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Lawrence SM. Human cytomegalovirus and neonatal infection. CURRENT RESEARCH IN MICROBIAL SCIENCES 2024; 7:100257. [PMID: 39070527 PMCID: PMC11276932 DOI: 10.1016/j.crmicr.2024.100257] [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] [Indexed: 07/30/2024] Open
Abstract
Human cytomegalovirus is an ancient virus that has co-evolved with humans. It establishes a life-long infection in suspectable individuals for which there is no vaccination or cure. The virus can be transmitted to a developing fetus in seropositive pregnant women, and it is the leading cause of congenital infectious disease. While the majority of infected infants remain asymptomatic at birth, congenital cytomegalovirus infection can lead to substantial long-term neurodevelopmental impairments in survivors, resulting in considerable economic and social hardships. Recent discoveries regarding cytomegalovirus pathophysiology and viral replication cycles might enable the development of innovative diagnostics and therapeutics, including an effective vaccine. This Review will detail our understanding of human cytomegalovirus infection, with an in-depth discussion regarding the viral genome and transcriptome that contributes to its pathophysiology. The neonate's clinical course will also be highlighted, including maternal and neonatal testing, treatment recommendations, and long-term outcomes.
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Affiliation(s)
- Shelley M. Lawrence
- University of Utah, College of Medicine, Department of Pediatrics, Division of Neonatology, Salt Lake City, UT, USA
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Mirsalehi N, Yavarian J, Ghavami N, Naseri M, Khodakhah F, Shatizadeh Malekshahi S, Zadheidar S, Mokhtari-Azad T, Shafiei-Jandaghi NZ. Congenital cytomegalovirus infection in newborns suspected of congenital rubella syndrome in Iran: a cross-sectional study. BMC Pediatr 2024; 24:31. [PMID: 38200453 PMCID: PMC10777647 DOI: 10.1186/s12887-023-04502-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Following rubella virus control, the most important cause of congenital infections is human cytomegalovirus (HCMV). Congenital CMV (cCMV) may happen both in primary and non-primary maternal infections. The present study aimed to screen cCMV in symptomatic newborns suspected of congenital rubella syndrome (CRS) in Iran. METHODS Out of 1629 collected infants' serum samples suspected of CRS but negative for rubella IgM, 524 samples were selected regarding cCMV complications. These samples were divided into two age groups: 1- one month and younger, 2- older than 1 month up to one year. Anti-HCMV IgM detection was performed on these serums. Then HCMV IgG avidity assay and HCMV DNA detection were carried out on all samples with positive and borderline results in IgM detection. RESULTS Herein, 3.67% of symptomatic infants aged one month and younger had positive and borderline HCMV IgM, 12.5% of which had a low avidity index (AI). HCMV IgM detection rate among symptomatic infants older than one month to one year was 14.5%. Identified genotypes in this study were gB-1(63.63%), gB2 (18.18%), and gB3 (18.18%), respectively. CONCLUSIONS This comprehensive study was performed on serum samples of symptomatic infants clinically suspected of cCMV from all over Iran. There was a good correlation between serology findings and PCR.
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Affiliation(s)
- Negar Mirsalehi
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jila Yavarian
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ghavami
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Naseri
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Khodakhah
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sevrin Zadheidar
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari-Azad
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin-Zahra Shafiei-Jandaghi
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Dong N, Cao L, Zheng D, Su L, Lu L, Dong Z, Xu M, Xu J. Distribution of CMV envelope glycoprotein B, H and N genotypes in infants with congenital cytomegalovirus symptomatic infection. Front Pediatr 2023; 11:1112645. [PMID: 37009289 PMCID: PMC10057549 DOI: 10.3389/fped.2023.1112645] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/20/2023] [Indexed: 04/04/2023] Open
Abstract
Background Cytomegalovirus (CMV) is the leading cause of congenital infections worldwide and contributes to long-term sequelae in neonates and children. CMV envelope glycoproteins play a vital role in virus entry and cell fusion. The association between CMV polymorphisms and clinical outcomes remains controversial. The present study aims to demonstrate the distribution of glycoprotein B (gB), H (gH) and N (gN) genotypes in congenitally CMV (cCMV) infected symptomatic infants and attempts to figure out the association between viral glycoprotein genotypes and clinical outcomes. Methods Genotyping of gB, gH and gN was performed in 42 cCMV symptomatic infants and 149 infants with postnatal CMV (pCMV) infection in Children's hospital of Fudan university. Nested PCR, gene sequencing and phylogenetic analyses were used to identify the genotypes. Results Our study demonstrated that: 1. The CMV gB1, gH1 and gN1 were the predominant genotypes among symptomatic cCMV infected infants, while gB1, gH1 and gN3a were more prevalent in pCMV group. gH1 genotype has a significant association with symptomatic cCMV infection (p = 0.006). 2. No significant correlation was found between CMV genotypes and hearing impairment. However, gH1 was more prevalent among cCMV infected infants with moderate/severe hearing loss although without statistical difference (p = 0.130). 3. gB3 was more prevalent among infants with skin petechiae (p = 0.049) and found to be associated with an increased risk of skin petechiae (OR = 6.563). The gN4a subtype was significantly associated with chorioretinitis due to cCMV infection (p = 0.007). 4. Urine viral loads were not significantly associated with different genotypes or hearing impairment among symptomatic cCMV infected infants. Conclusions Our findings demonstrated the overall distribution of gB, gH and gN genotypes in infants with symptomatic cCMV infection in Shanghai for the first time. The findings in our study may suggest a possible association between gH1 genotype and early infancy hearing loss. gB3 genotype was associated with a 6.5-fold increased risk of petechiae while gN4a strongly correlated with chorioretinitis due to cCMV infection. No significant correlation was found between urine viral loads and CMV genotypes or hearing impairment in cCMV infected infants.
