Abnormal Development - Cytomegalovirus - Revision history

Z8600021 at 01:56, 17 February 2020

2020-02-17T01:56:22Z

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			* '''Prenatal findings, neonatal symptoms and neurodevelopmental outcome of congenital cytomegalovirus infection in a university hospital in Montreal, Quebec'''{{#pmid:32031981\|PMID32031981}} "Background Outcome of congenital cytomegalovirus (cCMV) infection in the absence of routine CMV screening and third-trimester scan in North America is scarcely documented. The aim of this study was to assess the severe outcomes related to cCMV according to the indication for screening. Methods This was a retrospective study of 84 mother-child pairs followed for cCMV between 2003 and 2017 at CHU Sainte-Justine in Montreal, Canada. Prenatal ultrasound, neonatal symptoms, neuroimaging and severe outcomes (cerebral palsy, severe cognitive impairment, bilateral hearing loss or neonatal death) were reviewed. Results Among 38 cases with abnormal prenatal ultrasound, 41.9% of live-born infants developed severe outcomes. Sixteen (42.1%) were detected in the third trimester. Among 16 cases diagnosed prenatally because of maternal history, all had normal prenatal ultrasound, and none developed severe outcomes. Among cases diagnosed postnatally because of neonatal symptoms, 25% developed severe outcomes. All infants who developed severe outcomes had moderate/severe neonatal symptoms. Conclusion Outcome of cCMV infection varies according to the reason for screening and timing of diagnosis. Any prenatal ultrasound anomaly might indicate a risk of severe outcome, and warrants a detailed ultrasound scan. However, late detection, or postnatal diagnosis, represented more than half of the cases, and awareness of this will help ensuring optimal management."

	* '''Survey of cellular immune responses to human cytomegalovirus infection in the microenvironment of the uterine-placental interface'''{{#pmid:31065796\|PMID31065796}} "Congenital human cytomegalovirus (HCMV) infection is a leading cause of birth defects, yet there are no established treatments for preventing maternal-fetal transmission. During first trimester, HCMV replicates in basal decidua that functions as a reservoir for virus and source of transmission to the attached placenta and fetal hemiallograft but also contains immune cells, including natural killer cells, macrophages, and T cell subsets, that respond to pathogens, protecting the placenta and fetus. However, the specific cellular and cytokine responses to infection are unknown, nor are the immune correlates of protection that guide development of therapeutic strategies. Here we survey immune cell phenotypes in intact explants of basal decidua infected with a clinical pathogenic HCMV strain ex vivo and identify specific changes occurring in response to infection in the tissue environment. Using 4-color immunofluorescence microscopy, we found that at 3 days postinfection, virus replicates in decidual stromal cells and epithelial cells of endometrial glands. Infected cells and effector memory CD8+ T cells (TEM) in contact with them make IFN-γ. CD8+ TEM cells produce granulysin and cluster at sites of infection in decidua and the epithelium of endometrial glands. Quantification indicated expansion of two immune cell subtypes-CD8+ TEM cells and, to a lesser extent, iNKT cells. Approximately 20% of immune cells were found in pairs in both control and infected decidua, suggesting frequent cross-talk in the microenvironment of decidua. Our findings indicate a complex immune microenvironment in basal decidua and suggest CD8+ TEM cells play a role in early responses to decidual infection in seropositive women."		* '''Survey of cellular immune responses to human cytomegalovirus infection in the microenvironment of the uterine-placental interface'''{{#pmid:31065796\|PMID31065796}} "Congenital human cytomegalovirus (HCMV) infection is a leading cause of birth defects, yet there are no established treatments for preventing maternal-fetal transmission. During first trimester, HCMV replicates in basal decidua that functions as a reservoir for virus and source of transmission to the attached placenta and fetal hemiallograft but also contains immune cells, including natural killer cells, macrophages, and T cell subsets, that respond to pathogens, protecting the placenta and fetus. However, the specific cellular and cytokine responses to infection are unknown, nor are the immune correlates of protection that guide development of therapeutic strategies. Here we survey immune cell phenotypes in intact explants of basal decidua infected with a clinical pathogenic HCMV strain ex vivo and identify specific changes occurring in response to infection in the tissue environment. Using 4-color immunofluorescence microscopy, we found that at 3 days postinfection, virus replicates in decidual stromal cells and epithelial cells of endometrial glands. Infected cells and effector memory CD8+ T cells (TEM) in contact with them make IFN-γ. CD8+ TEM cells produce granulysin and cluster at sites of infection in decidua and the epithelium of endometrial glands. Quantification indicated expansion of two immune cell subtypes-CD8+ TEM cells and, to a lesser extent, iNKT cells. Approximately 20% of immune cells were found in pairs in both control and infected decidua, suggesting frequent cross-talk in the microenvironment of decidua. Our findings indicate a complex immune microenvironment in basal decidua and suggest CD8+ TEM cells play a role in early responses to decidual infection in seropositive women."

