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1.
MMWR Morb Mortal Wkly Rep ; 69(3): 67-71, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31971935

RESUMO

Zika virus infection during pregnancy can cause congenital brain and eye abnormalities and is associated with neurodevelopmental abnormalities (1-3). In areas of the United States that experienced local Zika virus transmission, the prevalence of birth defects potentially related to Zika virus infection during pregnancy increased in the second half of 2016 compared with the first half (4). To update the previous report, CDC analyzed population-based surveillance data from 22 states and territories to estimate the prevalence of birth defects potentially related to Zika virus infection, regardless of laboratory evidence of or exposure to Zika virus, among pregnancies completed during January 1, 2016-June 30, 2017. Jurisdictions were categorized as those 1) with widespread local transmission of Zika virus; 2) with limited local transmission of Zika virus; and 3) without local transmission of Zika virus. Among 2,004,630 live births, 3,359 infants and fetuses with birth defects potentially related to Zika virus infection during pregnancy were identified (1.7 per 1,000 live births, 95% confidence interval [CI] = 1.6-1.7). In areas with widespread local Zika virus transmission, the prevalence of birth defects potentially related to Zika virus infection during pregnancy was significantly higher during the quarters comprising July 2016-March 2017 (July-September 2016 = 3.0; October-December 2016 = 4.0; and January-March 2017 = 5.6 per 1,000 live births) compared with the reference period (January-March 2016) (1.3 per 1,000). These findings suggest a fourfold increase (prevalence ratio [PR] = 4.1, 95% CI = 2.1-8.4) in birth defects potentially related to Zika virus in widespread local transmission areas during January-March 2017 compared with that during January-March 2016, with the highest prevalence (7.0 per 1,000 live births) in February 2017. Population-based birth defects surveillance is critical for identifying infants and fetuses with birth defects potentially related to Zika virus regardless of whether Zika virus testing was conducted, especially given the high prevalence of asymptomatic disease. These data can be used to inform follow-up care and services as well as strengthen surveillance.


Assuntos
Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/virologia , Vigilância da População , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/complicações , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Prevalência , Porto Rico/epidemiologia , Estados Unidos/epidemiologia , Ilhas Virgens Americanas/epidemiologia
2.
Arch Oral Biol ; 110: 104598, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31775105

RESUMO

BACKGROUND: In Brazil, in October 2015, an outbreak of Zika virus (ZIKV) infection and an increase in newborns with microcephaly suggested a relationship between maternal infection and microcephaly in children. OBJECTIVE: First, to assess the presence of dental bud sin 13 infants with a confirmed diagnosis of congenital ZIKV syndrome, born to mothers infected with the virus during pregnancy; second, to evaluate the dental development of these children at a 36-month follow-up. DESIGN: Case-based longitudinal study. RESULTS: Dental radiographs in the first semester showed that all children had dental buds. Along with the study, the individuals presented with various dental disturbances. At the end of the evaluation period, some children still had incomplete deciduous dentition. CONCLUSION: The abnormal chronology of dental eruption and dental development disturbances in children with microcephaly infected with ZIKV born to infected mothers indicate a possible role of the virus in odontogenesis.


Assuntos
Odontogênese , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Brasil , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Mães , Gravidez , Síndrome , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito
3.
Arch. argent. pediatr ; 117(6): 635-639, dic. 2019. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1046601

RESUMO

En 2015, se observó un incremento en la incidencia de microcefalia congénita en recién nacidos en Brasil. Meses más tarde, se descubrió la relación causal entre el virus del Zika y estos hallazgos. Durante el primer brote en la Argentina, se reportaron 5 casos de síndrome de Zika congénito. En 2017, hubo un nuevo brote que involucró la provincia de Salta. En este trabajo, se presentan 2 casos clínicos con síndrome de Zika congénito autóctonos: una paciente con microcefalia congénita grave con lisencefalia, calcificaciones corticosubcorticales y ventriculomegalia y otra paciente con microcefalia posnatal con polimicrogiria asimétrica y calcificaciones subcorticales y retraso en la mielinización. El real impacto de esta enfermedad aún es incierto; es necesario un adecuado seguimiento multidisciplinario de los pacientes expuestos al virus del Zika para comprender mejor la infección y su historia natural.


