scholarly journals Possible Association of Pulmonary Atresia with In-Utero Coxsackievirus B Exposure

Author(s):  
Horacio G. Carvajal ◽  
Vipul Sharma ◽  
Lisa S. Goessling ◽  
Taylor C. Merritt ◽  
Anoop K. Brar ◽  
...  
Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vipul Sharma ◽  
Lisa S Goessling ◽  
Horacio G Carvajal ◽  
Anoop K Brar ◽  
Pirooz Eghtesady

Introduction: Maternal exposure to various pathogens during pregnancy has been well established as a cause of congenital heart defects (CHD). Suggestive, although inconclusive, data exists of an association between Coxsackievirus B (CVB) infection during pregnancy and CHD. Therefore, this study was undertaken to examine association between perinatal infection with CVB and CHD. Hypothesis: CVB infection during pregnancy may play a role in the pathogenesis of CHD. Methods: In a prospective study of 122 pregnant women with pregnancies affected with CHD, circulating CVB IgG and IgM antibodies in the maternal serum were quantified. To determine specific CVB serotypes involved, Neutralizing antibodies (NA) were measured against three CVB serotypes: CVB1-Chi07, CVB3, Nancy, and CVB4, J.V.B. Results: A significant number of the women were positive for CVB antibodies; 31.1% for IgG and 6.6% for IgM. Elevated levels of IgG were seen in 50% of women carrying babies with Pulmonary Atresia (PA) (p=0.04). In addition, 55.6% (p=0.100) of moms carrying babies with Hypoplastic Left Heart Syndrome (HLHS), aortic atresia/mitral stenosis (AA/MS) variant and 47.1% (p=0.127) of HLHS AA/mitral atresia (MA) had positive IgG levels. Among babies of women with positive IgM titers, 75% (p=0.001) had isolated Ventricular Septal Defect (VSD), comprising 26.1% (6/23) of all babies with isolated VSD in the cohort.We also show a possible association between CVB4 and CHD in the cohort. All mothers with positive IgM titers whose babies were born with a VSD had elevated CVB4 NA (p=0.001). Among women with elevated IgG having babies with PA, 40.0% (p=0.061) had elevated CVB1 NA, 70.0% (p=0.014) had elevated CVB3 NA, and 40.0% (p=0.876) had elevated CVB4 NA. Conclusion: We present data from a clinical study suggesting that CVB infection during pregnancy may contribute to the burden of CHD in affected babies. Our data demonstrates not only an association of CVB with CHD in pregnant women but this is the first report showing significant association between in-utero CVB infection and PA. Our study has broad implications for the future understanding and potential management of CHD as well as introduces a new avenue of research for cardiac defects.


Author(s):  
Vipul Sharma ◽  
Lisa S. Goessling ◽  
Anoop K. Brar ◽  
Pirooz Eghtesady

AbstractThe research for this study was undertaken to examine association between perinatal infection with Coxsackievirus B (CVB) and congenital heart defects (CHD). Suggestive, although inconclusive, data exists of an association between CVB infection during pregnancy and CHD. We present data from a clinical study showing that CVB infection in early pregnancy induces heart defects. In a prospective study of 123 pregnant women with pregnancies affected with CHD we found circulating CVB IgG and IgM in the serum. A significant number of the women were positive for CVB antibodies; 30.9% for IgG and 6.5% for IgM. Our data demonstrates not only an association of CVB with CHD in pregnant women but this is the first report showing significant association between in-utero CVB infection and Pulmonary Atresia (PA) and HLHS (AA/MS variant). Elevated levels of IgG were seen in 55.5% of women carrying babies with PA and 60% of women carrying babies with HLHS (AA/MS), with p-values of 0.01 and 0.03 respectively. To determine specific CVB serotypes involved, neutralizing antibody titers to CVB1, CVB3, and CVB4 were analyzed on samples with positive IgG/IgM levels, and showed a possible association between CVB4 and CHD in the cohort. Our study has broad implications for the future understanding and potential management of CHD as well as introduces a new avenue of research for cardiac defects.


PEDIATRICS ◽  
2009 ◽  
Vol 124 (3) ◽  
pp. e510-e518 ◽  
Author(s):  
W. Tworetzky ◽  
D. B. McElhinney ◽  
G. R. Marx ◽  
C. B. Benson ◽  
R. Brusseau ◽  
...  

1999 ◽  
Vol 41 (6) ◽  
pp. 716-721 ◽  
Author(s):  
MAKOTO Nishibatake ◽  
YOSHIO Matsuda ◽  
MASATO Kamitomo ◽  
SATOSHI Ibara ◽  
HIROSHI Sameshima

2021 ◽  
Vol 9 (7) ◽  
pp. 1537
Author(s):  
Aymen Halouani ◽  
Hélène Michaux ◽  
Habib Jmii ◽  
Charlotte Trussart ◽  
Ahlem Chahbi ◽  
...  

Thymus plays a fundamental role in central tolerance establishment, especially during fetal life, through the generation of self-tolerant T cells. This process consists in T cells education by presenting them tissue-restricted autoantigens promiscuously expressed by thymic epithelial cells (TECs), thus preventing autoimmunity. Thymus infection by Coxsackievirus B (CV-B) during fetal life is supposed to disturb thymic functions and, hence, to be an inducing or accelerating factor in the genesis of autoimmunity. To further investigate this hypothesis, in our current study, we analyzed thymic expression of autoantigens, at the transcriptional and protein level, following in utero infection by CV-B4. mRNA expression levels of Igf2 and Myo7, major autoantigens of pancreas and heart, respectively, were analyzed in whole thymus and in enriched TECs together along with both transcription factors, Aire and Fezf2, involved in autoantigens expression in the thymus. Results show that in utero infection by CV-B4 induces a significant decrease in Igf2 and Myo7 expression at both mRNA and protein level in whole thymus and in enriched TECs as well. Moreover, a correlation between viral load and autoantigens expression can be observed in the whole thymus, indicating a direct effect of in utero infection by CV-B4 on autoantigens expression. Together, these results indicate that an in utero infection of the thymus by CV-B4 may interfere with self-tolerance establishment in TECs by decreasing autoantigen expression at both mRNA and protein level and thereby increase the risk of autoimmunity onset.


2012 ◽  
Vol 34 (8) ◽  
pp. 1908-1910 ◽  
Author(s):  
Bo Kyung Jin ◽  
Gi Beom Kim ◽  
Bo Sang Kwon ◽  
Eun Jung Bae ◽  
Chung II Noh ◽  
...  

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