Z8600021 at 01:52, 17 February 2020

2020-02-17T01:52:55Z

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	{{Header}}		{{Header}}
	=KA62.3 Congenital cytomegalovirus infection=		=KA62.3 Congenital cytomegalovirus infection=
			{\|
	~~[https://icd.who.int/browse11/l~~-~~m/en#/http://id.who.int/icd/entity/1515465998 '''~~ICD-11~~''']: KA62.3~~ Congenital cytomegalovirus infection "A condition affecting neonates, caused by an infection with cytomegalovirus in utero. This condition is characterized by jaundice, low birth weight, splenomegaly, hepatomegaly, or pneumonia if symptoms develop shortly after birth, or may be asymptomatic. This condition commonly present later in life with loss of {{hearing}}, loss of {{vision}}, or developmental disabilities. Transmission is by vertical transmission. Confirmation is by detection of cytomegalovirus in neonatal urine, saliva, blood, or other body tissues within 2-3 weeks of birth."		\|-bgcolor="FFCC00"
			! {{ICD-11}} {{ICD11weblink}}1515465998 Congenital cytomegalovirus infection]
	~~:'''ICD-10''' P35.1 Congenital cytomegalovirus infection~~ \| [[International Classification of Diseases]]: [[International_Classification_of_Diseases_-_XVI_Perinatal_Period#P35_Congenital_viral_diseases\|P35 Congenital viral diseases]] \| [[International_Classification_of_Diseases_-_XVI_Perinatal_Period\|XVI Perinatal Period]]		\|-bgcolor="FEF9E7"
			\| "A condition affecting neonates, caused by an infection with cytomegalovirus in utero. This condition is characterized by jaundice, low birth weight, splenomegaly, hepatomegaly, or pneumonia if symptoms develop shortly after birth, or may be asymptomatic. This condition commonly present later in life with loss of {{hearing}}, loss of {{vision}}, or developmental disabilities. Transmission is by vertical transmission. Confirmation is by detection of cytomegalovirus in neonatal urine, saliva, blood, or other body tissues within 2-3 weeks of birth."
			\|}
	{{Viral Links}}		{{Viral Links}}
	==Introduction==		==Introduction==

Z8600021 at 01:50, 17 February 2020

2020-02-17T01:50:44Z

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	~~Cytomegalovirus~~ is the most common infectious cause and the second most common overall cause of congenital ~~malformation in Australia~~ and may be placental transmitted to the baby and can have serious consequences.<ref name=PregnancyCare2018>{{Ref-PregnancyCare2018}}</ref> HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.		In Australia, cytomegalovirus is the most common infectious cause and the second most common overall cause of congenital malformations and may be placental transmitted to the baby and can have serious consequences.<ref name=PregnancyCare2018>{{Ref-PregnancyCare2018}}</ref> HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.

Z8600021 at 01:49, 17 February 2020

2020-02-17T01:49:29Z

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	Cytomegalovirus is the most common infectious cause and the second most common overall cause of congenital malformation in Australia and may be placental transmitted to the baby and can have serious consequences. HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.		Cytomegalovirus is the most common infectious cause and the second most common overall cause of congenital malformation in Australia and may be placental transmitted to the baby and can have serious consequences.<ref name=PregnancyCare2018>{{Ref-PregnancyCare2018}}</ref> HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.

Z8600021 at 01:46, 17 February 2020

2020-02-17T01:46:46Z

← Older revision		Revision as of 12:46, 17 February 2020
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	HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.		Cytomegalovirus is the most common infectious cause and the second most common overall cause of congenital malformation in Australia and may be placental transmitted to the baby and can have serious consequences. HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.

