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Stone M, Spencer BR, Warden DE, Fink RV, Saa P, Leddy J, Mulach-Vannoy J, Townsend R, Krysztof D, Hughes AN, Di Germanio C, Kessler DA, Kleinman S, Busch MP, Norris PJ. Patient and immunological factors associated with delayed clearance of mucosal SARS-CoV-2 RNA and symptom persistence. J Infect Dis 2024:jiae132. [PMID: 38470857 DOI: 10.1093/infdis/jiae132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/01/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
Serial blood and mucosal samples were characterized for 102 participants enrolled a median of 7.0 days post-COVID-19 diagnosis. Mucosal RNA was detectable a median 31.5 (95% CI 20.5 - 63.5) days, with persistence ≥1 month associated with obesity (BMI ≥30, OR 3.9, 95% CI 1.2 - 13.8) but not age, sex, or chronic conditions. Fifteen participants had likely reinfection; lower serum anti-S IgG levels were associated with reinfection risk. Nearly half of participants (47%) reported symptoms lasting ≥2-3 months; persistence ≥3 months was associated with BMI ≥30 (OR = 4.2 95% CI 1.1 - 12.8) and peak anti-S and anti-NC antibody levels.
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Affiliation(s)
- Mars Stone
- Vitalant Research Institute, San Francisco, California, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Bryan R Spencer
- Scientific Affairs, American Red Cross, Rockville, Maryland, USA
| | | | | | - Paula Saa
- Scientific Affairs, American Red Cross, Rockville, Maryland, USA
| | - Jennifer Leddy
- Vitalant Research Institute, San Francisco, California, USA
| | | | - Rebecca Townsend
- Scientific Affairs, American Red Cross, Rockville, Maryland, USA
| | - David Krysztof
- Scientific Affairs, American Red Cross, Rockville, Maryland, USA
| | | | - Clara Di Germanio
- Vitalant Research Institute, San Francisco, California, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Steven Kleinman
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Philip J Norris
- Vitalant Research Institute, San Francisco, California, USA
- Departments of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
- Departments of Medicine, University of California San Francisco, San Francisco, California, USA
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2
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Busch MP, Stramer SL, Stone M, Yu EA, Grebe E, Notari E, Saa P, Ferg R, Manrique IM, Weil N, Fink RV, Levy M, Green V, Cyrus S, Williamson PC, Haynes J, Groves J, Krysztof D, Custer B, Kleinman S, Biggerstaff BJ, Opsomer JD, Jones JM. Population-Weighted Seroprevalence From Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, Vaccination, and Hybrid Immunity Among US Blood Donations From January to December 2021. Clin Infect Dis 2022; 75:S254-S263. [PMID: 35684973 PMCID: PMC9214177 DOI: 10.1093/cid/ciac470] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination, independently and combined ("hybrid immunity"), result in partial protection from subsequent infection and strong protection from severe disease. Proportions of the US population who have been infected, vaccinated, or have hybrid immunity remain unclear, posing a challenge for assessing effective pandemic mitigation strategies. METHODS In this serial cross-sectional study, nationwide blood donor specimens collected during January-December 2021 were tested for anti-spike and anti-nucleocapsid antibodies, and donor COVID-19 vaccination history of ≥1 dose was collected. Monthly seroprevalence induced from SARS-CoV-2 infection, COVID-19 vaccination, or both, were estimated. Estimates were weighted to account for demographic differences from the general population and were compared temporally and by demographic factors. RESULTS Overall, 1 123 855 blood samples were assayed. From January to December 2021, the weighted percentage of donations with seropositivity changed as follows: seropositivity due to vaccination without previous infection, increase from 3.5% (95% confidence interval, 3.4%-3.7%) to 64.0%, (63.5%-64.5%); seropositivity due to previous infection without vaccination, decrease from 15.6% (15.2%-16.0%) to 11.7% (11.4%-12.0%); and seropositivity due to hybrid immunity, increase from 0.7% (0.6%-0.7%) to 18.9% (18.5%-19.3%). Combined seroprevalence from infection, vaccination, or both increased from 19.8% (19.3%-20.2%) to 94.5% (93.5%-94.0%). Infection- and vaccination-induced antibody responses varied significantly by age, race-ethnicity, and region, but not by sex. CONCLUSIONS Our results indicate substantial increases in population humoral immunity from SARS-CoV-2 infection, COVID-19 vaccination, and hybrid immunity during 2021. These findings are important to consider in future COVID-19 studies and long-term pandemic mitigation efforts.
