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Czupryna P, Moniuszko-Malinowska A, Trojan G, Adamczuk J, Martonik D, Parfieniuk-Kowerda A, Kruszewska E, Giecko M, Grygorczuk S. The assessment of usefulness of cytokines and other soluble mediators as the predictors of sequalae development in various forms of tick-borne encephalitis (TBE). Cytokine 2024; 184:156767. [PMID: 39326199 DOI: 10.1016/j.cyto.2024.156767] [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: 08/12/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024]
Abstract
AIM The aim of the study was to assess the usefulness of cytokines and other soluble mediators in differentiation between severe and mild course of tick-borne encephalitis (TBE) as well as the predictor of sequalae development. MATERIAL AND METHODS 122 patients (mean age 47.66 ± 14.77 years, 43 females, 79 males) with TBE were included in the study. Concentrations of 82 cytokines, growth factors, selectins, matrix metalloproteinases and other soluble mediators were measured in serum and CSF samples according to the manufacturer's instruction on a Bio-Plex 200 System using the custom made Luminex assays. Enzyme-linked immunosorbent assays for the quantitative detection of human IL-26, IL-29 IL-22, CXCL12 were performed. RESULTS No significant differences between serum concentrations of examined factors between group with sequelae and group with complete recovery were observed. In the CSF the concentrations of GM-CSF, Il-1α, Il-2, Il-4, Il-6, Il-12p70, Il-17A, CXCL1, CXCL6, Il-8, CCL4, CCL20, TRAIL, CD40L, MMP8 were significantly higher in patients who developed sequelae than in patients with complete recovery. For TRAIL concentration over 26.65 pg/ml in CSF the probability of sequalae development was 10.5 higher. In case of CCL20 - the concentration over 21.38 pg/ml in CSF the odds ratio was 6.429 times. For MMP-8 over 4210.54 pg/ml, the odds ratio was 11.222 times. CONCLUSIONS TRAIL, CCL-20 and MMP-8 are promising biomarkers of prediction of the sequalae development of TBE. Pro-inflammatory cytokines IL-8, IL-1, IL-2, IL-12, IL-17A also associate well with the risk of sequelae and could be further evaluated as prognostic markers in TBE, individually or as elements of a larger model.
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Affiliation(s)
- Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Gabriela Trojan
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Justyna Adamczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Diana Martonik
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Anna Parfieniuk-Kowerda
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Ewelina Kruszewska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
| | - Maciej Giecko
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland.
| | - Sambor Grygorczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Zurawia 14, 15-540 Bialystok, Poland
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Chen D, Lu Y, Wang W, Zhang Y, Liu T, Liu H, Zhang L, Peng X, Lv S, Wang Z, Wu W, Hou Z. The Prevalence of Tick-Borne Encephalitis Virus Infection Among Humans in Heilongjiang Province of China in 2020-2023. Zoonoses Public Health 2024. [PMID: 39169601 DOI: 10.1111/zph.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND AND AIMS Tick-borne encephalitis (TBE) is a serious and acute central nervous system infection caused by the tick-borne encephalitis virus (TBEV). In recent years, TBE has emerged as a growing public health threat, with cases reported across Europe, the Russian Far East, Japan and China. This study aims to assess the prevalence of TBEV infection and examine behaviours associated with an increased risk of infection among individuals who visited the Heilongjiang Red Cross Sengong General Hospital due to tick bites from 2020 to 2023. METHODS AND RESULTS We collected blood samples and administered survey questionnaires from tick-bitten people. A total of 457 samples were screened using Nested PCR, and the detected TBEV prevalence rate was 29.54% (135/457). The symptoms of redness and swelling at the site of tick bite (42.57%), fever (28.71%) and headache (10.89%) were identified in the TBEV-positive individuals when they visited the hospital by the physician. Phylogenetic analysis of the partial E gene of TBEV revealed that the predominant strains in the region are highly virulent Far Eastern subtype. However, they do not cluster with the three established evolutionary clades of the Far Eastern type. Questionnaires data analysis identified age and first tick bite as important factors associated with TBEV infection. CONCLUSIONS This study provides basic information on the epidemiology of TBEV in Heilongjiang Province in recent years and identifies that the most related risk factor of infecting TBEV is tick exposure. Further research is needed to develop effective prevention and control measures.
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Affiliation(s)
- Denghui Chen
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
| | - Yaxian Lu
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
| | - Wei Wang
- Tick-Borne Diseases Research and Therapeutic Center, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Yu Zhang
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
| | - Tianlu Liu
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
| | - Hetong Liu
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
| | - Lu Zhang
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
| | - Xiaohong Peng
- Tick-Borne Diseases Research and Therapeutic Center, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Shouxu Lv
- Tick-Borne Diseases Research and Therapeutic Center, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Zedong Wang
- Department of Emerging Infectious Diseases, The First Hospital of Jilin University, Changchun, China
| | - Wenzhong Wu
- Tick-Borne Diseases Research and Therapeutic Center, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Zhijun Hou
- Laboratory of Vector-Borne Diseases and Pathogens Ecology, College of Wildlife and Protected Area, Northeast Forestry University, Harbin, China
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3
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Gęgotek A, Moniuszko-Malinowska A, Groth M, Skrzydlewska E. Changes in cerebrospinal fluid proteome of patients with tick-borne encephalitis. J Med Virol 2024; 96:e29763. [PMID: 38949193 DOI: 10.1002/jmv.29763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/11/2024] [Accepted: 06/11/2024] [Indexed: 07/02/2024]
Abstract
Tick-borne encephalitis (TBE) is one of the main diseases transmitted by ticks, the incidence of which is increasing. Moreover, its diagnosis and therapy are often long and difficult according to nonspecific symptoms and complex etiology. This study aimed to observe changes in the proteome of cerebrospinal fluid from TBE patients. Cerebrospinal fluid (CSF) of TBE patients (n = 20) and healthy individuals (n = 10) was analyzed using a proteomic approach (QExactiveHF-Orbitrap mass spectrometer) and zymography. Obtained results show that in CSF of TBE patients, the top-upregulated proteins are involved in pro-inflammatory reaction (interleukins), as well as antioxidant/protective response (peroxiredoxins, heat shock proteins). Moreover, changes in the proteome of CSF are not only the result of this disease development, but they can also be an indicator of its course. This mainly applies to proteins involved in proteolysis including serpins and metalloproteinases, whose activity is proportional to the length of patients' convalescence. The obtained proteomic data strongly direct attention to the changes caused by the development of TBE to antioxidant, pro-inflammatory, and proteolytic proteins, knowledge about which can significantly contribute to faster and more accurate diagnosis of various clinical forms of TBE.