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Affiliation(s)
- Niuniu Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Danni Zheng
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Liyun Su
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zuoquan Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Correspondence: Jin Xu
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Molecular Investigation of Human Cytomegalovirus and Epstein-Barr virus in Glioblastoma Brain Tumor: A Case-Control Study in Iran. IRANIAN BIOMEDICAL JOURNAL 2021; 25:426-33. [PMID: 34696577 DOI: 10.52547/ibj.25.6.426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Glioblastoma multiforme is the most invasive and lethal form of brain cancer with unclear etiology. Our study aimed to investigate the molecular prevalence of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) infections in patients with glioblastoma multiforme (GBM). Methods This case-control study was conducted on 42 FFPE brain tumor samples from GBM patients and 42 brain autopsies from subjects without neurological disorders. The presence of EBV and HCMV DNA was determined, using PCR and nested-PCR assays, respectively. Results HCMV DNA was detected in 3 out of 42 (7.1%) of GBM samples and was absent from the control group (p = 0.07). Importantly, EBV DNA was detected in 9 out of 42 (21.4%) brain tissue specimens of GBM subjects, but again in none of the control group (p = 0.001). Conclusion Our findings indicate that infection with EBV is associated with GBM.
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Wang HY, Valencia SM, Pfeifer SP, Jensen JD, Kowalik TF, Permar SR. Common Polymorphisms in the Glycoproteins of Human Cytomegalovirus and Associated Strain-Specific Immunity. Viruses 2021; 13:v13061106. [PMID: 34207868 PMCID: PMC8227702 DOI: 10.3390/v13061106] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Human cytomegalovirus (HCMV), one of the most prevalent viruses across the globe, is a common cause of morbidity and mortality for immunocompromised individuals. Recent clinical observations have demonstrated that mixed strain infections are common and may lead to more severe disease progression. This clinical observation illustrates the complexity of the HCMV genome and emphasizes the importance of taking a population-level view of genotypic evolution. Here we review frequently sampled polymorphisms in the glycoproteins of HCMV, comparing the variable regions, and summarizing their corresponding geographic distributions observed to date. The related strain-specific immunity, including neutralization activity and antigen-specific cellular immunity, is also discussed. Given that these glycoproteins are common targets for vaccine design and anti-viral therapies, this observed genetic variation represents an important resource for future efforts to combat HCMV infections.
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Affiliation(s)
- Hsuan-Yuan Wang
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10065, USA;
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA;
| | - Sarah M. Valencia
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA;
| | - Susanne P. Pfeifer
- Center for Evolution & Medicine, School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA; (S.P.P.); (J.D.J.)
| | - Jeffrey D. Jensen
- Center for Evolution & Medicine, School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA; (S.P.P.); (J.D.J.)
| | - Timothy F. Kowalik
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA 01655, USA;
| | - Sallie R. Permar
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10065, USA;
- Correspondence: ; Tel.: +1-212-746-4111
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Dhingra A, Götting J, Varanasi PR, Steinbrueck L, Camiolo S, Zischke J, Heim A, Schulz TF, Weissinger EM, Kay-Fedorov PC, Davison AJ, Suárez NM, Ganzenmueller T. Human cytomegalovirus multiple-strain infections and viral population diversity in haematopoietic stem cell transplant recipients analysed by high-throughput sequencing. Med Microbiol Immunol 2021; 210:291-304. [PMID: 34611744 PMCID: PMC8541999 DOI: 10.1007/s00430-021-00722-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/21/2021] [Indexed: 01/22/2023]
Abstract
Human cytomegalovirus (HCMV) is an important opportunistic pathogen in allogeneic haematopoietic stem cell transplant (HSCT) recipients. High-throughput sequencing of target-enriched libraries was performed to characterise the diversity of HCMV strains present in this high-risk group. Forty-four HCMV-DNA-positive plasma specimens (median viral input load 321 IU per library) collected at defined time points from 23 HSCT recipients within 80 days of transplantation were sequenced. The genotype distribution for 12 hypervariable HCMV genes and the number of HCMV strains present (i.e. single- vs. multiple-strain infection) were determined for 29 samples from 16 recipients. Multiple-strain infection was observed in seven of these 16 recipients, and five of these seven recipients had the donor (D)/recipient (R) HCMV-serostatus combination D + R + . A very broad range of genotypes was detected, with an intrahost composition that was generally stable over time. Multiple-strain infection was not associated with particular virological or clinical features, such as altered levels or duration of antigenaemia, development of acute graft-versus-host disease or increased mortality. In conclusion, despite relatively low viral plasma loads, a high frequency of multiple-strain HCMV infection and a high strain complexity were demonstrated in systematically collected clinical samples from this cohort early after HSCT. However, robust evaluation of the pathogenic role of intrahost viral diversity and multiple-strain infection will require studies enrolling larger numbers of recipients.
