Your browser doesn't support javascript.
loading
Montrer: 20 | 50 | 100
Résultats 1 - 20 de 28.482
Filtrer
1.
Arch Virol ; 169(8): 157, 2024 Jul 06.
Article de Anglais | MEDLINE | ID: mdl-38969819

RÉSUMÉ

Viruses use various strategies and mechanisms to deal with cells and proteins of the immune system that form a barrier against infection. One of these mechanisms is the encoding and production of viral microRNAs (miRNAs), whose function is to regulate the gene expression of the host cell and the virus, thus creating a suitable environment for survival and spreading viral infection. miRNAs are short, single-stranded, non-coding RNA molecules that can regulate the expression of host and viral proteins, and due to their non-immunogenic nature, they are not eliminated by the cells of the immune system. More than half of the viral miRNAs are encoded and produced by Orthoherpesviridae family members. Human cytomegalovirus (HCMV) produces miRNAs that mediate various processes in infected cells to contribute to HCMV pathogenicity, including immune escape, viral latency, and cell apoptosis. Here, we discuss which cellular and viral proteins or cellular pathways and processes these mysterious molecules target to evade immunity and support viral latency in infected cells. We also discuss current evidence that their function of bypassing the host's innate and adaptive immune system is essential for the survival and multiplication of the virus and the spread of HCMV infection.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , Échappement immunitaire , microARN , Latence virale , Cytomegalovirus/génétique , Cytomegalovirus/immunologie , Cytomegalovirus/physiologie , Latence virale/génétique , microARN/génétique , Humains , Infections à cytomégalovirus/virologie , Infections à cytomégalovirus/immunologie , ARN viral/génétique , Interactions hôte-pathogène/immunologie , Interactions hôte-pathogène/génétique , Régulation de l'expression des gènes viraux
3.
Sci Rep ; 14(1): 15210, 2024 07 02.
Article de Anglais | MEDLINE | ID: mdl-38956212

RÉSUMÉ

This retrospective cohort study investigated patients with cytomegalovirus anterior uveitis (CMV AU) and compared treatment outcomes between regional and systemic antiviral therapies. Treatment modalities included topical (2% ganciclovir [GCV] eye drops or 0.2% GCV eye gel) and systemic (intravenous GCV or oral valganciclovir) groups. The comparison parameters included response rates, time to response, recurrence rates, time to recurrence, and complications. Forty-four patients (54.5% male) with a mean age of 56 ± 9.87 years were enrolled, with 31 eyes in the topical group and 13 eyes in the systemic group. The median response time was significantly slower in the topical group (63 days [IQR 28-112]) compared to the systemic group (28 days [IQR 24-59]) (p = 0.04). Treatment response rates were 87.1% (27/31) in the topical group and 100% (13/13) in the systemic group (p = 0.30), while recurrence rates were 37% (10/27) and 69.2% (9/13) (p = 0.056), with a median time to recurrence of 483 days [IQR 145-1388] and 392 days [IQR 203.5-1907.5] (p = 0.20), respectively. In conclusion, both topical and systemic GCV treatments demonstrated favorable outcomes for CMV AU. Systemic GCV showed rapid control of intraocular inflammation.


Sujet(s)
Antiviraux , Infections à cytomégalovirus , Ganciclovir , Uvéite antérieure , Humains , Mâle , Femelle , Adulte d'âge moyen , Infections à cytomégalovirus/traitement médicamenteux , Infections à cytomégalovirus/virologie , Uvéite antérieure/traitement médicamenteux , Uvéite antérieure/virologie , Antiviraux/usage thérapeutique , Antiviraux/administration et posologie , Études rétrospectives , Résultat thérapeutique , Ganciclovir/usage thérapeutique , Ganciclovir/administration et posologie , Sujet âgé , Cytomegalovirus , Adulte , Valganciclovir/usage thérapeutique , Récidive , Solutions ophtalmiques
4.
Virol J ; 21(1): 149, 2024 Jul 02.
Article de Anglais | MEDLINE | ID: mdl-38956615

