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Cytomegalovirus

Introduction

Cytomegalovirus (CMV) is a common virus with manifestations ranging from asymptomatic to severe end-organ dysfunction in immunocompromised patients with congenital CMV disease. Like all herpesviruses, it establishes latency and persists for the life of the individual. Usually, CMV infection causes a wide range of symptoms: from no symptoms to fever and fatigue (resembling infectious mononucleosis) to severe symptoms involving the eyes, brain, or other internal organs. CMV seroprevalence in immunocompetent adults varies from 40-100% globally.

Structure

CMV is a member of the Betaherpesvirinae sub-family of Herpesviridae family. Human CMV (HCMV), also called human herpesvirus 5 (HHV-5), is one of the nine herpesviruses capable of successfully infecting humans. CMV is an icosahedral-shaped, encapsulated, double-stranded DNA virus, with varying sizes of 150 to 200 nm in diameter. The CMV genome is about 236 kb in size and segmented into a unique long (UL) and a unique short (US) segment, with each segment bracketed by terminal repeats.

Cytomegalovirus structure. Fig.1 Cytomegalovirus structure. (Makker, 2016)

Pathogenesis

  • The central concepts of HCMV pathogenesis that link together the diverse disease associations are viremia, the threshold relationship between viral load and disease, and immune pressure forcing the virus to persist in sanctuary sites.
  • CMV affects columnar epithelial cells, endothelial cells, and myofibroblasts within the lamina propria causing mucosal inflammation and ulceration.
  • The key step in the pathogenesis of CMV infection is reactivation from latency. Any process that results in tumor necrosis factor (TNF) release will promote the reactivation of CMV.
  • Reactivation can occur in response to inflammatory stimuli, physiologic stress, and immunosuppression releasing new virions that can infect new cells causing CMV end-organ infection.
  • In patients with T-cell deficiency, the viral replication is uncontrolled and results in excessive shedding of the virus.
  • When symptomatic, it results in a mononucleosis-like syndrome.

Epidemiology

  • CMV is a virus found around the world. CMV infects between 60% to 70% of adults in industrialized countries and close to 100% in emerging countries. And up to 50% of women of childbearing age are seronegative in industrialized countries.
  • 50%-80% of adults in the U.S. have it in their body by age 40. Most people infected with CMV have no symptoms or mild symptoms. In healthy kids, a CMV infection is rarely serious.
  • CMV can be acquired through person-to-person direct contact that can be sexually or by exposure to infected body fluids like urine and saliva. In addition, in-utero transmission happens from mother to fetus during pregnancy or postpartum during breastfeeding.

Worldwide CMV seroprevalence rates among women of reproductive age and birth prevalence of congenital CMV infection. Fig.2 Worldwide CMV seroprevalence rates among women of reproductive age and birth prevalence of congenital CMV infection. (Manicklal, 2013)

Symptoms

CMV can infect virtually any organ of the human body. The most common organs include the blood, brain, colon, eye, heart, kidney, liver, lung, and stomach. CMV often comes and goes without any obvious symptoms; however, some symptoms may appear. Some people get flu-like symptoms the first time they get CMV. Symptoms of recurring CMV vary, depending on which organs the virus has affected. People with weakened immune systems who get CMV can have more serious symptoms affecting the eyes, lungs, liver, esophagus, stomach, and intestines.

What Can We offer

There is no effective vaccine against HCMV, and drugs that inhibit viral replication exist but are ineffective due to high toxicity, low bioavailability, and the development of drug-resistant virus strains.

Creative Biolabs, a world-leading antibody provider, is dedicated to delivering high-quality and cost-effective ViroAntibody in support of pre-clinical and clinical stages of pharmaceutical drug development. For clients' goals, we provide a large number of CMV antibodies against various targets including:

  • gB (Envelope glycoprotein B)
  • gH (Envelope glycoprotein H)
  • gM/gN (Envelope glycoprotein M/Envelope glycoprotein N)
  • IE (Major immediate-early protein)
  • UL55 (Envelope glycoprotein B)
  • UL75 (Envelope glycoprotein H)
  • UL83 (65 kDa phosphoprotein)
  • CMV
  • HCMV

In addition, we can deliver customized ViroAntibody services to meet your needs, which helps to streamline your research. Please feel free to contact us for further information.

References

  1. Makker, J.; et al. Cytomegalovirus related fatal duodenal diverticular bleeding: case report and literature review. World J Gastroenterol. 2016, 22(31): 7166-7174.
  2. Manicklal, S.; et al. The "silent" global burden of congenital cytomegalovirus. Clin Microbiol Rev. 2013, 26(1): 86-102.

All products and services are intended for Research Use Only, and NOT to be used in diagnostic or therapeutic procedures.

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