Jung Sook Yeom1, Young-Soo Kim2, Jin-Su Jun3, Hyun Jung Do4, Ji Sook Park1, Ji-Hyun Seo1, Eun Sil Park1, Jae-Young Lim1, Hyang-Ok Woo1, Chan-Hoo Park5, Hee-Shang Youn6. 1. Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, South Korea; Gyeongsang Institute of Health Science, Jinju, South Korea. 2. Department of Neurology, Gyeongsang National University School of Medicine, Jinju, South Korea. 3. Gyeongsang Institute of Health Science, Jinju, South Korea. 4. Department of Pediatrics, Gyeongsang National University School of Medicine, Changwon, South Korea. 5. Gyeongsang Institute of Health Science, Jinju, South Korea; Department of Pediatrics, Gyeongsang National University School of Medicine, Changwon, South Korea. 6. Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, South Korea; Gyeongsang Institute of Health Science, Jinju, South Korea. Electronic address: hsyoun@gnu.ac.kr.
Abstract
BACKGROUND: Rotavirus nonstructural protein 4 (NSP4) has been suggested as a pathogen of rotavirus-associated seizures. We investigated pre-existing serum antibodies against NSP4 and VP6 (the most highly immunogenic rotavirus protein) in patients with rotavirus gastroenteritis and its correlation with the occurrence of seizures. METHODS: With an enzyme-linked immunosorbent assay, IgG and IgA titers against NSP4 (genotype [A] and [B]) and VP6 were measured in acute-phase sera of 202 children aged 0.5-6.0 years with rotavirus gastroenteritis. The clinical characteristics and antibody levels were compared between patients with (seizure group) and without seizures (non-seizure group). RESULTS: The non-seizure and seizure groups comprised 173 and 29 patients, respectively. Age, sex, hospital stay, presence of fever, white blood cell counts, C-reactive protein, vaccine status, IgG/IgA titers for VP6, and IgA titers for both NSP4s did not differ between the groups. The seizure group showed a lower level of IgG against NSP4 [A] (184.5 vs. 163.0 U/mL; P = 0.03) and NSP4 [B] (269.0 vs. 196.0 U/mL; P = 0.02). Delayed sampling time from the onset of gastroenteritis symptoms (3 vs. 2 days; P = 0.02) and lower serum sodium level (133.4 vs. 136.3 mEq/L; P < 0.01) were observed in the seizure group. Even after adjusting these factors, anti-NSP4 [A] IgG (OR 2.56 per 100 U/mL increment; 95% CI, 1.20-5.26, P = 0.01) and anti-NSP4 [B] IgG (OR 1.51 per 100 U/mL-increment; 95% CI, 1.04-2.22, P = 0.03) were independently associated with protection against seizures. CONCLUSIONS: Serum anti-NSP4 IgG might protect rotavirus-associated seizures.
BACKGROUND: Rotavirus nonstructural protein 4 (NSP4) has been suggested as a pathogen of rotavirus-associated seizures. We investigated pre-existing serum antibodies against NSP4 and VP6 (the most highly immunogenic rotavirus protein) in patients with rotavirus gastroenteritis and its correlation with the occurrence of seizures. METHODS: With an enzyme-linked immunosorbent assay, IgG and IgA titers against NSP4 (genotype [A] and [B]) and VP6 were measured in acute-phase sera of 202 children aged 0.5-6.0 years with rotavirus gastroenteritis. The clinical characteristics and antibody levels were compared between patients with (seizure group) and without seizures (non-seizure group). RESULTS: The non-seizure and seizure groups comprised 173 and 29 patients, respectively. Age, sex, hospital stay, presence of fever, white blood cell counts, C-reactive protein, vaccine status, IgG/IgA titers for VP6, and IgA titers for both NSP4s did not differ between the groups. The seizure group showed a lower level of IgG against NSP4 [A] (184.5 vs. 163.0 U/mL; P = 0.03) and NSP4 [B] (269.0 vs. 196.0 U/mL; P = 0.02). Delayed sampling time from the onset of gastroenteritis symptoms (3 vs. 2 days; P = 0.02) and lower serum sodium level (133.4 vs. 136.3 mEq/L; P < 0.01) were observed in the seizure group. Even after adjusting these factors, anti-NSP4 [A] IgG (OR 2.56 per 100 U/mL increment; 95% CI, 1.20-5.26, P = 0.01) and anti-NSP4 [B] IgG (OR 1.51 per 100 U/mL-increment; 95% CI, 1.04-2.22, P = 0.03) were independently associated with protection against seizures. CONCLUSIONS: Serum anti-NSP4 IgG might protect rotavirus-associated seizures.
Authors: Mark R Zweigart; Sylvia Becker-Dreps; Filemón Bucardo; Fredman González; Ralph S Baric; Lisa C Lindesmith Journal: Viruses Date: 2021-10-09 Impact factor: 5.048