New-Onset Myocarditis in an Immunocompetent Adult with Acute Metapneumovirus Infection

Weinreich, Mark; Jabbar, Ahmad; Malguria, Nagina; Haley, Robert W.

doi:10.1155/2015/814269

Cited by 10 publications

(7 citation statements)

References 25 publications

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“…In addition to upper respiratory involvement with symptoms typically associated with the common cold, HMPV infection can result in serious lower respiratory syndromes such as pneumonia, bronchitis, and bronchiolitis (3,11). Due to the recent ability to routinely detect this virus through the inclusion of HMPV in multiplex detection assays, HMPV has been associated with disease outside the respiratory tract in some cases, including viral encephalopathy (12)(13)(14) and acute myocarditis (15), from initial respiratory involvement. Despite this tremendous clinical burden, there is no known vaccine to prevent HMPV infection, and treatment options are limited to administering ribavirin, which does not have established efficacy against HMPV infection (16).…”

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confidence: 99%

Inhibition of Human Metapneumovirus Binding to Heparan Sulfate Blocks Infection in Human Lung Cells and Airway Tissues

Klimyte

Smith

Oreste³

et al. 2016

J Virol

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Human metapneumovirus (HMPV), a recently discovered paramyxovirus, infects nearly 100% of the world population and causes severe respiratory disease in infants, the elderly, and immunocompromised patients. We previously showed that HMPV binds heparan sulfate proteoglycans (HSPGs) and that HMPV binding requires only the viral fusion (F) protein. To characterize the features of this interaction critical for HMPV binding and the role of this interaction in infection in relevant models, we utilized sulfated polysaccharides, heparan sulfate mimetics, and occluding compounds. Iota-carrageenan demonstrated potent anti-HMPV activity by inhibiting binding to lung cells mediated by the F protein. Furthermore, analysis of a minilibrary of variably sulfated derivatives of Escherichia coli K5 polysaccharide mimicking the HS structure revealed that the highly O-sulfated K5 polysaccharides inhibited HMPV infection, identifying a potential feature of HS critical for HMPV binding. The peptide dendrimer SB105-A10, which binds HS, reduced binding and infection in an F-dependent manner, suggesting that occlusion of HS at the target cell surface is sufficient to prevent infection. HMPV infection was also inhibited by these compounds during apical infection of polarized airway tissues, suggesting that these interactions take place during HMPV infection in a physiologically relevant model. These results reveal key features of the interaction between HMPV and HS, supporting the hypothesis that apical HS in the airway serves as a binding factor during infection, and HS modulating compounds may serve as a platform for potential antiviral development. IMPORTANCE Human metapneumovirus (HMPV) is a paramyxovirus that causes respiratory disease worldwide. It has been previously shown that HMPV requires binding to heparan sulfate on the surfaces of target cells for attachment and infection.In this study, we characterize the key features of this binding interaction using heparan sulfate mimetics, identify an important sulfate modification, and demonstrate that these interactions occur at the apical surface of polarized airway tissues. These findings provide insights into the initial binding step of HMPV infection that has potential for antiviral development.A cute viral respiratory tract infection is the most frequently observed illness in humans worldwide (1). Human metapneumovirus (HMPV), an enveloped, negative-sense, singlestranded RNA virus in the Paramyxoviridae family, is a common cause of both upper and lower respiratory tract infections (2-4). First identified in 2001 in the Netherlands, HMPV is now known to be the cause of respiratory infections in humans since at least 1958 (2). Nearly every person is exposed to HMPV in the first decade of life; seroconversion occurs on average by the age of 5 years, and nearly 100% of individuals test seropositive for antibody reactivity to HMPV antigens by the age of 10 (5). In children, HMPV infection is the second most common cause of hospitalization due to respiratory infection after the ...

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confidence: 99%

Inhibition of Human Metapneumovirus Binding to Heparan Sulfate Blocks Infection in Human Lung Cells and Airway Tissues

Klimyte

Smith

Oreste³

et al. 2016

J Virol

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“…Few cases reported hMPV affecting the myocardium [11,12]. This patient was diagnosed with hMPV infection, complicated by AP.…”

Section: Discussionmentioning

confidence: 89%

Pericardial Effusion and Tamponade Complicating Acute Pericarditis in a Human Metapneumovirus-Infected Adult: A Unique Case Report

Mihyawi¹,

Fath²,

Findakly³

et al. 2020

Cureus

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Acute pericarditis (AP), or pericardial sac inflammation, is a self-limited condition in healthy individuals. Viruses, including adenoviruses, enteroviruses, cytomegalovirus, and influenza virus, have been well documented to cause AP. In contrast, human metapneumovirus (hMPV), a relatively newer virus, has been described in a few cases to cause serious cardiac complications. Here we report a patient who developed an imminent cardiac tamponade associated with hMVP respiratory infection.

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“… 4 – 6 The first case of hMPV myocarditis was described in 2015 in a 25-year-old man without any past medical history. 5 He presented with severe HF after 2weeks of respiratory illness and hMPV infection was diagnosed. He was successfully treated with diuretics and inotropic agents.…”

Section: Discussionmentioning

confidence: 99%

“…However, non-respiratory manifestations including cardiac impairments are rare. Acute myocarditis secondary to hMPV has only twice been described in adults, 4 , 5 and only one pediatric case with acute respiratory distress syndrome has been reported in the literature. 6 We report the first case of hMPV myocarditis, without respiratory manifestations, in a child who was successfully treated with venoarterial membrane extracorporeal oxygenation (VA–ECMO) and intravenous immunoglobulins (IVIg).…”

Section: Introductionmentioning

confidence: 99%

First Case of Acute Myocarditis Caused by Metapneumovirus in an Immunocompromised 14-year-old Girl

Makhlouf¹,

Peipoch²,

Duport³

et al. 2022

Indian Journal of Critical Care Medicine

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A bstract Background Human metapneumovirus (hMPV) is a paramyxovirus, well known as a causative agent of respiratory tract infections. Non-respiratory manifestations, including cardiac impairments, remain rare. Only two cases of myocarditis caused by hMPV have been described in adults. Case description We present the case of a 14-year-old female suffering from Burkitt leukemia and diagnosed with severe myocarditis caused by hMPV, based on results from real-time polymerase chain reaction (RT-PCR) and magnetic resonance imaging (MRI). She was successfully treated by venoarterial extracorporeal membrane oxygenation and intravenous immunoglobulins. She was discharged from pediatric intensive care unit (PICU) 3 weeks later. Conclusion This is the first pediatric case of hMPV myocarditis requiring venoarterial extracorporeal membrane oxygenation. How to cite this article Makhlouf A, Peipoch L, Duport P, Darrieux E, Reguerre Y, Ramful D, et al. First Case of Acute Myocarditis Caused by Metapneumovirus in an Immunocompromised 14-year-old Girl. Indian J Crit Care Med 2022;26(6):745–747.

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New-Onset Myocarditis in an Immunocompetent Adult with Acute Metapneumovirus Infection

Cited by 10 publications

References 25 publications

Inhibition of Human Metapneumovirus Binding to Heparan Sulfate Blocks Infection in Human Lung Cells and Airway Tissues

Inhibition of Human Metapneumovirus Binding to Heparan Sulfate Blocks Infection in Human Lung Cells and Airway Tissues

Pericardial Effusion and Tamponade Complicating Acute Pericarditis in a Human Metapneumovirus-Infected Adult: A Unique Case Report

First Case of Acute Myocarditis Caused by Metapneumovirus in an Immunocompromised 14-year-old Girl

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