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Affiliation(s)
- A. Dhingra
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - J. Götting
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - P. R. Varanasi
- German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany ,Department of Haematology, Haemostasis and Oncology, Hannover Medical School, Hannover, Germany ,Present Address: National Centre for Biological Sciences, Bangalore, India
| | - L. Steinbrueck
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - S. Camiolo
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - J. Zischke
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - A. Heim
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - T. F. Schulz
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - E. M. Weissinger
- German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany ,Department of Haematology, Haemostasis and Oncology, Hannover Medical School, Hannover, Germany
| | - P. C. Kay-Fedorov
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany
| | - A. J. Davison
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - N. M. Suárez
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - T. Ganzenmueller
- Hannover Medical School, Institute of Virology, Hannover, Germany ,German Center for Infection Research (DZIF), Site Hannover-Braunschweig, Hannover, Germany ,Institute for Medical Virology and Epidemiology, University Hospital Tuebingen, Elfriede-Aulhorn-Str. 6, 72076 Tuebingen, Germany
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Dong N, Cao L, Su L, Lu L, Dong Z, Xu M, Xu J. Human cytomegalovirus envelope glycoprotein B, H, and N polymorphisms among infants of Shanghai area in China. J Med Virol 2020; 92:3674-3681. [PMID: 32567060 DOI: 10.1002/jmv.26210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 11/11/2022]
Abstract
Human cytomegalovirus (HCMV) is the leading cause of congenital infection and an opportunistic pathogen capable of establishing lifelong latency. In the present study, we aimed to investigate the distribution of glycoprotein B, H, and N in infants of Shanghai and correlate the genotype with active and latent HCMV infection. A total of 129 urine samples were collected between August 2014 and December 2015 from infants under 3 years with HCMV infection. Nested PCR was used to amplify the regions of UL55 (gB), UL75 (gH), and UL73 (gN). Gene sequencing and phylogenetic analyses were used to classify the genotypes. Overall, regarding gB, gB1 (57.27%) was predominant, followed by gB3 (41.82%) and gB4 (0.91%). gH1 (54.33%) was the most prevalent genotype of gH, followed by gH2 (45.67%). Concerning gN, we detected gN1 (17.44%), gN2 (2.33%), gN3a (29.07%), gN3b (8.14%), gN4a (13.95%), gN4b (15.12%), and gN4c (13.95%), among which gN3a was the dominant genotype. All the expected genotypes were present except gB2 in children with active infection: gB1 (56.25%), gB3 (42.5%), gB4 (1.25%), gH1 (58.70%), gH2 (41.30%), gN1 (19.05%), gN2 (3.17%), gN3a (25.40%), gN3b (6.35%), gN4a (15.87%), gN4b (17.46%), and gN4c (12.70%). However, among latent cases, we detected gB1 (60%), gB3 (40%), gH1 (42.86%), gH2 (57.14%), gN1 (13.04%), gN3a (39.13%), gN3b (13.04%), gN4a (8.70%), gN4b (8.70%), and gN4c (17.39%), respectively. gB2, gB4, and gN2 were absent in this group. The results revealed that gB1, gH1, and gN3a were predominant in the infants of Shanghai. gH showed different trends among children with active and latent infection.
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Affiliation(s)
- Niuniu Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Liyun Su
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Zuoquan Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
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Min X, Wang L, Cui A, Zhang C, Wang D, Liu Y, Li Z, Xu W. The nucleic acid positive rate and genotype distribution of human cytomegalovirus in human milk banks in China. Arch Virol 2020; 165:1099-1107. [PMID: 32152788 DOI: 10.1007/s00705-020-04573-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/01/2020] [Indexed: 12/24/2022]
Abstract
To determine the status of human cytomegalovirus (HCMV) infection in human milk in China, a total of 510 human milk samples obtained from three provinces, including 211 donor human milk samples from human milk banks and 299 milk samples obtained from the mothers of premature infants, were tested to detect HCMV DNA. Overall, 46.4% of the donated milk samples and 59.2% of the samples obtained from mothers of premature infants were positive for HCMV DNA. The concentration of HCMV DNA was approximately 103 -104 copies/ml in the HCMV-DNA-positive human milk samples. Based on the nucleotide sequence of a 299- to 305-bp fragment of the glycoprotein B (gB) gene, three HCMV genotypes (gB1, gB2 and gB3) were identified in human milk samples. Mixed infection with genotypes gB1 and gB3 was also found in four milk samples from mothers. Genotype gB1 was the predominant genotype in the HCMV-DNA-positive human milk samples, and it could be subdivided into three lineages. There were also some characteristic nucleotides and amino acids in the three HCMV genotypes, which were helpful for distinguishing the genotypes. This is the first study to clarify the HCMV infection status and genetic characteristics of human milk obtained from banks in China, which will be helpful in preventing postnatal HCMV infections and ensuring the safety of human milk banks.
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Affiliation(s)
- Xiaoyu Min
- Medical School, Anhui University of Science and Technology, Huainan, 232001, Anhui, People's Republic of China
| | - Lin Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Aili Cui
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), WHO WPRO Regional Reference Measles/Rubella Laboratory, Beijing, 102206, People's Republic of China
| | - Chunli Zhang
- Department of Neonatal Medicine, Inner Mongolia People's Hospital, Huhhot, 010017, People's Republic of China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, The Third Medical University (Army Medical University), Chongqing, 400038, People's Republic of China
| | - Ying Liu
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), WHO WPRO Regional Reference Measles/Rubella Laboratory, Beijing, 102206, People's Republic of China
| | - Zhenghong Li
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.
| | - Wenbo Xu
- Medical School, Anhui University of Science and Technology, Huainan, 232001, Anhui, People's Republic of China. .,NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), WHO WPRO Regional Reference Measles/Rubella Laboratory, Beijing, 102206, People's Republic of China.
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Puhakka L, Pati S, Lappalainen M, Lönnqvist T, Niemensivu R, Lindahl P, Nieminen T, Seuri R, Nupponen I, Boppana S, Saxen H. Viral shedding, and distribution of cytomegalovirus glycoprotein H (UL75), glycoprotein B (UL55), and glycoprotein N (UL73) genotypes in congenital cytomegalovirus infection. J Clin Virol 2020; 125:104287. [PMID: 32086150 DOI: 10.1016/j.jcv.2020.104287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/13/2019] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Children with congenital CMV infection (cCMV) shed virus in urine and saliva for prolonged periods of time. Outcome of cCMV varies from asymptomatic infection with no sequelae in most cases, to severe longterm morbidity. The factors associated with asymptomatic cCMV are not well defined. We evaluated the viral shedding in a cohort of infants with cCMV identified on newborn screening. In addition, we describe the distribution of viral genotypes in our cohort of asymptomatic infants and previous cohorts of cCMV children in the literature. METHODS Study population consisted of 40 children with cCMV identified in screening of 19,868 infants, a prevalence of 2/1000. The viral shedding was evaluated at 3 and 18 months of age by real-time CMV-PCR of saliva and plasma, and CMV culture of urine. CMV positive saliva samples were analyzed for genotypes for CMV envelope glycoproteins gB (UL55), and gH (UL75) by genotype specific real-time PCR, and gN (UL73) by cloning and sequencing RESULTS: At 3 months age 40/40 saliva and urine samples, and 19/40 plasma samples were positive for CMV. At 18 months age all urine samples tested (33/33), 9/37 of saliva samples, and 2/34 plasma samples were positive for CMV. The genotype distribution did not differ from the published data CONCLUSIONS: The urinary virus shedding is more persistent than salivary shedding in children with cCMV. The genotype distribution was similar to previous literature and does not explain the low disease burden of cCMV in our population.
