Introduction The rapid expansion of the novel SARS-CoV-2 virus has raised serious public health concerns due to the possibility of misdiagnosis in regions where arboviral diseases are endemic. We performed the first study in northern Peru to describe the detection of SARSCoV-2 IgM antibodies in febrile patients with a suspected diagnosis of dengue and chikungunya fever. Materials and methods A consecutive cross-sectional study was performed in febrile patients attending primary healthcare centers from April 2020 through March 2021. Patients enrolled underwent serum sample collection for the molecular and serological detection of DENV and CHIKV. Also, serological detection of IgM antibodies against SARS-CoV-2 was performed. Results 464 patients were included during the study period, of which (40.51%) were positive for one pathogen, meanwhile (6.90%) presented co-infections between 2 or more pathogens. The majority of patients with monoinfections were positive for SARS-CoV-2 IgM with (73.40%), followed by DENV 18.09% and CHIKV (8.51%). The most frequent co-infection was DENV + SARS-CoV-2 with (65.63%), followed by DENV + CHIKV and DENV + CHIKV + SARSCoV-2, both with (12.50%). The presence of polyarthralgias in hands (43.75%, p<0.01) and feet (31.25%, p = 0.05) were more frequently reported in patients with CHIKV monoinfection. Also, conjunctivitis was more common in patients positive for SARS-CoV-2 IgM (11.45%, p<0.01). The rest of the symptoms were similar among all the study groups. Conclusion SARS-CoV-2 IgM antibodies were frequently detected in acute sera from febrile patients with a clinical suspicion of arboviral disease. The presence of polyarthralgias in hands and feet may be suggestive of CHIKV infection. These results reaffirm the need to consider SARS-CoV-2 infection as a main differential diagnosis of acute febrile illness in arboviruses endemic areas, as well as to consider co-infections between these pathogens. Copyright: / Revisión por pares

Venezuelan equine encephalitis virus (VEEV) is an alphavirus that causes disease in humans and equines eliciting both an agricultural and public health threat. In humans, the disease typically presents as a febrile illness with common signs of fever and malaise. Four to fourteen percent of Venezuelan equine encephalitis (VEE) cases are associated with severe neurological complications due to encephalitis caused by VEEV's propensity to infect the brain. Public health concerns are exacerbated by VEEV's aerosolization capabilities, low infectious dose and affordability to mass produce. These qualities drove interest in the pathogen as a bioweapon by the US and the former Soviet Union during the cold war. As a precautionary response to VEEV's notoriety as a biothreat, the National Institute of Allergies and Infectious Diseases has classified VEEV as a category B priority pathogen, and the Human Health Services and United States Department of Agriculture list live virulent strains of VEEV as a select agent and require the pathogen to be manipulated in highly regulated biosafety level 3 (BSL3) facilities. There are currently no FDA approved vaccines or antivirals to target VEEV or other closely related alphaviruses associated with clinical disease in humans. The research performed in this dissertation aimed to elucidate new antiviral targets and treatments to help bridge gaps in current understanding of alphaviruses. The current market lacks available antibodies for E1 specific isolation. In response, a recombinant VEEV TC-83 was produced with a V5 tag at the C-terminal of the E1 sequence to enable VEEV E1 detection. Sequencing was used to verify V5 insertion in the plasmid and immunoprecipitation was used to verify V5 insertion within the E1 glycoprotein. Replication kinetics experiments verified the virus replicated similarly to the parental VEEV TC-83 strain, while