In 2015, there was an increase in the incidence of congenital microcephaly in newborns in Brazil. Months later, the causal relationship between Zika virus and these findings was discovered. In Argentina, during the first outbreak there were 5 cases of congenital Zika syndrome reported. In 2017, there was a new outbreak which involved Salta province. We describe 2 patients with autochthonous congenital Zika syndrome: one of the babies with severe congenital microcephaly with lissencephaly, calcifications and ventriculomegaly; and another baby with postnatal microcephaly with asymmetric polymicrogyria, calcifications and delayed myelination. The real impact of this disease is still uncertain, so it is necessary an adequate multidisciplinary monitoring of patients exposed to Zika virus to better understand the infection and its natural history.


Assuntos
Humanos , Feminino , Recém-Nascido , Lactente , Complicações Infecciosas na Gravidez , Deficiências do Desenvolvimento/etiologia , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito , Microcefalia
4.
Clinics (Sao Paulo) ; 74: e798, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644665

RESUMO

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student's t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with p<0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (p<0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status.


Assuntos
Microcefalia/fisiopatologia , Estado Nutricional/fisiologia , Infecção por Zika virus/complicações , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Microcefalia/virologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Adulto Jovem
5.
PLoS Negl Trop Dis ; 13(10): e0007763, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589611

RESUMO

Defining cases of Zika virus (ZIKV) infection is a critical challenge for epidemiological research. Due to ZIKV's overlapping clinical features and potential immunologic cross-reactivity with other flaviviruses and the current lack of an optimal ZIKV-specific diagnostic assay, varying approaches for identifying ZIKV infections have been employed to date. This paper presents the laboratory results and diagnostic criteria developed by the Microcephaly Epidemic Research Group for defining cases of maternal ZIKV infection in a cohort of pregnant women with rash (N = 694) recruited during the declining 2015-2017 epidemic in northeast Brazil. For this investigation, we tested maternal sera for ZIKV by quantitative reverse transcription polymerase chain reaction (qRT-PCR), Immunoglobulin (Ig) M and IgG3 enzyme-linked immunosorbent assays (ELISAs), and Plaque Reduction Neutralization Test (PRNT50). Overall, 23.8% of participants tested positive by qRT-PCR during pregnancy (range of detection: 0-72 days after rash onset). However, the inter-assay concordance was lower than expected. Among women with qRT-PCR-confirmed ZIKV and further testing, only 10.1% had positive IgM tests within 90 days of rash, and only 48.5% had ZIKV-specific PRNT50 titers ≥20 within 1 year of rash. Given the complexity of these data, we convened a panel of experts to propose an algorithm for identifying ZIKV infections in pregnancy based on all available lines of evidence. When the diagnostic algorithm was applied to the cohort, 26.9% of participants were classified as having robust evidence of a ZIKV infection during pregnancy, 4.0% as having moderate evidence, 13.3% as having limited evidence of a ZIKV infection but with uncertain timing, and 19.5% as having evidence of an unspecified flavivirus infection before or during pregnancy. Our findings suggest that integrating longitudinal data from nucleic acid and serologic testing may enhance diagnostic sensitivity and underscore the need for an on-going dialogue regarding the optimization of strategies for defining cases of ZIKV in research.


