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Bogovič P, Lotrič-Furlan S, Ogrinc K, Avšič Županc T, Korva M, Kastrin A, Trampuš Bakija A, Strle K, Strle F. Elevated levels of serum muscle enzymes in the initial phase of tick-borne encephalitis. Infect Dis (Lond) 2024; 56:504-509. [PMID: 38564769 DOI: 10.1080/23744235.2024.2335349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE Since some patients with tick-borne encephalitis (TBE) have pronounced myalgias, and since myositis is reported in Flavivirus diseases such as dengue, we performed systematic search for abnormalities of muscle enzymes in a group of patients in whom the presence of tick-borne encephalitis virus (TBEV) RNA in the first phase of the disease was demonstrated and who developed second phase of TBE. METHODS Total leukocyte and platelet blood counts were determined routinely at the initial examination during the first and the second phase of TBE. Activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), myoglobin and troponin was determined from the available stored serum specimens; the first and second phase disease specimens were tested simultaneously. RESULTS Of 24 patients with biphasic course of TBE, 83% had leukopenia, 65% thrombocytopenia, 83% elevated AST and 4% elevated ALT level. Furthermore, 33% had elevated serum CK, 26% myoglobin and 22% troponin activity; at least one of the muscle enzymes was elevated in 42% of patients. Leukopenia, thrombocytopenia, elevated liver enzymes and elevations of CK and myoglobin were present in the initial phase but resolve later, while troponin abnormalities were also found in the second phase of TBE. CONCLUSIONS The present study exposes that in addition to previously known leukopenia, thrombocytopenia and increased liver enzymes activity, the initial phase of TBE is relatively often associated also with elevated muscle enzymes. Clinical relevance of these findings remains to be determined.
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Affiliation(s)
- Petra Bogovič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Stanka Lotrič-Furlan
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katarina Ogrinc
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Andrej Kastrin
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alenka Trampuš Bakija
- Clinical Institute of Special Laboratory Diagnostic, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Klemen Strle
- Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Zidovec-Lepej S, Bodulić K, Bogdanic M, Gorenec L, Savic V, Grgic I, Sabadi D, Santini M, Radmanic Matotek L, Kucinar J, Barbic L, Zmak L, Ferenc T, Stevanovic V, Antolasic L, Milasincic L, Hruskar Z, Vujica Ferenc M, Vilibic-Cavlek T. Proinflammatory Chemokine Levels in Cerebrospinal Fluid of Patients with Neuroinvasive Flavivirus Infections. Microorganisms 2024; 12:657. [PMID: 38674602 PMCID: PMC11052399 DOI: 10.3390/microorganisms12040657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Tick-borne encephalitis virus (TBEV) and West Nile virus (WNV) are the most important neuroinvasive arboviruses detected in Europe. In this study, we analyzed cerebrospinal fluid (CSF) concentrations of 12 proinflammatory chemokines (CCL2, CCL3, CCL4, CCL11, CCL17, CCL20, CXCL1, CXCL5, CXCL8, CXCL9, CXCL10, and CXCL11) in 77 patients with neuroinvasive diseases (NIDs). Flavivirus infection was confirmed in 62 patients (TBEV and WNV in 31 patients each), while in 15 patients the etiology of NID was not determined (NDE). Similar patterns of high-level expression of chemokines regulating monocyte/macrophage responses (CCL2), neutrophil recruitment (CXCL1 and CXCL8), and interferon-inducible chemoattractants for leukocytes (CXCL10 and CXCL11) have been observed in WNV and TBEV groups. None of the tested chemokines significantly differed between patients with TBEV or WNV. Concentrations of CCL17, CCL20, CXCL5, CXCL10, and CXCL11 were significantly lower in both WNV and TBEV groups compared to NID NDE patients. The logistic regression model showed that CSF concentrations of CXCL11, CXCL5, and CXCL10 could potentially be used for the classification of patients into the WNV or TBEV group versus groups with other NIDs. This study identified, for the first time, similar patterns of CSF chemokine expression in WNV and TBEV infections, suggesting common immunopathogenic mechanisms in neuroinvasive flavivirus infections that should be further evaluated.
