Mir Sheema
College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, United States.
Front Med (Lausanne). 2022 Jan 18;8:795340. doi: 10.3389/fmed.2021.795340. eCollection 2021.
Hantavirus induced hemorrhagic fever with renal syndrome (HFRS) is an emerging viral zoonosis affecting up to 200,000 humans annually worldwide. This review article is focused on recent advances in the mechanism, epidemiology, diagnosis, and treatment of hantavirus induced HFRS. The importance of interactions between viral and host factors in the design of therapeutic strategies is discussed. Hantavirus induced HFRS is characterized by thrombocytopenia and proteinuria of varying severities. The mechanism of kidney injury appears immunopathological with characteristic deterioration of endothelial cell function and compromised barrier functions of the vasculature. Although multidisciplinary research efforts have provided insights about the loss of cellular contact in the endothelium leading to increased permeability, the details of the molecular mechanisms remain poorly understood. The epidemiology of hantavirus induced renal failure is associated with viral species and the geographical location of the natural host of the virus. The development of vaccine and antiviral therapeutics is necessary to avoid potentially severe outbreaks of this zoonotic illness in the future. The recent groundbreaking approach to the SARS-CoV-2 mRNA vaccine has revolutionized the general field of vaccinology and has provided new directions for the use of this promising platform for widespread vaccine development, including the development of hantavirus mRNA vaccine. The combinational therapies specifically targeted to inhibit hantavirus replication and vascular permeability in infected patients will likely improve the disease outcome.
汉坦病毒引起的肾综合征出血热(HFRS)是一种新出现的病毒性人畜共患病,全球每年影响多达20万人。这篇综述文章聚焦于汉坦病毒引起的HFRS在发病机制、流行病学、诊断和治疗方面的最新进展。文中讨论了病毒与宿主因素之间的相互作用在治疗策略设计中的重要性。汉坦病毒引起的HFRS的特征是不同程度的血小板减少和蛋白尿。肾损伤机制似乎具有免疫病理学特征,表现为内皮细胞功能的特征性恶化和脉管系统屏障功能受损。尽管多学科研究工作已经对内皮细胞中细胞接触丧失导致通透性增加有了一定认识,但分子机制的细节仍知之甚少。汉坦病毒引起的肾衰竭的流行病学与病毒种类以及该病毒自然宿主的地理位置有关。开发疫苗和抗病毒疗法对于避免未来这种人畜共患病可能出现的严重疫情爆发是必要的。最近针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)mRNA疫苗的开创性方法彻底改变了疫苗学的整个领域,并为利用这个有前景的平台进行广泛的疫苗开发提供了新方向,包括开发汉坦病毒mRNA疫苗。专门针对抑制感染患者体内汉坦病毒复制和血管通透性的联合疗法可能会改善疾病预后。