Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection.
BACKGROUND: Puumala virus (PUUV) is the most important hantavirus species in Central Europe. Nephropathia epidemica (NE), caused by PUUV, is characterized by acute renal injury (AKI) with thrombocytopenia and frequently gastrointestinal symptoms. METHODS: 456 patients with serologically and clinical...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4032337?pdf=render |
| _version_ | 1818668992416448512 |
|---|---|
| author | Joerg Latus Klara Tenner-Racz Paul Racz Daniel Kitterer Daniel Cadar German Ott M Dominik Alscher Jonas Schmidt-Chanasit Niko Braun |
| author_facet | Joerg Latus Klara Tenner-Racz Paul Racz Daniel Kitterer Daniel Cadar German Ott M Dominik Alscher Jonas Schmidt-Chanasit Niko Braun |
| author_sort | Joerg Latus |
| collection | DOAJ |
| description | BACKGROUND: Puumala virus (PUUV) is the most important hantavirus species in Central Europe. Nephropathia epidemica (NE), caused by PUUV, is characterized by acute renal injury (AKI) with thrombocytopenia and frequently gastrointestinal symptoms. METHODS: 456 patients with serologically and clinically confirmed NE were investigated at time of follow-up in a single clinic. The course of the NE was investigated using medical reports. We identified patients who had endoscopy with intestinal biopsy during acute phase of NE. Histopathological, immunohistochemical and molecular analyses of the biopsies were performed. RESULTS: Thirteen patients underwent colonoscopy or gastroscopy for abdominal pain, diarrhea, nausea and vomiting during acute phase of NE. Immunohistochemistry (IHC) revealed PUUV nucleocapsid antigen in 11 biopsies from 8 patients; 14 biopsies from 5 patients were negative for PUUV nucleocapsid antigen. IHC localized PUUV nucleocapsid antigen in endothelial cells of capillaries or larger vessels in the lamina propria. Rate of AKI was not higher and severity of AKI was not different in the PUUV-positive compared to the PUUV-negative group. All IHC positive biopsies were positive for PUUV RNA using RT-PCR. Phylogenetic reconstruction revealed clustering of all PUUV strains from this study with viruses previously detected from the South-West of Germany. Long-term outcome was favorable in both groups. CONCLUSIONS: In patients with NE, PUUV nucleocapsid antigen and PUUV RNA was detected frequently in the intestine. This finding could explain frequent GI-symptoms in NE patients, thus demonstration of a more generalized PUUV infection. The RT-PCR was an effective and sensitive method to detect PUUV RNA in FFPE tissues. Therefore, it can be used as a diagnostic and phylogenetic approach also for archival materials. AKI was not more often present in patients with PUUV-positive IHC. This last finding should be investigated in larger numbers of patients with PUUV infection. |
| first_indexed | 2024-12-17T06:45:08Z |
| format | Article |
| id | doaj.art-bff36dcb14bf491f849ff82effc8918a |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T06:45:08Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-bff36dcb14bf491f849ff82effc8918a2022-12-21T21:59:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0195e9839710.1371/journal.pone.0098397Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection.Joerg LatusKlara Tenner-RaczPaul RaczDaniel KittererDaniel CadarGerman OttM Dominik AlscherJonas Schmidt-ChanasitNiko BraunBACKGROUND: Puumala virus (PUUV) is the most important hantavirus species in Central Europe. Nephropathia epidemica (NE), caused by PUUV, is characterized by acute renal injury (AKI) with thrombocytopenia and frequently gastrointestinal symptoms. METHODS: 456 patients with serologically and clinically confirmed NE were investigated at time of follow-up in a single clinic. The course of the NE was investigated using medical reports. We identified patients who had endoscopy with intestinal biopsy during acute phase of NE. Histopathological, immunohistochemical and molecular analyses of the biopsies were performed. RESULTS: Thirteen patients underwent colonoscopy or gastroscopy for abdominal pain, diarrhea, nausea and vomiting during acute phase of NE. Immunohistochemistry (IHC) revealed PUUV nucleocapsid antigen in 11 biopsies from 8 patients; 14 biopsies from 5 patients were negative for PUUV nucleocapsid antigen. IHC localized PUUV nucleocapsid antigen in endothelial cells of capillaries or larger vessels in the lamina propria. Rate of AKI was not higher and severity of AKI was not different in the PUUV-positive compared to the PUUV-negative group. All IHC positive biopsies were positive for PUUV RNA using RT-PCR. Phylogenetic reconstruction revealed clustering of all PUUV strains from this study with viruses previously detected from the South-West of Germany. Long-term outcome was favorable in both groups. CONCLUSIONS: In patients with NE, PUUV nucleocapsid antigen and PUUV RNA was detected frequently in the intestine. This finding could explain frequent GI-symptoms in NE patients, thus demonstration of a more generalized PUUV infection. The RT-PCR was an effective and sensitive method to detect PUUV RNA in FFPE tissues. Therefore, it can be used as a diagnostic and phylogenetic approach also for archival materials. AKI was not more often present in patients with PUUV-positive IHC. This last finding should be investigated in larger numbers of patients with PUUV infection.http://europepmc.org/articles/PMC4032337?pdf=render |
| spellingShingle | Joerg Latus Klara Tenner-Racz Paul Racz Daniel Kitterer Daniel Cadar German Ott M Dominik Alscher Jonas Schmidt-Chanasit Niko Braun Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. PLoS ONE |
| title | Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. |
| title_full | Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. |
| title_fullStr | Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. |
| title_full_unstemmed | Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. |
| title_short | Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. |
| title_sort | detection of puumala hantavirus antigen in human intestine during acute hantavirus infection |
| url | http://europepmc.org/articles/PMC4032337?pdf=render |
| work_keys_str_mv | AT joerglatus detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT klaratennerracz detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT paulracz detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT danielkitterer detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT danielcadar detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT germanott detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT mdominikalscher detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT jonasschmidtchanasit detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection AT nikobraun detectionofpuumalahantavirusantigeninhumanintestineduringacutehantavirusinfection |