Cytomegalovirus

巨细胞病毒
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    巨细胞病毒(CMV)的再激活是同种异体干细胞移植后的重要问题。虽然先前的研究强调了γδT细胞在免疫受损移植患者中的抗CMV再激活作用,CMV再激活高危受者的特征仍然有限.
    本研究的重点是处于CMV再激活高风险的D+/R+受者(供者和受者均为CMV血清阳性)。我们分析了28例异基因造血干细胞移植后100天内出现CMV复发的患者,以及36名未经历CMV复发的匹配接受者.比较两组的临床数据,并确定了CMV再激活的危险因素。此外,测量CMV病毒载量,并进行流式细胞术分析以评估外周血γδT细胞比例的变化,亚群分布,和差异化地位。我们还分析了不同γδT细胞亚群中TCRδ链的CDR3库。通过在刺激时测量CMV感染的细胞的裂解来进行功能分析。
    移植后CMV的再激活与急性移植物抗宿主病(aGvHD)和非CMV疱疹病毒的再激活有关。值得注意的是,CMV再激活导致γδT细胞持续扩增,主要在Vδ2negγδT细胞亚群内,从幼稚细胞分化为效应记忆细胞的趋势。对δ链CDR3库的分析显示,CMV再激活后Vδ2negγδT细胞中克隆多样性的重建延迟,而Vδ2posT细胞未受影响。在用CMV感染的MRC5细胞刺激时,Vδ2negγδT细胞亚群作为产生IFN-γ并能够裂解CMV感染细胞的主要效应细胞群出现。此外,我们的发现表明,NKG2D不一定参与Vδ2negγδT细胞介导的抗CMV细胞毒性。
    这项研究为γδT细胞在CMV感染高风险的移植受体中对CMV再激活的免疫反应中的作用提供了新的见解。具体来说,Vδ2negγδT细胞亚群似乎与CMV再激活密切相关,强调它们在控制感染和反映HSCT患者CMV再激活方面的潜在作用。
    UNASSIGNED: Cytomegalovirus (CMV) reactivation is a significant concern following allogeneic stem cell transplantation. While previous research has highlighted the anti-CMV reactivation effect of γδ T cells in immunocompromised transplant patients, their characterization in recipients at high risk of CMV reactivation remains limited.
    UNASSIGNED: This study focused on D+/R+ recipients (where both donor and recipient are CMV seropositive) at high risk of CMV reactivation. We analyzed 28 patients who experienced CMV recurrence within 100 days post-allogeneic hematopoietic stem cell transplantation, along with 36 matched recipients who did not experience CMV recurrence. Clinical data from both groups were compared, and risk factors for CMV reactivation were identified. Additionally, CMV viral load was measured, and flow cytometric analysis was conducted to assess changes in peripheral blood γδ T cell proportions, subpopulation distribution, and differentiation status. We also analyzed the CDR3 repertoire of the TCR δ chain in different γδ T cell subsets. Functional analysis was performed by measuring the lysis of CMV-infected cells upon stimulation.
    UNASSIGNED: CMV reactivation post-transplantation was associated with acute graft-versus-host disease (aGvHD) and reactivation of non-CMV herpesviruses. Notably, CMV reactivation led to sustained expansion of γδ T cells, primarily within the Vδ2neg γδ T cell subpopulation, with a trend toward differentiation from Naive to effector memory cells. Analysis of the δ chain CDR3 repertoire revealed a delay in the reconstitution of clonal diversity in Vδ2neg γδ T cells following CMV reactivation, while Vδ2pos T cells remained unaffected. Upon stimulation with CMV-infected MRC5 cells, the Vδ2neg γδ T cell subpopulation emerged as the primary effector cell group producing IFN-γ and capable of lysing CMV-infected cells. Moreover, our findings suggest that NKG2D is not necessary involved in Vδ2neg γδ T cell-mediated anti-CMV cytotoxicity.
    UNASSIGNED: This study provides novel insights into the role of γδ T cells in the immune response to CMV reactivation in transplantation recipients at high risk of CMV infection. Specifically, the Vδ2neg γδ T cell subpopulation appears to be closely associated with CMV reactivation, underscoring their potential role in controlling infection and reflecting CMV reactivation in HSCT patients.