passaging experiments verified the tag was highly stable for up to 10 passages. This research produced a cost-effective and highly efficient means to probe and isolate the E1 glycoprotein without modifying the viability of the virus. Knowledge of host protein interactions with VEEV E1 glycoprotein has been limited, with most E1 research focusing on its fusion capabilities. Utilizing 293-T cells infected with E1-V5 TC-83, co-immunoprecipitation was performed to isolate E1 and associated interactors. A total of 486 host and 5 viral protein interactors of E1 were discovered after normalization to the negative control. The top peptide spectrum matches (PSMs) revealed a number of chaperone proteins and ubiquitin proteins as top interactors of VEEV E1. These results effectively revealed a number of previously unknown alphavirus interactions that can be targeted by antivirals and explored further for implications in viral replication. LC-MS/MS results showed that protein disulfide isomerase family A member 6 (PDIA6) interacted with E1. High PSMs, presence in all 3 replicates, similar cellular localization to E1 and known associations between other viruses and protein disulfide isomerase (PDI) family members made this protein an optimum target for further analysis. Co-immunoprecipitation and co-localization experiments were used to validate the LC-MS/MS results. Involvement of PDIs in VEEV replication were explored utilizing two known PDI inhibitors, LOC14 and Nitazoxanide. LOC14, a non-FDA approved broad-spectrum PDI inhibitor, showed broad-spectrum alphavirus antiviral potential, decreasing titers of VEEV TC-83, VEEV Trinidad Donkey strain, eastern equine encephalitis virus (EEEV), chikungunya virus (CHIKV) and Sindbis (SINV) virus in a dose dependent manner. Nitazoxanide, an FDA approved drug known to inhibit PDIA3, was shown to have minimal toxicity and effectively reduced VEEV TC-83 and EEEV titers at concentrations with 100% cell viability. Time of addition assays, E1 expression time course studies, and early event assays showed PDI inhibition with these drugs effects early viral production events. RNA quantification, confocal microscopy and biotin switch assay experiments show that the drugs also prevented proper folding of the E1 glycoprotein and decreased expression of E1 on the peripheral membrane. With no current treatments for alphaviruses, these data provide an effective broad-spectrum target that affects viral replication at multiple stages in-vitro. Nitazoxanide also presents as a promising, non-toxic drug that could be repurposed to combat a number of clinically relevant alphaviruses. Valosin containing protein (VCP) was also shown to interact with the E1 glycoprotein. Exploration of VCP's interaction with alphavirus E1 has never been explored, yet it was previously shown to be involved in alphavirus replication. Co-localization and co-immunoprecipitation experiments were performed validating the interaction between VCP and E1. siRNA knockdown of VCP in 293-T cells and U87-MG cells showed a significant reduction in VEEV TC-83 titers. The allosteric VCP inhibitor, NMS-873, also reduced VEEV TC-83 titers, but was shown to be less effective against CHIKV, SINV and EEEV, suggesting the NMS-873 mechanism is more selective for VEEV. Mechanism experiments showed that reduction of VCP with NMS-873 inhibits early events of VEEV replication. These results elucidate VCP's association with E1 and show that VCP can be targeted to decrease VEEV viral replication. / Doctor of Philosophy / Venezuelan equine encephalitis virus (VEEV) causes disease in humans, as well as horses, donkeys and other closely related animals. In humans, the virus causes a flu-like disease and sometimes swelling of the brain. This can be associated with symptoms such as light sensitivity, confusion and sometimes coma. Prior to the Cold