Autoimmune neurological conditions associated with Zika virus infection

Zika virus (ZIKV) is an emerging flavivirus rapidly spreading throughout the tropical Americas. mosquitoes is the principal way of transmission of the virus to humans. ZIKV can be spread by transplacental, perinatal, and body fluids. ZIKV infection is often asymptomatic and those with symptoms present minor illness after 3 to 12 days of incubation, characterized by a mild and self-limiting disease with low-grade fever, conjunctivitis, widespread pruritic maculopapular rash, arthralgia and myalgia. ZIKV has been linked to a number of central and peripheral nervous system injuries such as Guillain-Barré syndrome (GBS), transverse myelitis (TM), meningoencephalitis, ophthalmological manifestations, and other neurological complications. Nevertheless, mechanisms of host-pathogen neuro-immune interactions remain incompletely elucidated. This review provides a critical discussion about the possible mechanisms underlying the development of autoimmune neurological conditions associated with Zika virus infection

Cytokine and autoantibody clusters interaction in systemic lupus erythematosus

Background: Evidence supports the existence of different subphenotypes in systemic lupus erythematosus (SLE) and the pivotal role of cytokines and autoantibodies, which interact in a highly complex network. Thus, understanding how these complex nonlinear processes are connected and observed in real-life settings is a major challenge. Cluster approaches may assist in the identification of these subphenotypes, which represent such a phenomenon, and may contribute to the development of personalized medicine. Therefore, the relationship between autoantibody and cytokine clusters in SLE was analyzed. Methods: This was an exploratory study in which 67 consecutive women with established SLE were assessed. Clinical characteristics including disease activity, a 14-autoantibody profile, and a panel of 15 serum cytokines were measured simultaneously. Mixed-cluster methodology and bivariate analyses were used to define autoantibody and cytokine clusters and to identify associations between them and related variables. Results: First, three clusters of autoantibodies were defined: (1) neutral, (2) antiphospholipid antibodies (APLA)-dominant, and (3) anti-dsDNA/ENA-dominant. Second, eight cytokines showed levels above the threshold thus making possible to find 4 clusters: (1) neutral, (2) chemotactic, (3) G-CSF dominant, and (4) IFN?/Pro-inflammatory. Furthermore, the disease activity was associated with cytokine clusters, which, in turn, were associated with autoantibody clusters. Finally, when all biomarkers were included, three clusters were found: (1) neutral, (2) chemotactic/APLA, and (3) IFN/dsDNA, which were also associated with disease activity. Conclusion: These results support the existence of three SLE cytokine-autoantibody driven subphenotypes. They encourage the practice of personalized medicine, and support proof-of-concept studies. © 2017 The Author(s)

Cytokines and Inflammatory Mediators in Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease characterised by a breakdown in immune tolerance that induces an attack on normal tissues by the immune system. The dysfunction within both the innate and adaptive immune systems increases cytokine production, B lymphocytic overproduction of autoantibodies, and T lymphocyte activity. Cytokines and inflammatory mediators have been associated with several clinical endpoints, including the activity of disease and outcomes. In fact, some of them have been associated with different clinical subphenotypes (e.g., lupus nephritis), suggesting their role as biomarkers, and, in some cases, therapeutic targets. Thus, knowledge of the pathophysiological processes associated with the development of SLE could aid in setting up better diagnostic and therapeutic approaches to reduce the high burden of disease, and thus improve quality of life and outcomes. Herein, the authors have compiled a concise review of the clinically relevant cytokines and inflammatory mediators associated with SLE and its manifestations

