CMV

CMV
  • 文章类型: Journal Article
    巨细胞病毒(CMV)由于其抵消宿主抗病毒先天性免疫反应的能力,已成功在人类中建立了持久的潜伏感染。在与宿主的协同进化过程中,该病毒已经进化出各种逃避技术来逃避宿主的先天免疫监视。目前,目前还没有疫苗可用于预防和治疗CMV感染,CMV感染与宿主抗病毒先天性免疫之间的相互作用尚不清楚。然而,正在进行的研究将为如何治疗和预防CMV感染及其相关疾病提供新的见解。这里,我们更新了最近关于CMV如何逃避抗病毒先天免疫的研究,重点关注CMV蛋白如何靶向和破坏抗病毒先天性免疫信号通路的关键衔接子。这篇综述还讨论了一些经典的内在细胞防御,这些防御对于抵抗病毒入侵至关重要。全面审查CMV抗病毒先天免疫的逃避机制将有助于研究人员确定新的治疗靶标并开发针对CMV感染的疫苗。
    Cytomegalovirus (CMV) has successfully established a long-lasting latent infection in humans due to its ability to counteract the host antiviral innate immune response. During coevolution with the host, the virus has evolved various evasion techniques to evade the host\'s innate immune surveillance. At present, there is still no vaccine available for the prevention and treatment of CMV infection, and the interaction between CMV infection and host antiviral innate immunity is still not well understood. However, ongoing studies will offer new insights into how to treat and prevent CMV infection and its related diseases. Here, we update recent studies on how CMV evades antiviral innate immunity, with a focus on how CMV proteins target and disrupt critical adaptors of antiviral innate immune signaling pathways. This review also discusses some classic intrinsic cellular defences that are crucial to the fight against viral invasion. A comprehensive review of the evasion mechanisms of antiviral innate immunity by CMV will help investigators identify new therapeutic targets and develop vaccines against CMV infection.
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  • 文章类型: Journal Article
    与男性发生性关系的男性中巨细胞病毒(CMV)获得的危险因素尚不清楚。血清阳性率,发病率,我们分析了HIV暴露前预防IPERGAY-ANRS试验参与者的危险因素和CMV脱落情况.在测试的417名参与者中,382例基线血清阳性(患病率91.6%;95CI[88.5-94.1]),研究期间10/35血清转化(发病率17.1/100人年;95CI[8.2-31.3])。大量的性伴侣与CMV血清阳性率独立相关。据报道,在口腔和肛门水平上,CMV血清转换器中的脱落分别为6/9和2/9。分别。我们的数据支持性接触期间CMV的传输。
    ClinicalTrials.gov编号,NCT01473472。
    Risk factors for cytomegalovirus (CMV) acquisition in men having sex with men remain unclear. Seroprevalence, incidence, risk factors and shedding of CMV were analyzed among participants enrolled in the HIV pre-exposure prophylaxis IPERGAY-ANRS trial. Among the 417 participants tested, 382 were seropositive at baseline (prevalence of 91.6%; 95%CI[88.5-94.1]) and 10/35 seroconverted during the study (incidence of 17.1 per 100 person-years; 95%CI[8.2-31.3]). A high number of sexual partners was independently associated with CMV seroprevalence. Shedding among CMV-seroconverters was reported for 6/9 and 2/9 at the oral and anal levels, respectively. Our data supports transmission of CMV during sexual contacts.
    UNASSIGNED: ClinicalTrials.gov number, NCT01473472.