War, VEEV was researched by the US and previous Soviet Union's militaries in hopes to deploy the virus as a bioweapon. Current treaties prevent active production of such weapons, yet allows for defensive research to continue in preparation for a worst-case scenario. Currently no FDA approved medications or vaccines exist to combat the virus further exacerbating concerns. In order to protect laboratorians and prevent unintentional or intentional introduction of the virus into the community, the virus is only manipulated in highly secure facilities with barriers that separate the virus from personnel and the outside environment. A component of the virus called E1, allows for the virus to be released from a structure, called an endosome, that transports the virus into the cell. Currently, E1 is mostly known for this function, yet our research found that E1 interacts with 486 protein components of the host cell, suggesting a more elaborate role of E1 than previously understood. This list of interactors provides numerous new targets for potential medications to combat VEEV and other closely related viruses. Discovered E1 interactors, protein disulfide isomerase family A member 6 (PDIA6) and valosin containing protein (VCP), were validated through extensive experimentation and their function in viral replication was further explored. Protein disulfide isomerases (PDI), such as PDIA6, play an important role in folding proteins, which are cellular components made of organic building blocks called amino acids. PDIs do so by creating organic pillars, called disulfide bonds, between two cysteine amino acid residues. These disulfide bonds contribute to the 3D shape of the proteins they fold which are essential for the protein's function. E1 of VEEV has a total of eight disulfide bonds within its structure, highlighting that disulfide bonds are likely essential for the protein's structure, and therefore, function. We verified that E1 could not properly fold without PDI function by using two compounds that prevented PDI from forming or breaking disulfide bonds, specifically LOC14 and FDA approved drug nitazoxanide. Cells treated with one of either compound before and after infection with VEEV, were found to produce E1 protein with significantly less disulfide bonds therefore producing less viable virus. Further experiments also showed that the compounds also affected early stages in the virus production cycle. These two mechanisms explain the significant reduction in production of VEEV and related viruses when PDI is inhibited. These results provide a new VEEV drug target, PDIs, as well as two compounds that can potentially be used to combat VEEV and other related viruses that have no current treatment options. Another host interactor, VCP, functions throughout the cell and is known for unfolding of numerous substrates, including proteins. It is involved in numerous cellular functions thus making this interactor a promising target for drug treatment. Cells with reduced VCP function were shown to produce less progeny VEEV. Cells treated with NMS-873, a compound that reduces VCP function was also shown to reduce VEEV production. NMS-863 inhibition of VCP was shown to effect early events in VEEV replication. These results further emphasize the E1 interactors discovered are invaluable novel targets for VEEV drug treatment.