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Scher G, Yankowski C, Kurup D, Josleyn NM, Wilkinson ER, Wells J, Steffens J, Lynn G, Vantongeren S, Zeng X, Twenhafel N, Cashman KA, Schnell MJ. Inactivated rabies-based Lassa fever virus vaccine candidate LASSARAB protects nonhuman primates from lethal disease. NPJ Vaccines 2024; 9:143. [PMID: 39122759 PMCID: PMC11315998 DOI: 10.1038/s41541-024-00930-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Lassa fever virus (LASV), a member of the Arenavirus family, is the etiological agent of Lassa fever, a severe hemorrhagic disease that causes considerable morbidity and mortality in the endemic areas of West Africa. LASV is a rodent-borne CDC Tier One biological threat agent and is on the World Health Organization's (WHO) Priority Pathogen list. Currently, no FDA-licensed vaccines or specific therapeutics are available. Here, we describe the efficacy of a deactivated rabies virus (RABV)-based vaccine encoding the glycoprotein precursor (GPC) of LASV (LASSARAB). Nonhuman primates (NHPs) were administered a two-dose regimen of LASSARAB or an irrelevant RABV-based vaccine to serve as a negative control. NHPs immunized with LASSARAB developed strong humoral responses to LASV-GPC. Upon challenge, NHPs vaccinated with LASSARAB survived to the study endpoint, whereas NHPs in the control group did not. This study demonstrates that LASSARAB is a worthy candidate for continued development.
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Affiliation(s)
- Gabrielle Scher
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Catherine Yankowski
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Drishya Kurup
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
- Jefferson Center for Vaccines and Pandemic Preparedness, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nicole M Josleyn
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Eric R Wilkinson
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Jay Wells
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Jesse Steffens
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Ginger Lynn
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Sean Vantongeren
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Xiankun Zeng
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Nancy Twenhafel
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA
| | - Kathleen A Cashman
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD, 21702, USA.
| | - Matthias J Schnell
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
- Jefferson Center for Vaccines and Pandemic Preparedness, Thomas Jefferson University, Philadelphia, PA, USA.
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Best KC, Ameh E, Weldon C, Shwe D, Maigari IM, Turaki I, Ma’an ND, Yilgwan CS, Makishima T, Weaver S, Paessler S, Shehu NY. Double stigma: a cross-sectional study of Lassa patients with hearing loss in North Central Nigeria. Front Public Health 2024; 12:1395939. [PMID: 39076422 PMCID: PMC11284147 DOI: 10.3389/fpubh.2024.1395939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/01/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Lassa fever is a zoonotic infectious disease endemic in West Africa with a high case-fatality rate and reported stigmatization of surviving patients. This study examines discrimination among survivors of Lassa fever (LF) complicated by hearing loss (HL). Methods This cross-sectional qualitative study used an in-depth interview guide to collect information from patients with HL about their experience of stigma. Interviews were conducted by a trained team of interviewers at the Jos University Teaching Hospital between January and April 2022 in Hausa language after informed consent was obtained. Recordings of the interviews were transcribed and translated from Hausa to English. Data analysis was conducted using NVivo software using a thematic framework approach. Results Most (73%) respondents were male (n = 11); 27% were female (n = 4). The median age was 35 years (interquartile range, 16.5). Some Lassa fever patients experienced stigma and discrimination (53%) including isolation and withdrawal of family and community support during and after illness. HL increased stigma, as some patients were labeled "deaf" by other community members, increasing perceived stigma and devaluation. HL affected the socio-economic wellbeing of some who could not communicate well with their families and customers and constrained social interactions, evoking pain and apathy. Some survivors of LF and victims of its sequelae of HL experienced double stigmatization. While they were ill with LF, a third of respondents reported avoidance and isolation by family and community members who withdrew care and support both to them and their close family members. These forms of stigmatization strained their relationships. Conclusion There is a need to address stigma in LF survivors who develop HL through concerted community-owned awareness to improve their quality of life along with a robust social support system to aid prevention.
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Affiliation(s)
- Kachollom C. Best
- Department of Sociology, Faculty of Social Sciences, University of Jos, Jos, Nigeria
- West African Center for Emerging Infectious Diseases, Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel Ameh
- West African Center for Emerging Infectious Diseases, Jos University Teaching Hospital, Jos, Nigeria
| | - Caroline Weldon
- Department of Microbiology, University of Texas Medical Branch, Galveston, TX, United States
| | - David Shwe
- Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria
| | - Ibrahim Mahmood Maigari
- Department of Internal Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Ishaku Turaki
- Department of Otorhinolaryngology, Jos University Teaching Hospital, Jos, Nigeria
| | - Nuhu D. Ma’an
- Department of Otorhinolaryngology, Jos University Teaching Hospital, Jos, Nigeria
| | | | - Tomoko Makishima
- Department of Ear, Nose and Throat, University of Texas Medical Branch, Galveston, TX, United States
| | - Scott Weaver
- Department of Microbiology, University of Texas Medical Branch, Galveston, TX, United States
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States
| | - Nathan Y. Shehu
- West African Center for Emerging Infectious Diseases, Jos University Teaching Hospital, Jos, Nigeria
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States
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Thai-Van H, Bagheri H, Valnet-Rabier MB. Sudden Sensorineural Hearing Loss after COVID-19 Vaccination: A Review of the Available Evidence through the Prism of Causality Assessment. Vaccines (Basel) 2024; 12:181. [PMID: 38400164 PMCID: PMC10892268 DOI: 10.3390/vaccines12020181] [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: 12/29/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
Sudden sensorineural hearing loss (SSNHL), a rare audiological condition that accounts for 1% of all cases of sensorineural hearing loss, can cause permanent hearing damage. Soon after the launch of global COVID-19 vaccination campaigns, the World Health Organization released a signal detection about SSNHL cases following administration of various COVID-19 vaccines. Post-marketing studies have been conducted in different countries using either pharmacovigilance or medico-administrative databases to investigate SSNHL as a potential adverse effect of COVID-19 vaccines. Here, we examine the advantages and limitations of each type of post-marketing study available. While pharmacoepidemiological studies highlight the potential association between drug exposure and the event, pharmacovigilance approaches enable causality assessment. The latter objective can only be achieved if an expert evaluation is provided using internationally validated diagnostic criteria. For a rare adverse event such as SSNHL, case information and quantification of hearing loss are mandatory for assessing seriousness, severity, delay onset, differential diagnoses, corrective treatment, recovery, as well as functional sequelae. Appropriate methodology should be adopted depending on whether the target objective is to assess a global or individual risk.
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Affiliation(s)
- Hung Thai-Van
- Department of Audiology and Otoneurological Evaluation, Hospices Civils de Lyon, 69003 Lyon, France;
- Institut Pasteur, Institut de l’Audition, 75015 Paris, France
- Faculté de Médecine, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Haleh Bagheri
- Department of Medical and Clinical Pharmacology, Centre Régional de Pharmacovigilance de Toulouse, CIC1436, Hôpital Universitaire de Toulouse, 31000 Toulouse, France;
| | - Marie-Blanche Valnet-Rabier
- Department of Clinical Pharmacology, Centre Régional de Pharmacovigilance et d’Information sur les Médicaments, Centre Hospitalier Universitaire de Besançon, 25000 Besançon, France
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Bohler F, Cashman K, Wilkinson E, Johnson JC, Rosenke K, Shamblin J, Hensley L, Honko A, Shaia C. An atlas of gross and histologic lesions and immunohistochemical immunoreactivity during the temporal progression of aerosolized Lassa virus induced hemorrhagic fever in cynomolgus macaques. Front Cell Infect Microbiol 2024; 14:1341891. [PMID: 38404292 PMCID: PMC10884106 DOI: 10.3389/fcimb.2024.1341891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/15/2024] [Indexed: 02/27/2024] Open
Abstract
Lassa virus (LASV) causes an acute multisystemic hemorrhagic fever in humans known as Lassa fever, which is endemic in several African countries. This manuscript focuses on the progression of disease in cynomolgus macaques challenged with aerosolized LASV and serially sampled for the development and progression of gross and histopathologic lesions. Gross lesions were first noted in tissues on day 6 and persisted throughout day 12. Viremia and histologic lesions were first noted on day 6 commencing with the pulmonary system and hemolymphatic system and progressing at later time points to include all systems. Immunoreactivity to LASV antigen was first observed in the lungs of one macaque on day 3 and appeared localized to macrophages with an increase at later time points to include immunoreactivity in all organ systems. Additionally, this manuscript will serve as a detailed atlas of histopathologic lesions and disease progression for comparison to other animal models of aerosolized Arenaviral disease.
