Corrigendum: Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture

Jiang, Hong; Du, Hongwu; Wang, Li M.; Wang, Ping Z.; Bai, Xue

doi:10.3389/fcimb.2016.00178

Cited by 11 publications

(22 citation statements)

References 2 publications

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“…The geographical distribution of the different hantavirus strains is related to the varying distribution of rodent species. The incidence of human infection increases in parallel with the rate of infection in rodents; transmission to humans usually occurs through aerosolization of vector excretions such as urine, feces, and saliva, and more rarely through the bite of an infected animal [7] . The main factors affecting the viability of the virus are ambient heat, humidity, ultraviolet light/sunlight and the organic content of contaminated fluids.…”

Section: Epidemiologymentioning

confidence: 99%

Section: Pathogenesis Viral Characteristicsmentioning

confidence: 99%

“…Although the exact pathogenesis remains unclear, organ dysfunction stemming in part from capillary leak is believed to play a key role in HTNV infections, which are responsible for a large portion of cases of HFRS [3,4,7] . It is believed that HFRS is a type of systemic inflammatory response syndrome and that the hypotensive phase which occurs during the disease course causes a shock-like condition [7,16] . Vascular endothelial dysfunction is the main mechanism in the pathogenesis, resulting in increased vascular permeability and cellular extravasation of plasma, with clinical manifestations such as hemorrhage as well as hemoconcentration, abdominal pain, and shock [16] .…”

Section: Pathogenesis Viral Characteristicsmentioning

confidence: 99%

“…The clinical presentation of HFRS is characterized by fever, hypotension, hemorrhage, and acute renal failure. The course of the disease is typically divided into five distinct phases: the febrile, hypotensive shock, oliguria, polyuria, and convalescent phases [7] . These phases may overlap in severe cases, and some may be absent in mild cases.…”

Section: Clinical Findingsmentioning

confidence: 99%

“…Human infections have two different clinical manifestations: hemorrhagic fever with renal syndrome (HFRS), seen in Asia and Europe, and Hantavirus cardiopulmonary syndrome (HCPS), which occurs in the U.S. with mortality rates of up to 50% [6] . It is estimated that there are more than 20,000 hantavirus cases annually worldwide, most of which are in Asia [7] .…”

Section: Introductionmentioning

confidence: 99%

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Hantavirus Infections in Light of Current Knowledge

Kaya¹

2018

mjima

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Hantavirus is an enveloped virus with an RNA genome comprised of three negative-sense, single-stranded segments and belongs to the genus Hantavirus in family Bunyaviridae. Human infections are seen in two different clinical presentations: "Hemorrhagic fever with renal syndrome" and "Hantavirus cardiopulmonary syndrome". However, the main pathogenic mechanism is vascular endothelial dysfunction; viral properties and host immunogenetic factors both play a role in pathogenesis. Early diagnosis and supportive treatment are crucial to prevent mortality. Fluid/ electrolyte and oxygen therapy, renal replacement, regulation of blood pressure, and blood or blood products replacement are the main components of supportive treatment. Although ribavirin is controversial in the specific treatment, some studies have suggested that it may be beneficial, especially during the oliguric phase. Favipiravir and icatibant are other effective drugs in the treatment, and the use of αvβ3 integrin inhibitors is also suggested. In recent years, monoclonal antibodies have been proposed for treatment as well as prophylaxis. DNA vaccines prepared with new technologies have good efficacy, enhancing the neutralizing antibody response. The next major breakthrough in Hantavirus immunization will be a vaccine that is effective against all viral subtypes.

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Section: Epidemiologymentioning

confidence: 99%

Section: Pathogenesis Viral Characteristicsmentioning

confidence: 99%

Section: Pathogenesis Viral Characteristicsmentioning

confidence: 99%

Section: Clinical Findingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hantavirus Infections in Light of Current Knowledge

Kaya¹

2018

mjima

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Investigation on risk factors of haemorrhagic fever with renal syndrome (HFRS) in Xuancheng City in Anhui Province, Mainland China

Xia²,

Wang³

et al. 2020

Epidemiol. Infect.

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Haemorrhagic fever with renal syndrome (HFRS), a rodent-borne disease, is a major public health concern in both developed and developing countries. China is the most severe endemic country in the world, constituting 90% of the cases. Although the incidence of HFRS has substantively decreased in most areas of China, HFRS has rebounded remarkably in some epidemic areas. Xuancheng is one of these areas. In this study, we collected the case data reported recently in Xuancheng and designed a 1:3 case−control study. The Chi-square test, univariate and multivariate logistic regression analysis were performed. In all cases, farmers made up the highest proportion of occupations. And there were 20 variables with statistical significance including indoor hygienic conditions; the surrounding environment; whether bitten by rats at work and other criteria. In addition, exposure to rodents and rats bites is a high-risk factor for HFRS. Rodent density was calculated at 20.9% (159/760), the virus carrier rate was 9.4% (15/159) and the index of rats with a virus was about 2.0%. Exposure to rodents and insect bites is also high-risk factors for HFRS among local residents in Xuancheng. More importantly, during the flood years, the increased density of rodents led to an increased risk of human exposure to rodents. As our statistical analysis proves, targeted strategies should be developed and implemented to reduce the incidence of local diseases in the future.

