先天性非小头畸形寨卡病毒感染的研究进展

寨卡病毒(Zika virus, ZIKV)是一种主要通过蚊虫叮咬传播的黄病毒。不同于其他黄病毒,ZIKV还可以通过性传播或垂直传播引起神经系统障碍,与新生儿小头畸形密切相关,这些特征使ZIKV受到全球关注。进一步临床证据表明,产前暴露于ZIKV的婴儿,即使在出生时没有小头畸形,也可能存在与ZIKV有关的神经发育障碍,尤其是在远期神经发育方面表现出语言、运动和认知的不同程度的发育迟缓。目前针对先天性非小头畸形ZIKV感染的机制已有一些直接和间接证据,其发病机制可能包括ZIKV导致神经细胞死亡、诱导细胞自噬以及非神经细胞作用等。现就近年来产前ZIKV暴露对非小头畸形新生儿神经发育影响相关的研究作一概述。     

Zika病毒与Zika病毒病

Zika病毒(Zika virus,ZIKV)是一种新现虫媒病毒,属于黄病毒科黄病毒属。其感染后临床表现为轻症发热,因病重住院者罕见。流行病学数据显示Zika病毒病的流行与自身免疫性神经性疾病格林-巴利综合征及先天性小头畸形有关,引起了专家和公众的关注,但具体机制有待深入研究。     

寨卡病毒引发小头症?关系越确定,防治越迫切!

自2015年初至今,寨卡病毒(Zika virus,ZIKV)以巴西为首先后在数十个国家和地区暴发流行。几乎同时,与日俱增的小头症患儿使全球对此陷入警惕状态。目前,全球正在积极探索ZIKV感染所引发的各种神经系统疾病。在越来越多证据表明在细胞水平和动物模型中ZIKV能直接损伤胚胎脑部发育的同时,ZIKV感染者的防治需求也越来越迫切。本文从ZIKV的流行病学、与小头畸形因果关系的研究进展及其预防疫苗和治疗药物的研究现状等方面进行概述。     

寨卡疫苗相关研究进展

寨卡病毒(zika virus, ZIKV)是一种主要以蚊虫传播的虫媒病毒,其感染孕妇后,可导致胎儿畸形和新生儿小头症;感染成人后,可引起以神经缺陷为特征的自身免疫性疾病"格林-巴利综合征"等病症。近年来,寨卡病毒已是一种严重危害人类健康的病原体,对全球公共卫生产生了重大威胁,因此,各国相关研究人员均在积极研制安全有效的ZIKV疫苗,以预防该病毒的感染和蔓延。现就ZIKV的基本特征、目前正在研究的几种ZIKV候选疫苗,如减毒活疫苗及嵌合活疫苗、全灭活病毒疫苗、核酸疫苗、病毒载体疫苗等作一概述,旨在为该疫苗的进一步研究提供参考。     

寨卡病毒及其疫苗研究

寨卡病毒与黄热病毒、登革热病毒、日本脑炎病毒、西尼罗病毒等都属于蚊媒传播的黄病毒属病毒。寨卡病毒分离于1947年,但由于分布区域有限,所致寨卡热症状较轻,很长一段时间并没有引起太多的关注。最近一些年,特别是2015年后,巴西的寨卡疫情暴发及其与新生儿小头畸形的关联,引起了全球越来越多的关注。疫苗是应对寨卡疫情的重要手段,目前全球有30余个机构在进行寨卡病毒疫苗的研发。本文综述了寨卡病毒的生物学、流行病学、临床特征以及当前不同类型寨卡病毒疫苗研发现状,同时对其他几种黄病毒属病毒批准和临床阶段疫苗情况进行了概述,以为相关研究人员提供参考。     

