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Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Erythema Infectiosum: A Narrative Review. Curr Pediatr Rev 2024; 20:462-471. [PMID: 37132144 DOI: 10.2174/1573396320666230428104619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Erythema infectiosum occurs worldwide. School-aged children are most often affected. Since the diagnosis is mainly clinical, physicians should be well-versed in the clinical manifestations of erythema infectiosum to avoid misdiagnosis, unnecessary investigations, and mismanagement of the disease. OBJECTIVES The purpose of this article is to familiarize physicians with the wide spectrum of clinical manifestations and complications of erythema infectiosum associated with parvovirus B19 infection. METHODS A search was conducted in July 2022 in PubMed Clinical Queries using the key terms "Erythema infectiosum" OR "Fifth disease" OR "Slapped cheek disease" OR "Parvovirus B19". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. RESULTS Erythema infectiosum is a common exanthematous illness of childhood caused by parvovirus B19. Parvovirus B19 spreads mainly by respiratory tract secretions and, to a lesser extent, the saliva of infected individuals. Children between 4 and 10 years of age are most often affected. The incubation period is usually 4 to 14 days. Prodromal symptoms are usually mild and consist of lowgrade fever, headache, malaise, and myalgia. The rash typically evolves in 3 stages. The initial stage is an erythematous rash on the cheeks, with a characteristic "slapped cheek" appearance. In the second stage, the rash spreads concurrently or quickly to the trunk, extremities, and buttocks as diffuse macular erythema. The rash tends to be more intense on extensor surfaces. The palms and soles are typically spared. Central clearing of the rash results in a characteristic lacy or reticulated appearance. The rash usually resolves spontaneously within three weeks without sequelae. The third stage is characterized by evanescence and recrudescence. In adults, the rash is less pronounced than that in children and is often atypical. Only approximately 20% of affected adults have an erythematous rash on the face. In adults, the rash is more frequently found on the legs, followed by the trunk, and arms. A reticulated or lacy erythema is noted in 80% of cases which helps to distinguish erythema infectiosum from other exanthems. Pruritus is noted in approximately 50% of cases. The diagnosis is mainly clinical. The many manifestations of parvovirus B19 infection can pose a diagnostic challenge even to the best diagnostician. Complications include arthritis, arthralgia, and transient aplastic crisis. In most cases, treatment is symptomatic and supportive. When parvovirus B19 infection occurs in pregnant women, hydrops fetalis becomes a real concern. CONCLUSION Erythema infectiosum, the most common clinical manifestation of parvovirus B19 infection, is characterized by a "slapped cheek" appearance on the face and lacy exanthem on the trunk and extremities. Parvovirus B19 infection is associated with a wide spectrum of clinical manifestations. Physicians should be aware of potential complications and conditions associated with parvovirus B19 infection, especially in individuals who are immunocompromised, chronically anemic, or pregnant.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benjamin Barankin
- Department of Dermatology, Toronto Dermatology Centre, Toronto, Ontario, Canada
| | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
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Jacquot R, Gerfaud-Valentin M, Mekki Y, Billaud G, Jamilloux Y, Sève P. [Parvovirus B19 infections in adults]. Rev Med Interne 2022; 43:713-726. [PMID: 36088203 DOI: 10.1016/j.revmed.2022.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 08/21/2022] [Indexed: 12/11/2022]
Abstract
Acute Parvovirus B19 (PVB19) infection is responsible for erythema infectiosum in children and non-specific polyarthralgias in immunocompetent adults associated with skin lesions and rarer manifestations (hepatic, neurological, cardiac or nephrological). In immunocompromised patients, cytopenias are more frequent and in some cases, viremia persists and is responsible for PVB19 chronic infection. PVB19 is responsible for pure red cell aplasia during chronic hemolytic diseases. Acute PVB19 infection is a differential diagnosis of some autoimmune diseases and has been suspected to be a trigger for some autoimmune diseases because of its ability to promote the emergence of autoimmune markers. Mechanisms of molecular mimicry, induction of apoptosis and activation of enzymes have been demonstrated, explaining in part the production of autoantibodies during infection. However, the demonstration of a causal relationship in the triggering of autoimmune disease remains to be done. This review provides a synthesis of the PVB19 infection clinical data in adults with a particular focus on these links with autoimmunity.
