1
|
Kon FC, Scheimberg I, Haini M, Cohen MC. Cardiovascular-related death in infancy and childhood: a clinicopathological study of two referral institutions in England. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00630-5. [PMID: 37233944 DOI: 10.1007/s12024-023-00630-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/27/2023]
Abstract
To review post-mortem findings among deaths presenting as sudden and/or unexpected deaths in two centers in the UK during a 16-year period in order to identify those related to cardiovascular conditions. The post-mortem databases of two tertiary referral institutions were searched, and all reports were reviewed. Histological features and results of ancillary investigations were noted. All cases of sudden and/or unexpected cardiac deaths (SCD) between 2003 and 2018 were identified. The study was PRISMA compliant and approved by clinical governance. 68/1129 cases of SCD (6.0%) were identified in one center and 83/753 cases (11%) in the other. These 151 cases constituted the study cohort. The mean annual incidence of SCD was 0.3 per 100,000 persons/annum. The three most prevalent groups of cardiac pathology were cardiac malformations (51/151; 33.8%), cardiomyopathies (32/151; 21.2%), and myocarditis (31/151; 20.5%). Mean age at death was 3.4 years. Prematurity was predominantly associated with deaths related to cardiac malformations (p < 0.001). Symptoms had been present for a mean of 3.8, 3.0, and 3.5 days before death for myocarditis, cardiomyopathy, and cardiac malformations/complications post-surgery. This retrospective comparative study represents the largest autopsy series of SCD in infants and children in the UK. Some entities are very infrequent. Several diseases could have been identified earlier in life allowing for the possibility of intervention. Limitation includes the retrospective nature of the study and that, as arrhythmogenic gene mutations are not yet routinely performed in unexplained deaths, the incidence of SCD in infants and children is most likely underestimated.
Collapse
Affiliation(s)
- Fu Chuen Kon
- Department of Pathology, Sheffield Children's Hospital NHS F.T., University of Sheffield, Western Bank, Sheffield, UK
| | - Irene Scheimberg
- Department of Pathology, Royal London Hospital, Barts Health NHS T., Tower Hamlets, London, UK
| | - Mohammad Haini
- Department of Pathology, Royal London Hospital, Barts Health NHS T., Tower Hamlets, London, UK
| | - Marta C Cohen
- Department of Pathology, Sheffield Children's Hospital NHS F.T., University of Sheffield, Western Bank, Sheffield, UK.
- Department of Oncology and Metabolism, University of Sheffield, Western Bank, Sheffield, UK.
| |
Collapse
|
2
|
Kuo LP, Tsai MT, Wang YC, Hsu CH, Lin WH, Wang WM, Shih CJ, Yang PN, Hu YN, Roan JN. Influence of confirmed viral infection on adult acute fulminant myocarditis supported with extracorporeal membrane oxygenation. Artif Organs 2023; 47:396-407. [PMID: 36269688 DOI: 10.1111/aor.14427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 07/14/2022] [Accepted: 10/13/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The impact of etiologies of acute fulminant myocarditis (AFM), which requires extracorporeal membrane oxygenation (ECMO), on clinical outcomes remains unknown. This study aimed to investigate the risk factors for ECMO weaning and mortality among patients with AFM due to viral etiologies in a tertiary referral medical center. METHODS We included 33 adults with AFM who received ECMO and were admitted between January 2002 and January 2021. General demographics, laboratory data, echocardiography findings, and long-term outcomes were analyzed for confirmed viral etiology and unconfirmed etiology groups. RESULTS The overall hospital survival rate was 54.5%. The age, sex, severity of the hemodynamic condition, and cardiac rhythm were similar between the two groups. Multivariate Cox regression analysis revealed that a confirmed viral etiology (HR 4.201, 95% CI 1.061-16.666), peri-ECMO renal replacement therapy (RRT) (HR 9.804, 1.140-83.333) and a high positive end-expiratory pressure (PEEP) in the ventilator settings at 24 h after ECMO (HR 1.479, 1.020-2.143) were significant prognostic factors for in-hospital mortality. Peri-ECMO RRT was also a significant negative prognostic factor for successful ECMO weaning (OR 0.061, 0.006-0.600) in the multivariate logistic model. CONCLUSIONS Among AFM patients receiving ECMO support, RRT use was associated with a decreased chance of survival to ECMO weaning. Multiple organ dysfunction and a high PEEP were also predictive of a lower chance of hospital survival. Those with a confirmed diagnosis of viral myocarditis may require more medical attention due to the higher risk of hospital mortality than those without a definite diagnosis.
