human herpesvirus

人类疱疹病毒
  • 文章类型: Meta-Analysis
    背景:宫颈癌(CC)是全世界女性中最常见的妇科肿瘤之一。尽管人乳头瘤病毒(HPV)在CC中的病因学作用已得到证实,CC癌变的其他因素尚不清楚.这里,我们进行了系统评价和荟萃分析,以探讨人类疱疹病毒(HHVs)感染与CC风险之间的关系.
    方法:利用Embase和PubMed数据库检索相关研究。修订后的JBI关键评估工具用于评估纳入研究的质量。计算患病率和比值比(ORs)和95%置信区间(CI),以评估病毒感染与CC或癌前宫颈病变(PCL)之间的关联。
    结果:共有67项符合条件的研究纳入荟萃分析,涉及7种不同的HHV。我们发现CC或PCL的风险增加,这与HHV的整体感染有关(CC,OR=2.74,95%CI2.13-3.53;PCL,OR=1.95,95%CI1.58-2.41)。亚组分析显示2型单纯疱疹病毒(HSV-2)感染与CC(OR=3.01,95%CI2.24至4.04)或PCL(OR=2.14,95%CI1.55至2.96)之间呈正相关。EB病毒(EBV)感染与CC(OR=4.89,95%CI2.18至10.96)或PCL(OR=3.55,95%CI2.52至5.00)之间也是如此。然而,对于HSV-1和巨细胞病毒(HCMV),病毒感染与CC或PCL无相关性.相比之下,由于研究数量有限,HHV-6,HHV-7和卡波西肉瘤相关疱疹病毒(KSHV)在宫颈病变中的作用尚不清楚.
    结论:这项研究提供了证据,表明HHV感染作为一个整体会增加CC发病率的风险。此外,某些类型的HHV,如EBV和HSV-2,可能成为宫颈病变新干预措施或治疗策略开发的潜在靶点.
    Cervical cancer (CC) is one of the most common gynecologic tumors among women around the world. Although the etiological role of human papillomavirus (HPV) in CC is well established, other factors in CC carcinogenesis remains unclear. Here, we performed a systematic review and meta-analysis to explore the association between infections of human herpesvirus (HHVs) and CC risk.
    Embase and PubMed databases were utilized to search the relevant studies. The revised JBI Critical Appraisal Tool was used to assess the quality of the included studies. Prevalence and odds ratios (ORs) with 95% confidence intervals (CI) were calculated to evaluate the association between viral infection and CC or precancerous cervical lesions (PCL).
    Totally 67 eligible studies involving 7 different HHVs were included in meta-analysis. We found an increased risk of CC or PCL that was associated with the overall infection of HHVs (CC, OR = 2.74, 95% CI 2.13-3.53; PCL, OR = 1.95, 95% CI 1.58-2.41). Subgroup analysis showed a trend towards positive correlations between herpes simplex virus type 2 (HSV-2) infection and CC (OR = 3.01, 95% CI 2.24 to 4.04) or PCL (OR = 2.14, 95% CI 1.55 to 2.96), and the same is true between Epstein-Barr virus (EBV) infection and CC (OR = 4.89, 95% CI 2.18 to 10.96) or PCL (OR = 3.55, 95% CI 2.52 to 5.00). However, for HSV-1 and cytomegalovirus (HCMV), there was no association between viral infection and CC or PCL. By contrast, the roles of HHV-6, HHV-7, and Kaposi sarcoma-associated herpesvirus (KSHV) in cervical lesions were unclear due to the limited number of studies.
    This study provided evidence that HHVs infection as a whole increase the risk of CC incidence. In addition, some types of HHVs such as EBV and HSV-2 may serve as potential targets in the development of new interventions or therapeutic strategies for cervical lesions.
