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1.
BMC Ophthalmol ; 21(1): 389, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34743692

RESUMO

PURPOSE: Cytomegalovirus (CMV)-related keratouveitis elevates intraocular pressure (IOP). Antiviral therapy does not always control IOP and some patients do not tolerate systemic antiviral therapy because of the side effects. The purpose of this study is to evaluate the clinical characteristics of patients with CMV-related keratouveitis and determine the impact of glaucoma surgeries on the postoperative antiviral therapy regimen. METHODS: We enrolled twenty-two patients with CMV-DNA-positive keratouveitis between June 2012 and July 2019 in Kobe University Hospital. The following clinical parameters were collected: gender, age, history of previous intraocular surgery, antiviral medications, visual acuity, IOP, glaucoma drug score, corneal endothelial cells density, and the mean deviation of a Humphrey visual field test at the first visit and before and 1 year after glaucoma surgery. RESULTS: All twenty-two patients started on oral and/or topical antiviral therapy. Eighteen patients needed glaucoma surgery despite their antiviral medications. Nine patients underwent trabeculotomy (TLO) and nine underwent trabeculectomy (TLE) as the first surgical intervention. Six of patients who initially underwent TLO and two of the patients who initially underwent TLE required additional TLE within 1 year. Each of the 15 patients who underwent at least 1 TLE showed a reduction in the magnitude and variation of IOP and glaucoma drug scores and 13 patients were able to discontinue antiviral therapy. For the remaining 4 patients, IOP and inflammation were controlled but with antiviral medications. CONCLUSIONS: In patients with CMV-related keratouveitis, TLE decreases and stabilizes IOP and contributes to withdrawal from antiviral medications.


Assuntos
Glaucoma , Trabeculectomia , Antivirais/uso terapêutico , Citomegalovirus , Células Endoteliais , Seguimentos , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Estudos Retrospectivos , Resultado do Tratamento
2.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(11): 587-592, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34756280

RESUMO

PURPOSE: To perform a retrospective analysis on patients with HLA-B27 negative hypertensive acute anterior uveitis. Aqueous humor samples were obtained on which a polymerase chain reaction (PCR) test was performed. The patients were then classified into 3 groups depending on whether they were positive for cytomegalovirus (CMV) or herpesvirus (HSV-VZV) or negative for both. MATERIAL AND METHODS: Different variables were collected in successive visits (baseline, 3, 6, and 12 months). The variables were age, sex, visual acuity, intraocular pressure (IOP), cells in the anterior chamber, retro-keratic precipitates, hypotensive treatment, glaucoma or retina surgery, corneal transplantation, and central thickness of the retinal nerve fiber layer. RESULTS: The sample was 36 patients, with a mean age of 59.78 ± 15.26 years. The mean baseline IOP value was 40 ± 10.42 mmHg in the CMV group compared to 23.8 ± 10.4 mmHg in the HSV-VZV, and 22.65 ± 9.9 mmHg in the negative group. The baseline frequency of retro-keratic precipitates, hypotensive treatment, glaucoma surgery, and corneal transplantation was higher in CMV positives. At one year, the loss of retinal nerve fiber layer and glaucoma surgery was greater in the negative group. In the 3 groups, there was a direct and positive correlation between IOP and inflammation in the anterior chamber. Being 0.94 (P = .05) for the positive for CMV, 0.24 (P = .75) in that of HSV-VZV, and 0.98 (P = .17) in the negative group. CONCLUSIONS: HLA-B27 negative hypertensive acute anterior uveitis with CMV positive has a more aggressive initial presentation. However, after one year, the glaucomatous damage is less than in the negative group. In hypertensive acute anterior uveitis, when inflammation in anterior chamber is controlled then IOP is also controlled.


Assuntos
Uveíte Anterior , Uveíte , Adulto , Idoso , Citomegalovirus , Antígeno HLA-B27/genética , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Rev Med Liege ; 76(11): 811-816, 2021 Nov.
Artigo em Francês | MEDLINE | ID: mdl-34738755

RESUMO

Summmary : In Belgium, as in most developed countries, routine antenatal screening for cytomegalovirus (CMV) remains controversial and is not recommended. However, 1-2 % of seronegative pregnant women will develop a primary infection during pregnancy and, with a prevalence of 0.7 % of live births, CMV is the leading cause of congenital infection. Among infected newborns, 20 to 25 % will develop auditory or neurological sequelae. The initial objective of our study was to evaluate, from a cohort of 48 patients followed in the antenatal diagnosis Unit of the University Hospital of Liège, the rates of maternal-fetal transmission, medical termination of pregnancy and rates of sequelae in infected newborns and to compare them with findings found in the literature. The second objective was to synthesize the current state of knowledge on maternal-fetal CMV infection and, in the light of recent data on prenatal treatment with valaciclovir, to propose a screening and management algorithm for primary CMV infection in the first trimester of pregnancy.