Z8600021 at 19:21, 28 July 2019

2019-07-28T19:21:06Z

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			* '''Survey of cellular immune responses to human cytomegalovirus infection in the microenvironment of the uterine-placental interface'''{{#pmid:31065796\|PMID31065796}} "Congenital human cytomegalovirus (HCMV) infection is a leading cause of birth defects, yet there are no established treatments for preventing maternal-fetal transmission. During first trimester, HCMV replicates in basal decidua that functions as a reservoir for virus and source of transmission to the attached placenta and fetal hemiallograft but also contains immune cells, including natural killer cells, macrophages, and T cell subsets, that respond to pathogens, protecting the placenta and fetus. However, the specific cellular and cytokine responses to infection are unknown, nor are the immune correlates of protection that guide development of therapeutic strategies. Here we survey immune cell phenotypes in intact explants of basal decidua infected with a clinical pathogenic HCMV strain ex vivo and identify specific changes occurring in response to infection in the tissue environment. Using 4-color immunofluorescence microscopy, we found that at 3 days postinfection, virus replicates in decidual stromal cells and epithelial cells of endometrial glands. Infected cells and effector memory CD8+ T cells (TEM) in contact with them make IFN-γ. CD8+ TEM cells produce granulysin and cluster at sites of infection in decidua and the epithelium of endometrial glands. Quantification indicated expansion of two immune cell subtypes-CD8+ TEM cells and, to a lesser extent, iNKT cells. Approximately 20% of immune cells were found in pairs in both control and infected decidua, suggesting frequent cross-talk in the microenvironment of decidua. Our findings indicate a complex immune microenvironment in basal decidua and suggest CD8+ TEM cells play a role in early responses to decidual infection in seropositive women."

	* '''Sequelae of congenital cytomegalovirus (cCMV) following maternal primary infection are limited to those acquired in the first trimester of pregnancy'''{{#pmid:30596974\|PMID30596974}} "Relationship between gestational age at maternal primary infection and outcome in cCMV was based on small retrospective studies between 1980 and 2011. They reported sequelae in 32% and 15% following maternal primary infection in first and second or third trimester respectively. ...These results suggest that CMV infection can be severe only when the virus hits the fetus in the embryonic or early fetal period. Recent guidelines recommend auditory follow-up for at least 5 years of all infected children. This raises parental anxiety and generates significant cost. We suggest that auditory and specialized neurologic follow-up may be recommended only to children infected from maternal infection in the first trimester."		* '''Sequelae of congenital cytomegalovirus (cCMV) following maternal primary infection are limited to those acquired in the first trimester of pregnancy'''{{#pmid:30596974\|PMID30596974}} "Relationship between gestational age at maternal primary infection and outcome in cCMV was based on small retrospective studies between 1980 and 2011. They reported sequelae in 32% and 15% following maternal primary infection in first and second or third trimester respectively. ...These results suggest that CMV infection can be severe only when the virus hits the fetus in the embryonic or early fetal period. Recent guidelines recommend auditory follow-up for at least 5 years of all infected children. This raises parental anxiety and generates significant cost. We suggest that auditory and specialized neurologic follow-up may be recommended only to children infected from maternal infection in the first trimester."

Z8600021 at 19:17, 28 July 2019

2019-07-28T19:17:02Z

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	\| [[File:Mark_Hill.jpg\|90px\|left]] {{Most_Recent_Refs}}		\| [[File:Mark_Hill.jpg\|90px\|left]] {{Most_Recent_Refs}}

	Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Abnormal+Development+Cytomegalovirus ''Abnormal Development Cytomegalovirus'']		Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Abnormal+Development+Cytomegalovirus ''Abnormal Development Cytomegalovirus''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Congenital+Cytomegalovirus ''Congenital Cytomegalovirus'']

	~~<pubmed limit=5>Abnormal Development Cytomegalovirus</pubmed>~~
	\|}		\|}

Z8600021 at 19:15, 28 July 2019

2019-07-28T19:15:59Z

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	=KA62.3 Congenital cytomegalovirus infection=		=KA62.3 Congenital cytomegalovirus infection=