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Affiliation(s)
- R Jacquot
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France.
| | - M Gerfaud-Valentin
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France
| | - Y Mekki
- Université de Lyon, Lyon, France
| | | | - Y Jamilloux
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France
| | - P Sève
- Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, Lyon, France; Université Claude-Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), Inserm U1290, Lyon, France; Laboratoire de virologie, hospices civils de Lyon, centre de biologie et de pathologie, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 04, France
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Khan U, Uzair Ahmad R, Ullah Z, Fida T, Shehryar M. Parvovirus b19-Induced Acute Hepatitis With Hepatosplenomegaly and Polyarthropathy. Cureus 2022; 14:e21494. [PMID: 35223271 PMCID: PMC8860716 DOI: 10.7759/cureus.21494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 11/29/2022] Open
Abstract
Parvovirus B19 infection can present with myriads of clinical diseases and syndromes; hepatitis and polyarthropathy are a few of these examples. Parvovirus frequently affects children but this condition has also been reported in adults. The present case report discusses a case of a 43-year-old female who presented to the outpatient department (OPD) with complaints of high-grade fever and pain in multiple joints of her body for three days. On examination, stiffness and swelling of the hand, knees, wrist, and ankles were noted. Laboratory investigations showed highly elevated aspartate transaminase (AST), alanine transaminase (ALT), and bilirubin. Electrocardiogram (ECG) and echocardiogram (ECHO) findings were unremarkable. PCR testing showed the presence of parvovirus. Parvovirus B19 infection led to the development of acute hepatitis, which appeared as yellowing of skin (jaundice) and led to hepatosplenomegaly. Parvovirus-induced polyarthropathy was also observed in the patient. The patient was managed with a parenteral course of ceftriaxone, paracetamol, and a normal saline infusion. Anti-viral drugs were also prescribed to the patient including ribavirin and pegylated interferon. This case study will explore how the patient was diagnosed and managed with conventional therapy and anti-viral to relieve parvovirus-induced hepatitis with hepatosplenomegaly and polyarthritis. Acute hepatitis can be caused by viruses and other noninfectious causes, all of which must be cleared out to avoid chronic disease development. When patients present with joint pain and skin rashes, a thorough workup for viral indicators, medication histories, autoimmune and metabolic illnesses, and parvovirus b19 infection is required.
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Hung KC, Huang ZY, Yow JL, Hsu TC, Tzang BS. Effect of N‑terminal region of human parvovirus B19‑VP1 unique region on cardiac injury in naïve mice. Mol Med Rep 2021; 24:759. [PMID: 34476499 PMCID: PMC8436207 DOI: 10.3892/mmr.2021.12399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/28/2021] [Indexed: 11/20/2022] Open
Abstract
A unique region of human parvovirus B19 virus-VP1 (B19V–VP1u) has been linked to a variety of cardiac disorders. However, the precise role of B19V–VP1u in inducing cardiac injury remains unknown. The present study investigated the effects of B19V–VP1u and different regions of B19V–VP1u, including B19V–VP1uA (residues 1–60), B19V–VP1uB (residues 61–129), B19V–VP1uC (residues 130–195) and B19V–VP1uD (residues 196–227), on inducing cardiac injury in naïve mice by zymography, immunoblotting, H&E staining and cytokine immunoassay. A significantly higher MMP-9/MMP-2 ratio and increased levels of inflammatory cytokines, including IL-6 and IL-1β, were detected in the left ventricles of the mice injected with B19V-non-structural protein 1 (B19V-NS1) and B19V–VP1u, accompanied by increased expression levels of phosphorylated (p-)ERK and p-P38. Significantly upregulated expression levels of atrial natriuretic peptide (ANP), heart-type fatty acid-binding protein (H-FABP) and creatine kinase isoenzyme-MB (CK-MB), which are well-known cardiac injury markers, as well as increased infiltration of lymphocytes, were detected in the left ventricles of the mice injected with B19V–VP1, B19V-NS1 and B19V–VP1u. Moreover, a significantly higher MMP-9/MMP-2 ratio and increased levels of IL-6 and IL-1β were observed in the left ventricles of the mice injected with B19V–VP1u, B19V–VP1u-A, B19V–VP1u-B and B19V–VP1u-C, accompanied by upregulated p-ERK and p-P38 expression. Notably, significantly lower levels of IL-6 and IL-1β were observed in the left ventricles of the mice injected with B19V–VP1uD. Furthermore, significantly increased ANP, H-FABP and CK-MB expression levels were detected in the left ventricles of the mice injected with B19V–VP1u, B19V–VP1u-A and B19V–VP1u-B, along with enhanced infiltration of lymphocytes. Significantly higher serum IL-1β, IL-6, TNF-α and IFN-γ levels were also detected in the mice injected with B19V–VP1u, B19V–VP1u-A and B19V–VP1u-B. To the best of our knowledge, the findings of the present study were the first to demonstrate that the N-terminal region (residues 1–129) of B19V–VP1u induces an increase in the levels of cardiac injury markers, thus providing evidence for understanding the possible functional regions within B19V–VP1u.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan 710, Taiwan
| | - Zi-Yun Huang
- Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Jia Le Yow
- Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Tsai-Ching Hsu
- Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Bor-Show Tzang
- Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
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Alves AD, Melgaço JG, Cássia Nc Garcia RD, Raposo JV, de Paula VS, Araújo CC, Pinto MA, Amado LA. Persistence of Parvovirus B19 in liver from transplanted patients with acute liver failure. Future Microbiol 2021; 15:307-317. [PMID: 32286103 DOI: 10.2217/fmb-2019-0224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: In this study, we investigated the presence of B19V in liver tissues from patients with acute liver failure (ALF) and evaluated the viral activity in infected liver. Methods: Serum and liver samples from 30 patients who underwent liver transplantation for ALF were investigated for B19V infection by real-time PCR, serological tests and examination of B19V mRNA (transcript) expression in the liver. Results: The serum and liver samples from seven patients were B19V DNA positive (103-105 copies/ml). Most of them presented detectable anti-B19V IgG, indicating persistent infection. B19V mRNA was detected in all patients, demonstrating intra-hepatic replication. Conclusion: B19V infection of the liver during the course of non-A-E ALF suggested a role of B19V, which produced the worst outcome in co-infected patients and in patients with cryptogenic ALF, in liver damage.