Assuntos
Exantema/epidemiologia , Exantema/imunologia , Complicações na Gravidez/imunologia , Infecção por Zika virus/complicações , Infecção por Zika virus/imunologia , Algoritmos , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Estudos de Coortes , Reações Cruzadas , Ensaio de Imunoadsorção Enzimática , Exantema/diagnóstico , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Testes de Neutralização , Gravidez , Zika virus/imunologia , Infecção por Zika virus/epidemiologia
6.
Sex Reprod Health Matters ; 27(2): 1586818, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31533583

RESUMO

Since the beginning of the Zika virus epidemic, the Brazilian Ministry of Health has reported over 2000 confirmed cases of microcephaly associated with Zika virus in Brazil, with the cases concentrated in the northeast states. The Zika epidemic reopened a debate in Brazil that has played out in the national newspapers about expanding the abortion law to provide autonomy and legal protection to women. The argument for expanding the abortion law to include microcephaly secondary to Zika virus infection called for autonomy for women and, more broadly, protection of reproductive rights. The argument against expanding the current abortion law was separated into two main moral veins: those citing eugenics and those citing religious beliefs. However, the debate on abortion in the case of microcephaly accomplished more than giving a voice to two different viewpoints; it exposed health disparities that exist in Brazil, which were magnified by Zika virus, and reopened the political arena for discussion of the abortion law.


Assuntos
Aborto Induzido/psicologia , Microcefalia/psicologia , Microcefalia/virologia , Complicações Infecciosas na Gravidez/psicologia , Infecção por Zika virus/complicações , Infecção por Zika virus/psicologia , Aborto Induzido/legislação & jurisprudência , Brasil , Tomada de Decisões , Surtos de Doenças , Feminino , Humanos , Jornais como Assunto , Política , Gravidez , Complicações Infecciosas na Gravidez/virologia , Direitos Sexuais e Reprodutivos , Zika virus
7.
Nat Commun ; 10(1): 4155, 2019 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519912

RESUMO

Zika virus (ZIKV) infection results in an increased risk of spontaneous abortion and poor intrauterine growth although the underlying mechanisms remain undetermined. Little is known about the impact of ZIKV infection during the earliest stages of pregnancy, at pre- and peri-implantation, because most current ZIKV pregnancy studies have focused on post-implantation stages. Here, we demonstrate that trophectoderm cells of pre-implantation human and mouse embryos can be infected with ZIKV, and propagate virus causing neural progenitor cell death. These findings are corroborated by the dose-dependent nature of ZIKV susceptibility of hESC-derived trophectoderm cells. Single blastocyst RNA-seq reveals key transcriptional changes upon ZIKV infection, including nervous system development, prior to commitment to the neural lineage. The pregnancy rate of mice is >50% lower in pre-implantation infection than infection at E4.5, demonstrating that pre-implantation ZIKV infection leads to miscarriage. Cumulatively, these data elucidate a previously unappreciated association of pre- and peri-implantation ZIKV infection and microcephaly.


Assuntos
Complicações Infecciosas na Gravidez/metabolismo , Infecção por Zika virus/complicações , Infecção por Zika virus/metabolismo , Zika virus/patogenicidade , Aborto Espontâneo/metabolismo , Aborto Espontâneo/fisiopatologia , Animais , Blastocisto/citologia , Blastocisto/metabolismo , Implantação do Embrião/fisiologia , Feminino , Desenvolvimento Fetal/genética , Desenvolvimento Fetal/fisiologia , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , RNA Viral/genética , Pesquisa Médica Translacional/métodos , Trofoblastos/citologia , Trofoblastos/metabolismo
8.
PLoS Negl Trop Dis ; 13(9): e0007721, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31545803