RÉSUMÉ

OBJECTIVES: This study aimed to characterize incidences of CMV reactivations within one year post-allo-SCT and identify risk factors for CMV second reactivation episode in population with high seropositivity where first CMV reactivation episode deemed to be high. METHODS: This retrospective cohort study analyzed data from 359 allo-SCT patients aged 14 and older admitted to a tertiary academic hospital. Data on demographic and clinical factors, CMV serostatus, conditioning regimens, graft-versus-host disease prophylaxis, engraftment time, and CMV reactivations were collected. RESULTS: First and second CMV reactivations occurred in 88.9% and 18.4% of post-allo-SCT patients respectively. Patients were stratified into two groups based on primary disease necessitating allo-SCT, patients with malignant (Group 1) and non-malignant (Group 2) hematological disease. Factors associated with the second reactivation included cord blood as a stem cell source, human leukocyte antigen mismatch, acute graft-versus-host disease, and hematological malignancies. Patients with non-malignant hematological disease displayed better outcomes, including a higher rate of spontaneous clearance of first CMV reactivation (70% versus 49.4%) and lower rates of second CMV reactivation (9.6% versus 31%) than those with malignant hematological disease. The one-year overall survival rate was 87.7% (95.5% in non-malignant hematological disease and 78.13% in malignant hematological disease). CONCLUSION: Our findings are concordant with previous local study in regard to high rate of first CMV reactivation post-allo-SCT. It appears that patients with nonmalignant hematological disease had better outcomes, such as lower second CMV reactivation and higher survival rates compared to patients with malignant hematological disease. Further investigation is needed to identify other factors affecting recurrent CMV reactivations in allo-SCT in patients with malignant hematological disease.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , Transplantation homologue , Activation virale , Humains , Mâle , Femelle , Infections à cytomégalovirus/virologie , Infections à cytomégalovirus/épidémiologie , Adulte d'âge moyen , Adulte , Études rétrospectives , Jeune adulte , Cytomegalovirus/immunologie , Adolescent , Facteurs de risque , Sujet âgé , Transplantation homologue/effets indésirables , Récidive , Maladie du greffon contre l'hôte/étiologie , Transplantation de cellules souches hématopoïétiques/effets indésirables , Transplantation de cellules souches/effets indésirables , Incidence
5.
J Infect Dev Ctries ; 18(6): 964-971, 2024 Jun 30.
Article de Anglais | MEDLINE | ID: mdl-38991003

RÉSUMÉ

INTRODUCTION: Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii (T. gondii), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii, rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province. METHODOLOGY: A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii, CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA). RESULTS: The seropositivity rates of T. gondii, CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively. CONCLUSIONS: A screening program should be implemented for T. gondii, CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.


Sujet(s)
Infections à cytomégalovirus , Réfugiés , Rubéole , Toxoplasmose , Humains , Femelle , Réfugiés/statistiques et données numériques , Adulte , Études séroépidémiologiques , Toxoplasmose/épidémiologie , Adolescent , Jeune adulte , Rubéole/épidémiologie , Syrie/épidémiologie , Syrie/ethnologie , Adulte d'âge moyen , Études transversales , Infections à cytomégalovirus/épidémiologie , Turquie/épidémiologie , Toxoplasma/immunologie , Anticorps antiviraux/sang , Cytomegalovirus/immunologie , Cytomegalovirus/isolement et purification , Immunoglobuline M/sang
6.
Am J Case Rep ; 25: e944337, 2024 Jul 18.
Article de Anglais | MEDLINE | ID: mdl-39021063

RÉSUMÉ

BACKGROUND Cytomegalovirus (CMV) is a common herpesvirus that often causes asymptomatic or mild infections. In immunocompromised patients, CMV can lead to severe complications, including Guillain-Barre syndrome (GBS) and encephalitis. While these conditions have been described in the immunocompetent population, simultaneous presentation of CMV-associated GBS and encephalitis in such individuals has not been previously reported. CASE REPORT We present a case of a 58-year-old woman with poorly controlled diabetes who developed concurrent GBS and encephalitis following a CMV infection. The patient experienced bilateral ascending paraparesis 1 week after self-limited gastrointestinal symptoms. Despite initial treatment with plasma exchange therapy, her condition deteriorated with altered mental status and generalized tonic-clonic seizures, necessitating orotracheal intubation. Laboratory analysis revealed the presence of CMV in her cerebrospinal fluid. After treatment with further sessions of plasma exchange therapy and ganciclovir, her muscular strength in the extremities improved. However, she developed acute lung edema and failed extubation, leading to cardiorespiratory arrest with neurological sequelae. Palliative care was institutionalized, and she died 2 weeks later due to pneumonia. CONCLUSIONS This case highlights an unusual clinical presentation of overlapping CMV-associated GBS and encephalitis in an immunocompetent individual, with diabetes as the only identified risk factor. It underscores the importance of considering CMV as a potential etiological factor in such complex cases and the need for prompt diagnosis to improve patient outcomes. Further research is warranted to explore the underlying mechanisms and implications of this rare overlapping neurological manifestation.


