1
|
Maccarone MC, Coraci D, Ragazzo L, Munari M, Piccione F, Masiero S. Rehabilitation approaches in West Nile Virus survivors: a systematic review. Eur J Phys Rehabil Med 2024; 60:113-121. [PMID: 38059575 PMCID: PMC10938036 DOI: 10.23736/s1973-9087.23.07880-2] [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: 01/16/2023] [Revised: 09/05/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Periodic increases in West Nile virus (WNV) infections have been documented. Proper rehabilitative management is essential for these patients, who may experience limitations in daily activities even after the resolution of the acute infection. Since there are currently no globally accepted guidelines, our aim is to conduct a best-evidence synthesis on rehabilitative management for patients with neuroinvasive WNV. EVIDENCE ACQUISITION We screened the literature with two independent researchers conducting searches on PubMed, Embase, SCOPUS, and Google Scholar databases for WNV-related studies in the field of rehabilitation. Suitable studies were identified and selected through a rigorous process. The review includes original research articles published up to August 15, 2023. EVIDENCE SYNTHESIS Despite the potential for bias in the studies, the literature suggests that a comprehensive and interdisciplinary rehabilitation program, which includes physical therapy with neuromotor and respiratory interventions, occupational therapy, neurocognitive interventions, and speech therapy for dysphagia and communication issues, can lead to functional improvement in WNV patients. This program should be tailored to address each patient's specific challenges, and the duration of the rehabilitation program may vary depending on the individual patient's needs. CONCLUSIONS Even if additional research with larger cohorts and higher evidence levels is needed for a comprehensive understanding of WNV patient rehabilitation, an early and comprehensive rehabilitation approach addressing respiratory, neuromuscular, and cognitive aspects appears effective for WNV patient recovery.
Collapse
Affiliation(s)
- Maria C Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy -
| | - Daniele Coraci
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
| | - Lisa Ragazzo
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
| | - Marina Munari
- Institute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy
| | - Francesco Piccione
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
| | - Stefano Masiero
- Unit of Neurorehabilitation, Department of Neuroscience, University of Padua, Padua, Italy
- Institute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy
| |
Collapse
|
2
|
Bampali M, Konstantinidis K, Kellis EE, Pouni T, Mitroulis I, Kottaridi C, Mathioudakis AG, Beloukas A, Karakasiliotis I. West Nile Disease Symptoms and Comorbidities: A Systematic Review and Analysis of Cases. Trop Med Infect Dis 2022; 7:tropicalmed7090236. [PMID: 36136647 PMCID: PMC9506265 DOI: 10.3390/tropicalmed7090236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
West Nile virus (WNV) is a mosquito-borne flavivirus that has emerged as a major cause of viral encephalitis and meningitis, rarely leading to death. Several risk factors have been discussed in the past concerning the severity of the disease, while few reports have focused on precipitating conditions that determine of WNV-related death. Studies on cohorts of patients suffering of West Nile disease (WND) usually encompass low numbers of deceased patients as a result of the rarity of the event. In this systematic review and critical analysis of 428 published case studies and case series, we sought to evaluate and highlight critical parameters of WND-related death. We summarized the symptoms, comorbidities, and treatment strategies related to WND in all published cases of patients that included clinical features. Symptoms such as altered mental status and renal problems presented increased incidence among deceased patients, while these patients presented increased cerebrospinal fluid (CSF) glucose. Our analysis also highlights underestimated comorbidities such as pulmonary disease to act as precipitating conditions in WND, as they were significantly increased amongst deceased patients. CSF glucose and the role of pulmonary diseases need to be revaluated either retrospectively or prospectively in WND patient cohorts, as they may be linked to increased mortality risk.
Collapse
Affiliation(s)
- Maria Bampali
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Konstantinos Konstantinidis
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Emmanouil E. Kellis
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Theodoti Pouni
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Ioannis Mitroulis
- First Department of Internal Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Christine Kottaridi
- Department of Genetics, Development and Molecular Biology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M23 9LT, UK
- The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Apostolos Beloukas
- Molecular Microbiology & Immunology Lab, Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
- National AIDS Reference Centre of Southern Greece, Department of Public Health Policy, University of West Attica, 11521 Athens, Greece
- Correspondence: (A.B.); (I.K.)
| | - Ioannis Karakasiliotis
- Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
- Correspondence: (A.B.); (I.K.)
| |
Collapse
|
3
|
Rudrappa M, Kokatnur L, Chernyshev O. Neurological Respiratory Failure. Diseases 2018; 6:diseases6010007. [PMID: 29320394 PMCID: PMC5871953 DOI: 10.3390/diseases6010007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 12/29/2017] [Accepted: 01/05/2018] [Indexed: 11/18/2022] Open
Abstract
West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.