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  • 文章类型: Journal Article
    关于病毒特征的知识,进入宿主细胞和增殖/传播的机制可以帮助控制和治疗病毒病理。与宿主相关的几种营养因素可能有利于病毒的繁殖及其控制,可能导致新的预防性替代品和/或抗病毒治疗。这篇综述的目的是讨论氨基酸L-赖氨酸与病毒感染控制之间的关系,针对可能的治疗性质。这项研究使用了PubMed等数据库,WebofScience,Scielo,Medline和谷歌学者,以及搜索期刊引用的参考文献。时间框架涵盖了1964年至2022年1月之间的时期。观察到的研究表明,通常的抗病毒疗法不能干扰潜伏状态的病毒;然而,它们可以干扰病毒颗粒的粘附和融合或蛋白质的产生,它们在病毒流行病学和控制中起着重要作用,特别是在最初的时刻和重新激活。赖氨酸是一种氨基酸,可以通过与氨基酸精氨酸的竞争性拮抗作用,主要干扰衣壳蛋白和DNA的形成。是某些病毒必需的氨基酸,还通过促进精氨酸酶的增加,增加精氨酸的分解代谢。虽然有证据表明L-赖氨酸在病毒控制中的重要性,需要更多的研究,以寻求新的抗病毒疗法。
    Knowledge about viral characteristics, mechanisms of entry into the host cell and multiplication/dissemination can help in the control and treatment of viral pathologies. Several nutritional factors linked to the host may favour viral multiplication and their control, may lead to new prophylactic alternatives and/or antiviral therapies. The objective of this review is to discuss the relationship between the amino acid L-lysine and the control of viral infections, aiming at a possible therapeutic property. This research used databases such as PubMed, Web of Science, Scielo, Medline and Google Scholar, as well as searching for references cited by journals. The time frame covered the period between 1964 and January 2022. The observed studies have shown that the usual antiviral therapies are not able to interfere with the viruses in their latent state; however, they can interfere with the adhesion and fusion of viral particles or the production of proteins, which play an important role in viral epidemiology and control, particularly in the initial moment and in reactivation. Lysine is an amino acid that can interfere mainly in the formation of capsid proteins and DNA by a competitive antagonism with amino acid arginine, which is an essential amino acid for some viruses, and also by promoting the increase of arginase, increasing the catabolism of arginine. Although there is evidence of the importance of L-lysine in viral control, more studies are needed, with a view to new antiviral therapies.
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  • 文章类型: Journal Article
    背景:玫瑰糠疹是一种常见的急性,主要影响儿童和年轻人的自限性丘疹鳞状皮肤病。该疾病及其临床变异可能构成诊断挑战,尤其是在没有先驱补丁的情况下。
    目的:本文旨在使儿科医生熟悉临床表现,评估,诊断,和玫瑰糠疹的管理。
    方法:于2020年3月在Pubmed临床查询中使用关键术语“玫瑰糠疹”进行了搜索。搜索策略包括所有临床试验(包括开放试验,非随机对照试验,和随机对照试验),观察性研究,以及过去10年发表的评论(包括叙述性评论和荟萃分析)。本评论仅包括在英语文献中发表的论文。从上述搜索中检索到的信息用于本文的汇编。
    结果:玫瑰糠疹主要发生在10至35岁的个体中,在青春期达到高峰。人类疱疹病毒(HHV)-7和HHV-6被认为是某些玫瑰糠疹患者的病原体。由头痛组成的轻度前驱症状,发烧,萎靡不振,疲劳,厌食症,喉咙痛,大约5%的患者存在淋巴结肿大和关节痛。最常见的提示标志,在大约80%的患者中发现,是一个“先驱”或“母亲”补丁,比后来爆发的病变更大,更明显。广义的,双边,对称喷发在大约4到14天内发展,并在接下来的12到21天内继续在作物中爆发。典型病变为0.5至1厘米,卵形或椭圆形,暗淡的粉红色或鲑鱼色的斑疹,外围有精致的鳞片。长轴倾向于沿着分裂的皮肤线(朗格线)取向。背部的病变可能具有特征性的“圣诞树”,而上胸部的病变可能具有V形图案。有许多条件可以模仿玫瑰糠疹。在没有先驱补丁及其变体的情况下,玫瑰糠疹可能会带来诊断挑战。典型的课程是6到8周。在绝大多数情况下,安慰和对症治疗就足够了。对于患有严重或复发性玫瑰糠疹的个体和患有该疾病的孕妇,可以考虑积极干预。治疗方案包括阿昔洛韦,大环内酯类(特别是,红霉素),和紫外线光疗。如果需要积极干预,有证据支持口服阿昔洛韦缩短病程.
    结论:玫瑰糠疹是一种常见的,急性,主要影响儿童和年轻人的自限性发斑性皮肤病。这种情况的特征是一个\'先驱斑块\'之后,椭圆形的红斑鳞状病变出现在躯干和近端的兰格的分裂线,给它一个“圣诞树”的外观。以其经典形式出现的疾病可以很容易地诊断。该疾病的临床变异可能对普通儿科医生构成诊断挑战。对疾病的了解对于迅速诊断和避免不必要的检查至关重要。
    BACKGROUND: Pityriasis rosea is a common acute, self-limited papulosquamous dermatosis that primarily affects children and young adults. The condition and its clinical variants may pose a diagnostic challenge, especially in the absence of the herald patch.
