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Rego N, Salazar C, Paz M, Costábile A, Fajardo A, Ferrés I, Perbolianachis P, Fernández-Calero T, Noya V, Machado MR, Brandes M, Arce R, Arleo M, Possi T, Reyes N, Bentancor MN, Lizasoain A, Bortagaray V, Moller A, Chappos O, Nin N, Hurtado J, Duquía M, González MB, Griffero L, Méndez M, Techera MP, Zanetti J, Pereira E, Rivera B, Maidana M, Alonso M, Smircich P, Arantes I, Mir D, Alonso C, Medina J, Albornoz H, Colina R, Bello G, Moreno P, Moratorio G, Iraola G, Spangenberg L. Emergence and Spread of a B.1.1.28-Derived P.6 Lineage with Q675H and Q677H Spike Mutations in Uruguay. Viruses 2021; 13:1801. [PMID: 34578382 PMCID: PMC8473254 DOI: 10.3390/v13091801] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/20/2021] [Accepted: 08/31/2021] [Indexed: 12/11/2022] Open
Abstract
Uruguay controlled the viral dissemination during the first nine months of the SARS-CoV-2 pandemic. Unfortunately, towards the end of 2020, the number of daily new cases exponentially increased. Herein, we analyzed the country-wide genetic diversity of SARS-CoV-2 between November 2020 and April 2021. We identified that the most prevalent viral variant during the first epidemic wave in Uruguay (December 2020-February 2021) was a B.1.1.28 sublineage carrying Spike mutations Q675H + Q677H, now designated as P.6, followed by lineages P.2 and P.7. P.6 probably arose around November 2020, in Montevideo, Uruguay's capital department, and rapidly spread to other departments, with evidence of further local transmission clusters; it also spread sporadically to the USA and Spain. The more efficient dissemination of lineage P.6 with respect to P.2 and P.7 and the presence of mutations (Q675H and Q677H) in the proximity of the key cleavage site at the S1/S2 boundary suggest that P.6 may be more transmissible than other lineages co-circulating in Uruguay. Although P.6 was replaced by the variant of concern (VOC) P.1 as the predominant lineage in Uruguay since April 2021, the monitoring of the concurrent emergence of Q675H + Q677H in VOCs should be of worldwide interest.
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Affiliation(s)
- Natalia Rego
- Bioinformatics Unit, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (N.R.); (T.F.-C.); (M.B.)
| | - Cecilia Salazar
- Laboratorio de Genómica Microbiana, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (C.S.); (I.F.)
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
| | - Mercedes Paz
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
| | - Alicia Costábile
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; (A.F.); (P.P.); (R.A.)
- Laboratorio de Evolución Experimental de Virus, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay
- Sección Bioquímica, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay
| | - Alvaro Fajardo
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; (A.F.); (P.P.); (R.A.)
- Laboratorio de Evolución Experimental de Virus, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay
| | - Ignacio Ferrés
- Laboratorio de Genómica Microbiana, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (C.S.); (I.F.)
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
| | - Paula Perbolianachis
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; (A.F.); (P.P.); (R.A.)
- Laboratorio de Evolución Experimental de Virus, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay
| | - Tamara Fernández-Calero
- Bioinformatics Unit, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (N.R.); (T.F.-C.); (M.B.)
- Department of Exact and Natural Sciences, Universidad Católica del Uruguay, Montevideo 11600, Uruguay
| | - Veronica Noya
- Laboratorio de Biología Molecular, Sanatorio Americano, Montevideo 11600, Uruguay; (V.N.); (M.A.); (T.P.); (N.R.); (M.N.B.)
| | - Matias R. Machado
- Protein Engineering, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay;
| | - Mariana Brandes
- Bioinformatics Unit, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (N.R.); (T.F.-C.); (M.B.)
| | - Rodrigo Arce
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; (A.F.); (P.P.); (R.A.)