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Affiliation(s)
- Agnieszka Gęgotek
- Department of Analytical Chemistry, Medical University of Bialystok, Bialystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Monika Groth
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland
| | - Elżbieta Skrzydlewska
- Department of Analytical Chemistry, Medical University of Bialystok, Bialystok, Poland
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4
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Worku DA. Tick-Borne Encephalitis (TBE): From Tick to Pathology. J Clin Med 2023; 12:6859. [PMID: 37959323 PMCID: PMC10650904 DOI: 10.3390/jcm12216859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a viral arthropod infection, endemic to large parts of Europe and Asia, and is characterised by neurological involvement, which can range from mild to severe, and in 33-60% of cases, it leads to a post-encephalitis syndrome and long-term morbidity. While TBE virus, now identified as Orthoflavivirus encephalitidis, was originally isolated in 1937, the pathogenesis of TBE is not fully appreciated with the mode of transmission (blood, tick, alimentary), viral strain, host immune response, and age, likely helping to shape the disease phenotype that we explore in this review. Importantly, the incidence of TBE is increasing, and due to global warming, its epidemiology is evolving, with new foci of transmission reported across Europe and in the UK. As such, a better understanding of the symptomatology, diagnostics, treatment, and prevention of TBE is required to inform healthcare professionals going forward, which this review addresses in detail. To this end, the need for robust national surveillance data and randomised control trial data regarding the use of various antivirals (e.g., Galidesivir and 7-deaza-2'-CMA), monoclonal antibodies, and glucocorticoids is required to improve the management and outcomes of TBE.
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Affiliation(s)
- Dominic Adam Worku
- Infectious Diseases, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, UK;
- Public Health Wales, 2 Capital Quarter, Cardiff CF10 4BZ, UK
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5
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Fortova A, Hönig V, Salat J, Palus M, Pychova M, Krbkova L, Barkhash AV, Kriha MF, Chrdle A, Lipoldova M, Ruzek D. Serum matrix metalloproteinase-9 (MMP-9) as a biomarker in paediatric and adult tick-borne encephalitis patients. Virus Res 2023; 324:199020. [PMID: 36528170 DOI: 10.1016/j.virusres.2022.199020] [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: 11/06/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
Matrix metalloproteinases (MMPs) play an important role in central nervous system infections. We analysed the levels of 8 different MMPs in the cerebrospinal fluid (CSF) of 89 adult patients infected with tick-borne encephalitis (TBE) virus and compared them with the levels in a control group. MMP-9 was the only MMP that showed significantly increased CSF levels in TBE patients. Serum MMP-9 levels were subsequently measured in 101 adult TBE patients at various time points during the neurological phase of TBE and at follow-up. In addition, serum MMP-9 was analysed in 37 paediatric TBE patients. Compared with control levels, both paediatric and adult TBE patients had significantly elevated serum MMP-9 levels. In most adult patients, serum MMP-9 levels peaked at hospital admission, with higher serum MMP-9 levels observed in patients with encephalitis than in patients with meningitis. Elevated serum MMP-9 levels were observed throughout hospitalisation but decreased to normal levels at follow-up. Serum MMP-9 levels correlated with clinical course, especially in patients heterozygous for the single-nucleotide polymorphism rs17576 (A/G; Gln279Arg) in the MMP9 gene. The results highlight the importance of MMP-9 in the pathogenesis of TBE and suggest that serum MMP-9 may serve as a promising bioindicator of TBE in both paediatric and adult TBE patients.
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Affiliation(s)
- Andrea Fortova
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, CZ-62100 Brno, Czechia
| | - Vaclav Hönig
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, CZ-62100 Brno, Czechia; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, CZ-37005 Ceske Budejovice, Czechia
| | - Jiri Salat
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, CZ-62100 Brno, Czechia; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, CZ-37005 Ceske Budejovice, Czechia
| | - Martin Palus
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, CZ-62100 Brno, Czechia; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, CZ-37005 Ceske Budejovice, Czechia
| | - Martina Pychova
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, CZ-62500 Brno, Czechia
| | - Lenka Krbkova
- Department of Children's Infectious Disease, Faculty of Medicine and University Hospital, Masaryk University, CZ-61300 Brno, Czechia
| | - Andrey V Barkhash
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, 10 Lavrentyeva Ave., Novosibirsk 630090, Russia
| | - Michal F Kriha
- Department of Infectious Diseases, Hospital Ceske Budejovice, CZ-37001 Ceske Budejovice, Czechia; Faculty of Science, University of South Bohemia, CZ-37005 Ceske Budejovice, Czechia
| | - Ales Chrdle
- Department of Infectious Diseases, Hospital Ceske Budejovice, CZ-37001 Ceske Budejovice, Czechia; Royal Liverpool University Hospital, Prescot St, Liverpool L7 8XP, UK
| | - Marie Lipoldova
- Institute of Molecular Genetics of the Czech Academy of Sciences, CZ-14220 Prague, Czechia
| | - Daniel Ruzek
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, CZ-62100 Brno, Czechia; Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, CZ-37005 Ceske Budejovice, Czechia; Department of Experimental Biology, Faculty of Science, Masaryk University, CZ-62500 Brno, Czechia.