寨卡病毒RNA恒温快速扩增检测方法的建立

2015年以来,寨卡病毒(Zika virus,ZIKV)感染被报告和小头症之间存有关联,已有多个国家和地区报告ZIKV感染证据,我国持续面对ZIKV输入风险。为发展适用于现场的快速高效的ZIKV核酸检测方法,选取ZIKV NS1片段保守区设计特异性引物探针,经优化建立了多种功能蛋白介导的ZIKV RNA恒温快速扩增检测方法。利用所制备的ZIKV NS1片段体外转录RNA作为参考品,并与实时荧光定量RT-PCR检测结果进行比较。同时利用ZIKV细胞培养物中加入健康人血清制备的模拟临床标本进行初步验证。结果显示,建立的RNA恒温快速扩增检测方法可100%检出100拷贝/μL体外转录RNA,可在15 min以内判读,大大低于PCR的常规检测时间;用该方法检测其他相关病毒,无交叉反应。病毒滴度在(10~4～10~7PFU/mL)之间的模拟临床病人标本可达到100%检出。本研究建立的ZIKV RNA恒温扩增快速检测方法快速、灵敏、特异,适用于ZIKV现场应急检测,为ZIKV的防控提供了重要的技术支撑。     

细胞焦亡在黄病毒致病机制中的作用

黄病毒(flavivirus)是一类具有包膜的单股正链RNA病毒,经蚊虫叮咬传播,是新发突发传染性疾病的重要病原体,严重威胁着人类健康。尽管不同黄病毒引起的临床疾病不同,但是它们的临床症状却有一些相似之处,发热是黄病毒感染后最常见的症状,而且往往表现为高热。研究发现,寨卡病毒和日本脑炎病毒感染中存在胱天蛋白酶1 (caspase1)依赖的炎性反应,而这一过程与细胞焦亡(pyroptosis)的部分机制相吻合。细胞焦亡是一种依赖于胱天蛋白酶(caspases)的炎性细胞程序性死亡类型,其特征有焦孔素(gasdermin)介导的孔形成、细胞肿胀破裂和炎性细胞因子释放。本文对黄病毒感染引起的固有免疫中巨噬细胞的焦亡现象进行综述,对细胞焦亡的分子机制、细胞焦亡的重要组分作用进行总结,分析了细胞焦亡与代表性黄病毒之间的关系,以期为细胞焦亡在黄病毒致病机制的后续研究提供参考,为抗病毒感染治疗提供新的思路。     

寨卡病毒NS1的结构研究进展及其应用

寨卡病毒感染与小头畸形和神经系统并发症紧密相关,甚至可能损伤男性生殖系统,引起了全球性的关注,研究其结构和致病机制以及开发有效的诊断治疗方法成为当务之急。寨卡病毒的非结构蛋白NS1是病毒与宿主相互作用的重要蛋白,在病毒复制、发病机制及免疫逃逸中起着关键作用。本文总结了寨卡病毒NS1的空间精细结构,并将其与其它黄病毒NS1进行比较。本文也分析了寨卡病毒基于NS1的致病机理,总结了NS1在疾病诊断中的应用。     

寨卡病毒和寨卡病毒病

寨卡病毒自1947年首次在乌干达被发现以来,已经在非洲、东南亚和美洲等地造成多次暴发流行,且在中国已有输入性寨卡病毒感染病例的报道。寨卡病毒为黄病毒科黄病毒属,存在非洲型和亚洲型两个亚型。寨卡病毒主要依赖感染病毒的伊蚊类蚊媒叮咬传播,也可通过母婴传播以及血液和性传播。寨卡病毒感染人体后经血播散并可跨越血脑屏障进入中枢神经系统,患者一般临床症状较轻,但有可能出现格林巴利综合症,婴儿小头畸形也与寨卡病毒感染孕妇有关。寨卡病毒的实验室诊断主要包括核酸检测、血清学检测和病毒分离。目前尚无有效疫苗预防寨卡病毒感染,主要预防措施包括防蚊控蚊和提高个人防护意识,并在重点地区加强病例监测。     