RESUMO

This study aimed to assess the impact of the Zika epidemic on the registration of birth defects in Brazil. We used an interrupted time series analysis design to identify changes in the trends in the registration of congenital anomalies. We obtained monthly data from Brazilian Live Birth Information System and used two outcome definitions: 1) rate of congenital malformation of the brain and eye (likely to be affected by Zika and its complications) 2) rate of congenital malformation not related to the brain or eye unlikely to be causally affected by Zika. The period between maternal infection with Zika and diagnosis of congenital abnormality attributable to the infection is around six months. We therefore used September 2015 as the interruption point in the time series, six months following March 2015 when cases of Zika started to increase. For the purposes of this analysis, we considered the period from January 2010 to September 2015 to be "pre-Zika event," and the period from just after September 2015 to December 2017 to be "post-Zika event." We found that immediately after the interruption point, there was a great increase in the notification rate of congenital anomalies of 14.9/10,000 live births in the brain and eye group and of 5.2/10,000 live births in the group not related with brain or eye malformations. This increase in reporting was in all regions of the country (except in the South) and especially in the Northeast. In the period "post-Zika event", unlike the brain and eye group which showed a monthly decrease, the group without brain or eye malformations showed a slow but significant increase (relative to the pre-Zika trend) of 0.2/10,000 live births. These findings suggest an overall improvement in the registration of birth malformations, including malformations that were not attributed to Zika, during and after the Zika epidemic.


Assuntos
Anormalidades Congênitas/epidemiologia , Sistema de Registros/normas , Infecção por Zika virus/complicações , Encéfalo/anormalidades , Brasil/epidemiologia , Anormalidades Congênitas/virologia , Coleta de Dados/normas , Epidemias/estatística & dados numéricos , Anormalidades do Olho/epidemiologia , Feminino , Humanos , Análise de Séries Temporais Interrompida , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Zika virus , Infecção por Zika virus/epidemiologia
9.
PLoS Pathog ; 15(8): e1007766, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31369649

RESUMO

Zika virus (ZIKV) and dengue virus (DENV) are genetically and antigenically related flaviviruses that now co-circulate in much of the tropical and subtropical world. The rapid emergence of ZIKV in the Americas in 2015 and 2016, and its recent associations with Guillain-Barré syndrome, birth defects, and fetal loss have led to the hypothesis that DENV infection induces cross-reactive antibodies that influence the severity of secondary ZIKV infections. It has also been proposed that pre-existing ZIKV immunity could affect DENV pathogenesis. We examined outcomes of secondary ZIKV infections in three rhesus and fifteen cynomolgus macaques, as well as secondary DENV-2 infections in three additional rhesus macaques up to a year post-primary ZIKV infection. Although cross-binding antibodies were detected prior to secondary infection for all animals and cross-neutralizing antibodies were detected for some animals, previous DENV or ZIKV infection had no apparent effect on the clinical course of heterotypic secondary infections in these animals. All animals had asymptomatic infections and, when compared to controls, did not have significantly perturbed hematological parameters. Rhesus macaques infected with DENV-2 approximately one year after primary ZIKV infection had higher vRNA loads in plasma when compared with serum vRNA loads from ZIKV-naive animals infected with DENV-2, but a differential effect of sample type could not be ruled out. In cynomolgus macaques, the serotype of primary DENV infection did not affect the outcome of secondary ZIKV infection.


Assuntos
Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Coinfecção/virologia , Vírus da Dengue/imunologia , Dengue/virologia , Infecção por Zika virus/virologia , Zika virus/imunologia , Animais , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Coinfecção/sangue , Coinfecção/complicações , Reações Cruzadas , Dengue/sangue , Dengue/complicações , Feminino , Macaca mulatta , Masculino , Infecção por Zika virus/sangue , Infecção por Zika virus/complicações
10.
Nat Med ; 25(8): 1213-1217, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31285631