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  • 文章类型: Journal Article
    目的:探讨风湿性疾病(RD)患者不同CMV感染状态下巨细胞病毒(CMV)抗原特异性多细胞因子免疫反应。
    方法:纳入了2023年3月至2023年8月在我们中心的60例RD患者。将患者分为潜伏性CMV感染和活动性CMV感染,根据是否存在CMV相关症状,后者被分类为亚临床CMV感染或CMV疾病.收集全血并用QuantiFERON-CMV抗原刺激。IFN-γ的水平,TNF-α,通过Luminex测定法测量上清液中的IL-2、IL-4、IL-6、IL-10、IL-17和CXCL-2。受试者工作特征曲线用于评估细胞因子对区分不同CMV感染状态的诊断准确性。
    结果:在潜伏性CMV感染组中,严重淋巴细胞减少的患者比例最低,而不同CMV感染状态下的用药情况无显著差异。用QF-CMV抗原刺激后,IFN-γ的水平,CMV病组的TNF-α和IL-2明显低于潜伏CMV感染组。CMV抗原特异性IFN-γ,TNF-α水平和严重的淋巴细胞减少一起提供了区分潜伏性和活动性CMV感染患者(AUC=0.854)或CMV疾病患者(AUC=0.935)的最佳区分性能。
    结论:非侵入性外周血生物标志物(CMV抗原特异性IFN-γ的组合,TNF-α水平和严重的淋巴细胞减少)可能有可能使RD人群中CMV感染的不同状态不同。
    OBJECTIVE: To explore Cytomegalovirus (CMV) antigen-specific multi-cytokine immune responses in patients with rheumatic disease (RD) under different CMV infection status.
    METHODS: A total of 60 RD patients in our center from March 2023 to August 2023 were enrolled. The patients were divided into latent CMV infection and active CMV infection, the latter was classified as subclinical CMV infection or CMV disease based on presence or absence of symptoms related to CMV. Whole blood was collected and stimulated with QuantiFERON-CMV antigen. The levels of IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10, IL-17 and CXCL-2 in supernatant were measured by Luminex Assays. The receiver operating characteristic curve was used to evaluate the diagnostic accuracy of cytokine for distinguishing different CMV infection status.
    RESULTS: The proportion of patients with severe lymphopenia was lowest in the latent CMV infection group, while there were no significant differences in medication usage in different CMV infection status. After stimulation with QF-CMV antigens, the levels of IFN-γ, TNF-α and IL-2 in the CMV disease group were significantly lower than those in the latent CMV infection group. CMV antigen-specific IFN-γ, TNF-α levels and severe lymphopenia together provided the best discriminatory performance for distinguishing between latent and either active CMV infection patients (AUC = 0.854) or CMV disease patients (AUC = 0.935).
    CONCLUSIONS: Noninvasive peripheral blood biomarkers (the combination of CMV antigen-specific IFN-γ, TNF-α levels and severe lymphopenia) may have the potential to diferentiate different status of CMV infection in RD population.
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  • 文章类型: Journal Article
    背景:人巨细胞病毒(HCMV)是一种疱疹病毒,可以感染各种细胞类型并调节宿主基因表达和免疫应答。它与各种癌症的发病机理有关,但其分子机制仍然难以捉摸。
    方法:我们使用癌症基因组图谱(TCGA)和基因型组织表达(GTEx)数据库全面分析了26种癌症类型中HCMV途径基因的表达。我们还使用生物信息学工具来研究泛癌症中的免疫侵袭和肿瘤微环境。采用Cox回归和机器学习分析预后基因及其与药物敏感性的关系。
    结果:我们发现HCMV通路基因在各种癌症中广泛表达。免疫浸润和肿瘤微环境表明HCMV参与复杂的免疫过程。我们获得了25种癌症的预后基因,并在HCMV途径中发现了23个关键基因,显着富集细胞趋化和突触功能,可能参与疾病进展。值得注意的是,在大多数肿瘤中,CaM家族基因上调,AC家族基因下调。这些hub基因与对各种药物的敏感性或抗性相关,表明它们作为治疗靶点的潜力。
    结论:我们的研究揭示了HCMV途径在各种癌症中的作用,并提供了对其分子机制和治疗意义的见解。值得注意的是,HCMV通路的关键基因可能为癌症预防和治疗打开新的大门。
    BACKGROUND: Human cytomegalovirus (HCMV) is a herpesvirus that can infect various cell types and modulate host gene expression and immune response. It has been associated with the pathogenesis of various cancers, but its molecular mechanisms remain elusive.