Sujet(s)
Infections à cytomégalovirus , Syndrome de Guillain-Barré , Immunocompétence , Humains , Femelle , Adulte d'âge moyen , Syndrome de Guillain-Barré/diagnostic , Syndrome de Guillain-Barré/thérapie , Syndrome de Guillain-Barré/étiologie , Infections à cytomégalovirus/complications , Infections à cytomégalovirus/diagnostic , Issue fatale , Encéphalite virale/diagnostic
7.
J Med Virol ; 96(7): e29814, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-39015038

RÉSUMÉ

Novel biomarkers reflecting the degree of immunosuppression in transplant patients are required to ensure eventual personalized equilibrium between rejection and infection risks. With the above aim, Torque Teno Virus (TTV) viremia was precisely examined in a large cohort of transplanted immunocompromised patients (192 hematological and 60 solid organ transplant recipients) being monitored for Cytomegalovirus reactivation. TTV load was measured in 2612 plasma samples from 448 patients. The results revealed a significant increase in TTV viral load approximately 14 days following CMV reactivation/infection in solid organ transplant (SOT) patients. No recognizable difference in TTV load was noted among hematological patients during the entire timeframe analyzed. Furthermore, a temporal gap of approximately 30 days was noted between the viral load peaks reached by the two viruses, with Cytomegalovirus (CMV) preceding TTV. It was not possible to establish a correlation between CMV reactivation/infection and TTV viremia in hematological patients. On the other hand, the SOT patient cohort allowed us to analyze viral kinetics and draw intriguing conclusions. Taken together, the data suggest, to our knowledge for the first time, that CMV infection itself could potentially cause an increase in TTV load in the peripheral blood of patients undergoing immunosuppressive therapy.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , Infections à virus à ADN , Sujet immunodéprimé , Virus torque teno , Charge virale , Virémie , Humains , Cytomegalovirus/immunologie , Cytomegalovirus/physiologie , Infections à cytomégalovirus/virologie , Infections à cytomégalovirus/immunologie , Infections à cytomégalovirus/sang , Mâle , Infections à virus à ADN/virologie , Infections à virus à ADN/sang , Infections à virus à ADN/immunologie , Adulte d'âge moyen , Femelle , Adulte , Immunosuppression thérapeutique/effets indésirables , Activation virale , Receveurs de transplantation/statistiques et données numériques , Sujet âgé , Études de cohortes
8.
Egypt J Immunol ; 31(3): 113-122, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38995716

RÉSUMÉ

End-stage renal disease (ESRD) patients are considered immunocompromised, putting them at high risk for infections, including cytomegalovirus (CMV). CMV can affect hematological parameters, causing further complications in ESRD patients. This study intended to determine the seropositivity of CMV infection in hemodialysis patients and its effect on different blood parameters in ESRD patients to help decrease the overall dialysis associated morbidity and mortality. Blood samples were collected from 45 ESRD patients and 45 controls. A complete blood count was performed using an automated cell counter. CMV-specific IgM and IgG levels were measured using immunochemistry testing. The seropositivity for CMV-IgG was 42.2% in ESRD patients which was significantly higher than in control group (22.2%) (p=0.042). The seropositivity for CMV-IgM was 6.7% in ESRD patients with no difference with the control group (4.4%). The prevalence of anemia was significantly higher in CMV seropositive (77.3%) compared to CMV seronegative (47.8%) ESRD patients. Other studied blood parameters were not different between CMV seronegative and seropositive ESRD patients. In conclusion, CMV infection is a significant concern for dialysis patients and can affect hematological parameters, leading to further complications. Early detection and treatment of CMV infection and monitoring of CMV IgM and IgG levels are critical to prevent further complications and improve clinical outcomes.


Sujet(s)
Anticorps antiviraux , Infections à cytomégalovirus , Cytomegalovirus , Immunoglobuline G , Immunoglobuline M , Défaillance rénale chronique , Dialyse rénale , Humains , Dialyse rénale/effets indésirables , Infections à cytomégalovirus/sang , Infections à cytomégalovirus/immunologie , Infections à cytomégalovirus/épidémiologie , Femelle , Mâle , Cytomegalovirus/immunologie , Défaillance rénale chronique/thérapie , Défaillance rénale chronique/sang , Défaillance rénale chronique/complications , Défaillance rénale chronique/immunologie , Adulte d'âge moyen , Immunoglobuline M/sang , Anticorps antiviraux/sang , Immunoglobuline G/sang , Adulte , Anémie/sang , Anémie/immunologie
9.
BMC Infect Dis ; 24(1): 691, 2024 Jul 11.
Article de Anglais | MEDLINE | ID: mdl-38992583

