A Rare Co-occurrence of Monkeypox Encephalitis and Neurosyphilis

Sharma, Rohit; Nguyen-Luu, Tristan; Dhaubhadel, Pragya; Sharma, Vishal; Naik, Roopa

doi:10.7759/cureus.35945

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…In the majority of severe cases, patients present with neuropsychiatric complications including seizures, confusion, and encephalitis, indicating that MPXV is able to invade the central nervous system (CNS) 7,10,[12][13][14][15] . Despite its severe manifestations, the underlying neuropathogenesis of mpox is unknown, and the susceptibility of different CNS cell types to MPXV infection has not been characterised.…”

Section: Main Textmentioning

confidence: 99%

Dissecting the neurotropism and neurovirulence of MPXV using human stem cell-based models

Bauer,

Giussani,

Palazzi

et al. 2023

Preprint

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Mpox, formerly known as monkeypox, is a zoonotic illness of international concern that can lead to severe disease including neurological sequelae. However, it remains unclear what the neurotropism of monkeypox virus (MPXV) is and how MPXV infection leads to neurological deficits. Here, we determined the neurotropism and neurovirulence of MPXV using human pluripotent stem cell- (hPSC)-derived neural stem cells, astrocytes, cortical neurons, and microglia together withex vivohuman brain tissue. We found that MPXV infects and replicates more efficiently in astrocytes and microglia compared to cortical neurons, which unlike glial cells showed activation of distinct antiviral programs that may confer differential susceptibility to MPXV.Ex vivoinfection of human brain tissue confirmed the susceptibility of astrocytes to MPXV infection, which also had the strongest disease-associated changes. Molecular pathway analyses revealed induction of cellular senescence and a senescence-associated secretory phenotype upon MPXV infection in astrocytes. Finally, we demonstrated that antiviral treatment using tecovirimat inhibits MPXV replication and prevents virus-induced senescence in hPSC-derived astrocytes. Altogether, leveraging hPSC-derived brain cells, we reveal MPXV-induced cell type-specific effects at the molecular and cellular level, which provide important insights into the neuropathogenesis of MPXV infection.

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Section: Main Textmentioning

confidence: 99%

Dissecting the neurotropism and neurovirulence of MPXV using human stem cell-based models

Bauer,

Giussani,

Palazzi

et al. 2023

Preprint

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show abstract

“…From 1985 to 2021, serious neurological manifestations, including confusion, seizures and encephalitis, have been recorded in around 3% of MPXV infected patients 5 , including one fatal case 6 . Since May 2022, encephalitis has been diagnosed in several patients affected by MPXV infection [7][8][9][10][11][12][13][14] , including two young, healthy men that died following the complications 7 . Animal studies have suggested neuroinvasive potential of MPXV, detecting viral DNA in the brain of several rodent species [15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Mpox virus spreads from cell-to-cell and leads to neuronal injury in human cerebral organoids

Schultz-Pernice,

Fahmi,

Chiu

et al. 2023

Preprint

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In 2022-23 the world experienced the largest recorded mpox virus (MPXV) outbreak outside of endemic regions. Remarkably, cases of neurological manifestations were reported, some of which fatal. MPXV DNA and MPXV-specific IgM antibodies were detected in the cerebrospinal fluid of encephalitis-affected patients, suggesting neuroinvasive potential of MPXV. We explored the susceptibility of neural tissue to MPXV infection using human cerebral organoids (hCOs) exposed to a primary isolate belonging to clade IIb lineage. The virus efficiently replicates in hCOs as indicated by the exponential increase of infectious viral loads and the elevated frequency of MPXV-positive cells over time. Also, electron microscopy imaging revealed the presence of viral particles as well as perinuclear viral factories. We observed susceptibility of several cell lineages to the virus, including neural progenitor cells, neurons, and astrocytes. Furthermore, we detected the presence of viral antigens in neurites and in foci of grouped cells distributed throughout the tissue. In line with this, examining released and cell-associated MPXV titers, we observed significantly more cell-associated infectious virus, suggesting viral spread by cell-to-cell contact. While hCOs displayed no evident outer morphological changes upon infection, we detected the formation of varicosities in neurites, pointing to viral manipulation of axonal transport and neuronal injury. In accordance, the apoptosis marker cleaved caspase-3 was detected within neurite swellings. Our findings identify a mechanism potentially contributing to MPXV-mediated neuropathology that may have therapeutic implications.

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Large Language Models and Artificial Intelligence: A Primer for Plastic Surgeons on the Demonstrated and Potential Applications, Promises, and Limitations of ChatGPT

Abi‐Rafeh

Kazan

et al. 2023

Aesthetic Surgery Journal

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Background The rapidly evolving field of artificial intelligence (AI) holds great potential for plastic surgeons. ChatGPT, a recently released AI large language model (LLM), promises application across many disciplines, including healthcare. Objectives The aim of this article is to provide a plastic surgeon’s primer on AI, LLM, and ChatGPT, including an analysis of current demonstrated and proposed clinical applications. Methods A systematic review was performed identifying medical and surgical literature on ChatGPT’s proposed clinical applications. Variables assessed included applications investigated, command tasks provided, user input information, AI-emulated human skills, output validation, and reported limitations. Results The analysis included 175 articles reporting on 13 plastic surgery applications and 116 additional clinical applications, categorized by field and purpose. Thirty-four plastic surgery applications were varied in their target audience, including attending plastic surgeons (n=17, 50%), trainees/educators (n=8, 24.0%), researchers/scholars (n=7, 21%), and patients (n=2, 6%). The 15 identified limitations of ChatGPT were categorized by training data, algorithm, and ethical considerations. Conclusions Widespread use of ChatGPT in plastic surgery will depend on rigorous research of proposed applications to validate performance and address limitations. This systemic review aims to guide research, development, and regulation to safely adopt AI in plastic surgery.

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A Rare Co-occurrence of Monkeypox Encephalitis and Neurosyphilis

Cited by 4 publications

References 11 publications

Dissecting the neurotropism and neurovirulence of MPXV using human stem cell-based models

Dissecting the neurotropism and neurovirulence of MPXV using human stem cell-based models

Mpox virus spreads from cell-to-cell and leads to neuronal injury in human cerebral organoids

Large Language Models and Artificial Intelligence: A Primer for Plastic Surgeons on the Demonstrated and Potential Applications, Promises, and Limitations of ChatGPT

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