Artículo de revista
Heart and Skeletal Muscle Are Targets of Dengue Virus Infection
Fecha
2010-03Registro en:
Pediatr Infect Dis J. 2010 March ; 29(3): 238–242.
doi:10.1097/INF.0b013e3181bc3c5b
Autor
Salgado, Doris Martha
Eltit Ortega, José Miguel
Mansfield, Keith
Panqueba, César
Castro, Dolly
Vega, Martha Rocío
Xhaja, Kris
Schmidt, Diane
Martin, Katherine J.
Allen, Paul D.
Rodríguez, Jairo Antonio
Dinsmore, Jonathan H.
López, José Rafael
Bosch, Irene
Institución
Resumen
Background—Dengue fever is one of the most significant re-emerging tropical diseases, despite
our expanding knowledge of the disease, viral tropism is still not known to target heart tissues or
muscle.
Methods—A prospective pediatric clinical cohort of 102 dengue hemorrhagic fever patients from
Colombia, South America, was followed for 1 year. Clinical diagnosis of myocarditis was routinely
performed. Electrocardiograph and echocardiograph analysis were performed to confirm those cases.
Immunohistochemistry for detection of dengue virus and inflammatory markers was performed on
autopsied heart tissue. In vitro studies of human striated skeletal fibers (myotubes) infected with
dengue virus were used as a model for myocyte infection. Measurements of intracellular Ca2+
concentration as well as immunodetection of dengue virus and inflammation markers in infected
myotubes were performed.
Results—Eleven children with dengue hemorrhagic fever presented with symptoms of myocarditis.
Widespread viral infection of the heart, myocardial endothelium, and cardiomyocytes, accompanied
by inflammation was observed in 1 fatal case. Immunofluorescence confocal microscopy showed
that myotubes were infected by dengue virus and had increased expression of the inflammatory genes
and protein IP-10. The infected myotubes also had increases in intracellular Ca2+ concentration.
Conclusions—Vigorous infection of heart tissues in vivo and striated skeletal cells in vitro are
demonstrated. Derangements of Ca2+ storage in the infected cells may directly contribute to the
presentation of myocarditis in pediatric patients.