Lymphocytic Choriomeningitis—Emerging Trends of a Neglected Virus: A Narrative Review
Abstract
:1. Introduction
2. Structure and Genome Organization of LCMV
3. Epidemiology of LCMV
3.1. LCMV Prevalence in Humans
3.2. LCMV Prevalence in Rodents
3.3. Molecular Epidemiology of LCMV
4. Clinical Characteristics of LCMV Infection
4.1. LCMV Infection in Immunocompetent Individuals
4.2. LCMV Infection in Immunocompromised Patients/Transplantation Associated LCMV Infection
4.3. Congenital LCMV Infection
5. Diagnosis of LCMV Infection
6. Therapy of LCMV Infection
7. LCMV Infection in Mice as an Immunological Model
8. LCMV in Vaccine Research
9. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Population | Clinical Symptoms | Outcome | Reference |
---|---|---|---|
Immunocompetent individuals | Asymptomatic infection, flu-like disease, aseptic meningitis/meningoencephalitis | Recovery in most cases; mortality < 1% | [54] |
Organ transplant recipients | Fatal hemorrhagic fever-like disease | Mortality > 70% | [15,55,56,57,58,59] |
Pregnant women | Asymptomatic infection, flu-like disease, aseptic meningitis/meningoencephalitis; symptoms may be severe | Depending on the time of infection: spontaneous abortion, congenital LCMV infection | [60,61] |
Newborns (congenital infection) | Hydrocephalus, periventricular calcifications, chorioretinitis | Mortality ~ 35%; persistent neurologic sequelae ~ 70% |
Country/Year | N Cases | Clinical Features | CT/MRI Imaging | Reference |
---|---|---|---|---|
England 1955 | 1 | Convulsion, opisthotonos, subarachnoid and intracerebral haemorrhage, petechiae, ventriculomegaly | ND * | [8] |
Germany 1974, 1999 | 8 (2-twins) | Hydrocephalus, microcephaly, intracranial calcifications, chorioretinitis, chorioretinal scars, blindness, conjuctivitis, developmental delay, myocarditis, congestive heart failure, psychomotor retardation, meningitis | ND | [9,68] |
Lithuania 1976, 1981 | 22 | Hydrocephalus, microcephaly, spastic tetraparesis, epilepsy-like attacks, chorioretinal degeneration, optic disc subatrophy, microphtalmy, cataract, psychomotor retardation | ND | [10,69] |
France 1978, 2000, 2009, 2017 | 6 (2-twins) | Hydrocephalus, ventriculomegaly, microcephaly, periventricular calcifications, chorioretinitis chorioretinal scars, fetal hydrops, hepatosplenomegaly, cardiomegaly, ascites, pericardial and pleural effusion | MRI: normal (2 cases) | [11,70,71,72] |
USA 1993, 1995, 1996, 1997, 2000, 2002, 2003, 2006, 2007, 2013, 2014, 2018 | 45 (2-twins) | Hydrocephalus, microcephaly, dolichocephaly, chorioretinitis, optic nerve atrophy, retinal colobomas, microphtalmia, blindness, hearing loss, developmental delay, pyschomotor retardation, spastic quadriplegia, seizures, heart abnormalities, ataxia, fetal hydrops, cataracts | CT: periventricular and intracranial calcifications, diffuse and periventricular brain substance loss, gyral malformations, shizencephaly, cerebellar hypoplasia, calcification of the lens MRI: ventriculomegaly, cerebral atrophy, corpus callosum atrophy and agenesis, encephalomalacia, cerebellar hypoplasia, intracranial hemorrhage, periventricular cysts | [12,13,67,71,73,74,75,76,77,78,79,80,81,82,83] |
Immune Responses | Areas of Immunological Research with a Major Contribution of LCMV Mouse Experimental Model |
---|---|
Innate immunity | |
Recognition of pathogen-associated molecular patterns by pattern-recognition receptors | Recognition of LCMV single-stranded RNA by TLR-7 and -8; recognition of double-stranded RNA and 5′-triphosphate RNA that are synthesized during the LCMV replication cycle by MDA-5 and RIG-I; role of TLR-2 in the immune response to LCMV |
Innate immunity signal-transduction pathways and transcription factors | Signaling pathways leading to the activation of transcription factors IRF-3, AP-1 and NF-κB that induce the synthesis of IFN-β, IFN-α4 and other pro-inflammatory cytokines |
Biology of type I IFNs | Role of interferons in regulating the activity of innate immune cells; differential regulation of interferon-stimulated genes during infection with various LCMV strains; relative contribution of STAT1 on innate and adaptive immunity during LCMV infection; role of IFN-mediated signals in CD8+ T-cell responses |
The role of NK-cells in the pathogenesis of viral infections | Cytolytic effect of NK-cells on activated CD4+ and CD8+ T-cells in viral infection; Treg, Th17 and Th2 cells are more sensitive to lysis by LCMV-induced activated NK-cells |
Specific immunity | |
Thymic depletion in chronic viral infections | Chronic LCMV infection induces severe thymic depletion, mediated by CD8+ T cell-intrinsic type I IFNs and STAT-2 signaling pathway |
Viral infection as a trigger of Treg cell impairment and associated immune-mediated pathology in autoimmunity | LCMV infection leads to the loss of IFN type I-dependent Treg cells, which is subsequently compensated by the conversion of Vβ5+ conventional T cells into iTreg cells; delayed replenishment of Treg cells in Vβ5-deficient mice compromises suppression of microbiota-dependent activation of CD8+ T-cells leading to the development of colitis |
Metabolic alterations in the liver during chronic viral infections | Type I interferon-mediated suppression of the hepatic urea cycle and subsequent suppression of virus-specific CD8+ T-cell responses and ameliorated liver pathology |
Indirect protective role of non-neutralizing antibodies in viral infections | LCMV-specific monoclonal Abs can prevent the establishment of chronic infection in an Fc-receptor-independent manner by inducing the differentiation of Ly6Chi inflammatory monocytes into antigen-presenting cells leading to an early activation of virus-specific CD8+ T-cells |
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Vilibic-Cavlek, T.; Savic, V.; Ferenc, T.; Mrzljak, A.; Barbic, L.; Bogdanic, M.; Stevanovic, V.; Tabain, I.; Ferencak, I.; Zidovec-Lepej, S. Lymphocytic Choriomeningitis—Emerging Trends of a Neglected Virus: A Narrative Review. Trop. Med. Infect. Dis. 2021, 6, 88. https://doi.org/10.3390/tropicalmed6020088
Vilibic-Cavlek T, Savic V, Ferenc T, Mrzljak A, Barbic L, Bogdanic M, Stevanovic V, Tabain I, Ferencak I, Zidovec-Lepej S. Lymphocytic Choriomeningitis—Emerging Trends of a Neglected Virus: A Narrative Review. Tropical Medicine and Infectious Disease. 2021; 6(2):88. https://doi.org/10.3390/tropicalmed6020088
Chicago/Turabian StyleVilibic-Cavlek, Tatjana, Vladimir Savic, Thomas Ferenc, Anna Mrzljak, Ljubo Barbic, Maja Bogdanic, Vladimir Stevanovic, Irena Tabain, Ivana Ferencak, and Snjezana Zidovec-Lepej. 2021. "Lymphocytic Choriomeningitis—Emerging Trends of a Neglected Virus: A Narrative Review" Tropical Medicine and Infectious Disease 6, no. 2: 88. https://doi.org/10.3390/tropicalmed6020088