RÉSUMÉ

BACKGROUND: Hemorrhagic varicella (HV) is a particular form of chicken pox.,with high mortality in adults. This form of the disease is rare, to date, approximately 4 cases have been reported. Occasional cases of HV have been documented in adults with hematologic disorders or other diseases. While there is one reported case of simultaneous reactivation of cytomegalovirus in an adult with chickenpox, there is a lack of information regarding changes in liver function indicators for such patients. This is unfortunate, as CMV reactivation can further exacerbate liver failure and increase mortality. In this report, we present a case of hemorrhagic varicella reactivation with cytomegalovirus and provide some relevant discussions. CASE PRESENTATION: We present the case of a 25-year-old male with HV, who had a history of nephrotic syndrome generally controlled with orally administered prednisone at a dosage of 50 mg per day for two months. The patient arrived at the emergency room with complaints of abdominal pain and the presence of hemorrhagic vesicles on his body for the past 3 days. Despite medical evaluation, a clear diagnosis was not immediately determined. Upon admission, the leukocyte count was recorded as 20.96 × 109/L on the first day, leading to the initiation of broad-spectrum antibiotic treatment. Despite the general interpretation that a positive IgG and a negative IgM indicate a previous infection, the patient's extraordinarily elevated IgG levels, coupled with a markedly increased CMV DNA quantification, prompted us to suspect a reactivation of the CMV virus. In light of these findings, we opted for the intravenous administration of ganciclovir as part of the treatment strategy. Unfortunately,,the patient succumbed to rapidly worsening symptoms and passed away. Within one week of the patient's demise, chickenpox gradually developed in the medical staff who had been in contact with him. In such instances, we speculate that the patient's diagnosis should be classified as a rare case of hemorrhagic varicella. CONCLUSION: Swift identification and timely administration of suitable treatment for adult HV are imperative to enhance prognosis.


Sujet(s)
Varicelle , Co-infection , Infections à cytomégalovirus , Cytomegalovirus , Humains , Mâle , Adulte , Infections à cytomégalovirus/traitement médicamenteux , Infections à cytomégalovirus/complications , Infections à cytomégalovirus/virologie , Infections à cytomégalovirus/diagnostic , Cytomegalovirus/isolement et purification , Varicelle/traitement médicamenteux , Varicelle/complications , Varicelle/virologie , Varicelle/diagnostic , Co-infection/virologie , Co-infection/traitement médicamenteux , Antiviraux/usage thérapeutique , Antiviraux/administration et posologie , Hémorragie/virologie , Hémorragie/étiologie , Herpèsvirus humain de type 3/isolement et purification , Activation virale
10.
Front Immunol ; 15: 1414830, 2024.
Article de Anglais | MEDLINE | ID: mdl-39007131

RÉSUMÉ

Introduction: Cytomegalovirus (CMV) infection remains a challenge following kidney transplantation (KTx). Currently, CMV-IgG serostatus at transplantation is used to individualize CMV preventive strategies. We assessed the clinical utility of CMV-IGRA for predicting CMV infection following KTx. Methods: We performed a nationwide prospective cohort study from August 2016 until December 2022. Data from all adult KTx recipients in Norway, n=1,546 (R+; n=1,157, D+/R-; n=260, D-/R-; 129), were included with a total of 3,556 CMV-IGRA analyses (1,375 at KTx, 1,188 at eight weeks, 993 one-year after KTx) and 35,782 CMV DNAemia analyses. Results: In R+ recipients CMV-IGRA status, measured at any of the time-points, could not identify any differential risk of later CMV infection. D+/R- recipients remaining CMV-IGRA negative 1-year after transplantation (regardless of positive CMV DNAemia and/or CMV IgG status at that time) had increased risk of developing later CMV infection compared to D+/R- recipients who had become CMV-IGRA positive (14% vs. 2%, p=0.01). Conclusion: Knowledge of pre-transplant CMV-IGRA status did not provide additional information to CMV-IgG serostatus that could improve current post-transplant CMV treatment algorithms. However, D+/R- recipients with a persisting negative CMV-IGRA one-year after transplantation remained at increased risk of experiencing later CMV infection. Therefore we advocate post-transplant CMV-IGRA monitoring in these patients.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , Immunité cellulaire , Transplantation rénale , Humains , Transplantation rénale/effets indésirables , Infections à cytomégalovirus/immunologie , Cytomegalovirus/immunologie , Mâle , Femelle , Adulte d'âge moyen , Adulte , Études prospectives , Anticorps antiviraux/sang , Sujet âgé , Norvège/épidémiologie , Facteurs de risque , Immunoglobuline G/sang
12.
J Med Virol ; 96(7): e29770, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38949200