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Bogovič P, Kastrin A, Lotrič-Furlan S, Ogrinc K, Avšič Županc T, Korva M, Knap N, Resman Rus K, Strle K, Strle F. Comparison of laboratory and immune characteristics of the initial and second phase of tick-borne encephalitis. Emerg Microbes Infect 2022; 11:1647-1656. [PMID: 35657098 PMCID: PMC9225760 DOI: 10.1080/22221751.2022.2086070] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Tick-borne encephalitis (TBE) usually has a biphasic course which begins with unspecific febrile illness, followed by central nervous system involvement. Because TBE is not yet suspected during the initial phase, knowledge of early TBE pathogenesis is incomplete. Herein we evaluated laboratory and immune findings in the initial and second (meningoencephalitic) phase of TBE in 88 well-defined adult patients. Comparison of nine laboratory blood parameters in both phases of TBE revealed that laboratory abnormalities, consisting of low leukocyte and platelet counts and increased liver enzymes levels, were predominately associated with the initial phase of TBE and resolved thereafter. Assessment of 29 immune mediators in serum during the initial phase, and in serum and cerebrospinal fluid (CSF) during the second phase of TBE revealed highly distinct clustering patterns among the three groups. In the initial phase of TBE, the primary finding in serum was a rather heterogeneous immune response involving innate (CXCL11), B cell (CXCL13, BAFF), and T cell mediators (IL-27 and IL-4). During the second phase of TBE, growth factors associated with angiogenesis (GRO-α and VEGF-A) were the predominant characteristic in serum, whereas innate and Th1 mediators were the defining feature of immune responses in CSF. These findings imply that distinct immune processes play a role in the pathophysiology of different phases of TBE and in different compartments.
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Affiliation(s)
- Petra Bogovič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Andrej Kastrin
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Stanka Lotrič-Furlan
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katarina Ogrinc
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Klemen Strle
- Laboratory of Microbial Pathogenesis and Immunology, Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Chiffi G, Grandgirard D, Stöckli S, Valente LG, Adamantidis A, Leib SL. Tick-borne encephalitis affects sleep–wake behavior and locomotion in infant rats. Cell Biosci 2022; 12:121. [PMID: 35918749 PMCID: PMC9344439 DOI: 10.1186/s13578-022-00859-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/21/2022] [Indexed: 08/30/2023] Open
Abstract
Background/Aims Tick-borne encephalitis (TBE) is a disease affecting the central nervous system. Over the last decade, the incidence of TBE has steadily increased in Europe and Asia despite the availably of effective vaccines. Up to 50% of patients after TBE suffer from post-encephalitic syndrome that may develop into long-lasting morbidity. Altered sleep–wake functions have been reported by patients after TBE. The mechanisms causing these disorders in TBE are largely unknown to date. As a first step toward a better understanding of the pathology of TBEV-inducing sleep dysfunctions, we assessed parameters of sleep structure in an established infant rat model of TBE. Methods 13-day old Wistar rats were infected with 1 × 106 FFU Langat virus (LGTV). On day 4, 9, and 21 post infection, Rotarod (balance and motor coordination) and open field tests (general locomotor activity) were performed and brains from representative animals were collected in each subgroup. On day 28 the animals were implanted with a telemetric EEG/EMG system. Sleep recording was continuously performed for 24 consecutive hours starting at day 38 post infection and visually scored for Wake, NREM, and REM in 4 s epochs. Results As a novelty of this study, infected animals showed a significant larger percentage of time spend awake during the dark phase and less NREM and REM compared to the control animals (p < 0.01 for all comparisons). Furthermore, it was seen, that during the dark phase the wake bout length in infected animals was prolonged (p = 0.043) and the fragmentation index decreased (p = 0.0085) in comparison to the control animals. LGTV-infected animals additionally showed a reduced rotarod performance ability at day 4 (p = 0.0011) and day 9 (p = 0.0055) and day 21 (p = 0.0037). A lower locomotor activity was also seen at day 4 (p = 0.0196) and day 9 (p = 0.0473). Conclusion Our data show that experimental TBE in infant rats affects sleep–wake behavior, leads to decreased spontaneous locomotor activity, and impaired moto-coordinative function. Supplementary Information The online version contains supplementary material available at 10.1186/s13578-022-00859-7.
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Marshall EM, Koopmans MPG, Rockx B. A Journey to the Central Nervous System: Routes of Flaviviral Neuroinvasion in Human Disease. Viruses 2022; 14:2096. [PMID: 36298652 PMCID: PMC9611789 DOI: 10.3390/v14102096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Many arboviruses, including viruses of the Flavivirus genera, are known to cause severe neurological disease in humans, often with long-lasting, debilitating sequalae in surviving patients. These emerging pathogens impact millions of people worldwide, yet still relatively little is known about the exact mechanisms by which they gain access to the human central nervous system. This review focusses on potential haematogenous and transneural routes of neuroinvasion employed by flaviviruses and identifies numerous gaps in knowledge, especially regarding lesser-studied interfaces of possible invasion such as the blood-cerebrospinal fluid barrier, and novel routes such as the gut-brain axis. The complex balance of pro-inflammatory and antiviral immune responses to viral neuroinvasion and pathology is also discussed, especially in the context of the hypothesised Trojan horse mechanism of neuroinvasion. A greater understanding of the routes and mechanisms of arboviral neuroinvasion, and how they differ between viruses, will aid in predictive assessments of the neuroinvasive potential of new and emerging arboviruses, and may provide opportunity for attenuation, development of novel intervention strategies and rational vaccine design for highly neurovirulent arboviruses.
