Sudden infant death syndrome, virus infections and cytokines

Raza, Muhammad W.; Blackwell, C. Caroline

doi:10.1111/j.1574-695x.1999.tb01330.x

Cited by 49 publications

(27 citation statements)

References 130 publications

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“…In Australia, common fetal pathogens include CMV, HSV, rubella virus, T. gondii and VZV (1,9,10,28,40). To our knowledge, there is no universal screening for any of these infections, and diagnosis is often difficult, particularly as detailed viral testing in this country is rarely performed in intrauterine deaths (40), in neonates and even in postnatal death from sudden infant death syndrome (23,41).…”

Section: Discussionmentioning

confidence: 99%

Development of Multiplex PCRs for Detection of Common Viral Pathogens and Agents of Congenital Infections

McIver

Jacques²,

Chow

et al. 2005

J Clin Microbiol

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Potential causes of congenital infection include Toxoplasma gondii and viruses such as cytomegalovirus (CMV), enterovirus, hepatitis C virus, herpes simplex virus types 1 and 2 (HSV-1 and -2), human herpesvirus types 6, 7, and 8, lymphocytic choriomeningitis virus, parvovirus, rubella virus, and varicella-zoster virus. Testing for each of these agents using nucleic acid tests is time consuming and the availability of clinical samples such as amniotic fluid or neonatal blood is often limited. The aim of this study was to develop multiplex PCRs (mPCRs) for detection of DNA and RNA agents in the investigation of congenital infection and an mPCR for the viruses most commonly requested in a diagnostic virology laboratory (CMV, Epstein-Barr virus, enterovirus, HSV-1, HSV-2, and varicella-zoster virus). The assays were assessed using known pathogenpositive tissues (cultures, placentae, plasma, and amniotic fluid) and limits of detection were determined for all the agents studied using serial dilutions of plasmid targets. Nested PCR was performed as the most sensitive assay currently available, and detection of the amplicons using hybridization to labeled probes and enzyme-linked immunosorbent assay detection was incorporated into three of the four assays. This allowed detection of 10 to 10 2 copies of each agent in the samples processed. In several patients, an unexpected infection was diagnosed, including a case of encephalitis where HSV was the initial clinical suspicion but CMV was detected. In the majority of these cases the alternative agent could be confirmed using reference culture, serology, or fluorescence methods and was of relevance to clinical care of the patient. The methods described here provide useful techniques for diagnosing congenital infections and a paradigm for assessment of new multiplex PCRs for use in the diagnostic laboratory.Nucleic acid testing has allowed more sensitive and specific detection of infectious agents and is being increasingly adopted by diagnostic laboratories. The technology is particularly useful in virology as it can replace conventional culture methods that are often expensive and labor intensive, detect fastidious organisms such as hepatitis C virus (HCV), detect low-copynumber agents such as herpes simplex virus (HSV) in cerebrospinal fluid, and improve turn-around times for detection of treatable agents such as herpesviruses (30,42,48,50). In the clinical and diagnostic setting, accurate and rapid diagnosis of the causative agent of disease is paramount. Testing for various agents using multiple primer sets in multiplex PCR (mPCR) reactions is an innovation that offers significant benefits in costs, time and accurate diagnosis (20,35). Furthermore, for any given clinical syndrome there a number of candidate agents that may be implicated, particularly with regard to congenital infection.In the diagnostic setting, standardization of assays, use of quality controlled (usually commercially available) reagents, extensive validation of the assays used, and sensitive detection ...

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Section: Discussionmentioning

confidence: 99%

Development of Multiplex PCRs for Detection of Common Viral Pathogens and Agents of Congenital Infections

McIver

Jacques²,

Chow

et al. 2005

J Clin Microbiol

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“…Episodes of marked hypoxaemia often occur during respiratory infection and this combination of stressors poses an appreciable risk to the newborn [9] . The major finding of the study was that LPS combined with hypoxia treatment had a greater effect on brain allopregnanolone concentrations in the majority of brain regions examined, than did either of the treatments alone.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have reported that hypoxia alters arousal, particularly during the newborn period when hypoxic events due to respiratory and cardiovascular instability is relatively common [9] . We have recently reported that episodes of asphyxia during fetal life markedly increase allopregnanolone concentrations in the developing brain [15] .…”

Section: Introductionmentioning

confidence: 99%

“…Infection and hypoxia have been identified as two of the most common factors contributing to neonatal morbidity and mortality [9][10][11] . Infection elicits a wide range of physiological changes following the induction of an immune response consistent with the profile of 'sickness behaviour' that includes the suppression of CNS activity [12] .…”

Section: Introductionmentioning

confidence: 99%

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Hypoxia Potentiates Endotoxin-Induced Allopregnanolone Concentrations in the Newborn Brain

Billiards

Nguyen²,

Scheerlinck³

et al. 2006

Neonatology

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Background: Allopregnanolone is a neurosteroid produced in the brain that can alter the excitability of the CNS. Neurosteroids have neuroprotective properties, and their elevation in response to stress may protect the newborn brain following infection or hypoxia. Infection, particularly of the respiratory tract, may lead to episodes of hypoxia. Infection and hypoxia have been identified as factors contributing to neonatal morbidity and mortality. Objectives: To determine the effect of acute episodes of hypoxia alone or in combination with lipopolysaccharide (LPS) exposure on plasma and brain allopregnanolone concentrations in lambs 10–21 days old. Also, to examine plasma levels of cortisol and the cytokines, tumour necrosis factor-α and interleutkin-6 after these challenges. Results: Allopregnanolone concentrations in the brain were markedly increased after hypoxia. Hypoxia following prior LPS treatment resulted in greater increases in brain allopregnanolone concentrations compared to either the LPS or hypoxia treatment alone. Importantly, brain regions unaffected by LPS or hypoxia alone (thalamus/hypothalamus, cerebellum) showed significant increases of allopregnanolone content following the combined LPS and hypoxia treatments. Plasma tumour necrosis factor-α and interleukin-6 concentrations were increased after LPS treatment with and without hypoxia, but not by hypoxia alone. In contrast, plasma cortisol concentrations were increased after both stressors. Conclusions: These results show that the brain of young lambs readily responds to physiological stress by increased production of allopregnanolone. This response may protect the developing brain from the cytotoxicity following hypoxic and infectious episodes.

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“…2 In the ensuing years, all SIDS hypotheses essentially invoked defective respiratory or autonomic mechanisms. 27,30,[51][52][53][54][55][56][57][58] The roles of respiratory and autonomic pathways in SIDS are not mutually exclusive, given that infants who subsequently died of SIDS have frequently been found to have subclinical deficits in both respiratory and autonomic function. [59][60][61] Ultimately, SIDS appears to involve failed defense mechanisms, with sleep in some important way unmasking the underlying vulnerability.…”

Section: Putative Terminal Pathways For Sidsmentioning

confidence: 99%

The Sudden Infant Death Syndrome

&NA;

2010

Survey of Anesthesiology

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Sudden infant death syndrome, virus infections and cytokines

Cited by 49 publications

References 130 publications

Development of Multiplex PCRs for Detection of Common Viral Pathogens and Agents of Congenital Infections

Development of Multiplex PCRs for Detection of Common Viral Pathogens and Agents of Congenital Infections

Hypoxia Potentiates Endotoxin-Induced Allopregnanolone Concentrations in the Newborn Brain

The Sudden Infant Death Syndrome

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