    METHODS: We comprehensively analyzed the expression of HCMV pathway genes across 26 cancer types using the Cancer Genome Atlas (TCGA) and The Genotype-Tissue Expression (GTEx) databases. We also used bioinformatics tools to study immune invasion and tumor microenvironment in pan-cancer. Cox regression and machine learning were used to analyze prognostic genes and their relationship with drug sensitivity.
    RESULTS: We found that HCMV pathway genes are widely expressed in various cancers. Immune infiltration and the tumor microenvironment revealed that HCMV is involved in complex immune processes. We obtained prognostic genes for 25 cancers and significantly found 23 key genes in the HCMV pathway, which are significantly enriched in cellular chemotaxis and synaptic function and may be involved in disease progression. Notably, CaM family genes were up-regulated and AC family genes were down-regulated in most tumors. These hub genes correlate with sensitivity or resistance to various drugs, suggesting their potential as therapeutic targets.
    CONCLUSIONS: Our study has revealed the role of the HCMV pathway in various cancers and provided insights into its molecular mechanism and therapeutic significance. It is worth noting that the key genes of the HCMV pathway may open up new doors for cancer prevention and treatment.
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  • 文章类型: Case Reports
    好综合征(GS)表现为胸腺瘤,低球蛋白血症,和反复感染。诊断为GS和巨细胞病毒(CMV)胃肠炎的患者的表现罕见且非特异性。早期诊断和治疗可改善罕见病的预后。
    好综合征(GS),一种罕见的获得性免疫缺陷疾病,以胸腺瘤为特征,低球蛋白血症,外周B淋巴细胞计数低。GS往往发生在40-60岁的个体中,导致各种条件致病菌反复感染的风险增加,病毒,和真菌。巨细胞病毒(CMV)可引起肺炎,视网膜炎,脑炎,GS患者的肠炎,但是消化道的CMV感染通常被低估了,延迟诊断和误诊。在这项研究中,我们报道了1例GS合并CMV感染引起的慢性腹泻的女性患者,并复习文献总结这种罕见疾病的特点,以提高GS患者CMV胃肠炎的临床诊断和预后.
    UNASSIGNED: Good\'s syndrome (GS) presents with thymoma, hypogammaglobulinemia, and recurrent infection. The manifestations of patients diagnosed with GS and Cytomegalovirus (CMV) gastroenteritis are rare and non-specific. Early diagnosis and treatment can improve the prognosis of the rare disease.
    UNASSIGNED: Good\'s syndrome (GS), a rare acquired immunodeficiency condition, is characterized by thymoma, hypogammaglobulinemia, and low peripheral B-lymphocyte count. GS tends to occur in individuals aged 40-60 years, resulting in increased risk of recurrent infections with various conditional pathogenic bacteria, viruses, and fungi. Cytomegalovirus (CMV) can cause pneumonia, retinitis, encephalitis, and enteritis in GS patient, but CMV infection in the alimentary tract is usually underestimated, delayed diagnosed and misdiagnosed. In this study, we reported a female patient with GS and chronic diarrhea due to CMV infection and reviewed the literature to conclude the characteristics of this rare condition to improve the clinical diagnosis and prognosis of CMV gastroenteritis in patients with GS.