Assuntos
Infecções por Citomegalovirus , Complicações Infecciosas na Gravidez , Citomegalovirus , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Diagnóstico Pré-Natal
4.
Zhonghua Xue Ye Xue Za Zhi ; 42(9): 757-762, 2021 Sep 14.
Artigo em Chinês | MEDLINE | ID: mdl-34753231

RESUMO

Objective: To explore the correlation between the affinity while donor's HLA type recognizing different cytomegalovirus (CMV) antigen peptide and the occurrence of CMV infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. Methods: To investigate the relationship between CMV reactivation, CMV infection or CMV related tissue/organ diseases and the different HLA-type recognition antigen peptide of the donors, we retrospectively analyzed the clinical data of 146 children with CMV infection for 6 months since from the time they underwent transplantation in Wuhan Children's Hospital. Results: Among 146 patients, the HLA type of 82 (56.16%) cases had high affinity with PP65 alone, and 34 cases of CMV infection occurred after transplantation (41.46%) . None of 5 cases that had a high affinity with IE-1 alone got CMV infection. None of 2 cases with no clear high-affinity peptide had CMV infection. Three of 5 cases that had a high affinity with PP65 and PP50 had CMV infection. Thirteen of 52 cases that had a high affinity with PP65 and IE-1 had CMV infection (25.00%) . HLA with exclusive PP50 high affinity was not encountered. Donors with a high-affinity HLA locus associated with IE-1 showed a lower incidence of CMV infection after HSCT compared to those carrying only the PP65 high-affinity allele (22.81% vs 41.46%, P=0.029) . Conclusion: HLA type with PP65 and IE-1 high-affinity covers approximately 99.8% of the donors. Stem cells generated from HLA donors with high affinity with the CMV antigen peptide IE-1 can reduce the risk of post-transplantation CMV-activated infection in children.


Assuntos
Infecções por Citomegalovirus , Transplante de Células-Tronco Hematopoéticas , Criança , Citomegalovirus , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Peptídeos , Estudos Retrospectivos
5.
Medicina (Kaunas) ; 57(11)2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34833380

RESUMO

Clinically significant isolated viral tracheitis is scarce in adults, and upper airway obstruction caused by viral tracheitis is even more infrequent. A 74-year-old woman, who was administered low-dose steroids for two months for chronic obstructive pulmonary disease (COPD), developed dyspnea with stridor and required mechanical ventilation for respiratory failure. Chest computed tomography showed a diffuse tracheal wall thickening with luminal narrowing and peribronchial consolidation in the right upper lobe. Bronchoscopy revealed a proximal tracheal narrowing with multiple ulcerations of the tracheal mucosa surrounded by an erythematous margin. Pathologic examinations of the tracheal mucosal tissue, including immunohistochemistry, revealed a cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Furthermore, the bronchial alveolar lavage fluid was positive on the CMV real-time polymerase chain reaction. The patient was treated with intravenous ganciclovir for 44 days. The follow-up bronchoscopy 49 days after the initiation of ganciclovir revealed improved multiple ulcerations with scars. We report a rare case of tracheitis caused by coinfection with CMV and HSV in a patient with COPD who had been taking low-dose steroids for months. The case showed that CMV and HSV are potential causes of serious tracheitis and respiratory failure.


