Available Evidence of Association between Zika Virus and Microcephaly.

Available Evidence of Association between Zika Virus and Microcephaly.
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DOI:
10.4103/0366-6999.190672
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发表时间:
2016-10-05
影响因子:
6.1
通讯作者:
Hu YF
Hu YF
中科院分区:
医学2区
文献类型:
--
作者:
Wu J;Huang DY;Ma JT;Ma YH;Hu YF

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为了澄清寨卡病毒(ZIKV)和小头畸形之间的可能关联,并了解我们在研究和辩论方面的进展,轻度母体临床特征和重度胎儿小头畸形之间的因果关系。我们使用PubMed对从成立到2016年5月27日的关键词“寨卡病毒”和/或“小头畸形”进行了全面的文献综述。如果研究符合以下所有标准,则将其纳入并分析:"可能或确认的婴儿小头畸形"和"母亲或婴儿中可能或确认的ZIKV感染"。我们强调ZIKV感染的诊断,包括母亲的临床表现,母亲和胎儿的实验室确认,以及必要时可能的尸检。其他可能导致小头畸形的混杂因素应从研究中排除。我们介绍了ZIKV感染的临床表现,检测方法不断发展但小头畸形的机制不确定,灵活的定义挑战小头畸形的诊断,以及对孕妇的因果参考有限的结果。我们从DNA突变和全球移动两个方面对SARS和基孔肯雅病毒进行类比比较,为进一步研究提供建议。追赶性生长的机会可能会减少先前“诊断”的小头畸形的数量。通过小鼠模型和在受影响的妊娠中直接分离ZIKV,有一些证据可以证明存在良好的因果关系,但还不够令人信服。我们分析并提出了已发表的报告的弱点或局限性,希望为进一步的研究方向提供启示。
To clarify the possible association between the Zika virus (ZIKV) and microcephaly and understand where we are in terms of research and the debate on the causation between mild maternal clinical features and severe fetal microcephaly. We did a comprehensive literature review with the keywords “zika” and/or “microcephaly” from inception to May 27, 2016, with PubMed. Studies were included and analyzed if they met all of the following criteria: “probable or confirmed infant microcephaly” and “probable or confirmed ZIKV infection among mothers or infants”. We emphasize the diagnosis of ZIKV infection, including maternal clinical manifestations, maternal and fetal laboratory confirmation, and possible autopsy if need. Other confounders that may lead to microcephaly should be excluded from the study. We presented the results from clinical manifestations of ZIKV infection, testing methods evolving but the mechanism of microcephaly uncertain, flexible definition challenging the diagnosis of microcephaly, and limited causal reference on pregnant women. We made analog comparison of severe acute respiratory syndrome and chikungunya virus in terms of DNA mutation and global movement to provide further research recommendation. The chance of catch-up growth may decrease the number of pervious “diagnosed” microcephaly. There are some evidence available through mice models and direct isolation of ZIKV in affected pregnancies on kindly causal relationship but not convincible enough. We analyzed and presented the weakness or limitation of published reports with the desire to shed light to further study directions.
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