Collapse
Affiliation(s)
- Mohan Rudrappa
- Department of Pulmonary and Critical Care, Louisiana State University Health Science Center, Shreveport, LA 71115, USA.
| | - Laxmi Kokatnur
- Department of Neurology, Louisiana State University Health Science Center, Shreveport, LA 71115, USA.
| | - Oleg Chernyshev
- Department of Neurology, Louisiana State University Health Science Center, Shreveport, LA 71115, USA.
| |
Collapse
|
4
|
Phrenic nerve deficits and neurological immunopathology associated with acute West Nile virus infection in mice and hamsters. J Neurovirol 2016; 23:186-204. [PMID: 27761801 PMCID: PMC5332528 DOI: 10.1007/s13365-016-0488-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/15/2016] [Accepted: 09/26/2016] [Indexed: 12/19/2022]
Abstract
Neurological respiratory deficits are serious outcomes of West Nile virus (WNV) disease. WNV patients requiring intubation have a poor prognosis. We previously reported that WNV-infected rodents also appear to have respiratory deficits when assessed by whole-body plethysmography and diaphragmatic electromyography. The purpose of this study was to determine if the nature of the respiratory deficits in WNV-infected rodents is neurological and if deficits are due to a disorder of brainstem respiratory centers, cervical spinal cord (CSC) phrenic motor neuron (PMN) circuitry, or both. We recorded phrenic nerve (PN) activity and found that in WNV-infected mice, PN amplitude is reduced, corroborating a neurological basis for respiratory deficits. These results were associated with a reduction in CSC motor neuron number. We found no dramatic deficits, however, in brainstem-mediated breathing rhythm generation or responses to hypercapnia. PN frequency and pattern parameters were normal, and all PN parameters changed appropriately upon a CO2 challenge. Histological analysis revealed generalized microglia activation, astrocyte reactivity, T cell and neutrophil infiltration, and mild histopathologic lesions in both the brainstem and CSC, but none of these were tightly correlated with PN function. Similar results in PN activity, brainstem function, motor neuron number, and histopathology were seen in WNV-infected hamsters, except that histopathologic lesions were more severe. Taken together, the results suggest that respiratory deficits in acute WNV infection are primarily due to a lower motor neuron disorder affecting PMNs and the PN rather than a brainstem disorder. Future efforts should focus on markers of neuronal dysfunction, axonal degeneration, and myelination.
Collapse
|
5
|
Quindry JC, Ballmann CG, Epstein EE, Selsby JT. Plethysmography measurements of respiratory function in conscious unrestrained mice. J Physiol Sci 2016; 66:157-64. [PMID: 26459291 PMCID: PMC10717823 DOI: 10.1007/s12576-015-0408-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/25/2015] [Indexed: 10/23/2022]
Abstract
Whole body plethysmography (WBP) is used to quantify pulmonary function in conscious, unrestrained mice. We determined currently whether time of day and environmental lighting influence day-to-day reproducibility of pulmonary function, and quantifed the necessary habituation time in the WBP chamber. Two-month-old male C57BL6 and mdx mice (n = 8/group, reverse light cycle), were examined on consecutive days using a calibrated WBP chamber and manufacturer software was used to calculate respiratory measures. Respiratory data stabilized between 5-10 min for all variables. Mice exhibited time of day respiratory differences, performing more forceful and less frequent breaths midday (11:45 a.m. and 3:00 p.m.) compared to 7:30 a.m. WBP performed in darkened conditions elicited more forceful breathing than lit conditions. Day-to-day reproducibility during controlled conditions ranged from r(2) = 0.58 to 0.62 for the functional measures. Findings indicate reproducible respiratory data are obtainable following a 15-min chamber habituation and standardization of time of day and room lighting.