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Affiliation(s)
- Michael P. Busch
- Corresponding authors Michael P. Busch, MD. PhD Vitalant Research Institute 270 Masonic Avenue San Francisco, CA 94118
| | - Susan L. Stramer
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Elaine A. Yu
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Edward Notari
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Paula Saa
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | | | | | | | | | | | | | | | | | - James Haynes
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Jamel Groves
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - David Krysztof
- American Red Cross, Scientific Affairs, Gaithersburg and Rockville, Maryland, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA,University of California San Francisco, San Francisco, California, USA
| | - Steve Kleinman
- Vitalant Research Institute, San Francisco, California, USA
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3
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Acklin JA, Cattle JD, Moss AS, Brown JA, Foster GA, Krysztof D, Stramer SL, Lim JK. Evaluating the Safety of West Nile Virus Immunity During Congenital Zika Virus Infection in Mice. Front Immunol 2021; 12:686411. [PMID: 34220838 PMCID: PMC8250419 DOI: 10.3389/fimmu.2021.686411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/24/2021] [Indexed: 12/19/2022] Open
Abstract
Antibody-dependent enhancement (ADE) is a phenomenon that occurs when cross-reactive antibodies generated from a previous flaviviral infection increase the pathogenesis of a related virus. Zika virus (ZIKV) is the most recent flavivirus introduced to the Western Hemisphere and has become a significant public health threat due to the unanticipated impact on the developing fetus. West Nile virus (WNV) is the primary flavivirus that circulates in North America, and we and others have shown that antibodies against WNV are cross-reactive to ZIKV. Thus, there is concern that WNV immunity could increase the risk of severe ZIKV infection, particularly during pregnancy. In this study, we examined the extent to which WNV antibodies could impact ZIKV pathogenesis in a murine pregnancy model. To test this, we passively transferred WNV antibodies into pregnant Stat2-/- mice on E6.5 prior to infection with ZIKV. Evaluation of pregnant dams showed weight loss following ZIKV infection; however, no differences in maternal weights or viral loads in the maternal brain, spleen, or spinal cord were observed in the presence of WNV antibodies. Resorption rates, and other fetal parameters, including fetal and placental size, were similarly unaffected. Further, the presence of WNV antibodies did not significantly alter the viral load or the inflammatory response in the placenta or the fetus in response to ZIKV. Our data suggest that pre-existing WNV immunity may not significantly impact the pathogenesis of ZIKV infection during pregnancy. Our findings are promising for the safety of implementing WNV vaccines in the continental US.
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Affiliation(s)
- Joshua A Acklin
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Javier D Cattle
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Arianna S Moss
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Julia A Brown
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Gregory A Foster
- Scientific Affairs, American Red Cross, Gaithersburg, MD, United States
| | - David Krysztof
- Scientific Affairs, American Red Cross, Gaithersburg, MD, United States
| | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, MD, United States
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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4
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Hoffman KW, Lee JJ, Foster GA, Krysztof D, Stramer SL, Lim JK. Sex differences in cytokine production following West Nile virus infection: Implications for symptom manifestation. Pathog Dis 2020; 77:5420468. [PMID: 30915442 DOI: 10.1093/femspd/ftz016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/19/2019] [Indexed: 02/02/2023] Open
Abstract
West Nile virus (WNV) infection outcomes vary among individuals, with most infections resulting in asymptomatic or mild flu-like symptoms. We previously reported an association between early cytokine production and symptom outcome following WNV infection in US blood donors. In this meta-analysis, we found that WNV-infected females reported more symptoms than WNV-infected males, despite similar initial viremia and type I interferon responses. As the infection progressed, males exhibited a protracted cytokine response-marked by sustained CCL2 (MCP-1), CCL11 (eotaxin-1), CXCL10 (IP-10) and IL-15-that was absent in females. Our results suggest that sex differences may be a factor in sustaining WNV immunity.
