VZV Infection of Primary Human Adrenal Cortical Cells Produces a Proinflammatory Environment without Cell Death

Niemeyer, Christy S.; Mescher, Teresa; Bubak, Andrew N.; Medina, Eva M.; Hassell, James E.; Nagel, Maria A.

doi:10.3390/v14040674

Cited by 3 publications

(3 citation statements)

References 37 publications

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“…Few studies have reported infections of the adrenal glands thus far [126,149]. Hence, this is a novel report that describes all aspects of adrenal abscesses based on the currently available literature.…”

Section: Discussionmentioning

confidence: 94%

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Adrenal Abscesses: A Systematic Review of the Literature

Gligorijevic

Kaljevic

Radovanović

et al. 2023

JCM

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Objective: To summarize the existing knowledge about adrenal gland abscesses, including etiology, clinical presentation, common laboratory and imaging findings, management and overall morbidity and mortality. Design: Systematic literature review. Methods: We performed a search in the PubMed database using search terms: ‘abscess and adrenal glands’, ‘adrenalitis’, ‘infection and adrenal gland’, ‘adrenal abscess’, ‘adrenal infection’ and ‘infectious adrenalitis’. Articles from 2017 to 2022 were included. We found total of 116 articles, and after applying exclusion criteria, data from 73 articles was included in the final statistical analysis. Results: Of 84 patients included in this review, 68 were male (81%), with a mean age of 55 years (range: 29 to 85 years). Weight loss was the most frequent symptom reported in 58.3% patients, followed by fever in 49%. Mean duration of symptoms was 4.5 months. The most common laboratory findings were low cortisol (51.9%), elevated ACTH (43.2%), hyponatremia (88.2%) and anemia (83.3%). Adrenal cultures were positive in 86.4% cases, with Histoplasma capsulatum (37.3%) being the leading causative agent. Blood cultures were positive in 30% of patients. The majority of the adrenal infections occurred through secondary dissemination from other infectious foci and abscesses were more commonly bilateral (70%). A total of 46.4% of patients developed long-term adrenal insufficiency requiring treatment. Abscess drainage was performed in 7 patients (8.3%) and adrenalectomy was performed in 18 (21.4%) patients. The survival rate was 92.9%. Multivariate analysis showed that the only independent risk factor for mortality was thrombocytopenia (p = 0.048). Conclusion: Our review shows that adrenal abscesses are usually caused by fungal pathogens, and among these, Histoplasma capsulatum is the most common. The adrenal glands are usually involved in a bilateral fashion and become infected through dissemination from other primary sources of infection. Long-term adrenal insufficiency develops in 46% of patients, which is more common than what is observed in non-infectious etiology of adrenal gland disorders. Mortality is about 7%, and the presence of thrombocytopenia is associated with worse prognosis. Further prospective studies are needed to better characterize optimal testing and treatment duration in patients with this relatively rare but challenging disorder.

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Section: Discussionmentioning

confidence: 94%

“…It is likely that not all cases of adrenal abscesses have been reported and the ones with unusual pathogens or unexpected outcomes are more likely to be reported. Finally, we have not described viral adrenalitis in this review, since our focus was on the abscesses and since it has been described already elsewhere [149].…”

Section: Limitations Of the Studymentioning

confidence: 99%

Adrenal Abscesses: A Systematic Review of the Literature

Gligorijevic

Kaljevic

Radovanović

et al. 2023

JCM

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“…Evidence of the presence of several other viruses in the endocrine organs is available for human T-cell lymphotropic virus-1, herpes simplex virus, rubella, mumps virus, Epstein–Barr virus, varicella zoster virus, cytomegalovirus, human foamy virus, and Simian virus 40, and these viruses have been associated with various endocrine diseases [ 173 , 174 , 175 , 176 ]. Viruses can transiently or permanently influence the functions of endocrine organs through direct damage of endocrine cells or through indirect mechanisms, especially through the activation of the host antiviral immune response, which may lead to the development of local or systemic inflammation or organ-specific autoimmunity that results in certain endocrinopathies.…”

Section: Discussionmentioning

confidence: 99%

Viruses and Endocrine Diseases

et al. 2023

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Viral infections have been frequently associated with physiological and pathological changes in the endocrine system for many years. The numerous early and late endocrine complications reported during the current pandemic of coronavirus disease 2019 (COVID-19) reinforce the relevance of improving our understanding of the impact of viral infections on the endocrine system. Several viruses have been shown to infect endocrine cells and induce endocrine system disturbances through the direct damage of these cells or through indirect mechanisms, especially the activation of the host antiviral immune response, which may lead to the development of local or systemic inflammation or organ-specific autoimmunity. In addition, endocrine disorders may also affect susceptibility to viral infections since endocrine hormones have immunoregulatory functions. This review provides a brief overview of the impact of viral infections on the human endocrine system in order to provide new avenues for the control of endocrine diseases.

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Trigeminal Postherpetic Neuralgia: From Pathophysiology to Treatment

Niemeyer,

Harlander-Locke,

Bubak

et al. 2024

Curr Pain Headache Rep

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Purpose of Review Trigeminal postherpetic neuralgia (TG-PHN) is a neuropathic pain condition complicating herpes zoster (HZ) attributed to the trigeminal nerve. It poses significant challenges due to its persistent and debilitating nature. This review explores the clinical characteristics of TG-PHN, analyzes its pathophysiological underpinnings, and addresses existent and potential therapies. Recent Findings TG-PHN is one of the most common and complex PHN locations. It has distinguishing clinical and pathophysiological characteristics, starting with viral triggered injuries to the trigeminal ganglion (TG) and peripheral tissue and involving the ascending and descending brain modulation pathways. Current therapies include vaccines, oral and topical medications, and interventional approaches, like nerve blocks and neurostimulation. Summary This review covers TG-PHN’s clinical and physiological components, treatment options, and potential future targets for improved management. By exploring the complexities of this condition, we aim to contribute to developing more effective and targeted therapies for patients suffering from trigeminal PHN.

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VZV Infection of Primary Human Adrenal Cortical Cells Produces a Proinflammatory Environment without Cell Death

Cited by 3 publications

References 37 publications

Adrenal Abscesses: A Systematic Review of the Literature

Adrenal Abscesses: A Systematic Review of the Literature

Viruses and Endocrine Diseases

Trigeminal Postherpetic Neuralgia: From Pathophysiology to Treatment

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