- Laboratorio de Evolución Experimental de Virus, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay
- Laboratorio de Biología Molecular, Sanatorio Americano, Montevideo 11600, Uruguay; (V.N.); (M.A.); (T.P.); (N.R.); (M.N.B.)
| | - Mailen Arleo
- Laboratorio de Biología Molecular, Sanatorio Americano, Montevideo 11600, Uruguay; (V.N.); (M.A.); (T.P.); (N.R.); (M.N.B.)
| | - Tania Possi
- Laboratorio de Biología Molecular, Sanatorio Americano, Montevideo 11600, Uruguay; (V.N.); (M.A.); (T.P.); (N.R.); (M.N.B.)
| | - Natalia Reyes
- Laboratorio de Biología Molecular, Sanatorio Americano, Montevideo 11600, Uruguay; (V.N.); (M.A.); (T.P.); (N.R.); (M.N.B.)
| | - María Noel Bentancor
- Laboratorio de Biología Molecular, Sanatorio Americano, Montevideo 11600, Uruguay; (V.N.); (M.A.); (T.P.); (N.R.); (M.N.B.)
| | - Andrés Lizasoain
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Salto 50000, Uruguay; (A.L.); (V.B.); (A.M.); (R.C.)
| | - Viviana Bortagaray
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Salto 50000, Uruguay; (A.L.); (V.B.); (A.M.); (R.C.)
| | - Ana Moller
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Salto 50000, Uruguay; (A.L.); (V.B.); (A.M.); (R.C.)
| | - Odhille Chappos
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Nicolas Nin
- Unidad de Cuidados Intensivos, Hospital Español “Juan J. Crottogini”, Montevideo 11800, Uruguay; (N.N.); (J.H.)
| | - Javier Hurtado
- Unidad de Cuidados Intensivos, Hospital Español “Juan J. Crottogini”, Montevideo 11800, Uruguay; (N.N.); (J.H.)
| | - Melissa Duquía
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Maria Belén González
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Luciana Griffero
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Mauricio Méndez
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Maria Pía Techera
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Juan Zanetti
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Emiliano Pereira
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Bernardina Rivera
- Laboratorio de Diagnóstico Molecular, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (B.R.); (M.M.); (M.A.)
| | - Matías Maidana
- Laboratorio de Diagnóstico Molecular, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (B.R.); (M.M.); (M.A.)
| | - Martina Alonso
- Laboratorio de Diagnóstico Molecular, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (B.R.); (M.M.); (M.A.)
| | - Pablo Smircich
- Bioinformatics Laboratory, Department of Genomics, Instituto de Investigaciones Biológicas Clemente Estable, MEC, Montevideo 11600, Uruguay;
- Laboratory of Molecular Interactions, Facultad de Ciencias, UdelaR, Montevideo 11400, Uruguay
| | - Ighor Arantes
- Laboratorio de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.A.); (G.B.)
| | - Daiana Mir
- Unidad de Genómica y Bioinformática, Departamento de Ciencias Biológicas, Centro Universitario Regional Litoral Norte, Universidad de la República, Salto 50000, Uruguay;
| | - Cecilia Alonso
- Centro Universitario Regional Este, Universidad de la República, Rocha 27000, Uruguay; (O.C.); (M.D.); (M.B.G.); (L.G.); (M.M.); (M.P.T.); (J.Z.); (E.P.); (C.A.)
| | - Julio Medina
- Cátedra de Enfermedades Infecciosas, Facultad de Medicina, Universidad de la República, Montevideo 11300, Uruguay; (J.M.); (H.A.)
- Dirección General de Salud, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - Henry Albornoz
- Cátedra de Enfermedades Infecciosas, Facultad de Medicina, Universidad de la República, Montevideo 11300, Uruguay; (J.M.); (H.A.)
- Dirección General de Salud, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - Rodney Colina
- Laboratorio de Virología Molecular, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Salto 50000, Uruguay; (A.L.); (V.B.); (A.M.); (R.C.)
| | - Gonzalo Bello
- Laboratorio de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-900, Brazil; (I.A.); (G.B.)
| | - Pilar Moreno
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; (A.F.); (P.P.); (R.A.)
- Laboratorio de Evolución Experimental de Virus, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay
| | - Gonzalo Moratorio
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo 11400, Uruguay; (A.F.); (P.P.); (R.A.)
- Laboratorio de Evolución Experimental de Virus, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay
| | - Gregorio Iraola
- Laboratorio de Genómica Microbiana, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (C.S.); (I.F.)
- Centro de Innovación en Vigilancia Epidemiológica, Institut Pasteur Montevideo, Montevideo 11400, Uruguay; (M.P.); (A.C.)