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Affiliation(s)
- Forrest Bohler
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, Division of Intramural Research, National Institutes of Health (NIH), Hamilton, MT, United States
| | - Kathleen Cashman
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD, United States
| | - Eric Wilkinson
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD, United States
| | - Joshua C. Johnson
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD, United States
| | - Kyle Rosenke
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, Division of Intramural Research, National Institutes of Health (NIH), Hamilton, MT, United States
| | - Josh Shamblin
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD, United States
| | - Lisa Hensley
- Zoonotic and Emerging Disease Research Unit, United States Department of Agriculture (USDA), Manhattan, KS, United States
| | - Anna Honko
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD, United States
| | - Carl Shaia
- Rocky Mountain Veterinary Branch, National Institute of Allergy and Infectious Diseases, Division of Intramural Research, National Institutes of Health (NIH), Hamilton, MT, United States
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Reyna RA, Littlefield KE, Shehu N, Makishima T, Maruyama J, Paessler S. The Importance of Lassa Fever and Its Disease Management in West Africa. Viruses 2024; 16:266. [PMID: 38400041 PMCID: PMC10892767 DOI: 10.3390/v16020266] [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: 12/11/2023] [Revised: 01/21/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Lassa virus (LASV) is a zoonotic pathogen endemic throughout western Africa and is responsible for a human disease known as Lassa fever (LF). Historically, LASV has been emphasized as one of the greatest public health threats in West Africa, with up to 300,000 cases and 5000 associated deaths per year. This, and the fact that the disease has been reported in travelers, has driven a rapid production of various vaccine candidates. Several of these vaccines are currently in clinical development, despite limitations in understanding the immune response to infection. Alarmingly, the host immune response has been implicated in the induction of sensorineural hearing loss in LF survivors, legitimately raising safety questions about any future vaccines as well as efficacy in preventing potential hearing loss. The objective of this article is to revisit the importance and prevalence of LF in West Africa, with focus on Nigeria, and discuss current therapeutic approaches and ongoing vaccine development. In addition, we aim to emphasize the need for more scientific studies relating to LF-associated hearing loss, and to promote critical discussion about potential risks and benefits of vaccinating the population in endemic regions of West Africa.
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Affiliation(s)
- Rachel A. Reyna
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Kirsten E. Littlefield
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Nathan Shehu
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Infectious Disease Unit, Department of Medicine, Jos University Teaching Hospital, Jos P.M.B. 2076, Nigeria
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Bell TM, Facemire P, Bearss JJ, Raymond JL, Chapman J, Zeng X, Shamblin JD, Williams JA, Grosenbach DW, Hruby DE, Damon IK, Goff AJ, Mucker EM. Smallpox lesion characterization in placebo-treated and tecovirimat-treated macaques using traditional and novel methods. PLoS Pathog 2024; 20:e1012007. [PMID: 38386661 PMCID: PMC10883539 DOI: 10.1371/journal.ppat.1012007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Smallpox was the most rampant infectious disease killer of the 20th century, yet much remains unknown about the pathogenesis of the variola virus. Using archived tissue from a study conducted at the Centers for Disease Control and Prevention we characterized pathology in 18 cynomolgus macaques intravenously infected with the Harper strain of variola virus. Six macaques were placebo-treated controls, six were tecovirimat-treated beginning at 2 days post-infection, and six were tecovirimat-treated beginning at 4 days post-infection. All macaques were treated daily until day 17. Archived tissues were interrogated using immunohistochemistry, in situ hybridization, immunofluorescence, and electron microscopy. Gross lesions in three placebo-treated animals that succumbed to infection primarily consisted of cutaneous vesicles, pustules, or crusts with lymphadenopathy. The only gross lesions noted at the conclusion of the study in the three surviving placebo-treated and the Day 4 treated animals consisted of resolving cutaneous pox lesions. No gross lesions attributable to poxviral infection were present in the Day 2 treated macaques. Histologic lesions in three placebo-treated macaques that succumbed to infection consisted of proliferative and necrotizing dermatitis with intracytoplasmic inclusion bodies and lymphoid depletion. The only notable histologic lesion in the Day 4 treated macaques was resolving dermatitis; no notable lesions were seen in the Day 2 treated macaques. Variola virus was detected in all three placebo-treated animals that succumbed to infection prior to the study's conclusion by all utilized methods (IHC, ISH, IFA, EM). None of the three placebo-treated animals that survived to the end of the study nor the animals in the two tecovirimat treatment groups showed evidence of variola virus by these methods. Our findings further characterize variola lesions in the macaque model and describe new molecular methods for variola detection.
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Affiliation(s)
- Todd M. Bell
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Paul Facemire
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Jeremy J. Bearss
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Jo Lynne Raymond
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Jennifer Chapman
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Xiankun Zeng
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Joshua D. Shamblin
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Janice A. Williams
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | | | - Dennis E. Hruby
- SIGA Technologies, Inc., Corvallis, Oregon, United States of America
| | - Inger K. Damon
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention (CDC) Atlanta, Georgia, United States of America
| | - Arthur J. Goff
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Eric M. Mucker
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
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7
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Hastie KM, Melnik LI, Cross RW, Klitting RM, Andersen KG, Saphire EO, Garry RF. The Arenaviridae Family: Knowledge Gaps, Animal Models, Countermeasures, and Prototype Pathogens. J Infect Dis 2023; 228:S359-S375. [PMID: 37849403 PMCID: PMC10582522 DOI: 10.1093/infdis/jiac266] [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] [Indexed: 10/19/2023] Open
Abstract
Lassa virus (LASV), Junin virus (JUNV), and several other members of the Arenaviridae family are capable of zoonotic transfer to humans and induction of severe viral hemorrhagic fevers. Despite the importance of arenaviruses as potential pandemic pathogens, numerous gaps exist in scientific knowledge pertaining to this diverse family, including gaps in understanding replication, immunosuppression, receptor usage, and elicitation of neutralizing antibody responses, that in turn complicates development of medical countermeasures. A further challenge to the development of medical countermeasures for arenaviruses is the requirement for use of animal models at high levels of biocontainment, where each model has distinct advantages and limitations depending on, availability of space, animals species-specific reagents, and most importantly the ability of the model to faithfully recapitulate human disease. Designation of LASV and JUNV as prototype pathogens can facilitate progress in addressing the public health challenges posed by members of this important virus family.
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Affiliation(s)
- Kathryn M Hastie
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
| | - Lilia I Melnik
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston National Laboratory, Galveston, Texas, USA
| | - Raphaëlle M Klitting
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, California, USA
- Scripps Research Translational Institute, La Jolla, California, USA
| | - Kristian G Andersen
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, California, USA
- Scripps Research Translational Institute, La Jolla, California, USA
| | - Erica Ollmann Saphire
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, USA
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Robert F Garry
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Zalgen Labs LLC, Frederick, Maryland, USA
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Murakami D, Kimura T, Kono M, Sakai A, Suenaga T, Hiraoka M, Sakatani H, Ohtani M, Suzuki H, Tokuhara D, Hotomi M. Case report: Cochlear implantation was effective for progressive bilateral severe hearing loss associated with Kawasaki disease. Front Pediatr 2023; 11:1199240. [PMID: 37635798 PMCID: PMC10448821 DOI: 10.3389/fped.2023.1199240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
Sensorineural hearing loss associated with Kawasaki disease has been increasingly reported, but its etiology remains unclear. Most reported cases of sensorineural hearing loss associated with Kawasaki disease have been mild and reversible during acute or subacute phases. However, bilateral severe hearing loss as a complication of Kawasaki disease can cause delays in cognitive and speech development. A 4-year-old Japanese boy treated for Kawasaki disease had right-side moderate and left-side profound sensorineural hearing loss on the 141st day after onset of Kawasaki disease. Despite systemic steroid pulse treatment, hearing loss remained in both sides. After the recurrence of Kawasaki disease, hearing on the right side progressively worsened, meaning there was now severe hearing loss on both sides. Left cochlear implantation performed on the 1065th day after the onset of Kawasaki disease improved the patient's hearing and his ability to communicate. Sensorineural hearing loss associated with Kawasaki disease may progress over a long period and cause bilateral severe hearing loss, although past reports showed occurrence during acute or subacute phases. The clinical course of our patient suggests that intense inflammation caused by Kawasaki disease could be related to prolonged hearing loss. Cochlear implantation seems to be effective for sensorineural hearing loss associated with Kawasaki disease.
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Affiliation(s)
- Daichi Murakami
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takahito Kimura
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masamitsu Kono
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Akihiro Sakai
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
- Sakai ENT Clinic, Kinokawa, Japan
| | - Tomohiro Suenaga
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Masanobu Hiraoka
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hideki Sakatani
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Makiko Ohtani
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
- Department of Pediatrics, Wakayama Tsukushi Medical and Welfare Center, Iwade, Japan
| | - Daisuke Tokuhara
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Muneki Hotomi
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
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Grant DS, Samuels RJ, Garry RF, Schieffelin JS. Lassa Fever Natural History and Clinical Management. Curr Top Microbiol Immunol 2023. [PMID: 37106159 DOI: 10.1007/82_2023_263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Lassa fever is caused by Lassa virus (LASV), an Old World Mammarenavirus that is carried by Mastomys natalensis and other rodents. It is endemic in Sierra Leone, Nigeria, and other countries in West Africa. The clinical presentation of LASV infection is heterogenous varying from an inapparent or mild illness to a fatal hemorrhagic fever. Exposure to LASV is usually through contact with rodent excreta. After an incubation period of 1-3 weeks, initial symptoms such as fever, headache, and fatigue develop that may progress to sore throat, retrosternal chest pain, conjunctival injection, vomiting, diarrhea, and abdominal pain. Severe illness, including hypotension, shock, and multiorgan failure, develops in a minority of patients. Patient demographics and case fatality rates are distinctly different in Sierra Leone and Nigeria. Laboratory diagnosis relies on the detection of LASV antigens or genomic RNA. LASV-specific immunoglobulin G and M assays can also contribute to clinical management. The mainstay of treatment for Lassa fever is supportive care. The nucleoside analog ribavirin is commonly used to treat acute Lassa fever but is considered useful only if treatment is begun early in the disease course. Drugs in development, including a monoclonal antibody cocktail, have the potential to impact the management of Lassa fever.
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Affiliation(s)
- Donald S Grant
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health, Kenema, Sierra Leone
- College of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Robert J Samuels
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health, Kenema, Sierra Leone
| | - Robert F Garry
- School of Medicine, Department of Microbiology and Immunology, Tulane University, New Orleans, LA, 70112, USA
- Zalgen Labs, Frederick, MD, 21703, USA
- Global Virus Network (GVN), Baltimore, MD, 21201, USA
| | - John S Schieffelin
- School of Medicine, Department of Pediatrics, Tulane University, New Orleans, LA, 70112, USA.