Autoimmune thyroid disease in euthyroid subjects

OBJECTIVE: To determine the prevalence of thyroid autoantibodies and the associated factors in euthyroid subjects. METHODS: In this study, 300 euthyroid subjects chosen by stratified sampling from an inception cohort of 1335 individuals were included. None of the subjects was under treatment. Thyroid function was evaluated by measuring serum levels of TSH (0.3-4.5 μIU / ml) and FT4 (5.2-12.7μg / dl). In addition, anti-peroxidase (TPOAbs), anti-thyroglobulin (TgAbs), and anti-TSH receptor (TrAbs) autoantibodies were evaluated together with other 23 autoantibodies and vitamin D levels. The analysis included sociodemographic, clinical, and environmental characteristics. Data were analyzed by chi-square (χ2), Kruskal-Wallis, Mann-Whitney and logistical regression tests. RESULTS: Thyroid autoimmunity was observed in 15.3% of the subjects (TPOAbs in 11.3% and TgAbs in 2%). In six individuals, both autoantibodies were positive. TrAbs were not detected in any individual. Familial thyroid disease (P = 0.021, = 3.4 CI: 1.2 – 9.5), low libido (P = 0.013, = 3.8 CI: 1.3 – 10.6), the presence of other ADs (P = 0.014, = 10.8 CI: 1.6 – 72.9) were associated with thyroid autoantibodies. In addition, VitD insufficiency (P= 0.03), never smoke (P = 0.010, = 6.9 CI: 1.6 – 30.4), drinking more than 4 cups of coffee (P = 0.036, = 3.8 CI: 1.1 – 13.1), and higher number of years exposed to wood smoke (P = 0.04), were associated with thyroid autoantibodies. Similar the last analysis, the presence of TPOAbs was associated with familial thyroid disease (P = 0.003, = 4.9 CI: 1.7 - 14.0), never smoke (P = 0.002, = 5.7 CI: 1.4 - 21.0), drinking > 4 cups of coffee (P = 0.047, = 3.6 CI: 1.1 - 13.1), low libido (P = 0.001, = 5.7 CI: 2.0 - 16.3). In addition, the presence of SS-A / Ro52 (P = 0.009, = 36.7 CI: 2.5 - 549.9), and Ku (P = 0.046, = 10.2 CI: 1.1 - 100.7), also was related to these autoantibodies. Regarding TgAbs, the presence of African ancestry (P = 0.01, = 10.5 CI: 1.7 – 63.2), SS-A / Ro52 (P = 0.03, = 15.8 CI: 1.2 – 198.6), and CENP-B (P = 0.02, = 31.2 CI: 1.8 – 565.9) was associated with TgAbs. CONCLUSIONS: Subclinical thyroid autoimmunity is not rare. Environmental, genetic, and immunological factors as well as ancestry are associated risk factors. These results will facilitate the implementation of screening strategies in order to provide timely diagnosis and treatment

Comment on : Zika virus and Guillain–Barré syndrome in Bangladesh

Apreciaciones de los autores en un estudio prospectivo realizado entre 2011 y 2015 en Bangladesh, que trató de determinar si la presencia de ZIKV podría estar asociada con GBS de Geurtsvan Kessel et al

Osteoarticular manifestations of Mayaro virus infection

PURPOSE OF REVIEW: To carry out an update on the state of the art of the Mayaro virus (MAYV) infection and its osteoarticular implications. RECENT FINDINGS: There is a wide distribution of MAYV in Latin America and documented exported cases to the United States and Europe. Although osteoarticular involvement is not the most frequent, it is one the most associated with disability. The main mechanisms related to arthropathy involves cellular infiltrates (i.e. macrophages, natural killer cells, lymphocytes) together with production of cytokines, such as IL-6, IL-7, IL8, IL-12p70. SUMMARY: MAYV infection is an emerging disease, which has been reported in many and increasing number of countries of Latin America. There is a high risk of epidemic outbreaks, given the inadequate vector control (Aedes mosquitoes). Its main symptoms, like other arbovirus infections, involve the presence of headache, rash, conjunctivitis, and arthralgias. MAYV arthropathy is usually severe, can last in time, and is associated with severe disability. There is currently no treatment for MAYV. Prevention of MAYV as a public health burden will be achieved by integrating vector control with vaccines (still under development)

Tick-borne diseases and autoimmunity: A comprehensive review

Tick-borne diseases (TBDs) are emerging and reemerging diseases transmitted by ticks, which portray wide heterogeneity and global distribution. TBDs may present acute clinical pictures that resemble those of autoimmune diseases (i.e., musculoskeletal symptoms, cutaneous involvement, neurologic impairment, renal failure, etc.), and in some cases infection is considered a triggering factor for autoimmunity (e.g., rheumatoid arthritis, autoimmune thyroid disease, vasculitides). The clinician should consider TBDs among the differential diagnoses when approaching autoimmune-like signs in areas of tick infestation. Epidemiological setting (e.g., endemic areas, seasons) and an accurate diagnostic approach (i.e., clinical history, physical examination and laboratory tests) are necessary to confirm TBDs. Further, control and prevention of TBDs is warranted. Research in the fields of ticks microbiome and vaccination (i.e., wildlife and humans) are ahead to control vector transmission and bacterial infection. This review offers a comprehensive update on TBDs and their relationship with autoimmunity. © 2017 Elsevier Lt

Impact of hyperprolactinemia in a patient with polyautoimmunity

Hyperprolactinemia has been proposed as a triggering factor for autoimmune diseases. The increased levels of prolactin could induce an abnormal immune response. Herein, we present a patient with hyperprolactinemia who developed polyautoimmunity. Patient's symptoms were associated with slightly raised levels of prolactin (20-40 ng/mL) and administration of dopaminergic agonists. © 2018 The Authors. Clinical Case Reports published by John Wiley and Sons Ltd