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Affiliation(s)
- Kevin W Hoffman
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY 10029, USA.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY 10029, USA
| | - Jakleen J Lee
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY 10029, USA.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY 10029, USA
| | - Gregory A Foster
- American Red Cross, 9315 Gaither Rd, Gaithersburg, MD 20877, USA
| | - David Krysztof
- American Red Cross, 9315 Gaither Rd, Gaithersburg, MD 20877, USA
| | - Susan L Stramer
- American Red Cross, 9315 Gaither Rd, Gaithersburg, MD 20877, USA
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY 10029, USA
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5
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Brown JA, Singh G, Acklin JA, Lee S, Duehr JE, Chokola AN, Frere JJ, Hoffman KW, Foster GA, Krysztof D, Cadagan R, Jacobs AR, Stramer SL, Krammer F, García-Sastre A, Lim JK. Dengue Virus Immunity Increases Zika Virus-Induced Damage during Pregnancy. Immunity 2019; 50:751-762.e5. [PMID: 30737148 DOI: 10.1016/j.immuni.2019.01.005] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 11/30/2018] [Accepted: 01/10/2019] [Indexed: 01/13/2023]
Abstract
Zika virus (ZIKV) has recently been associated with birth defects and pregnancy loss after maternal infection. Because dengue virus (DENV) and ZIKV co-circulate, understanding the role of antibody-dependent enhancement in the context of pregnancy is critical. Here, we showed that the presence of DENV-specific antibodies in ZIKV-infected pregnant mice significantly increased placental damage, fetal growth restriction, and fetal resorption. This was associated with enhanced viral replication in the placenta that coincided with an increased frequency of infected trophoblasts. ZIKV-infected human placental tissues also showed increased replication in the presence of DENV antibodies, which was reversed by FcγR blocking antibodies. Furthermore, ZIKV-mediated fetal pathogenesis was enhanced in mice in the presence of a DENV-reactive monoclonal antibody, but not in the presence of the LALA variant, indicating a dependence on FcγR engagement. Our data suggest a possible mechanism for the recent increase in severe pregnancy outcomes after ZIKV infection in DENV-endemic areas.
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Affiliation(s)
- Julia A Brown
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gursewak Singh
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua A Acklin
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Silviana Lee
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James E Duehr
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anupa N Chokola
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Justin J Frere
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin W Hoffman
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Richard Cadagan
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adam R Jacobs
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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6
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Saá P, Proctor M, Foster G, Krysztof D, Winton C, Linnen JM, Gao K, Brodsky JP, Limberger RJ, Dodd RY, Stramer SL. Investigational Testing for Zika Virus among U.S. Blood Donors. N Engl J Med 2018; 378:1778-1788. [PMID: 29742375 DOI: 10.1056/nejmoa1714977] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Because of the potential severe clinical consequences of Zika virus (ZIKV) infection, the large numbers of asymptomatic travelers returning from ZIKV-active areas, the detection of ZIKV nucleic acid in blood, and reports of transmission of ZIKV through transfusion, in 2016 the Food and Drug Administration released recommendations for individual-unit nucleic acid testing to minimize the risk of transmission of ZIKV through blood transfusions. METHODS The American Red Cross implemented investigational screening of donated blood for ZIKV RNA by means of transcription-mediated amplification (TMA). Confirmatory testing of reactive donations involved repeat TMA, TMA testing in exploratory minipools, real-time reverse-transcriptase polymerase chain reaction, IgM serologic testing, and red-cell TMA. Viral loads in plasma and red cells were estimated by means of end-point TMA. The costs of interdicting a donation that was confirmed to be positive were calculated for the 15-month period between June 2016 and September 2017. RESULTS Of the 4,325,889 donations that were screened, 393,713 (9%) were initially tested in 24,611 minipools, and no reactive donations were found. Of the 3,932,176 donations that were subsequently tested individually, 160 were initially reactive and 9 were confirmed positive (a 1:480,654 confirmed-positive rate overall; positive predictive value, 5.6%; specificity, 99.997%). Six (67%) of the confirmed-positive donations were reactive on repeat TMA, of which 4 were IgM-negative; of these 4, all 3 that could be tested were reactive on minipool TMA. Two confirmed-positive donors had infections that had been transmitted locally (in Florida), 6 had traveled to ZIKV-active areas, and 1 had received an experimental ZIKV vaccine. ZIKV RNA levels in red cells ranged from 40 to 800,000 copies per milliliter and were detected up to 154 days after donation, as compared with 80 days of detection in plasma at levels of 12 to 20,000 copies per milliliter. On the basis of industry-reported costs of testing and the yield of the tests in our study, the cost of identifying 8 mosquito-borne ZIKV infections through individual-unit nucleic acid testing was $5.3 million per ZIKV RNA-positive donation. CONCLUSIONS Screening of U.S. blood donations for ZIKV by individual-donation TMA was costly and had a low yield. Among the 9 confirmed ZIKV-positive donations, only 4 were IgM-negative; of these donations, all 3 that were tested were reactive on minipool TMA. (Funded by the American Red Cross and Grifols Diagnostic Solutions.).