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Affiliation(s)
- Laura Puhakka
- Department of Pediatric Infectious Diseases, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Sunil Pati
- Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maija Lappalainen
- Laboratory Services (HUSLAB), Division of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Tuula Lönnqvist
- Department of Child Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riina Niemensivu
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Päivi Lindahl
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tea Nieminen
- Department of Pediatric Infectious Diseases, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Raija Seuri
- Department of Pediatric Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Irmeli Nupponen
- Department of Neonatology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Suresh Boppana
- Pediatrics and Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harri Saxen
- Department of Pediatric Infectious Diseases, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Performance of Zika Assays in the Context of Toxoplasma gondii, Parvovirus B19, Rubella Virus, and Cytomegalovirus (TORCH) Diagnostic Assays. Clin Microbiol Rev 2019; 33:33/1/e00130-18. [PMID: 31826871 DOI: 10.1128/cmr.00130-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Infections during pregnancy that may cause congenital abnormalities have been recognized for decades, but their diagnosis is challenging. This was again illustrated with the emergence of Zika virus (ZIKV), highlighting the inherent difficulties in estimating the extent of pre- and postnatal ZIKV complications because of the difficulties in establishing definitive diagnoses. We reviewed the epidemiology, infection kinetics, and diagnostic methods used for Toxoplasma gondii, parvovirus B19, rubella virus, and cytomegalovirus (TORCH) infections and compared the results with current knowledge of ZIKV diagnostic assays to provide a basis for the inclusion of ZIKV in the TORCH complex evaluations. Similarities between TORCH pathogens and ZIKV support inclusion of ZIKV as an emerging TORCH infection. Our review evaluates the diagnostic performance of various TORCH diagnostic assays for maternal screening, fetal screening, and neonatal screening. We show that the sensitivity, specificity, and positive and negative predictive value of TORCH complex pathogens are widely variable, stressing the importance of confirmatory testing and the need for novel techniques for earlier and accurate diagnosis of maternal and congenital infections. In this context it is also important to acknowledge different needs and access to care for different geographic and resource settings.
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Dobbins GC, Patki A, Chen D, Tiwari HK, Hendrickson C, Britt WJ, Fowler K, Chen JY, Boppana SB, Ross SA. Association of CMV genomic mutations with symptomatic infection and hearing loss in congenital CMV infection. BMC Infect Dis 2019; 19:1046. [PMID: 31822287 PMCID: PMC6905059 DOI: 10.1186/s12879-019-4681-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/29/2019] [Indexed: 12/23/2022] Open
Abstract
Background Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and a leading cause of long-term neurological and sensory sequelae, the most common being sensorineural hearing loss (SNHL). Despite extensive research, clinical or laboratory markers to identify CMV infected children with increased risk for disease have not been identified. This study utilizes viral whole-genome next generation-sequencing (NGS) of specimens from congenitally infected infants to explore viral diversity and specific viral variants that may be associated with symptomatic infection and SNHL. Methods CMV DNA from urine specimens of 30 infants (17 asymptomatic, 13 symptomatic) was target enriched and next generation sequenced resulting in 93% coverage of the CMV genome allowing analysis of viral diversity. Results Variant frequency distribution was compared between children with symptomatic and asymptomatic cCMV and those with (n = 13) and without (n = 17) hearing loss. The CMV genes UL48A, UL88, US19 and US22 were found to have an increase in nucleotide diversity in symptomatic children; while UL57, UL20, UL104, US14, UL115, and UL35 had an increase in diversity in children with hearing loss. An analysis of single variant differences between symptomatic and asymptomatic children found UL55 to have the highest number, while the most variants associated with SNHL were in the RL11 gene family. In asymptomatic infants with SNHL, mutations were observed more frequently in UL33 and UL20. Conclusion CMV genomes from infected newborns can be mapped to 93% of the genome at a depth allowing accurate and reproducible analysis of polymorphisms for variant and gene discovery that may be linked to symptomatic and hearing loss outcomes.
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Affiliation(s)
- G Clement Dobbins
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA.
| | - Amit Patki
- Department of Biostatistics, The University of Alabama School of Public Health, Birmingham, AL, USA
| | - Dongquan Chen
- Informatics Institute, The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hemant K Tiwari
- Department of Biostatistics, The University of Alabama School of Public Health, Birmingham, AL, USA
| | - Curtis Hendrickson
- Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - William J Britt
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA.,Informatics Institute, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Fowler
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA
| | - Jake Y Chen
- Informatics Institute, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suresh B Boppana
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA.,Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shannon A Ross
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA. .,Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL, USA.