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Affiliation(s)
- Snjezana Zidovec-Lepej
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, 10000 Zagreb, Croatia; (S.Z.-L.); (L.G.); (I.G.); (L.R.M.)
| | - Kristian Bodulić
- Research Department, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, 10000 Zagreb, Croatia;
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (L.A.); (L.M.); (Z.H.)
| | - Lana Gorenec
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, 10000 Zagreb, Croatia; (S.Z.-L.); (L.G.); (I.G.); (L.R.M.)
| | - Vladimir Savic
- Poultry Center, Croatian Veterinary Institute, 10000 Zagreb, Croatia;
| | - Ivana Grgic
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, 10000 Zagreb, Croatia; (S.Z.-L.); (L.G.); (I.G.); (L.R.M.)
| | - Dario Sabadi
- Department of Infectious Diseases, Clinical Hospital Center Osijek, 31000 Osijek, Croatia;
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marija Santini
- Department for Infections in Immunocompromised Patients, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, 10000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Leona Radmanic Matotek
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr. Fran Mihaljevic”, 10000 Zagreb, Croatia; (S.Z.-L.); (L.G.); (I.G.); (L.R.M.)
| | - Jasmina Kucinar
- Department of Serology and Immunology, Istria County Institute of Public Health, 52100 Pula, Croatia;
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.); (V.S.)
| | - Ljiljana Zmak
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Department of Microbiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Thomas Ferenc
- Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.B.); (V.S.)
| | - Ljiljana Antolasic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (L.A.); (L.M.); (Z.H.)
| | - Ljiljana Milasincic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (L.A.); (L.M.); (Z.H.)
| | - Zeljka Hruskar
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (L.A.); (L.M.); (Z.H.)
| | - Mateja Vujica Ferenc
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (L.A.); (L.M.); (Z.H.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
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Sigdel TK, Sur S, Boada P, McDermott SM, Arlehamn CSL, Murray KO, Bockenstedt LK, Kerwin M, Reed EF, Harris E, Stuart K, Peters B, Sesma A, Montgomery RR, Sarwal MM. Proteome Analysis for Inflammation Related to Acute and Convalescent Infection. Inflammation 2024; 47:346-362. [PMID: 37831367 PMCID: PMC10799112 DOI: 10.1007/s10753-023-01913-3] [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: 07/23/2023] [Revised: 08/30/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023]
Abstract
Infectious diseases are a significant burden in global healthcare. Pathogens engage with different host defense mechanisms. However, it is currently unknown if there are disease-specific immune signatures and/or if different pathogens elicit common immune-associated molecular entities to common therapeutic interventions. We studied patients enrolled through the Human Immunology Project Consortium (HIPC), which focuses on immune responses to various infections. Blood samples were collected and analyzed from patients during infection and follow-up time points at the convalescent stage. The study included samples from patients with Lyme disease (LD), tuberculosis (TB), malaria (MLA), dengue virus (DENV), and West Nile virus (WNV), as well as kidney transplant patients with cytomegalovirus (CMV) and polyomavirus (BKV) infections. Using an antibody-based assay, we quantified ~ 350 cell surface markers, cytokines, and chemokines involved in inflammation and immunity. Unique protein signatures were identified specific to the acute phase of infection irrespective of the pathogen type, with significant changes during convalescence. In addition, tumor necrosis factor receptor superfamily member 6 (TNR6), C-C Motif Chemokine Receptor 7 (CCR7), and C-C motif chemokine ligand-1 (CCL1) were increased in the acute and convalescent phases across all viral, bacterial, and protozoan compared to blood from healthy donors. Furthermore, despite the differences between pathogens, proteins were enriched in common biological pathways such as cell surface receptor signaling pathway and response to external stimulus. In conclusion, we demonstrated that irrespective of the pathogen type, there are common immunoregulatory and proinflammatory signals.
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Affiliation(s)
- Tara K Sigdel
- Division of Multi-Organ Transplantation, Department of Surgery, University of California San Francisco, 513 Parnassus Ave, Med Sciences Bldg, Room S1268, San Francisco, CA, 94143, USA
| | - Swastika Sur
- Division of Multi-Organ Transplantation, Department of Surgery, University of California San Francisco, 513 Parnassus Ave, Med Sciences Bldg, Room S1268, San Francisco, CA, 94143, USA
| | - Patrick Boada
- Division of Multi-Organ Transplantation, Department of Surgery, University of California San Francisco, 513 Parnassus Ave, Med Sciences Bldg, Room S1268, San Francisco, CA, 94143, USA
| | | | - Cecilia S Lindestam Arlehamn
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- La Jolla Institute for Immunology, La Jolla, CA, USA
| | | | | | - Maggie Kerwin
- Division of Multi-Organ Transplantation, Department of Surgery, University of California San Francisco, 513 Parnassus Ave, Med Sciences Bldg, Room S1268, San Francisco, CA, 94143, USA
| | - Elaine F Reed
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Eva Harris
- University of California Berkeley, Berkeley, CA, USA
| | - Ken Stuart
- Seattle Children Research Institute, Seattle, WA, USA
| | - Bjoern Peters
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Ana Sesma
- Mount Sinai School of Medicine, New York, NY, USA
| | | | - Minnie M Sarwal
- Division of Multi-Organ Transplantation, Department of Surgery, University of California San Francisco, 513 Parnassus Ave, Med Sciences Bldg, Room S1268, San Francisco, CA, 94143, USA.
