Congenital infection of rabbits with Schistosoma japonicum and protective immunity of offspring

Background Recently congenital infection with Schistosoma japonicum (S. japonicum) has been domonstrated in pigs, rabbits, mice and dogs. We explored the rabbit as an animal model for the congenital infection of schistosomiasis japonica and assessed the effect of a congenital S. japonicum infection on the resistance of rabbit kittens to a postnatal challenge infection.Methods Sixteen pregnant New Zealand white rabbits were infected with a single dose of S. japonicum cercariae. The exposed animals were divided into three groups according to the gestation age at the time of infection. Diagnosis of prenatally acquired S. japonicum infection in the rabbit kittens was primarily based on serological tests in combination with parasitological and histopathological findings. Congenitally infected kittens were challenged percutaneously with 100 S. japonicum cercariae to assess the effect of a congenital S. japonicum infection on kitten resistance to a postnatal challenge infection.Results The overall prevalence of congenital infection in offspring of infected mothers was 20% (12/60). The congenital infection rate in group L (late gestation) was much higher than in group E (early gestation) and group M (mid-gestation) (P<0.05). After a postnatal challenge infection, prenatally infected kittens had a 54.66% worm reduction rate, 41.45% egg reduction rate, and 51.76% granuloma size reduction rate compared to nave kittens.Conclusions This study demonstrates the possibility of congenital infection of S. japonicum in rabbits and the resistance of congenitally infected kittens to a postnatal challenge infection. These results have important implications not only for epidemiological investigations, but also in designing government control programs for schistosomiasis.

Congenital Cytomegalovirus Infection and Maternal Varicella during Pregnancy.Is There a Coincidence?A Case Report

Background: Co-infections may represent substantial diagnostic and treatment challenges. Aim: To the better of our knowledge, we describe the first case in the literature of congenital Cytomegalovirus (CMV) infection following maternal CMV non primary infection contemporary to varicella during pregnancy. Case Presentation: A pregnant woman had a varicella during her pregnancy. Congenital CMV infection was fortuitously discovered in the neonate owing to a universal CMV screening. Retrospective analysis of maternal serums during pregnancy showed CMV reactivation. We aim to highlight that CMV reactivation could be due to varicella and discuss if it could facilitate the transplacental transmission of CMV. Conclusion: This case report emphasizes neonatal CMV screening, and warns against dual maternal infection especially because this may be at particular risk of transmission to the fetus.

Lymphocytic choriomeningitis virus:An under-recognized congenital teratogen

BACKGROUND Lymphocytic choriomeningitis virus(LCMV)is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection.AIM To summarize the epidemiological,clinical,and diagnostic features of reported patients with congenital LCMV infection.METHODS A literature search was conducted in PubMed,Medline,Google Scholar,and ResearchGate.The keywords used were‘congenital lymphocytic choriomeningitis virus,’and 48 studies were included.In addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://www.referencecitationan alysis.com).RESULTS The results have shown 27 reports of congenital LCMV infection in 86 patients,with 52.73%of them being males.Patients presented with chorioretinitis(83.53%),hydrocephalus(54.12%),and psychomotor retardation or developmental delay(54.12%).Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly(74.07%),periventricular calcifications(66.67%),and microcephaly(40%).Most mothers of congenitally infected infants were exposed to rodents during pregnancy,predominantly mice,with flu-like symptoms mainly occurring during the first two trimesters of gestation.Mortality in congenitally infected children was 16.47%.The diagnosis of congenital LCMV infection was confirmed serologically in most patients(86.67%).CONCLUSION LCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae.Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH(T:Toxoplasma gondii,O:Other pathogens,R:Rubella virus,C:Cytomegalovirus,H:Herpes simplex virus)pathogens.