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-04-27T14:37:47Z No. of bitstreams: 1 ROSEMARY DE CARVALHO ROCHA KOGA.pdf: 1840064 bytes, checksum: 5be7272271d61789b6dc93e32af0b7a3 (MD5) / Made available in DSpace on 2017-04-27T14:37:47Z (GMT). No. of bitstreams: 1 ROSEMARY DE CARVALHO ROCHA KOGA.pdf: 1840064 bytes, checksum: 5be7272271d61789b6dc93e32af0b7a3 (MD5) Previous issue date: 2017-03-15 / Introduction: Chikungunya fever (FCHIK) is a disease of abrupt onset, transmitted by arthropod mosquitoes intermediate hosts of the Chikungunya virus (CHIKV). The illness has a significant impact on the quality of life of the affected person. Since a disease causes intense and prolonged symptoms of polyarthralgia and myalgia, it requires health care, during a recovery, more than other arboviruses. The objective of this study was to study clinicians and clinicians suggestive of FCHIK, residing in the States of Amapá and Goiás, aiming to correlate the results of laboratory tests with the presented symptomatology. Materials and methods: The study was carried out at the Center for Immunological Studies and Research of the Pontifical Catholic University of Goiás, Goiânia, and in Emergency Care Units in the cities of Macapá, Oiapoque and Santana-AP. The study population consisted of 80 individuals with suspected FCHIK and for investigators of inflammatory markers, the control group consisted of 20 blood samples from healthy donors from Goiana Central de Serologia e Imunohematologia. Viral RNA extraction was performed, followed by RNA detection by Real-Time Polymerase Chain Reaction. In addition to ELISA for detection of IgM and IgG against Chikungunya virus. Participants symptoms were correlated with serology and Creactive protein (CRP), which was evaluated in healthy subjects and in people with FCHIK. Results: No data presented for detection of viral RNA by RT-qPCR for CHIKV, but three samples were positive in this technique for zika virus and one for dengue subtype 1 (DENV1). In an enzyme-linked immunosorbent assay, 26 samples were positive for IgG and 3 for IgM. Regarding the stage of the disease, 10 were in the acute phase, 04 in the subacute phase and 12 in the chronic phase. Correlated the results of the serology with a symptomatology it was observed that the acute phase, all have fever, 90% headache, 70% arthralgia and 60% edema. (100%), myalgia and edema (75%). (100%), arthralgia (92%) and myalgia (75%). When comparing participants with negative serology, n = 54, the most prevalent symptoms were rash, headache, fever, and arthralgia. The CRP levels in individuals infected with more than four symptoms were higher when compared with healthy individuals. Conclusion: The study focused on people with a clinical picture characteristic of FCHIK. The most common symptom in the three phases presented for arthralgia, followed by edema and myalgia, a fever was frequent only in the acute phase. All participants were negative in the evaluation of viral RNA by RT-qPCR for CHIKV, for the virus has a short duration in the body, and this methodology is limited to the time of symptom onset and sample collection, DENV and ZIKV. IG G. Those with negative serology for CHIKV, despite taking into account the joints, symptoms common to other arboviruses. CRP levels have been shown to be high relative to healthy subjects. / Introdução: A Febre Chikungunya (FCHIK) é uma doença de início abrupto, transmitida por mosquitos artrópodes hospedeiros intermediários do vírus Chikungunya (CHIKV). A enfermidade representa um significativo impacto na qualidade de vida da pessoa afetada. Uma vez que a doença causa sintomas intensos e prolongados de poliartralgia e mialgia, requerendo atenção de saúde, durante a recuperação, mais do que outras arboviroses. Objetivou-se estudar aspectos clínicos e sorológicos de indivíduos apresentando quadro clínico sugestivo de FCHIK, residentes nos Estados de Amapá e Goiás, visando correlacionar os resultados de testes laboratoriais com a sintomatologia apresentada. Materiais e métodos: O estudo foi realizado no Núcleo de Estudos e Pesquisa Imunológica da Pontifícia Universidade Católica de Goiás, em Goiânia, e em Unidades de Pronto Atendimento de Saúde das cidades de Macapá, Oiapoque e Santana-AP. A população de estudo foi constituída de 80 indivíduos com suspeita de FCHIK e para comparar os marcadores inflamatórios, o grupo