Dengue in Patients with Central Nervous System Manifestations, Brazil

Araújo, Fernanda Montenegro de Carvalho; Nogueira, Rita Maria Ribeiro; Araújo, Maurício de Sousa; Perdigão, Anne Carolinne Bezerra; Cavalcanti, Luciano Pamplona de Góes; Brilhante, Raimunda Sâmia Nogueira; Rocha, Marcos Fábio Gadelha; Vilar, Dina Feitosa; Holanda, Suzana Silveira; Braga, Deborah de Melo; Sidrim, José Júlio Costa

doi:10.3201/eid1804.111552

Cited by 31 publications

(29 citation statements)

References 13 publications

(20 reference statements)

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“…En la mayoría de estudios con pacientes, las manifestaciones neurológicas se han observado más frecuentemente en aquellos infectados con el DENV-2 (8), un hallazgo que coincide con lo reportado por Araujo, et al (11), y Solomon, et al (12), en el sentido de que este serotipo posee características intrínsecas que propician su efecto en el sistema nervioso. En el presente trabajo, la infección con el DENV-2 causó un evidente efecto citopático en los cultivos de neuroblastoma, así como pérdida de viabilidad, la cual fue más evidente cuando se usó una mayor multiplicidad de infección.…”

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“…Los signos neurológicos que se han reportado incluyen desde cefaleas intensas y vómito en niños, hasta alteraciones de la conciencia o la conducta, convulsiones, polineuropatías, síndrome de Guillain-Barré y mielitis transversa (11); en varios casos se ha podido encontrar ARN viral o anticuerpos en el líquido cefalorraquídeo, lo cual demuestra replicación en el sistema nervioso (12).…”

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La infección con el virus del dengue induce apoptosis en células del neuroblastoma humano SH-SY5Y

2016

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Contribución de los autores:Jaime E. Castellanos: ejecución del proyecto, análisis e interpretación de datos José I. Neissa: aplicación de la metodología Sigrid J. Camacho: análisis e interpretación de datos Todos los autores participaron en la redacción del manuscrito. Introducción. El dengue es una enfermedad humana producida por el virus del mismo nombre, que se transmite por la picadura de mosquitos del género Aedes. La infección tiene una amplia gama de presentaciones clínicas que van desde la ausencia de síntomas hasta los casos fatales y afecta principalmente a la población pediátrica. Según la nueva clasificación de la enfermedad, las manifestaciones neurológicas se consideran un criterio para el diagnóstico del dengue grave. Objetivo. Evaluar los posibles mecanismos involucrados en la aparición de los signos neurológicos en una línea celular de neuronas humanas, como modelo de infección con el virus del dengue del serotipo 2 (DENV-2). Materiales y métodos. Se evaluó la sensibilidad y la permisividad de la línea celular SH-SY5Y a la infección por el DENV-2; se encontró que la proporción entre infección y producción viral era similar a las de las células de primates usadas como control positivo de la infección. La infección con el virus del dengue induce apoptosis en células del neuroblastoma humano SH-SY5YResultados. La infección indujo un efecto citopático en la línea celular de neuroblastoma caracterizado por un proceso de muerte apoptótica, con aumento en la proporción de células positivas al emplear los métodos de anexina V y TUNEL. Se encontró una regulación positiva del factor de necrosis tumoral alfa (TNF-α), y el tratamiento con un anticuerpo anti-TNF-α aumentó ligeramente la supervivencia de las células infectadas. La adición de TNF-α exógeno a los cultivos infectados potenció la muerte celular. Conclusión. Estos resultados sugieren, en su conjunto, que la regulación positiva del TNF-α podría hacer parte del proceso que induce daño y muerte celular durante el desarrollo de la encefalitis por dengue.Palabras clave: dengue, apoptosis, factor de necrosis tumoral alfa, supervivencia celular, manifestaciones neurológicas, encefalitis. doi: http://dx.doi.org/10.7705/biomedica.v36i0.2984 Dengue virus induces apoptosis in SH-SY5Y human neuroblastoma cellsIntroduction: Dengue is a human disease caused by a virus with the same name, which is transmitted by the bite of Aedes mosquitoes. The infection has a wide range of clinical presentations ranging from asymptomatic to fatal cases, with the pediatric population being the most susceptible. According to the new classification of the disease, the neurological manifestations are considered a criterion for the diagnosis of severe dengue. Conclusion:These results as a whole suggest that the upregulation of TNF-α could be part of the process that induces cell damage and death in cases of dengue encephalitis.