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Affiliation(s)
- Arthur Dr Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Juliana G Melgaço
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Rita de Cássia Nc Garcia
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Jessica V Raposo
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Vanessa S de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Marcelo A Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Luciane A Amado
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Elbadry MI, Khaled SAA, Ahmed NM, Abudeif A, Abdelkareem RM, Ezeldin M, Tawfeek A. Acute human parvovirus B19 infection triggers immune-mediated transient bone marrow failure syndrome, extreme direct hyperbilirubinaemia and acute hepatitis in patients with hereditary haemolytic anaemias: multicentre prospective pathophysiological study. Br J Haematol 2021; 193:827-840. [PMID: 33899219 DOI: 10.1111/bjh.17484] [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] [Received: 12/28/2020] [Accepted: 03/02/2021] [Indexed: 12/23/2022]
Abstract
A total of 244 patients with hereditary haemolytic anaemias (HHA) were screened for acute symptomatic human parvovirus B19 infection (HPV-B19) in a prospective study. To assess the risks associated with HPV-B19 infection, patients were classified into Group I and Group II according to presence or absence (symptoms, signs and specific serology) of acute HPV-B19 infection respectively. In all, 131 (53·7%) patients had β-thalassaemia, 75 (30·7%) hereditary spherocytosis (HS), 27 (11·1%) sickle cell anaemia (SCA) and 11 (4·5%) glucose-6-phosphate dehydrogenase (G6PD) deficiency. Of 33 (13·5%) patients who presented with symptomatic HPV-B19 infection, 19 (57·5%) had HS, nine (27·3%) had β-thalassaemia and five (15·2%) had SCA. In Group I, there were significant differences in the mean white blood cell, red blood cell and platelet counts, haemoglobin concentration, total bilirubin (TB), alanine aminotransferase, aspartate aminotransferase and serum creatinine (all P < 0·001) compared to Group II. In all, 27 (81·8%) patients had arthropathy and bone marrow failure (BMF); 13 (39·4%) had acute kidney injury (AKI), more in SCA (80%); and 12 (36·4%) patients had hepatitis, more in HS (66·8%). Five (15·2%) patients with HS had BMF, AKI, nervous system involvement and extreme hyperbilirubinaemia (TB range 26·3-84·7 mg/dl). Five (15·2%) patients had haemophagocytic syndrome. Two patients with HS combined with Type-I autoimmune hepatitis presented with transient BMF. Complete recovery or stabilisation was noted at 12 months in every patient except for one patient with SCA who died during the infection. HPV-B19 must be suspected and screened in patients with HHA with typical and atypical presentations with careful follow-up.
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Affiliation(s)
- Mahmoud I Elbadry
- Department of Internal Medicine, Division of Haematology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Safaa A A Khaled
- Department of Internal Medicine-Clinical Haematology Unit, Faculty of Medicine, Assiut University Hospital/Unit of Bone Marrow Transplantation, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Nesma M Ahmed
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ahmed Abudeif
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Rasha M Abdelkareem
- Department of Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Ezeldin
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ahmed Tawfeek
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt
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Izquierdo-Blasco J, Salcedo Allende MT, Codina Grau MG, Gran F, Martínez Sáez E, Balcells J. Parvovirus B19 Myocarditis: Looking Beyond the Heart. Pediatr Dev Pathol 2020; 23:158-162. [PMID: 31335286 DOI: 10.1177/1093526619865641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Human parvovirus B19 represents the most common etiology of myocarditis in the pediatric population. Although it usually causes a benign exanthematic viral infection, parvovirus B19 may also present as disseminated disease with tropism for the myocardium, causing heart failure with high mortality. We present the case of a 2-year-old patient with fulminating acute myocarditis in whom the histological, immunophenotypic, and microbiological findings in necropsy showed multiorgan involvement caused by parvovirus B19. The autopsy revealed changes due to infection with parvovirus B19 as well as hypoxic-ischemic and secondary autoimmune changes. Medullary aplasia was observed, transmural lymphocyte myocarditis, lymphocytosis in the dermis with endothelial cells positive for parvovirus B19 in immunohistochemistry, cholestatic hepatitis due to ischemia and autoimmune hepatitis, lymphadenitis, and signs of hemophagocytosis. We also found hypoxic-ischemic encephalopathy.