RÉSUMÉ

Donor and recipient human cytomegalovirus (HCMV) seropositive (D+R+) lung transplant recipients (LTRs) often harbor multiple strains of HCMV, likely due to transmitted donor (D) strains and reactivated recipient (R) strains. To date, the extent and timely occurrence of each likely source in shaping the post-transplantation (post-Tx) strain population is unknown. Here, we deciphered the D and R origin of the post-Tx HCMV strain composition in blood, bronchoalveolar lavage (BAL), and CD45+ BAL cell subsets. We investigated either D and/or R formalin-fixed paraffin-embedded blocks or fresh D lung tissue from four D+R+ LTRs obtained before transplantation. HCMV strains were characterized by short amplicon deep sequencing. In two LTRs, we show that the transplanted lung is reseeded by R strains within the first 6 months after transplantation, likely by infiltrating CD14+ CD163+/- alveolar macrophages. In three LTRs, we demonstrate both rapid D-strain dissemination and persistence in the transplanted lung for >1 year post-Tx. Broad inter-host diversity contrasts with intra-host genotype sequence stability upon transmission, during follow-up and across compartments. In D+R+ LTRs, HCMV strains of both, D and R origin can emerge first and dominate long-term in subsequent episodes of infection, indicating replication of both sources despite pre-existing immunity.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , Transplantation pulmonaire , Donneurs de tissus , Receveurs de transplantation , Humains , Transplantation pulmonaire/effets indésirables , Cytomegalovirus/génétique , Cytomegalovirus/classification , Infections à cytomégalovirus/virologie , Mâle , Adulte d'âge moyen , Femelle , Adulte , Génotype , Poumon/virologie , Liquide de lavage bronchoalvéolaire/virologie
13.
S D Med ; 77(3): 134-139, 2024 Mar.
Article de Anglais | MEDLINE | ID: mdl-38990798

RÉSUMÉ

Cytomegalovirus, one of the most common congenital viruses in neonates, is represented within the TORCH acronym, which signifies its ability to be transmitted vertically to the fetus during maternal infection. Despite advances in prenatal diagnostics, CMV is still the leading cause of congenital infection in neonates, with a 0.64% prevalence. Additionally, the virus causes the majority of non-genetic hearing deficits, abnormal neurologic development, and other permanent disabilities seen in neonates. This primer describes the presentation, diagnosis, and treatment of congenital infection to benefit providers who work with women during the perinatal period as well as neonates and pediatric patients.


Sujet(s)
Infections à cytomégalovirus , Transmission verticale de maladie infectieuse , Femelle , Humains , Nouveau-né , Grossesse , Antiviraux/usage thérapeutique , Infections à cytomégalovirus/diagnostic , Infections à cytomégalovirus/congénital , Transmission verticale de maladie infectieuse/prévention et contrôle , Complications infectieuses de la grossesse/diagnostic , Complications infectieuses de la grossesse/thérapie
14.
Exp Clin Transplant ; 22(5): 392-395, 2024 May.
Article de Anglais | MEDLINE | ID: mdl-38970283

RÉSUMÉ

We present a challenging clinical case of a 68-year-old female kidney transplant recipient who had a complicated posttransplant course marked by borderline T-cell-mediated rejection and BK virus nephropathy. The treatment for borderline rejection with steroids resulted in overimmunosuppression, and the patient acquired cytomegalovirus infection manifesting as colitis and SARS-CoV-2 infection. This progressed rapidly to collapsing glomerulopathy and allograft failure. This study also highlights the challenges in surveillance with donor-derived cell-free DNA in the setting of allograft injury by multiple viral infections.


Sujet(s)
Virus BK , COVID-19 , Infections à cytomégalovirus , Rejet du greffon , Transplantation rénale , Infections à polyomavirus , Infections à virus oncogènes , Humains , Femelle , COVID-19/complications , COVID-19/immunologie , COVID-19/diagnostic , Sujet âgé , Transplantation rénale/effets indésirables , Infections à polyomavirus/immunologie , Infections à polyomavirus/virologie , Infections à polyomavirus/diagnostic , Infections à cytomégalovirus/immunologie , Infections à cytomégalovirus/diagnostic , Infections à cytomégalovirus/virologie , Infections à cytomégalovirus/traitement médicamenteux , Rejet du greffon/immunologie , Rejet du greffon/virologie , Virus BK/pathogénicité , Virus BK/immunologie , Infections à virus oncogènes/immunologie , Infections à virus oncogènes/virologie , Infections à virus oncogènes/diagnostic , Évolution de la maladie , Résultat thérapeutique , Immunosuppresseurs/effets indésirables , Immunosuppresseurs/usage thérapeutique , Co-infection
15.
Mikrobiyol Bul ; 58(3): 284-292, 2024 Jul.
Article de Turc | MEDLINE | ID: mdl-39046210