Science:寨卡病毒导致人神经球和大脑类器官生长下降和畸形

正在一项新的研究中,来自巴西里约热内卢联邦大学(UFRJ)、D'Or研究与教育研究所(D'Or Institute for Research and Education,IDOR)和坎皮纳斯州立大学的巴西研究人员进一步证实寨卡病毒(ZIKV)对人神经干细胞、神经球和大脑类器官(brain organoids)产生有害影响。鉴于科学家们已逐渐将ZIKV确立为中枢神经系统畸形的直接原因,这项研究有助阐述巴西最近增加的小头畸形病例的病因。相关研究结果在线发表在Science期刊上。     

Zika infection and the development of neurological defects

Starting with the outbreak in Brazil, Zika virus (ZIKV) infection has been correlated with severe syndromes such as congenital Zika syndrome and Guillain‐Barré syndrome. Here, we review the status of Zika virus pathogenesis in the central nervous system (CNS). One of the main concerns about ZIKV exposure during pregnancy is abnormal brain development, which results in microcephaly in newborns. Recent advances in in vitro research show that ZIKV can infect and obliterate cells from the CNS, such as progenitors, neurons, and glial cells. Neural progenitor cells seem to be the main target of the virus, with infection leading to less cell migration, neurogenesis impairment, cell death and, consequently, microcephaly in newborns. The downsizing of the brain can be directly associated with defective development of the cortical layer. In addition, in vivo investigations in mice reveal that ZIKV can cross the placenta and migrate to fetuses, but with a significant neurotropism, which results in brain damage for the pups. Another finding shows that hydrocephaly is an additional consequence of ZIKV infection, being detected during embryonic and fetal development in mouse, as well as after birth in humans. In spite of the advances in ZIKV research in the last year, the mechanisms underlying ZIKV infection in the CNS require further investigation particularly as there are currently no treatments or vaccines against ZIKV infection.     

Zika virus: An emerging flavivirus

Zika virus (ZIKV) is a previously little-known flavivirus closely related to Japanese encephalitis, West Nile, dengue, and yellow fever viruses, all of which are primarily transmitted by blood-sucking mosquitoes. Since its discovery in Uganda in 1947, ZIKV has continued to expand its geographic range, from equatorial Africa and Asia to the Pacific Islands, then further afield to South and Central America and the Caribbean. Currently, ZIKV is actively circulating not only in much of Latin America and its neighbors but also in parts of the Pacific Islands and Southeast Asia. Although ZIKV infection generally causes only mild symptoms in some infected individuals, it is associated with a range of neuroimmunological disorders, including Guillain-Barré syndrome, meningoencephalitis, and myelitis. Recently, maternal ZIKV infection during pregnancy has been linked to neonatal malformations, resulting in various degrees of congenital abnormalities, microcephaly, and even abortion. Despite its emergence as an important public health problem, however, little is known about ZIKV biology, and neither vaccine nor drug is available to control ZIKV infection. This article provides a brief introduction to ZIKV with a major emphasis on its molecular virology, in order to help facilitate the development of diagnostics, therapeutics, and vaccines.     

Different Gene Networks Are Disturbed by Zika Virus Infection in A Mouse Microcephaly Model

The association of Zika virus (ZIKV) infection with microcephaly has raised alarm worldwide. Their causal link has been confirmed in different animal models infected by ZIKV. However, the molecular mechanisms underlying ZIKV pathogenesis are far from clear. Hence, we performed global gene expression analysis of ZIKV-infected mouse brains to unveil the biological and molecular networks underpinning microcephaly. We found significant dysregulation of the sub-networks associated with brain development, immune response, cell death, microglial cell activation, and autophagy amongst others. We provided detailed analysis of the related complicated gene networks and the links between them. Additionally, we analyzed the signaling pathways that were likely to be involved. This report provides systemic insights into not only the pathogenesis, but also a path to the development of prophylactic and therapeutic strategies against ZIKV infection.     