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Affiliation(s)
- Paula Saá
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Melanie Proctor
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Gregory Foster
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - David Krysztof
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Colleen Winton
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Jeffrey M Linnen
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Kui Gao
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Jaye P Brodsky
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Ronald J Limberger
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Roger Y Dodd
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
| | - Susan L Stramer
- From the American Red Cross, Scientific Affairs, Gaithersburg, MD (P.S., M.P., G.F., D.K., C.W., R.Y.D., S.L.S.); Grifols Diagnostic Solutions, San Diego, CA (J.M.L., K.G.); Quality Analytics, Riverwoods, IL (J.P.B.); and Wadsworth Center, New York State Department of Health, Albany (R.J.L.)
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7
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Bardina SV, Bunduc P, Tripathi S, Duehr J, Frere JJ, Brown JA, Nachbagauer R, Foster GA, Krysztof D, Tortorella D, Stramer SL, García-Sastre A, Krammer F, Lim JK. Enhancement of Zika virus pathogenesis by preexisting antiflavivirus immunity. Science 2017; 356:175-180. [PMID: 28360135 DOI: 10.1126/science.aal4365] [Citation(s) in RCA: 386] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/17/2017] [Indexed: 12/23/2022]
Abstract
Zika virus (ZIKV) is spreading rapidly into regions around the world where other flaviviruses, such as dengue virus (DENV) and West Nile virus (WNV), are endemic. Antibody-dependent enhancement has been implicated in more severe forms of flavivirus disease, but whether this also applies to ZIKV infection is unclear. Using convalescent plasma from DENV- and WNV-infected individuals, we found substantial enhancement of ZIKV infection in vitro that was mediated through immunoglobulin G engagement of Fcγ receptors. Administration of DENV- or WNV-convalescent plasma into ZIKV-susceptible mice resulted in increased morbidity-including fever, viremia, and viral loads in spinal cord and testes-and increased mortality. Antibody-dependent enhancement may explain the severe disease manifestations associated with recent ZIKV outbreaks and highlights the need to exert great caution when designing flavivirus vaccines.
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Affiliation(s)
- Susana V Bardina
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Paul Bunduc
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shashank Tripathi
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - James Duehr
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Justin J Frere
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Julia A Brown
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Raffael Nachbagauer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | | | - Domenico Tortorella
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. .,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Jean K Lim
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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8
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Hoffman KW, Sachs D, Bardina SV, Michlmayr D, Rodriguez CA, Sum J, Foster GA, Krysztof D, Stramer SL, Lim JK. Differences in Early Cytokine Production Are Associated With Development of a Greater Number of Symptoms Following West Nile Virus Infection. J Infect Dis 2016; 214:634-43. [PMID: 27142077 DOI: 10.1093/infdis/jiw179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/27/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND West Nile virus (WNV) is an emerging cause of meningitis and encephalitis in the United States. Although severe neuroinvasive disease and death can occur in rare instances, the majority of infected individuals remain asymptomatic or present with a range of clinical manifestations associated with West Nile fever. METHODS To better understand the interindividual variability associated with the majority of WNV infections, we evaluated the association of cytokine/chemokine production and outcome of infection among 115 WNV-positive US blood donors identified in 2008-2011. All subjects self-reported symptoms as having occurred during the 2 weeks following blood donation, using a standardized questionnaire. RESULTS We discovered that, prior to seroconversion, an early potent, largely type I interferon-mediated response correlated with development of a greater number of symptoms in WNV-infected individuals. Interestingly, individuals who developed fewer symptoms had not only a more modest type I interferon response initially, but also a protracted cytokine response after seroconversion, marked by the production of monocyte and T-cell-associated chemokines. CONCLUSIONS Collectively, our data suggest that, although an early type I interferon response appears to be crucial to control WNV infection, successful immunity may require a modest early response that is maintained during the course of infection.