RÉSUMÉ

Viral load monitoring is important in identifying patients at risk of developing cytomegalovirus (CMV) related complications after transplantation and for this purpose, quantitative real-time polymerase chain reaction (Rt-qPCR) tests are most commonly used. The main problem in CMV DNA Rt-qPCR tests that make quantitative measurements is that there are significant differences in measurements performed with different kits in different laboratories. Comparability of viral load measurements between laboratories has increased with the introduction of quantitative PCR tests calibrated with the CMV International Quantitation Standard (IQS) developed by the World Health Organization (WHO). However, quantitative agreement between measurements made with different kits has still not been fully achieved. In this study, it was aimed to investigate the quantitative compatibility between measurements made with Cobas 6800 (Roche Diagnostics, Mannheim, Germany) and NeuMoDx (Qiagen, Ann Arbor, USA) CMV DNA Rt-qPCR tests, which are fully automated new generation systems calibrated with the WHO CMV IQS. The results of 214 plasma samples, which were studied simultaneously with Cobas 6800 CMV Rt-qPCR and NeuMoDx CMV Rt-qPCR tests were analyzed. In the tests, the extraction, amplification and detection stages were carried out fully automatically. CMV DNA was detected in 144 (67.28%) samples in both tests and was not detected in 53 (24.76%) samples. Incompatible results were obtained in a total of 17 (7.94%) samples. Good agreement was found between the qualitative results of both tests (kappa= 0.80, p< 0.001). When the quantitative results (n= 129) obtained in the dynamic measurement range of both tests were examined, the median viral load values measured by Cobas 6800 CMV Rt-qPCR and NeuMoDx CMV Rt-qPCR tests were 513 IU/mL (range= 35-37000) and 741 IU/mL (range= 68-48978), respectively. According to the correlation analysis, a very strong correlation was found between the results of both tests (r= 0.94, p< 0.001). According to Bland-Altman analysis; the average difference between the results of the NeuMoDx CMV Rt-qPCR test and the Cobas 6800 CMV Rt-qPCR test was found to be -0.14 log10 [standard deviation (SD)= 0.23] IU/mL and it was determined that the Cobas 6800 CMV Rt-qPCR test had lower measurements than the NeuMoDx CMV Rt-qPCR test. In 120 of 129 samples (93%) whose results were within the dynamic measurement range of both tests, the measurement difference was within ± 0.5 log10 IU/mL and in 9 (7%), it was detected as more than ± 0.5 log10 (median 0.54 log10 IU/ml; range= 0.51-0.81). No measurement difference of more than ± 1.0 log10 was detected in any sample. In this study, quantitative agreement was found in the measurements made in plasma samples with the fully automated Cobas 6800 CMV Rt-qPCR and NeuMoDx CMV Rt-qPCR tests calibrated with the CMV IQS. To the best of our knowledge, a study comparing viral load measurements made with Cobas 6800 and NeuMoDx fully automated systems in the detection of CMV DNA has not yet been conducted, and this is the first study on this subject.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , ADN viral , Réaction de polymérisation en chaine en temps réel , Charge virale , Humains , Infections à cytomégalovirus/diagnostic , Infections à cytomégalovirus/virologie , Cytomegalovirus/génétique , Cytomegalovirus/isolement et purification , Charge virale/méthodes , Charge virale/normes , Réaction de polymérisation en chaine en temps réel/méthodes , Réaction de polymérisation en chaine en temps réel/normes , ADN viral/analyse , ADN viral/sang , Trousses de réactifs pour diagnostic/normes
17.
Clin Transplant ; 38(6): e15375, 2024 Jun.
Article de Anglais | MEDLINE | ID: mdl-39031785

RÉSUMÉ

BACKGROUND: Cytomegalovirus infection (CMV) is a common complication after allogeneic hematopoietic stem cell transplantation (AHSCT). CMV infection increases transplantation costs; however, the extent of the financial burden may vary in different countries. This study aims to determine the clinical and economic impact of CMV infection in patients undergoing AHSCT in a middle-income country. METHODS: A total of 150 adult and pediatric patients post-AHSCT were included for analysis. In addition to incidence of CMV infections, data on graft versus host disease (GVHD) were also collected. Standard hospital charges for AHSCT and any additional transplantation-related expenditure within 12 months were also retrieved in 104 patients. RESULTS: CMV infection, acute GVHD and chronic GVHD occurred in 38.7%, 60.7%, and 22.0% of patients, respectively. Patients with CMV infections had higher readmission rates compared to those who did not (67.2% vs. 47.8%; p = 0.020). Additional expenditure was seen in HLA-haploidentical AHSCT and CMV infection (MYR11 712.25/USD2 504.49; p < 0.0001 and MYR5 807.24/USD1 241.79; p = 0.036), respectively. CONCLUSION: This single-center study demonstrated that patients who underwent HLA-haploidentical AHSCT and subsequently developed CMV infection had higher transplantation expenditures compared to those who had matched-related transplantation. Further studies should be conducted to evaluate if primary prophylaxis against CMV is cost-effective, especially in patients who undergo HLA-haploidentical AHSCT.