Collapse
Affiliation(s)
- John C Quindry
- Cardioprotection Laboratory, School of Kinesiology, Auburn University, Auburn, AL, 36830, USA.
| | - Christopher G Ballmann
- Cardioprotection Laboratory, School of Kinesiology, Auburn University, Auburn, AL, 36830, USA
| | - Erin E Epstein
- Cardioprotection Laboratory, School of Kinesiology, Auburn University, Auburn, AL, 36830, USA
| | | |
Collapse
|
6
|
Suen WW, Prow NA, Setoh YX, Hall RA, Bielefeldt-Ohmann H. End-point disease investigation for virus strains of intermediate virulence as illustrated by flavivirus infections. J Gen Virol 2015; 97:366-377. [PMID: 26614392 DOI: 10.1099/jgv.0.000356] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Viruses of intermediate virulence are defined as isolates causing an intermediate morbidity/mortality rate in a specific animal model system, involving specific host and inoculation parameters (e.g. dose and route). Therefore, variable disease phenotype may exist between animals that develop severe disease or die and those that are asymptomatic or survive after infection with these isolates. There may also be variability amongst animals within each of these subsets. Such potential variability may confound the use of time-point sacrifice experiments to investigate pathogenesis of this subset of virus strains, as uniformity in disease outcome is a fundamental assumption for time-course sacrifice experiments. In the current study, we examined the disease phenotype, neuropathology, neural infection and glial cell activity in moribund/dead and surviving Swiss white (CD-1) mice after intraperitoneal infection with various Australian flaviviruses, including West Nile virus (WNV) strains of intermediate virulence (WNVNSW2011 and WNVNSW2012), and highly virulent Murray Valley encephalitis virus (MVEV) isolates. We identified notable intragroup variation in the end-point disease in mice infected with either WNVNSW strain, but to a lesser extent in mice infected with MVEV strains. The variable outcomes associated with WNVNSW infection suggest that pathogenesis investigations using time-point sacrifice of WNVNSW-infected mice may not be the best approach, as the assumption of uniformity in outcomes is violated. Our study has therefore highlighted a previously unacknowledged challenge to investigating pathogenesis of virus isolates of intermediate virulence. We have also set a precedent for routine examination of the disease phenotype in moribund/dead and surviving mice during survival challenge experiments.
Collapse
Affiliation(s)
- Willy W Suen
- School of Veterinary Science, The University of Queensland, Gatton, Queensland 4343, Australia
| | - Natalie A Prow
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Yin X Setoh
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Roy A Hall
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland 4072, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Helle Bielefeldt-Ohmann
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland 4072, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland 4072, Australia.,School of Veterinary Science, The University of Queensland, Gatton, Queensland 4343, Australia
| |
Collapse
|
7
|
Knudson CJ, Hartwig SM, Meyerholz DK, Varga SM. RSV vaccine-enhanced disease is orchestrated by the combined actions of distinct CD4 T cell subsets. PLoS Pathog 2015; 11:e1004757. [PMID: 25769044 PMCID: PMC4358888 DOI: 10.1371/journal.ppat.1004757] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 02/20/2015] [Indexed: 12/24/2022] Open
Abstract
There is no currently licensed vaccine for respiratory syncytial virus (RSV) despite being the leading cause of lower respiratory tract infections in children. Children previously immunized with a formalin-inactivated RSV (FI-RSV) vaccine exhibited enhanced respiratory disease following natural RSV infection. Subsequent studies in animal models have implicated roles for CD4 T cells, eosinophils and non-neutralizing antibodies in mediating enhanced respiratory disease. However, the underlying immunological mechanisms responsible for the enhanced respiratory disease and other disease manifestations associated with FI-RSV vaccine-enhanced disease remain unclear. We demonstrate for the first time that while CD4 T cells mediate all aspects of vaccine-enhanced disease, distinct CD4 T cell subsets orchestrate discrete and specific disease parameters. A Th2-biased immune response, but not eosinophils specifically, was required for airway hyperreactivity and mucus hypersecretion. In contrast, the Th1-associated cytokine TNF-α was necessary to mediate airway obstruction and weight loss. Our data demonstrate that individual disease manifestations associated with FI-RSV vaccine-enhanced disease are mediated by distinct subsets of CD4 T cells. RSV is a significant healthcare burden and is the leading cause of bronchiolitis and pneumonia during childhood. The failure of the 1960's FI-RSV vaccine trial to not only elicit protection against RSV infection, but also provoke enhanced morbidity and mortality in vaccinees has significantly hampered development of new RSV vaccines for fear of disease potentiation. Therefore we sought to determine the specific immunological mechanisms that mediate FI-RSV VED to provide a framework to evaluate factors associated with disease exacerbation. Work presented herein demonstrate for the first time that individual disease manifestations associated with FI-RSV-immunization are mediated by distinct CD4 T cell subsets and not by eosinophils. Our results stress the need to evaluate multiple disease parameters for future RSV vaccine candidates. Failure to thoroughly assess the immune response and disease manifestations associated with new candidate vaccines may lead to undesired results in vaccine trials and further hinder future vaccine development.