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Affiliation(s)
- Jaume Izquierdo-Blasco
- Pediatric Critical Care Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Teresa Salcedo Allende
- Department of Pathology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Gemma Codina Grau
- Department of Microbiology, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ferran Gran
- Department of Pediatric Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Martínez Sáez
- Department of Pathology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Balcells
- Pediatric Critical Care Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Sharma S, Lal SB, Sachdeva M, Bhatia A, Varma N. Role of Granulocyte Colony Stimulating Factor on the Short-Term Outcome of Children with Acute on Chronic Liver Failure. J Clin Exp Hepatol 2020; 10:201-210. [PMID: 32405176 PMCID: PMC7212291 DOI: 10.1016/j.jceh.2019.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Acute-on-chronic liver failure (ACLF) results in very high mortality in children. We aimed to evaluate the role of granulocyte colony-stimulating factor (GCSF) on short-term outcome of children with ACLF in a nontransplant unit. METHODS Children (aged > 1 year) diagnosed with ACLF over a 15 month period were randomised. Group A was given GCSF therapy along with standard medical care (SMC - details in supplementary data) and group B was given only SMC. The outcome was evaluated as survival at 30 and 60 days of therapy. RESULT Thirty-one children with ACLF were enrolled, with a mean age of 6.92 ± 4.3yrs. A total of 15 patients were randomised to group A and 16 to group B. The overall mortality was 54.83%. The intervention group showed survival rates of 80%, 66.67% and 53.3%, whereas the control group had survival rates of 43.75%, 37.5% and 37.5% at 14, 30 and 60 days, respectively. A significant survival benefit was noted on day 14 (p = 0.043) of therapy in group A with significant difference in Child-Turcotte-Pugh (CTP) and pediatric end-stage liver disease (PELD) scores in the two groups. After an initial rise in group A, the granulocyte counts fell to become comparable in the two groups by day 30 and 60, indicating that the effect of GCSF therapy wears off over time. There was no significant difference in the overall survival, median/mean CTP, PELD and MCS (Modified Cliff sequential organ failure assesment (SOFA)) scores on day 30 and 60. Mean (%) CD 34 + cells level showed a rise on day 7 in group A but was statistically insignificant. CONCLUSION The present study shows that GCSF therapy at 5 mcg/kg/day for 5 days seems to be ineffective in improving the survival outcome on day 30 and 60 of therapy. Studies with larger number of children enrolled and longer duration of therapy are required. (CTRI/2017/11/010420).
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Affiliation(s)
- Shruti Sharma
- Division of Paediatric Gastroenterology, Hepatology & Nutrition, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Sadhna B. Lal
- Division of Paediatric Gastroenterology, Hepatology & Nutrition, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India,Address for correspondence: Sadhna B Lal,Professor & Head, Division Of Paediatric Gastroenterology, Hepatology & Nutrition, Post Graduate Institute Of Medical Education & Research, Sector 12, Chandigarh, 160012, India.
| | - Manupdesh Sachdeva
- Department of Hematology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Anmol Bhatia
- Division of Paediatric Radiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Neelam Varma
- Department of Hematology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
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Kishore J, Kishore D. Clinical impact & pathogenic mechanisms of human parvovirus B19: A multiorgan disease inflictor incognito. Indian J Med Res 2019; 148:373-384. [PMID: 30666000 PMCID: PMC6362725 DOI: 10.4103/ijmr.ijmr_533_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Human parvovirus B19 (B19V) causes myriads of clinical diseases; however, owing to lack of awareness and undetermined clinical impact, it has failed to become a virus pathogen of global concern. Cryptically, B19V causes significant morbidity and mortality. Half of the world population and 60 per cent of Indians are known to be serologically naive and are at risk of acquiring B19V infections. Cumulatively, our data showed 21.3 per cent B19V-infected patients with juvenile chronic arthropathy, recurrent abortions, multi-transfused thalassaemia and leukaemia. In addition, B19V-infected cases that ended fatally included patients with pure red cell aplasia, fulminant hepatitis and haemophagocytic syndrome. Novel clinical associations of B19V observed were amegakaryocytic thrombocytopaenia, myositis and non-occlusive ischaemic gangrene of bowel. B19V possesses multiple receptors which are distributed widely in human tissues. Vascular endothelial cell infection by B19V causes endothelialitis and vasculitic injuries besides antibody-dependent enhancement which empowered B19V to cause multiorgan diseases. Owing to lack of suitable animal model for B19V, true causal role remains to be determined, but numerous reports on B19V infections substantiate a causal role in multiorgan diseases. Hence, B19V infections need to be recognized, investigated and treated besides making efforts on vaccine developments.