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Mattatia C, Agyeman PKA, Schöbi N, Aebi S, Duppenthaler A, Büttcher M, Aebi C. Seroepidemiology of Human Tularemia-Systematic Review and Meta-analysis of Seroprevalence Studies. Open Forum Infect Dis 2024; 11:ofad636. [PMID: 38312214 PMCID: PMC10837002 DOI: 10.1093/ofid/ofad636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/13/2023] [Indexed: 02/06/2024] Open
Abstract
Background Seroepidemiologic studies of human tularemia have been conducted throughout the northern hemisphere. The purposes of this study were (1) to provide an overview of Francisella tularensis seroprevalence data, and (2) to generate an estimate of the proportion of study participants whose infection remained subclinical. Methods We conducted a systematic review of F tularensis seroprevalence studies according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched PubMed, Embase, and Web of Science covering the period from 1951 to 2023. Results The weighted pooled seroprevalence among 44 486 participants recruited in 52 studies was 3.7% (95% confidence interval [CI], 2.7-5.1). Reported seroprevalences ranged between 0.2% and 31.3%. Occupational activities associated with an increased likelihood of exposure (risk ratio, 3.51 [95% CI, 3.2-3.86]) and studies from North America versus Europe and Asia (4.53 [4.15-4.94]) were associated with significantly increased seropositive rates. Twenty-eight data sets (47%) reported clinical information on a total of 965 seropositive participants. The weighted pooled estimate for subclinical seropositivity was 84.4% (95% CI, 72.9%-991.7%). Studies from F tularensis type A areas (risk ratio, 0.37 [95% CI, .27-.51) and studies from sites where pulmonary tularemia prevailed (0.38 [.28-.51]) reported lower subclinical seropositivity rates than studies from type B areas and from areas of predominance of (ulcero)glandular or oropharyngeal tularemia, respectively. Conclusions Throughout the northern hemisphere, only a small proportion of study participants showed serologic evidence of exposure to F tularensis. Eight of 10 seropositive participants had no historical evidence of past clinical tularemia.
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Affiliation(s)
- Chantal Mattatia
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp K A Agyeman
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nina Schöbi
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Simon Aebi
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland
- Risk and Resilience Team, Center for Security Studies (CSS), Eidgenössische Technische Hochschule (ETH), Zurich, Switzerland
| | - Andrea Duppenthaler
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Büttcher
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Children's Hospital Lucerne, Lucerne Cantonal Hospital, Lucerne, Switzerland
- Faculty of Medicine and Health Sciences, University Lucerne, Lucerne, Switzerland
- Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, Basel, Switzerland
| | - Christoph Aebi
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland
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5
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Ackermann-Gäumann R, Lang P, Zens KD. Defining the "Correlate(s) of Protection" to tick-borne encephalitis vaccination and infection - key points and outstanding questions. Front Immunol 2024; 15:1352720. [PMID: 38318179 PMCID: PMC10840404 DOI: 10.3389/fimmu.2024.1352720] [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] [Received: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
Tick-borne Encephalitis (TBE) is a severe disease of the Central Nervous System (CNS) caused by the tick-borne encephalitis virus (TBEV). The generation of protective immunity after TBEV infection or TBE vaccination relies on the integrated responses of many distinct cell types at distinct physical locations. While long-lasting memory immune responses, in particular, form the basis for the correlates of protection against many diseases, these correlates of protection have not yet been clearly defined for TBE. This review addresses the immune control of TBEV infection and responses to TBE vaccination. Potential correlates of protection and the durability of protection against disease are discussed, along with outstanding questions in the field and possible areas for future research.