RESUMO

We report neurodevelopmental outcomes in 216 infants followed since the time of PCR-confirmed maternal Zika virus (ZIKV) infection in pregnancy during the Rio de Janeiro epidemic of 2015-2016 (refs. 1,2). Neurodevelopment was assessed by Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; cognitive, language and motor domains) in 146 children and through neurodevelopment questionnaires/neurological examinations in 70 remaining children. Complete eye exams (n = 137) and hearing assessments (n = 114) were also performed. Below-average neurodevelopment and/or abnormal eye or hearing assessments were noted in 31.5% of children between 7 and 32 months of age. Among children assessed by Bayley-III, 12% scored below -2 s.d. (score <70; a score of 100 ± 2 s.d. is the range) in at least one domain; and 28% scored between -1 and -2 s.d. in any domain (scores <85-70). Language function was most affected, with 35% of 146 children below average. Improved neurodevelopmental outcomes were noted in female children, term babies, children with normal eye exams and maternal infection later in pregnancy (P = 0.01). We noted resolution of microcephaly with normal neurodevelopment in two of eight children, development of secondary microcephaly in two other children and autism spectrum disorder in three previously healthy children in the second year of life.


Assuntos
Transtornos do Neurodesenvolvimento/etiologia , Transtornos das Sensações/etiologia , Infecção por Zika virus/congênito , Infecção por Zika virus/complicações , Adulto , Transtorno do Espectro Autista/etiologia , Pré-Escolar , Feminino , Audição , Humanos , Lactente , Recém-Nascido , Masculino , Microcefalia/etiologia , Gravidez , Complicações Infecciosas na Gravidez , Estudos Prospectivos , Visão Ocular
11.
Rev Assoc Med Bras (1992) ; 65(6): 909-913, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340324

RESUMO

INTRODUCTION: The Zika virus (ZIKV) is an arbovirus isolated for the first time in 1947 and transmitted to humans by the Aedes aegypti mosquito. In Brasil, it was first detected in May 2015. Since then, ZIKV has been identified as the etiological agent of acute exanthematous disease in Brasil, and Neuropediatricians of the Recife warned about an epidemic of microcephaly, and the Brazilian Ministry of Health confirmed the association between ZIKV and Congenital malformations and neurological syndromes. The eye, as an extension of the developing brain, has been examined in patients with microcephaly and maternal history of ZIKV infection. METHODS: Twenty newborn patients with microcephaly, whose mothers had presumed Zika virus during pregnancy, were analyzed through medical records. The nonparametric chi-square statistic was used to verify the association between head circumference and ocular alteration at a significance level of 0.0001. RESULTS: The significance of P = 0.000 in the value of non-parametric chi-square statistics was lower than the value of α = 0.0001, demonstrating that, at a level of 0.0001, there is an association between head circumference and ocular alteration. CONCLUSION: Although the knowledge of the natural evolution of the disease is still scarce, the current evidence is strong enough to establish a causal relationship between ZIKV infection during pregnancy and the increased incidence of the microcephaly and serious eye alterations that lead to the severe lower vision of these children.


Assuntos
Cefalometria , Oftalmopatias/virologia , Microcefalia/virologia , Infecção por Zika virus/complicações , Brasil , Oftalmopatias/patologia , Feminino , Cabeça/patologia , Humanos , Lactente , Masculino , Microcefalia/patologia , Valores de Referência
12.
Rev Soc Bras Med Trop ; 52: e20190105, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340371

RESUMO

INTRODUCTION: Clinical and epidemiological data on suspected congenital Zika syndrome (CZS) cases from southern Mato Grosso (MT) in Brazil during the Zika virus (ZIKV) outbreak in 2015-2016 were evaluated. METHODS: This is a descriptive case series study of newborns whose mothers were suspected cases of ZIKV infections during their pregnancies. The medical records of all the suspected CZS cases (mothers and newborns) treated by the specialized ambulatory service from June 2015 to August 2016 were analyzed. RESULTS: Twenty suspected CZS cases were included in these analyses. They were categorized into four groups based on the clinical and laboratory findings: confirmed cases (n=1), highly probable cases (n=13), moderately probable cases (n=5), and somewhat probable cases (n=1). The mothers tested negative for STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) and other important congenital infections; however, specific ZIKV tests were not performed during the study period. Microcephaly was observed in the majority of these newborns, and all the patients showed altered cranial computed tomography image findings. Extracranial abnormalities such as arthrogryposis, and otological and ophthalmological manifestations were also observed. CONCLUSIONS: Although ZIKV was not confirmed to cause the congenital malformations, this study demonstrated that the clinical and epidemiological findings associated with a STORCH exclusion strengthened the CZS diagnosis. The suspected cases in MT occurred simultaneously with the first CZS cases reported in Brazil, suggesting ZIKV circulation in the study region during the same period.


