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de Sousa JR, Azevedo RSS, Martins Filho AJ, Araujo MTF, Moutinho ERC, Baldez Vasconcelos BC, Cruz ACR, Oliveira CS, Martins LC, Baldez Vasconcelos BH, Casseb LMN, Chiang JO, Quaresma JAS, Vasconcelos PFC. Correlation between Apoptosis and in Situ Immune Response in Fatal Cases of Microcephaly Caused by Zika Virus. Am J Pathol 2018; 188:2644-2652. [PMID: 30121258 DOI: 10.1016/j.ajpath.2018.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 12/27/2022]
Abstract
Zika virus (ZIKV) is a single-stranded positive-sense RNA flavivirus that possesses a genome approximately 10.7 Kb in length. Although pro-inflammatory and anti-inflammatory cytokines and apoptotic markers belonging to the extrinsic and intrinsic pathways are suggested to be involved in fatal cases of ZIKV-induced microcephaly, their exact roles and associations are unclear. To address this, brain tissue samples were collected from 10 individuals, five of whom were diagnosed as ZIKV positive with microcephaly and a further five were flavivirus-negative controls that died because of other causes. Examination of material from the fatal cases of microcephaly revealed lesions in the cerebral cortex, edema, vascular proliferation, neuronal necrosis, gliosis, neuronophagy, calcifications, apoptosis, and neuron loss. The expression of various apoptosis markers in the neural parenchyma, including FasL, FAS, BAX, BCL2, and caspase 3 differed between ZIKV-positive cases and controls. Further investigation of type 1 and 2 helper T-cell cytokines confirmed a greater anti-inflammatory response in fatal ZIKV-associated microcephaly cases. Finally, an analysis of the linear correlation between tumor necrosis factor-α, IL-1β, IL-4, IL-10, transforming growth factor-β, and IL-33 expression and various apoptotic markers suggested that the immune response may be associated with the apoptotic phenomenon observed in ZIKV-induced microcephaly.
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Affiliation(s)
- Jorge R de Sousa
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Raimunda S S Azevedo
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | | | - Marialva T F Araujo
- Department of Pathology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Ermelinda R C Moutinho
- Department of Pathology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | | | - Ana C R Cruz
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil; Center of Biological and Health Sciences, State University of Pará, Belém, Brazil
| | - Consuelo S Oliveira
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Lívia C Martins
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | | | - Livia M N Casseb
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Jannifer O Chiang
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Juarez A S Quaresma
- Department of Pathology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil; Center of Biological and Health Sciences, State University of Pará, Belém, Brazil; Tropical Medicine Center, Federal University of Pará, Belém, Brazil.
| | - Pedro F C Vasconcelos
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil; Center of Biological and Health Sciences, State University of Pará, Belém, Brazil.
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Azevedo RSS, de Sousa JR, Araujo MTF, Martins Filho AJ, de Alcantara BN, Araujo FMC, Queiroz MGL, Cruz ACR, Vasconcelos BHB, Chiang JO, Martins LC, Casseb LMN, da Silva EV, Carvalho VL, Vasconcelos BCB, Rodrigues SG, Oliveira CS, Quaresma JAS, Vasconcelos PFC. In situ immune response and mechanisms of cell damage in central nervous system of fatal cases microcephaly by Zika virus. Sci Rep 2018; 8:1. [PMID: 29311619 PMCID: PMC5758755 DOI: 10.1038/s41598-017-17765-5] [Citation(s) in RCA: 2254] [Impact Index Per Article: 375.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/30/2017] [Indexed: 02/07/2023] Open
Abstract
Zika virus (ZIKV) has recently caused a pandemic disease, and many cases of ZIKV infection in pregnant women resulted in abortion, stillbirth, deaths and congenital defects including microcephaly, which now has been proposed as ZIKV congenital syndrome. This study aimed to investigate the in situ immune response profile and mechanisms of neuronal cell damage in fatal Zika microcephaly cases. Brain tissue samples were collected from 15 cases, including 10 microcephalic ZIKV-positive neonates with fatal outcome and five neonatal control flavivirus-negative neonates that died due to other causes, but with preserved central nervous system (CNS) architecture. In microcephaly cases, the histopathological features of the tissue samples were characterized in three CNS areas (meninges, perivascular space, and parenchyma). The changes found were mainly calcification, necrosis, neuronophagy, gliosis, microglial nodules, and inflammatory infiltration of mononuclear cells. The in situ immune response against ZIKV in the CNS of newborns is complex. Despite the predominant expression of Th2 cytokines, other cytokines such as Th1, Th17, Treg, Th9, and Th22 are involved to a lesser extent, but are still likely to participate in the immunopathogenic mechanisms of neural disease in fatal cases of microcephaly caused by ZIKV.
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Affiliation(s)
- Raimunda S S Azevedo
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Jorge R de Sousa
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Marialva T F Araujo
- Departamento de Patologia, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | | | - Bianca N de Alcantara
- Programa de Pós-Graduação em Virologia, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Fernanda M C Araujo
- Laboratório Central de Saúde Pública, SES do Ceará, Fortaleza, Ceará, Brazil
| | - Maria G L Queiroz
- Laboratório Central de Saúde Pública, SES do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana C R Cruz
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil.,Universidade do Estado do Pará, Belém, Pará, Brazil
| | | | - Jannifer O Chiang
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Lívia C Martins
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Livia M N Casseb
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Eliana V da Silva
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Valéria L Carvalho
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | | | - Sueli G Rodrigues
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil
| | - Consuelo S Oliveira
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil.,Universidade do Estado do Pará, Belém, Pará, Brazil
| | - Juarez A S Quaresma
- Universidade do Estado do Pará, Belém, Pará, Brazil.,Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Pedro F C Vasconcelos
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, Pará, Brazil. .,Universidade do Estado do Pará, Belém, Pará, Brazil.
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