Brainstem encephalitis and acute polyneuropathy associated with hepatitis E infection

Salim, Omar; Davidson, Amy; Li, Kathy; Leach, John Paul; Heath, Craig

doi:10.1136/bcr-2017-220799

Cited by 12 publications

(3 citation statements)

References 11 publications

(4 reference statements)

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“…HEV RNA was detectable in the HEV-replicated sites, including the liver, spleen, kidneys, intestines, brain, and uterus, and this result stably confirmed the extrahepatic replication sites of HEV. HEV replication has recently been identified in the kidneys (Geng et al, 2015;Pischke et al, 2017), brain (Salim et al, 2017;Zhou et al, 2017), and reproductive organs (Soomro et al, 2017;Huang et al, 2018) of patients infected with HEV. HEV RNA and antigens were all detectable in these replication sites and will thus facilitate studies on HEV pathogenesis and tissue tropism.…”

Section: Discussionmentioning

confidence: 99%

BALB/c Mouse Is a Potential Animal Model System for Studying Acute and Chronic Genotype 4 Hepatitis E Virus Infection

Long

Yang

et al. 2020

Front. Microbiol.

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Hepatitis E virus (HEV) is the main pathogen of hepatitis worldwide. However, its infection biology and pathogenesis remain largely unknown. Suitable small-animal models are required to advance the study of HEV infection. Although an efficient model of genotype 1 (gt1) and gt3 HEV infection has been established in human liver chimeric mice, the infectivity of gt4 HEV infection in mice has not been comprehensively characterized. In this study, immunocompromised BALB/c nude, immunocompetent BALB/c, and C57BL/6 mice were inoculated with either gt3 or gt4 HEV (19 HEV strains, including human, swine, macaque-adapted, and cow HEV strains). Infectivity was identified by viral RNA and antigen detection, inflammation, and histopathological analysis. Then, HEV-infected BALB/c mice were treated with antiviral drugs. Acute HEV infection was established in BALB/c mice inoculated with eight gt4 HEV strains. However, gt3 HEV strains failed to achieve active HEV infection. HEV infection was established in BALB/c nude and regular mice inoculated with gt4 HEV but not in C57BL/6 mice. Gt4 HEV infection resulted in rapid viremia and high titers in feces, sera, and replication sites. HEV infection in mice showed no gender preference. Furthermore, chronic gt4 HEV infection was well imitated in BALB/c mice for 32 weeks and caused liver fibrosis. Conclusion: BALB/c mice have a great potential for reproducing the process of gt4 HEV infection. The successful establishment of a gt4 HEV small-animal model provides an opportunity to further understand HEV infection biology and zoonotic transmission and develop anti-HEV vaccine.

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Section: Discussionmentioning

confidence: 99%

BALB/c Mouse Is a Potential Animal Model System for Studying Acute and Chronic Genotype 4 Hepatitis E Virus Infection

Long

Yang

et al. 2020

Front. Microbiol.

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“…13 Other common predisposing microorganisms include Epstein-Barr virus, cytomegalovirus (CMV), influenza A virus, and hepatitis E virus. 14,15 In 1976, an epidemiological study showed a large increase in the incidence of GBS after swine influenza A vaccines specific to that year. 16,17 However, recent studies showed that the risk of acquiring GBS is only slightly higher after vaccination, and there is a larger benefit in reducing the occurrence of GBS after vaccination.…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

Guillain–Barre Syndrome

Malek

Salameh

2019

Semin Neurol

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Guillain–Barre syndrome (GBS) is the leading cause of acute paralysis that can potentially affect all of the human population. GBS is believed to be an immune-mediated disease, possibly triggered by a recent infection, and driven by an immune attack targeting the peripheral nervous system. GBS can be divided into several subtypes depending on the phenotype, pathophysiology, and neurophysiological features. Unfortunately, morbidity and mortality rates are still high despite the current understanding of the pathophysiology and available treatment options. Additional research is still needed to shed more light into the pathogenesis for a better understanding and treatment of this condition.

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“…Among the neuro-muscular manifestations, the commonly reported were neuralgic amyotrophy (n = 102/179; 56.98%) [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] and Guillain-Barré syndrome (n = 36/179; 20.11%) [10,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The other rarer neurological manifestations that were reported include mononeuritis multiplex [10], encephalitis [11,13,39,41], cerebral ischemia [11,39], myasthenia gravis [42], polyneuromyopathy [24,43], meningo-radiculitis [10,44], epilepsy [11], encephalopathy [45], facial nerve palsy…”

Section: Neurological and Musculoskeletal Manifestationsmentioning

confidence: 99%

A Systematic Review of the Extra-Hepatic Manifestations of Hepatitis E Virus Infection

et al. 2020

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Hepatitis E virus (HEV) is a non-enveloped, positive-sense, single-stranded RNA icosahedral virus belongs to the genus Orthohepevirus within the Hepeviridae family. HEV infection can be asymptomatic, or it can cause icteric or fulminant hepatitis. Off late, there have been a number of publications reporting the extra-hepatic manifestations of HEV infection, and this systematic review is aimed at summarizing the available evidence in this regard. Two independent investigators searched PubMed, PubMed Central and Embase databases using the search string “(((hepatitis E) AND (Extrahepatic OR Extra-Hepatic))) OR ((Hepatitis E) AND (Neurology OR Cardiology OR Respiratory OR Lung OR Gastrointestinal OR musculoskeletal OR immunology OR pulmonary)) Filters: Abstract availability, English language, and Human studies”. The extra-hepatic manifestations reported in each of the selected articles were classified and reported as neurological, cardiovascular, and hematological and miscellaneous manifestations. The total number of various manifestations reported in our study were n = 324. These include neurological manifestations (n = 178/324 (54.94%)), cardiovascular and hematological manifestations (n = 113/324 (34.88%)), gastro-intestinal/pancreaticobiliary manifestations (n = 24/324 (7.41%)) and other rarer manifestations involving systems such as renal (n = 4/324; 1.24%), endocrine (n = 1/324; 0.31%), dermatology (n = 1/324; 0.31%), respiratory (n = 1/324; 0.31%), muscular (n = 1/324; 0.31%) and immune system (n = 1/324; 0.31%). Thus, HEV can have extra-hepatic manifestations affecting any system of the human body. Further research is needed to elucidate the underlying pathophysiological manifestations of these extra-hepatic manifestations and to prove causal association with HEV.

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Brainstem encephalitis and acute polyneuropathy associated with hepatitis E infection

Cited by 12 publications

References 11 publications

BALB/c Mouse Is a Potential Animal Model System for Studying Acute and Chronic Genotype 4 Hepatitis E Virus Infection

BALB/c Mouse Is a Potential Animal Model System for Studying Acute and Chronic Genotype 4 Hepatitis E Virus Infection

Guillain–Barre Syndrome

A Systematic Review of the Extra-Hepatic Manifestations of Hepatitis E Virus Infection

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