Assuntos
Coinfecção , Herpes Simples , Traqueíte , Adulto , Idoso , Citomegalovirus , Feminino , Herpes Simples/complicações , Herpes Simples/tratamento farmacológico , Humanos , Simplexvirus , Traqueíte/complicações , Traqueíte/tratamento farmacológico
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 723-727, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814458

RESUMO

Objective: To understand the prevalence and correlates of plasma cytomegalovirus (CMV) viremia among HIV-infected individuals by Meta-analysis. Methods: A systematic literature retrieval was conducted by PubMed, CNKI, Wanfang, and VIP databases for the information about the prevalence of plasma CMV viremia among HIV-infected individuals published from 2011 to 2020. Meta-analysis was used to calculate the pooled prevalence after literature screening and data extraction. Results: Fifteen studies were included, and the total sample size was 5 076. The random effect model showed that the pooled prevalence of CMV viremia among HIV-infected individuals was 26.2% (95%CI: 16.8%-35.6%, I2=99%); Subgroup analysis and Meta-regression showed that the sources of heterogeneity among different studies were: the proportion of individuals aged >30 years in sample, the proportion of homosexual transmission in the sample, the proportion of individuals whose HIV viral load > 104 copies/ml, the proportion of individuals whose CD4+T lymphocyte counts <200 cells/µl. Conclusion: Among HIV-infected individuals, the prevalence of CMV viremia was high and might be associated with age, HIV transmission mode, the status of HIV/AIDS.


Assuntos
Infecções por Citomegalovirus , Infecções por HIV , Citomegalovirus , Infecções por Citomegalovirus/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Prevalência , Viremia/epidemiologia
7.
Rev Gastroenterol Peru ; 41(2): 121-125, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34724695

RESUMO

Congenital cytomegalovirus infection is a cause of neonatal infection that can be asymptomatic; however, its complications are possible in some organs such as the nervous system and the liver. We report a case of a 2-month-old female infant with cytomegalovirus hepatitis characterized by abdominal distention, cholestasis, irritability, and poor breastfeeding. In the tests, liver involvement, periventricular microcalcifications, and sensorineural hearing loss were found. The diagnosis was determined by serum antibodies, confirmed with viral load in blood, urine, and liver tissue. Treatment with ganciclovir, vitamin K, and ursodeoxycholic acid was administered with adequate evolution. Cytomegalovirus hepatitis is a complication that may be associated with the involvement of other organs. Antiviral treatment for liver involvement is still controversial; however, it is recommended in children under one month of age if it is associated with neurological damage.


Assuntos
Infecções por Citomegalovirus , Hepatite , Antivirais/uso terapêutico , Criança , Citomegalovirus , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/tratamento farmacológico , Feminino , Ganciclovir/uso terapêutico , Humanos , Lactente , Recém-Nascido
8.
AIDS Res Ther ; 18(1): 83, 2021 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763708

RESUMO

OBJECTIVES: Accelerated atherosclerosis in older HIV-infected patients has been attributed to persistent immune activation and high burden cytomegalovirus (CMV), as demonstrated in transplant recipients and the general population. Here we assess CMV and inflammatory markers linked with vascular health in young adult patients treated in Indonesia. STUDY DESIGN: HIV-infected adults (n = 32) were examined when they began antiretroviral therapy (ART) with < 200 CD4 T-cells/µl (V0) and after 60 months (V60). Age-matched healthy controls (HC, n = 32) were assessed once. METHODS: Flow Mediated Dilatation (FMD) was assessed by ultrasound on brachial arteries at V60 and in HC. Plasma markers of immune activation and endothelial activation, and CMV antibodies (lysate, gB, IE-1) were assessed in all samples. Results were assessed using bivariate (non-parametric) and multivariable analyses. RESULTS: Levels of inflammatory biomarkers and CMV antibodies declined on ART, but the antibodies remained higher than in HC. FMD values were similar in patients and HC at V60. In HIV patients, levels of CMV lysate antibody correlated inversely (r = - 0.37) with FMD. The optimal model predicting lower FMD values (adjusted R2 = 0.214, p = 0.012) included CMV lysate antibodies and chondroitin sulphate. In HC, levels of sTNFR correlated inversely with FMD (r = - 0.41) and remained as a risk factor in the optimal multivariable model, with CMV glycoprotein-B (gB) antibody predicting a healthier FMD (adjusted R2 = 0.248, p = 0.013). CONCLUSIONS: Higher levels CMV antibodies optimally predict vascular health measured by FMD in HIV patients. However in healthy controls, sTNFR marks risk and CMV gB antibody may be protective.