Collapse
Affiliation(s)
- Lan-Pin Kuo
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Ta Tsai
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chen Wang
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsin Hsu
- Division of Cardiology, Department of Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Hung Lin
- Division of General Medicine, Department of Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ming Wang
- Department of Statistics and Institute of Data Science, College of Management, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Jung Shih
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Ni Yang
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ning Hu
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jun-Neng Roan
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Medical Device Innovation Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
3
|
Neagu O, Rodríguez AF, Callon D, Andréoletti L, Cohen MC. Myocarditis Presenting as Sudden Death in Infants and Children: A Single Centre Analysis by ESGFOR Study Group. Pediatr Dev Pathol 2021; 24:327-336. [PMID: 33872111 DOI: 10.1177/10935266211007262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acute myocarditis is an inflammatory disease of the heart mostly diagnosed in young people, which can present as sudden death. The etiology includes infectious agents (mostly viruses), systemic diseases and toxins. We aim to characterize infants and children with myocarditis at post-mortem presenting as sudden deaths. METHODS Retrospective evaluation of 813 post-mortems in infants and children dying suddenly and unexpectedly between 2009-2019. Data retrieved included histological features, microbiology and clinical history. RESULTS 23 of 813 post-mortems reviewed corresponded to acute myocarditis and 1 to dilated cardiomyopathy related to remote Parvovirus infection. PCR identified enterovirus (7), parvovirus (7 cases, 2 also with HHV6 and 1 case with EVB), Influenza A (1), Parainfluenza type 3 (1). Two cases corresponded to hypersensitivity myocarditis, 1 was Group A Streptococcus and 5 idiopathic myocarditis. Enterovirus was frequent in infants (7/10), and in newborns was associated with meningoencephalitis or congenital myocarditis. More than 50% were less than 2 years of age and all remained clinically unsuspected. CONCLUSION Myocarditis represents almost 3% of all sudden pediatric deaths. Enterovirus and parvovirus were the most common viruses. This retrospective analysis showed that patients experienced viral symptoms but remained unsuspected, highlighting the need for more clinical awareness of myocarditis.
Collapse
Affiliation(s)
- Oana Neagu
- Histopathology Department, Sheffield Children's NHS FT, Sheffield, UK
| | - Amparo Fernández Rodríguez
- Forensic Microbiology Laboratory, Instituto Nacional de Toxicología y Ciencias Forenses, Madrid, Spain.,Joint Working Group of the European Society of Clinical Microbiology and Infectious Diseases Study Group of Forensic and Postmortem Microbiology and the European Society of Pathology, Basel, Switzerland
| | - Domitille Callon
- Joint Working Group of the European Society of Clinical Microbiology and Infectious Diseases Study Group of Forensic and Postmortem Microbiology and the European Society of Pathology, Basel, Switzerland.,Clinical and Molecular Virology Unit, Centre Hospitalier Universitaire, Reims, France
| | - Laurent Andréoletti
- Joint Working Group of the European Society of Clinical Microbiology and Infectious Diseases Study Group of Forensic and Postmortem Microbiology and the European Society of Pathology, Basel, Switzerland.,Clinical and Molecular Virology Unit, Centre Hospitalier Universitaire, Reims, France
| | - Marta C Cohen
- Histopathology Department, Sheffield Children's NHS FT, Sheffield, UK.,Joint Working Group of the European Society of Clinical Microbiology and Infectious Diseases Study Group of Forensic and Postmortem Microbiology and the European Society of Pathology, Basel, Switzerland.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| |
Collapse
|
4
|
Farahmand M, Shatizadeh Malekshahi S, Jabbari MR, Shayestehpour M. The landscape of extrapulmonary manifestations of human parainfluenza viruses: A systematic narrative review. Microbiol Immunol 2020; 65:1-9. [PMID: 33270253 DOI: 10.1111/1348-0421.12865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/23/2020] [Accepted: 11/28/2020] [Indexed: 10/22/2022]
Abstract