Collapse
Affiliation(s)
- Cory J. Knudson
- Interdisciplinary Graduate Program in Immunology, University of Iowa, Iowa City, Iowa, United States of America
| | - Stacey M. Hartwig
- Department of Microbiology, University of Iowa, Iowa City, Iowa, United States of America
| | - David K. Meyerholz
- Department of Pathology, University of Iowa, Iowa City, Iowa, United States of America
| | - Steven M. Varga
- Interdisciplinary Graduate Program in Immunology, University of Iowa, Iowa City, Iowa, United States of America
- Department of Microbiology, University of Iowa, Iowa City, Iowa, United States of America
- Department of Pathology, University of Iowa, Iowa City, Iowa, United States of America
- * E-mail:
| |
Collapse
|
8
|
Multiplexed digital mRNA profiling of the inflammatory response in the West Nile Swiss Webster mouse model. PLoS Negl Trop Dis 2014; 8:e3216. [PMID: 25340818 PMCID: PMC4207670 DOI: 10.1371/journal.pntd.0003216] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 08/26/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND PURPOSE The ability to track changes in gene expression following viral infection is paramount to understanding viral pathogenesis. This study was undertaken to evaluate the nCounter, a high throughput digital gene expression system, as a means to better understand West Nile virus (WNV) dissemination and the inflammatory response against WNV in the outbred Swiss Webster (SW) mouse model over the course of infection. METHODOLOGY The nCounter Mouse Inflammation gene expression kit containing 179 inflammation related genes was used to analyze gene expression changes in multiple tissues over a nine day course of infection in SW mice following intraperitoneal injection with WNV. Protein expression levels for a subset of these cytokine/chemokine genes were determined using a multiplex protein detection system (BioPlex) and comparisons of protein/RNA expression levels made. RESULTS Expression analysis of spleen, lung, liver, kidney and brain of SW mice infected with WNV revealed that Cxcl10 and Il12b are differentially expressed in all tissues tested except kidney. Data stratification of positively confirmed infected (WNV (+)) versus non-infected (WNV (-) tissues allowed differentiation of the systemic inflammatory gene response from tissue-specific responses arising from WNV infection. Significant (p<0.05) decrease in C3ar1 was found in WNV (-) spleen. Il23a was significantly upregulated, while Il10rb was down-regulated in WNV (-) lung. Il3 and Mbl2 were down-regulated in WNV (-) liver. In WNV (+) livers, Stat1, Tlr2, chemokines Cxcl1, Cxcl3, Cxcl9, Cxcl10, cytokines Il6, Il18, cytokine-related gene Il1r and cytokine agonist Ilrn were significantly upregulated. In WNV (-) brain tissues, Csf2 and Cxcl10 were significantly upregulated. Similar gene and protein expression kinetics were found for Ccl2, Ccl3, Ccl4 and Ccl5 and correlated with the presence of infectious virus. In summary, the utility of the nCounter platform for rapid identification of gene expression changes in SW mice associated with WNV infection was demonstrated.
Collapse
|
9
|
Suen WW, Prow NA, Hall RA, Bielefeldt-Ohmann H. Mechanism of West Nile virus neuroinvasion: a critical appraisal. Viruses 2014; 6:2796-825. [PMID: 25046180 PMCID: PMC4113794 DOI: 10.3390/v6072796] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/09/2014] [Accepted: 07/10/2014] [Indexed: 12/11/2022] Open
Abstract
West Nile virus (WNV) is an important emerging neurotropic virus, responsible for increasingly severe encephalitis outbreaks in humans and horses worldwide. However, the mechanism by which the virus gains entry to the brain (neuroinvasion) remains poorly understood. Hypotheses of hematogenous and transneural entry have been proposed for WNV neuroinvasion, which revolve mainly around the concepts of blood-brain barrier (BBB) disruption and retrograde axonal transport, respectively. However, an over‑representation of in vitro studies without adequate in vivo validation continues to obscure our understanding of the mechanism(s). Furthermore, WNV infection in the current rodent models does not generate a similar viremia and character of CNS infection, as seen in the common target hosts, humans and horses. These differences ultimately question the applicability of rodent models for pathogenesis investigations. Finally, the role of several barriers against CNS insults, such as the blood-cerebrospinal fluid (CSF), the CSF-brain and the blood-spinal cord barriers, remain largely unexplored, highlighting the infancy of this field. In this review, a systematic and critical appraisal of the current evidence relevant to the possible mechanism(s) of WNV neuroinvasion is conducted.