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Affiliation(s)
| | | | - Barry Rockx
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
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Lubarski K, Mania A, Małecki P, Mazur-Melewska K, Figlerowicz M. Inflammatory Markers Combined With Metalloproteinase-9, Neopterin, and S100B Concentrations May Indicate the Pathogenesis of Central Nervous System Diseases in Children. J Child Neurol 2022; 37:707-716. [PMID: 35722724 DOI: 10.1177/08830738221106663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The identification of central nervous system inflammation etiology leads to adjusted therapy. We analyzed the potential inflammatory and neuro-axonal damage markers in children. Our target was to correlate the findings with a disease's course or a sequalae risk and assess their clinical usefulness. The study included 96 children with symptoms of central nervous system inflammation who underwent diagnostics. The research group involved 24 children with autoimmune disorders and 31 with neuroinfection. The control group included patients with both etiologies excluded. We analyzed the results of routine laboratory tests together with chosen serum (neopterin, interleukin [IL]-1β, IL-6) and CSF (metalloproteinase [MMP]-9, S100B protein) markers. In the whole cohort, CSF MMP-9 correlated with CSF cytosis and serum IL-6 and CRP. In the undivided neuroinflammatory group, CSF S100B correlated with serum IL-6 and IgM concentrations. CSF cytosis was associated with CSF MMP-9 and serum neopterin levels. Among the infective patients, IL-6 was linked with increased CSF MMP-9. We conclude that astroglial protein S100B, neopterin, and cytokine concentrations may enable predicting long-term consequences, whereas CSF MMP-9 concentration may reflect the actual central nervous system injury regardless of etiology.
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Affiliation(s)
- Karol Lubarski
- Department of Infectious Diseases and Child Neurology, 37807Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, 37807Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Małecki
- Department of Infectious Diseases and Child Neurology, 37807Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, 37807Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, 37807Poznan University of Medical Sciences, Poznan, Poland
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Bhide K, Mochnáčová E, Tkáčová Z, Petroušková P, Kulkarni A, Bhide M. Signaling events evoked by domain III of envelop glycoprotein of tick-borne encephalitis virus and West Nile virus in human brain microvascular endothelial cells. Sci Rep 2022; 12:8863. [PMID: 35614140 PMCID: PMC9133079 DOI: 10.1038/s41598-022-13043-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
Tick-borne encephalitis virus and West Nile virus can cross the blood–brain barrier via hematogenous route. The attachment of a virion to the cells of a neurovascular unit, which is mediated by domain III of glycoprotein E, initiates a series of events that may aid viral entry. Thus, we sought to uncover the post-attachment biological events elicited in brain microvascular endothelial cells by domain III. RNA sequencing of cells treated with DIII of TBEV and WNV showed significant alteration in the expression of 309 and 1076 genes, respectively. Pathway analysis revealed activation of the TAM receptor pathway. Several genes that regulate tight-junction integrity were also activated, including pro-inflammatory cytokines and chemokines, cell-adhesion molecules, claudins, and matrix metalloprotease (mainly ADAM17). Results also indicate activation of a pro-apoptotic pathway. TLR2 was upregulated in both cases, but MyD88 was not. In the case of TBEV DIII, a MyD88 independent pathway was activated. Furthermore, both cases showed dramatic dysregulation of IFN and IFN-induced genes. Results strongly suggest that the virus contact to the cell surface emanates a series of events namely viral attachment and diffusion, breakdown of tight junctions, induction of virus uptake, apoptosis, reorganization of the extracellular-matrix, and activation of the innate immune system.
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Affiliation(s)
- Katarína Bhide
- Laboratory of Biomedical Microbiology and Immunology, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181, Kosice, Slovak Republic
| | - Evelína Mochnáčová
- Laboratory of Biomedical Microbiology and Immunology, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181, Kosice, Slovak Republic
| | - Zuzana Tkáčová
- Laboratory of Biomedical Microbiology and Immunology, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181, Kosice, Slovak Republic
| | - Patrícia Petroušková
- Laboratory of Biomedical Microbiology and Immunology, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181, Kosice, Slovak Republic
| | - Amod Kulkarni
- Laboratory of Biomedical Microbiology and Immunology, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181, Kosice, Slovak Republic.,Institute of Neuroimmunology of Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Mangesh Bhide
- Laboratory of Biomedical Microbiology and Immunology, University of Veterinary Medicine and Pharmacy, Komenského 73, 04181, Kosice, Slovak Republic. .,Institute of Neuroimmunology of Slovak Academy of Sciences, Bratislava, Slovak Republic.
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Gudowska-Sawczuk M, Mroczko B. Selected Biomarkers of Tick-Borne Encephalitis: A Review. Int J Mol Sci 2021; 22:10615. [PMID: 34638953 PMCID: PMC8509006 DOI: 10.3390/ijms221910615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/13/2021] [Accepted: 09/27/2021] [Indexed: 12/30/2022] Open
Abstract
Tick-borne encephalitis (TBE) is an acute disease caused by the tick-borne encephalitis virus. Due to the viral nature of the condition, there is no effective causal treatment for full-blown disease. Current and nonspecific TBE treatments only relieve symptoms. Unfortunately, the first phase of TBE is characterized by flu-like symptoms, making diagnosis difficult during this period. The second phase is referred to as the neurological phase as it involves structures in the central nervous system-most commonly the meninges and, in more severe cases, the brain and the spinal cord. Therefore, it is important that early markers of TBE that will guide clinical decision-making and the choice of treatment are established. In this review, we performed an extensive search of literature reports relevant to biomarkers associated with TBE using the MEDLINE/PubMed database. We observed that apart from routinely determined specific immunoglobulins, free light chains may also be useful in the evaluation of intrathecal synthesis in the central nervous system (CNS) during TBEV infection. Moreover, selected metalloproteinases, chemokines, or cytokines appear to play an important role in the pathogenesis of TBE as a consequence of inflammatory reactions and recruitment of white blood cells into the CNS. Furthermore, we reported promising findings on tau protein or Toll-like receptors. It was also observed that some people may be predisposed to TBE. Therefore, to understand the role of selected tick-borne encephalitis biomarkers, we categorized these factors and discussed their potential application in the diagnosis, prognosis, monitoring, or management of TBE.