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Dorobisz K, Pazdro-Zastawny K, Misiak P, Kruk-Krzemień A, Zatoński T. Sensorineural Hearing Loss in Patients with Long-COVID-19: Objective and Behavioral Audiometric Findings. Infect Drug Resist 2023; 16:1931-1939. [PMID: 37025195 PMCID: PMC10072149 DOI: 10.2147/idr.s398126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/28/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction The symptoms of COVID-19 are primarily respiratory system disorders. Sensorineural hearing loss can be caused by COVID-19, as other symptoms in the nervous system. Hearing loss may also be the only symptom or complication of this disease or the symptoms of long COVID-19. The study aimed to assess hearing in patients after COVID-19 infection. Material and Methods The study conducted ENT and full hearing assessment in COVID-19 infection. All patients underwent complete audiological diagnostics, including threshold tonal audiometry, tympanometry, otoacoustic emissions, and auditory brainstem evoked potentials (ABR) tests. The study group included 58 patients aged 23 to 75 years who were diagnosed with COVID-19 infection six months before inclusion in the present study and reported post-COVID-19 hearing impairment. Results There were statistically significant differences between the control and study groups. Sensorineural hearing loss was found in 65.5% of the tonal audiometry test. The stapes reflex was absent in almost 20% of post-COVID-19 patients. The analysis of ABRs demonstrated longer latencies of wave III, V, and time intervals I-III, I-V in post-COVID-19 patients. Conclusion COVID-19 can damage the inner ear as well as the auditory pathway. Hearing loss may be the only symptom of COVID-19 or be a late complication of the disease due to postinfectious inflammation of the nerve tissue as a symptom of long COVID-19. Prolonged conduction of the auditory pathway shows the affinity of the virus to the nervous system as a symptom of long COVID. It is advisable to perform hearing diagnostics in patients after COVID-19 and provide them with specialist care.
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Affiliation(s)
- Karolina Dorobisz
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Katarzyna Pazdro-Zastawny
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
- Correspondence: Katarzyna Pazdro-Zastawny, Email
| | - Paula Misiak
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Anna Kruk-Krzemień
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Tomasz Zatoński
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
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11
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Elmoursy MM, Bakr MS, Mohamed ES, Ragaee MA. The Incidence of Sudden Sensorineural Hearing Loss (SSNHL) in COVID-19 Patients in Tertiary Care Referral Units. SN COMPREHENSIVE CLINICAL MEDICINE 2023; 5:87. [PMID: 36845674 PMCID: PMC9942031 DOI: 10.1007/s42399-023-01420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/23/2023]
Abstract
COVID-19 is a new pandemic infectious disease that emerged in Wuhan, China, at the end of 2019. We aimed to evaluate the sudden sensorineural hearing loss (SSNHL) prevalence after COVID-19 infection or even vaccination. This is a two-center retrospective, observational cross-sectional study performed at tertiary care referral Audiovestibular Medicine Units at the period between August 1, 2020, and October 31, 2021. All SSNHL patients diagnosed in a period of a month with COVID-19 or vaccinated with a COVID-19 vaccine were included in this study. Fifty-three cases with confirmed COVID-19 and one patient vaccinated with a COVID-19 vaccine 1 week before, who reported sudden sensory neural hearing loss, were included in this study. Forty-eight patients had unilateral hearing loss and 6 patients had bilateral hearing loss. Forty-nine patients had typical COVID-19 symptoms; one patient discovered them after complaining of anosmia and ageusia and one patient after COVID-19 vaccination; and three patients were complaining only from hearing loss and had a PCR test for nasopharyngeal swabs to prove infection. Different degrees of SSNHL ranged from mild to severe and most of the patients had severe hearing loss. With more patients, COVID-19 may be a potential factor in sudden sensorineural hearing loss. It should be kept in mind that SSNHL may be the only indicator used to identify COVID-19 cases.
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Affiliation(s)
| | - Mohamed Salama Bakr
- Audiovestibular Medicine Unit, ENT Department, Assiut University, Asyut, Egypt
| | - Enass Sayed Mohamed
- Audiovestibular Medicine Unit, ENT Department, Assiut University, Asyut, Egypt
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12
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Brisse M, Fernández-Alarcón C, Huang Q, Kirk N, Schleiss MR, Liang Y, Ly H. Hearing loss in outbred Hartley guinea pigs experimentally infected with Pichinde virus as a surrogate model of human mammarenaviral hemorrhagic fevers. Virulence 2022; 13:1049-1061. [PMID: 35758052 PMCID: PMC9794012 DOI: 10.1080/21505594.2022.2087948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Lassa fever (LF) is a neglected tropical disease that is caused by Lassa virus (LASV), a human hemorrhagic fever-causing mammarenavirus. A notable sequela of LF is sensorineural hearing loss (SNHL) that can develop in about 33% of the patients. Animal models of LF-associated SNHL have been limited in size and scope because LASV is a biosafety level 4 (BSL4) pathogen that requires its handling in a high biocontainment laboratory. In this report, we describe the development of an alternative arenavirus hearing loss model by infecting outbred Hartley guinea pigs with a virulent strain (rP18) of the Pichinde virus (PICV), which is a guinea pig-adapted mammarenavirus that has been used as a surrogate model of mammarenaviral hemorrhagic fevers in a conventional (BSL2) laboratory. By measuring auditory brainstem response (ABR) throughout the course of the virulent rP18 PICV infection, we noticed that some of the animals experienced an acute but transient level of hearing loss. Cochleae of hearing-impaired animals, but not of controls, had demonstrable viral RNA by quantitative RT-PCR, indicating the presence of virus in the affected inner ear with no overt histopathological changes. In contrast, neither the outbred Hartley guinea pigs infected with a known avirulent strain (rP2) of PICV nor those that were mock-infected showed any evidence of hearing loss or viral infection of the inner ear. This is the first report of an immunocompetent small animal model of mammarenavirus-induced hearing loss that can be used to evaluate potential therapeutics against virus-induced hearing impairment under a conventional laboratory setting.
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Affiliation(s)
- Morgan Brisse
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | | | - Qinfeng Huang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Natalie Kirk
- Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Mark R. Schleiss
- Department of Pediatrics, School of Medicine University of Minnesota, Twin Cities, Minnesota, USA
| | - Yuying Liang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Hinh Ly
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA,CONTACT Hinh Ly
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13
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Reyna RA, Maruyama J, Mantlo EK, Manning JT, Taniguchi S, Makishima T, Lukashevich IS, Paessler S. Depletion of CD4 and CD8 T Cells Reduces Acute Disease and Is Not Associated with Hearing Loss in ML29-Infected STAT1-/- Mice. Biomedicines 2022; 10:2433. [PMID: 36289695 PMCID: PMC9598517 DOI: 10.3390/biomedicines10102433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Abstract
Lassa virus (LASV) is a zoonotic virus endemic to western Africa that can cause a potentially lethal and hemorrhagic disease, Lassa fever (LF). Survivors suffer a myriad of sequelae, most notably sudden onset sensorineural hearing loss (SNHL), the mechanism of which remains unclear. Unfortunately, studies aiming to identify the mechanism of these sequelae are limited due to the biosafety level 4 (BSL4) requirements of LASV itself. ML29, a reassortant virus proposed as an experimental vaccine candidate against LASV, is potentially an ideal surrogate model of LF in STAT1-/- mice due to similar phenotype in these animals. We intended to better characterize ML29 pathogenesis and potential sequelae in this animal model. Our results indicate that while both CD4 and CD8 T cells are responsible for acute disease in ML29 infection, ML29 induces significant hearing loss in a mechanism independent of either CD4 or CD8 T cells. We believe that this model could provide valuable information for viral-associated hearing loss in general.
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Affiliation(s)
- Rachel A. Reyna
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Emily K. Mantlo
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - John T. Manning
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Satoshi Taniguchi
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Igor S. Lukashevich
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40292, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
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14
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Enriquez AS, Buck TK, Li H, Norris MJ, Moon-Walker A, Zandonatti MA, Harkins SS, Robinson JE, Branco LM, Garry RF, Saphire EO, Hastie KM. Delineating the mechanism of anti-Lassa virus GPC-A neutralizing antibodies. Cell Rep 2022; 39:110841. [PMID: 35613585 PMCID: PMC9258627 DOI: 10.1016/j.celrep.2022.110841] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/16/2022] [Accepted: 04/28/2022] [Indexed: 12/16/2022] Open
Abstract
Lassa virus (LASV) is the etiologic agent of Lassa Fever, a hemorrhagic disease that is endemic to West Africa. During LASV infection, LASV glycoprotein (GP) engages with multiple host receptors for cell entry. Neutralizing antibodies against GP are rare and principally target quaternary epitopes displayed only on the metastable, pre-fusion conformation of GP. Currently, the structural features of the neutralizing GPC-A antibody competition group are understudied. Structures of two GPC-A antibodies presented here demonstrate that they bind the side of the pre-fusion GP trimer, bridging the GP1 and GP2 subunits. Complementary biochemical analyses indicate that antibody 25.10C, which is broadly specific, neutralizes by inhibiting binding of the endosomal receptor LAMP1 and also by blocking membrane fusion. The other GPC-A antibody, 36.1F, which is lineage-specific, prevents LAMP1 association only. These data illuminate a site of vulnerability on LASV GP and will guide efforts to elicit broadly reactive therapeutics and vaccines. Enriquez et al. present two structures of GPC-A antibody Fab fragments bound to Lassa virus glycoprotein. Complementary biochemical analyses illuminate mechanistic differences between pan-Lassa 25.10C and lineage-specific 36.1F. 25.10C inhibits two steps of Lassa virus infection, LAMP1 binding and membrane fusion, while 36.1F only blocks LAMP1.