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Affiliation(s)
- Rahel Ackermann-Gäumann
- Microbiologie, ADMED Analyses et Diagnostics Médicaux, La Chaux-de-Fonds, Switzerland
- Swiss National Reference Center for Tick-transmitted Diseases, La Chaux-de-Fonds, Switzerland
| | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kyra D. Zens
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Institute for Experimental Immunology, University of Zurich, Zurich, Switzerland
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Banović P, Mijatović D, Bogdan I, Simin V, Meletis E, Kostoulas P, Resman Rus K, Knap N, Korva M, Avšič-Županc T, Cabezas-Cruz A. Evidence of tick-borne encephalitis virus neutralizing antibodies in Serbian individuals exposed to tick bites. Front Microbiol 2023; 14:1314538. [PMID: 38156013 PMCID: PMC10754514 DOI: 10.3389/fmicb.2023.1314538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/14/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Tick-borne encephalitis (TBE) is an emerging vector-borne and food-borne disease caused by the tick-borne encephalitis virus (TBEV; Orthoflavivirus encephalitidis), with a distribution spanning the Eurasian continent. Despite its significant public health impact in various European regions, TBE remains largely underdiagnosed in Serbia due to limited awareness and diagnostic challenges. In response to this, our study aimed to comprehensively assess TBEV exposure in individuals infested with ticks and to identify potential TBEV foci within Serbia. Materials and methods From 2019 to 2021, we conducted an observational study involving 450 patients who reported tick infestations. Results Our demographic analysis revealed a median age of 38 years, with a slight male predominance among the participants. We documented tick infestations in 38 municipalities across 14 districts of Serbia, with a notable concentration in proximity to Fruška Gora Mountain. The ticks most frequently removed were Ixodes ricinus, with nymphs and adult females being the predominant stages. On average, nymphs were removed after about 27.1 hours of feeding, while adult females remained attached for approximately 44.4 hours. Notably, we found age as a significant predictor of infestation time for both nymphs and adult females. Furthermore, we detected TBEV-neutralizing antibodies in 0.66% of the serum samples, shedding light on potential TBEV foci, particularly in Fruška Gora Mountain and other regions of Serbia. Conclusion Our study emphasizes the urgent need for active TBE surveillance programs, especially in areas suspected of hosting TBEV foci, in order to assess the true TBE burden, identify at-risk populations, and implement effective preventive measures.
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Affiliation(s)
- Pavle Banović
- Clinic for Lyme Borreliosis and Other Tick-Borne Diseases, Pasteur Institute Novi Sad, Novi Sad, Serbia
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia
| | - Dragana Mijatović
- Department for Research and Monitoring of Rabies and Other Zoonoses, Pasteur Institute Novi Sad, Novi Sad, Serbia
| | - Ivana Bogdan
- Department of Microbiology, Pasteur Institute Novi Sad, Novi Sad, Serbia
| | - Verica Simin
- Department of Microbiology, Pasteur Institute Novi Sad, Novi Sad, Serbia
| | - Eleftherios Meletis
- Faculty of Public and One Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - Polychronis Kostoulas
- Faculty of Public and One Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alejandro Cabezas-Cruz
- Anses, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
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Illarionova V, Rogova A, Tuchynskaya K, Volok V, Rogova Y, Baryshnikova V, Turchenko Y, Litov A, Kalyanova A, Siniugina A, Ishmukhametov A, Karganova G. Inapparent Tick-Borne Orthoflavivirus Infection in Macaca fascicularis: A Model for Antiviral Drug and Vaccine Research. Vaccines (Basel) 2023; 11:1754. [PMID: 38140159 PMCID: PMC10747564 DOI: 10.3390/vaccines11121754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Tick-borne encephalitis virus (TBEV) and Powassan virus (POWV) are neurotropic tick-borne orthoflaviviruses. They cause mostly asymptomatic infections in hosts, but severe forms with CNS involvement can occur. Studying the early stages of viral infections in humans is challenging, and appropriate animal models are essential for understanding the factors determining the disease severity and for developing emergency prophylaxis and treatment options. In this work, we assessed the model of the early stages of TBEV and POWV mono- and co-infections in Macaca fascicularis. Serological, biochemical, and virological parameters were investigated to describe the infection, including its impact on animal behavior. Viremia, neutralizing antibody dynamics, and viral load in organs were chosen as the main parameters distinguishing early-stage orthoflavivirus infection. Levels of IFNα, monocyte count, and cognitive test scores were proposed as additional informative indicators. An assessment of a tick-borne encephalitis vaccine using this model showed that it provided partial protection against POWV infection in Macaca fascicularis without signs of antibody-dependent enhancement of infection.