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Affiliation(s)
- Monika Gudowska-Sawczuk
- Department of Biochemical Diagnostics, Medical University of Bialystok, ul. Waszyngtona 15A, 15-269 Bialystok, Poland;
| | - Barbara Mroczko
- Department of Biochemical Diagnostics, Medical University of Bialystok, ul. Waszyngtona 15A, 15-269 Bialystok, Poland;
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, ul. Waszyngtona 15A, 15-269 Bialystok, Poland
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12
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Pavletič M, Korva M, Knap N, Bogovič P, Lusa L, Strle K, Nahtigal Klevišar M, Vovko T, Tomažič J, Lotrič-Furlan S, Strle F, Avšič-Županc T. Upregulated Intrathecal Expression of VEGF-A and Long Lasting Global Upregulation of Proinflammatory Immune Mediators in Vaccine Breakthrough Tick-Borne Encephalitis. Front Cell Infect Microbiol 2021; 11:696337. [PMID: 34277474 PMCID: PMC8281926 DOI: 10.3389/fcimb.2021.696337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/19/2021] [Indexed: 12/30/2022] Open
Abstract
Although anti-TBE vaccines are highly effective, vaccine breakthrough (VBT) cases have been reported. With increasing evidence for immune system involvement in TBE pathogenesis, we characterized the immune mediators reflecting innate and adaptive T and B cell responses in neurological and convalescent phase in VBT TBE patients. At the beginning of the neurological phase, VBT patients have significantly higher serum levels of several innate and adaptive inflammatory cytokines compared to healthy donors, reflecting a global inflammatory state. The majority of cytokines, particularly those associated with innate and Th1 responses, are highly concentrated in CSF and positively correlate with intrathecal immune cell counts, demonstrating the localization of Th1 and proinflammatory responses in CNS, the site of disease in TBE. Interestingly, compared to unvaccinated TBE patients, VBT TBE patients have significantly higher CSF levels of VEGF-A and IFN-β and higher systemic levels of neutrophil chemoattractants IL-8/CXCL8 and GROα/CXCL1 on admission. Moreover, serum levels of IL-8/CXCL8 and GROα/CXCL1 remain elevated for two months after the onset of neurological symptoms, indicating a prolonged systemic immune activation in VBT patients. These findings provide the first insights into the type of immune responses and their dynamics during TBE in VBT patients. An observed systemic upregulation of neutrophil derived inflammation in acute and convalescent phase of TBE together with highly expressed VEGF-A could contribute to BBB disruption that facilitates the entry of immune cells and supports the intrathecal localization of Th1 responses observed in VBT patients.
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Affiliation(s)
- Miša Pavletič
- Laboratory for Diagnostic of Zoonoses and World Health Organization (WHO) Center, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Misa Korva
- Laboratory for Diagnostic of Zoonoses and World Health Organization (WHO) Center, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Knap
- Laboratory for Diagnostic of Zoonoses and World Health Organization (WHO) Center, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Petra Bogovič
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Lara Lusa
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Mathematics, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Koper, Slovenia
| | - Klemen Strle
- Division of Infectious Diseases, Microbial Pathogenesis and Immunology Laboratory, Wadsworth Center, New York State (NYS) Department of Health, Albany, NY, United States
| | | | - Tomaž Vovko
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Janez Tomažič
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Stanka Lotrič-Furlan
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Franc Strle
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Laboratory for Diagnostic of Zoonoses and World Health Organization (WHO) Center, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Fang Y, Lian C, Huang D, Xu L. Analysis of Clinical Related Factors of Neonatal Hand-Foot-Mouth Disease Complicated With Encephalitis. Front Neurol 2020; 11:543013. [PMID: 33281697 PMCID: PMC7689027 DOI: 10.3389/fneur.2020.543013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/29/2020] [Indexed: 12/05/2022] Open
Abstract
Objective: To explore the clinical related factors of neonatal hand-foot-mouth disease (HFMD) complicated with encephalitis. Method: The neonatal HFMD complicated with encephalitis treated in our hospital from July 2015 to July 2020 was taken as the object of study. According to the NBNA score at discharge, the patients were divided into normal group and abnormal group. The clinical symptoms, auxiliary examination and prognosis of the two groups were compared. Result: (1) General condition: there was no significant difference in sex, age, duration of fever, treatment time and etiological test between the two groups (P > 0.05). (2) Clinical symptoms and signs: there was significant difference in abnormal consciousness between the two groups (P < 0.05). However, there was no significant difference in skin rash, respiratory system symptoms, digestive system symptoms, signs of high intracranial pressure, increased muscle tone and weakening of primitive reflex (P > 0.05). (3) Auxiliary examination: the number of white blood cells and the level of cytokines (CK-BB, UCH-L1) in cerebrospinal fluid (CSF) in the group with abnormal NBNA score were significantly higher than those in the group with normal NBNA score (P < 0.05). The serum IgM level in the abnormal NBNA score group was higher than that in the normal NBNA score group, and the serum IgG level in the abnormal NBNA score group was lower than that in the normal NBNA score group, and the difference was statistically significant (P < 0.05). The abnormal rate of Craniocerebral MRI in abnormal NBNA score group was higher than that in normal NBNA score group, and there was significant difference between the two groups (P < 0.05). There was no significant difference in the levels of protein, sugar, chloride, lactate dehydrogenase, and MMP-9 in CSF and the abnormal rate of amplitude integrated EEG (aEEG) between the two groups (P > 0.05). (4) The prognoses of patients with normal and abnormal NBNA score are good, and there are not significantly differences in the prognosis between the two groups (P > 0.05). Conclusion: (1) Neonatal HFMD complicated with encephalitis occurs more than 10 days after birth, there is no obvious abnormality in male and female, the vast majority of newborns have febrile symptoms, rash is not its specific manifestation, and most of them are atypical. (2) The positive rate of HFMD-related virus detected in CSF of neonatal HFMD is high. For newborns with abnormal consciousness, CSF examination should be accomplished in time, which has certain clinical significance for early diagnosis and treatment of severe newborns. (3) The increase of white blood cell count and cytokines (CK-BB, UCH-L1) in CSF of neonatal HFMD complicated with encephalitis has a certain clinical reference value for early diagnosis and identification of severe newborns. (4) There is a certain humoral immune disorder in newborns with HFMD complicated with encephalitis, but the overall prognosis is better due to the protective effect of maternal IgG.