- Center for Integrative Biology, Universidad Mayor, Santiago de Chile 8580745, Chile
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
| | - Lucía Spangenberg
- Bioinformatics Unit, Institut Pasteur de Montevideo, Montevideo 11400, Uruguay; (N.R.); (T.F.-C.); (M.B.)
- Department of Informatics and Computer Science, Universidad Católica del Uruguay, Montevideo 11600, Uruguay
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Rojas E, Valinotti V, Vazquez M, Roman L, Maidana M, Ramirez J, Cabrera-Villalba S. AB0193 PRESENCE OF SUBLINICAL SYNOVITIS IN A ESTABLISHED RHEUMATOID ARTHRITIS COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Some studies prove that a significant percentage of patients with rheumatoid arthritis (RA) in sustained clinical remission has radiological progression or joint damage, and the presence of residual activity objectified by imaging studies such as ultrasonography could be related to a relapse or flare of RA.(1,2)Objectives:To determine the presence of subclinical synovitis measured by ultrasonography in patients with RA on sustained clinical remission from the Rheumatology service at Hospital de Clínicas, San Lorenzo, Paraguay.Materials and Methods:Prospective, cross sectional, descriptive study, in RA patients meeting ACR/EULAR 2010 criteria, older than 18 years, on sustained clinical remission (≥6 months), measured by ESR-DAS28 (<2,6), doing follow-ups on our service. A healthy control group was included. All groups signed informed consent. Synovial hypertrophy (SH) and intraarticular vascularization grades on Power Doppler (PD) mode were determined according to EULAR recommendations and OMERACT 7 group definitions. Clinical data were obtained from the service’s registries.SPSS 23rd version was used for data analysis. Quantitative variables were presented as means and qualitative as frequencies. Chi square test was performed for comparisons between dichotomous variables and t Student for continuous. For comparisons between variables the Spearman’s rank correlation coefficient was performed, and p≤0.05 for statistical significance. Factors predicting subclinical synovitis were analyzed with Odds Ratio (OR) CI 95%.Results:From 147 patients, 31 (21%) met remission criteria; 87.1% women, mean age 51.9±14.8 years. Mean disease duration was 9,06±10,81 years. 64,5% were RF and ACPA positive and 25,9% had erosions.Ultrasonograms were made in 20 joints of both hands: radiocarpals (RC), metacarpophalangeals (MCP) and proximal interphalangeals (PIP). 12 patients (38.7%) presented subclinical synovitis (SH≥2+PD), more frequently on RC (29% right, 22.6% left), and MCP (9.7% on 2RMCP, 9.7% 4LMCP). These patients had greater CDAI (3.9±1.37 vs 2.89±1.15, p=0.03), HAQ (0.14±0.29 vs 0.00±0.00, p=0.04), CRP (9.90±7.46 vs 4.74±2.30, p=0.00) RF levels (502.67±275.66 vs 200.92±158.43, p=0,00), greater prednisone (16.5% vs 3.2%, p=0.04), and methotrexate use (20.16±5.54 vs 17.50±3.98, p=0.01). None of the healthy controls presented subclinical synovitis.In binary logistic regression CRP levels, RF titers and methotrexate doses were associated to subclinical synovitis. This association is not found in multivariate logistic regression. Negative association was found between subclinical synovitis and two csDMARDs use.Conclusion:This is the first study of its type in Paraguayan patients, which clearly evidenced that an important part of RA patients in clinical remission still presented subclinical synovitis (HS≥2 + PD). It was associated with CRP, RF and methotrexate dose.References:[1]Płaza M, Nowakowska-Płaza A, Pracoń G, Sudoł-Szopińska I. Role of ultrasonography in the diagnosis of rheumatic diseases in light of ACR/EULAR guidelines. J Ultrason. marzo de 2016;16(64):55-64.[2]Foltz V, Gandjbakhch F, Etchepare F, Rosenberg C, Tanguy ML, Rozenberg S, et al. Power Doppler ultrasound, but not low-field magnetic resonance imaging, predicts relapse and radiographic disease progression in rheumatoid arthritis patients with low levels of disease activity. Arthritis & Rheumatism. 2012;64(1):67-76.Disclosure of Interests:None declared
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