	[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1515465998 '''ICD-11''']: KA62.3 Congenital cytomegalovirus infection "A condition affecting neonates, caused by an infection with cytomegalovirus in utero. This condition is characterized by jaundice, low birth weight, splenomegaly, hepatomegaly, or pneumonia if symptoms develop shortly after birth, or may be asymptomatic. This condition commonly present later in life with loss of hearing, loss of vision, or developmental disabilities. Transmission is by vertical transmission. Confirmation is by detection of cytomegalovirus in neonatal urine, saliva, blood, or other body tissues within 2-3 weeks of birth."		[https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1515465998 '''ICD-11''']: KA62.3 Congenital cytomegalovirus infection "A condition affecting neonates, caused by an infection with cytomegalovirus in utero. This condition is characterized by jaundice, low birth weight, splenomegaly, hepatomegaly, or pneumonia if symptoms develop shortly after birth, or may be asymptomatic. This condition commonly present later in life with loss of {{hearing}}, loss of {{vision}}, or developmental disabilities. Transmission is by vertical transmission. Confirmation is by detection of cytomegalovirus in neonatal urine, saliva, blood, or other body tissues within 2-3 weeks of birth."

	:'''ICD-10''' P35.1 Congenital cytomegalovirus infection \| [[International Classification of Diseases]]: [[International_Classification_of_Diseases_-_XVI_Perinatal_Period#P35_Congenital_viral_diseases\|P35 Congenital viral diseases]] \| [[International_Classification_of_Diseases_-_XVI_Perinatal_Period\|XVI Perinatal Period]]		:'''ICD-10''' P35.1 Congenital cytomegalovirus infection \| [[International Classification of Diseases]]: [[International_Classification_of_Diseases_-_XVI_Perinatal_Period#P35_Congenital_viral_diseases\|P35 Congenital viral diseases]] \| [[International_Classification_of_Diseases_-_XVI_Perinatal_Period\|XVI Perinatal Period]]

Z8600021 at 23:09, 3 Ocak 2019

2019-01-03T23:09:56Z

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	* '''Neuroimaging Profiles and Neurodevelopmental Outcome in Infants With Congenital Cytomegalovirus Infection'''{{#pmid:30222696}} "The accurate stratification of infants with congenital cytomegalovirus (CMV) infection at risk for more severe outcome may help in the management of patients. All consecutive neonates born from 2002 to 2015 with congenital CMV infection were considered eligible for the study. Neuroimaging findings were scored according to both scores. ...Although HUS is the safest neuroimaging technique, it performs less well in detecting some brain abnormalities that can be associated with a poor neurodevelopmental outcome. A comprehensive neuroimaging evaluation is mandatory in infants with congenital CMV infection to decide for treatment and make a prognostic evaluation.

	* '''~~Maternal Immunity and~~ the ~~Natural History~~ of ~~Congenital Human Cytomegalovirus Infection~~'''{{#pmid:~~30081449~~}} "~~Congenital HCMV infections account for an estimated 25~~% ~~of all cases of hearing loss~~ in ~~the US~~. ~~It has long been argued~~ that ~~maternal adaptive immune responses to HCMV~~ can ~~modify both~~ the ~~likelihood of intrauterine transmission of HCMV, and~~ the ~~severity of~~ fetal ~~infection and risk~~ of ~~long term sequelae in~~ infected ~~infants~~. ~~Over the last two decades, multiple studies have challenged this paradigm, including findings~~ that ~~have demonstrated that the vast majority of infants with congenital HCMV infections in most populations are born~~ to ~~women with established immunity prior to conception. Furthermore, the incidence of clinically apparent congenital HCMV~~ infection in ~~infants born to immune and non-immune pregnant women appears to be similar~~."		* '''Sequelae of congenital cytomegalovirus (cCMV) following maternal primary infection are limited to those acquired in the first trimester of pregnancy'''{{#pmid:30596974\|PMID30596974}} "Relationship between gestational age at maternal primary infection and outcome in cCMV was based on small retrospective studies between 1980 and 2011. They reported sequelae in 32% and 15% following maternal primary infection in first and second or third trimester respectively. ...These results suggest that CMV infection can be severe only when the virus hits the fetus in the embryonic or early fetal period. Recent guidelines recommend auditory follow-up for at least 5 years of all infected children. This raises parental anxiety and generates significant cost. We suggest that auditory and specialized neurologic follow-up may be recommended only to children infected from maternal infection in the first trimester."