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Affiliation(s)
| | - David Sachs
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, New York
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Chiu CY, Bres V, Yu G, Krysztof D, Naccache SN, Lee D, Pfeil J, Linnen JM, Stramer SL. Genomic Assays for Identification of Chikungunya Virus in Blood Donors, Puerto Rico, 2014. Emerg Infect Dis 2016. [PMID: 26196378 PMCID: PMC4517739 DOI: 10.3201/eid2108.150458] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A newly developed transcription-mediated amplification assay was used to detect chikungunya virus infection in 3 of 557 asymptomatic donors (0.54%) from Puerto Rico during the 2014–2015 Caribbean epidemic. Viral detection was confirmed by using PCR, microarray, and next-generation sequencing. Molecular clock analysis dated the emergence of the Puerto Rico strains to early 2013.
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10
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Delwart E, Slikas E, Stramer SL, Kamel H, Kessler D, Krysztof D, Tobler LH, Carrick DM, Steele W, Todd D, Wright DJ, Kleinman SH, Busch MP. Genetic diversity of recently acquired and prevalent HIV, hepatitis B virus, and hepatitis C virus infections in US blood donors. J Infect Dis 2012; 205:875-85. [PMID: 22293432 DOI: 10.1093/infdis/jir862] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Genetic variations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) can affect diagnostic assays and therapeutic interventions. Recent changes in prevalence of subtypes/genotypes and drug/immune-escape variants were characterized by comparing recently infected vs more remotely infected blood donors. METHODS Infected donors were identified among approximately 34 million US blood donations, 2006-2009; incident infections were defined as having no or low antiviral antibody titers. Viral genomes were partially sequenced. RESULTS Of 321 HIV strains (50% incident), 2.5% were non-B HIV subtypes. Protease and reverse transcriptase (RT) inhibitor resistance mutations were found in 2% and 11% of infected donors, respectively. Subtypes in 278 HCV strains (31% incident) yielded 1a>1b>3a>2b>2a>4a>6d, 6e: higher frequencies of 3a in incident cases vs higher frequencies of 1b in prevalent cases were found (P = .04). Twenty subgenotypes among 193 HBV strains (26% incident) yielded higher frequencies of A2 in incident cases and higher frequencies of A1, B2, and B4 in prevalent cases (P = .007). No HBV drug resistance mutations were detected. Six percent of incident vs 26% of prevalent HBV contained antibody neutralization escape mutations (P = .01). CONCLUSIONS Viral genetic variant distribution in blood donors was similar to that seen in high-risk US populations. Blood-borne viruses detected through large-scale routine screening of blood donors can complement molecular surveillance studies of highly exposed populations.
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Affiliation(s)
- Eric Delwart
- Blood Systems Research Institute, San Francisco, CA, USA.
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11
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Zou S, Stramer SL, Notari EP, Kuhns MC, Krysztof D, Musavi F, Fang CT, Dodd RY. Current incidence and residual risk of hepatitis B infection among blood donors in the United States. Transfusion 2011; 49:1609-20. [PMID: 19413732 DOI: 10.1111/j.1537-2995.2009.02195.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND This study used two approaches to estimate the current incidence of hepatitis B virus (HBV) in a US donor population. METHODS HBV incidence was estimated through the hepatitis B surface antigen (HBsAg) yield approach and the seroconversion method. Residual risk was estimated by the incidence–window period model. HBsAg yield refers to an HBsAg confirmed-positive, antibody against hepatitis B core antigen (anti-HBc)–nonreactive donation, adjusted for false-positive neutralization results. The number of HBsAg-seroconverting repeat donors divided by total number of person-years of evaluation or the HBsAg yield rate divided by HBsAg yield window gave rise to incidence estimates. RESULTS The seroconversion and the yield approach, respectively, gave an incidence estimate of 3.41 or 3.43 per 105 person-years. Using a revised infectious window period of 38 or 30 days for current HBsAg assays, the current residual risk for HBV was respectively estimated for 2006 to 2008 at 1 in 282,000 or 1 in 357,000 donations from the seroconversion approach and 1 in 280,000 or 1 in 355,000 donations from the yield approach. With the same database and methods, this is a decrease from 1 in 86,000 to 1 in 110,000 observed in 1997 to 1999. CONCLUSIONS Current HBV incidence and residual risk are lower than earlier estimates, especially in the youngest donors, but remain higher in the absence of HBV nucleic acid test than those for human immunodeficiency virus or hepatitis C virus (HCV). In addition to the exclusion of HBsAg false-positive donors, the reduction could reflect shortened window periods and decreased incidence rates due to vaccination or other reasons.
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Affiliation(s)
- Shimian Zou
- Transmissible Diseases Department, American Red Cross Blood Services, 15601 Crabbs BranchWay, Rockville MD 20855, USA.
