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Wachira VK, Farinasso CM, Silva RB, Peixoto HM, de Oliveira MRF. Incidence of Guillain-Barré syndrome in the world between 1985 and 2020: A systematic review. GLOBAL EPIDEMIOLOGY 2023; 5:100098. [PMID: 37638372 PMCID: PMC10445966 DOI: 10.1016/j.gloepi.2023.100098] [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: 08/08/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
Introduction Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy that affects the peripheral nervous system. The study aimed to describe the incidence of GBS in the world up to the year 2020. Methods A systematic review was conducted. Searches were done in four databases, PUBMED, EMBASE, EBSCO and Biblioteca virtual em Saude (BVS), and in grey literature and manual search in the reference lists of eligible studies. Results A total of 72 studies were included. The incidence of GBS among the cohort studies varied from 0.30 to 6.08 cases per 100.000 habitants and 0.42 to 6.58 cases per 100.000 person-years. Among the self-controlled studies, the risk incidence ranged from 0.072 to 1 case per 100.000 habitants and 1.73 to 4.30 cases per 100.000 person-years. Conclusions The reported incidence of GBS in the world among the studies included in the review is slightly higher than that reported in previous studies. The highest incidence rates were associated with public health events of international concern.
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Affiliation(s)
- Virginia Kagure Wachira
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
| | | | | | - Henry Maia Peixoto
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
| | - Maria Regina Fernandes de Oliveira
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
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Medina A, Rusnak R, Richardson R, Zimmerman MG, Suthar M, Schoof N, Kovacs-Balint Z, Mavigner M, Sanchez M, Chahroudi A, Raper J. Treatment with sofosbuvir attenuates the adverse neurodevelopmental consequences of Zika virus infection in infant rhesus macaques. J Neuroimmunol 2023; 381:578148. [PMID: 37451078 PMCID: PMC10528946 DOI: 10.1016/j.jneuroim.2023.578148] [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: 04/22/2023] [Revised: 06/25/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Zika virus (ZIKV) infection during infancy in a rhesus macaque (RM) model negatively impacts brain development resulting in long-term behavioral alterations. The current study investigated whether postexposure prophylaxis could alleviate these negative neurodevelopmental consequences. Three RM infants received a 14-day course of sofosbuvir (SOF; 15 mg/kg p.o.) treatment starting at 3 days post-infection with a Puerto Rican strain of ZIKV (PRVABC59) and were then monitored longitudinally for one year. In contrast to ZIKV-infected infant RMs who did not receive SOF, postexposure SOF treatment mitigated the neurodevelopmental, behavioral and cognitive changes seen after postnatal ZIKV infection even while not accelerating viral clearance from the blood. These data suggest that antiviral treatment may help ameliorate some, but not all, of the neurodevelopmental abnormalities associated with early postnatal ZIKV infection.
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Affiliation(s)
- Alejandra Medina
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Rebecca Rusnak
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Rebecca Richardson
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Matthew G Zimmerman
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Mehul Suthar
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nils Schoof
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Zsofia Kovacs-Balint
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Maud Mavigner
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mar Sanchez
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ann Chahroudi
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Jessica Raper
- Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.
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Lai ZZ, Shen HH, Lee YM. Inhibitory effect of β-escin on Zika virus infection through the interruption of viral binding, replication, and stability. Sci Rep 2023; 13:10014. [PMID: 37340032 DOI: 10.1038/s41598-023-36871-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/12/2023] [Indexed: 06/22/2023] Open
Abstract
β-Escin is a mixture of triterpenoid saponins extracted from horse chestnut seeds that have diverse pharmacological activities, including anti-inflammation, anti-edematous, venotonic, and antiviral effects. In the clinical setting, β-escin is primarily used to treat venous insufficiency and blunt trauma injuries. The anti-Zika virus (ZIKV) activity of β-escin has not been explored. This study investigated the antiviral efficacy of β-escin on ZIKV and dengue virus (DENV) in vitro and then elucidated the underlying mechanism. The inhibitory effects of β-escin on viral RNA synthesis, protein levels, and infection ability were determined using qRT-PCR, Western blotting, and immunofluorescence assays, respectively. To further characterize how β-escin interferes with the viral life cycle, the time-of-addition experiment was performed. An inactivation assay was performed to determine whether β-escin affects ZIKV virion stability. To broaden these findings, the antiviral effects of β-escin on different DENV serotypes were assessed using dose-inhibition and time-of-addition assays. The results showed that β-escin exhibits anti-ZIKV activity by decreasing viral RNA levels, protein expression, progeny yield, and virion stability. β-Escin inhibited ZIKV infection by disrupting viral binding and replication. Furthermore, β-escin demonstrated antiviral activities against four DENV serotypes in a Vero cell model and prophylactic protection against ZIKV and DENV infections.
