Puumala virus RNA in cerebrospinal fluid in a patient with uncomplicated nephropathia epidemica

Mähönen, Saara-Mari; Sironen, Tarja; Vapalahti, Olli; Pääkkö, Eija; Hautala, Nina; Ilonen, Jorma; Glumoff, Virpi; Vainio, Olli; Kauma, Heikki; Vaheri, Antti; Plyusnin, Alexander; Hautala, Timo

doi:10.1016/j.jcv.2007.08.008

Cited by 25 publications

(19 citation statements)

References 16 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…24 Furthermore, the central nervous system was also shown to be affected by hantavirus infection, with reports of cerebral hemorrhage, the presence of Puumala virus RNA, and increased levels of the monocyte/macrophage activation marker neopterin in cerebrospinal fluid. [25][26][27][28] HFRS also causes intravascular damage 29 and dysfunctional platelets. 30 Endothelial cells are infected with hantaviruses with subsequent activation.…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Acute Myocardial Infarction and Stroke During Hemorrhagic Fever With Renal Syndrome

et al. 2014

View full text Add to dashboard Cite

G lobally, cardiovascular diseases (CVDs) are the leading cause of death and a major source of disability. The majority of these are caused by ischemic heart disease such as acute myocardial infarction (AMI), stroke, and other cerebrovascular diseases.1 Several factors, including infectious diseases, have been associated with increased risk for CVD. [2][3][4][5][6] The host inflammatory response to infection often results in release of proinflammatory cytokines and activation of platelets, leukocytes, and endothelial cells that can activate procoagulant pathways and can inhibit anticoagulant pathways. 2,3 This can tip the balance of hemostasis toward a prothrombotic state, laying the foundation for acute cardiovascular events such as AMI and stroke. 2,3 Clinical Perspective on p 1302Viral hemorrhagic fevers are characterized by fever, hemorrhages, and shock. Abnormal coagulation and vascular dysfunction are common observations during viral hemorrhagic fevers, 7 which could be risk factors for CVD. Four viral families contain members that cause viral hemorrhagic fevers: Bunyaviridae, Flaviviridae, Filoviridae and Arenaviridae. Pathogenic hantaviruses in the Bunyaviridae family cause hemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus cardiopulmonary syndrome in the Americas.8 HFRS caused by Puumala virus is considered a mild viral hemorrhagic fever 7 characterized by thrombocytopenia, enhanced coagulation and fibrinolysis, 9 and disseminated intravascular coagulopathy. 10In a highly endemic area for Puumala virus in Northern Sweden, we observed a tendency of HFRS patients to develop acute cardiovascular events. Furthermore, we have recently shown that CVD is a common cause of death during acute HFRS in Sweden.11 Together, these findings suggest a possible association between acute HFRS and CVD. Therefore, we decided to investigate in more detail whether HFRS is a risk factor for CVD. To test this, we compared the incidence of AMI and stroke Background-We recently observed that cardiovascular causes of death are common in patients with hemorrhagic fever with renal syndrome (HFRS), which is caused by hantaviruses. However, it is not known whether HFRS is a risk factor for the acute cardiovascular events of acute myocardial infarction (AMI) and stroke. Methods and Results-Personal identification numbers from the Swedish HFRS patient database (1997-2012; n=6643) were cross-linked with the National Patient Register from 1987 to 2011. Using the self-controlled case series method, we calculated the incidence rate ratio of AMI/stroke in the 21 days after HFRS against 2 different control periods either excluding (analysis 1) or including (analysis 2) fatal AMI/stroke events. The incidence rate ratios for analyses 1 and 2 for all AMI events were 5.53 (95% confidence interval [CI], 2.6-11.8) and 6.02 (95% CI, 2.95-12.3) and for first AMI events were 3.53 (95% CI, 1.25-9.96) and 4.64 (95% CI, 1.83-11.77). The incidence rate ratios for analyses 1 and 2 for all stroke events were 12.93 (95% CI, 5.62-29.74)...

show abstract

Section: Discussionmentioning

confidence: 99%

Increased Risk of Acute Myocardial Infarction and Stroke During Hemorrhagic Fever With Renal Syndrome

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The CSF samples were analyzed for cell count, glucose and protein concentrations and CSF and serum PUUV IgM and IgG antibody levels were titrated as described [7]. As previously described, the CSF sample of only one patient was positive for PUUV RNA [9]. …”