Sujet(s)
Infections à cytomégalovirus , Cytomegalovirus , Maladie du greffon contre l'hôte , Transplantation de cellules souches hématopoïétiques , Transplantation homologue , Humains , Infections à cytomégalovirus/économie , Infections à cytomégalovirus/étiologie , Transplantation de cellules souches hématopoïétiques/effets indésirables , Transplantation de cellules souches hématopoïétiques/économie , Mâle , Femelle , Adulte , Études de suivi , Cytomegalovirus/isolement et purification , Enfant , Maladie du greffon contre l'hôte/économie , Maladie du greffon contre l'hôte/étiologie , Adolescent , Adulte d'âge moyen , Jeune adulte , Pronostic , Facteurs de risque , Enfant d'âge préscolaire , Études rétrospectives , Incidence , Conditionnement pour greffe/effets indésirables
18.
Cell Mol Life Sci ; 81(1): 289, 2024 Jul 06.
Article de Anglais | MEDLINE | ID: mdl-38970696

RÉSUMÉ

Congenital human cytomegalovirus (HCMV) infection is a major cause of abnormalities and disorders in the central nervous system (CNS) and/or the peripheral nervous system (PNS). However, the complete pathogenesis of neural differentiation disorders caused by HCMV infection remains to be fully elucidated. Stem cells from human exfoliated deciduous teeth (SHEDs) are mesenchymal stem cells (MSCs) with a high proliferation and neurogenic differentiation capacity. Since SHEDs originate from the neural crest of the early embryonic ectoderm, SHEDs were hypothesized to serve as a promising cell line for investigating the pathogenesis of neural differentiation disorders in the PNS caused by congenital HCMV infection. In this work, SHEDs were demonstrated to be fully permissive to HCMV infection and the virus was able to complete its life cycle in SHEDs. Under neurogenic inductive conditions, HCMV infection of SHEDs caused an abnormal neural morphology. The expression of stem/neural cell markers was also disturbed by HCMV infection. The impairment of neural differentiation was mainly due to a reduction of intracellular cholesterol levels caused by HCMV infection. Sterol regulatory element binding protein-2 (SREBP2) is a critical transcription regulator that guides cholesterol synthesis. HCMV infection was shown to hinder the migration of SREBP2 into nucleus and resulted in perinuclear aggregations of SREBP2 during neural differentiation. Our findings provide new insights into the prevention and treatment of nervous system diseases caused by congenital HCMV infection.


Sujet(s)
Différenciation cellulaire , Cholestérol , Infections à cytomégalovirus , Cytomegalovirus , Cellules souches mésenchymateuses , Protéine-2 de liaison à l'élément de régulation des stérols , Humains , Cholestérol/métabolisme , Cholestérol/biosynthèse , Infections à cytomégalovirus/virologie , Infections à cytomégalovirus/métabolisme , Protéine-2 de liaison à l'élément de régulation des stérols/métabolisme , Protéine-2 de liaison à l'élément de régulation des stérols/génétique , Cytomegalovirus/physiologie , Cytomegalovirus/métabolisme , Cellules souches mésenchymateuses/métabolisme , Cellules souches mésenchymateuses/virologie , Cellules souches mésenchymateuses/cytologie , Cellules cultivées , Dent de lait/virologie , Dent de lait/cytologie , Dent de lait/métabolisme , Neurones/métabolisme , Neurones/virologie , Neurogenèse
19.
Crit Care ; 28(1): 243, 2024 Jul 16.
Article de Anglais | MEDLINE | ID: mdl-39014504