Assuntos
Infecções por Citomegalovirus , Infecções por HIV , Idoso , Anticorpos Antivirais , Citomegalovirus , Infecções por Citomegalovirus/epidemiologia , Infecções por HIV/tratamento farmacológico , Humanos , Indonésia/epidemiologia
9.
J Prev Med Hyg ; 62(2): E372-E376, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34604575

RESUMO

Introduction: Cytomegalovirus is ubiquitous and easily transmitted by contact. Following the first infection, the virus becomes latent and periodic reactivation could occur due to immunosuppression. If the infection is acquired in pregnancy, especially in the first trimester, the foetal consequences could be serious. The present study was conducted to assess the serological profile of pregnant women with respect to cytomegalovirus in Apulia from 2016 to 2019. Methods: Serum samples were tested by commercial ELISA kit for the detection of specific IgM and IgG antibodies against cytomegalovirus. Results: The data showed that most of the pregnant women (70.8%), especially those of ≥ 40 years of age (80.6%), has antibodies against cytomegalovirus, though these do not confer fully protective immunity against infection by different strains nor can prevent the re-activation of the latent one. Conversely, most of the youngest women are seronegative (44.4% in women < 25 years of age) and vulnerable during pregnancy. Conclusions: Currently, cytomegalovirus screening for pregnant women is not mandatory in Italy. Considering that congenital cytomegalovirus is the leading non-genetic cause of sensorineural hearing loss, it would be extremely useful and cost-saving to screen women of childbearing age and women at early stage of pregnancy for cytomegalovirus infection in addition to increase awareness of cytomegalovirus infection and consequences among pregnant women, health care workers and the public.


Assuntos
Infecções por Citomegalovirus/epidemiologia , Citomegalovirus , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Itália/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/virologia , Gestantes , Estudos Soroepidemiológicos
10.
Behav Neurol ; 2021: 9603660, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34691283

RESUMO

Objective: To assess association between congenital cytomegalovirus (CMV) infection and brain injury in neonates. Methods: The literatures from inception to November 4, 2020, were searched through PubMed, Embase, Cochrane Library, and Web of Science. Heterogeneity test was conducted for each indicator and measured by I 2 statistics. If I 2 ≥ 50%, the random effects model was applied; otherwise, the fixed effects model was used. Sensitivity analysis was performed for all models. Weighed mean difference (WMD) was used as the effect size for measurement data, and risk ratio (RR) was as the effect indicator. Results: A total of 13 studies, including 4,262 congenital CMV infection neonates, were enrolled in this study. Our results showed that the rate of hearing impairment (RR: 2.105, 95% CI: (1.115, 3.971), P = 0.002), sensorineural hearing loss (SNHL) (RR: 17.051, 95% CI: (6.201, 46.886), P < 0.001), and microcephaly (RR: 2.283, 95% CI: (1.325, 3.935), P =0.003) in neonates infected congenital CMV was higher than that in control group. Conclusion: The risks of hearing impairment, SNHL, and microcephaly in neonates during childhood may be associated with congenital CMV infection. It is necessary to establish neonatal screening programs and comprehensive diagnostic tests for patients to reduce the risk of adverse brain damage to the congenital CMV infection as early as possible and to improve the prognosis of the newborn.


Assuntos
Lesões Encefálicas , Infecções por Citomegalovirus , Perda Auditiva Neurossensorial , Estudos de Coortes , Citomegalovirus , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/epidemiologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/epidemiologia , Humanos , Recém-Nascido
11.
BMC Infect Dis ; 21(1): 1026, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34592936

RESUMO

BACKGROUND: Cytomegalovirus (CMV) reactivation is associated with adverse prognoses of critically ill patients. However, the epidemiology and predictors of CMV reactivation in immunocompetent patients receiving mechanical ventilation (MV) are not clear. The aim of this study was to investigate the epidemiology and predictors of CMV reactivation in immunocompetent patients requiring MV. METHODS: A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with MV at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week for 28 days (Days 1, 7, 14, 21, and 28). CMV serology, laboratory findings, and clinical data were obtained during hospitalization. RESULTS: Among 71 patients, 13 (18.3%) showed CMV reactivation within 28 days in the ICU. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body mass index (BMI), sepsis, N-terminal pro-b-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), and hemoglobin (Hb) levels (P < 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were independently associated with CMV reactivation patients (P < 0.05). Moreover, the area under the receiver operating characteristic (AUROC) of BMI, Hb, and BMI combined with Hb was 0.69, 0.70, and 0.76, respectively. The duration of MV, hospitalization expense, length of ICU stay, and 90 day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P < 0.05). CONCLUSIONS: Among immunocompetent patients with MV, the incidence of CMV reactivation was 18.3%. CMV reactivation was associated with several adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.


