Mucocutaneous Findings and Course in an Adult With Zika Virus Infection

Derrington, Sarah; Cellura, A; McDermott, Laura E.; Gubitosi, Taylor; Sonstegard, Anna Marie; Chen, Sheng; Garg, Amit

doi:10.1001/jamadermatol.2016.1433

Cited by 26 publications

(11 citation statements)

References 6 publications

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“…The histopathology of the skin consisting of minimal amounts of non-specific lymphoplasmacytic infiltrates within the superficial dermis is similar to findings described in humans which have developed cutaneous erythematous lesions50. However, we consider that there is limited scientific value to a single incidence of rash.…”

Section: Discussionsupporting

confidence: 78%

Zika virus pathogenesis in rhesus macaques is unaffected by pre-existing immunity to dengue virus

et al. 2017

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Zika virus (ZIKV) is a re-emerging virus that has recently spread into dengue virus (DENV) endemic regions and cross-reactive antibodies (Abs) could potentially affect ZIKV pathogenesis. Using DENV-immune serum, it has been shown in vitro that antibody-dependent enhancement (ADE) of ZIKV infection can occur. Here we study the effects of pre-existing DENV immunity on ZIKV infection in vivo. We infect two cohorts of rhesus macaques with ZIKV; one cohort has been exposed to DENV 2.8 years earlier and a second control cohort is naïve to flaviviral infection. Our results, while confirming ADE in vitro, suggest that pre-existing DENV immunity does not result in more severe ZIKV disease. Rather our results show a reduction in the number of days of ZIKV viremia compared to naïve macaques and that the previous exposure to DENV may result in modulation of the immune response without resulting in enhancement of ZIKV pathogenesis.

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Section: Discussionsupporting

confidence: 78%

Zika virus pathogenesis in rhesus macaques is unaffected by pre-existing immunity to dengue virus

et al. 2017

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“…Atypical cutaneous manifestations include subcutaneous haematomas due to ZIKV immune‐mediated thrombocytopenia, petechiae (Fig. b), ecchymosis, aphthous and ulcerous lesions of the oral mucosa, and jaundice .…”

Section: Clinical Presentationmentioning

confidence: 99%

Cutaneous features of Zika virus infection: a clinicopathological overview

et al. 2018

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Summary Zika virus (ZIKV) is an emerging mosquito‐borne flavivirus transmitted mainly by Aedes species of mosquitos. Although the infection is usually mild and self‐limiting, it is emerging as a public health challenge in tropical and subtropical countries owing to its unprecedented pathogenicity and increased risk for fetal malformations and neurological symptoms. Cutaneous manifestations as for other mosquito‐borne viruses remain a hallmark of the disease. This article provides a detailed overview on ZIKV infection, including its varied cutaneous clinical manifestations and diagnostic aspects, and also provides detailed insights into its pathogenesis in human skin.

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“…Risk factors for ocular involvement in infants with presumed ZIKV congenital infection include smaller cephalic diameters at birth and infants whose mother develop symptoms during the first trimester of pregnancy [ 16 ]. Adults with acute ZIKV disease often experience hyperemic sclera, conjunctivitis, and retro-orbital pain, and uveitis has also been observed in a patient with ZIKV infection after an initial clinical presentation of conjunctival hyperemia [ 17 – 19 ]. The target cells for ZIKV-associated ocular disease are unknown.…”

Section: Introductionmentioning

confidence: 99%

Zika virus infection of cellular components of the blood-retinal barriers: implications for viral associated congenital ocular disease

Roach

Alcendor

2017

J Neuroinflammation

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BackgroundOcular abnormalities present in microcephalic infants with presumed Zika virus (ZIKV) congenital disease includes focal pigment mottling of the retina, chorioretinal atrophy, optic nerve abnormalities, and lens dislocation. Target cells in the ocular compartment for ZIKV infectivity are unknown. The cellular response of ocular cells to ZIKV infection has not been described. Mechanisms for viral dissemination in the ocular compartment of ZIKV-infected infants and adults have not been reported. Here, we identify target cells for ZIKV infectivity in both the inner and outer blood-retinal barriers (IBRB and OBRB), describe the cytokine expression profile in the IBRB after ZIKV exposure, and propose a mechanism for viral dissemination in the retina.MethodsWe expose primary cellular components of the IBRB including human retinal microvascular endothelial cells, retinal pericytes, and Müller cells as well as retinal pigmented epithelial cells of the OBRB to the PRVABC56 strain of ZIKV. Viral infectivity was analyzed by microscopy, immunofluorescence, and reverse transcription polymerase chain reaction (RT-PCR and qRT-PCR). Angiogenic and proinflammatory cytokines were measured by Luminex assays.ResultsWe find by immunofluorescent staining using the Flavivirus 4G2 monoclonal antibody that retinal endothelial cells and pericytes of the IBRB and retinal pigmented epithelial cells of the OBRB are fully permissive for ZIKV infection but not Müller cells when compared to mock-infected controls. We confirmed ZIKV infectivity in retinal endothelial cells, retinal pericytes, and retinal pigmented epithelial cells by RT-PCR and qRT-PCR using ZIKV-specific oligonucleotide primers. Expression profiles by Luminex assays in retinal endothelial cells infected with ZIKV revealed a marginal increase in levels of beta-2 microglobulin (β2-m), granulocyte macrophage colony-stimulating factor (GMCSF), intercellular adhesion molecule 1 (ICAM-1), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP1), and vascular cell adhesion molecule 1 (VCAM-1) and higher levels of regulated upon activation, normal T cell expressed and presumably secreted (RANTES) but lower levels of interleukin-4 (IL-4) compared to controls.ConclusionsRetinal endothelial cells, retinal pericytes, and retinal pigmented epithelial cells are fully permissive for ZIKV lytic replication and are primary target cells in the retinal barriers for infection. ZIKV infection of retinal endothelial cells and retinal pericytes induces significantly higher levels of RANTES that likely contributes to ocular inflammation.

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Mucocutaneous Findings and Course in an Adult With Zika Virus Infection

Cited by 26 publications

References 6 publications

Zika virus pathogenesis in rhesus macaques is unaffected by pre-existing immunity to dengue virus

Zika virus pathogenesis in rhesus macaques is unaffected by pre-existing immunity to dengue virus

Cutaneous features of Zika virus infection: a clinicopathological overview

Zika virus infection of cellular components of the blood-retinal barriers: implications for viral associated congenital ocular disease

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