Assuntos
Microcefalia/virologia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Zika virus/isolamento & purificação , Adolescente , Adulto , Brasil/epidemiologia , Surtos de Doenças , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Fatores Socioeconômicos , Adulto Jovem , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito
16.
PLoS One ; 14(6): e0218539, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31220154

RESUMO

Zika virus (ZIKV) is a mosquito-borne flavivirus associated with microcephaly and other neurological disorders in infants born to infected mothers. Despite being declared an international emergency by the World Health Organization, very little is known about the mechanisms of ZIKV pathogenesis or the long-term consequences of maternal ZIKV infection in the affected offspring, largely due to the lack of appropriate rodent models. To address this issue, our lab has developed a working model of prenatal ZIKV infection in rats. In this study, we infected immune competent pregnant female rats with 105-107 PFU of ZIKV (PRVABC59, Puerto Rico/Human/Dec 2015) in order to examine its pathogenesis in the dams and pups. We examined the febrile response and sickness behavior in the dams, in addition to neonatal mortality, microglia morphology, cortical organization, apoptosis, and brain region-specific volumes in the offspring. Here, we demonstrate that pregnant and non-pregnant female rats have a distinct febrile response to ZIKV infection. Moreover, prenatal ZIKV infection increased cell death and reduced tissue volume in the hippocampus and cortex in the neonatal offspring. For the first time, we demonstrate the efficacy and validity of an immunocompetent rat model for maternal ZIKV infection that results in significant brain malformations in the neonatal offspring.


Assuntos
Efeitos Tardios da Exposição Pré-Natal/patologia , Convulsões/patologia , Infecção por Zika virus/patologia , Animais , Apoptose , Córtex Cerebral/metabolismo , Córtex Cerebral/patologia , Feminino , Hipocampo/metabolismo , Hipocampo/patologia , Masculino , Microglia/metabolismo , Microglia/patologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Ratos , Ratos Sprague-Dawley , Convulsões/etiologia , Convulsões/fisiopatologia , Células Vero , Infecção por Zika virus/complicações , Infecção por Zika virus/fisiopatologia
17.
Acta Trop ; 197: 105064, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31220435

RESUMO

Guillain-Barre syndrome (GBS) is one of the main neurologic manifestations of arboviruses, especially Zika virus infection. As known, the prevalence of these diseases is high, so the risk of having an increase on GBS is relevant. The study purposes making a comparative survey between the involvement of dengue, Zika and chikungunya infections in the development of the GBS in Brazil, as well as search in literature resemblances and distinctions between beforehand reported cases. It was performed an electronic search in online databases, with articles published between the years of 2004-2018. A total of 729 articles about the proposed search were found, and 10 were selected according to inclusion and exclusion criteria. The medium age found in Brazilian studies was 429. The time lapse for the neurological symptoms manifest was 6,5-11 days. Facial palsy, paresthesia and member weakness were the main symptoms related. Pediatric cases are rare. There are many studies that implicated the association of GBS and arboviruses and point it to one of the main neurological manifestation of these infections. More research and consistent data are needed to clarify unanswered questions and guide public health measures.


