Department of Medical Microbiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Department of Medical Microbiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute of Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands.
Clin Chim Acta. 2017 Oct;473:191-197. doi: 10.1016/j.cca.2017.08.029. Epub 2017 Aug 25.
Congenital Cytomegalovirus infection (cCMV) is the most common cause of congenital infections worldwide that can cause long-term impairment (LTI). The metabolic alterations due to cCMV are largely unknown. This study aims to assess the metabolites included in the neonatal screening in relation to cCMV and cCMV outcome, allowing the identification of prognostic markers for clinical outcome. Essential amino acids, hormones, carnitines and enzymes from Dried Blood Spots (DBS) were analyzed of 102 children with cCMV and 179 children without cCMV, and they were related to symptoms at birth and LTI at 6years of age. In this cohort, the neonatal screening parameters did not change in relation to cCMV, nor to symptoms at birth or LTI. However, metabolic changes were observed in children born preterm, with lower concentrations of essential amino acids in premature infants with cCMV compared to premature controls. Finally, a higher concentration of palmytoilcarnitine (C16) in the group with higher viral load was observed. Though these data demonstrate limitations in the use of neonatal screening data as predictors for long-term cCMV outcome, the metabolism of preterm neonates with cCMV merits further evaluation.
先天性巨细胞病毒感染（cCMV）是全球最常见的先天性感染病因，可导致长期损伤（LTI）。cCMV 引起的代谢改变在很大程度上尚不清楚。本研究旨在评估新生儿筛查中包含的代谢物与 cCMV 及 cCMV 结局的关系，从而确定用于临床结局的预后标志物。对 102 例 cCMV 患儿和 179 例无 cCMV 患儿的干血斑（DBS）中的必需氨基酸、激素、肉碱和酶进行了分析，并将其与出生时的症状和 6 岁时的 LTI 相关联。在该队列中，新生儿筛查参数与 cCMV 以及出生时的症状或 LTI 均无变化。然而，在早产儿中观察到代谢变化，与无 cCMV 的早产儿相比，cCMV 早产儿的必需氨基酸浓度较低。最后，观察到病毒载量较高组的棕榈酰肉碱（C16）浓度较高。尽管这些数据表明新生儿筛查数据作为长期 cCMV 结局的预测指标存在局限性，但 cCMV 早产儿的代谢值得进一步评估。