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12
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Lee CY, Lin KY, Chen TH, Sung CH, Fang YP, Sung PL, Chan YJ. Prevalence of cytomegalovirus DNAemia and genotypic distribution among childbearing mothers and neonates in Taiwan. Int J Infect Dis 2019; 91:240-245. [PMID: 31783095 DOI: 10.1016/j.ijid.2019.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is the leading cause of neurologic disabilities and sensorineural hearing loss in children. However, in Taiwan, there is limited information on the genotypic diversity and prevalence of perinatal CMV infection in both mothers and neonates. The aim of this study was to screen samples from both mothers and umbilical cord blood for CMV at the time of delivery and to determine the CMV genotypic distribution. METHODS Between June 2012 and July 2015, residual maternal and umbilical cord blood samples were collected from consenting participants admitted to the Chang Bing Show Chwan Memorial Hospital in central Taiwan. The blood samples were screened for CMV DNA using real-time PCR assay, and the genotypic classification of the CMV UL55, UL144, and US28 genes was determined by sequencing and phylogenetic analysis. RESULTS A total of 1282 mother-neonate paired samples were enrolled in the study, 95.3% of whom were Taiwanese. CMV DNA was detectable in 6.2% of the maternal blood samples, with a significantly higher rate noted in non-Taiwanese mothers (11.7%,p=0.027). For the 1,282 umbilical cord blood samples, CMV DNA was detectable in 5.3% of the samples. The presence of CMV DNA in maternal blood was positively associated with the presence of CMV DNA in umbilical cord blood (p=0.01). In addition, the UL55, UL144, and US28 genotypic distribution was similar between mothers and neonates. CONCLUSION The prevalence of CMV DNAemia in childbearing mothers and neonates is similar and their genotypic distribution implies potential CMV infection during pregnancy.
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Affiliation(s)
- Chun Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kun Yi Lin
- Department of Obstetrics and Gynecology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Tien Hui Chen
- Department of Obstetrics and Gynecology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chia Hsing Sung
- Department of Clinical Laboratory, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yu Ping Fang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Pi Lin Sung
- Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei, Taiwan
| | - Yu Jiun Chan
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
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13
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Alwan SN, Shamran HA, Ghaib AH, Kadhim HS, Al-Mayah QS, AL-Saffar AJ, Bayati AH, Arif HS, Fu J, Wickes BL. Genotyping of Cytomegalovirus from Symptomatic Infected Neonates in Iraq. Am J Trop Med Hyg 2019; 100:957-963. [PMID: 30810104 PMCID: PMC6447132 DOI: 10.4269/ajtmh.18-0152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 11/12/2018] [Indexed: 12/11/2022] Open
Abstract
Among all other viruses, human cytomegalovirus (HCMV) is the most frequent cause of congenital infection worldwide. Strain variation in HCMV may predict severity or outcome of congenital HCMV disease. Previous studies have associated a particular genotype with specific sequelae or more severe illness, but the results were contradictory. There are no previous studies addressing the genotype of HCMV in Iraq. Therefore, the present study is aimed at molecular detection and genotyping of HCMV isolated from symptomatic congenitally/perinatally infected neonates. This prospective study comprised 24 serum samples from symptomatic neonates with congenital/perinatal infection. Viral DNA was extracted from these serum samples; nested polymerase chain reaction was used to amplify the HCMV gB (UL55) gene. Polymerase chain reaction products of the second round of amplification were subjected to direct Sanger sequencing. Bioedit and MEGA5 software (EMBL-EBI, Hinxton, Cambridgeshire, UK) were used for alignment and construction of a phylogenetic tree. Human cytomegalovirus DNA was detected in 23 of 24 samples (95.8%). According to the phylogenetic analysis, three genotypes of the virus were identified; gB1, gB2, and gB3 genotypes. However, the gB4 genotype was not detected. Human cytomegalovirus gB3 was the most frequent genotype: 14 of 24 (58.33%) among symptomatic infected infants, followed by gB1 (6/24; 25%) and gB2 (4/24; 16.67%). A mixed HCMV infection with gB3/gB1 was detected in only one case. Human cytomegalovirus gB3 was the most predominant genotype among symptomatic congenitally/perinatally HCMV-infected neonates. No association was found between B3 genotype and specific clinical presentation. Jaundice was the most common clinical feature among symptomatically infected neonates, followed by hepatosplenomegaly.
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Affiliation(s)
- Sevan N. Alwan
- Department of Biochemistry and Structural Biology, UT Health at San Antonio, San Antonio, Texas
| | - Haidar A. Shamran
- Medical Research Unit, College of Medicine, University of AL-Nahrain, Baghdad, Iraq
| | - Avan H. Ghaib
- Microbiology and Immunology Department, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq
| | - Haider S. Kadhim
- Microbiology Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Qasim S. Al-Mayah
- Medical Research Unit, College of Medicine, University of AL-Nahrain, Baghdad, Iraq
| | - Atheer J. AL-Saffar
- Community and Family Medicine Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Ali H. Bayati
- Community Health Department, Technical College of Health, Sulaimani Polytechnic University, Sulaymaniyah, Kurdistan Region, Iraq
| | - Hala S. Arif
- Pediatric Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Jianmin Fu
- Department of Microbiology, Immunology, and Molecular Genetics, UT Heath at San Antonio, San Antonio, Texas
| | - Brian L. Wickes
- Department of Microbiology, Immunology, and Molecular Genetics, UT Heath at San Antonio, San Antonio, Texas
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Garcia de Figueiredo G, Marques AA, Mussi-Pinhata MM, Silva WA, Yamamoto AY. Is the mixture of human cytomegalovirus genotypes frequent in infants with congenital infection at birth in a high seroprevalence population? J Med Virol 2018; 90:1389-1397. [DOI: 10.1002/jmv.25205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/13/2018] [Indexed: 11/06/2022]
Affiliation(s)
| | - Adriana Aparecida Marques
- Center for Medical Genetics at General Hospital of Ribeirão Preto, Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | | | - Wilson Araújo Silva
- Center for Medical Genetics at General Hospital of Ribeirão Preto, Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
- Department of Genetics, Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - Aparecida Yulie Yamamoto
- Department of Pediatrics, Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
- Center for Medical Genetics at General Hospital of Ribeirão Preto, Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
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Polymorphisms and features of cytomegalovirus UL144 and UL146 in congenitally infected neonates with hepatic involvement. PLoS One 2017; 12:e0171959. [PMID: 28222150 PMCID: PMC5319779 DOI: 10.1371/journal.pone.0171959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/28/2017] [Indexed: 10/25/2022] Open
Abstract
Human cytomegalovirus is a significant agent of hepatic involvement in neonates. In this study, we investigated the polymorphisms and features of the viral genes UL144 and UL146 as well as their significance to congenital hepatic involvement. In 79 neonates with congenital cytomegalovirus infection and hepatic involvement, full length UL144 and UL146 were successfully amplified in 73.42% and 60.76% of cases, respectively. Sequencing indicated that both genes were hypervariable. Notably, UL144 genotype B was highly associated with aspartate aminotransferase (P = 0.028) and lactate dehydrogenase (P = 0.046). Similarly, UL146 genotype G1 and G13 were significantly associated with CMV IgM (P = 0.026), CMV IgG (P = 0.034), alanine aminotransferase (P = 0.019), and aspartate aminotransferase (P = 0.032). In conclusion, dominant UL144 (genotype B) and UL146 (genotype G1 and G13) genotypes are associated with elevated levels of enzymes and CMV IgM and IgG of cytomegalovirus infection.