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Affiliation(s)
- Janak Kishore
- Division of Virology, Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Divya Kishore
- Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
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Tomlinson JE, Van de Walle GR, Divers TJ. What Do We Know About Hepatitis Viruses in Horses? Vet Clin North Am Equine Pract 2019; 35:351-362. [PMID: 31084975 DOI: 10.1016/j.cveq.2019.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Theiler disease (serum hepatitis or idiopathic acute hepatic necrosis) has long been suspected to have a viral etiology. Four viruses have been described in association with hepatitis in horses. Further investigation suggests equine pegivirus and Theiler disease-associated virus (a second pegivirus) are neither hepatotropic nor pathogenic. Nonprimate hepacivirus (NPHV) causes subclinical disease in experimental models and has been associated with hepatitis in some clinical cases. Equine parvovirus-hepatitis (EqPV-H) experimentally causes subclinical-to-clinical liver disease and is found in the vast majority of Theiler disease cases. EqPV-H is likely of clinical significance, whereas the significance of NPHV is unknown.
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Affiliation(s)
- Joy E Tomlinson
- Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, 235 Hungerford Hill Road, Ithaca, NY 14853, USA.
| | - Gerlinde R Van de Walle
- Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, 235 Hungerford Hill Road, Ithaca, NY 14853, USA
| | - Thomas J Divers
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Box25, Ithaca, NY 14853, USA
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Alves ADR, Cubel Garcia RDCN, Cruz OG, Pinto MA, Amado Leon LA. Quantitative real-time PCR for differential diagnostics of parvovirus B19 infection in acute liver failure patients. Expert Rev Mol Diagn 2019; 19:259-266. [DOI: 10.1080/14737159.2019.1582333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Arthur Daniel Rocha Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Luciane Almeida Amado Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Divers TJ, Tennant BC, Kumar A, McDonough S, Cullen J, Bhuva N, Jain K, Chauhan LS, Scheel TKH, Lipkin WI, Laverack M, Trivedi S, Srinivasa S, Beard L, Rice CM, Burbelo PD, Renshaw RW, Dubovi E, Kapoor A. New Parvovirus Associated with Serum Hepatitis in Horses after Inoculation of Common Biological Product. Emerg Infect Dis 2019; 24:303-310. [PMID: 29350162 PMCID: PMC5782890 DOI: 10.3201/eid2402.171031] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Equine serum hepatitis (i.e., Theiler's disease) is a serious and often life-threatening disease of unknown etiology that affects horses. A horse in Nebraska, USA, with serum hepatitis died 65 days after treatment with equine-origin tetanus antitoxin. We identified an unknown parvovirus in serum and liver of the dead horse and in the administered antitoxin. The equine parvovirus-hepatitis (EqPV-H) shares <50% protein identity with its phylogenetic relatives of the genus Copiparvovirus. Next, we experimentally infected 2 horses using a tetanus antitoxin contaminated with EqPV-H. Viremia developed, the horses seroconverted, and acute hepatitis developed that was confirmed by clinical, biochemical, and histopathologic testing. We also determined that EqPV-H is an endemic infection because, in a cohort of 100 clinically normal adult horses, 13 were viremic and 15 were seropositive. We identified a new virus associated with equine serum hepatitis and confirmed its pathogenicity and transmissibility through contaminated biological products.
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Abstract
B19V has been proposed as an etiologic agent for hepatitis, mainly in children, but this is a rare clinical occurrence. In this article, we report a case of non-A-E acute liver failure in an immunocompetent child with B19 infection. The clinical findings of severe anemia and pancytopenia combined with the detection of anti-B19 Immunoglobulin G (IgG), B19 DNA and B19 mRNA in liver indicate a persistent infection and suggest a diagnosis of parvovirus B19-associated acute liver failure.
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15
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Elmasry S, Wadhwa S, Bang BR, Cook L, Chopra S, Kanel G, Kim B, Harper T, Feng Z, Jerome KR, Kahn JA, Saito T. Detection of Occult Hepatitis C Virus Infection in Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents for Recurrent Infection After Liver Transplantation. Gastroenterology 2017; 152:550-553.e8. [PMID: 27838287 PMCID: PMC5285320 DOI: 10.1053/j.gastro.2016.11.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 12/16/2022]
Abstract
Occult infection with hepatitis C virus (HCV) is defined as the presence of the HCV genome in either liver tissue or peripheral blood monocytes, despite constant negative results from tests for HCV RNA in serum. We investigated whether patients who maintained a sustained virologic response 12 weeks after therapy (SVR12) with direct-acting antiviral (DAA) agents for recurrent HCV infection after liver transplantation had occult HCV infections. We performed a prospective study of 134 patients with recurrent HCV infection after liver transplantation who were treated with DAAs, with or without ribavirin, from 2014 through 2016 (129 patients achieved an SVR12). In >10% of the patients who achieved SVR12 (n = 14), serum levels of aminotransferases did not normalize during or after DAA therapy, or they normalized transiently but then increased sharply after DAA therapy. Of these 14 patients, 9 were assessed for occult HCV infection by reverse transcription quantitative polymerase chain reaction. This analysis revealed that 55% of these patients (n = 5) had an occult infection, with the detection of negative strand viral genome, indicating viral replication. These findings indicate the presence of occult HCV infection in some patients with abnormal levels of serum aminotransferases, despite SVR12 to DAAs for HCV infection after liver transplantation.
