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Infeção congénita pelo vírus Zika : mecanismos patogénicos envolvidos
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Resumo(s)
Esta revisão sistemática pretende reunir informação sobre a infeção congénita pelo vírus Zika, com foco nos mecanismos patogénicos envolvidos, e ressalvar a importância do diagnóstico e seguimento dos fetos infetados. Para isso, realizou-se uma pesquisa bibliográfica na base de dados PubMed, recorrendo às palavras-chave: “Zika Virus”, “Microcephaly” e “Congenital Zika Syndrome”. O vírus Zika é um arbovírus da família Flaviviridae, género Flavivirus, que foi isolado pela primeira vez no Uganda, em 1947, tendo sido associado aos humanos pela primeira vez em 2007, na Micronésia. Em 2015, ocorreu um surto de maiores dimensões, com ínicio na América do Sul, que atingiu numerosos países, tendo sido declarado pela Organização Mundial de Saúde como uma Emergência de Saúde Pública de Preocupação Internacional, em 2016. A transmissão do vírus Zika faz-se essencialmente por via vetorial, através de mosquitos do género Aedes, mas também por via sexual, sanguínea e vertical. Esta última tem particular relevo, uma vez que as principais consequências da infeção pelo vírus Zika incidem sobre os fetos, levando ao desenvolvimento da Sindrome Congénita do vírus Zika, que abrange uma gama alargada de anomalias no desenvolvimento fetal, nomeadamente anomalias morfológicas, cerebrais, oculares e motoras, sendo dado destaque à microcefalia e às sequelas que advêm da diminuição do perímetro cefálico. Todas as sequelas da infeção pelo vírus Zika durante a gestação estão associadas ao tropismo deste vírus, que tende a infetar preferencialmente as células progenitoras do sistema nervoso. No sentido de proteger os fetos dessas sequelas, desenvolveram-se medidas de prevenção da infeção a serem adotadas pelas mulheres grávidas. No entanto, estas não são realmente eficazes, pelo que, nos últimos anos, se têm vindo a estudar os mecanismos patogénicos envolvidos, de forma a ser possível o desenvolvimento de protocolos farmacológicos, bem como de vacinas que reforcem a prevenção da infeção.
This systematic review aims to gather information on congenital Zika virus infection, focusing on the pathogenic mechanisms involved and to highlight the importance of diagnosing and tracking infected fetuses. For this, bibliographical search was carried out in the PubMed database, using the keywords: "Zika Virus", "Microcephaly" and "Congenital Zika Syndrome". Zika virus is an arbovirus of the family Flaviviridae, genus Flavivirus, which was first isolated in Uganda, in 1947, and first associated with humans, in 2007, in Micronesia. In 2015, occured a larger surto, beginning in South America, which hit numerous countries, and the World Health Organization declared it a Public Health Emergency of International Concern, in 2016. Zika virus transmission occurs mainly by vector, namely mosquitoes of the genus Aedes, but also sexually, by blood and vertically. This last one is particular important, since the main consequences of Zika virus infection affect fetuses, leading to the development of Congenital Zika Syndrome, which covers a wide range of abnormalities in fetal development, including morphological, brain, ocular and motor abnormalities, with emphasis on microcephaly and sequelae resulting from decreased head circumference. All sequelae of Zika virus infection during pregnancy are associated with tropism of this virus, which tends to preferentially infect the stem cells of the nervous system. To protect fetuses from these sequels, measures to prevent the infection of pregnant women have been developed and adopted. However, these haven’t been effective. So, in recent years the pathogenic mechanisms involved have been studied in order to develop pharmacological protocols, as well as vaccines, that strengthen the prevention of infection.
This systematic review aims to gather information on congenital Zika virus infection, focusing on the pathogenic mechanisms involved and to highlight the importance of diagnosing and tracking infected fetuses. For this, bibliographical search was carried out in the PubMed database, using the keywords: "Zika Virus", "Microcephaly" and "Congenital Zika Syndrome". Zika virus is an arbovirus of the family Flaviviridae, genus Flavivirus, which was first isolated in Uganda, in 1947, and first associated with humans, in 2007, in Micronesia. In 2015, occured a larger surto, beginning in South America, which hit numerous countries, and the World Health Organization declared it a Public Health Emergency of International Concern, in 2016. Zika virus transmission occurs mainly by vector, namely mosquitoes of the genus Aedes, but also sexually, by blood and vertically. This last one is particular important, since the main consequences of Zika virus infection affect fetuses, leading to the development of Congenital Zika Syndrome, which covers a wide range of abnormalities in fetal development, including morphological, brain, ocular and motor abnormalities, with emphasis on microcephaly and sequelae resulting from decreased head circumference. All sequelae of Zika virus infection during pregnancy are associated with tropism of this virus, which tends to preferentially infect the stem cells of the nervous system. To protect fetuses from these sequels, measures to prevent the infection of pregnant women have been developed and adopted. However, these haven’t been effective. So, in recent years the pathogenic mechanisms involved have been studied in order to develop pharmacological protocols, as well as vaccines, that strengthen the prevention of infection.
Descrição
Tese de mestrado, Análises Clínicas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Química clínica Imunologia Microbiologia Hematologia Biologia molecular Teses de mestrado - 2023