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Yao Z, Liang M, Zhu S. Infectious factors in myocarditis: a comprehensive review of common and rare pathogens. Egypt Heart J 2024; 76:64. [PMID: 38789885 PMCID: PMC11126555 DOI: 10.1186/s43044-024-00493-3] [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: 03/07/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Myocarditis is a significant health threat today, with infectious agents being the most common cause. Accurate diagnosis of the etiology of infectious myocarditis is crucial for effective treatment. MAIN BODY Infectious myocarditis can be caused by viruses, prokaryotes, parasites, and fungi. Viral infections are typically the primary cause. However, some rare opportunistic pathogens can also damage heart muscle cells in patients with immunodeficiencies, neoplasms and those who have undergone heart surgery. CONCLUSIONS This article reviews research on common and rare pathogens of infectious myocarditis, emphasizing the complexity of its etiology, with the aim of helping clinicians make an accurate diagnosis of infectious myocarditis.
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Affiliation(s)
- Zongjie Yao
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qindao, China.
| | - Mingjun Liang
- Department of Intensive Care Medicine, Shanghai Six People's Hospital Affilicated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Simin Zhu
- Wuhan Third Hospital-Tongren Hospital of Wuhan University, Wuhan, China
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2
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Barbosa ICDQ, de Paula Gomes L, de Almeida Feitosa IN, Botelho LFB, Barbosa BRC, Barbosa A, Araújo ATDV, de Melo MDT, Melo ASDO, Salemi VMC. Morphological and functional cardiac alterations in children with congenital Zika syndrome and severe neurological deficits. PLoS Negl Trop Dis 2023; 17:e0011762. [PMID: 38019886 PMCID: PMC10712894 DOI: 10.1371/journal.pntd.0011762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/11/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Zika virus infection during pregnancy causes fetal microcephaly and brain damage. Congenital Zika syndrome (CZS) is characterized by systemic involvement with diffuse muscle impairment, a high frequency of arthrogryposis, and microphthalmia. Cardiac impairment in CZS has rarely been evaluated. Our study assessed morphology and biventricular cardiac function in children with CZS and advanced neurological dysfunction. METHODS This cross-sectional study was conducted on 52 children with CZS (Zika group; ZG) and 25 healthy children (control group; CG) in Paraiba, Brazil. Clinical evaluation, electrocardiogram (EKG), and transthoracic echocardiogram (TTE) were performed on all children. Additionally, troponin I and natriuretic peptide type B (BNP) levels, the degree of cerebral palsy, and neuroimaging findings were assessed in the ZG group. RESULTS The median age of the study population was 5 years in both groups, and 40.4% (ZG) and 60% (CG) were female. The most prevalent electrocardiographic alteration was sinus arrhythmia in both the ZG (n = 9, 17.3%) and CG (n = 4, 16%). The morphological parameters adjusted for Z score were as follows: left ventricular (LV) end-diastolic diameter in ZG: -2.36 [-5.10, 2.63] vs. CG: -1.07 [-3.43, 0.61], p<0.001); ascending aorta (ZG: -0.09 [-2.08, 1.60] vs. CG: 0.43 [-1.47, 2.2], p = 0.021); basal diameter of the right ventricle (RV) (ZG: -2.34 [-4.90, 0.97] vs. CG: -0.96 [-2.21, 0.40], p<0.01); and pulmonary artery dimension (ZG: -2.13 [-5.99, 0.98] vs. CG: -0.24 [-2.53, 0.59], p<0.01). The ejection fractions (%) were 65.7 and 65.6 in the ZG and CG, respectively (p = 0.968). The left atrium volume indices (mL/m2) in the ZG and CG were 13.15 [6.80, 18.00] and 18.80 [5.90, 25.30] (p<0.01), respectively, and the right atrium volume indices (mL/m2) were 10.10 [4.90, 15.30] and 15.80 [4.10, 24.80] (p<0.01). The functional findings adjusted for Z score were as follows: lateral systolic excursion of the mitral annular plane (MAPSE) (ZG: 0.36 [-2.79, 4.71] vs. CG: 1.79 [-0.93, 4.5], p = 0.001); tricuspid annular plane systolic excursion (TAPSE) (ZG: -2.43 [-5.47, 5.09] vs. CG: 0.07 [-1.98, 3.64], p<0.001); and the S' of the RV (ZG: 1.20 [3.35, 2.90] vs. CG: -0.20 [-2.15, 1.50], p = 0.0121). No differences in biventricular strain measurements were observed between the groups. Troponin I and BNP levels were normal in in the ZG. Grade V cerebral palsy and subcortical calcification were found in 88.6% and 97.22% of children in the ZG group, respectively. CONCLUSION A reduction in cardiac dimensions and functional changes were found in CZS patients, based on the TAPSE, S' of the RV, and MAPSE, suggesting the importance of cardiac evaluation and follow-up in this group of patients.