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  • 文章类型: Journal Article
    巨细胞病毒(CMV)感染对免疫系统有终身影响,特别是在记忆T细胞上。然而,生命早期CMV感染对婴儿T细胞表型和功能的影响,尤其是儿童期发生的纵向变化尚未得到详细研究.使用高维流式细胞术分析了早期(<6月龄)感染CMV的儿童的外周血CD8和CD4T细胞的表型和功能。在6个月和6岁时收集来自CMVIgG血清阳性(CMV+)儿童的样品,并与来自CMV血清阴性(CMV-)儿童的样品进行比较。早期CMV感染引起T细胞内的多种改变。这些包括在6月龄时CD27+早期和CD27-晚期效应记忆CD8+和CD4+T细胞内CD28表达的下调和CD57表达的上调。在这些变化中,只有高度分化的晚期效应记忆区内的改变在6岁时持续存在.生命早期CMV感染对CD8+和CD4+记忆T细胞区室的发育有明显影响。它似乎会引起暂时和更持久的改变,这可能会影响整个生命中免疫系统的功能。
    Cytomegalovirus (CMV) infection has a life-long impact on the immune system, particularly on memory T cells. However, the effect of early life CMV infection on the phenotype and functionality of T cells in infants and especially longitudinal changes occurring during childhood have not been explored in detail. The phenotype and functionality of peripheral blood CD8+ and CD4+ T cells from children infected with CMV in early life (< 6 months of age) was analyzed using high-dimensional flow cytometry. Samples from CMV IgG-seropositive (CMV+) children were collected at 6 months and 6 years of age and compared to samples from CMV-seronegative (CMV-) children. Early life CMV infection caused multiple alterations within T cells. These include downregulation of CD28 expression and upregulation of CD57 expression within both CD27+ early and CD27- late effector memory CD8+ and CD4+ T-cells at 6 months of age. Of these changes, only alterations within the highly differentiated late effector memory compartment persisted at the age of 6 years. Early life CMV-infection has a distinct impact on developing CD8+ and CD4+ memory T cell compartments. It appears to induce both temporary as well as longer-lasting alterations, which may affect the functionality of the immune system throughout life.
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  • 文章类型: Journal Article
    背景:先天性CMV感染(cCMVI)的早期诊断允许早期干预和随访以发现延迟性听力损失。虽然尿液中的CMVPCR是cCMVI诊断的金标准,经常进行唾液测试。
    目的:我们的目的是确定(i)拭子唾液采样是否需要标准化,(ii)如果唾液样本中的“每百万细胞病毒拷贝(Mc)”阈值可以提高临床特异性,和(iii)建立唾液中的病毒载量与cCMVI的症状学/结果之间的相关性。
    方法:在我们的机构中,新生儿普遍筛查是在分娩时或出生后第3天对唾液拭子进行的。如果是积极的,在2周内完成尿液中的CMVPCR以确认或排除cCMVI。
    结果:细胞定量表明,唾液拭子采样进行得很好,因为95.4%的样品具有超过100个细胞/10µL。唾液病毒载量(拷贝/mL)和拷贝/Mc之间存在良好的相关性(Pearson'sr=0.96,p<0.0001)。然而,阈值,为了确定病毒载量水平,我们可以自信地识别受感染的新生儿,没有提高阳性预测值(拷贝/mL为21.8%,拷贝/Mc为21%,无阈值为25.4%),而是降低了灵敏度(88%和85%,无阈值为100%)。与在第1天收集的样品(23.8%)相比,在第2天或第3天收集的样品具有更好的阳性预测值(38.7%)。出生时的症状与诊断时唾液中的病毒载量没有显着相关。然而,后遗症的发生与唾液中的病毒载量(拷贝数/Mc)有关。
    结论:我们的结果证实,唾液拭子是普遍新生儿筛查的合适样本。然而,确定会出现后遗症的新生儿仍然是cCMVI管理中的一个问题。
    BACKGROUND: Early diagnosis of congenital CMV infection (cCMVI) allows for early intervention and follow-up to detect delayed hearing loss. While CMV PCR in urine is the gold standard for cCMVI diagnosis, saliva testing is often performed.
    OBJECTIVE: Our aim was to determine (i) if swab saliva sampling needed standardization, (ii) if a threshold value in \"virus copies per million cells (Mc)\" in saliva samples could improve clinical specificity, and (iii) to establish a correlation between viral load in saliva and symptomatology/outcome of cCMVI.
    METHODS: In our institution, universal newborn screening is performed on saliva swabs at delivery or until day 3 of life. If positive, CMV PCR in urine is done within 2 weeks to confirm or exclude cCMVI.
    RESULTS: Cell quantification showed that saliva swab sampling was well performed as 95.4 % samples had more than 100 cells/10 µL. There was a good correlation between saliva viral load in copies/mL and in copies/Mc (Pearson\'s r = 0.96, p < 0.0001). However, threshold values, established to determine a viral load level at which we could confidently identify infected newborns, did not improve positive predictive value (21.8 % for copies/mL and 21 % for copies/Mc vs 25.4 % without threshold) but instead reduced sensitivity (88 % and 85% vs 100 % without threshold). Samples collected on day 2 or 3 had better positive predictive value (38.7 %) compared to those collected on day 1 (23.8 %). Symptomatology at birth was not significantly associated with viral load in saliva at diagnosis. However, sequelae occurrence was associated with viral load in saliva (copies/Mc).
