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Hellysaz A, Hagbom M. Understanding the Central Nervous System Symptoms of Rotavirus: A Qualitative Review. Viruses 2021; 13:v13040658. [PMID: 33920421 PMCID: PMC8069368 DOI: 10.3390/v13040658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 01/08/2023] Open
Abstract
This qualitative review on rotavirus infection and its complications in the central nervous system (CNS) aims to understand the gut–brain mechanisms that give rise to CNS driven symptoms such as vomiting, fever, feelings of sickness, convulsions, encephalitis, and encephalopathy. There is substantial evidence to indicate the involvement of the gut–brain axis in symptoms such as vomiting and diarrhea. The underlying mechanisms are, however, not rotavirus specific, they represent evolutionarily conserved survival mechanisms for protection against pathogen entry and invasion. The reviewed studies show that rotavirus can exert effects on the CNS trough nervous gut–brain communication, via the release of mediators, such as the rotavirus enterotoxin NSP4, which stimulates neighboring enterochromaffin cells in the intestine to release serotonin and activate both enteric neurons and vagal afferents to the brain. Another route to CNS effects is presented through systemic spread via lymphatic pathways, and there are indications that rotavirus RNA can, in some cases where the blood brain barrier is weakened, enter the brain and have direct CNS effects. CNS effects can also be induced indirectly as a consequence of systemic elevation of toxins, cytokines, and/or other messenger molecules. Nevertheless, there is still no definitive or consistent evidence for the underlying mechanisms of rotavirus-induced CNS complications and more in-depth studies are required in the future.
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Justino MCA, Campos EA, Mascarenhas JDP, Soares LS, Guerra SDFS, Furlaneto IP, Pavão MJC, Maciel TS, Farias FP, Bezerra OM, Vinente CBG, Barros RJS, Linhares AC. Rotavirus antigenemia as a common event among children hospitalised for severe, acute gastroenteritis in Belém, northern Brazil. BMC Pediatr 2019; 19:193. [PMID: 31189470 PMCID: PMC6560848 DOI: 10.1186/s12887-019-1535-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/14/2019] [Indexed: 12/24/2022] Open
Abstract
Background Rotavirus antigenemia and RNAemia (the presence of rotavirus RNA in serum) have been commonly identified among paediatric patients with acute gastroenteritis. In this study we examined the association between rotavirus antigenemia and clinical features, and sought to determine the genotypes of rotaviruses detected in paired stool and serum samples. Methods Paired stool and serum samples were obtained from children hospitalised for acute gastroenteritis in Belém, Brazil, between June 2012 and June 2015. The 20-point Vesikari scoring system was used to assess the disease severity upon a retrospective medical record review. Stool and serum samples were primarily screened for the presence of rotavirus antigen using a commercial ELISA assay. The rotavirus isolates from stool and serum samples were genotyped by using the classical reverse-transcriptase polymerase chain reaction (RT-PCR) and/or through nucleotide sequencing of VP4 and VP7 genes. Viral load was estimated using real-time RT-PCR. Results In total rotavirus antigen was detected in 109 (24.2%) stool samples from 451 children, whereas antigenemia occurred in 38.5% (42/109) of these patients. We demonstrated that patients positive for rotavirus RNA in paired stool and serum samples were more likely to have a higher frequency of vomiting episodes in a 24-h period (p = 0.0035). Our findings also suggested that children not vaccinated against rotavirus are more likely to develop antigenemia, as compared to those given at least one vaccine dose (p = 0.0151). G12P [8] and G2P [4] genotypes were predominant throughout the study period, accounting for 52.3% (57/109) and 27.5% (30/109) of the typed isolates, respectively. Ten stool-serum pairs could be typed for VP4 and VP7 genes. Seven of these pairs showed concordant results with G2P [4] genotype being detected in stool and serum samples, whereas discrepancies between genotypes (G2P [4]/G2P[NT] and G12P [8]/G2P[NT]) were seen in three pairs. Conclusions Rotavirus antigenemia and RNAemia occur in a significant number of children hospitalised for acute gastroenteritis in Belém, Brazil, and may contribute to a greater disease severity, particularly translated into a greater number of vomiting episodes. This study documented a high concordance of genotypes detected in a subgroup of paired stool and serum samples. Electronic supplementary material The online version of this article (10.1186/s12887-019-1535-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Cleonice A Justino
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil.