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Affiliation(s)
- Imara Correia de Queiroz Barbosa
- Federal University of Campina Grande, Campina Grande, Brazil
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Luís Fábio Barbosa Botelho
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Federal University of Paraíba, João Pessoa, Brazil
| | | | - Alex Barbosa
- Federal University of Campina Grande, Campina Grande, Brazil
| | | | | | - Adriana Suely de Oliveira Melo
- Federal University of Campina Grande, Campina Grande, Brazil
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, Brazil
| | - Vera Maria Cury Salemi
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Sirio Libanes Hospital, São Paulo, Brazil
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Ma X, Jia Y, Yuan J, Tang QJ, Gao WC, Zhou GF, Yang RH, Pang W, Zheng CB. Inhibiting cardiac autophagy suppresses Zika virus replication. J Med Virol 2023; 95:e28483. [PMID: 36625392 DOI: 10.1002/jmv.28483] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
Zika Virus (ZIKV) infection is a global threat. Other than the congenital neurological disorders it causes, ZIKV infection has been reported to induce cardiac complications. However, the precise treatment plans are unclear. Thus, illustrating the pathogenic mechanism of ZIKV in the heart is critical to providing effective prevention and treatment of ZIKV infection. The mechanism of autophagy has been reported recently in Dengue virus infection. Whether or not autophagy participates in ZIKV infection and its role remains unrevealed. This study successfully established the in vitro cardiomyocytes and in vivo mouse models of ZIKV infection to investigate the involvement of autophagy in ZIKV infection. The results showed that ZIKV infection is both time and gradient-dependent. The key autophagy protein, LC3B, increased remarkably after ZIKV infection. Meanwhile, autophagic flux was detected by immunofluorescence. Applying autophagy inhibitors decreased the LC3B levels. Furthermore, the number of viral copies was quantified to evaluate the influence of autophagy during infection. We found that autophagy was actively involved in the ZIKV infection and the inhibition of autophagy could effectively reduce the viral copies, suggesting a potential intervention strategy for reducing ZIKV infection and the undesired complications caused by ZIKV.
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Affiliation(s)
- Xin Ma
- Yunnan Key Laboratory of Pharmacology for Natural Products, School of Pharmaceutical Science, Kunming Medical University, Kunming, China
| | - Yinnong Jia
- Yunnan Key Laboratory of Pharmacology for Natural Products, School of Pharmaceutical Science, Kunming Medical University, Kunming, China
| | - Jing Yuan
- Yunnan Key Laboratory of Pharmacology for Natural Products, School of Pharmaceutical Science, Kunming Medical University, Kunming, China
| | - Qiu-Ju Tang
- Chinese Academy of Sciences, Center for Cancer Immunology, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Shenzhen, People's Republic of China
| | - Wen-Cong Gao
- Yunnan Key Laboratory of Pharmacology for Natural Products, School of Pharmaceutical Science, Kunming Medical University, Kunming, China
| | - Guang-Feng Zhou
- Key Laboratory of Animal Models and Human Diseases Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Ren-Hua Yang
- Yunnan Key Laboratory of Pharmacology for Natural Products, School of Pharmaceutical Science, Kunming Medical University, Kunming, China
| | - Wei Pang
- Key Laboratory of Animal Models and Human Diseases Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Chang-Bo Zheng
- Yunnan Key Laboratory of Pharmacology for Natural Products, School of Pharmaceutical Science, Kunming Medical University, Kunming, China
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4