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Affiliation(s)
- Zheng-Zong Lai
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, 114, Taiwan
- Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, 114, Taiwan
- Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan
| | - Hsin-Hsuen Shen
- Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, 114, Taiwan
| | - Yen-Mei Lee
- Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, 114, Taiwan.
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Matos LMD, Borges AT, Palmeira AB, Lima VM, Maciel EP, Fernandez RNM, Mendes JPL, Romero GAS. Frequency of exposure to arboviruses and characterization of Guillain Barré syndrome in a clinical cohort of patients treated at a tertiary referral center in Brasília, Federal District. Rev Soc Bras Med Trop 2022; 55:e03062021. [PMID: 35416870 PMCID: PMC9009888 DOI: 10.1590/0037-8682-0306-2021] [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: 06/10/2021] [Accepted: 01/26/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Guillian Barré syndrome (GBS) is an acute autoimmune polyradiculoneuropathy
often associated with previous exposure to infectious agents. Methods: A clinical cohort of 41 patients with GBS admitted to the Base Hospital
Institute of the Federal District between May 2017 and April 2019 was
followed up for 1 year. Serological tests for arbovirus detection and
amplification of nucleic acids using polymerase chain reaction for zika
virus (ZIKV), dengue virus (DENV), and chikungunya virus (CHIKV) were
performed. Results: The cohort consisted of 61% men with a median age of 40 years, and 83% had
GBS-triggering events. A total of 54% had Grade 4 disability, 17% had Grade
3, 12% had Grade 2, 10% had Grade 5, and 7% had Grade 1. The classic form
occurred in 83% of patients. Nerve conduction evaluations revealed acute
demyelinating inflammatory polyneuropathy (51%), acute motor axonal
neuropathy (17%), acute sensory-motor neuropathy (15%), and indeterminate
forms (17%). Four patients were seropositive for DENV. There was no
laboratory detection of ZIKV or CHIKV infection. Ninety percent of patients
received human immunoglobulin. Intensive care unit admission occurred in
17.1% of the patients, and mechanical ventilation was used in 14.6%. One
patient died of Bickerstaff’s encephalitis. Most patients showed an
improvement in disability at 10 weeks of follow-up. Conclusions: GBS in the Federal District showed a variable clinical spectrum, and it was
possible to detect recent exposure to DENV.
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Affiliation(s)
- Luíza Morais de Matos
- Universidade de Brasília, Faculdade de Medicina, Núcleo de Medicina Tropical, Brasília, DF, Brasil.,Instituto Hospital de Base do Distrito Federal, Unidade de Infectologia, Brasília, DF, Brasil
| | - Ariely Teotonio Borges
- Instituto Hospital de Base do Distrito Federal, Unidade de Neurologia, Brasília, DF, Brasil
| | - Aline Barbosa Palmeira
- Instituto Hospital de Base do Distrito Federal, Unidade de Neurologia, Brasília, DF, Brasil
| | - Vinicius Moreira Lima
- Instituto Hospital de Base do Distrito Federal, Unidade de Neurologia, Brasília, DF, Brasil
| | - Ernane Pires Maciel
- Instituto Hospital de Base do Distrito Federal, Unidade de Neurologia, Brasília, DF, Brasil
| | | | - João Pedro Lima Mendes
- Universidade de Brasília, Faculdade de Medicina, Núcleo de Medicina Tropical, Brasília, DF, Brasil
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Vidal ERN, Frutuoso LCV, Duarte EC, Peixoto HM. Epidemiological burden of Chikungunya fever in Brazil, 2016 and 2017. Trop Med Int Health 2021; 27:174-184. [PMID: 34905272 DOI: 10.1111/tmi.13711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To describe Chikungunya fever (CHIKF) cases and estimate the burden of the disease in Brazil between 2016 and 2017. METHODS The first stage of this study consisted of a descriptive epidemiological study with estimations of incidence, mortality and case-fatality rates for each Brazilian state. The second stage provided estimates of the disease burden using DALY, an indicator that aggregates measures of morbidity (years lived with disability - YLD) and mortality (years of life