Assuntos
Infecções por Citomegalovirus , Citomegalovirus , Estado Terminal , Infecções por Citomegalovirus/epidemiologia , Humanos , Respiração Artificial/efeitos adversos , Ativação Viral
12.
Viruses ; 13(10)2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34696506

RESUMO

Infections with viral pathogens are widespread and can cause a variety of different diseases. In-depth knowledge about viral triggers initiating an immune response is necessary to decipher viral pathogenesis. Inflammasomes, as part of the innate immune system, can be activated by viral pathogens. However, viral structural components responsible for inflammasome activation remain largely unknown. Here we analyzed glycoproteins derived from SARS-CoV-1/2, HCMV and HCV, required for viral entry and fusion, as potential triggers of NLRP3 inflammasome activation and pyroptosis in THP-1 macrophages. All tested glycoproteins were able to potently induce NLRP3 inflammasome activation, indicated by ASC-SPECK formation and secretion of cleaved IL-1ß. Lytic cell death via gasdermin D (GSDMD), pore formation, and pyroptosis are required for IL-1ß release. As a hallmark of pyroptosis, we were able to detect cleavage of GSDMD and, correspondingly, cell death in THP-1 macrophages. CRISPR-Cas9 knockout of NLRP3 and GSDMD in THP-1 macrophages confirmed and strongly support the evidence that viral glycoproteins can act as innate immunity triggers. With our study, we decipher key mechanisms of viral pathogenesis by showing that viral glycoproteins potently induce innate immune responses. These insights could be beneficial in vaccine development and provide new impulses for the investigation of vaccine-induced innate immunity.


Assuntos
Imunidade Inata/imunologia , Inflamassomos/imunologia , Macrófagos/imunologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/imunologia , Proteínas do Envelope Viral/imunologia , Proteínas Virais de Fusão/imunologia , Linhagem Celular Tumoral , Citomegalovirus/imunologia , Hepacivirus/imunologia , Humanos , Interleucina-1beta/biossíntese , Interleucina-1beta/imunologia , Piroptose/imunologia , Vírus da SARS/imunologia , SARS-CoV-2/imunologia , Células THP-1
13.
ACS Chem Neurosci ; 12(20): 3947-3956, 2021 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-34617722

RESUMO

Human cytomegalovirus (HCMV) harnesses a cell-specific manner to infect human nervous system cancer cells, establishes a life-long persistent infection without cell death, and modulates signaling pathways associated with cancer. We previously identified that the HCMV immediate-early 2 (IE2-86) protein binds and activates activating transcription factor 5 (ATF5), a survival factor in many tumor cells. In this study, we investigated a new mechanism of stress-induced miRNA regulation at the ATF5 3' UTR under the HCMV infection and other cellular stress conditions. We employed RNA-Seq and in silico analysis to screen stress response gene sets and identify miRNA candidates as potential regulators of ATF5 following HCMV infection. We found that ATF5 and cellular stress response genes were significantly upregulated under HCMV infection and diverse stress conditions. Three downregulated miRNAs were filtrated based on our threshold, and their binding sites for 3' UTR of ATF5 were predicted. Then, luciferase reporter assays were carried out to verify the binding sites for all three miRNA candidates targeting ATF5. However, in vitro validation has shown that miR-134-5p is the only candidate that can reverse the ATF5 protein upregulation under infection and other cell stresses. Additionally, miR-134-5p levels were significantly reduced and inversely related to ATF5 mRNA under HCMV infection. These results provide new evidence that quiescent HCMV infection can trigger a stress response in glioma cells and modulate ATF5 levels by downregulating specific miRNA.