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Rezende LDA, Freitas PDSS, Catabriga DDS, Mocelin HJS, De Jesus Silva KE, Moreira Silva L, Fiorin BH. Cardiovascular disorders in patients with Zika Virus: integrative review. REVISTA CIÊNCIAS EM SAÚDE 2022. [DOI: 10.21876/rcshci.v12i1.1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To describe the primary cardiovascular disorders manifested in patients infected with the zika virus and understand the pathophysiological process. Methods: This integrative literature review occurred in January 2021 through the PICO strategy, which answered the guiding question: “What are the main cardiovascular disorders manifested in patients infected with zika virus?” For this, a time interval of 5 years was defined, using the descriptors “Zika Virus”,“Heart” and “Cardiovascular Diseases” in English, Portuguese and Spanish. The contemplated databases were MEDLINE, LILACS, and BDENF. Results: There were a total of 77,872 articles, of which, after the exclusion and inclusion processes, it was summarized in eight articles included in this review. The main cardiovascular findings present were apical muscular ventricular septal defect and ostium secundum, in addition to atrial fibrillation and heart failure with reduced ejection fraction. Conclusions: Further studies with more robustness that clearly establish the mechanism of cellular tropism for cardiac muscle cells and involve the pathophysiological process of cardiac alterations more clearly and reliably are needed.
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Bai C, Hao J, Li S, Gao GF, Nie Y, Han P. Myocarditis and heart function impairment occur in neonatal mice following in utero exposure to the Zika virus. J Cell Mol Med 2021; 25:2730-2733. [PMID: 33590650 PMCID: PMC7933927 DOI: 10.1111/jcmm.16064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 01/24/2023] Open
Affiliation(s)
- Chongzhi Bai
- Central LaboratoryShanxi Province Hospital of Traditional Chinese MedicineTaiyuanChina
- CAS Key Laboratory of Pathogenic Microbiology & ImmunologyInstitute of MicrobiologyChinese Academy of SciencesBeijingChina
- Shanxi Academy of Advanced Research and InnovationTaiyuanChina
| | - Jianqing Hao
- School of Basic Medical SciencesShanxi Medical UniversityTaiyuanChina
| | - Shihua Li
- CAS Key Laboratory of Pathogenic Microbiology & ImmunologyInstitute of MicrobiologyChinese Academy of SciencesBeijingChina
| | - George Fu Gao
- CAS Key Laboratory of Pathogenic Microbiology & ImmunologyInstitute of MicrobiologyChinese Academy of SciencesBeijingChina
- Shanxi Academy of Advanced Research and InnovationTaiyuanChina
| | - Yu Nie
- State Key Laboratory of Cardiovascular DiseaseNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
| | - Pengcheng Han
- Department of Biomedical EngineeringEmory UniversityAtlantaGAUSA
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Freitas DA, Souza-Santos R, Carvalho LMA, Barros WB, Neves LM, Brasil P, Wakimoto MD. Congenital Zika syndrome: A systematic review. PLoS One 2020; 15:e0242367. [PMID: 33320867 PMCID: PMC7737899 DOI: 10.1371/journal.pone.0242367] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The signs and symptoms of Zika virus infection are usually mild and self-limited. However, the disease has been linked to neurological complications such as Guillain-Barré syndrome and peripheral nerve involvement, and also to abortion and fetal deaths due to vertical transmission, resulting in various congenital malformations in newborns, including microcephaly. This review aimed to describe the o signs and symptoms that characterize the congenital Zika syndrome. METHODS AND FINDINGS A systematic review was performed with a protocol and described according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search strategy yielded 2,048 studies. After the exclusion of duplicates and application of inclusion criteria, 46 studies were included. The main signs and symptoms associated with the congenital Zika syndrome were microcephaly, parenchymal or cerebellar calcifications, ventriculomegaly, central nervous system hypoplasia or atrophy, arthrogryposis, ocular findings in the posterior and anterior segments, abnormal visual function and low birthweight for gestational age. CONCLUSIONS Zika virus infection during pregnancy can cause a series of changes in the growth and development of children, while impacting the healthcare system due to the severity of cases. Our findings outline the disease profile in newborns and infants and may contribute to the development and updating of more specific clinical protocols.