	* '''~~Maternal~~ and ~~fetal cytomegalovirus infection: diagnosis, management, and prevention~~'''{{#pmid:~~29560263~~\|~~PMID29560263~~}} "~~Congenital~~ cytomegalovirus infection ~~is a major cause~~ of ~~central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision~~. ~~Although the importance of~~ congenital ~~cytomegalovirus~~ infection ~~is readily evident,~~ the ~~vast majority of maternal and fetal infections are not identified, even in developed countries~~. ~~Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach~~ to ~~suspected or proven maternal and fetal infection~~. ~~Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality~~. ~~Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied~~. ~~There~~ is ~~evidence~~ that ~~public health approaches based on hygiene~~ can ~~dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy~~. ~~This review will consider the epidemiology of~~ congenital ~~cytomegalovirus~~ infection~~, the diagnosis~~ and ~~management of primary infection during pregnancy, and approaches to preventing maternal infection~~.~~" {{vaccination}}~~		* '''Neuroimaging Profiles and Neurodevelopmental Outcome in Infants With Congenital Cytomegalovirus Infection'''{{#pmid:30222696\|PMID30222696}} "The accurate stratification of infants with congenital cytomegalovirus (CMV) infection at risk for more severe outcome may help in the management of patients. All consecutive neonates born from 2002 to 2015 with congenital CMV infection were considered eligible for the study. Neuroimaging findings were scored according to both scores. ...Although HUS is the safest neuroimaging technique, it performs less well in detecting some brain abnormalities that can be associated with a poor neurodevelopmental outcome. A comprehensive neuroimaging evaluation is mandatory in infants with congenital CMV infection to decide for treatment and make a prognostic evaluation.

	* '''~~Pathogenesis~~ of ~~developmental anomalies of the central nervous system induced by congenital cytomegalovirus infection~~'''{{#pmid:~~28074532~~}} "~~In humans,~~ the ~~herpes virus family member cytomegalovirus (CMV) is~~ the ~~most prevalent mediator~~ of intrauterine ~~infection-induced congenital defect. Central nervous system (CNS) dysfunction is a distinguishing symptom~~ of ~~CMV infection~~, and ~~characterized by ventriculoencephalitis and microglial nodular encephalitis. Reports on~~ the ~~initial distribution~~ of ~~CMV particles~~ and ~~its receptors on~~ the ~~blood brain barrier (BBB) are rare. Nevertheless~~, ~~several factors are suggested to affect CMV etiology. Viral particle size is the primary factor in determining~~ the ~~pattern~~ of ~~CNS~~ infections~~, followed by the expression of integrin β1~~ in ~~endothelial cells, pericytes, meninges~~, ~~choroid plexus, and neural stem progenitor cells (NSPCs), which are~~ the ~~primary targets~~ of ~~CMV~~ infection~~. After initial infection, CMV disrupts BBB structural integrity~~ to ~~facilitate the spread of viral particles into parenchyma. Then, the initial meningitis~~ and ~~vasculitis eventually reaches NSPC~~-dense areas such as ventricular zone and subventricular zone, where viral infection inhibits NSPC proliferation and differentiation and results in neuronal cell loss. These cellular events clinically manifest as brain malformations such as a microcephaly."		* '''Maternal Immunity and the Natural History of Congenital Human Cytomegalovirus Infection'''{{#pmid:30081449\|PMID30081449}} "Congenital HCMV infections account for an estimated 25% of all cases of hearing loss in the US. It has long been argued that maternal adaptive immune responses to HCMV can modify both the likelihood of intrauterine transmission of HCMV, and the severity of fetal infection and risk of long term sequelae in infected infants. Over the last two decades, multiple studies have challenged this paradigm, including findings that have demonstrated that the vast majority of infants with congenital HCMV infections in most populations are born to women with established immunity prior to conception. Furthermore, the incidence of clinically apparent congenital HCMV infection in infants born to immune and non-immune pregnant women appears to be similar."