Assuntos
Infecções por Citomegalovirus , Glioma , MicroRNAs , Fatores Ativadores da Transcrição/genética , Citomegalovirus/genética , Infecções por Citomegalovirus/genética , Humanos , MicroRNAs/genética
14.
Curr Opin Organ Transplant ; 26(6): 646-653, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34620783

RESUMO

PURPOSE OF REVIEW: Uterine transplantation (UTx) is a burgeoning new category of solid organ transplantation (SOT) that is practiced at several centers worldwide (first transplantation in 2013). Although there are still relatively low numbers of transplants (<75 published in literature), they are increasing in frequency and thus we attempt to discuss the current documented infections in this population as well as theoretical infectious risks and summarize prophylaxis and treatment strategies of centers current performing these procedures. RECENT FINDINGS: The most reported posttransplantation infection is not surprisingly urinary tract infections, with other documented infections including bacterial infections at site of graft (Enterococcus), herpes simplex virus, cytomegalovirus (CMV), human papillomavirus, Candida, and reportedly posttransplant lymphoproliferative disorder. The net state of immunosuppression and host factors (host colonization and serologic status of viral exposures) plays a significant role in infectious risk and with low numbers of infections documented, much of our guidance surrounding prophylaxis is inferred from SOT literature. SUMMARY: In this review, we give an overview of described infections in UTx and theoretical infectious risks, detailing how to tailor prophylaxis base on host risk, with specific focus that the goal of transplantation is completion of a successful pregnancy as the desired outcome. Special considerations should be given to pregnant recipients when managing infectious complications and further data collection and reporting regarding infectious complications is crucial to advance this field as numbers of transplantation continue to increase.


Assuntos
Infecções por Citomegalovirus , Transplante de Órgãos , Viroses , Antivirais/uso terapêutico , Citomegalovirus , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/epidemiologia , Infecções por Citomegalovirus/prevenção & controle , Humanos , Imunossupressão , Transplante de Órgãos/efeitos adversos , Viroses/epidemiologia , Viroses/prevenção & controle
15.
Int J Mol Sci ; 22(19)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34638896

RESUMO

Human cytomegalovirus (HCMV) continues to be a major cause of morbidity in transplant patients and newborns. However, the functions of many of the more than 282 genes encoded in the HCMV genome remain unknown. The development of bacterial artificial chromosome (BAC) technology contributes to the genetic manipulation of several organisms including HCMV. The maintenance of the HCMV BAC in E. coli cells permits the rapid generation of recombinant viral genomes that can be used to produce viral progeny in cell cultures for the study of gene function. We optimized the Lambda-Red Recombination system to construct HCMV gene deletion mutants rapidly in the complete set of tested genes. This method constitutes a useful tool that allows for the quick generation of a high number of gene deletion mutants, allowing for the analysis of the whole genome to improve our understanding of HCMV gene function. This may also facilitate the development of novel vaccines and therapeutics.


Assuntos
Bacteriófago lambda/genética , Cromossomos Artificiais Bacterianos/genética , Citomegalovirus/genética , Escherichia coli/genética , Deleção de Genes , Recombinação Genética , Bacteriófago lambda/metabolismo , Linhagem Celular , Clonagem Molecular/métodos , Infecções por Citomegalovirus/virologia , Genoma Viral/genética , Células HEK293 , Humanos , Mutação , Plasmídeos/genética , Reprodutibilidade dos Testes
16.
Invest Ophthalmol Vis Sci ; 62(13): 22, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34698772

RESUMO

Purpose: Considering the difficulty of obtaining adequate biological tissue in clinical practice, we established an animal model of cytomegalovirus (CMV) keratouveitis in rats and investigated the viral infection sites and corresponding imaging and histopathological features. Methods: Subconjunctival injection and topical use of dexamethasone were used to induce ocular immunosuppression in rats followed by intracameral inoculation of murine cytomegalovirus (MCMV). The clinical manifestations, intraocular pressure (IOP) and imaging changes were observed. Infected eyes were further examined by immunofluorescence, light microscopy, and electron microscopy. MCMV RNA was detected by reverse transcription-polymerase chain reaction. Results: Typical keratouveitis occurred in the experimental rats and was characterized by corneal edema, keratic precipitates, and iridocyclitis with increased IOP. Corneal endothelial lesions displayed as "black holes," enlarged intercellular gaps, and high-intensity cellular infiltration by confocal microscopy, consistent with the pathological changes of "ballooning degeneration," endothelial cell detachment, and inflammatory cell infiltration. Mitochondrial edema was the most prominent organelle lesion in endothelial cells. Trabeculitis, mechanical obstruction of Schlemm's canal, and anterior chamber angle stenosis accounted for elevated IOP. Inflammation of the iris and ciliary body tended to transform into a chronic form. Immunofluorescence revealed that corneal endothelial cells, iris cells, trabecular meshwork cells, and monocytes could be infected by MCMV. MCMV RNA was found in the anterior segments after infection. Conclusions: CMV can widely infect anterior segment tissue, including the corneal endothelium, iris, and trabecular meshwork, in vivo, inducing the corresponding clinical manifestations. Corneal endotheliitis and hypertensive anterior uveitis could be the specific stage of anterior segment infection of CMV.


