dengue fever, hepatitis E, influenza, and novel coronavirus infections.
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Affiliation(s)
- Emily F Cornish
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - Iva Filipovic
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Fredrika Åsenius
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - David J Williams
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - Thomas McDonnell
- Department of Biochemical Engineering, University College London, London, United Kingdom
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48
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Romero-Acosta K, Marbán-Castro E, Arroyo-Alvis K, Arrieta G, Mattar S. Perceptions and Emotional State of Mothers of Children with and without Microcephaly after the Zika Virus Epidemic in Rural Caribbean Colombia. Behav Sci (Basel) 2020; 10:bs10100147. [PMID: 32992703 PMCID: PMC7599807 DOI: 10.3390/bs10100147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022] Open
Abstract
Zika virus (ZIKV) infection during pregnancy can cause neurological manifestations such as microcephaly. The aim of this study was to explore perceptions of ZIKV and mental health in women exposed to ZIKV during pregnancy in Colombia. This was a mixed-methods study based on structured interviews and psychological tests. Structured interviews were transcribed and analysed with Atlas Ti software. A grounded theory approach was applied. Quantitative analysis was performed with Statistical Package for Social Science, SPSS, V. 20. The study was approved by the Ethics Committee of the Universidad de Córdoba, Montería. Seventeen women participated in the study; nine of them were mothers of children with microcephaly. Maternal age ranged from 16 to 41 years old. The main themes discussed during interviews were: feelings, support, sources of information, and consequences on children's health. Women with children affected by microcephaly showed worse mental health compared to women with normocephalic children. Maternal mental health worsened after 24 months from giving birth. Perceptions regarding disease severity and lack of knowledge were considered to affect maternal mental health. Social support and spirituality were key determinants for caregivers. Future research is needed to further study coping mechanisms and mental health outcomes over time by affected populations.
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Affiliation(s)
- Kelly Romero-Acosta
- Faculty of Humanities and Education, Corporación Universitaria del Caribe CECAR, Sincelejo 700001, Colombia; (K.R.-A.); (K.A.-A.); (G.A.)
| | - Elena Marbán-Castro
- Department of Maternal, Child, and Reproductive health, ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- Correspondence:
| | - Katy Arroyo-Alvis
- Faculty of Humanities and Education, Corporación Universitaria del Caribe CECAR, Sincelejo 700001, Colombia; (K.R.-A.); (K.A.-A.); (G.A.)
| | - Germán Arrieta
- Faculty of Humanities and Education, Corporación Universitaria del Caribe CECAR, Sincelejo 700001, Colombia; (K.R.-A.); (K.A.-A.); (G.A.)
- Clinica Salud Social SAS, Sincelejo 700002, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería 230002, Colombia;
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49
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Clé M, Eldin P, Briant L, Lannuzel A, Simonin Y, Van de Perre P, Cabié A, Salinas S. Neurocognitive impacts of arbovirus infections. J Neuroinflammation 2020; 17:233. [PMID: 32778106 PMCID: PMC7418199 DOI: 10.1186/s12974-020-01904-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/17/2020] [Indexed: 12/15/2022] Open
Abstract
Arthropod-borne viruses or arbovirus, are most commonly associated with acute infections, resulting on various symptoms ranging from mild fever to more severe disorders such as hemorrhagic fever. Moreover, some arboviral infections can be associated with important neuroinflammation that can trigger neurological disorders including encephalitis, paralysis, ophthalmological impairments, or developmental defects, which in some cases, can lead to long-term defects of the central nervous system (CNS). This is well illustrated in Zika virus-associated congenital brain malformations but also in West Nile virus-induced synaptic dysfunctions that can last well beyond infection and lead to cognitive deficits. Here, we summarize clinical and mechanistic data reporting on cognitive disturbances triggered by arboviral infections, which may highlight growing public health issues spanning the five continents.
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Affiliation(s)
- Marion Clé
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Montpellier, France
| | - Patrick Eldin
- Institute of Research in Infectiology of Montpellier, CNRS, University of Montpellier, Montpellier, France
| | - Laurence Briant
- Institute of Research in Infectiology of Montpellier, CNRS, University of Montpellier, Montpellier, France
| | - Annie Lannuzel
- Neurology Unit, INSERM CIC 1424, Guadeloupe University Hospital, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France
- INSERM U1127, CNRS, UMR7225, Brain and Spine Institute, Sorbonne University Medical School, Paris, France
| | - Yannick Simonin
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, CHU Montpellier, Montpellier, France
| | - André Cabié
- INSERM CIC 1424, Infectious Disease and Tropical Medicine Unit, Martinique University Hospital, Université des Antilles EA4537, Martinique, France.
| | - Sara Salinas
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, Montpellier, France.
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Liang B, Guida JP, Costa Do Nascimento ML, Mysorekar IU. Host and viral mechanisms of congenital Zika syndrome. Virulence 2020; 10:768-775. [PMID: 31451049 PMCID: PMC6735503 DOI: 10.1080/21505594.2019.1656503] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In 2015–2016, in the Americas, and especially in northeast Brazil, a significant number of cases of microcephaly and other congenital brain abnormalities were linked with an outbreak of Zika virus (ZIKV) infection in pregnant women. While maternal symptoms of ZIKV are generally mild and self-limiting, clinical presentation in fetuses and newborns infected is extensive and includes microcephaly, decreased cortical development, atrophy and hypoplasia of the cerebellum and cerebellar vermis, arthrogryposis, and polyhydramnios. The term congenital ZIKV syndrome (CZS) was introduced to describe the range of findings associated with maternal-fetal ZIKV transmission. ZIKV is primarily transmitted by Aedes aegypti mosquitoes, however non-vector-dependent routes are also possible. Mechanisms of maternal-fetal transmission remain unknown, and the trans-placental route has been extensively studied in animal models and in human samples. The aim of this review was to summarize recent studies that helped to elucidate the mechanism of CZS in animal models and observational studies. There are still challenges in the diagnosis and prevention of CZS in humans, due to the large gap that remains in translating ZIKV research to clinical practice. Translational research linking governments, local health workers, scientists and industry is fundamental to improve care for mothers and children.
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Affiliation(s)
- Brooke Liang
- Department of Obstetrics and Gynecology, Washington University School of Medicine , St. Louis , MO , USA
| | - José Paulo Guida
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas , Campinas , Brazil
| | | | - Indira U Mysorekar
- Department of Obstetrics and Gynecology, Washington University School of Medicine , St. Louis , MO , USA.,Department of Pathology and Immunology, Washington University School of Medicine , St. Louis , MO , USA.,Center for Reproductive Health Sciences, Washington University School of Medicine , St. Louis , MO , USA
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