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16
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Arcangeletti MC, Vasile Simone R, Rodighiero I, De Conto F, Medici MC, Maccari C, Chezzi C, Calderaro A. Human cytomegalovirus reactivation from latency: validation of a "switch" model in vitro. Virol J 2016; 13:179. [PMID: 27770817 PMCID: PMC5075216 DOI: 10.1186/s12985-016-0634-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 10/10/2016] [Indexed: 02/07/2023] Open
Abstract
Background Human cytomegalovirus (HCMV) is an opportunistic pathogen leading to severe and even fatal diseases in ‘at-risk’ categories of individuals upon primary infection or the symptomatic reactivation of the endogenous virus. The mechanisms which make the virus able to reactivate from latency are still matter of intense study. However, the very low number of peripheral blood monocytes (an important latent virus reservoir) harbouring HCMV DNA makes it very difficult to obtain adequate viral quantities to use in such studies. Thus, the aim of the present study was to demonstrate the usefulness of human THP-1 monocytes, mostly employed as HCMV latent or lytic infection system, as a reactivation model. Methods THP-1 monocytes were infected with HCMV TB40E strain (latency model) at multiplicities of infection (MOI) of 0.5, 0.25 or 0.125. After infection, THP-1 aliquots were differentiated into macrophages (reactivation model). Infections were carried out for 30 h, 4, 6 and 7 days. Viral DNA evaluation was performed with viable and UV-inactivated virus by q-Real-Time PCR. RNA extracted from latency and reactivation models at 7 days post-infection (p.i.) was subjected to RT-PCR to analyse viral latency and lytic transcripts. To perform viral progeny analysis and titration, the culture medium from infected THP-1 latency and reactivation models (7 days p.i.) was used to infect human fibroblasts; it was also checked for the presence of exosomes. For viral progeny analysis experiments, the Towne strain was also used. Results Our results showed that, while comparable TB40E DNA amounts were present in both latent and reactivation models at 30 h p.i., gradually increased quantities of viral DNA were only evident in the latter model at 4, 6, 7 days p.i.. The completion of the lytic cycle upon reactivation was also proved by the presence of HCMV lytic transcripts and an infectious viral yield at 7 days p.i. Conclusions Our data demonstrate the effectiveness of THP-1 cells as a “switch” model for studying the mechanisms that regulate HCMV reactivation from latency. This system is able to provide adequate quantities of cells harbouring latent/reactivated virus, thereby overcoming the intrinsic difficulties connected to the ex vivo system. Electronic supplementary material The online version of this article (doi:10.1186/s12985-016-0634-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria-Cristina Arcangeletti
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy.
| | - Rosita Vasile Simone
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
| | - Isabella Rodighiero
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
| | - Flora De Conto
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
| | - Maria-Cristina Medici
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
| | - Clara Maccari
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
| | - Carlo Chezzi
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
| | - Adriana Calderaro
- Department of Clinical and Experimental Medicine, Unit of Microbiology and Virology, University of Parma, Viale A. Gramsci, 14, Parma, 43126, Italy
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Görzer I, Trajanoski S, Popow-Kraupp T, Puchhammer-Stöckl E. Analysis of human cytomegalovirus strain populations in urine samples of newborns by ultra deep sequencing. J Clin Virol 2015; 73:101-104. [DOI: 10.1016/j.jcv.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/30/2015] [Accepted: 11/01/2015] [Indexed: 11/26/2022]
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18
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Arcangeletti MC, Vasile Simone R, Rodighiero I, De Conto F, Medici MC, Martorana D, Chezzi C, Calderaro A. Combined genetic variants of human cytomegalovirus envelope glycoproteins as congenital infection markers. Virol J 2015; 12:202. [PMID: 26611326 PMCID: PMC4662005 DOI: 10.1186/s12985-015-0428-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/16/2015] [Indexed: 11/22/2022] Open
Abstract
Background Human cytomegalovirus (HCMV) is still considered to be the main viral cause of birth defects and long-term neurological and sensory sequelae following congenital infection. Several Authors sustain a key role of HCMV envelope glycoproteins, such as gB, gN and gO - mainly involved in cell targeting, viral penetration and spread - as putative virulence factors. The genes coding for these glycoproteins possess hypervariable regions, resulting in a number of genetic variants in circulating clinical strains. Considering that the genetic polymorphisms underlying the specific differences between gB, gN and gO genotypes can influence the ability of HCMV to preferentially target specific host cells, it is very likely that they play an important role in defining HCMV infection outcome. In the present study, we analysed HCMV gB, gN and gO gene polymorphisms in viral strains isolated from paediatric patients with congenital or post-natal infection, to investigate whether specific genetic variants may be associated with congenital infection. Methods The restriction fragment polymorphisms of genes coding for HCMV gB (UL55), gN (UL73) and gO (UL74) were investigated by analysing viral DNA extracted from 40 urine samples of as many paediatric patients with congenital or post-natal HCMV infection. Randomly selected samples were subjected to DNA sequencing and phylogenetic analysis. Statistical analysis was performed using Fisher’s exact test to assess the significance of single and combined glycoprotein genotypes frequency distribution. Statistical significance was considered at a P <0.05. Results While gB genomic variants were quite homogeneously represented in both paediatric groups, the gN4 genotype significantly prevailed in congenitally infected children (89.5 %) vs post-natally infected children (47.6 %), with a predominance of the gN4c variant (47.4 %). A similar trend was observed for gO3 (52.6 % vs 19 %). Concerning genotypes association, a statistically significant (P = 0.037) gN4-gO3 combination was found specifically in the congenitally infected group. Conclusions The results indicate that the gN4 (mostly the gN4c variant) and gO3 combined genotypes could provide useful markers of congenital infection and represent suitable candidate molecules for prophylactic vaccine preparations.