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	! Older papers		! Older papers
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			* '''Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention'''{{#pmid:29560263\|PMID29560263}} "Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection." {{vaccination}}

			* '''Pathogenesis of developmental anomalies of the central nervous system induced by congenital cytomegalovirus infection'''{{#pmid:28074532\|PMID28074532}} "In humans, the herpes virus family member cytomegalovirus (CMV) is the most prevalent mediator of intrauterine infection-induced congenital defect. Central nervous system (CNS) dysfunction is a distinguishing symptom of CMV infection, and characterized by ventriculoencephalitis and microglial nodular encephalitis. Reports on the initial distribution of CMV particles and its receptors on the blood brain barrier (BBB) are rare. Nevertheless, several factors are suggested to affect CMV etiology. Viral particle size is the primary factor in determining the pattern of CNS infections, followed by the expression of integrin β1 in endothelial cells, pericytes, meninges, choroid plexus, and neural stem progenitor cells (NSPCs), which are the primary targets of CMV infection. After initial infection, CMV disrupts BBB structural integrity to facilitate the spread of viral particles into parenchyma. Then, the initial meningitis and vasculitis eventually reaches NSPC-dense areas such as ventricular zone and subventricular zone, where viral infection inhibits NSPC proliferation and differentiation and results in neuronal cell loss. These cellular events clinically manifest as brain malformations such as a microcephaly."

	* '''Congenital Cytomegalovirus Infection in the Absence of Maternal Cytomegalovirus-IgM Antibodies'''{{#pmid:28259882\|PMID28259882}} "Congenital cytomegalovirus (cCMV) infections are the most prevalent intrauterine infections worldwide and are the result of maternal primary or non-primary infections. Early maternal primary infections are thought to carry the highest risk of fetal developmental abnormalities as seen by ultrasound; however, non-primary infections may prove equally detrimental. METHODS/RESULTS: This case series presents 5 cases with fetal abnormalities detected in the second and third trimester, in which cCMV infection was ruled out due to negative maternal CMV-IgM. DISCUSSION: This series highlights the possible pitfalls in serology interpretation and fetal diagnosis necessary for appropriate parental counseling. Once fetal abnormalities have been confirmed and cCMV is suspected, maternal CMV serostatus and fetal infection should be determined. Maternal CMV serology may be ambiguous; therefore, caution should be exercised when interpreting the results."		* '''Congenital Cytomegalovirus Infection in the Absence of Maternal Cytomegalovirus-IgM Antibodies'''{{#pmid:28259882\|PMID28259882}} "Congenital cytomegalovirus (cCMV) infections are the most prevalent intrauterine infections worldwide and are the result of maternal primary or non-primary infections. Early maternal primary infections are thought to carry the highest risk of fetal developmental abnormalities as seen by ultrasound; however, non-primary infections may prove equally detrimental. METHODS/RESULTS: This case series presents 5 cases with fetal abnormalities detected in the second and third trimester, in which cCMV infection was ruled out due to negative maternal CMV-IgM. DISCUSSION: This series highlights the possible pitfalls in serology interpretation and fetal diagnosis necessary for appropriate parental counseling. Once fetal abnormalities have been confirmed and cCMV is suspected, maternal CMV serostatus and fetal infection should be determined. Maternal CMV serology may be ambiguous; therefore, caution should be exercised when interpreting the results."

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	{{Footer}}		{{Footer}}


	[[Category:Abnormal Development]] [[Category:Environmental Abnormalities]] [[Category:Virus]]		[[Category:Abnormal Development]] [[Category:Environmental Abnormalities]] [[Category:Virus]]

Z8600021 at 01:38, 14 October 2018

2018-10-14T01:38:46Z

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			* '''Neuroimaging Profiles and Neurodevelopmental Outcome in Infants With Congenital Cytomegalovirus Infection'''{{#pmid:30222696}} "The accurate stratification of infants with congenital cytomegalovirus (CMV) infection at risk for more severe outcome may help in the management of patients. All consecutive neonates born from 2002 to 2015 with congenital CMV infection were considered eligible for the study. Neuroimaging findings were scored according to both scores. ...Although HUS is the safest neuroimaging technique, it performs less well in detecting some brain abnormalities that can be associated with a poor neurodevelopmental outcome. A comprehensive neuroimaging evaluation is mandatory in infants with congenital CMV infection to decide for treatment and make a prognostic evaluation.

			* '''Maternal Immunity and the Natural History of Congenital Human Cytomegalovirus Infection'''{{#pmid:30081449}} "Congenital HCMV infections account for an estimated 25% of all cases of hearing loss in the US. It has long been argued that maternal adaptive immune responses to HCMV can modify both the likelihood of intrauterine transmission of HCMV, and the severity of fetal infection and risk of long term sequelae in infected infants. Over the last two decades, multiple studies have challenged this paradigm, including findings that have demonstrated that the vast majority of infants with congenital HCMV infections in most populations are born to women with established immunity prior to conception. Furthermore, the incidence of clinically apparent congenital HCMV infection in infants born to immune and non-immune pregnant women appears to be similar."