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Affiliation(s)
- Sandra Elmasry
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sanya Wadhwa
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Bo-Ram Bang
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Linda Cook
- Department of Laboratory Medicine, School of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Shefali Chopra
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Gary Kanel
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Brian Kim
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Tammy Harper
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Zongdi Feng
- Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Keith R Jerome
- Department of Laboratory Medicine, School of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jeffrey A Kahn
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California.
| | - Takeshi Saito
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California; Molecular Microbiology and Immunology, University of Southern California, Research Center for Liver Diseases, Los Angeles, California.
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16
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Abstract
Parvovirus B19 (B19V) and human bocavirus 1 (HBoV1), members of the large Parvoviridae family, are human pathogens responsible for a variety of diseases. For B19V in particular, host features determine disease manifestations. These viruses are prevalent worldwide and are culturable in vitro, and serological and molecular assays are available but require careful interpretation of results. Additional human parvoviruses, including HBoV2 to -4, human parvovirus 4 (PARV4), and human bufavirus (BuV) are also reviewed. The full spectrum of parvovirus disease in humans has yet to be established. Candidate recombinant B19V vaccines have been developed but may not be commercially feasible. We review relevant features of the molecular and cellular biology of these viruses, and the human immune response that they elicit, which have allowed a deep understanding of pathophysiology.
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Affiliation(s)
- Jianming Qiu
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Neal S Young
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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17
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Leon LAA, Marchevsky RS, Gaspar AMC, Garcia RDCNC, Almeida AJD, Pelajo-Machado M, Castro TXD, Nascimento JPD, Brown KE, Pinto MA. Cynomolgus monkeys (Macaca fascicularis) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure. Mem Inst Oswaldo Cruz 2016; 111:258-66. [PMID: 27074255 PMCID: PMC4830115 DOI: 10.1590/0074-02760160013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/11/2016] [Indexed: 12/19/2022] Open
Abstract
This study was conducted to analyse the course and the outcome of the liver disease
in the co-infected animals in order to evaluate a possible synergic effect of human
parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus
monkeys were inoculated with serum obtained from a fatal case of B19V infection
and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV
and B19V, liver enzyme levels, viraemia, haematological changes, and
necroinflammatory liver lesions were used for monitoring the infections.
Seroconversion was confirmed in all infected groups. A similar pattern of B19V
infection to human disease was observed, which was characterised by high and
persistent viraemia in association with reticulocytopenia and mild to moderate
anaemia during the period of investigation (59 days). Additionally, the intranuclear
inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus
and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte
counts were more evident in the co-infected group. The present results demonstrated,
for the first time, the susceptibility of cynomolgus to B19V infection, but it did
not show a worsening of liver histopathology in the co-infected group.
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Affiliation(s)
- Luciane Almeida Amado Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Ana Maria Coimbra Gaspar
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Adilson José de Almeida
- Hospital Universitário Gaffrée e Guinle, Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Marcelo Pelajo-Machado
- Laboratório de Patologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Tatiana Xavier de Castro
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Jussara Pereira do Nascimento
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Kevin E Brown
- Virus Reference Department, Health Protection Agency, London, UK
| | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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18
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Hsu TC, Chiu CC, Chang SC, Chan HC, Shi YF, Chen TY, Tzang BS. Human parvovirus B19 VP1u Protein as inflammatory mediators induces liver injury in naïve mice. Virulence 2015; 7:110-8. [PMID: 26632342 DOI: 10.1080/21505594.2015.1122165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Human parvovirus B19 (B19V) is a human pathogen known to be associated with many non-erythroid diseases, including hepatitis. Although B19V VP1-unique region (B19-VP1u) has crucial roles in the pathogenesis of B19V infection, the influence of B19-VP1u proteins on hepatic injury is still obscure. This study investigated the effect and possible inflammatory signaling of B19-VP1u in livers from BALB/c mice that were subcutaneously inoculated with VP1u-expressing COS-7 cells. The in vivo effects of B19-VP1u were analyzed by using live animal imaging system (IVIS), Haematoxylin-Eosin staining, gel zymography, and immunoblotting after inoculation. Markedly hepatocyte disarray and lymphocyte infiltration, enhanced matrix metalloproteinase (MMP)-9 activity and increased phosphorylation of p38, ERK, IKK-α, IκB and NF-κB (p-p65) proteins were observed in livers from BALB/c mice receiving COS-7 cells expressing B19-VP1u as well as the significantly increased CRP, IL-1β and IL-6. Notably, IFN-γ and phosphorylated STAT1, but not STAT3, were also significantly increased in the livers of BALB/c mice that were subcutaneously inoculated with VP1u-expressing COS-7 cells. These findings revealed the effects of B19-VP1u on liver injury and suggested that B19-VP1u may have a role as mediators of inflammation in B19V infection.