lost - YLL) into a single value. RESULTS In Brazil, the incidence rate in 2016 was 114.70 per 100,000 inhabitants, while the mortality rate was 0.15 per 100,000, for a case-fatality rate of 0.13%. In 2017, these figures were 87.59 and 0.12 per 100,000 inhabitants and 0.14%, respectively. The estimated CHIKF burden for Brazil in 2016 was 77,422.61 DALY or 0.3757 per 1000 inhabitants. In 2016, the YLL share of DALY was 10.04%, with YLD accounting for the remaining 89.96%. In 2017, the estimated burden was 59,307.59 DALY or 0.2856 per 1000 inhabitants, with YLL accounting for 9.65% of the total and YLD for 90.35%. CONCLUSION CHIKF causes a significant disease burden in Brazil. The chronic phase of CHIKF is responsible for the largest portion of DALY. Deaths from CHIKF are a significant component of the disease burden, with YLL accounting for approximately 10% of the total DALY value.
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Affiliation(s)
- Emily Raquel Nunes Vidal
- Center of Tropical Medicine, Faculty of Medicine, Universidade de Brasília, Brasília, Brazil.,Federal District Health Secretariat, Brasília, Brazil
| | - Livia Carla Vinhal Frutuoso
- Center of Tropical Medicine, Faculty of Medicine, Universidade de Brasília, Brasília, Brazil.,Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, Brasil
| | - Elisabeth Carmen Duarte
- Center of Tropical Medicine, Faculty of Medicine, Universidade de Brasília, Brasília, Brazil
| | - Henry Maia Peixoto
- Center of Tropical Medicine, Faculty of Medicine, Universidade de Brasília, Brasília, Brazil.,National Institute of Science and Technology for Health Technology Assessment, Porto Alegre, Brazil
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Florian IA, Lupan I, Sur L, Samasca G, Timiș TL. To be, or not to be… Guillain-Barré Syndrome. Autoimmun Rev 2021; 20:102983. [PMID: 34718164 DOI: 10.1016/j.autrev.2021.102983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023]
Abstract
Guillain-Barré Syndrome (GBS) is currently the most frequent cause of acute flaccid paralysis on a global scale, being an autoimmune disorder wherein demyelination of the peripheral nerves occurs. Its main clinical features are a symmetrical ascending muscle weakness with reduced osteotendinous reflexes and variable sensory involvement. GBS most commonly occurs after an infection, especially viral (including COVID-19), but may also transpire after immunization with certain vaccines or in the development of specific malignancies. Immunoglobulins, plasmapheresis, and glucocorticoids represent the principal treatment modalities, however patients with severe disease progression may require supportive therapy in an intensive care unit. Due to its symptomology, which overlaps with numerous neurological and infectious illnesses, the diagnosis of GBS may often be misattributed to pathologies that are essentially different from this syndrome. Moreover, many of these require specific treatment methods distinct to those recommended for GBS, in lack of which the prognosis of the patient is drastically affected. Such diseases include exposure to toxins either environmental or foodborne, central nervous system infections, metabolic or serum ion alterations, demyelinating pathologies, or even conditions amenable to neurosurgical intervention. This extensive narrative review aims to systematically and comprehensively tackle the most notable and challenging differential diagnoses of GBS, emphasizing on the clinical discrepancies between the diseases, the appropriate paraclinical investigations, and suitable management indications.
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Affiliation(s)
- Ioan Alexandru Florian
- Department of Neurology, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania, Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Iulia Lupan
- Department of Molecular Biology, Babes Bolyai University, Cluj-Napoca, Romania.
| | - Lucia Sur
- Department of Pediatrics I, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Gabriel Samasca
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Teodora Larisa Timiș
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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