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Affiliation(s)
| | - Tierra K Buck
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Haoyang Li
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | | | - Alex Moon-Walker
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Program in Virology, Harvard University, Boston, MA 02115, USA; Department of Molecular Microbiology, Washington University in Saint Louis, St. Louis, MO 63130, USA
| | | | | | - James E Robinson
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | | | - Robert F Garry
- Zalgen Labs, LLC, Germantown, MD 20876, USA; Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA
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15
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Maruyama J, Reyna RA, Kishimoto-Urata M, Urata S, Manning JT, Harsell N, Cook R, Huang C, Nikolich-Zugich J, Makishima T, Paessler S. CD4 T-cell depletion prevents Lassa fever associated hearing loss in the mouse model. PLoS Pathog 2022; 18:e1010557. [PMID: 35605008 PMCID: PMC9166448 DOI: 10.1371/journal.ppat.1010557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/03/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Abstract
Lassa virus (LASV) is the causative agent of Lassa fever (LF), which presents as a lethal hemorrhagic disease in severe cases. LASV-induced hearing loss in survivors is a huge socioeconomic burden, however, the mechanism(s) leading to hearing loss is unknown. In this study, we evaluate in a mouse LF model the auditory function using auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE) to determine the mechanisms underlying LASV-induced hearing loss. In the process, we pioneered measures of ABR and DPOAE tests in rodents in biosafety level 4 (BSL-4) facilities. Our T cell depletion studies demonstrated that CD4 T-cells play an important role in LASV-induced hearing loss, while CD8 T-cells are critical for the pathogenicity in the acute phase of LASV infection. Results presented in this study may help to develop future countermeasures against acute disease and LASV-induced hearing loss.
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Affiliation(s)
- Junki Maruyama
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Rachel A. Reyna
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Megumi Kishimoto-Urata
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Shinji Urata
- Department of Otolaryngology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - John T. Manning
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Nantian Harsell
- Department of Otolaryngology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Rebecca Cook
- Department of Otolaryngology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Cheng Huang
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Janko Nikolich-Zugich
- Department of Immunobiology and the University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Arizona, United States of America
| | - Tomoko Makishima
- Department of Otolaryngology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Slobodan Paessler
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
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16
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Murphy HL, Ly H. Pathogenicity and virulence mechanisms of Lassa virus and its animal modeling, diagnostic, prophylactic, and therapeutic developments. Virulence 2021; 12:2989-3014. [PMID: 34747339 PMCID: PMC8923068 DOI: 10.1080/21505594.2021.2000290] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Lassa fever (LF) is a deadly viral hemorrhagic disease that is endemic to West Africa. The causative agent of LF is Lassa virus (LASV), which causes approximately 300,000 infections and 5,000 deaths annually. There are currently no approved therapeutics or FDA-approved vaccines against LASV. The high genetic variability between LASV strains and immune evasion mediated by the virus complicate the development of effective therapeutics and vaccines. Here, we aim to provide a comprehensive review of the basic biology of LASV and its mechanisms of disease pathogenesis and virulence in various animal models, as well as an update on prospective vaccines, therapeutics, and diagnostics for LF. Until effective vaccines and/or therapeutics are available for use to prevent or treat LF, a better level of understanding of the basic biology of LASV, its natural genetic variations and immune evasion mechanisms as potential pathogenicity factors, and of the rodent reservoir-vector populations and their geographical distributions, is necessary for the development of accurate diagnostics and effective therapeutics and vaccines against this deadly human viral pathogen.
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Affiliation(s)
- Hannah L Murphy
- Department of Veterinary & Biomedical Sciences, Comparative & Molecular Biosciences Graduate Program, College of Veterinary Medicine, University of Minnesota, Twin Cities
| | - Hinh Ly
- Department of Veterinary & Biomedical Sciences, Comparative & Molecular Biosciences Graduate Program, College of Veterinary Medicine, University of Minnesota, Twin Cities
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17
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Yaseen NK, Al-Ani RM, Ali Rashid R. COVID-19-related sudden sensorineural hearing loss. Qatar Med J 2021; 2021:58. [PMID: 34745911 PMCID: PMC8555677 DOI: 10.5339/qmj.2021.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) can be a feature of COVID-19. It may present alone or with other symptoms of the disease. However, there is little written in the literature about its occurrence. We aimed to evaluate the socio-clinical characteristics and outcome of confirmed mild- to moderate COVID-19 cases with SSNHL in Tikrit city, Iraq. MATERIALS AND METHODS This descriptive study was conducted at the Otolaryngology Department, Tikrit General Hospital, Tikrit city, Iraq. The period of the study was from December 1, 2020 to June 30, 2021.Mild and moderate COVID-19 subjects confirmed by real-time polymerase reaction were included in the study. Detailed demographic (age, gender, and smoking habit) and clinical characteristics (onset and duration of deafness, side, severity, associated ear, nose, and throat symptoms, and comorbidity) were recorded for every patient. Outcomes following the steroid treatment protocol were also registered. RESULTS SSNHL was identified in 26 patients, of whom 20 (76.9%) were women, 20 (76.9%) were in the age group ≥ 30 years, and 21 (80.8%) were non-smokers. Around three-quarters of the subjects were identified within the first week of deafness occurrence. Bilateral (18/26) was more common than unilateral deafness (8/26); therefore, the total number of deaf ears was 44. Besides, bilateral symmetrical deafness (13/18) outnumbered the asymmetrical type (5/18). Around three-quarters were of moderate severity. The most common otological symptom was tinnitus (25/26). The most common nose and throat symptom was anosmia (6/26). The mean hearing threshold before and after treatment with oral steroids ± intratympanic steroids was 50.91 ± 11.777 dB and 40.24 ± 15.693, respectively. One patient with bilateral SSNHL was lost to follow-up; the remaining number of deaf ears was 42, and half of them were partially improved. The outcome of the treatment showed no statistically significant relation with the duration, side, and severity of SSNHL (p>0.05). CONCLUSION The majority of COVID-19-related SSNHL cases presented within one week of onset, with bilateral outnumbering unilateral cases. Tinnitus was the most common associated symptom. Treatment with steroids achieved partial improvement in half of the cases, and this outcome was not affected by the duration, side, and severity of deafness.
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Affiliation(s)
- Nada Khaleel Yaseen
- Department of Surgery/Otolaryngology, College of Medicine, Tikrit University, Tikrit, Iraq. E-mail:
| | - Raid M Al-Ani
- Department of Surgery/Otolaryngology, College of Medicine, University Of Anbar, Anbar, Iraq
| | - Rasheed Ali Rashid
- Department of Surgery/Otolaryngology, College of Medicine, Tikrit University, Tikrit, Iraq. E-mail:
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18
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Hirschenberger M, Hunszinger V, Sparrer KMJ. Implications of Innate Immunity in Post-Acute Sequelae of Non-Persistent Viral Infections. Cells 2021; 10:2134. [PMID: 34440903 PMCID: PMC8391718 DOI: 10.3390/cells10082134] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Non-persistent viruses classically cause transient, acute infections triggering immune responses aimed at the elimination of the pathogen. Successful viruses evolved strategies to manipulate and evade these anti-viral defenses. Symptoms during the acute phase are often linked to dysregulated immune responses that disappear once the patient recovers. In some patients, however, symptoms persist or new symptoms emerge beyond the acute phase. Conditions resulting from previous transient infection are termed post-acute sequelae (PAS) and were reported for a wide range of non-persistent viruses such as rota-, influenza- or polioviruses. Here we provide an overview of non-persistent viral pathogens reported to be associated with diverse PAS, among them chronic fatigue, auto-immune disorders, or neurological complications and highlight known mechanistic details. Recently, the emergence of post-acute sequelae of COVID-19 (PASC) or long COVID highlighted the impact of PAS. Notably, PAS of non-persistent infections often resemble symptoms of persistent viral infections, defined by chronic inflammation. Inflammation maintained after the acute phase may be a key driver of PAS of non-persistent viruses. Therefore, we explore current insights into aberrant activation of innate immune signaling pathways in the post-acute phase of non-persistent viruses. Finally, conclusions are drawn and future perspectives for treatment and prevention of PAS are discussed.
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Ricciardiello F, Pisani D, Viola P, Cristiano E, Scarpa A, Giannone A, Longo G, Russo G, Bocchetti M, Coppola C, Perrella M, Oliva F, Chiarella G. Sudden Sensorineural Hearing Loss in Mild COVID-19: Case Series and Analysis of the Literature. Audiol Res 2021; 11:313-326. [PMID: 34287226 PMCID: PMC8293051 DOI: 10.3390/audiolres11030029] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/06/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background: There is growing evidence of otoneurological involvement of SARS-CoV-2, such as tinnitus and balance disorders and smell and taste disorders, but HL in COVID-19 patients has still been marginally studied. Investigating the role of SARS-CoV-2 as an aetiological factor of Sudden Sensorineural Hearing Loss (SSNHL) may offer the opportunity to address treatment strategies to maximize clinical recovery and avoid side effects. Methods and results: For this purpose, we will present case studies of five patients who experienced SSNHL during COVID-19. Patients were selected from COVID-19 positive adult subjects with mild clinical presentation, admitted to the outpatient Ear Nose and Throat Department of Cardarelli Hospital due to the onset of SSNHL during the infection. All underwent a complete audio-vestibular investigation before and after SSNHL treatment protocol. Each patient is described with a detailed analysis. Conclusions: SSNHL could be an occasional symptom of COVID-19, even in mild manifestations of the disease. Our experience leads us to underline the value of promptly recognizing and addressing this and other uncommon symptoms, giving patients the opportunity to receive early treatment.