Congenital abnormalities associated with Zika virus infection–Dengue as potential co-factor? A systematic review

Zika virus (ZIKV) emerged in Brazil during 2013–2014 causing an epidemic of previously unknown congenital abnormalities. The frequency of severe congenital abnormalities after maternal ZIKV infection revealed an unexplained geographic variability, especially between the Northeast and the rest of Brazil. Several reasons for this variability have been discussed. Prior immunity against Dengue virus (DENV) affecting ZIKV seems to be the most likely explanation. Here we summarise the current evidence regarding this prominent co-factor to potentially explain the geographic variability.This systematic review followed the PRISMA guidelines. The search was conducted up to May 15th, 2020, focussing on immunological interactions from Zika virus with previous Dengue virus infections as potential teratogenic effect for the foetus.Eight out of 339 screened studies reported on the association between ZIKV, prior DENV infection and microcephaly, mostly focusing on antibody-dependent enhancement (ADE) as potential pathomechanism. Prior DENV infection was associated with enhancement for ZIKV infection and increased neurovirulence in one included in vitro study only. Interestingly, the seven in vivo studies exhibited a heterogeneous picture with three studies showing a protective effect of prior DENV infections and others no effect at all. According to several studies, socio-economic factors are associated with increased risk for microcephaly.Very few studies addressed the question of unexplained variability of infection-related microcephaly. Many studies focussed on ADE as mechanism without measuring microcephaly as endpoint. Interestingly, three of the included studies reported a protective effect of prior DENV infection against microcephaly. This systematic review strengthens the hypothesis that immune priming after recent DENV infection is the crucial factor for determining protection or enhancement activity. It is of high importance that the currently ongoing prospective studies include a harmonised assessment of the potential candidate co-factors.     

Growth hormone attenuates the brain damage caused by ZIKV infection in mice

As a member of vector-borne viruses, Zika virus (ZIKV) can cause microcephaly and various neurological symptoms in newborns. Previously, we found that ZIKV could infect hypothalamus, causing a decrease in growth hormone (GH) secretion, growth delay and deficits in learning and memory in suckling mice. Early administration of GH can improve the cognitive function of the mice. Therefore, in this study we further investigated the mechanism underlying the protective role of GH in ZIKV infection in suckling mice. Our results showed that GH could effectively reduce brain damage caused by ZIKV infection via reducing cell apoptosis and inflammatory response rather than inhibiting viral replication. Our results provide important evidences not only for understanding the mechanism underlying ZIKV-associated neurological symptoms but also for the treatment of ZIKV infection.     

Plasma lipidome profiling of newborns with antenatal exposure to Zika virus

The 2015–2016 Zika virus (ZIKV) outbreak in Brazil was remarkably linked to the incidence of microcephaly and other deleterious clinical manifestations, including eye abnormalities, in newborns. It is known that ZIKV targets the placenta, triggering an inflammatory profile that may cause placental insufficiency. Transplacental lipid transport is delicately regulated during pregnancy and deficiency on the delivery of lipids such as arachidonic and docosahexaenoic acids may lead to deficits in both brain and retina during fetal development. Here, plasma lipidome profiles of ZIKV exposed microcephalic and normocephalic newborns were compared to non-infected controls. Our results reveal major alterations in circulating lipids from both ZIKV exposed newborns with and without microcephaly relative to controls. In newborns with microcephaly, the plasma concentrations of hydroxyoctadecadienoic acid (HODE), primarily as 13-HODE isomer, derived from linoleic acid were higher as compared to normocephalic ZIKV exposed newborns and controls. Total HODE concentrations were also positively associated with levels of other oxidized lipids and several circulating free fatty acids in newborns, indicating a possible plasma lipidome signature of microcephaly. Moreover, higher concentrations of lysophosphatidylcholine in ZIKV exposed normocephalic newborns relative to controls suggest a potential disruption of polyunsaturated fatty acids transport across the blood-brain barrier of fetuses. The latter data is particularly important given the neurocognitive and neurodevelopmental abnormalities observed in follow-up studies involving children with antenatal ZIKV exposure, but normocephalic at birth. Taken together, our data reveal that plasma lipidome alterations associated with antenatal exposure to ZIKV could contribute to identification and monitoring of the wide spectrum of clinical phenotypes at birth and further, during childhood.     