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Affiliation(s)
- Yanling Fang
- Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, China
| | | | - Dali Huang
- Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, China
| | - Liping Xu
- Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, China
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The Cerebrospinal Fluid Interleukin-6/Interleukin-10 Ratio Differentiates Pediatric Tick-borne Infections. Pediatr Infect Dis J 2020; 39:239-243. [PMID: 32032308 DOI: 10.1097/inf.0000000000002552] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Borrelia burgdorferi and tick-borne encephalitis (TBE) virus are 2 types of tick-borne pathogens that can cause central nervous system infection. Routine diagnostics have so far included analysis of cerebrospinal fluid (CSF) cell numbers, CSF serology for Borrelia burgdorferi and serum serology for TBE virus. However, early diagnosis may be difficult based on antibody detection which takes time to analyze, and with the possibility of false negative results, thus delaying treatment. Cytokine analyses are becoming increasingly available in clinical routine care and may offer important information. METHODS Fifteen cytokines and chemokines were measured in the CSF from the diagnostic lumbar puncture of 37 children with TBE, 34 children with neuroborreliosis and 19 children without evidence of central nervous system infection, using Luminex technology. RESULTS Significantly higher levels of proinflammatory interleukin-6 were detected in the samples from TBE-infected children, when compared with neuroborreliosis or controls. In comparison, children with neuroborreliosis had significantly higher levels of interleukin-7, interleukin-8, interleukin-10, and interleukin-13 when compared with TBE infected or controls. Furthermore, the ratio between interleukin-6 and interleukin-10 was significantly different between the 2 types of tick-borne infections. CONCLUSIONS The interleukin-6/interleukin-10 ratio can be used as a rapid diagnostic cue upon suspected tick-borne infection, enabling fast and correct treatment. Also, in serology-negative results, such information may strengthen a clinical suspicion.
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Potokar M, Jorgačevski J, Zorec R. Astrocytes in Flavivirus Infections. Int J Mol Sci 2019; 20:ijms20030691. [PMID: 30736273 PMCID: PMC6386967 DOI: 10.3390/ijms20030691] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/27/2019] [Accepted: 01/29/2019] [Indexed: 12/14/2022] Open
Abstract
Virus infections of the central nervous system (CNS) can manifest in various forms of inflammation, including that of the brain (encephalitis) and spinal cord (myelitis), all of which may have long-lasting deleterious consequences. Although the knowledge of how different viruses affect neural cells is increasing, understanding of the mechanisms by which cells respond to neurotropic viruses remains fragmented. Several virus types have the ability to infect neural tissue, and astrocytes, an abundant and heterogeneous neuroglial cell type and a key element providing CNS homeostasis, are one of the first CNS cell types to get infected. Astrocytes are morphologically closely aligned with neuronal synapses, blood vessels, and ventricle cavities, and thereby have the capacity to functionally interact with neurons and endothelial cells. In this review, we focus on the responses of astrocytes to infection by neurotropic flaviviruses, including tick-borne encephalitis virus (TBEV), Zika virus (ZIKV), West Nile virus (WNV), and Japanese encephalitis virus (JEV), which have all been confirmed to infect astrocytes and cause multiple CNS defects. Understanding these mechanisms may help design new strategies to better contain and mitigate virus- and astrocyte-dependent neuroinflammation.
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Affiliation(s)
- Maja Potokar
- Laboratory of Neuroendocrinology-Molecular Cell Physiology, Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
- Celica BIOMEDICAL, Tehnološki park 24, 1000 Ljubljana, Slovenia.
| | - Jernej Jorgačevski
- Laboratory of Neuroendocrinology-Molecular Cell Physiology, Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
- Celica BIOMEDICAL, Tehnološki park 24, 1000 Ljubljana, Slovenia.
| | - Robert Zorec
- Laboratory of Neuroendocrinology-Molecular Cell Physiology, Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
- Celica BIOMEDICAL, Tehnološki park 24, 1000 Ljubljana, Slovenia.