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Affiliation(s)
- Danielle A. Freitas
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Reinaldo Souza-Santos
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Liege M. A. Carvalho
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Wagner B. Barros
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Luiza M. Neves
- Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Patrícia Brasil
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Mayumi D. Wakimoto
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
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7
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Rossi F, Josey B, Sayitoglu EC, Potens R, Sultu T, Duru AD, Beljanski V. Characterization of zika virus infection of human fetal cardiac mesenchymal stromal cells. PLoS One 2020; 15:e0239238. [PMID: 32941515 PMCID: PMC7498051 DOI: 10.1371/journal.pone.0239238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/01/2020] [Indexed: 12/16/2022] Open
Abstract
Zika virus (ZIKV) is a single-stranded RNA virus belonging to the family Flaviviridae. ZIKV predominantly enters cells using the TAM-family protein tyrosine kinase receptor AXL, which is expressed on a range of cell types, including neural progenitor cells, keratinocytes, dendritic cells, and osteoblasts. ZIKV infections have been associated with fetal brain damage, which prompted the World Health Organization to declare a public health emergency in 2016. ZIKV infection has also been linked to birth defects in other organs. Several studies have reported congenital heart defects (CHD) in ZIKV infected infants and cardiovascular complications in adults infected with ZIKV. To develop a better understanding of potential causes for these pathologies at a cellular level, we characterized ZIKV infection of human fetal cardiac mesenchymal stromal cells (fcMSCs), a cell type that is known to contribute to both embryological development as well as adult cardiac physiology. Total RNA, supernatants, and/or cells were collected at various time points post-infection to evaluate ZIKV replication, cell death, and antiviral responses. We found that ZIKV productively infected fcMSCs with peak (~70%) viral mRNA detected at 48 h. Use of an antibody blocking the AXL receptor decreased ZIKV infection (by ~50%), indicating that the receptor is responsible to a large extent for viral entry into the cell. ZIKV also altered protein expression of several mesenchymal cell markers, which suggests that ZIKV could affect fcMSCs’ differentiation process. Gene expression analysis of fcMSCs exposed to ZIKV at 6, 12, and 24 h post-infection revealed up-regulation of genes/pathways associated with interferon-stimulated antiviral responses. Stimulation of TLR3 (using poly I:C) or TLR7 (using Imiquimod) prior to ZIKV infection suppressed viral replication in a dose-dependent manner. Overall, fcMSCs can be a target for ZIKV infection, potentially resulting in CHD during embryological development and/or cardiovascular issues in ZIKV infected adults.
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Affiliation(s)
- Fiorella Rossi
- NSU Cell Therapy Institute, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
| | - Benjamin Josey
- NSU Cell Therapy Institute, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
| | - Ece Canan Sayitoglu
- NSU Cell Therapy Institute, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
| | - Renee Potens
- NSU Cell Therapy Institute, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
| | - Tolga Sultu
- Department of Molecular Biology and Genetics, Bogaziçi University, Istanbul, Turkey
| | - Adil Doganay Duru
- NSU Cell Therapy Institute, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Vladimir Beljanski
- NSU Cell Therapy Institute, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
- * E-mail:
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8
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Steinbach RJ, Haese NN, Smith JL, Colgin LMA, MacAllister RP, Greene JM, Parkins CJ, Kempton JB, Porsov E, Wang X, Renner LM, McGill TJ, Dozier BL, Kreklywich CN, Andoh TF, Grafe MR, Pecoraro HL, Hodge T, Friedman RM, Houser LA, Morgan TK, Stenzel P, Lindner JR, Schelonka RL, Sacha JB, Roberts VHJ, Neuringer M, Brigande JV, Kroenke CD, Frias AE, Lewis AD, Kelleher MA, Hirsch AJ, Streblow DN. A neonatal nonhuman primate model of gestational Zika virus infection with evidence of microencephaly, seizures and cardiomyopathy. PLoS One 2020; 15:e0227676. [PMID: 31935257 PMCID: PMC6959612 DOI: 10.1371/journal.pone.0227676] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022] Open
Abstract
Zika virus infection during pregnancy is associated with miscarriage and with a broad spectrum of fetal and neonatal developmental abnormalities collectively known as congenital Zika syndrome (CZS). Symptomology of CZS includes malformations of the brain and skull, neurodevelopmental delay, seizures, joint contractures, hearing loss and visual impairment. Previous studies of Zika virus in pregnant rhesus macaques (Macaca mulatta) have described injury to the developing fetus and pregnancy loss, but neonatal outcomes following fetal Zika virus exposure have yet to be characterized in nonhuman primates. Herein we describe the presentation of rhesus macaque neonates with a spectrum of clinical outcomes, including one infant with CZS-like symptoms including cardiomyopathy, motor delay and seizure activity following maternal infection with Zika virus during the first trimester of pregnancy. Further characterization of this neonatal nonhuman primate model of gestational Zika virus infection will provide opportunities to evaluate the efficacy of pre- and postnatal therapeutics for gestational Zika virus infection and CZS.