Collapse
Affiliation(s)
- Willy W Suen
- School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia.
| | - Natalie A Prow
- Australian Infectious Diseases Research Centre, University of Queensland, St. Lucia, QLD, 4072, Australia.
| | - Roy A Hall
- Australian Infectious Diseases Research Centre, University of Queensland, St. Lucia, QLD, 4072, Australia.
| | | |
Collapse
|
10
|
Abstract
Immunity to respiratory virus infection is governed by complex biological networks that influence disease progression and pathogenesis. Systems biology provides an opportunity to explore and understand these multifaceted interactions based on integration and modeling of multiple biological parameters. In this review, we describe new and refined systems‐based approaches used to model, identify, and validate novel targets within complex networks following influenza and coronavirus infection. In addition, we propose avenues for extension and expansion that can revolutionize our understanding of infectious disease processes. Together, we hope to provide a window into the unique and expansive opportunity presented by systems biology to understand complex disease processes within the context of infectious diseases.
Collapse
Affiliation(s)
- Vineet D Menachery
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7435, USA
| | | |
Collapse
|
11
|
Donadieu E, Lowenski S, Servely JL, Laloy E, Lilin T, Nowotny N, Richardson J, Zientara S, Lecollinet S, Coulpier M. Comparison of the neuropathology induced by two West Nile virus strains. PLoS One 2013; 8:e84473. [PMID: 24367664 PMCID: PMC3867487 DOI: 10.1371/journal.pone.0084473] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/21/2013] [Indexed: 12/11/2022] Open
Abstract
Some strains of West Nile virus (WNV) are neuroinvasive and may induce fatal encephalitis/meningitis in a variety of animal species including humans. Whether, however, there is a strain-specific signature in the brain is as yet unknown. Here we investigated the neuropathogenesis induced by two phylogenetically distant WNV strains of lineage 1, WNVIS98 and WNVKUN35 911. While four-week old C57Bl/6J mice were susceptible to both strains and succumbed rapidly after intraperitoneal inoculation, differences were observed in virulence and clinical disease. WNVKUN35 911, the less virulent strain as judged by determination of LD50, induced typical signs of encephalitis. Such signs were not observed in WNVIS98-infected mice, although they died more rapidly. Histological examination of brain sections also revealed differences, as the level of apoptosis and inflammation was higher in WNVKUN35 911- than WNVIS98-infected mice. Moreover, staining for cleaved caspase 3 showed that the two WNV strains induced apoptotic death through different molecular mechanisms in one particular brain area. Finally, the two strains showed similar tropism in cortex, striatum, brainstem, and cerebellum but a different one in hippocampus. In summary, our data show that, upon peripheral administration, WNVIS98 and WNVKUN35 911 strains induce partially distinct lesions and tissue tropism in the brain. They suggest that the virulence of a WNV strain is not necessarily correlated with the severity of apoptotic and inflammatory lesions in the brain.