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Affiliation(s)
- Victoria Illarionova
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
- Department of Biology, Lomonosov Moscow State University, Leninskie Gory 1 bd. 3, Moscow 119991, Russia
| | - Anastasia Rogova
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
| | - Ksenia Tuchynskaya
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
| | - Viktor Volok
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
- Research Institute for Systems Biology and Medicine (RISBM), Laboratory of Infectious Immunology, Moscow 117246, Russia
| | - Yulia Rogova
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
| | - Victoria Baryshnikova
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biochemistry, Moscow 108819, Russia; (V.B.); (Y.T.)
| | - Yuriy Turchenko
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biochemistry, Moscow 108819, Russia; (V.B.); (Y.T.)
| | - Alexander Litov
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
- Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow 119991, Russia;
| | - Anna Kalyanova
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
| | - Alexandra Siniugina
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Moscow 108819, Russia;
| | - Aydar Ishmukhametov
- Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow 119991, Russia;
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Moscow 108819, Russia;
| | - Galina Karganova
- FSASI “Chumakov FSC R&D IBP RAS” (Institute of Poliomyelitis), Laboratory of Biology of Arbovirus, Moscow 108819, Russia; (V.I.); (A.R.); (K.T.); (V.V.); (Y.R.); (A.L.); (A.K.)
- Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow 119991, Russia;
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8
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Worku DA. Tick-Borne Encephalitis (TBE): From Tick to Pathology. J Clin Med 2023; 12:6859. [PMID: 37959323 PMCID: PMC10650904 DOI: 10.3390/jcm12216859] [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: 09/07/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a viral arthropod infection, endemic to large parts of Europe and Asia, and is characterised by neurological involvement, which can range from mild to severe, and in 33-60% of cases, it leads to a post-encephalitis syndrome and long-term morbidity. While TBE virus, now identified as Orthoflavivirus encephalitidis, was originally isolated in 1937, the pathogenesis of TBE is not fully appreciated with the mode of transmission (blood, tick, alimentary), viral strain, host immune response, and age, likely helping to shape the disease phenotype that we explore in this review. Importantly, the incidence of TBE is increasing, and due to global warming, its epidemiology is evolving, with new foci of transmission reported across Europe and in the UK. As such, a better understanding of the symptomatology, diagnostics, treatment, and prevention of TBE is required to inform healthcare professionals going forward, which this review addresses in detail. To this end, the need for robust national surveillance data and randomised control trial data regarding the use of various antivirals (e.g., Galidesivir and 7-deaza-2'-CMA), monoclonal antibodies, and glucocorticoids is required to improve the management and outcomes of TBE.
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Affiliation(s)
- Dominic Adam Worku
- Infectious Diseases, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, UK;
- Public Health Wales, 2 Capital Quarter, Cardiff CF10 4BZ, UK
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9
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Neumann B, Hierl A, Wunderlich S, Meier H, Bauer C, Gerner ST, Rieder G, Geis T, Kunkel J, Bauswein M, Niller HH, Schmidt B, Rubbenstroth D, Beer M, Linker RA, Jantsch J, Angstwurm K. Cerebrospinal fluid in Borna disease virus 1 (BoDV-1) encephalitis. J Neurol Sci 2023; 446:120568. [PMID: 36716549 DOI: 10.1016/j.jns.2023.120568] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/22/2023] [Indexed: 01/26/2023]
Abstract
Borna disease virus 1 (BoDV-1) has been recognized as a rare cause of very severe encephalitis with rapid onset in central Europe. Data on cerebrospinal fluid (CSF) analysis have not yet been analyzed in detail. Here, we present the first study on CSF changes in BoDV-1 encephalitis. We retrospectively analyzed CSFs from 18 BoDV-1 encephalitis cases from Bavaria, Germany, an endemic region, from 1996 to 2021. Data were obtained through review of medical records and institutional databases. We found that white blood cell count (WBC) in CSF is elevated in 13 of our 18 patients at first examination (average 83.2 ± 142.3 leukocytes/μl) and cytology showed predominance of lymphocytes. Patients with typical symptoms of meningoencephalitis had higher WBC in first CSF analyzation (133.5 ± 163.1 vs 4.0 ± 3.2/μl; p = 0.065). BoDV-1 PCR of CSF is not always positive when tested (7 of 9 cases). Four of five patients tested showed a polyvalent reaction against multiple viruses in the CSF suggesting that BoDV-1 may trigger autoimmune mechanisms. CSF changes in BoDV-1 encephalitis seem similar to those of other viral encephalitis and at the beginning WBC can be normal in up to 28%, making the diagnosis even more challenging. All in all, BoDV-1 should be included in the diagnostic workup of patients with rapidly evolving and/or severe encephalitis and patients with severe neuropathy and secondary encephalopathy with and without CSF changes. Repeated CSF examinations as well as BoDV-1 serology and CSF PCR have to be considered in endemic areas.