Adults with Congenital Heart Disease during the COVID-19 Era:One-Year Tertiary Center Experience

Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection in ACHD patients.Methods:This is a one-year(March-2020 to March-2021)tertiary-center retrospective study that enrolled all ACHD patients;COVID-19 positive patients’medical records,and management were reported.Results:We recorded 542 patients,205(37.8%)COVID-19-positive,and 337(62.2%)COVID-19-negative patients.Palliated single ventricle and Eisenmenger syndrome patients were more vulnerable to COVID-19 infection(P<0.05*).Cardiovascular COVID-19 complications were arrhythmias in 47(22.9%)patients,heart failure in 39(19.0%)patients,cyanosis in 12(5.9%)patients,stroke/TIA in 5(2.4%)patients,hypertension and infective endocarditis in 2(1.0%)patients for each,pulmonary hypertension and pulmonary embolism in 1(0.5%)patient for each.11(5.4%)patients were managed with home isolation,147(71.7%)patients required antibiotics,32(15.6%)patients required intensive care unit(ICU),8(3.9%)patients required inotropes,7(3.4%)patients required mechanical ventilation,and 2(1.0%)patients required extracorporeal membrane oxygenation(ECMO).Thromboprophylaxis was given to all 46(22.4%)hospitalized patients.American College of Cardiology/American Heart Association classification revealed that complex lesions,and FC-C/D categories were more likely to develop severe/critical symptoms,that required mechanical ventilation and ECMO(P<0.05*).Mortality was reported in 3(0.6%)patients with no difference between groups(P=0.872).193(35.6%)patients were vaccinated.Conclusions:COVID-19 infection in ACHD patients require individualized risk stratification and management.Eisenmenger syndrome,single ventricle palliation,complex lesions,and FC-C/D patients were more vulnerable to severe/critical symptoms that required ICU admission,mechanical ventilation,and ECMO.The vaccine was mostly tolerable.

Immunobiology of congenital cytomegalovirus infection of the central nervous system--the murine cytomegalovirus model

Congenital human cytomegalovirus infection is a leading infectious cause of long-term neurodevelopmental sequelae, including mental retardation and hearing defects. Strict species specificity of cytomegaloviruses has restricted the scope of studies of cytomegalovirus infection in animal models. To investigate the pathogenesis of congenital human cytomegalovirus infection, we developed a mouse cytomegalovirus model that recapitulates the major characteristics of central nervous system infection in human infants, including the route of neuroinvasion and neuropathological findings. Following intraperitoneal inoculation of newborn animals with mouse cytomegalovirus, the virus disseminates to the central nervous system during high-level viremia and replicates in the brain parenchyma, resulting in a focal but widespread, non-necrotizing encephalitis. Central nervous system infection is coupled with the recruitment of resident and peripheral immune cells as well as the expression of a large number of pro-inflammatory cytokines. Although infiltration of cellular constituents of the innate immune response characterizes the early immune response in the central nervous system, resolution of productive infection requires virus-specific CD8＋ T cells. Perinatal mouse cytomegalovirus infection results in profoundly altered postnatal development of the mouse central nervous system and long-term motor and sensory disabilities. Based on an enhanced understanding of the pathogenesis of this infection, prospects for novel intervention strategies aimed to improve the outcome of congenital human cytomegalovirus infection are proposed.

Vertical Transmission of Schistosoma Japonicum in the Rabbit

The aim of the present study was to confirm observations on the vertical transmission of Schistosoma japonicum in the rabbit. S. japonicum- infected pregnant rabbits were used in this study. Perfusion of mother rabbits was done 9weeks after infection in order to obtain worm bur- dens in relation to their initial cercarial dose.Anti- schistosoma specific Ig M antibodies in serum samples collected from rabbit kittens were detected by EL ISA.Our results showed that gestation period lasted the norm al2 9- 31days.All the exposed mother rabbits became infected with S. japonicum.Positive Ig M antibody OD values were detected in12 out of the6 0 kittens exam ined (2 0 .0 % ) . In group C and A,4 0 .0 % and 17.9% of the kitten were congenitally infected,re- spectively. 18.1% of the kittens born to mothers infected with a single dose of 2 0 0 cercariae per rabbit were positives;this is not significantly different from that obtained for the 6 0 0 dose group (2 2 .2 % ) .Three randomly selected Ig M+ kittens harbored between one and two adult worm s. The livers of these kittens displayed granulomatous lesions. It is concluded that congenital S. japonicum infection does occur in the rabbit and is affected by the m other stage of pregnancy and to a lesser extent by its infection load.