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Affiliation(s)
- Filippo Ricciardiello
- ENT Department, AORN Cardarelli, 80131 Napoli, Italy; (F.R.); (E.C.); (A.G.); (F.O.)
| | - Davide Pisani
- Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (G.C.)
- Correspondence: ; Tel.: +39-096-1364-7124
| | - Pasquale Viola
- Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (G.C.)
| | - Elisabetta Cristiano
- ENT Department, AORN Cardarelli, 80131 Napoli, Italy; (F.R.); (E.C.); (A.G.); (F.O.)
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, 84084 Fisciano, Italy;
| | - Antonio Giannone
- ENT Department, AORN Cardarelli, 80131 Napoli, Italy; (F.R.); (E.C.); (A.G.); (F.O.)
| | | | - Giuseppe Russo
- Health Management AORN Cardarelli, 80131 Napoli, Italy; (G.R.); (C.C.)
| | - Marco Bocchetti
- Biogem Scarl, Molecular Oncology and Precision Medicine Laboratory, 83031 Irpino, Italy;
| | - Ciro Coppola
- Health Management AORN Cardarelli, 80131 Napoli, Italy; (G.R.); (C.C.)
| | - Marco Perrella
- Anesthesiology and Reanimation Department AORN Cardarelli, 80100 Napoli, Italy;
| | - Flavia Oliva
- ENT Department, AORN Cardarelli, 80131 Napoli, Italy; (F.R.); (E.C.); (A.G.); (F.O.)
| | - Giuseppe Chiarella
- Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (G.C.)
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20
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Ficenec SC, Percak J, Arguello S, Bays A, Goba A, Gbakie M, Shaffer JG, Emmett SD, Schieffelin JS, Bausch D. Lassa Fever Induced Hearing Loss: The Neglected Disability of Hemorrhagic Fever. Int J Infect Dis 2020; 100:82-87. [PMID: 32795603 PMCID: PMC7807889 DOI: 10.1016/j.ijid.2020.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/27/2020] [Accepted: 08/07/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Lassa fever (LF) a hemorrhagic fever endemic to Western has an incidence of approximately 500,000 cases per year. Here, we evaluate hearing loss and other sequelae following LF. METHODS This case-control study enrolled laboratory confirmed LF survivors, non-LF Febrile controls and Matched Community controls with no history of LF or recent hospitalization for a febrile illness. Study participants completed a symptom questionnaire. Pure-tone audiometry was completed by a subset of participants. RESULTS One hundred forty-seven subjects were enrolled aged from 3-66 years (mean = 23.3). LF survivors were significantly more likely to report balance difficulties (55% vs 20%, p < 0.001), hair loss (32% vs 7%, p < 0.001), difficulty speaking (19% vs 1%, p < 0.001), social isolation (50% vs 0%, p < 0.001), and hearing loss (17% vs 1%, p = 0.002) in comparison to Matched-Community Controls. Similar trends were noted in comparison to Febrile Controls, although these findings were non-significant. Fifty subjects completed audiometry. Audiometry found that LF survivors had significantly more bilateral hearing loss in comparison to Matched-Community Controls (30% vs 4%, p = 0.029). CONCLUSION This study characterizes the sequelae of LF and highlights the need for increased access to hearing care in West Africa.
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Affiliation(s)
| | - Jeffrey Percak
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Sara Arguello
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Alison Bays
- Division of Rheumatology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | | | | | - Jeffrey G Shaffer
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Susan D Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
| | | | - Daniel Bausch
- Tulane Viral Hemorrhagic Fever Research Program, Kenema Government Hospital, Kenema, Sierra Leone
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Affiliation(s)
- Jeyasakthy Saniasiaya
- Department of Otorhinolaryngology, 173800Hospital Tuanku Ja'afar, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
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22
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Schmaljohn C, Safronetz D. Editorial overview: Lassa virus. Curr Opin Virol 2020; 37:vii-ix. [PMID: 31564289 DOI: 10.1016/j.coviro.2019.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Connie Schmaljohn
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, United States.
| | - David Safronetz
- Special Pathogens, Public Health Agency of Canada - National Microbiology Laboratory, Winnipeg, Manitoba, R3E 3P6, Canada.
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23
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Di Paola N, Sanchez-Lockhart M, Zeng X, Kuhn JH, Palacios G. Viral genomics in Ebola virus research. Nat Rev Microbiol 2020; 18:365-378. [PMID: 32367066 PMCID: PMC7223634 DOI: 10.1038/s41579-020-0354-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2020] [Indexed: 12/20/2022]
Abstract
Filoviruses such as Ebola virus continue to pose a substantial health risk to humans. Advances in the sequencing and functional characterization of both pathogen and host genomes have provided a wealth of knowledge to clinicians, epidemiologists and public health responders during outbreaks of high-consequence viral disease. Here, we describe how genomics has been historically used to investigate Ebola virus disease outbreaks and how new technologies allow for rapid, large-scale data generation at the point of care. We highlight how genomics extends beyond consensus-level sequencing of the virus to include intra-host viral transcriptomics and the characterization of host responses in acute and persistently infected patients. Similar genomics techniques can also be applied to the characterization of non-human primate animal models and to known natural reservoirs of filoviruses, and metagenomic sequencing can be the key to the discovery of novel filoviruses. Finally, we outline the importance of reverse genetics systems that can swiftly characterize filoviruses as soon as their genome sequences are available.
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Affiliation(s)
- Nicholas Di Paola
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Mariano Sanchez-Lockhart
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Xiankun Zeng
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
| | - Gustavo Palacios
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA.
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Liu J, Babka AM, Kearney BJ, Radoshitzky SR, Kuhn JH, Zeng X. Molecular detection of SARS-CoV-2 in formalin-fixed, paraffin-embedded specimens. JCI Insight 2020; 5:139042. [PMID: 32379723 PMCID: PMC7406253 DOI: 10.1172/jci.insight.139042] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/06/2020] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of human coronavirus disease 2019 (COVID-19), emerged in Wuhan, China, in December 2019. The virus rapidly spread globally, resulting in a public health crisis including almost 5 million cases and 323,256 deaths as of May 21, 2020. Here, we describe the identification and evaluation of commercially available reagents and assays for the molecular detection of SARS-CoV-2 in infected FFPE cell pellets. We identified a suitable rabbit polyclonal anti-SARS-CoV spike protein antibody and a mouse monoclonal anti-SARS-CoV nucleocapsid protein (NP) antibody for cross-detection of the respective SARS-CoV-2 proteins by IHC and immunofluorescence assay (IFA). Next, we established RNAscope in situ hybridization (ISH) to detect SARS-CoV-2 RNA. Furthermore, we established a multiplex FISH (mFISH) to detect positive-sense SARS-CoV-2 RNA and negative-sense SARS-CoV-2 RNA (a replicative intermediate indicating viral replication). Finally, we developed a dual staining assay using IHC and ISH to detect SARS-CoV-2 antigen and RNA in the same FFPE section. It is hoped that these reagents and assays will accelerate COVID-19 pathogenesis studies in humans and in COVID-19 animal models.
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Affiliation(s)
- Jun Liu
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, Maryland, USA
| | - April M. Babka
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, Maryland, USA
| | - Brian J. Kearney
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, Maryland, USA
| | - Sheli R. Radoshitzky
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, Maryland, USA
| | - Jens H. Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Fort Detrick, Frederick, Maryland, USA
| | - Xiankun Zeng
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, Maryland, USA
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25
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Kilic O, Kalcioglu MT, Cag Y, Tuysuz O, Pektas E, Caskurlu H, Cetın F. Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss. Int J Infect Dis 2020; 97:208-211. [PMID: 32535294 PMCID: PMC7289736 DOI: 10.1016/j.ijid.2020.06.023] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 01/08/2023] Open
Abstract
During the COVID-19 pandemic it is important to recognize every possible symptom of the virus to break the chain of transmission. COVID-19 patients could present with nonspecific symptoms other than those that are commonly known. Sudden sensorineural hearing loss may be one of the symptoms of COVID-19. Until now there have been no reports of COVID-19 patients diagnosed with isolated sudden sensorineural hearing loss.
Objective This study aimed to investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients presenting with only sudden sensorineural hearing loss (SSHNL) during the COVID-19 pandemic. Methods The study included five male patients who presented with the sole complaint of unilateral SSNHL to the otolaryngology outpatient clinic between 03–12 April 2020. The patients were referred to the infectious diseases clinic to be evaluated for SARS-CoV-2 by real time polymerase chain reaction (RT-PCR) testing. Results RT-PCR testing for SARS-CoV-2 was positive in one of the patients and negative in the other four patients. A positive response to COVID-19-specific treatment in the SARS-CoV-2 positive SSNHL patient was noted. Conclusion It should be remembered that non-specific symptoms such as SSNHL could be the only sign with which to recognize a COVID-19 case. Awareness of such a non-specific presentation of COVID-19 patients is crucial during this pandemic period for preventing infectious spread through isolation and early initiation of COVID-19 targeted treatment.