    CONCLUSIONS: Our results confirm that saliva swab is a suitable sample for universal neonatal screening. However, identifying newborns that will develop sequelae remains an issue in the management of cCMVI.
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  • 文章类型: Journal Article
    巨细胞病毒(CMV)感染和疾病是移植受体发病和死亡的重要原因。为了在临床试验中开发CMV结局的一致报告,制定了CMV感染和疾病的定义,最近一次于2017年发表。从那以后,有了重大发展,包括新的抗病毒药物的注册。因此,移植相关病毒感染论坛,由科学家组成,临床医生,监管者,和行业代表,已经产生了这些定义的更新版本,结合了最近的知识,目的是支持临床研究和药物开发。这还包括有关先前于2019年发布的耐药性和难治性CMV感染定义的更新。随着田野的发展,这些定义的更新的需要是明确的,和临床医生之间的合作努力,科学家,监管者,行业代表可以为这项工作提供平台。
    Cytomegalovirus (CMV) infection and disease are important causes of morbidity and mortality in transplant recipients. For the purpose of developing consistent reporting of CMV outcomes in clinical trials, definitions of CMV infection and disease were developed and most recently published in 2017. Since then, there have been major developments, including registration of new antiviral agents. Therefore, the Transplant Associated Virus Infections Forum, which consists of scientists, clinicians, regulators, and industry representatives, has produced an updated version of these definitions that incorporates recent knowledge with the aim of supporting clinical research and drug development. This also includes an update regarding the definition of resistant and refractory CMV infections previously published in 2019. As the field evolves, the need for updates of these definitions is clear, and collaborative efforts among clinicians, scientists, regulators, and industry representatives can provide a platform for this work.
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  • 文章类型: Case Reports
    巨细胞病毒(CMV)在免疫功能低下的人群中得到了广泛的研究,导致结肠炎等疾病,视网膜炎,食管炎,脑炎,和肺炎。然而,关于这种疾病如何在有免疫能力的宿主中出现的数据有限,除了自限性单核细胞增多症样综合征。该病例报告介绍了CMV胃肠炎,导致免疫功能正常的女性胃十二指肠梗阻。重要的是要考虑CMV是免疫活性人群中各种胃病的潜在原因。需要进一步研究以建立诊断和治疗该病原体的指南。
    Cytomegalovirus (CMV) has been extensively researched in immunocompromised people, causing conditions such as colitis, retinitis, esophagitis, encephalitis, and pneumonitis. However, there are limited data on how the disease presents itself in immunocompetent hosts, apart from a self-limited mononucleosis-like syndrome. This case report presents CMV gastroenteritis causing gastroduodenal obstruction in an immunocompetent woman. It is important to consider CMV as a potential cause of various gastric pathologies in immunocompetent people. Further research is necessary to establish guidelines for diagnosing and treating this pathogen.
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  • 文章类型: Journal Article
    目的:进行眼疱疹病毒感染的病原学分析,揭示病原体种类和眼睛内不同病毒类型的分布。
    方法:从2017年到2021年在眼科收集样本,北京大学第三医院,采用实时PCR检测常见眼部病毒:单纯疱疹病毒1型(HSV-1),巨细胞病毒(CMV),水痘-带状疱疹病毒(VZV)和EB病毒(EBV)。根据感染部位对不同病毒的发病机理进行分类和分析。
    结果:对5年收集的3627个样本进行了病毒PCR检测,649个(17.89%)样本中含有一种或多种所测试的病毒。CMV的总体检出率最高,为9.93%。在所有样品类型中,房水是最常见的(1752例),其中阳性340例(阳性率19.41%)。角膜样本是下一个最常见的样本,1481例,阳性250例(阳性率16.88%)。CMV在房水和角膜标本中的阳性率高于其他病毒;玻璃体的阳性率最高,为36.36%(20/55),其中VZV阳性18例。
    结论:感染部位的病毒类型分布不同,CMV是在角膜和房水中检测到的最常见的病毒类型,而VZV是在玻璃体中检测到的最常见的病毒。
    OBJECTIVE: To do the etiological analysis of ocular herps virus infection, revealing the pathogen species and the distribution of different virus types within the eye.
    METHODS: Samples were collected from 2017 to 2021 at the Department of Ophthalmology, Peking University Third Hospital and tested using real-time PCR for common ocular viruses: herpes simplex virus 1 (HSV-1), cytomegalovirus (CMV), varicella-zoster virus (VZV) and Epstein-Barr virus (EBV). The pathogenesis of the different viruses was classified and analyzed according to the site of infection.
