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寨卡病毒疫情:神经并发症、诊断和治疗选择综述。

Zika virus outbreak: a review of neurological complications, diagnosis, and treatment options.

机构信息

Global Bioassay Development and Quality, Biopharmaceutical Development, MedImmune, Gaithersburg, MD, USA.

出版信息

J Neurovirol. 2018 Jun;24(3):255-272. doi: 10.1007/s13365-018-0614-8. Epub 2018 Feb 13.

Abstract

Zika virus (ZIKV) is an arbovirus transmitted mainly by mosquitos of Aedes species. The virus has emerged in recent years and spread throughout North and South Americas. The recent outbreak of ZIKV started in Brazil (2015) has resulted in infections surpassing a million mark. Contrary to the previous beliefs that Zika causes mildly symptomatic infections fever, headache, rash, arthralgia, and conjunctivitis, the recent outbreak associated ZIKV to serious neurological complications such as microcephaly, Guillain-Barré syndrome, and eye infections. The recent outbreak has resulted in an astonishing number of microcephaly cases in fetus and infants. Consequently, numerous studies were conducted using in vitro cell and in vivo animal models. These studies showed clear links between ZIKV infections and neurological abnormalities. Diagnosis methods based on nucleic acid and serological detection facilitated rapid and accurate identification of ZIKV infections. New transmission modalities such as sexual and transplacental transmission were uncovered. Given the seriousness of ZIKV infections, WHO declared the development of safe and effective vaccines and new antiviral drugs as an urgent global health priority. Rapid work in this direction has led to the identification of several vaccine and antiviral drug candidates. Here, we review the remarkable progress made in understanding the molecular links between ZIKV infections and neurological irregularities, new diagnosis methods, potential targets for antiviral drugs, and the current state of vaccine development.

摘要

Zika 病毒(ZIKV)是一种主要通过埃及伊蚊属蚊子传播的虫媒病毒。该病毒近年来出现并传播到北美和南美。最近在巴西(2015 年)爆发的 ZIKV 疫情已导致超过 100 万人感染。与之前认为 Zika 引起轻度症状感染(发热、头痛、皮疹、关节痛和结膜炎)的观点相反,最近与 ZIKV 相关的爆发与严重的神经系统并发症有关,如小头畸形、格林-巴利综合征和眼部感染。最近的爆发导致胎儿和婴儿小头畸形病例惊人增加。因此,许多研究使用体外细胞和体内动物模型进行。这些研究表明 ZIKV 感染与神经发育异常之间存在明确联系。基于核酸和血清学检测的诊断方法促进了 ZIKV 感染的快速准确识别。新的传播方式,如性传播和胎盘传播,也被发现。鉴于 ZIKV 感染的严重性,世界卫生组织宣布安全有效的疫苗和新型抗病毒药物的研发是一项紧急的全球卫生重点。在这方面的快速工作导致了几种疫苗和抗病毒药物候选物的鉴定。在这里,我们回顾了在理解 ZIKV 感染与神经异常之间的分子联系、新的诊断方法、抗病毒药物的潜在靶点以及疫苗开发的现状方面取得的显著进展。

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