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Affiliation(s)
- Osman Kilic
- Istanbul Medeniyet University, Faculty of Medicine, Departments of Otorhinolaryngology- Head and Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Tayyar Kalcioglu
- Istanbul Medeniyet University, Faculty of Medicine, Departments of Otorhinolaryngology- Head and Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey.
| | - Yasemin Cag
- Istanbul Medeniyet University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ozan Tuysuz
- Istanbul Medeniyet University, Faculty of Medicine, Departments of Otorhinolaryngology- Head and Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Emel Pektas
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Audiology, Istanbul, Turkey
| | - Hulya Caskurlu
- Istanbul Medeniyet University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ferihan Cetın
- Istanbul Medeniyet University, Faculty of Medicine, Departments of Physiology, Istanbul, Turkey
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26
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Downs IL, Shaia CI, Zeng X, Johnson JC, Hensley L, Saunders DL, Rossi F, Cashman KA, Esham HL, Gregory MK, Pratt WD, Trefry JC, Everson KA, Larcom CB, Okwesili AC, Cardile AP, Honko A. Natural History of Aerosol Induced Lassa Fever in Non‑Human Primates. Viruses 2020; 12:E593. [PMID: 32485952 PMCID: PMC7354473 DOI: 10.3390/v12060593] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/15/2022] Open
Abstract
Lassa virus (LASV), an arenavirus causing Lassa fever, is endemic to West Africa with up to 300,000 cases and between 5000 and 10,000 deaths per year. Rarely seen in the United States, Lassa virus is a CDC category A biological agent inasmuch deliberate aerosol exposure can have high mortality rates compared to naturally acquired infection. With the need for an animal model, specific countermeasures remain elusive as there is no FDA-approved vaccine. This natural history of aerosolized Lassa virus exposure in Macaca fascicularis was studied under continuous telemetric surveillance. The macaque response to challenge was largely analogous to severe human disease with fever, tachycardia, hypotension, and tachypnea. During initial observations, an increase trend of activated monocytes positive for viral glycoprotein was accompanied by lymphocytopenia. Disease uniformly progressed to high viremia followed by low anion gap, alkalosis, anemia, and thrombocytopenia. Hypoproteinemia occurred late in infection followed by increased levels of white blood cells, cytokines, chemokines, and biochemical markers of liver injury. Viral nucleic acids were detected in tissues of three non‑survivors at endpoint, but not in the lone survivor. This study provides useful details to benchmark a pivotal model of Lassa fever in support of medical countermeasure development for both endemic disease and traditional biodefense purposes.
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Affiliation(s)
- Isaac L. Downs
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Carl I. Shaia
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Xiankun Zeng
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Joshua C. Johnson
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21702, USA
| | - Lisa Hensley
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21702, USA
| | - David L. Saunders
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Franco Rossi
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Kathleen A. Cashman
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Heather L. Esham
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Melissa K. Gregory
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - William D. Pratt
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - John C. Trefry
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
- Defense Threat Reduction Agency, Fort Belvoir, VA 22060, USA
| | - Kyle A. Everson
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Charles B. Larcom
- Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431, USA;
| | - Arthur C. Okwesili
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Anthony P. Cardile
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
| | - Anna Honko
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (I.L.D.); (C.I.S.); (X.Z.); (J.C.J.); (L.H.); (D.L.S.); (F.R.); (K.A.C.); (H.L.E.); (M.K.G.); (W.D.P.); (J.C.T.); (K.A.E.); (A.C.O.); (A.H.)
- Investigator at National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
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Kainulainen MH, Spengler JR, Welch SR, Coleman-McCray JD, Harmon JR, Scholte FEM, Goldsmith CS, Nichol ST, Albariño CG, Spiropoulou CF. Protection From Lethal Lassa Disease Can Be Achieved Both Before and After Virus Exposure by Administration of Single-Cycle Replicating Lassa Virus Replicon Particles. J Infect Dis 2020; 220:1281-1289. [PMID: 31152662 DOI: 10.1093/infdis/jiz284] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/30/2019] [Indexed: 11/14/2022] Open
Abstract
Lassa fever is a frequently severe human disease that is endemic to several countries in West Africa. To date, no licensed vaccines are available to prevent Lassa virus (LASV) infection, even though Lassa fever is thought to be an important disease contributing to mortality and both acute and chronic morbidity. We have previously described a vaccine candidate composed of single-cycle LASV replicon particles (VRPs) and a stable cell line for their production. Here, we refine the genetic composition of the VRPs and demonstrate the ability to reproducibly purify them with high yields. Studies in the guinea pig model confirm efficacy of the vaccine candidate, demonstrate that single-cycle replication is necessary for complete protection by the VRP vaccine, and show that postexposure vaccination can confer protection from lethal outcome.
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Affiliation(s)
| | | | | | | | | | | | - Cynthia S Goldsmith
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
Lassa fever was first described as a clinical entity fifty years ago. The causative agent Lassa virus was isolated from these first known cases. This chapter reviews the key publications on Lassa fever research that appeared in the scientific literature at that time and over the ensuing decades.
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Affiliation(s)
- Robert F Garry
- Department of Microbiology and Immunology, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70118, USA. .,Zalgen Labs, LLC, 20271 Goldenrod Lane, Suite 2083, Germantown, MD, 20876, USA.
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Carol Liu YC, Ibekwe T, Kelso JM, Klein NP, Shehu N, Steuerwald W, Aneja S, Dudley MZ, Garry R, Munoz FM. Sensorineural hearing loss (SNHL) as an adverse event following immunization (AEFI): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2020; 38:4717-4731. [PMID: 32418788 DOI: 10.1016/j.vaccine.2020.05.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/22/2023]
Abstract
This is a Brighton Collaboration case definition of the term "Sensorineural Hearing Loss" to be utilized in the evaluation of adverse events following immunization. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of vaccines for Lassa Fever and other emerging pathogens. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and define levels of diagnostic certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network.
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Affiliation(s)
- Yi-Chun Carol Liu
- Department of Otorhinolaryngology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Titus Ibekwe
- Department of Otorhinolaryngology, University of Abuja, Nigeria
| | - John M Kelso
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, CA, USA
| | - Nathan Shehu
- Department of Pediatric Infectious Diseases, Jos University, Nigeria
| | - Wendy Steuerwald
- Department of Audiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, Gr Noida, India
| | - Matthew Z Dudley
- Department of International Health, and Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Flor M Munoz
- Department of Pediatrics, Section of Infectious Diseases, and Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
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30
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Prevalence and outcome of Lassa fever among hospitalized patients in Ebonyi State, Nigeria, 2018-2019. Virus Res 2020; 285:198000. [PMID: 32380207 DOI: 10.1016/j.virusres.2020.198000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 01/26/2023]
Abstract
Lassa fever (LF) is a viral hemorrhagic illness endemic in West Africa. Annually, about 300,000-500,000 people are being infected, with about 5000 deaths. Symptoms of LF include high grade fever, headache, malaise, abdominal pain, vomiting, diarrhea, or sore throat. Terminal features may include bleeding from all orifices (mouth, nose, ear, anus and vagina), facial and neck oedema or pleural effusion. People of all ages, gender, and occupations were included in this study. A total of 440 patients' samples and Bio data were used for this study. The samples were analyzed for Lassa fever virus RNA using Real Time Reverse Transcriptase Polymerase Chain Reaction. The data obtained were analyzed using SPSS 20.0 and version 7 of Epi-Info statistical software. Analysis of these samples showed LASV prevalence of 25.7%. Chi-square analysis (p ≤ 0.05) showed that LASV infection does not depend on age, gender, or occupation. Our research re-emphasized the fact that LASV is a serious cause of fatality in humans. Our data showed that among 327 negative patients, 19 died. On the contrary, 113 LASV confirmed positive cases had 42 deaths. This result is highly significant. More so, Lassa fever disease outcome was compared across gender. There was no significant difference between the two genders. Death or recovery from LF infection does not depend on sex. However, recovery from LF significantly depends on age of the patient. Fatal outcome is significantly higher among adults/elderly. We aim to raise awareness to the recurrence of LASV in Ebonyi State and urgent need for other medical interventions, including other therapeutic measures, and possible vaccine production, considering the impact of this virus.
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31
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Meeting report: WHO consultation on accelerating Lassa fever vaccine development in endemic countries, Dakar, 10–11 September 2019. Vaccine 2020; 38:4135-4141. [DOI: 10.1016/j.vaccine.2020.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/07/2020] [Indexed: 01/08/2023]
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32
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Liu J, Babka AM, Kearney BJ, Radoshitzky SR, Kuhn JH, Zeng X. Molecular Detection of SARS-CoV-2 in Formalin Fixed Paraffin Embedded Specimens. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020:2020.04.21.042911. [PMID: 32511350 PMCID: PMC7255791 DOI: 10.1101/2020.04.21.042911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of human coronavirus disease 2019 (COVID-19), emerged in Wuhan, China in December 2019. The virus rapidly spread globally, resulting in a public-health crisis including more than one million cases and tens of thousands of deaths. Here, we describe the identification and evaluation of commercially available reagents and assays for the molecular detection of SARS-CoV-2 in infected formalin fixed paraffin embedded (FFPE) cell pellets. We identified a suitable rabbit polyclonal anti-SARS-CoV spike protein antibody and a mouse monoclonal anti-SARS-CoV nucleocapsid protein (NP) antibody for cross detection of the respective SARS-CoV-2 proteins by immunohistochemistry (IHC) and immunofluorescence assay (IFA). Next, we established RNAscope in situ hybridization (ISH) to detect SARS-CoV-2 RNA. Furthermore, we established a multiplex fluorescence ISH (mFISH) to detect positive-sense SARS-CoV-2 RNA and negative-sense SARS-CoV-2 RNA (a replicative intermediate indicating viral replication). Finally, we developed a dual staining assay using IHC and ISH to detect SARS-CoV-2 antigen and RNA in the same FFPE section. These reagents and assays will accelerate COVID-19 pathogenesis studies in humans and in COVID-19 animal models.