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Affiliation(s)
- Rosemary J. Steinbach
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Nicole N. Haese
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Jessica L. Smith
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - Lois M. A. Colgin
- Division of Comparative Medicine, Pathology Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Rhonda P. MacAllister
- Division of Comparative Medicine, Clinical Medicine Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Justin M. Greene
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Christopher J. Parkins
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - J. Beth Kempton
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Edward Porsov
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Xiaojie Wang
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Lauren M. Renner
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Trevor J. McGill
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Brandy L. Dozier
- Division of Comparative Medicine, Clinical Medicine Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Craig N. Kreklywich
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - Takeshi F. Andoh
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
| | - Marjorie R. Grafe
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Heidi L. Pecoraro
- Veterinary Diagnostic Services Department, North Dakota State University, Fargo, North Dakota, United States of America
| | - Travis Hodge
- Division of Comparative Medicine, Time Mated Breeding Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Robert M. Friedman
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Lisa A. Houser
- Division of Comparative Medicine, Behavioral Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Terry K. Morgan
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Peter Stenzel
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Jonathan R. Lindner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Robert L. Schelonka
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Jonah B. Sacha
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Victoria H. J. Roberts
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Martha Neuringer
- Department of Neuroscience, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - John V. Brigande
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Christopher D. Kroenke
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Antonio E. Frias
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Anne D. Lewis
- Division of Comparative Medicine, Pathology Services Unit, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Meredith A. Kelleher
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Alec J. Hirsch
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Daniel Neal Streblow
- Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, Oregon, United States of America
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
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Counotte MJ, Meili KW, Taghavi K, Calvet G, Sejvar J, Low N. Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review. F1000Res 2019; 8:1433. [PMID: 31754425 PMCID: PMC6852328 DOI: 10.12688/f1000research.19918.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2019] [Indexed: 01/10/2023] Open
Abstract
Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review. Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019. Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I
2=19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I
2=0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I
2=0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I
2=0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I
2=74.6%). In case-control studies, selection of controls from hospitals could have biased results. Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.