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Affiliation(s)
- Maria-Cristina Arcangeletti
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Rosita Vasile Simone
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Isabella Rodighiero
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Flora De Conto
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Maria-Cristina Medici
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Davide Martorana
- Unit of Molecular Genetics, University-Hospital of Parma, Parma, Italy.
| | - Carlo Chezzi
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Adriana Calderaro
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
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19
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Brañas P, Blázquez-Gamero D, Galindo A, Prieto C, Olabarrieta I, Cuadrado I, Folgueira L. Cytomegalovirus Genotype Distribution Among Congenitally and Postnatally Infected Patients: Association of Particular Glycoprotein (g)B and gN Types With Symptomatic Disease. Open Forum Infect Dis 2015; 2:ofv151. [PMID: 26613094 PMCID: PMC4653958 DOI: 10.1093/ofid/ofv151] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/30/2015] [Indexed: 01/15/2023] Open
Abstract
Background. Human cytomegalovirus is a leading cause of congenital infection, and there are limited data on prognosis markers in disease development. We aimed to study 3 virology targets (glycoprotein [g]B, gN, and UL144) to assess their correlation with congenital infection and various organ system involvement. Methods. Forty-eight congenital cases and 58 postnatally infected children were included (2003–2014). Genotyping for the 3 targets and distribution among the cohorts were investigated, and the relationship between the gB, gN, and UL144 types with clinical manifestations in congenital infection was also studied. Results. All of the genotypes were similarly represented among cohorts, and the most prevalent were the UL144B, gB1, and gN1 genotypes. The gB2 genotype was associated with abnormal image findings by ultrasound and/or magnetic resonance in congenital infection (odds ratio [OR], 6.2; 95% confidence interval [CI], 1.1–34.3; P = .036); the gN1 genotype was associated with an elevated risk of developing neurological disorders (OR, 7.0; 95% CI, 1.1–45.9; P = .043). Both gN1 and gB2 were independent factors for symptomatic infection. Statistical analyses showed no association between any UL144 genotype and disease severity. Conclusions. All of the genotypes can be involved in congenital infection, although the gB2 and gN1 genotypes might be associated with a more serious illness.
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Affiliation(s)
- Patricia Brañas
- Department of Clinical Microbiology ; Instituto de Investigación Biomédica "i+12"
| | | | - Alberto Galindo
- Fetal Medicine Unit, Department of Obstetrics and Gynecology , Hospital Universitario 12 de Octubre
| | - Columbiana Prieto
- Department of Clinical Microbiology ; Instituto de Investigación Biomédica "i+12"
| | - Iciar Olabarrieta
- Department of Pediatrics , Hospital Universitario Severo Ochoa , Leganés
| | - Irene Cuadrado
- Department of Pediatrics , Hospital Universitario de Getafe , Madrid , Spain
| | - Lola Folgueira
- Department of Clinical Microbiology ; Instituto de Investigación Biomédica "i+12"
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Strain Variation and Disease Severity in Congenital Cytomegalovirus Infection: In Search of a Viral Marker. Infect Dis Clin North Am 2015; 29:401-14. [PMID: 26154664 DOI: 10.1016/j.idc.2015.05.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The wide spectrum of congenital cytomegalovirus (CMV) disease and known differences in the biology and in vitro growth of CMV strains continue to drive studies in search for specific viral genetic determinants that may predict severity of congenital CMV disease. Several CMV genes have been studied in detail in congenitally infected children, but the complexity of the viral genome and differences in the definition of symptomatic disease versus asymptomatic CMV infection continue to raise questions related to what constitutes a pathogenic CMV strain.