    RESULTS: Viral PCR detections were performed on 3627 samples collected over the 5-years and 649 (17.89%) samples contained one or more of the viruses tested. The overall detection rate of CMV was highest at 9.93%. Of all sample types, aqueous humor was the most common (1752 cases), of which 340 were positive (19.41% positive rate). Corneal samples were the next most common, with 1481 cases and 250 positive results (16.88% positive rate). CMV positivity was higher in aqueous humor and corneal samples than other viruses; vitreous body had the highest positive rate at 36.36% (20/55), among which 18 cases were VZV positive.
    CONCLUSIONS: Distribution of virus types differed among infection sites, with CMV the most common virus type detected in the cornea and aqueous humor, while VZV was the most common virus detected in the vitreous body.
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  • 文章类型: Journal Article
    巨细胞病毒(CMV)是世界上流行的病毒,属于疱疹病毒科,但在体内保持休眠状态,除非免疫系统受损。此外,当细菌受损而没有任何健康风险时,感染通过体液从一个人传播到另一个人,比如唾液,血,等。更昔洛韦是一种用于治疗病毒感染的抗病毒药物,特别是在患有获得性免疫缺陷综合征和免疫风险的人的CMV治疗中。更昔洛韦在工业中的质量控制是通过使用大量的抗绿色溶剂进行的;考虑到环境因素和分析人员,这些溶剂是不安全的。此外,这些溶剂产生的废物会对环境产生有害影响。Further,使用12种绿色分析化学原理可以提高研究小组的分析判断意识。提高环境安全性是分析领域的革命性一步,和分析师,除了安全,有助于控制废物产生和节约能源,减少职业危害。许多工作已经进行了质量控制更昔洛韦使用不同的溶剂,如乙腈,甲醇,等。尽管如此,没有现有的方法与绿色溶剂或程序,以减少能源和废物的产生。因此,这篇综述的目的是了解更昔洛韦的药物概况和开发的方法。
    Cytomegalovirus (CMV) is a prevalent virus across the world that belongs to the family Herpesviridae but remains dormant in the body unless the immune system is compromised. In addition, when the bacterium is compromised without any health risks, the infection spreads from one person to another person through body fluids, such as saliva, blood, etc. Ganciclovir is an anti- viral medication used in treating viral infections, especially in the treatment of CMV in people with acquired immune deficiency syndrome and immunity at risk. The quality control of ganciclovir in industries is carried out by using anti-green solvents in large volumes; these solvents are not safe in consideration of environmental factors and analysts. Also, the waste generation by these solvents causes hazardous effects on the environment. Further, using 12 green analytical chemistry principles promotes the awareness of analytical judgments among the research groups. It is a revolutionary step in the analytical field to enhance the safety of the environment, and analysts, apart from safety, help to control waste production and conserve energy-reducing occupational hazards. Many works have been carried out for the quality control of ganciclovir using different solvents, such as acetonitrile, methanol, etc. Despite this, there are no existing methods with green solvents or procedures to reduce energy and waste generation. Therefore, the purpose of this review is to understand the drug profile of ganciclovir and the methods developed.
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  • 文章类型: Journal Article
    背景:对于终末期肾病(ESRD)患者,肾移植是透析的最佳选择,提高了生活质量和生存率。这项研究的目的是确定肾移植后最初两年内感染的患病率和相关危险因素。
    方法:对所有在麦加国王阿卜杜拉医疗城接受肾移植的肾移植受者进行的回顾性研究,沙特阿拉伯1月1日2018年,至2021年12月底,为期两年。
    结果:共有43名患者被纳入研究,经历过传染病发作的参与者的平均年龄更高,平均45.26±14,与没有的人相比,平均38.75±12。纳入研究的大多数患者是男性,占总人口的70%。然而,大多数感染性并发症发生在女性(77%vs.30%,分别,p值0.004)。关于移植前的透析方式,大多数患者维持血液透析(76.7%),与没有感染的人相比,在移植后两年内出现感染的人的平均透析时间更长(3.26±1.6vs.分别为2±1.14年)。感染的发生率为44.2%(19例)。肾移植后两年内患者最常见的感染是尿路感染(20.9%),复发率高达11.6%。其次是冠状病毒病(COVID-19)和巨细胞病毒(CMV)。
    结论:本研究揭示了肾移植术后感染并发症的发生率,并强调了与这些感染相关的特定危险因素。了解这些模式可以帮助制定预防策略,并在移植后早期为移植受者提供优化护理。
    BACKGROUND: For patients with End-Stage Renal Disease (ESRD), kidney transplantation stands as the superior alternative to dialysis, exhibiting enhancements in both quality of life and survival rates. The objective of this study is to ascertain the prevalence of infections and associated risk factors within the initial two years post-renal transplant.