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12
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Lim JK, McDermott DH, Lisco A, Foster GA, Krysztof D, Follmann D, Stramer SL, Murphy PM. CCR5 deficiency is a risk factor for early clinical manifestations of West Nile virus infection but not for viral transmission. J Infect Dis 2010; 201:178-85. [PMID: 20025530 DOI: 10.1086/649426] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND West Nile virus (WNV) is a neurotropic flavivirus transmitted to humans by mosquito vectors. Homozygosity for CCR5Delta32, a complete loss-of-function mutation in CC chemokine receptor 5 (CCR5), has been previously associated with severe symptomatic WNV infection in patients who present with clinical disease; however, whether it acts at the level of initial infection or in promoting clinical progression is unknown. METHODS Here, we address this gap in knowledge by comparing CCR5Delta32 distribution among US blood donors identified through a comprehensive blood supply screening program (34,766,863 donations from 2003 through 2008) as either WNV true positive (634 WNV-positive cases) or false positive (422 WNV-negative control participants). All subjects self-reported symptoms occurring during the 2 weeks following blood donation using a standardized questionnaire. RESULTS No difference was observed in CCR5Delta32 homozygous frequency between the WNV-positive cases and WNV-negative control participants. However, CCR5Delta32 homozygosity was associated in cases but not controls with clinical symptoms consistent with WNV infection (P = .002). CONCLUSIONS CCR5 deficiency is not a risk factor for WNV infection per se, but it is a risk factor for both early and late clinical manifestations after infection. Thus, CCR5 may function normally to limit disease due to WNV infection in humans.
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Affiliation(s)
- Jean K Lim
- Molecular Signaling Section, Laboratory of Molecular Immunology, Laboratory of Cellular and Molecular Biology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA
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13
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Lim JK, Lisco A, McDermott DH, Huynh L, Ward JM, Johnson B, Johnson H, Pape J, Foster GA, Krysztof D, Follmann D, Stramer SL, Margolis LB, Murphy PM. Genetic variation in OAS1 is a risk factor for initial infection with West Nile virus in man. PLoS Pathog 2009; 5:e1000321. [PMID: 19247438 PMCID: PMC2642680 DOI: 10.1371/journal.ppat.1000321] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Accepted: 01/30/2009] [Indexed: 12/11/2022] Open
Abstract
West Nile virus (WNV) is a re-emerging pathogen that can cause fatal encephalitis. In mice, susceptibility to WNV has been reported to result from a single point mutation in oas1b, which encodes 2'-5' oligoadenylate synthetase 1b, a member of the type I interferon-regulated OAS gene family involved in viral RNA degradation. In man, the human ortholog of oas1b appears to be OAS1. The 'A' allele at SNP rs10774671 of OAS1 has previously been shown to alter splicing of OAS1 and to be associated with reduced OAS activity in PBMCs. Here we show that the frequency of this hypofunctional allele is increased in both symptomatic and asymptomatic WNV seroconverters (Caucasians from five US centers; total n = 501; OR = 1.6 [95% CI 1.2-2.0], P = 0.0002 in a recessive genetic model). We then directly tested the effect of this SNP on viral replication in a novel ex vivo model of WNV infection in primary human lymphoid tissue. Virus accumulation varied markedly among donors, and was highest for individuals homozygous for the 'A' allele (P<0.0001). Together, these data identify OAS1 SNP rs10774671 as a host genetic risk factor for initial infection with WNV in humans.
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Affiliation(s)
- Jean K. Lim
- Molecular Signaling Section, Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Andrea Lisco
- Section on Intercellular Interactions, Laboratory of Cellular and Molecular Biology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
| | - David H. McDermott
- Molecular Signaling Section, Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Linda Huynh
- Molecular Signaling Section, Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jerrold M. Ward
- Comparative Medicine Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, United States of America
| | - Bernard Johnson
- Illinois Department of Public Health, Division of Laboratories, Chicago, Illinois, United States of America
| | - Hope Johnson
- Illinois Department of Public Health, Division of Laboratories, Chicago, Illinois, United States of America
| | - John Pape
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Gregory A. Foster
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - David Krysztof
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Dean Follmann
- American Red Cross, Gaithersburg, Maryland, United States of America
| | - Susan L. Stramer
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Leonid B. Margolis
- Section on Intercellular Interactions, Laboratory of Cellular and Molecular Biology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Philip M. Murphy
- Molecular Signaling Section, Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
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