    OBJECTIVE: This article aimed to familiarize pediatricians with clinical manifestations, evaluation, diagnosis, and management of pityriasis rosea.
    METHODS: A search was conducted in March 2020 in Pubmed Clinical Queries using the key term \' pityriasis rosea\'. The search strategy included all clinical trials (including open trials, non-randomized controlled trials, and randomized controlled trials), observational studies, and reviews (including narrative reviews and meta-analyses) published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.
    RESULTS: Pityriasis rosea occurs mainly in individuals between 10 and 35 years of age with a peak during adolescence. Human herpesvirus (HHV)-7 and HHV-6 have been implicated as the causative agents in some patients with pityriasis rosea. A mild prodrome consisting of headaches, fever, malaise, fatigue, anorexia, sore throat, enlarged lymph nodes and arthralgia is present in about 5% of patients. The most common presenting sign, found in approximately 80% of patients, is a \'herald\' or \"mother\" patch which is larger and more noticeable than the lesions of the later eruption. A generalized, bilateral, symmetrical eruption develops in approximately 4 to 14 days and continues to erupt in crops over the next 12 to 21 days. Typical lesions are 0.5 to 1 cm, oval or elliptical, dull pink or salmon-colored macules with a delicate collarette of scales at the periphery. The long axes tend to be oriented along the skin lines of cleavage (Langer lines). Lesions on the back may have a characteristic \"Christmas tree\" whereas lesions on the upper chest may have a V-shaped pattern. There are many conditions that may mimic pityriasis rosea. Pityriasis rosea in the absence of the herald patch and its variants may pose a diagnostic challenge. The typical course is 6 to 8 weeks. In the vast majority of cases, reassurance and symptomatic treatment should suffice. Active intervention may be considered for individuals with severe or recurrent pityriasis rosea and pregnant women with the disease. Treatment options include acyclovir, macrolides (in particular, erythromycin), and ultraviolet phototherapy. If active intervention is needed, there is evidence supporting the use of oral acyclovir to shorten the duration of illness.
    CONCLUSIONS: Pityriasis rosea is a common, acute, self-limiting exanthematous skin disease that primarily affects children and young adults. The condition is characterized by a \'herald patch\' after which oval erythematous squamous lesions appear along Langer\'s lines of cleavage on the trunk and proximal extremities, giving it a \"Christmas tree\" appearance. The disease presenting in its classical form can easily be diagnosed. Clinical variants of the disease may pose a diagnostic challenge for the general pediatrician. Knowledge of the disease is essential to allow a prompt diagnosis and to avoid unnecessary investigations.
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  • 文章类型: Journal Article
    Frailty is an emerging geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to environmental factors. Several studies have examined the association between persistent cytomegalovirus (CMV) infection and poor clinical outcomes in the elderly, but the results are often contradictory. Here, we performed a systematic review and meta-analysis to analyze the association between human herpesvirus seropositivity [CMV, Epstein-Barr virus (EBV), Varicella zoster virus (VZV), and Herpes simplex virus (HSV)] and frailty in elderly people. Searches were performed in PubMed, SCOPUS, Lilacs, IBECS, and Web of Science databases. We used the odds ratio (OR) as a measure of the association between herpesvirus infections and frailty. Summary estimates were calculated using random-effects models. Six studies were included in the present systematic review. The data from 2559 elderly subjects were analyzed; 1571 of the subjects had ages between 60 and 79 years, and 988 of the subjects were older than 80. We found an association between CMV seropositivity and frailty in the elderly aged 60-79 years (OR 2.33, CI 95% 1.48-3.67) but not in the oldest-old subjects (OR 0.67, CI 95% 0.42-1.05). Moreover, no association was found between EBV, VZV, and HSV infections and frailty. Current evidence suggests an association between CMV seropositivity and frailty in individuals aged 60-79 years old.
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  • 文章类型: Journal Article
    Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi\'s sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch\'s postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagnostic criteria also streamline clinical audits and surveillance of these diseases from community perspectives. However, over-dependence on diagnostic criteria in the face of conflicting clinical features is a potential pitfall. Clinical acumen and the experience of the clinicians cannot be replaced by diagnostic criteria. Diagnostic criteria should be validated and re-validated in response to the ever-changing manifestations of these intriguing rashes. We advocate the establishment and validation of diagnostic criteria of these rashes. We also encourage the ongoing conduction of studies with a small number of patients. However, for a wider purpose, these studies should recruit homogenous patient groups with a view towards future data aggregation.
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