The etiology of congenital nephrotic syndrome: current status and challenges

Background:Congenital nephrotic syndrome(CNS),defined as heavy proteinuria,hypoalbuminemia,hyperlipidemia and edema presenting in the first 0-3 months of life,may be caused by congenital syphilis,toxoplasmosis,or congenital viral infections(such as cytomegalovirus).However,the majority of CNS cases are caused by monogenic defects of structural proteins that form the glomerular fi ltration barrier in the kidneys.Since 1998,an increasing number of genetic defects have been identifi ed for their involvements in the pathogenesis of CNS,including NPHS1,NPHS2,WT1,PLCE1,and LAMB2.Data sources:We searched databases such as PubMed,Elsevier and Wanfang with the following key words:congenital nephrotic syndrome,proteinuria,infants,neonate,congenital infection,mechanism and treatment;and we selected those publications written in English that we judged to be relevant to the topic of this review.Results:Based on the data present in the literature,we reviewed the following topics:1)Infection associated CNS including congenital syphilis,congenital toxoplasmosis,and congenital cytomegalovirus infection;2)genetic CNS including mutation of NPHS1(Nephrin),NPHS2(Podocin),WT1,LAMB2(Laminin-β2),PLCE1(NPHS3);3)Other forms of CNS including maternal systemic lupus erythematosus,mercury poisoning,renal vein thrombosis,neonatal alloimmunization against neutral endopeptidase.Conclusions:At present,the main challenge in CNS is to identify the cause of disease for individual patients.To make a definitive diagnosis,with the exclusion of infection-related CNS and maternal-associated disorders,pathology,family history,inheritance mode,and other accompanying congenital malformations are sometimes,but not always,useful indicators for diagnosing genetic CNS.Next-generation sequencing would be a more effective method for diagnosing genetic CNS in some patients,however,there are still some challenges with next-generation sequencing that need to be resolved in the future.

Detection of congenital cytomegalovirus in newborns using nucleic acid amplification techniques and its public health implications

Human cytomegalovirus(HCMV), a herpesvirus, is an important human pathogen that causes asymptomatic infections in healthy or immunocompetent individuals but can lead to severe and potentially life-threatening complications in immune-immature individuals such as neonates or immune-compromised patients such as organ-transplant recipients and HIV-positive individuals.Congenital HCMV infection represents a significant public health issue and poses substantial healthcare and economic burden to society. This virus causes the most common viral congenital infection worldwide, and is the leading non-genetic cause of sensorineural hearing loss in children in developed countries. Congenital HCMV infection is believed to fulfill the criteria of the American College of Medical Genetics to be considered as a condition targeted for a newborn screening program. This is because congenital HCMV infection can be identified during a time(within 2 days after birth) at which it would not ordinarily be detected clinically, and there are demonstrated benefits of early detection, timely intervention, and efficacious treatment of the condition. Recent progresses in developing polymerase chain reaction-based approaches to detect HCMV in samples obtained from newborns have generated much excitement in the field. In this review, we highlight the recent progress in diagnostic techniques that could potentially be used for the detection of HCMV infection in neonates and its direct implications in public health settings for diagnosing congenital HCMV infection.

Viral Infections During Pregnancy:The Big Challenge Threatening Maternal and Fetal Health

Viral infections during pregnancy are associated with adverse pregnancy outcomes,including maternal and fetal mortality,pregnancy loss,premature labor,and congenital anomalies.Mammalian gestation encounters an immunological paradox wherein the placenta balances the tolerance of an allogeneic fetus with protection against pathogens.Viruses cannot easily transmit from mother to fetus due to physical and immunological barriers at the maternal-fetal interface posing a restricted threat to the fetus and newborns.Despite this,the unknown strategies utilized by certain viruses could weaken the placental barrier to trigger severe maternal and fetal health issues especially through vertical transmission,which was not fully understood until now.In this review,we summarize diverse aspects of the major viral infections relevant to pregnancy,including the characteristics of pathogenesis,related maternal-fetal complications,and the underlying molecular and cellular mechanisms of vertical transmission.We highlight the fundamental signatures of complex placental defense mechanisms,which will prepare us to fight the next emerging and re-emerging infectious disease in the pregnancy population.