controle foi constituído de 20 amostras de sangue de doadores saudáveis da Central Goiana de Sorologia e Imunohematologia. Foi realizada a extração do RNA viral, seguido de detecção do RNA por meio de Reação em Cadeia de Polimerase em Tempo Real. Além de ELISA para detecção de IgM e IgG específicos para o CHIKV. Os sintomas dos participantes foram correlacionados com o resultado da sorologia e da proteína C reativa (PCR), que foi avaliada em indivíduos saudáveis e em pessoas com FCHIK. Resultados: Nenhuma amostra apresentou limiar de detecção do RNA viral por RT-qPCR para CHIKV, porém três amostras foram positivas nessa técnica para vírus zika (ZIKV) e uma para dengue subtipo 1 (DENV1). Em ensaio imunoenzimático, 26 amostras foram positivas para IgG e 3 dessas para IgM. Em relação ao estágio da doença, 10 encontravam-se em fase aguda, 04 em fase subaguda e 12 em fase crônica. Correlacionados os resultados da sorologia com a sintomatologia observou-se que os de fase aguda, todos tiveram febre, 90% cefaleia, 70% artralgia e 60% edema. Enquanto que, os de fase subaguda tiveram: artralgia e cefaleia (100%), mialgia e edema (75%). Os de fase crônica tiveram edema (100%), artralgia (92%) e mialgia (75%). Quando comparados os participantes com sorologia negativa, n=54, os sintomas mais apresentados foram exantema, cefaleia, febre e artralgia. Os níveis de PCR nos indivíduos infectados e que apresentavam mais de quatro sintomas foram maiores quando comparados com indivíduos saudáveis. Conclusão: O estudo focou em pessoas com quadro clínico característico para FCHIK. O sintoma mais comum nas três fases apresentadas foi a artralgia, seguido de edema e mialgia, a febre foi frequente somente na fase aguda. Todos os participantes foram negativos na avaliação do RNA viral por RT-qPCR para CHIKV, pois o vírus tem uma curta duração no organismo, e esta metodologia é limitada ao tempo de início dos sintomas e coleta de amostra, ainda assim foi encontrado RNA viral do DENV e ZIKV. Alguns participantes foram positivos para sorologia IgG. Aqueles com sorologia negativa para CHIKV, apesar de terem dor nas articulações, tinham sintomas comuns a outras arboviroses. Os níveis de PCR demonstraram-se elevados em relação aos indivíduos saudáveis.

Zusammenfassung Yauhen Karliuk Einfluss der 3' nichttranslatierten Region von Chikungunya-Virus auf die Replikation in verschiedenen Stechmückenarten Institut für Tierhygiene und Öffentliches Veterinärwesen der Veterinärmedizinischen Fakultät, Universität Leipzig Eingereicht im Februar 2022 52 Seiten, 7 Abbildungen, 116 Literaturangaben, 1 Publikation Schlüsselwörter: Chikungunya-Virus; 3′ UTR; direct repeats (DRs); CHIKV 3́ UTR-Deletionsmutante; Vektorkompetenz; Aedes vexans; Culex pipiens Einleitung: Arthropoden-übertragene Viren (Arboviren) spielen weltweit eine große Rolle für die Gesundheit von Menschen und Tieren. Das Chikungunya-Virus (CHIKV) wird v.a. durch Stechmücken der Gattung Aedes übertragen. Die Hauptvektoren sind Aedes aegypti (Ae. aegypti) und Aedes albopictus (Ae. albopictus), wobei letzterer sich zunehmend auch in gemäßigten Breiten etabliert. Ziele der Untersuchungen: Zum einen sollte untersucht werden, ob auch die Stechmückenarten Aedes vexans (Ae. vexans) und Culex pipiens molestus (Cx. pipiens), die in gemäßigten Klimazonen vorkommen, als CHIKV-Vektoren fungieren können. Zum anderen sollte der Einfluss von Deletionen der Sequenzwiederholungen (DR) in der 3‘ nichttranslatierten Region (3‘ UTR) auf die virale Replikation in Zellkultur und in Stechmücken untersucht werden. Tiere, Material und Methoden: Zunächst wurde eine CHIKV 3́ UTR-Deletionsmutante mit einer Deletion von DR1a und DR2a in der 3́ UTR (CHIKV-ΔDR) hergestellt und diese bezüglich der Wachstumskinetik mit Chikungunya-Wildtyp-Virus (CHIKV-WT) in C6/36- und Aag2-Stechmückenzellen sowie in BHK-21/J- Wirbeltier-Zellen