Assuntos
Febre de Chikungunya/complicações , Dengue/complicações , Síndrome de Guillain-Barré/etiologia , Infecção por Zika virus/complicações , Feminino , Humanos , Masculino , Inquéritos e Questionários
19.
Fisioter. Pesqui. (Online) ; 26(2): 145-150, abr.-jun. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1012137

RESUMO

RESUMO O objetivo do estudo foi avaliar longitudinalmente o desempenho funcional de lactentes acometidos pela síndrome congênita do zika (SCZ). Realizou-se um estudo com lactentes provenientes do Laboratório de Estudos em Pediatria da Universidade Federal de Pernambuco e da Aliança de Mães e Famílias Raras, com idade entre 6 e 24 meses, de ambos os sexos. O Inventário de Avaliação Pediátrica de Incapacidade (PEDI) foi aplicado para análise do desempenho funcional em duas avaliações, com no mínimo seis meses de intervalo. A análise dos dados foi realizada pelo teste de Wilcoxon. Na amostra de 16 lactentes, observou-se que entre as avaliações houve mudança na classificação de normal para atraso nos domínios de autocuidado e função social, com diminuição significativa dos escores normativos (p=0,001 e p<0,001, respectivamente); na mobilidade, os lactentes inicialmente classificados com atraso também apresentaram redução dos escores normativos (p=0,001), mantendo-se na classificação. Apesar do aumento significativo nos escores brutos do autocuidado (p=0,024) e mobilidade (p=0,001), os lactentes continuaram classificados em atraso. Na assistência do cuidador, 100% dos lactentes se encontraram em atraso nos três domínios do PEDI, recebendo assistência máxima ou total. As principais modificações ambientais encontradas foram as centradas na criança. Em suma, os lactentes com SCZ deste estudo apresentaram atrasos significativos no desempenho funcional, com uma evolução lenta no intervalo de tempo avaliado.


RESUMEN El objetivo del estudio fue evaluar longitudinalmente el desempeño funcional de lactantes con síndrome congénito del zika (SCZ). Se realizó un estudio con lactantes de entre 6 y 24 meses, de ambos los sexos, identificados por el Laboratorio de Estudios en Pediatría de la Universidad Federal de Pernambuco y por la Aliança de Mães e Famílias Raras (Alianza de Madres y Familias Raras). Se aplicó el Inventario de Evaluación Pediátrica de Discapacidad (PEDI) para análisis del desempeño funcional en dos evaluaciones, con al menos seis meses de intervalo. El análisis de los datos fue realizado por la prueba de Wilcoxon. En la muestra de 16 lactantes se observó cambio en los campos de autocuidado y función social, de "normal" para "retraso", con disminución significativa de los puntajes normativos (p=0,001 y p<0,001, respectivamente). En la movilidad, los lactantes inicialmente clasificados con retraso también presentaron reducción de los puntajes normativos (p=0,001), manteniéndose en la clasificación. A pesar del aumento significativo en los puntajes netos del autocuidado (p=0,024) y movilidad (p=0,001), los lactantes continuaron clasificados en retraso. En la asistencia del cuidador, un 100% de los lactantes se encontraban en retraso en los tres dominios del PEDI, recibiendo asistencia máxima o total. Las principales modificaciones ambientales encontradas fueron las centradas en el niño. En resumen, los lactantes con SCZ presentaron retrasos significativos en el desempeño funcional, con una evolución lenta en el intervalo de tiempo evaluado.


ABSTRACT This study aimed to longitudinally evaluate the functional performance of infants affected by Congenital Zika Syndrome (CZS). A study was carried out with infants from the Laboratório de Estudos em Pediatria of the Universidade Federal de Pernambuco and the Aliança de Mães e Famílias Raras, aged between 6 and 24 months, of both genders. The Pediatric Evaluation of Disability Inventory (PEDI) was applied to analyze functional performance in two evaluations, with a minimum of six months interval between them. Data analysis was performed using the Wilcoxon test. In the sample of 16 infants, we observed a change in the classification from normal to delay in the domains of self-care and social function, with a significant decrease in normative scores (p=0.001 and p<0.001, respectively); in the mobility, individuals initially classified with delay also presented reduction of normative scores (p=0.001), remaining in the same classification. Despite the significant increase in gross self-care scores (p=0.024) and mobility (p=0.001), infants remained classified as delayed. Caregiver care was analyzed in these evaluation, in which 100% of infants were delayed in all three domains of the PEDI, receiving maximum or full care. The main environmental modifications were those focused on the child. We concluded that infants with CZS presented significant delays in functional performance, with a slow evolution in the evaluated range.


