From the Division of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, NV.
Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
Epidemiology. 2018 Jul;29(4):571-573. doi: 10.1097/EDE.0000000000000844.
Gastroschisis is a congenital malformation that has been shown to be more common in younger mothers and appears to be increasing in prevalence in the United States and elsewhere. Epidemiologic data suggest a potential role of infection and recent studies report an association between maternal antibodies to human herpesviruses (HHV) and development of gastroschisis.
In this study, we examined newborn bloodspots from 50 children with gastroschisis and 50 healthy controls using a highly sensitive digital droplet polymerase chain reaction assay covering eight human herpesviruses [herpes simplex sirus 1/2, Epstein-Barr virus (HHV-4), cytomegalovirus (HHV-5), HHV-6A/B, HHV-7, and HHV-8], to examine the presence of herpesvirus DNA at birth, which would suggest in utero infection.
One control tested positive for low-level cytomegalovirus infection. We found no evidence of an association between herpesvirus DNA in neonatal blood spots taken at birth and gastroschisis.
Our results do not support direct involvement of herpesviruses in the etiology of gastroschisis. However, there are several limitations in our study, most notably the known induction of this congenital malformation early in pregnancy and our analysis of blood taken at birth. Therefore, we cannot conclude that herpesviruses play no role in the etiology of gastroschisis and further research is needed to better define this relationship.
先天性腹壁缺损(腹裂)较为常见于年轻的母亲,其在美国和其他国家的发病率似乎呈上升趋势。流行病学数据表明感染可能发挥了一定作用,最近的研究报告称母体针对人类疱疹病毒(HHV)的抗体与腹裂的发生之间存在关联。
本研究采用高度敏感的数字液滴聚合酶链反应检测技术,对 50 例腹裂患儿和 50 例健康对照新生儿的血斑样本进行了检测,共涵盖八种人类疱疹病毒[单纯疱疹病毒 1/2、EB 病毒(HHV-4)、巨细胞病毒(HHV-5)、HHV-6A/B、HHV-7 和 HHV-8],以检查出生时存在疱疹病毒 DNA,这提示宫内感染。
一名对照者的低水平巨细胞病毒感染检测呈阳性。我们未发现新生儿血斑中疱疹病毒 DNA 与腹裂之间存在关联。
我们的结果不支持疱疹病毒直接参与腹裂的病因。然而,我们的研究存在一些局限性,最显著的是已知这种先天性畸形会在妊娠早期诱发,以及我们对出生时采集的血液进行分析。因此,我们不能得出疱疹病毒在腹裂病因学中不起作用的结论,需要进一步研究以更好地定义这种关系。