	* '''Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention'''{{#pmid:29560263\|PMID29560263}} "Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection." {{vaccination}}		* '''Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention'''{{#pmid:29560263\|PMID29560263}} "Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection." {{vaccination}}

	* '''Pathogenesis of developmental anomalies of the central nervous system induced by congenital cytomegalovirus infection'''{{#pmid:28074532}} "In humans, the herpes virus family member cytomegalovirus (CMV) is the most prevalent mediator of intrauterine infection-induced congenital defect. Central nervous system (CNS) dysfunction is a distinguishing symptom of CMV infection, and characterized by ventriculoencephalitis and microglial nodular encephalitis. Reports on the initial distribution of CMV particles and its receptors on the blood brain barrier (BBB) are rare. Nevertheless, several factors are suggested to affect CMV etiology. Viral particle size is the primary factor in determining the pattern of CNS infections, followed by the expression of integrin β1 in endothelial cells, pericytes, meninges, choroid plexus, and neural stem progenitor cells (NSPCs), which are the primary targets of CMV infection. After initial infection, CMV disrupts BBB structural integrity to facilitate the spread of viral particles into parenchyma. Then, the initial meningitis and vasculitis eventually reaches NSPC-dense areas such as ventricular zone and subventricular zone, where viral infection inhibits NSPC proliferation and differentiation and results in neuronal cell loss. These cellular events clinically manifest as brain malformations such as a microcephaly."		* '''Pathogenesis of developmental anomalies of the central nervous system induced by congenital cytomegalovirus infection'''{{#pmid:28074532}} "In humans, the herpes virus family member cytomegalovirus (CMV) is the most prevalent mediator of intrauterine infection-induced congenital defect. Central nervous system (CNS) dysfunction is a distinguishing symptom of CMV infection, and characterized by ventriculoencephalitis and microglial nodular encephalitis. Reports on the initial distribution of CMV particles and its receptors on the blood brain barrier (BBB) are rare. Nevertheless, several factors are suggested to affect CMV etiology. Viral particle size is the primary factor in determining the pattern of CNS infections, followed by the expression of integrin β1 in endothelial cells, pericytes, meninges, choroid plexus, and neural stem progenitor cells (NSPCs), which are the primary targets of CMV infection. After initial infection, CMV disrupts BBB structural integrity to facilitate the spread of viral particles into parenchyma. Then, the initial meningitis and vasculitis eventually reaches NSPC-dense areas such as ventricular zone and subventricular zone, where viral infection inhibits NSPC proliferation and differentiation and results in neuronal cell loss. These cellular events clinically manifest as brain malformations such as a microcephaly."

	* '''Congenital Cytomegalovirus Infection in the Absence of Maternal Cytomegalovirus-IgM Antibodies'''{{#pmid:28259882\|PMID28259882}} "Congenital cytomegalovirus (cCMV) infections are the most prevalent intrauterine infections worldwide and are the result of maternal primary or non-primary infections. Early maternal primary infections are thought to carry the highest risk of fetal developmental abnormalities as seen by ultrasound; however, non-primary infections may prove equally detrimental. METHODS/RESULTS: This case series presents 5 cases with fetal abnormalities detected in the second and third trimester, in which cCMV infection was ruled out due to negative maternal CMV-IgM. DISCUSSION: This series highlights the possible pitfalls in serology interpretation and fetal diagnosis necessary for appropriate parental counseling. Once fetal abnormalities have been confirmed and cCMV is suspected, maternal CMV serostatus and fetal infection should be determined. Maternal CMV serology may be ambiguous; therefore, caution should be exercised when interpreting the results."