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La infección con el virus del dengue induce apoptosis en células del neuroblastoma humano SH-SY5Y

2016

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“…However, some reports indicating the unequivocal presence of viral proteins and genetic viral material in the brain and CSF of infected individuals suggest otherwise (Araujo et al , 2012; Soares et al , 2006; Solomon et al , 2000). Thus, the nature and mechanisms of CNS injury induced by these viruses must be examined.…”

Section: Blood-brain Barrier (Bbb) Dysfunction and Cns Compromisementioning

confidence: 99%

Flaviviruses, an expanding threat in public health: focus on dengue, West Nile, and Japanese encephalitis virus

2014

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The flaviviruses Dengue, West Nile, and Japanese encephalitis represent three major mosquito-borne viruses worldwide. These pathogens impact the lives of millions of individuals and potentially could affect non-endemic areas already colonized by mosquito vectors. Unintentional transport of infected vectors (Aedes and Culex sp), traveling within endemic areas, rapid adaptation of the insects into new geographic locations, climate change, and lack of medical surveillance have greatly contributed to the increase in flaviviral infections worldwide. The mechanisms by which flaviviruses alter the immune and the central nervous system have only recently been examined despite the alarming number of infections, related deaths, and increasing global distribution. In this review, we will discuss the expansion of the geographic areas affected by flaviviruses, the potential threats to previously unaffected countries, the mechanisms of pathogenesis, and the potential therapeutic interventions to limit the devastating consequences of these viruses.

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“…The incidence of dengue has increased throughout the 2000s with a consequent global increase in atypical clinical forms 3 . Several studies have described neurological symptoms among the unusual viral manifestations [4][5][6][7] .…”

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Neurological manifestations of dengue in Central Brazil

Tassara

Guilarde

Rocha

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction:The incidence of dengue has increased throughout the 2000s with a consequent global increase in atypical clinical forms. Methods: This study reports a series of cases of neurological dengue out of 498 confirmed cases of laboratory dengue in Goiânia, Brazil. Cases were confirmed based on viral RNA detection via polymerase chain reaction or IgM antibody capture. Results: Neurological symptoms occurred in 5.6% of cases, including paresthesia (3.8%), encephalitis (2%), encephalopathy (1%), seizure (0.8%), meningoencephalitis (0.4%), and paresis (0.4%). DENV-3 was the predominant circulating serotype (93%). Conclusions:We reported dengue cases with neurological manifestations in endemic area.Keywords: Dengue. Neurological. Encephalopathy.Dengue is an acute febrile infectious disease of viral etiology that can progress to severe disease and shock 1,2 . The incidence of dengue has increased throughout the 2000s with a consequent global increase in atypical clinical forms 3 . Several studies have described neurological symptoms among the unusual viral manifestations 4-7 .We previously reported clinical and laboratory findings related to dengue severity and outcome in adult patients recruited during the epidemic period of 2005 to 2006 in Central Brazil 8 . In the present study, we focused on neurological findings in this large cohort of patients with confirmed dengue infections.This study reports findings from a series of cases with neurological manifestations of dengue out of 498 confirmed cases of laboratory dengue in the City of Goiãnia in Midwestern region of Brazil, from January 2005 to July 2006. Patients were enrolled from the major referral center for dengue, the Hospital of Tropical Diseases, as well as from private hospitals and primary healthcare units. The follow-up duration for hospitalized patients was defined from the first medical visit to the discharge date. The follow up duration for outpatients was measured as the interval between the first and second blood collections during the convalescent phase (~15 days).We prospectively collected baseline demographic and clinical information from all patients using a standard study protocol. Data on age, sex, previous dengue episodes, and key clinical symptoms (hypotension, intense abdominal pain, and bleeding) were recorded. Clinical data and laboratory tests were recorded daily in patient files and reviewed by the clinical coordinator at the end of the follow-up. Dengue cases were confirmed by: a) isolation of dengue virus (DENV) 9 or detection of viral ribonucleic acid (RNA) by multiplex-or real-time polymerase chain reaction (qPCR) 10 ; or b) immunoglobulin M (IgM) antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA) of the first or second paired blood samples 11 . Confirmatory tests were performed at the State Central Laboratory and the University of São Paulo.Patients with clinical symptoms compatible with a diagnosis of dengue and neurological manifestations were included in this study. Neurological manifestations were defin...

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Dengue in Patients with Central Nervous System Manifestations, Brazil

Cited by 31 publications

References 13 publications

La infección con el virus del dengue induce apoptosis en células del neuroblastoma humano SH-SY5Y

La infección con el virus del dengue induce apoptosis en células del neuroblastoma humano SH-SY5Y

Flaviviruses, an expanding threat in public health: focus on dengue, West Nile, and Japanese encephalitis virus

Neurological manifestations of dengue in Central Brazil

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