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High-throughput analysis of human cytomegalovirus genome diversity highlights the widespread occurrence of gene-disrupting mutations and pervasive recombination. J Virol 2015; 89:7673-7695. [PMID: 25972543 DOI: 10.1128/jvi.00578-15] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Human cytomegalovirus is a widespread pathogen of major medical importance. It causes significant morbidity and mortality in the immunocompromised and congenital infections can result in severe disabilities or stillbirth. Development of a vaccine is prioritized, but no candidate is close to release. Although correlations of viral genetic variability with pathogenicity are suspected, knowledge about strain diversity of the 235kb genome is still limited. In this study, 96 full-length human cytomegalovirus genomes from clinical isolates were characterized, quadrupling the available information for full-genome analysis. These data provide the first high-resolution map of human cytomegalovirus interhost diversity and evolution. We show that cytomegalovirus is significantly more divergent than all other human herpesviruses and highlight hotspots of diversity in the genome. Importantly, 75% of strains are not genetically intact, but contain disruptive mutations in a diverse set of 26 genes, including immunomodulative genes UL40 and UL111A. These mutants are independent from culture passaging artifacts and circulate in natural populations. Pervasive recombination, which is linked to the widespread occurrence of multiple infections, was found throughout the genome. Recombination density was significantly higher than in other human herpesviruses and correlated with strain diversity. While the overall effects of strong purifying selection on virus evolution are apparent, evidence of diversifying selection was found in several genes encoding proteins that interact with the host immune system, including UL18, UL40, UL142 and UL147. These residues may present phylogenetic signatures of past and ongoing virus-host interactions. IMPORTANCE Human cytomegalovirus has the largest genome of all viruses that infect humans. Currently, there is a great interest in establishing associations between genetic variants and strain pathogenicity of this herpesvirus. Since the number of publicly available full-genome sequences is limited, knowledge about strain diversity is highly fragmented and biased towards a small set of loci. Combined with our previous work, we have now contributed 101 complete genome sequences. We have used these data to conduct the first high-resolution analysis of interhost genome diversity, providing an unbiased and comprehensive overview of cytomegalovirus variability. These data are of major value to the development of novel antivirals and a vaccine and to identify potential targets for genotype-phenotype experiments. Furthermore, they have enabled a thorough study of the evolutionary processes that have shaped cytomegalovirus diversity.
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Oka N, Suzuki T, Inoue T, Kobayashi T, Ohashi Y. Polymorphisms in cytomegalovirus genotype in immunocompetent patients with corneal endotheliitis or iridocyclitis. J Med Virol 2015; 87:1441-5. [PMID: 25963863 DOI: 10.1002/jmv.24239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 12/28/2022]
Abstract
Cytomegalovirus (CMV) that caused corneal endotheliitis and iridocyclitis in immunocompetent patients was genotyped. The gB type1 was detected in seven endotheliitis samples (77.8%) and five iridocyclitis samples (100%), and the gB type 3 was detected in two endotheliitis samples (22.2%). The UL144 type 1 was found in five endotheliitis samples (45.5%) and five iridocyclitis samples (83.3%). The UL144 type 2 was found in two endotheliitis samples (18.2%) and one iridocyclitis sample (16.7%). The gB type 1 was predominant in endotheliitis and iridocyclitis, and the CMV genotypes in eyes with endotheliitis and iridocyclitis were similar.
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Affiliation(s)
- Naoko Oka
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Japan
| | - Takashi Suzuki
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Japan
| | - Tomoyuki Inoue
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Japan
| | - Takeshi Kobayashi
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Japan
| | - Yuichi Ohashi
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Japan
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Paradowska E, Studzińska M, Suski P, Kasztelewicz B, Wiśniewska-Ligier M, Zawilińska B, Gaj Z, Nowakowska D. Human cytomegalovirus UL55, UL144, and US28 genotype distribution in infants infected congenitally or postnatally. J Med Virol 2015; 87:1737-48. [DOI: 10.1002/jmv.24222] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Edyta Paradowska
- Laboratory of Molecular Virology and Biological Chemistry; Institute of Medical Biology; Polish Academy of Sciences; Lodz Poland
| | - Mirosława Studzińska
- Laboratory of Molecular Virology and Biological Chemistry; Institute of Medical Biology; Polish Academy of Sciences; Lodz Poland
| | - Patrycja Suski
- Laboratory of Molecular Virology and Biological Chemistry; Institute of Medical Biology; Polish Academy of Sciences; Lodz Poland
| | - Beata Kasztelewicz
- Department of Clinical Microbiology and Immunology; The Children's Memorial Health Institute; Warsaw Poland
| | | | - Barbara Zawilińska
- Department of Virology; Jagiellonian University Medical College; Cracow Poland
| | - Zuzanna Gaj
- Department of Fetal-Maternal Medicine and Gynaecology; Polish Mother's Memorial Hospital Research Institute; Lodz Poland
| | - Dorota Nowakowska
- Department of Fetal-Maternal Medicine and Gynaecology; Polish Mother's Memorial Hospital Research Institute; Lodz Poland
- Department of Fetal-Maternal Medicine and Gynaecology; 3rd Chair of Gynaecology and Obstetrics; Medical University; Lodz Poland
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A role for 3-O-sulfated heparan sulfate in promoting human cytomegalovirus infection in human iris cells. J Virol 2015; 89:5185-92. [PMID: 25717110 DOI: 10.1128/jvi.00109-15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 02/18/2015] [Indexed: 01/17/2023] Open
Abstract
Human cytomegalovirus (HCMV) has emerged as a clinically opportunistic pathogen that targets multiple types of ocular cells and tissues, including the iris region of the uveal tract during anterior uveitis. In this report, we used primary cultures of human iris stroma (HIS) cells derived from human eye donors to investigate HCMV entry. The following lines of evidence suggested the role of 3-O-sulfated heparan sulfate (3-OS HS) during HCMV-mediated entry and cell-to-cell fusion in HIS cells. First, 3-O-sulfotransferase-3 (3-OST-3) expression in HIS cells promoted HCMV internalization, while pretreatment of HIS cells with heparinase enzyme or with anti-3-OS HS (G2) peptide significantly reduced the HCMV-mediated formation of plaques/foci. Second, coculture of the HCMV-infected HIS cells with CHO-K1 cells expressing 3-OS HS significantly enhanced cell fusion. Finally, a similar trend of enhanced fusion was observed with cells expressing HCMV glycoproteins (gB, gO, and gH-gL) cocultured with 3-OS HS cells. Taken together, these results highlight the role of 3-OS HS during HCMV plaque formation and cell-to-cell fusion and identify a novel target for future therapeutic interventions.
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