verglichen. Um die Vektorkompetenz von beiden Viren in Stechmücken zu untersuchen, wurden Ae. aegypti, Ae. albopictus, Ae. vexans und Cx. pipiens in einem Insektarium gezüchtet. Bei den Infektionsexperimenten im S3-Labor wurden insgesamt 27 Ae. aegypti, 20 Ae. albopictus, 78 Ae. vexans und 62 Cx. pipiens Stechmücken verwendet. In diesen Experimenten wurden diese mit CHIKV-ΔDR und CHIKV-WT sowohl oral mit je 1x 10^6 PFU/ml über eine Fütterungsmembran als auch intrathorakal mit je 200 PFU (zur Umgehung der Mitteldarmbarriere) infiziert und an verschiedenen Tagen nach der Infektion und in verschiedenen Körperteilen sowie im Speichel auf virale RNA mittels Real-Time Reverser Transkription-Polymerase Kettenreaktion (RT-PCR) untersucht. Unterschiede in der Virusreplikation wurden entweder mit Mann-Whitney- oder Fisher’s Exakt-Test überprüft. Das Signifikanzniveau lag bei p < 0,05. Ergebnisse: Beide Viren, das CHIKV-WT und das CHIKV-ΔDR, zeigten ein vergleichbares Wachstum in Wirbeltier-Zellen (BHK-21/J) und erreichten einen Titer von 5x 10^8 PFU/ml. Das Wachstum beider Viren war auch in von Ae. albopictus abgeleiteten C6/36- Stechmückenzellen effizient, wobei CHIKV-WT ein um knapp eine Log-Stufe höheres Wachstum zeigte als CHIKV-ΔDR. In unseren Experimenten zeigte CHIKV-WT ein weniger effizientes Wachstum in von Ae. aegypti abgeleiteten Aag2-Stechmückenzellen, als in Ae. albopictus abgeleiteten C6/36-Stechmückenzellen, obwohl Ae. aegypti als Hauptvektor für CHIKV-WT gilt. In einer intrathorakalen und oralen Infektion konnten sowohl die bekannten CHIKV-Vektoren Ae. aegypti und Ae. albopictus als auch die einheimische Stechmückenarten Ae. vexans und Cx. pipiens erfolgreich infiziert werden. Bei einer intrathorakalen Infektion mit Umgehung der Mitteldarmbarriere wurde bei Ae. vexans oder Cx. pipiens eine effizientere Virusreplikation beobachtet als bei einer oralen Infektion. CHIKV-WT zeigte eine signifikant höhere Replikation in Ae. vexans im Vergleich zu CHIKV-ΔDR am Tag 7 und am Tag 14 nach der Infektion. Bei Cx. pipiens wurden signifikante Unterschiede für CHIKV-WT im Vergleich zu CHIKV-ΔDR nur am Tag 7 beobachtet. Schlussfolgerungen: Das beeinträchtigte Wachstum in C6/36- und Aag2-Zellen von CHIKV-ΔDR deutet darauf hin, dass die deletierten Sequenzwiederholungen spezifisch mit noch unbekannten Faktoren in Stechmückenzellen interagieren. Dennoch konnte CHIKV-ΔDR die bekannten CHIKV-Vektoren Ae. aegypti und Ae. albopictus problemlos nach intrathorakaler und oraler Infektion infizieren. Die Mitteldarm-Entweichungsbarriere scheint also nicht der einzige Faktor zu sein, der die Vektorkompetenz von Stechmücken beeinflusst. Auch die Replikationskinetik des Virus in den Sekundärgeweben scheint bei den verschiedenen Stechmückenarten unterschiedlich zu sein. Zwar umfassten unsere Studien zur oralen Infektion mit CHIKV nur einige einheimische Ae. vexans und Cx. pipiens Stechmücken, jedoch deuten die Ergebnisse darauf hin, dass diese Stechmücken potenziell als Vektoren für CHIKV dienen können.:Inhaltsverzeichnis Abkürzungsverzeichnis 1 Einleitung 1 2 Literaturübersicht 2 2.1 Alphaviren 2 2.1.1 Klassifikation 2 2.1.2 Virusmorphologie und Genomaufbau 2 2.1.3 Virusreplikation 4 2.2 Chikungunya-Virus 5 2.2.1 Übertragungszyklus 5 2.2.2 Epidemiologie 7 2.2.3 Genotypen und die 3′ UTR Region 9 2.2.4 Chikungunya-Fieber 12 2.3 Stechmücken 13 2.3.1 Taxonomie und Stechmückenarten in Deutschland 13 2.3.2 Allgemeine Morphologie, Biologie und Ökologie 14 2.3.2.1 Eiablage und Schlüpfen der Larven 15 2.3.2.2 Aquatische Entwicklungsstadien 16 2.3.2.3 Adulte 17 2.3.2.4 Flugverhalten und Überwinterungsstrategien 19 2.3.3 Arboviren in Deutschland 20 3 Publikation 26 3.1 Stellungnahme zum Eigenanteil an den Arbeiten zur Publikation 26 3.2 Publikation 27 4 Diskussion 42 5 Zusammenfassung 49 6 Summary 51 7 Literaturverzeichnis 53 8 Danksagung 66