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16
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Barkhash AV, Yurchenko AA, Yudin NS, Ignatieva EV, Kozlova IV, Borishchuk IA, Pozdnyakova LL, Voevoda MI, Romaschenko AG. A matrix metalloproteinase 9 (MMP9) gene single nucleotide polymorphism is associated with predisposition to tick-borne encephalitis virus-induced severe central nervous system disease. Ticks Tick Borne Dis 2018; 9:763-767. [DOI: 10.1016/j.ttbdis.2018.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/25/2017] [Accepted: 02/08/2018] [Indexed: 12/30/2022]
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Palus M, Vancova M, Sirmarova J, Elsterova J, Perner J, Ruzek D. Tick-borne encephalitis virus infects human brain microvascular endothelial cells without compromising blood-brain barrier integrity. Virology 2017; 507:110-122. [DOI: 10.1016/j.virol.2017.04.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/13/2017] [Accepted: 04/14/2017] [Indexed: 12/11/2022]
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18
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Sun RX, Lai SJ, Yang Y, Li XL, Liu K, Yao HW, Zhou H, Li Y, Wang LP, Mu D, Yin WW, Fang LQ, Yu HJ, Cao WC. Mapping the distribution of tick-borne encephalitis in mainland China. Ticks Tick Borne Dis 2017; 8:631-639. [DOI: 10.1016/j.ttbdis.2017.04.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 12/15/2022]
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19
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Tick-borne encephalitis virus neutralization by high dose intravenous immunoglobulin. Ticks Tick Borne Dis 2017; 8:253-258. [DOI: 10.1016/j.ttbdis.2016.11.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/08/2016] [Accepted: 11/14/2016] [Indexed: 11/22/2022]
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20
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Moniuszko-Malinowska A, Czupryna P, Dunaj J, Swierzbinska R, Guziejko K, Rutkowski R, Zajkowska J, Grygorczuk S, Kondrusik M, Pancewicz S. Evaluation of NF-κB concentration in patients with tick-borne encephalitis, neuroborreliosis, anaplasmosis and Anaplasma phagocythophilum with tick-borne encephalitis virus co-infection. Cytokine 2016; 90:155-160. [PMID: 27918952 DOI: 10.1016/j.cyto.2016.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/05/2016] [Accepted: 10/24/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of the study was the evaluation of NF-κB concentration in serum and cerebrospinal fluid (CSF) of patients with diagnosis of tick-borne diseases: tick-borne encephalitis (TBE), neuroborreliosis (NB), anaplasmosis (ANA) and patients co-infected with tick-borne encephalitis virus and Anaplasma phagocythophilum (TBE+ANA). Additionally NF-κB concentration during acute and convalescent period was compared. METHODS Sixty-seven patients with diagnosis of tick-borne diseases were included in the study. The control group (CG) consisted of 18 patients hospitalized because of headaches and had lumbar puncture performed. The NF-κB was measured by human inhibitory subunit of NF-κB ELISA Kit during acute and convalescent period. RESULTS In serum the significant differences were observed only in patients with TBE+ANA co-infection. In CSF the concentration of NF-κB was significantly higher in patients with TBE, TBE+ANA co-infection, and patients with NB than in CG. Receiver operating characteristic (ROC) curves analysis showed that NF-κB concentration in CSF differentiated patients with NB with CG; patients co-infected with TBE and ANA with CG and patients with TBE with CG. NF-κB concentration in serum differentiated patients co-infected with TBE and ANA with NB and with ANA, with TBE and with CG. In TBE group the serum NF-κB concentration significantly decreased in convalescent period, while in NB and TBE groups significant CSF decrease of NF-κB concentration was observed. CONCLUSIONS
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Affiliation(s)
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Justyna Dunaj
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Renata Swierzbinska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Katarzyna Guziejko
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Ryszard Rutkowski
- Department of Respiratory Diagnostics and Bronchoscopy, Medical University of Bialystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Sambor Grygorczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Maciej Kondrusik
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
| | - Sławomir Pancewicz
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland
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Michael BD, Griffiths MJ, Granerod J, Brown D, Davies NWS, Borrow R, Solomon T. Characteristic Cytokine and Chemokine Profiles in Encephalitis of Infectious, Immune-Mediated, and Unknown Aetiology. PLoS One 2016; 11:e0146288. [PMID: 26808276 PMCID: PMC4726626 DOI: 10.1371/journal.pone.0146288] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/15/2015] [Indexed: 01/20/2023] Open
Abstract
Background Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes. However, in 15–60% the cause remains unknown. This study aimed to determine if the cytokine/chemokine-mediated host response can distinguish infectious from immune-mediated cases, and whether this may give a clue to aetiology in those of unknown cause. Methods We measured 38 mediators in serum and cerebrospinal fluid (CSF) of patients from the Health Protection Agency Encephalitis Study. Of serum from 78 patients, 38 had infectious, 20 immune-mediated, and 20 unknown aetiology. Of CSF from 37 patients, 20 had infectious, nine immune-mediated and eight unknown aetiology. Results Heat-map analysis of CSF mediator interactions was different for infectious and immune-mediated cases, and that of the unknown aetiology group was similar to the infectious pattern. Higher myeloperoxidase (MPO) concentrations were found in infectious than immune-mediated cases, in serum and CSF (p = 0.01 and p = 0.006). Serum MPO was also higher in unknown than immune-mediated cases (p = 0.03). Multivariate analysis selected serum MPO; classifying 31 (91%) as infectious (p = 0.008) and 17 (85%) as unknown (p = 0.009) as opposed to immune-mediated. CSF data also selected MPO classifying 11 (85%) as infectious as opposed to immune-mediated (p = 0.036). CSF neutrophils were detected in eight (62%) infective and one (14%) immune-mediated cases (p = 0.004); CSF MPO correlated with neutrophils (p<0.0001). Conclusions Mediator profiles of infectious aetiology differed from immune-mediated encephalitis; and those of unknown cause were similar to infectious cases, raising the hypothesis of a possible undiagnosed infectious cause. Particularly, neutrophils and MPO merit further investigation.
