Cerebrospinal fluid immunoglobulins are increased in neonates exposed to Zika virus during foetal life - 20/03/20
, Eduardo C. Nascimento-Carvalho a , Martijn M. VanDuijn b , Clara L. Ramos a , Ana-Luisa Vilas-Boas a , Otávio A. Moreno-Carvalho c , Lona Zeneyedpour b , Gerben Ferwerda d , Ronald de Groot d , Theo M. Luider b , Cristiana M. Nascimento-Carvalho e, ⁎ Highlights |
• | CSF immunoglobulins are increased in probable congenital Zika virus infection. |
• | CSF IgM was 100 times higher in cases with microcephaly than in controls. |
• | CSF IgA was 34.4 times higher in cases with microcephaly than in controls. |
• | Immunoglobulins may contribute to a pro-inflammatory state in the foetal brain. |
• | IgM and IgA are prime candidates for factors that mediate Zika virus brain pathology. |
Abstract |
Objective |
To compare immunoglobulin levels in cerebrospinal fluid (CSF) of neonates exposed to Zika virus (ZIKV) during foetal life (cases) with levels in CSF of control neonates.
Methods |
We identified 16 neonates who underwent lumbar puncture (LP), during the ZIKV epidemic (December/2015 to March/2016) whose mothers reported ZIKV clinical symptoms during gestation (cases). Congenital microcephaly was defined as head circumference ≤31.9 cm (boys) and ≤31.5 cm (girls) for term neonates, or ≤2 standard deviations below the mean for premature (<37 weeks) neonates. Subsequently, we identified neonates who underwent LP in the same lab and fulfilled criteria to be controls: age ≤4 days, CSF white blood cell count ≤8/mm3, CSF protein ≤132 mg/dL, CSF red blood cell count ≤1,000/mm3, neither central nervous system illness, nor congenital infection, nor microcephaly. CSF immunoglobulin concentrations were measured by mass spectrometry.
Results |
13 controls were included. IgM, IgA, IgG, IgK, and IgL were significantly higher among cases (p < 0.001). Eight (50%) ZIKV exposed infants had congenital microcephaly. These showed the strongest immunoglobulin elevation of the IgM and IgA classes.
Conclusion |
Neonates exposed to ZIKV infection during gestation present with elevated distinct immunoglobulins in CSF, both in cases that developed microcephaly and in cases that did not.
Le texte complet de cet article est disponible en PDF.Keywords : Cerebrospinal fluid, Congenital Zika virus infection, Immunoglobulins, Mass spectrometry, Microcephaly
Plan
Vol 80 - N° 4
P. 419-425 - avril 2020 Retour au numéro
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