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Affiliation(s)
- Bernhard Neumann
- Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Regensburg, Germany; Department of Neurology, Donau-Isar-Klinikum Deggendorf, Deggendorf, Germany
| | - Andreas Hierl
- Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Regensburg, Germany
| | - Silke Wunderlich
- Department of Neurology, Klinikum rechts der Isar der TU Muenchen, Muenchen, Germany
| | - Helen Meier
- Department of Neurology, Paracelsus Medizinische Privatuniversitaet, Klinikum Nürnberg, Nürnberg, Germany
| | - Christina Bauer
- Department of Neurology, Paracelsus Medizinische Privatuniversitaet, Klinikum Nürnberg, Nürnberg, Germany
| | - Stefan T Gerner
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Georg Rieder
- Department of Neurology, Klinikum Traunstein, Traunstein, Germany
| | - Tobias Geis
- University Children's Hospital Regensburg (KUNO-Clinics) at St Hedwig Hospital, Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Jürgen Kunkel
- University Children's Hospital of Regensburg (KUNO), Regensburg, Germany
| | - Markus Bauswein
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany
| | - Hans Helmut Niller
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany
| | - Barbara Schmidt
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany
| | - Dennis Rubbenstroth
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | - Martin Beer
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | - Ralf A Linker
- Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Regensburg, Germany
| | - Jonathan Jantsch
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany; Institute for Medical Microbiology, Immunology, and Hygiene, University Hospital Cologne, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany
| | - Klemens Angstwurm
- Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Regensburg, Germany.
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10
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Activation of Early Proinflammatory Responses by TBEV NS1 Varies between the Strains of Various Subtypes. Int J Mol Sci 2023; 24:ijms24021011. [PMID: 36674524 PMCID: PMC9863113 DOI: 10.3390/ijms24021011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Tick-borne encephalitis (TBE) is an emerging zoonosis that may cause long-term neurological sequelae or even death. Thus, there is a growing interest in understanding the factors of TBE pathogenesis. Viral genetic determinants may greatly affect the severity and consequences of TBE. In this study, nonstructural protein 1 (NS1) of the tick-borne encephalitis virus (TBEV) was tested as such a determinant. NS1s of three strains with similar neuroinvasiveness belonging to the European, Siberian and Far-Eastern subtypes of TBEV were studied. Transfection of mouse cells with plasmids encoding NS1 of the three TBEV subtypes led to different levels of NS1 protein accumulation in and secretion from the cells. NS1s of TBEV were able to trigger cytokine production either in isolated mouse splenocytes or in mice after delivery of NS1 encoding plasmids. The profile and dynamics of TNF-α, IL-6, IL-10 and IFN-γ differed between the strains. These results demonstrated the involvement of TBEV NS1 in triggering an immune response and indicated the diversity of NS1 as one of the genetic factors of TBEV pathogenicity.
