Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder
The emergence of immunodeficiency-associated vaccine-derived polioviruses (iVDPV) from children with primary immunodeficiency disorders poses a threat to the eradication program. Herein, we report a patient with severe combined immunodeficiency (SCID), identified as a prolonged serotype 3 iVDPV (iVD...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fimmu.2019.01567/full |
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| author | Madhu Chhanda Mohanty Manisha Ranjan Madkaikar Mukesh Desai Jahnavi Aluri Swapnil Yashwant Varose Prasad Taur Deepa Kailash Sharma Uma Prajwal Nalavade Sneha Vijay Rane Maya Gupta Snehal Shabarish Aparna Dalvi Jagadish Mohanrao Deshpande |
| author_facet | Madhu Chhanda Mohanty Manisha Ranjan Madkaikar Mukesh Desai Jahnavi Aluri Swapnil Yashwant Varose Prasad Taur Deepa Kailash Sharma Uma Prajwal Nalavade Sneha Vijay Rane Maya Gupta Snehal Shabarish Aparna Dalvi Jagadish Mohanrao Deshpande |
| author_sort | Madhu Chhanda Mohanty |
| collection | DOAJ |
| description | The emergence of immunodeficiency-associated vaccine-derived polioviruses (iVDPV) from children with primary immunodeficiency disorders poses a threat to the eradication program. Herein, we report a patient with severe combined immunodeficiency (SCID), identified as a prolonged serotype 3 iVDPV (iVDPV3) excreter with 13 VDPV3 isolates and a maximum of 10.33% nucleotide divergence, who abruptly cleared infection after a period of 2 years. Occurrence of an episode of norovirus diarrhea associated with increased activated oligoclonal cytotoxic T cells, inverse CD4:CD8 ratio, significantly elevated pro-inflammatory cytokines, and subsequent clearance of the poliovirus suggests a possible link between inflammatory diarrheal illness and clearance of iVDPV. Our findings suggest that in the absence of B cells and sufficiently activated T/NK cells, macrophages and other T cells may produce auto-inflammatory conditions by TLR/RLR ligands expressed by previous/ongoing bacterial or viral infections to clear VDPV infection. The study highlights the need to screen all the patients with combined immunodeficiency for poliovirus excretion and intermittent follow-up of their immune parameters if found positive, in order to manage the risk of iVDPV excretion in the polio eradication endgame strategy. |
| first_indexed | 2024-12-13T06:21:24Z |
| format | Article |
| id | doaj.art-db843467bb4c456a9843c99c8e565641 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-13T06:21:24Z |
| publishDate | 2019-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-db843467bb4c456a9843c99c8e5656412022-12-21T23:56:51ZengFrontiers Media S.A.Frontiers in Immunology1664-32242019-07-011010.3389/fimmu.2019.01567470707Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency DisorderMadhu Chhanda Mohanty0Manisha Ranjan Madkaikar1Mukesh Desai2Jahnavi Aluri3Swapnil Yashwant Varose4Prasad Taur5Deepa Kailash Sharma6Uma Prajwal Nalavade7Sneha Vijay Rane8Maya Gupta9Snehal Shabarish10Aparna Dalvi11Jagadish Mohanrao Deshpande12ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, IndiaICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, IndiaBai Jer Bai Wadia Childrens Hospital, Mumbai, IndiaICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, IndiaICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, IndiaBai Jer Bai Wadia Childrens Hospital, Mumbai, IndiaICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, IndiaICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, IndiaICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, IndiaICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, IndiaICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, IndiaICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, IndiaICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, IndiaThe emergence of immunodeficiency-associated vaccine-derived polioviruses (iVDPV) from children with primary immunodeficiency disorders poses a threat to the eradication program. Herein, we report a patient with severe combined immunodeficiency (SCID), identified as a prolonged serotype 3 iVDPV (iVDPV3) excreter with 13 VDPV3 isolates and a maximum of 10.33% nucleotide divergence, who abruptly cleared infection after a period of 2 years. Occurrence of an episode of norovirus diarrhea associated with increased activated oligoclonal cytotoxic T cells, inverse CD4:CD8 ratio, significantly elevated pro-inflammatory cytokines, and subsequent clearance of the poliovirus suggests a possible link between inflammatory diarrheal illness and clearance of iVDPV. Our findings suggest that in the absence of B cells and sufficiently activated T/NK cells, macrophages and other T cells may produce auto-inflammatory conditions by TLR/RLR ligands expressed by previous/ongoing bacterial or viral infections to clear VDPV infection. The study highlights the need to screen all the patients with combined immunodeficiency for poliovirus excretion and intermittent follow-up of their immune parameters if found positive, in order to manage the risk of iVDPV excretion in the polio eradication endgame strategy.https://www.frontiersin.org/article/10.3389/fimmu.2019.01567/fullprimary immunodeficiency disorderoral polio vaccinevaccine-derived poliovirusessevere combined immune-deficiencyleaky SCIDinflammatory cytokines |
| spellingShingle | Madhu Chhanda Mohanty Manisha Ranjan Madkaikar Mukesh Desai Jahnavi Aluri Swapnil Yashwant Varose Prasad Taur Deepa Kailash Sharma Uma Prajwal Nalavade Sneha Vijay Rane Maya Gupta Snehal Shabarish Aparna Dalvi Jagadish Mohanrao Deshpande Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder Frontiers in Immunology primary immunodeficiency disorder oral polio vaccine vaccine-derived polioviruses severe combined immune-deficiency leaky SCID inflammatory cytokines |
| title | Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder |
| title_full | Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder |
| title_fullStr | Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder |
| title_full_unstemmed | Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder |
| title_short | Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder |
| title_sort | natural clearance of prolonged vdpv infection in a child with primary immunodeficiency disorder |
| topic | primary immunodeficiency disorder oral polio vaccine vaccine-derived polioviruses severe combined immune-deficiency leaky SCID inflammatory cytokines |
| url | https://www.frontiersin.org/article/10.3389/fimmu.2019.01567/full |
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