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Affiliation(s)
- Jun Liu
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702, USA
| | - April M. Babka
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702, USA
| | - Brian J. Kearney
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702, USA
| | - Sheli R. Radoshitzky
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702, USA
| | - Jens H. Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National, Institutes of Health, Fort Detrick, Frederick, MD 21702, USA
| | - Xiankun Zeng
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702, USA
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Ibukun FI. Inter-Lineage Variation of Lassa Virus Glycoprotein Epitopes: A Challenge to Lassa Virus Vaccine Development. Viruses 2020; 12:v12040386. [PMID: 32244402 PMCID: PMC7232328 DOI: 10.3390/v12040386] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/26/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022] Open
Abstract
Lassa virus (LASV), which causes considerable morbidity and mortality annually, has a high genetic diversity across West Africa. LASV glycoprotein (GP) expresses this diversity, but most LASV vaccine candidates utilize only the Lineage IV LASV Josiah strain GP antigen as an immunogen and homologous challenge with Lineage IV LASV. In addition to the sequence variation amongst the LASV lineages, these lineages are also distinguished in their presentations. Inter-lineage variations within previously mapped B-cell and T-cell LASV GP epitopes and the breadth of protection in LASV vaccine/challenge studies were examined critically. Multiple alignments of the GP primary sequence of strains from each LASV lineage showed that LASV GP has diverging degrees of amino acid conservation within known epitopes among LASV lineages. Conformational B-cell epitopes spanning different sites in GP subunits were less impacted by LASV diversity. LASV GP diversity should influence the approach used for LASV vaccine design. Expression of LASV GP on viral vectors, especially in its prefusion configuration, has shown potential for protective LASV vaccines that can overcome LASV diversity. Advanced vaccine candidates should demonstrate efficacy against all LASV lineages for evidence of a pan-LASV vaccine.
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Affiliation(s)
- Francis Ifedayo Ibukun
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, 21201, MD, USA
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34
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Asogun DA, Günther S, Akpede GO, Ihekweazu C, Zumla A. Lassa Fever: Epidemiology, Clinical Features, Diagnosis, Management and Prevention. Infect Dis Clin North Am 2020; 33:933-951. [PMID: 31668199 DOI: 10.1016/j.idc.2019.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Lassa fever outbreaks West Africa have caused up to 10,000 deaths annually. Primary infection occurs from contact with Lassa virus-infected rodents and exposure to their excreta, blood, or meat. Incubation takes 2 to 21 days. Symptoms are difficult to distinguish from malaria, typhoid, dengue, yellow fever, and other viral hemorrhagic fevers. Clinical manifestations range from asymptomatic, to mild, to severe fulminant disease. Ribavirin can improve outcomes. Overall mortality is between 1% and 15%. Lassa fever should be considered in the differential diagnosis with travel to West Africa. There is an urgent need for rapid field-friendly diagnostics and preventive vaccine.
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Affiliation(s)
- Danny A Asogun
- Department of Public Health, College of Medicine, Ambrose Alli University, Ekpoma, Nigeria; Department of Public Health, Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, P.M.B 008, Kilometre 87, Benin City-Auchi Road, Irrua, Nigeria.
| | - Stephan Günther
- Bernhard-Nocht Institute for Tropical Medicine, Strab 74, Hamburg 20359, Germany; German Centre for Infection Research (DZIF), Partner Site Hamburg, Hamburg, Germany
| | - George O Akpede
- Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, Ambrose Alli University, Ekpoma, Nigeria
| | - Chikwe Ihekweazu
- Nigeria Centre for Disease Control, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - Alimuddin Zumla
- Center for Clinical Microbiology, University College London, Royal Free Campus 2nd Floor, Rowland Hill Street, London NW3 2PF, United Kingdom
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35
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Animal Models of Lassa Fever. Pathogens 2020; 9:pathogens9030197. [PMID: 32155851 PMCID: PMC7157617 DOI: 10.3390/pathogens9030197] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/31/2022] Open
Abstract
Lassa virus (LASV), the causative agent of Lassa fever, is estimated to be responsible for up to 300,000 new infections and 5000 deaths each year across Western Africa. The most recent 2018 and 2019 Nigerian outbreaks featured alarmingly high fatality rates of up to 25.4%. In addition to the severity and high fatality of the disease, a significant population of survivors suffer from long-term sequelae, such as sensorineural hearing loss, resulting in a huge socioeconomic burden in endemic regions. There are no Food and Drug Administration (FDA)-approved vaccines, and therapeutics remain extremely limited for Lassa fever. Development of countermeasures depends on relevant animal models that can develop a disease strongly mimicking the pathogenic features of Lassa fever in humans. The objective of this review is to evaluate the currently available animal models for LASV infection with an emphasis on their pathogenic and histologic characteristics as well as recent advances in the development of a suitable rodent model. This information may facilitate the development of an improved animal model for understanding disease pathogenesis of Lassa fever and for vaccine or antiviral testing.
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36
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Ficenec SC, Schieffelin JS, Emmett SD. A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever. Am J Trop Med Hyg 2020; 101:484-490. [PMID: 31333155 PMCID: PMC6726950 DOI: 10.4269/ajtmh.18-0934] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The neglected tropical diseases Zika, Ebola, and Lassa fever (LF) have all been noted to cause some degree of hearing loss (HL). Hearing loss is a chronic disability that can lead to a variety of detrimental effects, including speech and language delays in children, decreased economic productivity in adults, and accelerated cognitive decline in older adults. The objective of this review is to summarize what is known regarding HL secondary to these viruses. Literature for this review was gathered using the PubMed database. Articles were excluded if there were no data of the respective viruses, postinfectious complications, or conditions related to survivorship. A total of 50 articles were included in this review. Fourteen articles discussing Zika virus and subsequent complications were included. Across these studies, 56 (21.2%) of 264 Zika-infected individuals were found to have HL. Twenty-one articles discussing Ebola virus and subsequent complications were included, with 190 (5.7%) of 3,350 Ebola survivors found to have HL. Fifteen additional articles discussing LF and subsequent complications were included. Of 926 individuals with LF, 79 (8.5%) were found to have HL. These results demonstrate a relationship between HL and infection. The true prevalence is likely underestimated, however, because of lack of standardization of reporting and measurement. Future studies of viral sequelae would benefit from including audiometric evaluation. This information is critical to understanding pathophysiology, preventing future cases of this disability, and improving quality of life after survival of infection.
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Affiliation(s)
| | | | - Susan D Emmett
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina.,Duke Global Health Institute, Durham, North Carolina.,Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina
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37
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Differential Immune Responses to Hemorrhagic Fever-Causing Arenaviruses. Vaccines (Basel) 2019; 7:vaccines7040138. [PMID: 31581720 PMCID: PMC6963578 DOI: 10.3390/vaccines7040138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 12/28/2022] Open
Abstract
The family Arenaviridae contains several pathogens of major clinical importance. The Old World (OW) arenavirus Lassa virus is endemic in West Africa and is estimated to cause up to 300,000 infections each year. The New World (NW) arenaviruses Junín and Machupo periodically cause hemorrhagic fever outbreaks in South America. While these arenaviruses are highly pathogenic in humans, recent evidence indicates that pathogenic OW and NW arenaviruses interact with the host immune system differently, which may have differential impacts on viral pathogenesis. Severe Lassa fever cases are characterized by profound immunosuppression. In contrast, pathogenic NW arenavirus infections are accompanied by elevated levels of Type I interferon and pro-inflammatory cytokines. This review aims to summarize recent findings about interactions of these pathogenic arenaviruses with the innate immune machinery and the subsequent effects on adaptive immunity, which may inform the development of vaccines and therapeutics against arenavirus infections.
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38
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Garnett LE, Strong JE. Lassa fever: With 50 years of study, hundreds of thousands of patients and an extremely high disease burden, what have we learned? Curr Opin Virol 2019; 37:123-131. [PMID: 31479990 DOI: 10.1016/j.coviro.2019.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/23/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Lauren E Garnett
- Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Canada; Departments of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - James E Strong
- Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Canada; Departments of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Departments of Paediatrics and Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
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Sattler RA, Maruyama J, Shehu NY, Makishima T, Paessler S. Current small animal models for LASV hearing loss. Curr Opin Virol 2019; 37:118-122. [PMID: 31479989 DOI: 10.1016/j.coviro.2019.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 11/20/2022]
Abstract
Lassa virus (LASV) is endemic in West Africa, causing an estimated 100000-300000 new infections and up to 5000-10000 deaths yearly. There are no vaccines and therapeutics are extremely limited. Typical case fatality rates are ∼1%, although a recent 2018 Nigerian outbreak featured an unprecedented 25.4% case fatality rate. Survivors of infection suffer a lifetime of sequelae with sudden onset sensorineural hearing loss (SNHL) being the most prevalent. The cause of this hearing loss remains unknown, and there is a critical need for further research on its mechanisms and potential therapeutics. The objective of this review is to outline the only currently available small animal model for LASV-induced hearing loss and to identify potential surrogate models.
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Affiliation(s)
- Rachel A Sattler
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Junki Maruyama
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Nathan Y Shehu
- Department of Medicine, Infectious Disease Unit, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Tomoko Makishima
- Department of Otolaryngology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77551-0609, USA.
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40
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Tang-Huau TL, Feldmann H, Rosenke K. Animal models for Lassa virus infection. Curr Opin Virol 2019; 37:112-117. [PMID: 31442921 DOI: 10.1016/j.coviro.2019.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 12/20/2022]
Abstract
In humans, Lassa virus infection can result in disease with hemorrhagic manifestations and high fatality rates. There are no approved treatments or vaccines available and the inherent danger of studying Lassa virus means it can only be studied in high containment labs (BSL4). Under these conditions, mouse models are becoming an important instrument in the study of Lassa virus infection, disease and host responses. While guinea pigs and non-human primates are the critical components in assessing treatments and vaccines and have recently been used with great affect in this capacity.