Human parainfluenza virus (HPIV) infection is associated with every kind of respiratory tract illnesses, including the common cold, laryngotracheobronchitis (i.e. croup), tracheobronchitis, bronchiolitis, and pneumonia, in both children and adults. Although HPIVs are common respiratory pathogens, there are increasing reports about extrapulmonary manifestations of HPIVs infection. Each of the HPIVs could produce infection of other organs (central nervous system, heart, myocardium, etc.) in all age groups who are either immunocompetent or immunocompromised. This review aimed at summarizing the available data on clinical manifestations of HPIV infection outside the respiratory tract from 1961 to 2020. The findings support the possibility of extrapulmonary infections that were thought to be due to rare host genetic or immunologic defects in infected patients. These findings highlight the fact that extrapulmonary dissemination of HPIV can occur, but the association is not clearly demonstrated. Our data support the hypothesis that HPIV infection is one of the possible causes of these alterations and may even be the direct cause in some cases.
Collapse
Affiliation(s)
- Mohammad Farahmand
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Reza Jabbari
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Shayestehpour
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.,Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|
5
|
Qian J, Xie J, Lakshmipriya T, Gopinath SCB, Xu H. Heart Infection Prognosis Analysis by Two-dimensional Spot Tracking Imaging. Curr Med Imaging 2020; 16:534-544. [PMID: 32484087 DOI: 10.2174/1573405615666190130164037] [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: 09/07/2018] [Revised: 12/19/2018] [Accepted: 01/04/2019] [Indexed: 11/22/2022]
Abstract
Cardiovascular death is one of the leading causes worldwide; an accurate identification followed by diagnosing the cardiovascular disease increases the chance of a better recovery. Among different demonstrated strategies, imaging on cardiac infections yields a visible result and highly reliable compared to other analytical methods. Two-dimensional spot tracking imaging is the emerging new technology that has been used to study the function and structure of the heart and test the deformation and movement of the myocardium. Particularly, it helps to capture the images of each segment in different directions of myocardial strain values, such as valves of radial strain, longitudinal strain, and circumferential strain. In this overview, we discussed the imaging of infections in the heart by using the two-dimensional spot tracking.
Collapse
Affiliation(s)
- Jie Qian
- Department of ICU, Shuyang Hospital of Traditional Chinese Medicine, Shuyang, Suqian, Jiangsu 223600, China
| | - Jing Xie
- Department of ICU, Shuyang Hospital of Traditional Chinese Medicine, Shuyang, Suqian, Jiangsu 223600, China
| | - Thangavel Lakshmipriya
- Institute of Nano Electronic Engineering, Universiti Malaysia Perlis, Kangar 01000, Perlis, Malaysia
| | - Subash C B Gopinath
- Institute of Nano Electronic Engineering, Universiti Malaysia Perlis, Kangar 01000, Perlis, Malaysia.,School of Bioprocess Engineering, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia
| | - Huaigang Xu
- Department of ICU, Shuyang Hospital of Traditional Chinese Medicine, Shuyang, Suqian, Jiangsu 223600, China
| |
Collapse
|
6
|
den Boer SL, Meijer RPJ, van Iperen GG, Ten Harkel ADJ, du Marchie Sarvaas GJ, Straver B, Rammeloo LAJ, Tanke RB, van Kampen JJA, Dalinghaus M. Evaluation of the diagnostic work-up in children with myocarditis and idiopathic dilated cardiomyopathy. Pediatr Cardiol 2015; 36:409-16. [PMID: 25194576 DOI: 10.1007/s00246-014-1022-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 08/22/2014] [Indexed: 02/02/2023]
Abstract
The underlying etiology of dilated cardiomyopathy (DCM) in children varies, 14-22% is secondary to myocarditis, and the majority remains idiopathic. Etiology has prognostic value; however, 'a clinical diagnosis of myocarditis' has been frequently used because the gold standard [endomyocardial biopsy (EMB)] is often not performed. Therefore, a consistent diagnostic approach and interpretation is needed. In this multicenter study, we evaluated the diagnostic approach and interpretation of the viral results in children with myocarditis and idiopathic DCM. We included 150 children with DCM, of whom 103 were assigned the diagnosis myocarditis (n = 21) or idiopathic DCM (n = 82) by the attending physician. Viral tests were performed in 97/103 patients, in only 34% (n = 35) some of the tests were positive. Of those patients, we evaluated the probability of the assigned diagnosis using the viral test results. We classified viral test results as reflecting definite or probable myocarditis in 14 children and possible or unlikely myocarditis in 21 children. Based on this classification, 23% of patients were misclassified. We found that in children with DCM, the diagnostic approach varied and the interpretation was mainly based on viral results. Since a 'clinical diagnosis of myocarditis' has been frequently used in daily practice because of the lack of EMB results, a uniform protocol is needed. We propose to use viral test results in several steps (blood PCR, serology, PCR and/or cultures of the gastro-intestinal and respiratory tract, and EMB results) to estimate the probability of myocarditis.