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  • 文章类型: Case Reports
    我们介绍了一名感染巨细胞病毒的艾滋病患者,肺孢子虫肺炎,非结核分枝杆菌,和COVID-19,他们最终从合并感染中恢复过来。这名36岁的男子两次住院。在第一次住院时,病人被诊断为巨细胞病毒,肺孢子虫肺炎,艾滋病毒,和COVID-19快速准确,相应的治疗效果很好。第二次住院可分为四个阶段:(1)持续发热期;(2)持续发热和肺进展;(3)ICU期;(4)气胸期。在第二次住院期间,因为NGS,抗酸杆菌,和呕吐物的培养,痰,支气管肺泡灌洗液均为阴性。尽管如此,我们在血液分枝杆菌培养物中检测到抗酸杆菌。总之,我们报告了一名合并感染巨细胞病毒的严重肺炎艾滋病患者,肺孢子虫肺炎,COVID-19和哥伦比亚分枝杆菌,他们最终从疾病中康复。非结核分枝杆菌感染在HIV患者中很常见,但是在我们的报告中,支气管肺泡灌洗液NGS不能识别非结核性分枝杆菌.在我们的研究中,传统的血培养有助于检测抗酸杆菌,然后用NGS检测病原体。将传统的微生物培养与新兴的快速NGS方法相结合,更有利于临床诊断和治疗。
    We present an AIDS patient coinfected with Cytomegalovirus, Pneumocystis jirovecii pneumonia, nontuberculous mycobacteria, and COVID-19, who finally recovered from the coinfection. The 36-year-old man had two hospitalizations. In the first hospitalization, the patient was diagnosed with Cytomegalovirus, Pneumocystis jirovecii pneumonia, HIV, and COVID-19 quickly and accurately, and the corresponding treatment worked well. The second hospitalization can be divided into four stages: (1) Persistent fever period; (2) Persistent fever and Pulmonary Progression; (3) ICU period; and (4) Pneumothorax period. During the second hospitalization, the diagnosis of Mycobacterium colombiense was hard because the NGS, acid-fast bacilli, and culture of vomit, sputum, and bronchoalveolar lavage fluid were all negative. Still, we detected acid-fast bacilli in the blood mycobacterium culture. In conclusion, we report a severe pneumonia AIDS patient coinfected with Cytomegalovirus, Pneumocystis jirovecii pneumonia, COVID-19, and Mycobacterium colombiense who finally recovered from the disease. Nontuberculous mycobacteria infection is common in HIV patients, but bronchoalveolar lavage fluid NGS cannot identify nontuberculous mycobacteria in our report. Traditional blood culture was useful in detecting acid-fast bacilli in our study and then detecting the pathogens with NGS. Combining traditional microbial culture and emerging rapid NGS methods is more conducive to clinical diagnosis and treatment.
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  • 文章类型: Journal Article
    目的:已在双相情感障碍(BD)中观察到免疫改变。然而,弓形虫(Tgondii)抗体的血清阳性,风疹,巨细胞病毒(CMV)与BD具有临床相关性,仍然有争议。本研究旨在探讨这种关联。
    方法:弓形虫的抗体血清阳性,风疹病毒,CMVIgM,根据病历(2018年1月至2023年1月)提取了女性BD患者和对照组的IgG.家族史,BD类型,发病年龄,并收集精神病症状史。
    结果:585名BD患者和800名健康对照。BD患者在10-20岁组发现弓形虫IgG阳性率较低(OR=0.10),风疹IgG阳性率在10-20岁组(OR=5.44)和20-30岁组(OR=3.15)较高。有家族史的BD优选弓形虫IgG阳性率较高(OR=24.00)。与II型BD相比,I型BD的风疹IgG阳性率降低(OR=0.37),CMVIgG阳性率升高(OR=2.12)。而早期发作的BD与无早期发作的BD相比显示出对比结果(风疹IgG,OR=2.54;CMVIgG,OR=0.26)。有精神病症状史的BD显示风疹IgG阳性率较低(OR=0.50)。
    结论:缺乏男性证据和控制社会经济地位和环境暴露。
    结论:弓形虫的差异抗体阳性率,风疹,在BD中观察到巨细胞病毒。
    OBJECTIVE: Immunity alterations have been observed in bipolar disorder (BD). However, whether serum positivity of antibodies to Toxoplasma gondii (T gondii), rubella, and cytomegalovirus (CMV) shared clinical relevance with BD, remains controversial. This study aimed to investigate this association.
    METHODS: Antibody seropositivity of IgM and IgG to T gondii, rubella virus, and CMV of females with BD and controls was extracted based on medical records from January 2018 to January 2023. Family history, type of BD, onset age, and psychotic symptom history were also collected.
    RESULTS: 585 individuals with BD and 800 healthy controls were involved. Individuals with BD revealed a lower positive rate of T gondii IgG in the 10-20 aged group (OR = 0.10), and a higher positive rate of rubella IgG in the 10-20 (OR = 5.44) and 20-30 aged group (OR = 3.15). BD with family history preferred a higher positive rate of T gondii IgG (OR = 24.00). Type-I BD owned a decreased positive rate of rubella IgG (OR = 0.37) and an elevated positive rate of CMV IgG (OR = 2.12) compared to type-II BD, while BD with early onset showed contrast results compared to BD without early onset (Rubella IgG, OR = 2.54; CMV IgG, OR = 0.26). BD with psychotic symptom history displayed a lower positive rate of rubella IgG (OR = 0.50).