Collapse
Affiliation(s)
- Emilie Donadieu
- Virology (UMR1161), French National Institute for Agricultural Research (INRA), Maisons-Alfort, France
- Virology (UMR1161), French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
- Virology (UMR1161), Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Steeve Lowenski
- Virology (UMR1161), French National Institute for Agricultural Research (INRA), Maisons-Alfort, France
- Virology (UMR1161), French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
- Virology (UMR1161), Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Jean-Luc Servely
- French National Institute for Agricultural Research (INRA), Nouzilly, France
- Histology and Pathological Anatomy, Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Eve Laloy
- Histology and Pathological Anatomy, Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Thomas Lilin
- Biomedical Research Center, Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Norbert Nowotny
- Institute of Virology, University of Veterinary Medicine, Vienna, Austria
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Jennifer Richardson
- Virology (UMR1161), French National Institute for Agricultural Research (INRA), Maisons-Alfort, France
- Virology (UMR1161), French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
- Virology (UMR1161), Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Stéphan Zientara
- Virology (UMR1161), French National Institute for Agricultural Research (INRA), Maisons-Alfort, France
- Virology (UMR1161), French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
- Virology (UMR1161), Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Sylvie Lecollinet
- Virology (UMR1161), French National Institute for Agricultural Research (INRA), Maisons-Alfort, France
- Virology (UMR1161), French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
- Virology (UMR1161), Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Muriel Coulpier
- Virology (UMR1161), French National Institute for Agricultural Research (INRA), Maisons-Alfort, France
- Virology (UMR1161), French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
- Virology (UMR1161), Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France
- * E-mail:
| |
Collapse
|
12
|
Donadieu E, Bahuon C, Lowenski S, Zientara S, Coulpier M, Lecollinet S. Differential virulence and pathogenesis of West Nile viruses. Viruses 2013; 5:2856-80. [PMID: 24284878 PMCID: PMC3856419 DOI: 10.3390/v5112856] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 11/13/2013] [Accepted: 11/14/2013] [Indexed: 12/21/2022] Open
Abstract
West Nile virus (WNV) is a neurotropic flavivirus that cycles between mosquitoes and birds but that can also infect humans, horses, and other vertebrate animals. In most humans, WNV infection remains subclinical. However, 20%-40% of those infected may develop WNV disease, with symptoms ranging from fever to meningoencephalitis. A large variety of WNV strains have been described worldwide. Based on their genetic differences, they have been classified into eight lineages; the pathogenic strains belong to lineages 1 and 2. Ten years ago, Beasley et al. (2002) found that dramatic differences exist in the virulence and neuroinvasion properties of lineage 1 and lineage 2 WNV strains. Further insights on how WNV interacts with its hosts have recently been gained; the virus acts either at the periphery or on the central nervous system (CNS), and these observed differences could help explain the differential virulence and neurovirulence of WNV strains. This review aims to summarize the current state of knowledge on factors that trigger WNV dissemination and CNS invasion as well as on the inflammatory response and CNS damage induced by WNV. Moreover, we will discuss how WNV strains differentially interact with the innate immune system and CNS cells, thus influencing WNV pathogenesis.
Collapse
Affiliation(s)
- Emilie Donadieu
- Université Paris Est Créteil (UPEC), UMR 1161 Virologie, Institut National de la Recherche Agronomique (INRA), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES) , Ecole Nationale Vétérinaire d'Alfort (ENVA), 7 avenue du Général De Gaulle, Maisons-Alfort 94700, France.
| | | | | | | | | | | |
Collapse
|
13
|
Wang H, Siddharthan V, Hall JO, Morrey JD. Autonomic deficit not the cause of death in West Nile virus neurological disease. Clin Auton Res 2013; 24:15-23. [PMID: 24158383 PMCID: PMC3918122 DOI: 10.1007/s10286-013-0213-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 08/20/2013] [Indexed: 11/20/2022]
Abstract
Introduction Some West Nile virus (WNV)-infected patients have been reported to manifest disease signs consistent with autonomic dysfunction. Moreover, WNV infection in hamsters causes reduced electromyography amplitudes of the gastrointestinal tract and diaphragm, and they have reduced heart rate variability (HRV), a read-out for the parasympathetic autonomic function. Methods HRV was measured in both hamsters and mice using radiotelemetry to identify autonomic deficits. To identify areas of WNV infection within the medulla oblongata mapping to the dorsal motor nucleus of vagus (DMNV) and the nucleus ambiguus (NA), fluorogold dye was injected into the cervical trunk of the vagus nerve of hamsters. As a measurement of the loss of parasympathetic function, tachycardia was monitored contiguously over the time course of the disease. Results Decrease of HRV did not occur in all animals that died, which is not consistent with autonomic function being the mechanism of death. Fluorogold-stained cells in the DMNV were not stained for WNV envelope protein. Fourteen percent of WNV-stained cells were co-localized with fluorogold-stained cells in the NA. These data, however, did not suggest a fatal loss of autonomic functions because tachycardia was not observed in WNV-infected hamsters. Conclusion Parasympathetic autonomic function deficit was not a likely mechanism of death in WNV-infected rodents and possibly in human patients with fatal WN neurological disease.