Collapse
Affiliation(s)
- S L den Boer
- Department of Pediatrics, division of Pediatric Cardiology, Sophia Children's Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, P.O. Box 2060, Rotterdam, 3000 CB, The Netherlands,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Navarro-Marí JM, Pérez-Ruiz M, Galán Montemayor JC, Marcos Maeso MÁ, Reina J, de Oña Navarro M, Cilla Eguiluz CG. Circulation of other respiratory viruses and viral co-infection during the 2009 pandemic influenza. Enferm Infecc Microbiol Clin 2013; 30 Suppl 4:25-31. [PMID: 23116789 PMCID: PMC7130202 DOI: 10.1016/s0213-005x(12)70101-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Coinciding with the pandemic wave of the influenza A(H1N1)pdm09 virus, other respiratory viruses have co-circulated in our area and were responsible for many acute respiratory infections and influenza-like illness (ILI). Apart from the pandemic virus that was responsible for most ILI cases, incidence rates of other viruses have varied among geographical areas. In general, human rhinovirus was the most frequent among individuals from the community, and respiratory syncytial virus among hospitalized patients. Detection rates of other respiratory viruses such as human metapneumovirus, adenovirus or parainfluenza viruses have been much lower. On the basis of an interference mechanism, human rhinovirus may contribute to modulate the pandemic wave, although available data are not conclusive to support this hypothesis. In contrast, the epidemic wave of respiratory syncytial virus during 2009–2010 was similar to previous seasons. Overall, incidence rates of respiratory viruses other than influenza did not change significantly during the pandemic season compared to other seasons. No association has been found between coinfection of pandemic influenza and other respiratory viruses with the prognosis of patients with influenza. The involvement of clinical virology laboratories in the etiological diagnosis of ILI cases has improved and has optimized diagnostic procedures.
Collapse
|
8
|
Kalimuddin S, Sessions OM, Hou Y, Ooi EE, Sim D, Cumaraswamy S, Tan TE, Lai SH, Low CY. Successful clearance of human parainfluenza virus type 2 viraemia with intravenous ribavirin and immunoglobulin in a patient with acute myocarditis. J Clin Virol 2012; 56:37-40. [PMID: 23137789 PMCID: PMC7185820 DOI: 10.1016/j.jcv.2012.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 10/05/2012] [Accepted: 10/10/2012] [Indexed: 01/03/2023]
Abstract
Human parainfluenza virus (HPIV) infection as an aetiology of acute viral myocarditis is rare, with only few cases reported in the literature to date. Here we report a case of fulminant HPIV-2 myocarditis in a 47 year-old man with viraemia who was successfully treated with intravenous ribavirin and intravenous immunoglobulin (IVIG). There are currently no recommendations on the treatment of HPIV myocarditis. We are, to our knowledge, the first to report a patient with a documented HPIV-2 viraemia that subsequently cleared after the initiation of antiviral therapy. Although it is difficult to definitively attribute the patient's clinical improvement to ribavirin or IVIG alone, our case does suggest that clinicians may wish to consider initiating ribavirin and IVIG in patients with HPIV myocarditis and persistent viraemia not responding to supportive measures alone.
