Intravenous immunoglobulin therapy for severe arthritis associated with human parvovirus B19 infection

Ogawa, Eiichi; Otaguro, Shigeru; Murata, Masayuki; Kainuma, Mosaburo; Sawayama, Yasunori; Furusyo, Norihiro; Hayashi, Jun

doi:10.1007/s10156-008-0636-x

Cited by 28 publications

(17 citation statements)

References 23 publications

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“…High-dose IVIG is currently administered to patients with B19V-associated chronic anemia and PRCA (137,1136,1137). Symptoms can recur when IVIG treatment is interrupted (1138)(1139)(1140)(1141). The administered IVIG may be contaminated with B19V or other viruses (e.g., hepatitis A virus) (700, 1138).…”

Section: Treatment and Preventionmentioning

confidence: 99%

“…No specific antiviral drugs have been developed for the treatment of B19V infection. High-dose IVIG is administered to patients with B19V chronic anemia due to PRCA (137,1136,1137), but symptoms can recur when IVIG treatment is halted (1138)(1139)(1140)(1141). Repeated applications of IVIG and maintenance therapy (744,1136,(1188)(1189)(1190)(1191)(1192)(1193) may be cost-prohibitive.…”

Section: Antiviral Drug Developmentmentioning

confidence: 99%

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Human Parvoviruses

2017

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Parvovirus B19 (B19V) and human bocavirus 1 (HBoV1), members of the large Parvoviridae family, are human pathogens responsible for a variety of diseases. For B19V in particular, host features determine disease manifestations. These viruses are prevalent worldwide and are culturable in vitro, and serological and molecular assays are available but require careful interpretation of results. Additional human parvoviruses, including HBoV2 to -4, human parvovirus 4 (PARV4), and human bufavirus (BuV) are also reviewed. The full spectrum of parvovirus disease in humans has yet to be established. Candidate recombinant B19V vaccines have been developed but may not be commercially feasible. We review relevant features of the molecular and cellular biology of these viruses, and the human immune response that they elicit, which have allowed a deep understanding of pathophysiology.

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Section: Treatment and Preventionmentioning

confidence: 99%

Section: Antiviral Drug Developmentmentioning

confidence: 99%

Human Parvoviruses

2017

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“…The role of IVIg in the management of MAS is still not clear, and the published results have been equivocal. While there have been reports of good response when IVIg has been used as a first-line agent [23][24][25], Stephan et al reported very poor response with IVIg [2].…”

Section: Discussionmentioning

confidence: 97%

Macrophage activation syndrome in children with systemic onset juvenile idiopathic arthritis: clinical experience from northwest India

et al. 2011

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The objective of this study is to describe the clinical and laboratory features of macrophage activation syndrome (MAS) in systemic onset juvenile idiopathic arthritis (SOJIA) at a tertiary care center in northwest India. Review of medical records of all children with SOJIA admitted during the period January 1995-December 2008 in Pediatric Allergy and Immunology Unit, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, was done. Six patients (5 boys and 1 girl) with SOJIA and MAS were identified. Mean age at time of disease onset was 6.5 years. MAS was the presenting manifestation of SOJIA in 4 patients. Clinical manifestations included fever (6/6), clinical shock (6/6), encephalopathy (5/6), generalized lymphadenopathy (4/6), hepatosplenomegaly (3/6), jaundice and abdominal tenderness (3/6), cardiac involvement (3/6), and meningeal irritation (2/6). Laboratory findings at onset of MAS included decreasing total leukocyte and platelet counts, coagulopathy, elevated transaminases, hyponatremia, and lipid abnormalities. Hemophagocytosis was demonstrable in the bone marrow in 4 patients and in the lymph node in 1. For treatment, we used intravenous methylprednisolone (4/6), oral prednisolone (2/6), and intravenous immunoglobulin (2/6). Outcome was favorable in all patients except one who died of rapidly progressive disease. This paper describes the experience of JIA-related macrophage activation syndrome in a tertiary Indian center. We have shown that MAS can be the early presenting manifestation of evolving SOJIA. Early diagnosis and aggressive management can have a significant impact on the mortality associated with this syndrome. We stress on the role of glucocorticoids in the management of this condition and believe that glucocorticoids have a far more important role in the management of this condition than what has been previously reported.

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“…To date, a vaccine against B19V infection and specific treatments for B19V infection-caused transient aplastic crisis, chronic anemia, pure red cell aplasia, hydrops fetalis, and congenital anemia in infants are not available. Although intravenous immunoglobulin (IVIG) can be administered to patients with B19V-associated chronic anemia and pure red cell aplasia (50)(51)(52), the symptoms often recur when IVIG treatment is interrupted (53)(54)(55)(56). The repeated applications of IVIG and the maintenance therapy that are required to fully eliminate B19V-associated pure red cell aplasia are cost prohibitive (51,(57)(58)(59)(60)(61)(62)(63).…”

Section: Discussionmentioning

confidence: 99%

Endonuclease Activity Inhibition of the NS1 Protein of Parvovirus B19 as a Novel Target for Antiviral Drug Development

Peng

Ganaie

Wang

et al. 2019

Antimicrob Agents Chemother

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Human parvovirus B19 (B19V), a member of the genus Erythroparvovirus of the family Parvoviridae, is a small nonenveloped virus that has a single-stranded DNA (ssDNA) genome of 5.6 kb with two inverted terminal repeats (ITRs). B19V infection often results in severe hematological disorders and fetal death in humans. B19V replication follows a model of rolling hairpin-dependent DNA replication, in which the large nonstructural protein NS1 introduces a site-specific single-strand nick in the viral DNA replication origins, which locate at the ITRs. NS1 executes endonuclease activity through the N-terminal origin-binding domain. Nicking of the viral replication origin is a pivotal step in rolling hairpin-dependent viral DNA replication. Here, we developed a fluorophore-based in vitro nicking assay of the replication origin using the origin-binding domain of NS1 and compared it with the radioactive in vitro nicking assay. We used both assays to screen a set of small-molecule compounds (n ϭ 96) that have potential antinuclease activity. We found that the fluorophore-based in vitro nicking assay demonstrates sensitivity and specificity values as high as those of the radioactive assay. Among the 96 compounds, we identified 8 which have an inhibition of Ͼ80% at 10 M in both the fluorophore-based and radioactive in vitro nicking assays. We further tested 3 compounds that have a flavonoid-like structure and an in vitro 50% inhibitory concentration that fell in the range of 1 to 3 M. Importantly, they also exhibited inhibition of B19V DNA replication in UT7/Epo-S1 cells and ex vivo-expanded human erythroid progenitor cells.

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Intravenous immunoglobulin therapy for severe arthritis associated with human parvovirus B19 infection

Cited by 28 publications

References 23 publications

Human Parvoviruses

Human Parvoviruses

Macrophage activation syndrome in children with systemic onset juvenile idiopathic arthritis: clinical experience from northwest India

Endonuclease Activity Inhibition of the NS1 Protein of Parvovirus B19 as a Novel Target for Antiviral Drug Development

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