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11
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Bauer A, Rudzki D, Berek K, Dinoto A, Lechner C, Wendel EM, Hegen H, Deisenhammer F, Berger T, Höftberger R, Rostasy K, Mariotto S, Reindl M. Increased peripheral inflammatory responses in myelin oligodendrocyte glycoprotein associated disease and aquaporin-4 antibody positive neuromyelitis optica spectrum disorder. Front Immunol 2022; 13:1037812. [PMID: 36451827 PMCID: PMC9703059 DOI: 10.3389/fimmu.2022.1037812] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/27/2022] [Indexed: 09/30/2023] Open
Abstract
Autoantibody-associated demyelinating diseases of the central nervous system such as myelin oligodendrocyte glycoprotein-antibody associated disease (MOGAD) and aquaporin 4-antibody positive neuromyelitis optica spectrum disorders (AQP4+ NMOSD) are rare diseases but can cause severe disability. In both diseases, associated neuroinflammation is accompanied by blood and cerebrospinal fluid cytokine and chemokine signatures, which were shown to be distinct from those observed in patients with multiple sclerosis (MS). In this study, we aimed to confirm and extend these findings by analyzing a larger number of serum cytokines, chemokines and related molecules in patients with MOGAD or AQP4+ NMOSD in comparison to MS, to better understand the pathophysiology and to identify biomarkers potentially useful in clinical practice for diagnostic and treatment purposes. A total of 65 serum cytokines, chemokines and related molecules like growth factors and soluble receptors were measured by Procartaplex multiplex immunoassays in 40 MOGAD, 40 AQP4+ NMOSD and 54 MS patients at baseline. Furthermore, follow-up samples of 25 AQP4+ NMOSD and 40 MOGAD patients were measured after 6-12 months. Selected analytes were validated in a subgroup of samples using other bead-based assays and ELISA. At baseline, 36 analytes in MOGAD and 30 in AQP4+ NMOSD were significantly increased compared to MS. K-means cluster analysis of all significantly altered molecules revealed three distinct groups: Cluster I, including 12 MOGAD, 2 AQP4+ NMOSD and 3 MS patients, had a specific association with 11 IL-6/IL-17A associated cytokines. In this cluster, 9/17 (53%) patients were children. Cluster II with 13 MOGAD, 24 AQP4+ NMOSD and 1 MS patient was associated with 31 upregulated analytes. Cluster III contained 15 MOGAD, 14 AQP4+ NMOSD and 50 MS patients. In cluster II and III the majority were adults (82% and 92%). Most measured analytes remained stable over time. Validation of selected cytokines and chemokines using other analytical methods revealed moderate to high correlation coefficients, but absolute values differed between assays. In conclusion, these results obtained by bead-based multiplex assays highlight a significant association of biomarkers of peripheral inflammation in patients with antibody-associated demyelinating diseases in comparison with MS.
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Affiliation(s)
- Angelika Bauer
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Dagmar Rudzki
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Klaus Berek
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alessandro Dinoto
- Neurology Unit, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Christian Lechner
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Eva-Maria Wendel
- Department of Neuropediatrics, Olgahospital/Klinikum Stuttgart, Stuttgart, Germany
| | - Harald Hegen
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Deisenhammer
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Romana Höftberger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Kevin Rostasy
- Paediatric Neurology, Witten/Herdecke University, Children’s Hospital Datteln, Datteln, Germany
| | - Sara Mariotto
- Neurology Unit, Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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12
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Zidovec-Lepej S, Vilibic-Cavlek T, Ilic M, Gorenec L, Grgic I, Bogdanic M, Radmanic L, Ferenc T, Sabadi D, Savic V, Hruskar Z, Svitek L, Stevanovic V, Peric L, Lisnjic D, Lakoseljac D, Roncevic D, Barbic L. Quantification of Antiviral Cytokines in Serum, Cerebrospinal Fluid and Urine of Patients with Tick-Borne Encephalitis in Croatia. Vaccines (Basel) 2022; 10:1825. [PMID: 36366333 PMCID: PMC9698853 DOI: 10.3390/vaccines10111825] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Tick-borne encephalitis virus (TBEV) is one of the most significant arboviruses affecting the human central nervous system (CNS) in Europe. Data on cytokine response in TBEV infection are limited. METHODS We analyzed the cytokine response in serum, cerebrospinal fluid (CSF) and urine samples of patients with TBE. The control group consisted of patients with 'febrile headache' who had normal CSF cytology. The panel included 12 cytokines: TNF-α, IL-6, Th1 (IL-2, IFN-γ), Th2 (IL-4, IL-5, IL-13), Th9 (IL-9), Th17 (IL-17A, IL-17F), Th22 (IL-22) cytokines and IL-10. RESULTS TBE patients were more likely to have increased levels of IL-6 and IFN-γ in CSF compared to controls (85.7% vs. 58.8% and 85.7% vs. 47.1%, respectively). However, concentrations of IL-6 (the most abundant cytokine in the CSF of both groups), IL-10 and IL-9 were lower in TBEV patients compared with controls, but the difference was statistically significant for IL-9 only (p = 0.001). By analyzing the cytokine levels in different clinical samples, all measured cytokines were detected in the serum, with the highest concentrations found for IFN-γ, TNF-α, IL-10, IL-17F and IL-22. Higher concentrations of cytokines in the CSF compared with serum were observed for IL-5, IL-6 and IL-22. All cytokines except IL-13 were detectable in urine but in a small proportion of patients, except for IL-22, which was detectable in 95.8% of patients. CONCLUSIONS Cytokine composition in different clinical samples of TBE patients reveals a different network of early innate immune response cytokines, Th1, Th2, Th9, Th22, Th17 and anti-inflammatory cytokines.