Assuntos
Humanos , Masculino , Feminino , Lactente , Desenvolvimento Infantil , Infecção por Zika virus/congênito , Complicações Infecciosas na Gravidez , Deficiências do Desenvolvimento/etiologia , Estudos Longitudinais , Neuroimagem Funcional , Infecção por Zika virus/complicações
20.
mSphere ; 4(3)2019 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068433

RESUMO

Zika virus (ZIKV) infection during pregnancy leads to devastating fetal outcomes, including neurological (microcephaly) and ocular pathologies such as retinal lesions, optic nerve abnormalities, chorioretinal atrophy, and congenital glaucoma. Only clinical case reports have linked ZIKV infection to causing glaucoma, a major blinding eye disease. In the present study, we have investigated the role of ZIKV in glaucoma pathophysiology using in vitro and in vivo experimental models. We showed that human primary trabecular meshwork (Pr. TM) cells, as well as a human GTM3 cell line, were permissive to ZIKV infection. ZIKV induced the transcription of various genes expressing pattern recognition receptors (TLR2, TLR3, and RIG-I), cytokines/chemokines (TNF-α, IL-1ß, CCL5, and CXCL10), interferons (IFN-α2, IFN-ß1, and IFN-γ), and interferon-stimulated genes (ISG15 and OAS2) in Pr. TM cells. ZIKV infection in IFNAR1-/- and wild-type (WT) mouse eyes resulted in increased intraocular pressure (IOP) and the development of chorioretinal atrophy. Anterior chamber (AC) inoculation of ZIKV caused infectivity in iridocorneal angle and TM, leading to the death of TM cells in the mouse eyes. Moreover, anterior segment tissue of infected eyes exhibited increased expression of inflammatory mediators and interferons. Furthermore, ZIKV infection in IFNAR1-/- mice resulted in retinal ganglion cell (RGC) death and loss, coinciding with optic nerve infectivity and disruption of anterograde axonal transport. Because of similarity in glaucomatous pathologies in our study and other experimental glaucoma models, ZIKV infection can be used to study infectious triggers of glaucoma, currently an understudied area of investigation.IMPORTANCE Ocular complications due to ZIKV infection remains a major public health concern because of their ability to cause visual impairment or blindness. Most of the previous studies have shown ZIKV-induced ocular pathology in the posterior segment (i.e., retina) of the eye. However, some recent clinical reports from affected countries highlighted the importance of ZIKV in affecting the anterior segment of the eye and causing congenital glaucoma. Because glaucoma is the second leading cause of blindness worldwide, it is imperative to study ZIKV infection in causing glaucoma to identify potential targets for therapeutic intervention. In this study, we discovered that ZIKV permissively infects human TM cells and evokes inflammatory responses causing trabeculitis. Using a mouse model, we demonstrated that ZIKV infection resulted in higher IOP, increased RGC loss, and optic nerve abnormalities, the classical hallmarks of glaucoma. Collectively, our study provides new insights into ocular ZIKV infection resulting in glaucomatous pathology.


Assuntos
Olho/patologia , Olho/virologia , Glaucoma/virologia , Malha Trabecular/virologia , Infecção por Zika virus/complicações , Zika virus/patogenicidade , Animais , Morte Celular , Linhagem Celular , Quimiocinas/genética , Citocinas/genética , Modelos Animais de Doenças , Feminino , Glaucoma/fisiopatologia , Humanos , Interferons/genética , Pressão Intraocular , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/virologia , Malha Trabecular/patologia , Transcriptoma , Infecção por Zika virus/patologia
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