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Affiliation(s)
- Tsai-Ching Hsu
- a Institute of Biochemistry; Microbiology and Immunology; Chung Shan Medical University ; Taichung , Taiwan.,b Clinical Laboratory; Chung Shan Medical University Hospital ; Taichung , Taiwan
| | - Chun-Ching Chiu
- a Institute of Biochemistry; Microbiology and Immunology; Chung Shan Medical University ; Taichung , Taiwan.,c Department of Neurology and Department of Medical Intensive Care Unit ; Changhua Christian Hospital ; Changhua , Taiwan
| | - Shun-Chih Chang
- a Institute of Biochemistry; Microbiology and Immunology; Chung Shan Medical University ; Taichung , Taiwan
| | - Hsu-Chin Chan
- d Department of Biochemistry ; School of Medicine; China Medical University ; Taichung , Taiwan
| | - Ya-Fang Shi
- a Institute of Biochemistry; Microbiology and Immunology; Chung Shan Medical University ; Taichung , Taiwan
| | - Tzy-Yen Chen
- e Department of Internal Medicine ; Chung Shan Medical University Hospital and School of Medicine; Chung Shan Medical University ; Taichung , Taiwan
| | - Bor-Show Tzang
- a Institute of Biochemistry; Microbiology and Immunology; Chung Shan Medical University ; Taichung , Taiwan.,b Clinical Laboratory; Chung Shan Medical University Hospital ; Taichung , Taiwan.,f Department of Biochemistry ; School of Medicine; Chung Shan Medical University ; Taichung , Taiwan
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19
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Acute hepatitis and myositis associated with Erythema infectiosum by Parvovirus B19 in an adolescent. BMC Pediatr 2014; 14:6. [PMID: 24410941 PMCID: PMC3937157 DOI: 10.1186/1471-2431-14-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 12/14/2013] [Indexed: 12/19/2022] Open
Abstract
Background Erythema infectiosum is the most common clinical manifestation of Parvovirus B19 infection although it has also been associated with rheumatologic diseases and various types of systemic vasculitides. Acute hepatitis and benign myositis however are rarely reported in association with Parvovirus B19 infection. Case presentation Here we report a 14-year old male, who developed acute hepatitis and benign myositis associated with erythema infectiosum following Parvovirus B19 infection. Conclusion Parvovirus B19 infection has rarely been associated with acute hepatitis and exceptionally rarely with benign myositis. Parvovirus B19 should be considered in the differential diagnosis of acute non-A to E hepatitis and in the case of acute benign myositis presenting with a rash especially in children.
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Parvovirus b19 associated hepatitis. HEPATITIS RESEARCH AND TREATMENT 2013; 2013:472027. [PMID: 24232179 PMCID: PMC3819764 DOI: 10.1155/2013/472027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/10/2013] [Accepted: 09/04/2013] [Indexed: 12/21/2022]
Abstract
Parvovirus B19 infection can present with myriads of clinical diseases and syndromes; liver manifestations and hepatitis are examples of them. Parvovirus B19 hepatitis associated aplastic anemia and its coinfection with other hepatotropic viruses are relatively underrecognized, and there is sufficient evidence in the literature suggesting that B19 infections can cause a spectrum of liver diseases from elevation of transaminases to acute hepatitis to fulminant liver failure and even chronic hepatitis. It can also cause fatal macrophage activation syndrome and fibrosing cholestatic hepatitis. Parvovirus B19 is an erythrovirus that can only be replicate in pronormoblasts and hepatocytes, and other cells which have globosides and glycosphingolipids in their membrane can also be affected by direct virus injury due to nonstructural protein 1 persistence and indirectly by immune mediated injury. The virus infection is suspected in bone marrow aspiration in cases with sudden drop of hemoglobin and onset of transient aplastic anemia in immunosuppressed or immunocompetent patients and is confirmed either by IgM and IgG positive serology, PCR analysis, and in situ hybridization in biopsy specimens or by application of both. There is no specific treatment for parvovirus B19 related liver diseases, but triple therapy regimen may be effective consisting of immunoglobulin, dehydrohydrocortisone, and cyclosporine.