RÉSUMÉ

BACKGROUND: Cytomegalovirus (CMV) infection in patients with cellular immune deficiencies is associated with significant morbidity and mortality. However, data on CMV end-organ disease (CMV-EOD) in critically ill, immunocompromised patients are scarce. Our objective here was to describe the clinical characteristics and outcomes of CMV-EOD in this population. METHODS: We conducted a multicenter, international, retrospective, observational study in adults who had CMV-EOD and were admitted to any of 18 intensive care units (ICUs) in France, Israel, and Spain in January 2010-December 2021. Patients with AIDS were excluded. We collected the clinical characteristics and outcomes of each patient. Survivors and non-survivors were compared, and multivariate analysis was performed to identify risk factors for hospital mortality. RESULTS: We studied 185 patients, including 80 (43.2%) with hematologic malignancies, 55 (29.7%) with solid organ transplantation, 31 (16.8%) on immunosuppressants, 16 (8.6%) with solid malignancies, and 3 (1.6%) with primary immunodeficiencies. The most common CMV-EOD was pneumonia (n = 115, [62.2%] including 55 [47.8%] with a respiratory co-pathogen), followed by CMV gastrointestinal disease (n = 64 [34.6%]). More than one organ was involved in 16 (8.8%) patients. Histopathological evidence was obtained for 10/115 (8.7%) patients with pneumonia and 43/64 (67.2%) with GI disease. Other opportunistic infections were diagnosed in 69 (37.3%) patients. Hospital mortality was 61.4% overall and was significantly higher in the group with hematologic malignancies (75% vs. 51%, P = 0.001). Factors independently associated with higher hospital mortality were hematologic malignancy with active graft-versus-host disease (OR 5.02; 95% CI 1.15-27.30), CMV pneumonia (OR 2.57; 95% CI 1.13-6.03), lymphocytes < 0.30 × 109/L at diagnosis of CMV-EOD (OR 2.40; 95% CI 1.05-5.69), worse SOFA score at ICU admission (OR 1.18; 95% CI 1.04-1.35), and older age (OR 1.04; 95% CI 1.01-1.07). CONCLUSIONS: Mortality was high in critically ill, immunocompromised patients with CMV-EOD and varied considerably with the cause of immunodeficiency and organ involved by CMV. Three of the four independent risk factors identified here are also known to be associated with higher mortality in the absence of CMV-EOD. CMV pneumonia was rarely proven by histopathology and was the most severe CMV-EOD.


Sujet(s)
Maladie grave , Infections à cytomégalovirus , Sujet immunodéprimé , Humains , Études rétrospectives , Mâle , Femelle , Infections à cytomégalovirus/immunologie , Adulte d'âge moyen , Sujet âgé , Espagne/épidémiologie , Études de cohortes , Unités de soins intensifs/statistiques et données numériques , Unités de soins intensifs/organisation et administration , France/épidémiologie , Adulte , Israël/épidémiologie , Mortalité hospitalière , Cytomegalovirus/immunologie , Cytomegalovirus/pathogénicité , Facteurs de risque
20.
PLoS Pathog ; 20(7): e1010785, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38976755

RÉSUMÉ

The involvement of γδ TCR-bearing lymphocytes in immunological memory has gained increasing interest due to their functional duality between adaptive and innate immunity. γδ T effector memory (TEM) and central memory (TCM) subsets have been identified, but their respective roles in memory responses are poorly understood. In the present study, we used subsequent mouse cytomegalovirus (MCMV) infections of αß T cell deficient mice in order to analyze the memory potential of γδ T cells. As for CMV-specific αß T cells, MCMV induced the accumulation of cytolytic, KLRG1+CX3CR1+ γδ TEM that principally localized in infected organ vasculature. Typifying T cell memory, γδ T cell expansion in organs and blood was higher after secondary viral challenge than after primary infection. Viral control upon MCMV reinfection was prevented when masking γδ T-cell receptor, and was associated with a preferential amplification of private and unfocused TCR δ chain repertoire composed of a combination of clonotypes expanded post-primary infection and, more unexpectedly, of novel expanded clonotypes. Finally, long-term-primed γδ TCM cells, but not γδ TEM cells, protected T cell-deficient hosts against MCMV-induced death upon adoptive transfer, probably through their ability to survive and to generate TEM in the recipient host. This better survival potential of TCM cells was confirmed by a detailed scRNASeq analysis of the two γδ T cell memory subsets which also revealed their similarity to classically adaptive αß CD8 T cells. Overall, our study uncovered memory properties of long-lived TCM γδ T cells that confer protection in a chronic infection, highlighting the interest of this T cell subset in vaccination approaches.


Sujet(s)
Infections à Herpesviridae , Mémoire immunologique , Cellules T mémoire , Muromegalovirus , Récepteur lymphocytaire T antigène, gamma-delta , Animaux , Souris , Muromegalovirus/immunologie , Récepteur lymphocytaire T antigène, gamma-delta/immunologie , Récepteur lymphocytaire T antigène, gamma-delta/métabolisme , Infections à Herpesviridae/immunologie , Mémoire immunologique/immunologie , Cellules T mémoire/immunologie , Réinfection/immunologie , Souris de lignée C57BL , Souris knockout , Infections à cytomégalovirus/immunologie
SÉLECTION CITATIONS
DÉTAIL DE RECHERCHE