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Affiliation(s)
| | - Kaspar Walter Meili
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| | - Katayoun Taghavi
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
| | - Guilherme Calvet
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - James Sejvar
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nicola Low
- Institute of Social and Preventive Medicine, University Bern, Bern, Switzerland
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10
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Santana MB, Lamas CC, Athayde JG, Calvet G, Moreira J, De Lorenzo A. Congenital Zika syndrome: is the heart part of its spectrum? Clin Microbiol Infect 2019; 25:1043-1044. [PMID: 30922930 DOI: 10.1016/j.cmi.2019.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/26/2022]
Affiliation(s)
- M B Santana
- Department of Internal Medicine, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Cardio-intensive Care Unit, Americas Medical City, Rio de Janeiro, Brazil; Cardiovascular Research Unit, National Institute of Cardiology, Rio de Janeiro, Brazil
| | - C C Lamas
- Cardiovascular Research Unit, National Institute of Cardiology, Rio de Janeiro, Brazil; Medical School, Unigranrio University, Rio de Janeiro, Brazil; National Institute of Infectious Diseases Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - J G Athayde
- Echocardiography Department, National Institute of Cardiology, Rio de Janeiro, Brazil
| | - G Calvet
- National Institute of Infectious Diseases Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - J Moreira
- Cardiovascular Research Unit, National Institute of Cardiology, Rio de Janeiro, Brazil; National Institute of Infectious Diseases Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - A De Lorenzo
- Cardiovascular Research Unit, National Institute of Cardiology, Rio de Janeiro, Brazil
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11
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Tai W, Voronin D, Chen J, Bao W, Kessler DA, Shaz B, Jiang S, Yazdanbakhsh K, Du L. Transfusion-Transmitted Zika Virus Infection in Pregnant Mice Leads to Broad Tissue Tropism With Severe Placental Damage and Fetal Demise. Front Microbiol 2019; 10:29. [PMID: 30728813 PMCID: PMC6351479 DOI: 10.3389/fmicb.2019.00029] [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: 08/28/2018] [Accepted: 01/09/2019] [Indexed: 01/10/2023] Open
Abstract
Zika virus (ZIKV) infection during pregnancy can cause significant problems, particularly congenital Zika syndrome. Nevertheless, the potential deleterious consequences and associated mechanisms of transfusion-transmitted ZIKV infection on pregnant individuals and their fetuses and babies have not been investigated. Here we examined transmissibility of ZIKV through blood transfusion in ZIKV-susceptible pregnant A129 mice. Our data showed that transfused-transmitted ZIKV at the early infection stage led to significant viremia and broad tissue tropism in the pregnant recipient mice, which were not seen in those transfused with ZIKV-positive (ZIKV+) plasma at later infection stages. Importantly, pregnant mice transfused with early-stage, but not later stages, ZIKV+ plasma also exhibited severe placental infection with vascular damage and apoptosis, fetal infection and fetal damage, accompanied by fetal and pup death. Overall, this study suggests that transfusion-related transmission of ZIKV during initial stage of infection, which harbors high plasma viral titers, can cause serious adverse complications in the pregnant recipients and their fetuses and babies.
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Affiliation(s)
- Wanbo Tai
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Denis Voronin
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Jiawei Chen
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Weili Bao
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Debra A Kessler
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Beth Shaz
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Shibo Jiang
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States.,Key Laboratory of Medical Molecular Virology of MOE/MOH, Fudan University, Shanghai, China
| | - Karina Yazdanbakhsh
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
| | - Lanying Du
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
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12
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Walker CL, Little MTE, Roby JA, Armistead B, Gale M, Rajagopal L, Nelson BR, Ehinger N, Mason B, Nayeri U, Curry CL, Adams Waldorf KM. Zika virus and the nonmicrocephalic fetus: why we should still worry. Am J Obstet Gynecol 2019; 220:45-56. [PMID: 30171843 PMCID: PMC6501788 DOI: 10.1016/j.ajog.2018.08.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/12/2018] [Accepted: 08/21/2018] [Indexed: 02/06/2023]
Abstract
Zika virus is a mosquito-transmitted flavivirus and was first linked to congenital microcephaly caused by a large outbreak in northeastern Brazil. Although the Zika virus epidemic is now in decline, pregnancies in large parts of the Americas remain at risk because of ongoing transmission and the potential for new outbreaks. This review presents why Zika virus is still a complex and worrisome public health problem with an expanding spectrum of birth defects and how Zika virus and related viruses evade the immune response to injure the fetus. Recent reports indicate that the spectrum of fetal brain and other anomalies associated with Zika virus exposure is broader and more complex than microcephaly alone and includes subtle fetal brain and ocular injuries; thus, the ability to prenatally diagnose fetal injury associated with Zika virus infection remains limited. New studies indicate that Zika virus imparts disproportionate effects on fetal growth with an unusual femur-sparing profile, potentially providing a new approach to identify viral injury to the fetus. Studies to determine the limitations of prenatal and postnatal testing for detection of Zika virus-associated birth defects and long-term neurocognitive deficits are needed to better guide women with a possible infectious exposure. It is also imperative that we investigate why the Zika virus is so adept at infecting the placenta and the fetal brain to better predict other viruses with similar capabilities that may give rise to new epidemics. The efficiency with which the Zika virus evades the early immune response to enable infection of the mother, placenta, and fetus is likely critical for understanding why the infection may either be fulminant or limited. Furthermore, studies suggest that several emerging and related viruses may also cause birth defects, including West Nile virus, which is endemic in many parts of the United States. With mosquito-borne diseases increasing worldwide, there remains an urgent need to better understand the pathogenesis of the Zika virus and related viruses to protect pregnancies and child health.