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MESH Headings
- Adult
- Bacterial Infections/blood
- Bacterial Infections/cerebrospinal fluid
- Biomarkers
- Cell Adhesion Molecules/blood
- Cell Adhesion Molecules/cerebrospinal fluid
- Chemokines/cerebrospinal fluid
- Chemokines/classification
- Cytokines/blood
- Cytokines/cerebrospinal fluid
- Diagnosis, Differential
- Encephalitis/blood
- Encephalitis/cerebrospinal fluid
- Encephalitis/etiology
- Encephalitis/immunology
- Encephalitis, Viral/blood
- Encephalitis, Viral/cerebrospinal fluid
- Encephalitis, Viral/diagnosis
- England/epidemiology
- Female
- Humans
- Infectious Encephalitis/blood
- Infectious Encephalitis/cerebrospinal fluid
- Infectious Encephalitis/diagnosis
- Leukocyte Count
- Male
- Multicenter Studies as Topic
- Mycoses/blood
- Mycoses/cerebrospinal fluid
- Mycoses/diagnosis
- Paraneoplastic Syndromes, Nervous System/blood
- Paraneoplastic Syndromes, Nervous System/cerebrospinal fluid
- Paraneoplastic Syndromes, Nervous System/diagnosis
- Peroxidase/blood
- Peroxidase/cerebrospinal fluid
- Retrospective Studies
- Toxoplasmosis, Cerebral/blood
- Toxoplasmosis, Cerebral/cerebrospinal fluid
- Toxoplasmosis, Cerebral/diagnosis
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Affiliation(s)
- Benedict D. Michael
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- The Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
| | - Michael J. Griffiths
- The Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | | | - David Brown
- Public Health England, London, United Kingdom
- Influenza and measles laboratory, IOC, Fiocruz, Rio de Janeiro, Brazil
| | | | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester, United Kingdom
| | - Tom Solomon
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- The Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
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Palus M, Formanová P, Salát J, Žampachová E, Elsterová J, Růžek D. Analysis of serum levels of cytokines, chemokines, growth factors, and monoamine neurotransmitters in patients with tick-borne encephalitis: identification of novel inflammatory markers with implications for pathogenesis. J Med Virol 2015; 87:885-92. [PMID: 25675945 DOI: 10.1002/jmv.24140] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 12/30/2022]
Abstract
Tick-borne encephalitis (TBE) is a leading human neuroinfection in Europe and northeastern Asia. However, the pathophysiology of TBE is not understood completely. This study sought to determine the specific serum mediators that are associated with acute TBE. The levels of 30 cytokines, chemokines, and growth factors were measured in serum samples from 87 patients with clinically and serologically confirmed acute TBE and from 32 control subjects using the Cytokine Human Magnetic 30-Plex Panel for the Luminex platform. Serum levels of the monoamine neurotransmitters serotonin, dopamine, and noradrenaline were measured via enzyme-linked immunosorbent assay. TBE virus infection elicited increased levels of the pro-inflammatory cytokines interleukin (IL)-6, IL-8, and IL-12. TBE patients had higher IL-12:IL-4 and IL-12:IL-10 ratios than control patients, reflecting the global pro-inflammatory cytokine balance. Serum levels of the monoamine neurotransmitters serotonin, dopamine, and noradrenaline were significantly lower in TBE patients than in the control group. Most interestingly, increased levels of hepatocyte growth factor and vascular endothelial growth factor were observed in TBE patients; these proteins may be novel and mechanistically important inflammatory biomarkers of TBE.
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Affiliation(s)
- Martin Palus
- Department of Virology, Veterinary Research Institute, Brno, Czech Republic; Laboratory of Arbovirology, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, České Budějovice, Czech Republic; Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
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23
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Palus M, Bílý T, Elsterová J, Langhansová H, Salát J, Vancová M, Růžek D. Infection and injury of human astrocytes by tick-borne encephalitis virus. J Gen Virol 2014; 95:2411-2426. [PMID: 25000960 DOI: 10.1099/vir.0.068411-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Tick-borne encephalitis (TBE), a disease caused by tick-borne encephalitis virus (TBEV), represents the most important flaviviral neural infection in Europe and north-eastern Asia. In the central nervous system (CNS), neurons are the primary target for TBEV infection; however, infection of non-neuronal CNS cells, such as astrocytes, is not well understood. In this study, we investigated the interaction between TBEV and primary human astrocytes. We report for the first time, to the best of our knowledge, that primary human astrocytes are sensitive to TBEV infection, although the infection did not affect their viability. The infection induced a marked increase in the expression of glial fibrillary acidic protein, a marker of astrocyte activation. In addition, expression of matrix metalloproteinase 9 and several key pro-inflammatory cytokines/chemokines (e.g. tumour necrosis factor α, interferon α, interleukin (IL)-1β, IL-6, IL-8, interferon γ-induced protein 10, macrophage inflammatory protein, but not monocyte chemotactic protein 1) was upregulated. Moreover, we present a detailed description of morphological changes in TBEV-infected cells, as investigated using three-dimensional electron tomography. Several novel ultrastructural changes were observed, including the formation of unique tubule-like structures of 17.9 ±0.15 nm diameter with associated viral particles and/or virus-induced vesicles and located in the rough endoplasmic reticulum of the TBEV-infected cells. This is the first demonstration that TBEV infection activates primary human astrocytes. The infected astrocytes might be a potential source of pro-inflammatory cytokines in the TBEV-infected brain, and might contribute to the TBEV-induced neurotoxicity and blood-brain barrier breakdown that occurs during TBE. The neuropathological significance of our observations is also discussed.
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Affiliation(s)
- Martin Palus
- Faculty of Science, University of South Bohemia, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Department of Virology, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic
| | - Tomáš Bílý
- Faculty of Science, University of South Bohemia, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, Branišovská 31, CZ-37005 České Budějovice, Czech Republic
| | - Jana Elsterová
- Department of Virology, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic.,Faculty of Science, University of South Bohemia, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, Branišovská 31, CZ-37005 České Budějovice, Czech Republic
| | - Helena Langhansová
- Faculty of Science, University of South Bohemia, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, Branišovská 31, CZ-37005 České Budějovice, Czech Republic
| | - Jiří Salát
- Department of Virology, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic
| | - Marie Vancová
- Faculty of Science, University of South Bohemia, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, Branišovská 31, CZ-37005 České Budějovice, Czech Republic
| | - Daniel Růžek
- Department of Virology, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic.,Faculty of Science, University of South Bohemia, Branišovská 31, CZ-37005 České Budějovice, Czech Republic.,Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, Branišovská 31, CZ-37005 České Budějovice, Czech Republic
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