Collapse
Affiliation(s)
- Hong Wang
- Department of Animal, Dairy, and Veterinary Sciences, School of Veterinary Medicine, Institute for Antiviral Research, Utah State University, 4700 Old Main Hill, Logan, UT, 84322-4700, USA
| | | | | | | |
Collapse
|
14
|
Abstract
The field of anatomic pathology has changed significantly over the last decades and, as a result of the technological developments in molecular pathology and genetics, has had increasing pressures put on it to become quantitative and to provide more information about protein expression on a cellular level in tissue sections. Multispectral imaging (MSI) has a long history as an advanced imaging modality and has been used for over a decade now in pathology to improve quantitative accuracy, enable the analysis of multicolor immunohistochemistry, and drastically reduce the impact of contrast-robbing tissue autofluorescence common in formalin-fixed, paraffin-embedded tissues. When combined with advanced software for the automated segmentation of different tissue morphologies (eg, tumor vs stroma) and cellular and subcellular segmentation, MSI can enable the per-cell quantitation of many markers simultaneously. This article covers the role that MSI has played in anatomic pathology in the analysis of formalin-fixed, paraffin-embedded tissue sections, discusses the technological aspects of why MSI has been adopted, and provides a review of the literature of the application of MSI in anatomic pathology.
Collapse
|
15
|
Morrey JD, Siddharthan V, Wang H. Neurological approaches for investigating West Nile virus disease and its treatment in rodents. Antiviral Res 2013; 100:535-45. [PMID: 24055448 DOI: 10.1016/j.antiviral.2013.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/28/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022]
Abstract
West Nile virus (WNV) has had a major public health impact since its emergence in the Western Hemisphere; in 2012, nearly 3000 cases of WN neuroinvasive disease were identified in the United States. The underlying mechanisms of WN neurologic disease can only be studied to a limited extent in patients, but can be investigated in much greater detail in animal models. In this paper, we describe how we and others have employed a variety of electrophysiological and neurological techniques to study experimental WNV infections in hamsters and mice. The methods have included electrophysiological motor unit number estimation; optogenetic photoactivation of the spinal cord and electromyography; plethysmography; measurement of heart rate variability as an indication of autonomic nervous system dysfunction; and an assessment of spatial memory loss using the Morris water maze. These techniques provide a more refined assessment of disease manifestations in rodents than traditional measurements of weight loss and mortality, and should make it possible to identify targets for therapeutic intervention and to directly assess the effects of novel treatments.
Collapse
Affiliation(s)
- John D Morrey
- Institute for Antiviral Research, School of Veterinary Medicine, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT, USA.
| | | | | |
Collapse
|
16
|
Wang H, Siddharthan V, Kesler KK, Hall JO, Motter NE, Julander JG, Morrey JD. Fatal neurological respiratory insufficiency is common among viral encephalitides. J Infect Dis 2013; 208:573-83. [PMID: 23641019 PMCID: PMC3719899 DOI: 10.1093/infdis/jit186] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background. Neurological respiratory insufficiency strongly correlates with mortality among rodents infected with West Nile virus (WNV), which suggests that this is a primary mechanism of death in rodents and possibly fatal West Nile neurological disease in human patients. Methods. To explore the possibility that neurological respiratory insufficiency is a broad mechanism of death in cases of viral encephalitis, plethysmography was evaluated in mice infected with 3 flaviviruses and 2 alphaviruses. Pathology was investigated by challenging the diaphragm, using electromyography with hypercapnia and optogenetic photoactivation. Results. Among infections due to all but 1 alphavirus, death was strongly associated with a suppressed minute volume. Virally infected mice with a very low minute volume did not neurologically respond to hypercapnia or optogenetic photoactivation of the C4 cervical cord. Neurons with the orexin 1 receptor protein in the ventral C3–5 cervical cord were statistically diminished in WNV-infected mice with a low minute volume as compared to WNV-infected or sham-infected mice without respiratory insufficiency. Also, WNV-infected cells were adjacent to neurons with respiratory functions in the medulla. Conclusions. Detection of a common neurological mechanism of death among viral encephalitides creates opportunities to create broad-spectrum therapies that target relevant neurological cells in patients with types of viral encephalitis that have not been treatable in the past.
Collapse
Affiliation(s)
- Hong Wang
- Institute for Antiviral Research, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT 84322-4700, USA
| | | | | | | | | | | | | |
Collapse
|