Collapse
Affiliation(s)
- Shirin Kalimuddin
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Zeft AS, Menon SC, Miller D. Fatal myocarditis in a child with systemic onset juvenile idiopathic arthritis during treatment with an interleukin 1 receptor antagonist. Pediatr Rheumatol Online J 2012; 10:8. [PMID: 22490470 PMCID: PMC3340295 DOI: 10.1186/1546-0096-10-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/10/2012] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The pathologic diagnosis of isolated myocarditis without pericardial involvement is uncommonly encountered in systemic onset Juvenile Idiopathic Arthritis (soJIA). CASE An eleven year-old boy with soJIA died suddenly while being treated with the interleukin 1 (IL-1) receptor inhibitor, anakinra. His autopsy revealed an enlarged heart and microscopic findings were consistent with myocarditis, but not pericarditis. Viral PCR testing performed on his myocardial tissue was negative. CONCLUSION This case illustrates myocarditis as a fatal complication of soJIA, potentially enabled by anakinra.
Collapse
Affiliation(s)
- Andrew S Zeft
- Children's Hospital, Cleveland Clinic, Pediatric Rheumatology, 9500 Euclid Avenue/A111, Cleveland, OH 44195, USA
| | - Shaji C Menon
- Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT 84158, USA
| | - Dylan Miller
- Department of Pathology, Intermountain Medical Center, Salt Lake City, UT 84158, USA
| |
Collapse
|
10
|
Farzan SF, Palermo LM, Yokoyama CC, Orefice G, Fornabaio M, Sarkar A, Kellogg GE, Greengard O, Porotto M, Moscona A. Premature activation of the paramyxovirus fusion protein before target cell attachment with corruption of the viral fusion machinery. J Biol Chem 2011; 286:37945-37954. [PMID: 21799008 PMCID: PMC3207398 DOI: 10.1074/jbc.m111.256248] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 07/26/2011] [Indexed: 11/06/2022] Open
Abstract
Paramyxoviruses, including the childhood pathogen human parainfluenza virus type 3, enter host cells by fusion of the viral and target cell membranes. This fusion results from the concerted action of its two envelope glycoproteins, the hemagglutinin-neuraminidase (HN) and the fusion protein (F). The receptor-bound HN triggers F to undergo conformational changes that render it competent to mediate fusion of the viral and cellular membranes. We proposed that, if the fusion process could be activated prematurely before the virion reaches the target host cell, infection could be prevented. We identified a small molecule that inhibits paramyxovirus entry into target cells and prevents infection. We show here that this compound works by an interaction with HN that results in F-activation prior to receptor binding. The fusion process is thereby prematurely activated, preventing fusion of the viral membrane with target cells and precluding viral entry. This first evidence that activation of a paramyxovirus F can be specifically induced before the virus contacts its target cell suggests a new strategy with broad implications for the design of antiviral agents.
Collapse
Affiliation(s)
- Shohreh F Farzan
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021
| | - Laura M Palermo
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021
| | - Christine C Yokoyama
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021
| | - Gianmarco Orefice
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021
| | - Micaela Fornabaio
- Department of Medicinal Chemistry and Institute for Structural Biology and Drug Discovery, Virginia Commonwealth University, Richmond, Virginia, 23298-0540
| | - Aurijit Sarkar
- Department of Medicinal Chemistry and Institute for Structural Biology and Drug Discovery, Virginia Commonwealth University, Richmond, Virginia, 23298-0540
| | - Glen E Kellogg
- Department of Medicinal Chemistry and Institute for Structural Biology and Drug Discovery, Virginia Commonwealth University, Richmond, Virginia, 23298-0540
| | - Olga Greengard
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021; Department of Pediatrics, Mount Sinai School of Medicine, New York, New York 10029
| | - Matteo Porotto
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021
| | - Anne Moscona
- Departments of Pediatrics and of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10021.
| |
Collapse
|