Section: Methodsmentioning

confidence: 99%

“…Many patients with acute NE display signs of central nervous system (CNS) involvement [4-7] and evidence of PUUV infection in the CNS has been provided [8,9]. Pituitary hemorrhage as a potential complication of NE has been documented [7,8].…”

Section: Introductionmentioning

confidence: 99%

Young male patients are at elevated risk of developing serious central nervous system complications during acute Puumala hantavirus infection

Hautala

Mähönen

et al. 2011

BMC Infect Dis

Self Cite

View full text Add to dashboard Cite

BackgroundOur aim was to characterize clinical properties and laboratory parameters in patients with or without cerebrospinal fluid (CSF) findings suggestive of central nervous system (CNS) involvement, and especially those who developed serious CNS complications during acute nephropathia epidemica (NE) caused by Puumala hantavirus (PUUV) infection.MethodsA prospective cohort of 40 patients with acute NE and no signs of major CNS complications was analyzed. In addition, 8 patients with major CNS complications associated with NE were characterized. We collected data of CNS symptoms, CSF analysis, brain magnetic resonance imaging (MRI) results, electroencephalography (EEG) recordings, kidney function, and a number of laboratory parameters. Selected patients were evaluated by an ophthalmologist.ResultsPatients with a positive CSF PUUV IgM finding or major CNS complications were more often males (p < 0.05) and they had higher plasma creatinine values (p < 0.001) compared to those with negative CSF PUUV IgM. The degree of tissue edema did not explain the CSF findings. Patients with major CNS complications were younger than those with negative CSF PUUV IgM finding (52.9 vs. 38.5 years, p < 0.05). Some patients developed permanent neurological and ophthalmological impairments.ConclusionsCNS and ocular involvement during and after acute NE can cause permanent damage and these symptoms seem to be attributable to true infection of the CNS rather than increased tissue permeability. The possibility of this condition should be borne in mind especially in young male patients.

show abstract

“…Therefore, antibody application is essential for diagnosis of NPC at early stages and new biologic therapies of NPC. Elevated Rta, VCA, EA, NA-1 antibody titers targeting EBV antigens have been used as screening or diagnostic biomarkers for NPC [16,17,18,19,20]. Based on the results of the present study, the combined measurement of the anti-Rta and anti-EA antibodies could increase the sensitivity and the validity for the serologic screening and diagnosis of nasopharyngeal carcinoma [21].…”

Section: Resultsmentioning

confidence: 85%

Generation and Characterization of a Novel Recombinant Antibody against LMP1-TES1 of Epstein-Barr Virus Isolated by Phage Display

Zhang

Yuan

Cao

et al. 2013

Viruses

View full text Add to dashboard Cite

Latent Membrane Protein 1 (LMP1) is a primary target for controlling tumorigenesis in Epstein-Barr virus related malignancies; in this study, we aimed to develop a specific antibody against the TES1 domain of the oncogenic LMP1. We screened a full human naïve Fab phage library against TES1 peptide, which consisted of C terminal-activating regions proximal 44 amino acids. After three rounds of panning, enrichment and testing by phage ELISA and further analyzed by DNA sequencing, we selected a phage clone with the highest affinity to LMP1-TES1 and designated it as htesFab. The positive clone was expressed in Escherichia coli and the purified htesFab was characterized for its binding specificity and affinity to LMP1. ELISA, immunofluorescence and FACS analysis confirmed that htesFab could recognize LMP1 TES1 both in vitro and in LMP1 expressing HNE2-LMP1 cells. Furthermore, MTT assay showed that htesFab inhibited the proliferation of HNE2-LMP1 cells in a dose-dependent manner. In summary, this study reported the isolation and characterization of human Fab, which specifically targets the C terminal region/TES1 of LMP1, and has potential to be developed as novel tool for the diagnosis and therapy of Epstein-Barr virus related carcinoma.

show abstract

Puumala virus RNA in cerebrospinal fluid in a patient with uncomplicated nephropathia epidemica

Cited by 25 publications

References 16 publications

Increased Risk of Acute Myocardial Infarction and Stroke During Hemorrhagic Fever With Renal Syndrome

Increased Risk of Acute Myocardial Infarction and Stroke During Hemorrhagic Fever With Renal Syndrome

Young male patients are at elevated risk of developing serious central nervous system complications during acute Puumala hantavirus infection

Generation and Characterization of a Novel Recombinant Antibody against LMP1-TES1 of Epstein-Barr Virus Isolated by Phage Display

Contact Info

Product

Resources

About