    CONCLUSIONS: Absence of male evidence and control of socioeconomic status and environmental exposure.
    CONCLUSIONS: Differential antibody seropositive rates of T gondii, rubella, and cytomegalovirus in BD were observed.
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  • 文章类型: Case Reports
    新生儿肺出血是多种疾病的晚期表现。早产和低体重常被视为高危因素,以急性发作为特征,快速发展,和高死亡率。巨细胞病毒感染引起的肺出血在免疫功能正常的新生儿中是罕见的。该病例报告的重点是出生体重正常的足月新生儿,其出生后不久仅出现鼻塞。然而,出生后4天,新生儿突然从口腔和鼻腔涌出血液。病人被诊断为消化道出血,新生儿肺炎和新生儿肺实变。对症治疗十天后出院。然而,回家后,患者突然出现口鼻出血,导致他不合时宜的死亡。随后的尸检显示新生儿存在肺出血,表现为间质性肺炎。肺出血的原因是巨细胞病毒感染。本病例强调儿科医生提高鉴别肺出血的技能的重要性,尤其是巨细胞病毒肺炎.
    Neonatal pulmonary hemorrhage is a late manifestation of various diseases. Premature delivery and low body weight are frequently observed as high-risk factors, characterized by acute onset, rapid progression, and high mortality rates. Pulmonary hemorrhage caused by cytomegalovirus infection in newborns with normal immune function is a rare occurrence. This case report focuses on a term neonate with normal birth weight who presented solely with nasal obstruction shortly after birth. However, 4 days after birth, the newborn experienced a sudden onset of blood gushing from both the mouth and nasal cavity. The patient was diagnosed with gastrointestinal bleeding, neonatal pneumonia and neonatal lung consolidation. And he was discharged after ten days of symptomatic treatment. However, upon returning home, the patient experienced a sudden onset of bleeding from the mouth and nose, leading to his untimely demise. Subsequent autopsy revealed the presence of pulmonary hemorrhage in newborn, which presented as interstitial pneumonia. The cause of pulmonary hemorrhage is cytomegalovirus infection. This case emphasizes the importance of pediatricians enhancing their skills in differentiating pulmonary hemorrhage, especially from cytomegalovirus pneumonia.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Case Reports
    猪肝毛肠综合征是由TTC37(又称SKIC3)或SKIV2L基因变异所惹起的罕见常染色体隐性遗传病。我们介绍了一个受严重影响的2个月大的男婴,患有反复发烧和无法解释的腹泻。此外,本文报道了11例发病1~60天的毛管肝肠综合征患者的临床资料。头孢噻肟舒巴坦和美罗培南治疗后,婴儿的病情没有明显缓解。全外显子测序揭示了父母是相应基因座的杂合携带者的孩子的TTC37中的复合杂合变体(c.1708C>T和c.3342-9T>G)。c.3342-9T>G变体起源于他的母亲,并首次报道。结合临床表现,婴儿被诊断为毛管肝肠综合征,并接受更昔洛韦抗病毒治疗,静脉营养支持,和肝功能保护。婴儿出院时没有发烧,大便频率高,但他的病情有所好转.因此,对于反复发热和原因不明的腹泻,应考虑滴肝肠综合征。
    Trichohepatoenteric syndrome is a rare autosomal recessive genetic disease caused by TTC37 (also known as SKIC3) or SKIV2L gene variant. We present a severely affected 2-month-old male infant with recurrent fever and unexplained diarrhea. Additionally, clinical data of 11 patients with trichohepatoenteric syndrome in China from 1 to 60 days of onset was presented. The infant\'s condition was not substantially relieved after cefotaxime sulbactam and meropenem treatment. Whole-exome sequencing revealed compound heterozygous variants (c.1708C>T and c.3342-9T>G) in TTC37 of the child whose parents were heterozygous carriers of the corresponding locus. The c.3342-9T>G variant originated from his mother and was reported for the first time. Combined with the clinical manifestations, the infant was diagnosed with trichohepatoenteric syndrome and treated with ganciclovir antiviral, intravenous nutritional support, and liver function protection. The infant was discharged with no fever and high stool frequency, but his condition improved. Therefore, trichohepatoenteric syndrome should be considered for recurrent fever and unexplained diarrhea.
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