TY - JOUR

T1 - Tick-borne encephalitis in Europe and Russia

T2 - Review of pathogenesis, clinical features, therapy, and vaccines

AU - Ruzek, Daniel

AU - Avšič Županc, Tatjana

AU - Borde, Johannes

AU - Chrdle, Ales

AU - Eyer, Ludek

AU - Karganova, Galina

AU - Kholodilov, Ivan

AU - Knap, Nataša

AU - Kozlovskaya, Liubov

AU - Matveev, Andrey

AU - Miller, Andrew D.

AU - Osolodkin, Dmitry I.

AU - Överby, Anna K.

AU - Tikunova, Nina

AU - Tkachev, Sergey

AU - Zajkowska, Joanna

N1 - Funding Information: The authors acknowledge financial support from: Funding Information: • The Russian Scientific Foundation (project #16-14-00083) to NT and AM,• Ministry of Education and Science of the Russian Federation (project 0309-2016-0002) to NT and ST,• Ministry of Health of the Czech Republic (grant No. 16-34238A) (to DR and LE), by Project “FIT” (Pharmacology, Immunotherapy, nanoToxicology; CZ.02.1.01/0.0/0.0/15_003/0000495), which was funded by the European Regional Development Fund (to ADM and DR),• The Laboratory for Molecular Medicine Sweden (MIMS), the Swedish Research Council (VR; 2017-02438), the Swedish Foundation for Strategic Research (SSF; FFL12-0089) to AKÖ,• The Ministry of Higher Education, Science and Sport of Slovenia (grant no. P3-0083) to TAŽ and NK. Funding Information: • Ministry of Health of the Czech Republic (grant No. 16-34238A ) (to DR and LE), by Project “ FIT ” (Pharmacology, Immunotherapy, nanoToxicology; CZ.02.1.01/0.0/0.0/15_003/0000495 ), which was funded by the European Regional Development Fund (to ADM and DR), Publisher Copyright: © 2019 Elsevier B.V. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2019/4

Y1 - 2019/4

N2 - Tick-borne encephalitis (TBE) is an illness caused by tick-borne encephalitis virus (TBEV) infection which is often limited to a febrile illness, but may lead to very aggressive downstream neurological manifestations. The disease is prevalent in forested areas of Europe and northeastern Asia, and is typically caused by infection involving one of three TBEV subtypes, namely the European (TBEV-Eu), the Siberian (TBEV-Sib), or the Far Eastern (TBEV-FE) subtypes. In addition to the three main TBEV subtypes, two other subtypes; i.e., the Baikalian (TBEV-Bkl) and the Himalayan subtype (TBEV-Him), have been described recently. In Europe, TBEV-Eu infection usually results in only mild TBE associated with a mortality rate of <2%. TBEV-Sib infection also results in a generally mild TBE associated with a non-paralytic febrile form of encephalitis, although there is a tendency towards persistent TBE caused by chronic viral infection. TBE-FE infection is considered to induce the most severe forms of TBE. Importantly though, viral subtype is not the sole determinant of TBE severity; both mild and severe cases of TBE are in fact associated with infection by any of the subtypes. In keeping with this observation, the overall TBE mortality rate in Russia is ∼2%, in spite of the fact that TBEV-Sib and TBEV-FE subtypes appear to be inducers of more severe TBE than TBEV-Eu. On the other hand, TBEV-Sib and TBEV-FE subtype infections in Russia are associated with essentially unique forms of TBE rarely seen elsewhere if at all, such as the hemorrhagic and chronic (progressive) forms of the disease. For post-exposure prophylaxis and TBE treatment in Russia and Kazakhstan, a specific anti-TBEV immunoglobulin is currently used with well-documented efficacy, but the use of specific TBEV immunoglobulins has been discontinued in Europe due to concerns regarding antibody-enhanced disease in naïve individuals. Therefore, new treatments are essential. This review summarizes available data on the pathogenesis and clinical features of TBE, plus different vaccine preparations available in Europe and Russia. In addition, new treatment possibilities, including small molecule drugs and experimental immunotherapies are reviewed. The authors caution that their descriptions of approved or experimental therapies should not be considered to be recommendations for patient care.

AB - Tick-borne encephalitis (TBE) is an illness caused by tick-borne encephalitis virus (TBEV) infection which is often limited to a febrile illness, but may lead to very aggressive downstream neurological manifestations. The disease is prevalent in forested areas of Europe and northeastern Asia, and is typically caused by infection involving one of three TBEV subtypes, namely the European (TBEV-Eu), the Siberian (TBEV-Sib), or the Far Eastern (TBEV-FE) subtypes. In addition to the three main TBEV subtypes, two other subtypes; i.e., the Baikalian (TBEV-Bkl) and the Himalayan subtype (TBEV-Him), have been described recently. In Europe, TBEV-Eu infection usually results in only mild TBE associated with a mortality rate of <2%. TBEV-Sib infection also results in a generally mild TBE associated with a non-paralytic febrile form of encephalitis, although there is a tendency towards persistent TBE caused by chronic viral infection. TBE-FE infection is considered to induce the most severe forms of TBE. Importantly though, viral subtype is not the sole determinant of TBE severity; both mild and severe cases of TBE are in fact associated with infection by any of the subtypes. In keeping with this observation, the overall TBE mortality rate in Russia is ∼2%, in spite of the fact that TBEV-Sib and TBEV-FE subtypes appear to be inducers of more severe TBE than TBEV-Eu. On the other hand, TBEV-Sib and TBEV-FE subtype infections in Russia are associated with essentially unique forms of TBE rarely seen elsewhere if at all, such as the hemorrhagic and chronic (progressive) forms of the disease. For post-exposure prophylaxis and TBE treatment in Russia and Kazakhstan, a specific anti-TBEV immunoglobulin is currently used with well-documented efficacy, but the use of specific TBEV immunoglobulins has been discontinued in Europe due to concerns regarding antibody-enhanced disease in naïve individuals. Therefore, new treatments are essential. This review summarizes available data on the pathogenesis and clinical features of TBE, plus different vaccine preparations available in Europe and Russia. In addition, new treatment possibilities, including small molecule drugs and experimental immunotherapies are reviewed. The authors caution that their descriptions of approved or experimental therapies should not be considered to be recommendations for patient care.

KW - Antiviral therapy

KW - Clinical course

KW - Pathogenesis

KW - Tick-borne encephalitis

KW - Tick-borne encephalitis virus

KW - Vaccines

KW - Encephalitis Viruses, Tick-Borne/immunology

KW - Europe

KW - Humans

KW - Encephalitis, Tick-Borne/drug therapy

KW - Phylogeny

KW - Russia

KW - Ticks/virology

KW - Animals

KW - Antiviral Agents/therapeutic use

KW - Viral Vaccines/immunology

KW - Mice

UR - http://www.scopus.com/inward/record.url?scp=85061389498&partnerID=8YFLogxK

U2 - 10.1016/j.antiviral.2019.01.014

DO - 10.1016/j.antiviral.2019.01.014

M3 - Review article

C2 - 30710567

AN - SCOPUS:85061389498

VL - 164

SP - 23

EP - 51

JO - Antiviral Research

JF - Antiviral Research

SN - 0166-3542

ER -