	*'''Natural killer cells attenuate cytomegalovirus-induced hearing loss in mice'''{{#pmid:28859161\|PMID28859161}} }Congenital cytomegalovirus (CMV) infection is the most common non-hereditary cause of sensorineural hearing loss (SNHL) yet the mechanisms of hearing loss remain obscure. Natural Killer (NK) cells play a critical role in regulating murine CMV infection via NK cell recognition of the Ly49H cell surface receptor of the viral-encoded m157 ligand expressed at the infected cell surface.... These results demonstrate participation of NK cells in protection from CMV-induced labyrinthitis and SNHL in mice." {{mouse}}

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			* '''Congenital Cytomegalovirus Infection in the Absence of Maternal Cytomegalovirus-IgM Antibodies'''{{#pmid:28259882\|PMID28259882}} "Congenital cytomegalovirus (cCMV) infections are the most prevalent intrauterine infections worldwide and are the result of maternal primary or non-primary infections. Early maternal primary infections are thought to carry the highest risk of fetal developmental abnormalities as seen by ultrasound; however, non-primary infections may prove equally detrimental. METHODS/RESULTS: This case series presents 5 cases with fetal abnormalities detected in the second and third trimester, in which cCMV infection was ruled out due to negative maternal CMV-IgM. DISCUSSION: This series highlights the possible pitfalls in serology interpretation and fetal diagnosis necessary for appropriate parental counseling. Once fetal abnormalities have been confirmed and cCMV is suspected, maternal CMV serostatus and fetal infection should be determined. Maternal CMV serology may be ambiguous; therefore, caution should be exercised when interpreting the results."

			*'''Natural killer cells attenuate cytomegalovirus-induced hearing loss in mice'''{{#pmid:28859161\|PMID28859161}} }Congenital cytomegalovirus (CMV) infection is the most common non-hereditary cause of sensorineural hearing loss (SNHL) yet the mechanisms of hearing loss remain obscure. Natural Killer (NK) cells play a critical role in regulating murine CMV infection via NK cell recognition of the Ly49H cell surface receptor of the viral-encoded m157 ligand expressed at the infected cell surface.... These results demonstrate participation of NK cells in protection from CMV-induced labyrinthitis and SNHL in mice." {{mouse}}

	* '''Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases''': a 5 years' single center experience{{#pmid:28207161\|PMID28207161}} "The objective of this study is to investigate the diagnostic value of invasive prenatal diagnosis (PD) of congenital cytomegalovirus (CMV) infection from amniotic fluid (AF) and fetal blood (FB). A retrospective study was conducted on 115 pregnancies with CMV primary infection. A total of 111 AF and 106 FB samples were investigated for various virological and non-virological markers. Detailed ultrasound examinations were performed at time of PD. Overall sensitivity of CMV PCR in FB (75.6%; 95%CI 60-87) and AF (72.7%; 95%CI 57-85) was comparable. In women with amniocentesis >8 weeks between seroconversion and PD, we did not observe significant differences between amniocentesis performed ≥17 + 0 (sensitivity 90.9%; 95%CI 71-99) and ≥20 + 0 gestational weeks (sensitivity 90.0%; 95%CI 68-99). Virological markers in FB were higher in symptomatic compared with asymptomatic fetuses (p < 0.05). ...Optimal timing of amniocentesis in women with primary infection in early gestation should be reevaluated in a prospective study. Analysis of FB markers may be beneficial in the individual management of pregnant women with confirmed congenital CMV infection."		* '''Prenatal diagnosis of congenital cytomegalovirus infection in 115 cases''': a 5 years' single center experience{{#pmid:28207161\|PMID28207161}} "The objective of this study is to investigate the diagnostic value of invasive prenatal diagnosis (PD) of congenital cytomegalovirus (CMV) infection from amniotic fluid (AF) and fetal blood (FB). A retrospective study was conducted on 115 pregnancies with CMV primary infection. A total of 111 AF and 106 FB samples were investigated for various virological and non-virological markers. Detailed ultrasound examinations were performed at time of PD. Overall sensitivity of CMV PCR in FB (75.6%; 95%CI 60-87) and AF (72.7%; 95%CI 57-85) was comparable. In women with amniocentesis >8 weeks between seroconversion and PD, we did not observe significant differences between amniocentesis performed ≥17 + 0 (sensitivity 90.9%; 95%CI 71-99) and ≥20 + 0 gestational weeks (sensitivity 90.0%; 95%CI 68-99). Virological markers in FB were higher in symptomatic compared with asymptomatic fetuses (p < 0.05). ...Optimal timing of amniocentesis in women with primary infection in early gestation should be reevaluated in a prospective study. Analysis of FB markers may be beneficial in the individual management of pregnant women with confirmed congenital CMV infection."