Amyloid precursor protein is a restriction factor that protects against Zika virus infection in mammalian brains

Zika virus (ZIKV) is a neurotropic flavivirus that causes several diseases including birth defects such as microcephaly. Intrinsic immunity is known to be a frontline defense against viruses through host anti-viral restriction factors. Limited knowledge is available on intrinsic immunity against ZIKV in brains. Amyloid precursor protein (APP) is predominantly expressed in brains and implicated in the pathogenesis of Alzheimer''s diseases. We have found that ZIKV interacts with APP, and viral infection increases APP expression via enhancing protein stability. Moreover, we identified the viral peptide, HGSQHSGMIVNDTGHETDENRAKVEITPNSPRAEATLGGFGSLGL, which is capable of en-hancing APP expression. We observed that aging brain tissues with APP had protective effects on ZIKV infection by reducing the availability of the viruses. Also, knockdown of APP expression or blocking ZIKV-APP interactions enhanced ZIKV replication in human neural progenitor/stem cells. Finally, intracranial infection of ZIKV in APP-null neonatal mice resulted in higher mortality and viral yields. Taken together, these findings suggest that APP is a restriction factor that protects against ZIKV by serving as a decoy receptor, and plays a protective role in ZIKV-mediated brain injuries.     

Recent Advances in Animal Models of Zika Virus Infection

An infection by Zika virus(ZIKV), a mosquito-borne flavivirus, broke out in South American regions in 2015, and recently showed a tendency of spreading to North America and even worldwide. ZIKV was first detected in 1947 and only 14 human infection cases were reported until 2007. This virus was previously observed to cause only mild flu-like symptoms.However, recent ZIKV infections might be responsible for the increasing cases of neurological disorders such as GuillainBarre′ syndrome and congenital defects, including newborn microcephaly. Therefore, researchers have established several animal models to study ZIKV transmission and pathogenesis, and test therapeutic candidates. This review mainly summarizes the reported animal models of ZIKV infection, including mice and non-human primates.     

The clinical spectrum and immunopathological mechanisms underlying ZIKV-induced neurological manifestations

Since the 2015 to 2016 outbreak in America, Zika virus (ZIKV) infected almost 900,000 patients. This international public health emergency was mainly associated with a significant increase in the number of newborns with congenital microcephaly and abnormal neurologic development, known as congenital Zika syndrome (CZS). Furthermore, Guillain–Barré syndrome (GBS), a neuroimmune disorder of adults, has also been associated with ZIKV infection. Currently, the number of ZIKV-infected patients has decreased, and most of the cases recently reported present as a mild and self-limiting febrile illness. However, based on its natural history of a typical example of reemerging pathogen and the lack of specific therapeutic options against ZIKV infection, new outbreaks can occur worldwide, demanding the attention of researchers and government authorities. Here, we discuss the clinical spectrum and immunopathological mechanisms underlying ZIKV-induced neurological manifestations. Several studies have confirmed the tropism of ZIKV for neural progenitor stem cells by demonstrating the presence of ZIKV in the central nervous system (CNS) during fetal development, eliciting a deleterious inflammatory response that compromises neurogenesis and brain formation. Of note, while the neuropathology of CZS can be due to a direct viral neuropathic effect, adults may develop neuroimmune manifestations such as GBS due to poorly understood mechanisms. Antiganglioside autoantibodies have been detected in multiple patients with ZIKV infection–associated GBS, suggesting a molecular mimicry. However, further additional immunopathological mechanisms remain to be uncovered, paving the way for new therapeutic strategies.