Assuntos
Segmento Anterior do Olho/virologia , Infecções por Citomegalovirus/virologia , Citomegalovirus/genética , DNA Viral/análise , Infecções Oculares Virais/virologia , Uveíte Anterior/virologia , Animais , Segmento Anterior do Olho/diagnóstico por imagem , Humor Aquoso/virologia , Infecções por Citomegalovirus/diagnóstico , Modelos Animais de Doenças , Endotélio Corneano/patologia , Endotélio Corneano/virologia , Infecções Oculares Virais/diagnóstico , Feminino , Ratos , Ratos Sprague-Dawley , Uveíte Anterior/diagnóstico
17.
Transplant Proc ; 53(9): 2734-2738, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34598807

RESUMO

BACKGROUND: The primary aim of this study was to analyze the survival of patients undergoing lung transplant (LT) with cytomegalovirus (CMV)-positive serologies at the time of transplantation, according to the presence of CMV events and according to the severity of these events. The secondary objective was to assess whether there are differences in the incidence of chronic lung allograft dysfunction (CLAD) according to the presence of these events. METHODS: This was an observational, single-center, retrospective study. The inclusion criterion for the study was having undergone LT at the Hospital Universitario 12 de Octubre from October 2008 to February 2019. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. The incidence of CLAD was compared using the χ2 test. RESULTS: Inclusion criteria were met by 239 LTs. In terms of survival, no difference was found between patients with and without CMV events (log-rank P = .52), with mean survival of 3223 ± 164 days and 3024 ± 146 days, respectively. Nor did we find a difference when stratifying patients according to no CMV events, infection, syndrome, and disease (log-rank P = .6). There was also no difference in the incidence of CLAD between patients with and without CMV events (P > .178). CONCLUSION: In patients with positive CMV serology, the development of CMV events, including severe disease, does not seem to influence survival. The incidence of CLAD also is not increased by the presence of CMV events.


Assuntos
Infecções por Citomegalovirus , Transplante de Pulmão , Antivirais/uso terapêutico , Citomegalovirus , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/epidemiologia , Humanos , Incidência , Transplante de Pulmão/efeitos adversos , Estudos Retrospectivos , Transplante Homólogo
20.
Pediatrics ; 148(5)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34716219

RESUMO

Lymphomatous involvement of the larynx is a rare entity. We present a case of atypical laryngotracheitis as the initial manifestation of non-Hodgkin's lymphoma in a pediatric patient. The diagnosis was aided through the use of microbial cell-free DNA (mcfDNA) testing, which detected the presence of Epstein-Barr virus in the patient's plasma. This enabled the consideration of an Epstein-Barr virus-related lymphoproliferative process, leading to additional workup and the final diagnosis of lymphoma. To our knowledge, this is the first case of mcfDNA testing leading not simply to an infectious organism, but further to a new oncologic diagnosis. Plasma mcfDNA testing has the potential to inform clinical practice beyond classic infectious disease manifestations. In this article, we review both the possible future applications and the areas of further investigation that remain.


Assuntos
Infecções por Vírus Epstein-Barr/diagnóstico , Herpesvirus Humano 4/genética , Sequenciamento de Nucleotídeos em Larga Escala , Neoplasias Laríngeas/diagnóstico , Linfoma não Hodgkin/diagnóstico , Ácidos Nucleicos Livres/sangue , Criança , Citomegalovirus/genética , Herpesvirus Humano 4/isolamento & purificação , Humanos , Neoplasias Infratentoriais/terapia , Neoplasias Laríngeas/complicações , Neoplasias Laríngeas/virologia , Laringite/diagnóstico , Laringite/etiologia , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/virologia , Masculino , Meduloblastoma/terapia , Neoplasias da Coluna Vertebral/terapia , Tomografia Computadorizada por Raios X , Traqueíte/diagnóstico , Traqueíte/etiologia
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