Maternal Immunity and the Natural History of Congenital Human Cytomegalovirus Infection

Britt, William J.

doi:10.3390/v10080405

Cited by 97 publications

(107 citation statements)

References 115 publications

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“…These results demonstrated that postnatal infection of CMV in infants with gestational age ≥ 32 weeks does not cause obvious adverse influence on the health of infants. The minimal influence on the health of infants may be associated with the presence of maternal CMV IgG in infants, which can neutralize the virulence of CMV and provide substantial protection against symptomatic diseases or sequelae [21].…”

Section: Discussionmentioning

confidence: 99%

Minimal adverse outcomes of postnatal cytomegalovirus infection in term or late preterm infants

J¹,

Zhou²,

Chen³

et al. 2019

Preprint

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Background: To investigate at what extent breastfeeding and vaginal delivery can increase mother-to-child transmission of cytomegalovirus (CMV) and to observe the clinical outcomes of postnatal CMV infection in infants. Methods: In this secondary study of prospectively collected clinical data and serum samples, April 2012 through March 2015, 380 pregnant women with CMV IgG positive/CMV IgM negative and their 384 infants (4 twin pairs) with gestational age ≥32 weeks were included. CMV IgG and IgM were measured with enzyme-linked immunosorbent assay. Results: Of 384 infants followed up at 10.2 ± 2.3 months age, 177 (46.1%) were defined with CMV infection based on the presence of higher CMV IgG levels than in their mothers. The infection rate in 190 breastfed infants was higher than in 194 formula-fed infants (62.6% vs 29.9%, P < 0.001). Vaginally delivered infants (172) had higher CMV infection rate than 212 infants delivered by caesarean section (55.2% vs. 38.7%, P = 0.001). Compared with formula feeding and caesarean section, breastfeeding and vaginal delivery increased postnatal CMV infection respectively (OR = 3.801, 95% CI 2.474‒5.840, P < 0.001; OR = 1.818, 95% CI 1.182‒2.796, P = 0.007). Nevertheless, CMV-infected infants normally developed and did not show adverse clinical outcomes compared to uninfected infants. Conclusions: Breastfeeding and vaginal delivery can increase postnatal CMV infection; however, the infection does not cause adverse events in term or late preterm infants. Detection of CMV DNA in breastmilk should not be routinely performed, and breastfeeding should be encouraged in these infants.

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Section: Discussionmentioning

confidence: 99%

Minimal adverse outcomes of postnatal cytomegalovirus infection in term or late preterm infants

J¹,

Zhou²,

Chen³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…As many as 1% of newborns are infected with congenitallyacquired HCMV infections that can cause life-long neurological problems including microcephaly, mental defects, and hearing loss (Britt, 2018;Permar et al, 2018). The virus can infect neural progenitor cells where pp71 expression results in slight decreases in the steady state levels of JAG1 and NICD1, components of the Notch pathway (Li et al, 2015).…”

Section: Pathogenesismentioning

confidence: 99%

Expanding the Known Functional Repertoire of the Human Cytomegalovirus pp71 Protein

Kalejta

Albright

2020

Front. Cell. Infect. Microbiol.

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The human cytomegalovirus pp71 protein is packaged within the tegument of infectious virions and performs multiple functions in host cells to prime them for productive, lytic replication. Here we review the known and hypothesized functions of pp71 in regulating proteolysis, infection outcome (lytic or latent), histone deposition, transcription, translation, immune evasion, cell cycle progression, and pathogenesis. We also highlight recent advances in CMV-based vaccine candidates informed by an improved understanding of pp71 function.

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“…Even though HCMV infection is asymptomatic in immunocompetent individuals, it may lead to several lifethreatening conditions in immunosuppressed subjects, such as organ and stem cell transplant recipients or AIDS patients. Furthermore, it can cause severe morbidity in congenitally infected children and elderly people (Cannon et al, 2010;Manicklal et al, 2013;Tu and Rao, 2016;Britt, 2018). Additionally, spontaneous reactivation of latent endogenous virus and/or superinfection with multiple viral strains can contribute to the overall burden and individual disease severity, as neither a vaccine nor an effective cure is currently available (Schleiss et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Tuning the Orchestra: HCMV vs. Innate Immunity

et al. 2020

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Understanding how the innate immune system keeps human cytomegalovirus (HCMV) in check has recently become a critical issue in light of the global clinical burden of HCMV infection in newborns and immunodeficient patients. Innate immunity constitutes the first line of host defense against HCMV as it involves a complex array of cooperating effectors -e.g., inflammatory cytokines, type I interferon (IFN-I), natural killer (NK) cells, professional antigen-presenting cells (APCs) and phagocytes -all capable of disrupting HCMV replication. These factors are known to trigger a highly efficient adaptive immune response, where cellular restriction factors (RFs) play a major gatekeeping role. Unlike other innate immunity components, RFs are constitutively expressed in many cell types, ready to act before pathogen exposure. Nonetheless, the existence of a positive regulatory feedback loop between RFs and IFNs is clear evidence of an intimate cooperation between intrinsic and innate immunity. In the course of virushost coevolution, HCMV has, however, learned how to manipulate the functions of multiple cellular players of the host innate immune response to achieve latency and persistence. Thus, HCMV acts like an orchestra conductor able to piece together and rearrange parts of a musical score (i.e., innate immunity) to obtain the best live performance (i.e., viral fitness). It is therefore unquestionable that innovative therapeutic solutions able to prevent HCMV immune evasion in congenitally infected infants and immunocompromised individuals are urgently needed. Here, we provide an up-to-date review of the mechanisms regulating the interplay between HCMV and innate immunity, focusing on the various strategies of immune escape evolved by this virus to gain a fitness advantage.

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Maternal Immunity and the Natural History of Congenital Human Cytomegalovirus Infection

Cited by 97 publications

References 115 publications

Minimal adverse outcomes of postnatal cytomegalovirus infection in term or late preterm infants

Minimal adverse outcomes of postnatal cytomegalovirus infection in term or late preterm infants

Expanding the Known Functional Repertoire of the Human Cytomegalovirus pp71 Protein

Tuning the Orchestra: HCMV vs. Innate Immunity

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