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Innate lymphoid cells are activated and their levels correlate with viral load in patients with Puumala hantavirus caused hemorrhagic fever with renal syndrome

García

Tauriainen

et al. 2022

Preprint

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BackgroundInnate lymphoid cells (ILCs) are involved in immunity and homeostasis but, except for natural killer (NK) cells, their role in human viral infections is not well known. Puumala virus (PUUV) is a hantavirus that causes the acute zoonotic disease hemorrhagic fever with renal syndrome (HFRS). HFRS is characterized by strong systemic inflammation and NK cells are highly activated in HFRS, suggesting that also other ILCs might be responding to infection.MethodsHere we phenotypically analyzed peripheral ILCs in acute and convalescent PUUV-infected HFRS patients. Additionally, plasma levels of soluble factors and viral load were analyzed.FindingsOverall, the frequencies of NK cells and naïve ILCs were reduced while the frequency of ILC2, in particular the ILC2-lineage committed c-Kitlo ILC2 subset, was increased during acute HFRS. Interestingly, we observed a negative correlation between viral load and frequencies of both NK and non-NK ILCs in acute HFRS. Phenotypically, ILCs displayed an activated profile with increased proliferation, and showed altered expression of several homing markers during acute HFRS. In line with the observation of activated ILCs, plasma levels of inflammatory proteins, including the ILC-associated cytokines interleukin (IL)-13, IL-23, IL-25, IL-33, and thymic stromal lymphopoietin (TSLP), were elevated during acute HFRS.InterpretationThese findings indicate a general involvement of ILCs in response to human hantavirus infection. Further, this constitutes the first comprehensive study of ILCs in a hantavirus-caused disease, aiding in further understanding the role of these cells in disease pathogenesis and in human viral infections in general.FundingA full list of funding bodies that contributed to this study can be found in the Acknowledgements section.RESEARCH IN CONTEXTEvidence before this studyInnate lymphoid cells (ILCs) include a broad range of innate cell subsets involved, among other functions, in early response to infections. Natural killer (NK) cells have been broadly characterized in human viral infections, but much less is known in such context about other more recently discovered ILCs. Puumala virus is one of the causative agents of hemorrhagic fever with renal syndrome (HFRS), an acute zoonotic disease characterized by systemic inflammation. No current treatment or vaccines are available to date for hantavirus-caused diseases and pathogenesis is still not fully understood. A PubMed search up until April 2022 using a combination of the terms virus, Puumala virus, hantavirus, HFRS, ILCs, and NK cells shows that while studies have been performed characterizing NK cells in HFRS, no studies are available on the rest of ILCs in hantavirus-caused diseases, which in addition have been studied in only a handful of human viral infections.Added value of this studyIn this study we thoroughly characterized the ILC landscape in circulation and its milieu in acute and convalescent Puumala-infected HFRS patients. We found that the frequency of NK cells and other ILC subsets was altered in the acute HFRS patients as compared to convalescent HFRS patients and control individuals, with a decrease in NK cells and naïve ILCs, and an increase in ILC2. In particular the ILC2-lineage committed c-Kitlo ILC2 subset was found increased. Total ILCs showed increased levels of activation and proliferation, and signs of altered migration patterns in acute HFRS patients. The finding of elevated levels of several soluble inflammatory proteins associated with ILCs in acute HFRS patients further suggests an implication of ILCs in HFRS. Moreover, an association between the frequency of NK cells and non-NK ILCs and plasma viral load suggest a possible connection between viremia and the activity of these cell types during the course of disease.Implications of all the available evidenceOur research shows that all circulating ILCs, including non-NK ILCs, are activated, proliferating, and correlate with viral load in acute HFRS patients, indicating a general involvement in human hantavirus infection and disease. Being the first comprehensive study on ILCs in hantavirus infections, further research will give relevant insight into the roles of ILCs in disease pathogenesis and protection.

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Corrigendum: Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture

Cited by 11 publications

References 2 publications

Hantavirus Infections in Light of Current Knowledge

Hantavirus Infections in Light of Current Knowledge

Investigation on risk factors of haemorrhagic fever with renal syndrome (HFRS) in Xuancheng City in Anhui Province, Mainland China

Innate lymphoid cells are activated and their levels correlate with viral load in patients with Puumala hantavirus caused hemorrhagic fever with renal syndrome

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