Congenital cytomegalovirus infection: Diagnosis, treatment, and prevention

Karpova, A.L.; Narogan, M.V.; Karpov, N. I.

doi:10.21508/1027-4065-2017-62-1-10-18

Cited by 12 publications

(3 citation statements)

References 44 publications

(91 reference statements)

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“…Врожденная цитомегаловирусная инфекция (ЦМВИ) проявляется иктеричностью кожи, увеличением печени, селезенки, геморрагическим синдромом, уменьшением числа тромбоцитов и прогрессирующей анемией, что свидетельствует о неспецифическом характере клинической симптоматики. Для новорожденных детей с инфекцией, вызванной вирусом цитомегалии, в ряде случаев характерно также развитие энцефалита, хориоретинита и атрофии дисков зрительных нервов [2,7].…”

Section: Introductionunclassified

Prognosis of severe cytomegalovirus infection in newborns

Кравченко

2021

Russian Journal of Infection and Immunity

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Objective is to study the features of impaired activation of T and B lymphocytes in order to predicting severe cytomegalovirus infection in newborns. Materials and methods. 133 newborns with cytomegalovirus infection were examined. Immediately after diagnosing cytomegalovirus infection, all patients observed were immunologically ex amined, including assessing count of peripheral blood T and B lymphocytes, as well as their intercellular interaction by using flow cytometry immunostaining for CD3, CD3+CD28–, CD3+CD28+, CD3–CD28+, CD4, CD8, CD20, CD20+CD40+, CD28, CD40. The test was performed by using a Beckman Coulter Epics XL laser flow cytofluorometer. Depending on the condition severity, all children were divided into two groups: 1 — cytomegalovirus infection, severe form — 60 subjects (45.1%); 2 — cytomegalovirus infection, moderate form — 73 subjects (54.9%). Results of the entire set of studied indicators for cellular and humoral arms of immune system revealed statistically significant differences for the prognosis of severe cytomegalovirus infection: CD3+CD28–, CD20, CD20+CD40+, CD4. T lymphocytes with CD3+CD28+ activation markers, through which costimulating signals necessary for the activation of T helper cells are exerted cell-intrinsic features, serving as an important factor ensuring immune response. Using the “classification trees” method, we developed a differentiated approach to forecast severe cytomegalovirus infection in newborns. Systems of inequalities were obtained, four of which classify a subgroup of newborns with severe cytomegalovirus infection. The consistent application of the obtained inequalities makes it possible to isolate from the input stream of sick patients with a prognosis of the development of severe cytomegalovirus infection. The proposed diagnostic rules can be considered as screening markers for predicting a severe cytomegalovirus infection in newborns, which makes possible the timely onset of specific therapy.

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Section: Introductionunclassified

Prognosis of severe cytomegalovirus infection in newborns

Кравченко

2021

Russian Journal of Infection and Immunity

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“…Диагноз цитомегаловирусной инфекции не может быть установлен только на основании клинических данных, так как симптомы заболевания характеризуются неспецифичностью. Это заболевание у новорожденных характеризуется склонностью к генерализации, высокой частотой поражения ЦНС, трудностью диагностики, прогнозирования течения, высокой частотой инвалидизации [1,2].…”

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The importance of immunosupression in the development of the heavy form of cytomegaloviral infection in newborn children

Кравченко

2021

VIČ-infekc. immunosupr.

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Objective: to study the features of disorders in T and B cell immunity and the synthesis of serum immunoglobulins of classes IgA, IgM, IgG with the aim of predicting severe cytomegalovirus infection (CMVI) in newborns.Research methods: 133 newborns with cytomegalovirus infection were examined. Lymphocytes were typed to differentiation clusters CD3, CD4, CD8, CD20 using monoclonal antibodies, IMMUNOTECH (France). The expression of membrane markers of immunocompetent cells was determined using a Beckman COULTER EpicsXLII ﬂow laser cytoﬂuorimeter. Depending on the severity of the condition, all children were divided into two groups: 1 — CMVI, severe form — 60 people (45,1%); 2 CMVI, moderate form — 73 people (54,9%).Results. Using the «classiﬁcation trees» method, we were able to develop a differentiated approach to the prognosis of a severe form of CMVI in newborn children. Systems of inequalities were obtained, four of which classify a subgroup of newborns with severe CMVI. Conclusion: the proposed diagnostic rules can be considered screening markers for prognosis of a severe form of CMVI in newborns.

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“…В настоящее время общепризнано, что цитомегаловирусная (ЦМВ) инфекция, как и другие оппортунистические заболевания, является одной из основных причин невынашивания беременности [1], врождённых дефектов [2], а также различных заболеваний новорождённых и детей раннего возраста [3][4][5]. При этом отмечается, что первичная ЦМВ инфекция во время гестации (т. е. когда серонегативная беременная впервые инфицируется ЦМВ и происходит сероконверсия), встречается достаточно редко -0,7-4,1 % случаев.…”

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Role of Inflammatory Mediators in Endothelial Dysfunction of Umbilical Cord Vessels in Pregnant Women after Third-Trimester Nonprimary Cytomegaloviral Infection

Dorofienko

Andrievskaya

Ishutina

2021

Acta biomedica scientifica

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Background. Endothelial cells are the site of productive replication, hematogenous spread and persistence for a variety of viruses, including cytomegalovirus, which play a critical role in the development of vascular complications associated with cytomegalovirus infection due to developing endothelial dysfunction.Aim: to reveal the role of inflammatory mediators (tumor necrosis factor alpha, interleukin-1β, interleukin-8) in the formation of umbilical cord vascular endothelial dysfunction in reactivation of latent cytomegalovirus infection in the third trimester of pregnancy.Material and methods. The standard method of solid-phase (“sandwich” variant) enzyme immunoassay was carried out to study pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin-1β, -8), endothelin-1, nitrite anion in the blood of the umbilical cord of newborns from mothers who come through reactivation of latent cytomegalovirus infection in the third trimester of pregnancy. The work includes examination data of 78 newborns born at 38–40 weeks of gestation. Among them: 45 newborns were born by CMV-seropositive women with reactivation of latent cytomegalovirus infection in the third trimester of pregnancy (main group) and 33 – by CMV-seronegative women (control group). Umbilical vein blood serum was chosen as the material for the study.Results. In the blood of the umbilical vein of newborns from mothers with reactivation of latent cytomegalovirus infection in the third trimester of pregnancy, a high level of pro-inflammatory cytokines was detected: tumor necrosis factor alpha, interleukin-1β, interleukin-8 (p < 0.001) with a simultaneous increase in the content of endothelin-1 and nitrite anion (p < 0.001), compared with similar indicators for healthy newborns.Conclusion. Reactivation of latent cytomegalovirus infection in the third trimester of pregnancy is associated with the formation of a systemic fetal inflammatory response determined by a high concentration of inflammatory mediators (tumor necrosis factor alpha, interleukin-1β, interleukin-8) and an increase in vasoactive compounds (endothelin-1 and nitrite-anion) leading to the formation of dysfunction of the vascular endothelium of the umbilical cord.

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Congenital cytomegalovirus infection: Diagnosis, treatment, and prevention

Cited by 12 publications

References 44 publications

Prognosis of severe cytomegalovirus infection in newborns

Prognosis of severe cytomegalovirus infection in newborns

The importance of immunosupression in the development of the heavy form of cytomegaloviral infection in newborn children

Role of Inflammatory Mediators in Endothelial Dysfunction of Umbilical Cord Vessels in Pregnant Women after Third-Trimester Nonprimary Cytomegaloviral Infection

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