Publication: "Citomegalovirus" congénito: análisis de los genotipos virales
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2017
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Universidad Complutense de Madrid
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Abstract
Citomegalovirus humano (CMVh) infecta a muchos tipos de células dando lugar a un rango diverso de manifestaciones clínicas sugiriendo que la evolución clínica puede estar relacionada con la variación genética entre las cepas y la respuesta inmune del hospedador. Las técnicas diagnósticas utilizadas en la actualidad no nos permiten identificar que pacientes infectados desarrollarán secuelas; sin embargo, la evidencia disponible hasta la fecha sugiere que tanto los factores del hospedador y factores virales como la inmunidad maternal, la carga viral en el líquido amniótico o el tipo de cepa de CMVh, pueden contribuir a la evolución de la infección congénita, siendo recientemente la carga viral propuesta como un buen marcador predictivo y pronóstico de la severidad de la enfermedad especialmente de la pérdida auditiva y las manifestaciones sistémicas, pero aún se desconoce que genes influyen en las cargas virales. Aproximadamente veinte Open Read Fragments han demostrado exhibir variabilidad nucleotídica en diversos estudios estableciendo la existencia de diferentes grupos o genotipos. Si esta variabilidad contribuye a la evolución de la infección por CMVh en general y a la infección congénita en particular, está actualmente en pleno debate. HIPÓTESIS: El estudio de los diferentes genotipos de las diferentes genes que codifican las proteínas de la envoltura como gB, gH, y el homólogo del receptor del factor de necrosis tumoral UL144, y su correlación con la severidad y curso clínico de la infección, nos ayudarán a establecer qué marcadores de virulencia deben ser monitorizados con fines pronósticos, y a la adecuación de la duración del tratamiento antiviral cuando esté indicado...
Human cytomegalovirus (hCMV) infects many cell types resulting in a diverse range of clinical manifestations suggesting that the clinical course may be related to genetic variation between strains and host immune response. The diagnostic techniques used today do not allow us to identify that infected patients will develop sequelae; however, to date the evidence available suggests that both factors of the host and viral factors as maternal immunity, viral load in the amniotic fluid or the type strain hCMV, can contribute to the development of congenital infection, being recently viral load proposed as a good predictive and prognostic marker of the severity of the disease especially hearing loss and systemic manifestations, but still unknown genes that influence viral load. Approximately twenty Open Read Fragments exhibit nucleotide variability demonstrated in several studies established the existence of different genotypes or groups. If this variability contributes to the evolution of hCMV infection in general and congenital infection in particular, it is currently being debated. HYPOTHESIS: The study of the different genotypes of genes encoding the envelope proteins such as gB, gH, and homologous receptor UL144 tumor necrosis factor, and its correlation with clinical severity and course of the infection, they will help us to establish what virulence markers should be monitored for prognostic purposes, and the appropriateness of the duration of antiviral treatment when indicated...
Human cytomegalovirus (hCMV) infects many cell types resulting in a diverse range of clinical manifestations suggesting that the clinical course may be related to genetic variation between strains and host immune response. The diagnostic techniques used today do not allow us to identify that infected patients will develop sequelae; however, to date the evidence available suggests that both factors of the host and viral factors as maternal immunity, viral load in the amniotic fluid or the type strain hCMV, can contribute to the development of congenital infection, being recently viral load proposed as a good predictive and prognostic marker of the severity of the disease especially hearing loss and systemic manifestations, but still unknown genes that influence viral load. Approximately twenty Open Read Fragments exhibit nucleotide variability demonstrated in several studies established the existence of different genotypes or groups. If this variability contributes to the evolution of hCMV infection in general and congenital infection in particular, it is currently being debated. HYPOTHESIS: The study of the different genotypes of genes encoding the envelope proteins such as gB, gH, and homologous receptor UL144 tumor necrosis factor, and its correlation with clinical severity and course of the infection, they will help us to establish what virulence markers should be monitored for prognostic purposes, and the appropriateness of the duration of antiviral treatment when indicated...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Microbiología I, leída el 21-01-2016