Immunological imbalance in microcephalic children with congenital Zika virus syndrome

• Published in: Medical microbiology and immunology 2022-12, Vol.211 (5-6), p.219-235
• Main Authors: Salmeron, Amanda Costa Ayres, Bezerra, Wallace Pitanga, de Souza, Rafaela Lúcia Lopes, Pereira, Luanderson Cardoso, do Nascimento, Lícia Maria, Branco, Anna Cláudia Calvielli Castelo, Simas, Luiza Emilia Cavalcanti, de Almeida, Valéria Azevedo, de Souza Palmeira, Pedro Henrique, Bezerra, Christiane Medeiros, Guedes, Paulo Marcos Matta, Sato, Maria Notomi, de Farias Sales, Valéria Soraya, de Oliveira Freitas Júnior, Reginaldo Antônio, de Souza Lima Keesen, Tatjana, Nascimento, Manuela Sales Lima
• Format: Article
• Language: English
• Subjects: Biomedical and Life Sciences; Biomedicine; Children; Cytology; Immune system; Immunological memory; Immunology; Infections; Interleukin 2; Interleukin 4; Interleukin 5; Leukocytes (eosinophilic); Leukocytes (neutrophilic); Lymph nodes; Lymphocytes; Medical Microbiology; Microcephaly; Original Investigation; Skin tests; Tuberculin; Urinary tract; Vaccination; Virology; Zika virus; γ-Interferon
• ISSN: 0300-8584; 1432-1831
• DOI: 10.1007/s00430-022-00746-5

Microcephalic children due congenital Zika virus syndrome (CZS) present neurological symptoms already well described. However, several other alterations can also be observed. Here, we aimed to evaluate the immune system of microcephaly CZS children. We showed that these patients have enlarged thymus, spleen and cervical lymph nodes, analysed by ultrasound and compared to the reference values for healthy children. In the periphery, they have an increase in eosinophil count and morphological alterations as hypersegmented neutrophils and atypical lymphocytes, even in the absence of urinary tract infections, parasitological infections or other current symptomatic infections. Microcephalic children due CZS also have high levels of IFN-γ, IL-2, IL-4, IL-5 and type I IFNs, compared to healthy controls. In addition, this population showed a deficient cellular immune memory as demonstrated by the low reactivity to the tuberculin skin test even though they had been vaccinated with BCG less than 2 years before the challenge with the PPD. Together, our data demonstrate for the first time that CZS can cause alterations in primary and secondary lymphoid organs and also alters the morphology and functionality of the immune system cells, which broadens the spectrum of CZS symptoms. This knowledge may assist the development of specific therapeutic and more efficient vaccination schemes for this population of patients.