    METHODS: A retrospective study of all renal transplant recipients who underwent renal transplantation at king Abdullah medical city in Makkah, Saudi Arabia from January 1st, 2018, till end of December 2021 followed up for two years.
    RESULTS: A total of 43 patients were included in the study, The participants who experienced infectious episodes had a higher mean age, averaging 45.26 ± 14, in contrast to those who did not, averaging 38.75 ± 12. Most of the patients included in the study were male, 70 % of the total population. However, most infectious complications occurred in women (77 % vs. 30 %, respectively, p-value 0.004). Regarding the mode of dialysis before the transplantation, most of the patients were maintained on hemodialysis (76.7 %), and the mean duration of dialysis was longer on those presented with infections within two years post-transplant compared to those without it (3.26 ± 1.6 vs. 2 ± 1.14 years respectively). The incidence of the infections was 44.2 % (19 individuals). The most common presented infections in the patients within two years post renal transplant were urinary tract infections (20.9 %), with a high recurrence rate reaching 11.6 %. This was followed by Coronavirus disease (COVID-19) and Cytomegalovirus (CMV).
    CONCLUSIONS: This study sheds light on the prevalence of infectious complications following renal transplantation and highlights specific risk factors associated with these infections. Understanding these patterns can aid in the development of preventive strategies and optimized care for transplant recipients during the early post-transplant period.
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  • 文章类型: Journal Article
    巨细胞病毒(CMV)感染仍然是实体器官移植后的常见问题。我们描述了CMV感染的负担,胰肾联合移植(SPK)后CMV预防的不良事件。我们纳入了2010年以来我国所有SPK患者(n=236)。免疫抑制是ATG,他克莫司,霉酚酸酯,和类固醇。对所有CMVD+/R-患者给予伐更昔洛韦预防6个月,以及自2019年2月以来三个月的血清阳性SPK患者。用定量PCR从血浆中监测CMVDNA血症。在D+/R-SPK收件人中,预防后CMV感染在随访期间检测到41/60(68%)。在没有预防的血清阳性SPK接受者中,在53/95(56%)中检测到CMV感染,vs.28/78(36%)在接受3个月预防的人中(P=0.01)。35例(15%)患者出现CMV症状,其中10人需要住院治疗。病毒血症的平均持续时间为28天(IQR21-41)。在138例使用伐更昔洛韦预防的患者中,有63例(46%)检测到白细胞减少症。7/122(6%)的CMV感染检测被定义为难治性治疗,3例患者证实更昔洛韦耐药。尽管有CMV预防,SPK接受者的CMV感染负担仍然很高。在伐更昔洛韦预防期间白细胞减少症很常见。
    Cytomegalovirus (CMV) infections remain a common problem after solid-organ transplantation. We characterized the burden of CMV infections, and adverse events of CMV prophylaxis after simultaneous pancreas-kidney transplantation (SPK). We included all SPK patients (n = 236) since 2010 in our country. Immunosuppression was ATG, tacrolimus, mycophenolate, and steroids. Valganciclovir prophylaxis was given to all CMV D+/R- patients for six months, and to seropositive SPK patients for three months since February 2019. CMV DNAemia was monitored with quantitative PCR from plasma. Among D+/R- SPK recipients, post prophylaxis CMV infection was detected in 41/60 (68%) during follow-up. In seropositive SPK recipients with no prophylaxis, CMV infection was detected in 53/95 (56%), vs. 28/78 (36%) in those who received 3 months of prophylaxis (P = 0.01). CMV was symptomatic in 35 (15%) patients, of which 10 required hospitalization. Mean duration of viremia was 28 days (IQR 21-41). Leukopenia was detected in 63 (46%) of the 138 patients with valganciclovir prophylaxis. 7/122 (6%) of the CMV infections detected were defined as refractory to treatment, and three patients had confirmed ganciclovir resistance. SPK recipients experience a high burden of CMV infections despite CMV prophylaxis. Leukopenia is common during valganciclovir prophylaxis.
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