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Affiliation(s)
- Snjezana Zidovec-Lepej
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr Fran Mihaljevic”, 10000 Zagreb, Croatia
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health,10000 Zagreb, Croatia
- Department of Microbiology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Maja Ilic
- Department of Epidemiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Lana Gorenec
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr Fran Mihaljevic”, 10000 Zagreb, Croatia
| | - Ivana Grgic
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr Fran Mihaljevic”, 10000 Zagreb, Croatia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health,10000 Zagreb, Croatia
| | - Leona Radmanic
- Department of Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases “Dr Fran Mihaljevic”, 10000 Zagreb, Croatia
| | - Thomas Ferenc
- Clinical Department of Diagnostic and Interventional Radiology, Merkur University Hospital, 10000 Zagreb, Croatia
| | - Dario Sabadi
- Clinic for Infectious Diseases, Clinical Hospital Center Osijek, 31000 Osijek, Croatia
- Medical Faculty, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vladimir Savic
- Laboratory for Virology and Serology, Poultry Center, Croatian Veterinary Institute, 10000 Zagreb, Croatia
| | - Zeljka Hruskar
- Department of Virology, Croatian Institute of Public Health,10000 Zagreb, Croatia
| | - Luka Svitek
- Clinic for Infectious Diseases, Clinical Hospital Center Osijek, 31000 Osijek, Croatia
- Medical Faculty, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ljiljana Peric
- Medical Faculty, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Dubravka Lisnjic
- Clinic for Infectious Diseases, Clinical Hospital Center Osijek, 31000 Osijek, Croatia
- Medical Faculty, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Danijela Lakoseljac
- Primorje-Gorski Kotar County Teaching Institute of Public Health, 51000 Rijeka, Croatia
| | - Dobrica Roncevic
- Primorje-Gorski Kotar County Teaching Institute of Public Health, 51000 Rijeka, Croatia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
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13
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Grygorczuk S, Dunaj-Małyszko J, Czupryna P, Sulik A, Toczyłowski K, Siemieniako-Werszko A, Żebrowska A, Pancewicz S, Moniuszko-Malinowska A. The Detectability of the Viral RNA in Blood and Cerebrospinal Fluid of Patients with Tick-Borne Encephalitis. Int J Mol Sci 2022; 23:ijms23169332. [PMID: 36012596 PMCID: PMC9408829 DOI: 10.3390/ijms23169332] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The detection rate of viral RNA in tick-borne encephalitis (TBE) is low and variable between studies, and its diagnostic/prognostic potential is not well defined. We attempted to detect RNA of TBE virus (TBEV) in body fluids of TBE patients. Methods: We studied 98 adults and 12 children with TBEV infection, stratified by the disease phase and presentation. EDTA blood and cerebrospinal fluid (CSF) samples were obtained upon hospital admission. RNA was extracted from freshly obtained plasma, concentrated leukocyte-enriched CSF, and whole blood samples, and real time PCR was performed with a Rotor-Gene Q thermocycler. Results: TBEV RNA was detected in (1) plasma of one (of the two studied) adult patients with an abortive infection, (2) plasma of two (of the two studied) adults in the peripheral phase of TBE, and (3) plasma and blood of an adult in the neurologic phase of TBE presenting as meningoencephalomyelitis. No CSF samples were TBEV RNA-positive. Conclusions: The detection of TBEV RNA in blood might be diagnostic in the peripheral phase of TBE. The lack of TBEV RNA in the CSF cellular fraction speaks against TBEV influx into the central nervous system with infiltrating leukocytes and is consistent with a relatively low intrathecal viral burden.
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Affiliation(s)
- Sambor Grygorczuk
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
| | - Justyna Dunaj-Małyszko
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
| | - Piotr Czupryna
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
- Correspondence:
| | - Artur Sulik
- Department of the Pediatric Infectious Diseases of the Medical University in Białystok, Ul. Jerzego Waszyngtona 17, 15-274 Białystok, Poland
| | - Kacper Toczyłowski
- Department of the Pediatric Infectious Diseases of the Medical University in Białystok, Ul. Jerzego Waszyngtona 17, 15-274 Białystok, Poland
| | | | - Agnieszka Żebrowska
- Regional Centre of Transfusion Medicine in Białystok, Ul. Marii Skłodowskiej-Curie 23, 15-950 Białystok, Poland
| | - Sławomir Pancewicz
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of the Infectious Diseases and Neuroinfections, Medical University in Białystok, Ul. Żurawia 14, 15-540 Białystok, Poland
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