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Affiliation(s)
- Tsing-Lee Tang-Huau
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - H Feldmann
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA; Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - K Rosenke
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA.
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41
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Viruses and Autoimmunity: A Review on the Potential Interaction and Molecular Mechanisms. Viruses 2019; 11:v11080762. [PMID: 31430946 PMCID: PMC6723519 DOI: 10.3390/v11080762] [Citation(s) in RCA: 297] [Impact Index Per Article: 59.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 02/06/2023] Open
Abstract
For a long time, viruses have been shown to modify the clinical picture of several autoimmune diseases, including type 1 diabetes (T1D), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren’s syndrome (SS), herpetic stromal keratitis (HSK), celiac disease (CD), and multiple sclerosis (MS). Best examples of viral infections that have been proposed to modulate the induction and development of autoimmune diseases are the infections with enteric viruses such as Coxsackie B virus (CVB) and rotavirus, as well as influenza A viruses (IAV), and herpesviruses. Other viruses that have been studied in this context include, measles, mumps, and rubella. Epidemiological studies in humans and experimental studies in animal have shown that viral infections can induce or protect from autoimmunopathologies depending on several factors including genetic background, host-elicited immune responses, type of virus strain, viral load, and the onset time of infection. Still, data delineating the clear mechanistic interaction between the virus and the immune system to induce autoreactivity are scarce. Available data indicate that viral-induced autoimmunity can be activated through multiple mechanisms including molecular mimicry, epitope spreading, bystander activation, and immortalization of infected B cells. Contrarily, the protective effects can be achieved via regulatory immune responses which lead to the suppression of autoimmune phenomena. Therefore, a better understanding of the immune-related molecular processes in virus-induced autoimmunity is warranted. Here we provide an overview of the current understanding of viral-induced autoimmunity and the mechanisms that are associated with this phenomenon.
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42
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Jiang J, Banglore P, Cashman KA, Schmaljohn CS, Schultheis K, Pugh H, Nguyen J, Humeau LM, Broderick KE, Ramos SJ. Immunogenicity of a protective intradermal DNA vaccine against lassa virus in cynomolgus macaques. Hum Vaccin Immunother 2019; 15:2066-2074. [PMID: 31071008 PMCID: PMC6773375 DOI: 10.1080/21645515.2019.1616499] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Lassa virus (LASV) is a hemorrhagic fever virus of the Arenaviridae family with high rates of mortality and co-morbidities, including chronic seizures and permanent bilateral or unilateral deafness. LASV is endemic in West Africa and Lassa fever accounts for 10-16% of hospitalizations annually in parts of Sierra Leone and Liberia according to the CDC. An ongoing outbreak in Nigeria has resulted in 144 deaths in 568 cases confirmed as LASV as of November 2018, with many more suspected, highlighting the urgent need for a vaccine to prevent this severe disease. We previously reported on a DNA vaccine encoding a codon-optimized LASV glycoprotein precursor gene, pLASV-GPC, which completely protects Guinea pigs and nonhuman primates (NHPs) against viremia, clinical disease, and death following lethal LASV challenge. Herein we report on the immunogenicity profile of the LASV DNA vaccine in protected NHPs. Antigen-specific binding antibodies were generated in 100% (6/6) NHPs after two immunizations with pLASV-GPC. These antibodies bound predominantly to the assembled LASV glycoprotein complex and had robust neutralizing activity in a pseudovirus assay. pLASV-GPC DNA-immunized NHPs (5/6) also developed T cell responses as measured by IFNγ ELISpot assay. These results revealed that the pLASV-GPC DNA vaccine is capable of generating functional, LASV-specific T cell and antibody responses, and the assays developed in this study will provide a framework to identify correlates of protection and characterize immune responses in future clinical trials.
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Affiliation(s)
- Jingjing Jiang
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA
| | - Preeti Banglore
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA
| | - Kathleen A. Cashman
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA
| | - Connie S. Schmaljohn
- Office of the Chief Scientists, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA
| | | | - Holly Pugh
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA
| | - Jacklyn Nguyen
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA
| | - Laurent M. Humeau
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA
| | - Kate E. Broderick
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA
| | - Stephanie J. Ramos
- Research & Development, Inovio Pharmaceuticals Inc, Plymouth Meeting, PA, USA,CONTACT Stephanie J. Ramos 10480 Wateridge Circle, San Diego, CA 92121, USA
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Abstract
According to a recent epidemiological survey, the incidence of sudden sensorineural hearing loss (SSNHL) is increasing yearly. The cause of SSNHL is of great interest in research. To date, viral infection, vascular occlusion, abnormal cellular stress responses within the cochlea, and immune-mediated mechanisms are considered the most likely etiologies of this disease. Among these etiologies, the relationship between viral infection and sudden deafness has been unclear. In this review, we mainly discuss the viral hypothesis of SSNHL. There is little research proving or clearly indicating the pathogenesis of this disease. Further research is needed to elucidate the precise etiopathogenesis to better understand SSNHL and establish more suitable treatment to help restore hearing in affected patients.
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Affiliation(s)
- Xin Chen
- 1 ENT institute, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Yao-Yao Fu
- 1 ENT institute, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Tian-Yu Zhang
- 2 ENT institute, Eye & ENT Hospital of Fudan University, Shanghai, China; Hearing Medicine Key Laboratory, National Health and Family Planning Commission, Shanghai, China
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44
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Brisse ME, Ly H. Hemorrhagic Fever-Causing Arenaviruses: Lethal Pathogens and Potent Immune Suppressors. Front Immunol 2019; 10:372. [PMID: 30918506 PMCID: PMC6424867 DOI: 10.3389/fimmu.2019.00372] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/14/2019] [Indexed: 12/22/2022] Open
Abstract
Hemorrhagic fevers (HF) resulting from pathogenic arenaviral infections have traditionally been neglected as tropical diseases primarily affecting African and South American regions. There are currently no FDA-approved vaccines for arenaviruses, and treatments have been limited to supportive therapy and use of non-specific nucleoside analogs, such as Ribavirin. Outbreaks of arenaviral infections have been limited to certain geographic areas that are endemic but known cases of exportation of arenaviruses from endemic regions and socioeconomic challenges for local control of rodent reservoirs raise serious concerns about the potential for larger outbreaks in the future. This review synthesizes current knowledge about arenaviral evolution, ecology, transmission patterns, life cycle, modulation of host immunity, disease pathogenesis, as well as discusses recent development of preventative and therapeutic pursuits against this group of deadly viral pathogens.
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Affiliation(s)
- Morgan E Brisse
- Biochemistry, Molecular Biology, and Biophysics Graduate Program, University of Minnesota, St. Paul, MN, United States.,Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
| | - Hinh Ly
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, United States
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45
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Lukashevich IS, Paessler S, de la Torre JC. Lassa virus diversity and feasibility for universal prophylactic vaccine. F1000Res 2019; 8. [PMID: 30774934 PMCID: PMC6357994 DOI: 10.12688/f1000research.16989.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 12/14/2022] Open
Abstract
Lassa virus (LASV) is a highly prevalent mammarenavirus in West Africa and is maintained in nature in a persistently infected rodent host, Mastomys natalensis, which is widely spread in sub-Saharan Africa. LASV infection of humans can cause Lassa fever (LF), a disease associated with high morbidity and significant mortality. Recent evidence indicates an LASV expansion outside its traditional endemic areas. In 2017, the World Health Organization (WHO) included LASV in top-priority pathogens and released a Target Product Profile (TPP) for vaccine development. Likewise, in 2018, the US Food and Drug Administration added LF to a priority review voucher program to encourage the development of preventive and therapeutics measures. In this article, we review recent progress in LASV vaccine research and development with a focus on the impact of LASV genetic and biological diversity on the design and development of vaccine candidates meeting the WHO's TPP for an LASV vaccine.
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Affiliation(s)
- Igor S Lukashevich
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, 40292, USA
| | - Slobodan Paessler
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX, 77555, USA
| | - Juan Carlos de la Torre
- Department of Immunology and Microbiology IMM-6, The Scripps Research Institute, La Jolla, CA, 92037, USA
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46
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Loureiro ME, D'Antuono A, López N. Virus⁻Host Interactions Involved in Lassa Virus Entry and Genome Replication. Pathogens 2019; 8:pathogens8010017. [PMID: 30699976 PMCID: PMC6470645 DOI: 10.3390/pathogens8010017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 01/08/2023] Open
Abstract
Lassa virus (LASV) is the causative agent of Lassa fever, a human hemorrhagic disease associated with high mortality and morbidity rates, particularly prevalent in West Africa. Over the past few years, a significant amount of novel information has been provided on cellular factors that are determinant elements playing a role in arenavirus multiplication. In this review, we focus on host proteins that intersect with the initial steps of the LASV replication cycle: virus entry and genome replication. A better understanding of relevant virus⁻host interactions essential for sustaining these critical steps may help to identify possible targets for the rational design of novel therapeutic approaches against LASV and other arenaviruses that cause severe human disease.
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Affiliation(s)
- María Eugenia Loureiro
- Centro de Virología Animal (CEVAN), CONICET-SENASA, Av Sir Alexander Fleming 1653, Martínez, Provincia de Buenos Aires B1640CSI, Argentina.
| | - Alejandra D'Antuono
- Centro de Virología Animal (CEVAN), CONICET-SENASA, Av Sir Alexander Fleming 1653, Martínez, Provincia de Buenos Aires B1640CSI, Argentina.
| | - Nora López
- Centro de Virología Animal (CEVAN), CONICET-SENASA, Av Sir Alexander Fleming 1653, Martínez, Provincia de Buenos Aires B1640CSI, Argentina.
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