Genetic Variants and Immune Responses in a Cohort of Patients With Varicella Zoster Virus Encephalitis.


Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
15 12 2021
Historique:
received: 02 04 2021
accepted: 06 05 2021
pubmed: 12 5 2021
medline: 27 1 2022
entrez: 11 5 2021
Statut: ppublish

Résumé

Infection with varicella zoster virus (VZV) may involve different central nervous system (CNS) manifestations, including meningitis, encephalitis, and vasculitis. In cases in which otherwise healthy individuals are affected, an inborn error of immunity may underlie increased susceptibility or severity of infection. We collected a cohort of 17 adults who experienced VZV encephalitis and performed whole exome sequencing. Patient peripheral blood mononuclear cells were infected with VZV, and innate antiviral interferon (IFN) and cytokine responses as well as viral replication were evaluated. Data were analyzed by Mann-Whitney U test. We identified a total of 21 different potentially disease-causing variants in a total of 13 of the 17 patients included. These gene variants were within 2 major functional clusters: (1) innate viral sensors and immune pathways and (2) autophagy pathways. Antiviral IFN and cytokine responses were abnormal in the majority of patients, whereas viral replication was increased in only 2 of 17 patients. This study identifies a list of variants of pathogenic potential, which may serve as a platform for generating hypotheses for future studies addressing genetic and immunological factors associated with susceptibility to VZV encephalitis. These data, taken together, suggest that disturbances in innate sensing and autophagy pathways may predispose to VZV encephalitis.

Sections du résumé

BACKGROUND
Infection with varicella zoster virus (VZV) may involve different central nervous system (CNS) manifestations, including meningitis, encephalitis, and vasculitis. In cases in which otherwise healthy individuals are affected, an inborn error of immunity may underlie increased susceptibility or severity of infection.
METHODS
We collected a cohort of 17 adults who experienced VZV encephalitis and performed whole exome sequencing. Patient peripheral blood mononuclear cells were infected with VZV, and innate antiviral interferon (IFN) and cytokine responses as well as viral replication were evaluated. Data were analyzed by Mann-Whitney U test.
RESULTS
We identified a total of 21 different potentially disease-causing variants in a total of 13 of the 17 patients included. These gene variants were within 2 major functional clusters: (1) innate viral sensors and immune pathways and (2) autophagy pathways. Antiviral IFN and cytokine responses were abnormal in the majority of patients, whereas viral replication was increased in only 2 of 17 patients.
CONCLUSIONS
This study identifies a list of variants of pathogenic potential, which may serve as a platform for generating hypotheses for future studies addressing genetic and immunological factors associated with susceptibility to VZV encephalitis. These data, taken together, suggest that disturbances in innate sensing and autophagy pathways may predispose to VZV encephalitis.

Identifiants

pubmed: 33974706
pii: 6273784
doi: 10.1093/infdis/jiab254
doi:

Substances chimiques

Antiviral Agents 0
Cytokines 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2122-2132

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Michelle M Thomsen (MM)

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Department of Biomedicine, Aarhus University, Aarhus, Denmark.

Tobias Tyrberg (T)

Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Kristoffer Skaalum (K)

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

Madalina Carter-Timofte (M)

Department of Biomedicine, Aarhus University, Aarhus, Denmark.

Mette R Freytag (MR)

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

Peter Norberg (P)

Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.

Marie Helleberg (M)

Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.

Merete Storgaard (M)

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

Henrik Nielsen (H)

Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Jacob Bodilsen (J)

Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.

Anna Grahn (A)

Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Trine H Mogensen (TH)

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Department of Biomedicine, Aarhus University, Aarhus, Denmark.

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