| | - Erika A Campos
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
| | - Joana D'arc P Mascarenhas
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
| | - Luana S Soares
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
| | - Sylvia de Fátima S Guerra
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
| | | | | | | | | | | | - Caio Breno G Vinente
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
| | - Rodrigo José S Barros
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
| | - Alexandre C Linhares
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Rodovia BR 316, Km 7, s/n, Levilândia, Belém, 67.030-000, Brazil
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Bentes GA, Guimarães JR, Volotão EDM, Fialho AM, Hooper C, Ganime AC, Gardinali NR, Lanzarini NM, da Silva ADS, Pitcovski J, Leite JP, Pinto MA. Cynomolgus Monkeys ( Macaca fascicularis) as an Experimental Infection Model for Human Group A Rotavirus. Viruses 2018; 10:v10070355. [PMID: 29973483 PMCID: PMC6071073 DOI: 10.3390/v10070355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/23/2018] [Accepted: 04/27/2018] [Indexed: 12/25/2022] Open
Abstract
Group A rotaviruses (RVA) are one of the most common causes of severe acute gastroenteritis in infants worldwide. Rotaviruses spread from person to person, mainly by faecal–oral transmission. Almost all unvaccinated children may become infected with RVA in the first two years of life. The establishment of an experimental monkey model with RVA is important to evaluate new therapeutic approaches. In this study, we demonstrated viral shedding and viraemia in juvenile–adult Macaca fascicularis orally inoculated with Wa RVA prototype. Nine monkeys were inoculated orally: seven animals with human RVA and two control animals with saline solution. During the study, the monkeys were clinically monitored, and faeces and blood samples were tested for RVA infection. In general, the inoculated animals developed an oligosymptomatic infection pattern. The main clinical symptoms observed were diarrhoea in two monkeys for three days, associated with a reduction in plasmatic potassium content. Viral RNA was detected in seven faecal and five sera samples from inoculated animals, suggesting virus replication. Cynomolgus monkeys are susceptible hosts for human Wa RVA infection. When inoculated orally, they presented self-limited diarrhoea associated with presence of RVA infectious particles in faeces. Thus, cynomolgus monkeys may be useful as animal models to evaluate the efficacy of new antiviral approaches.
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Affiliation(s)
- Gentil Arthur Bentes
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Juliana Rodrigues Guimarães
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Eduardo de Mello Volotão
- Laboratório de Virologia Comparada e Ambiental, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Alexandre Madi Fialho
- Laboratório de Virologia Comparada e Ambiental, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Cleber Hooper
- Serviço de Controle da Qualidade Animal, Instituto de Ciência e Tecnologia em Biomodelos, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Ana Carolina Ganime
- Laboratório de Virologia Comparada e Ambiental, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Noemi Rovaris Gardinali
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Natália Maria Lanzarini
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Alexandre Dos Santos da Silva
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Jacob Pitcovski
- Virology and Vaccine Development Laboratory, MIGAL Technology Center, Kiryat Shmona 11016, Israel.
| | - José Paulo Leite
- Laboratório de Virologia Comparada e Ambiental, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
| | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro/RJ 21.040-360, Brazil.
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Wangchuk S, Mitui MT, Tshering K, Yahiro T, Bandhari P, Zangmo S, Dorji T, Tshering K, Matsumoto T, Nishizono A, Ahmed K. Dominance of emerging G9 and G12 genotypes and polymorphism of VP7 and VP4 of rotaviruses from Bhutanese children with severe diarrhea prior to the introduction of vaccine. PLoS One 2014; 9:e110795. [PMID: 25330070 PMCID: PMC4203849 DOI: 10.1371/journal.pone.0110795] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 09/12/2014] [Indexed: 11/19/2022] Open
Abstract
A prospective study was performed to determine the molecular characteristics of rotaviruses circulating among children aged <5 years in Bhutan. Stool samples were collected from February 2010 through January 2011 from children who attended two tertiary care hospitals in the capital Thimphu and the eastern regional headquarters, Mongar. The samples positive for rotavirus was mainly comprised genotype G1, followed by G12 and G9. The VP7 and VP4 genes of all genotypes clustered mainly with those of neighboring countries, thereby indicating that they shared common ancestral strains. The VP7 gene of Bhutanese G1 strains belonged to lineage 1c, which differed from the lineages of vaccine strains. Mutations were also identified in the VP7 gene of G1 strains, which may be responsible for neutralization escape strains. Furthermore, we found that lineage 4 of P[8] genotype differed antigenically from the vaccine strains, and mutations were identified in Bhutanese strains of lineage 3. The distribution of rotavirus genotypes varies among years, therefore further research is required to determine the distribution of rotavirus strain genotypes in Bhutan.
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Affiliation(s)
- Sonam Wangchuk
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Marcelo T. Mitui
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kinlay Tshering
- Department of Pediatrics, Jigme Dorji Wangchuk National Referral Hospital, Thimphu, Bhutan
| | - Takaaki Yahiro
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
| | | | - Sangay Zangmo
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Tshering Dorji
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Karchung Tshering
- Public Health Laboratory, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Takashi Matsumoto
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Akira Nishizono
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kamruddin Ahmed
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
- Research Promotion Institute, Oita University, Yufu, Japan
- * E-mail:
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Evidences and consequences of extra-intestinal spread of rotaviruses in humans and animals. Virusdisease 2014; 25:186-94. [PMID: 25674584 DOI: 10.1007/s13337-014-0197-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/16/2014] [Indexed: 10/25/2022] Open
Abstract
Rotavirus is recognized as one of the main diarrheal pathogens in young children and animals. The prevailing central dogma of rotavirus infection states that the infection is confined in the gastrointestinal tract. However, increasing evidences indicate that rotavirus infection is systemic. Clinical case reports of systemic manifestations to rotavirus infection in children has continued to accumulate over the past years. The use of animal models provided pathological and molecular evidences for extra-intestinal infection of rotaviruses. The mechanism correlated with the extra-intestinal spread of rotavirus infection from the intestine is through cell-free and cell-associated viremia. The extent of the extra-intestinal spread of rotavirus infection has not yet been fully elucidated; whether it can only affect a limited number of organs and tissues or capable of involving the body as a whole. Moreover, the influence of systemic rotavirus infections remains to be determined. In this review, combination of previous and new data are outlined to help in better understanding of the extra-intestinal infections of rotaviruses.
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