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The perils of pathogen discovery: origin of a novel parvovirus-like hybrid genome traced to nucleic acid extraction spin columns. J Virol 2013; 87:11966-77. [PMID: 24027301 DOI: 10.1128/jvi.02323-13] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Next-generation sequencing was used for discovery and de novo assembly of a novel, highly divergent DNA virus at the interface between the Parvoviridae and Circoviridae. The virus, provisionally named parvovirus-like hybrid virus (PHV), is nearly identical by sequence to another DNA virus, NIH-CQV, previously detected in Chinese patients with seronegative (non-A-E) hepatitis. Although we initially detected PHV in a wide range of clinical samples, with all strains sharing ∼99% nucleotide and amino acid identity with each other and with NIH-CQV, the exact origin of the virus was eventually traced to contaminated silica-binding spin columns used for nucleic acid extraction. Definitive confirmation of the origin of PHV, and presumably NIH-CQV, was obtained by in-depth analyses of water eluted through contaminated spin columns. Analysis of environmental metagenome libraries detected PHV sequences in coastal marine waters of North America, suggesting that a potential association between PHV and diatoms (algae) that generate the silica matrix used in the spin columns may have resulted in inadvertent viral contamination during manufacture. The confirmation of PHV/NIH-CQV as laboratory reagent contaminants and not bona fide infectious agents of humans underscores the rigorous approach needed to establish the validity of new viral genomes discovered by next-generation sequencing.
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Prieto de Paula JM, Sanmamed Salgado N, Castro López H, Franco Hidalgo S. [Liver involvement and Parvovirus B19 infection in healthy adults]. GASTROENTEROLOGIA Y HEPATOLOGIA 2013; 36:440-441. [PMID: 23597570 DOI: 10.1016/j.gastrohep.2013.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 01/15/2013] [Indexed: 06/02/2023]
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23
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Tsai CC, Chiu CC, Hsu JD, Hsu HS, Tzang BS, Hsu TC. Human parvovirus B19 NS1 protein aggravates liver injury in NZB/W F1 mice. PLoS One 2013; 8:e59724. [PMID: 23555760 PMCID: PMC3605340 DOI: 10.1371/journal.pone.0059724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 02/21/2013] [Indexed: 01/28/2023] Open
Abstract
Human parvovirus B19 (B19) has been associated with a variety of diseases. However, the influence of B19 viral proteins on hepatic injury in SLE is still obscure. To elucidate the effects of B19 viral proteins on livers in SLE, recombinant B19 NS1, VP1u or VP2 proteins were injected subcutaneously into NZB/W F1 mice, respectively. Significant expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) were detected in NZB/W F1 mice receiving B19 NS1 as compared to those mice receiving PBS. Markedly hepatocyte disarray and lymphocyte infiltration were observed in livers from NZB/WF 1 mice receiving B19 NS1 as compared to those mice receiving PBS. Additionally, significant increases of Tumor Necrosis Factor -α (TNF-α), TNF-α receptor, IκB kinase -α (IKK-α), nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor (IκB) and nuclear factor-kappa B (NF-κB) were detected in livers from NZB/W F1 mice receiving B19 NS1 as compared to those mice receiving PBS. Accordingly, significant increases of matrix metalloproteinase-9 (MMP9) and U-plasminogen activator (uPA) were also detected in livers from NZB/W F1 mice receiving B19 NS1 as compared to those mice receiving PBS. Contrarily, no significant variation on livers from NZB/W F1 mice receiving B19 VP1u or VP2 was observed as compared to those mice receiving PBS. These findings firstly demonstrated the aggravated effects of B19 NS1 but not VP1u or VP2 protein on hepatic injury and provide a clue in understanding the role of B19 NS1 on hepatic injury in SLE.
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Affiliation(s)
- Chun-Chou Tsai
- Institute of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Ching Chiu
- Institute of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
- Department of Neurology and Department of Medical Intensive Care Unit, Chunghua Christian Hospital, Chunghua, Taiwan
| | - Jeng-Dong Hsu
- Department of Pathology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Pathology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Huai-Sheng Hsu
- Institute of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Bor-Show Tzang
- Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Biochemistry and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
- Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (BST); (TCH)
| | - Tsai-Ching Hsu
- Institute of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
- Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (BST); (TCH)
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Acute fulminant hepatic failure associated with parvovirus B19 infection in an immunocompetent adult. Dig Dis Sci 2012; 57:2811-3. [PMID: 22395961 DOI: 10.1007/s10620-012-2110-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 02/22/2012] [Indexed: 12/09/2022]
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25
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Martínez González J, Senosiain Lalastra C, Mesonero Gismero F, Moreira Vicente V. [An exceptional cause of acute hepatitis in an adult: parvovirus B19]. GASTROENTEROLOGIA Y HEPATOLOGIA 2012; 35:697-9. [PMID: 22749503 DOI: 10.1016/j.gastrohep.2012.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/18/2012] [Accepted: 04/22/2012] [Indexed: 11/25/2022]
Abstract
There are multiple causes of hepatitis. The most frequent etiologies are viral, usually hepatitis A, B and C viruses. However, other, non-hepatotropic viruses can cause this disease, including parvovirus B19. We present a case of acute hepatitis due to parvovirus B19, as well as a review of the epidemiological, clinical, diagnostic and therapeutic features of this entity.
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