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Affiliation(s)
- Christie L Walker
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Washington, Seattle, WA
| | - Marie-Térèse E Little
- Fourth Dimension Biomedical and Research Consulting, Victoria, British Columbia, Canada
| | - Justin A Roby
- Center for Innate Immunity and Immune Disease, Department of Immunology, University of Washington, Seattle, WA
| | - Blair Armistead
- Department of Global Health, University of Washington, Seattle, WA; Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA
| | - Michael Gale
- Center for Innate Immunity and Immune Disease, Departments of Immunology, Microbiology, and Global Health, University of Washington, Seattle, WA
| | - Lakshmi Rajagopal
- Center for Innate Immunity and Immune Disease, Department of Pediatrics, University of Washington, Seattle, WA; Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, WA
| | - Branden R Nelson
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA
| | - Noah Ehinger
- Department of Obstetrics and Gynecology, University of Miami, Miami, FL
| | - Brittney Mason
- Department of Obstetrics and Gynecology, University of Miami, Miami, FL
| | - Unzila Nayeri
- Department of Obstetrics and Gynecology, University of Miami, Miami, FL
| | - Christine L Curry
- Department of Obstetrics and Gynecology, University of Miami, Miami, FL
| | - Kristina M Adams Waldorf
- Department of Obstetrics and Gynecology and Global Health, University of Washington, Seattle, WA; Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA; Sahlgrenska Academy, Gothenburg University, Gothenburg Sweden.
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13
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Vielot NA, Stamm L, Herrington J, Squiers L, Kelly B, McCormack L, Becker-Dreps S. United States Travelers' Concern about Zika Infection and Willingness to Receive a Hypothetical Zika Vaccine. Am J Trop Med Hyg 2018; 98:1848-1856. [PMID: 29692314 PMCID: PMC6086173 DOI: 10.4269/ajtmh.17-0907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The ongoing Zika pandemic has affected many countries that are common travel destinations. We assessed the willingness to receive a prophylactic Zika virus (ZIKV) vaccine, currently under development, among travelers to areas with reported autochthonous ZIKV transmission. We surveyed United States (U.S.) residents aged 18–44 years who had ever heard of ZIKV and planned to travel to Florida and/or Texas (N = 420) or a U.S. territory or foreign country (N = 415) in 2017, using a nationally representative internet panel. Travelers to Florida and/or Texas reported less concern about ZIKV infection than travelers to other destinations (27% versus 36%, P = 0.01). Female sex, Hispanic ethnicity, discussing ZIKV with medical professionals, ZIKV risk perception, and self-efficacy for ZIKV prevention predicted concern about ZIKV infection in both groups. Travelers to Florida and/or Texas (43%) and other destinations (44%) were equally willing to receive a ZIKV vaccine. Hispanic ethnicity, discussing ZIKV with medical professionals, and concern about ZIKV infection predicted vaccine willingness in both groups. Likelihood of using existing ZIKV prevention methods, confidence in the U.S. government to prevent ZIKV spread, self-efficacy for ZIKV prevention, and knowledge about ZIKV symptoms further predicted vaccine willingness in travelers to other destinations. In multivariable analyses, only concern about ZIKV infection was associated with vaccine willingness in both groups (prevalence ratio [95% confidence interval]: Florida and/or Texas: 1.34 [1.06, 1.69]; other: 1.82 [1.44, 2.29]). Targeted communications can educate travelers, particularly travelers who are pregnant or may become pregnant, about ZIKV risk to generate ZIKV vaccine demand.
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Affiliation(s)
- Nadja A Vielot
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lola Stamm
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - James Herrington
- Department of Health Behavior, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Linda Squiers
- RTI International, Research Triangle Park, North Carolina
| | - Bridget Kelly
- RTI International, Research Triangle Park, North Carolina
| | | | - Sylvia Becker-Dreps
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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