Autoimmune Response in Individuals Infected with Zika Virus - RAIZ

In 2015, the world was confronted with a new epidemic of Zika virus (vZIKA). The vZIKA infection is transmitted by mosquitoes of the genus Aedes. Its clinical presentation, in most patients, varies from asymptomatic cases to mild, self-limited disease. Typical symptoms include rash, fever, arthralgias and conjunctivitis. This led to the understanding of vZIKA infection as a benign disease; however, the new epidemic has been directly associated with an increase in the incidence of Guillain¿Barré syndrome (GBS) and the presence of neurological alterations and malformations in fetuses of infected pregnant mothers. GBS is a peripheral neuropathy with autoimmune characteristics, with great impact on health status, quality of life and high cost, in which antibodies directed against gangliosides are related to several types of clinical presentation of this disease. Through the present research, we seek to determine the factors associated with neurological autoimmune response in vZIKA-infected individuals in Cúcuta, Colombia. This will be an association study based on cases and controls, where cases were defined according to the list provided by the Secretariat of Health of Cúcuta, with the diagnosis of neurological syndrome with strong suspicion of vZIKA, notified between November 2015 and May 2016, to the National Public Health Surveillance System -SIVIGILA- through the complementary data sheet code 895. The individuals involved as cases meet the Asbury diagnostic criteria (internationally validated) for GBS. Controls were selected from the list of cases of vZIKA infection without neurological syndrome reported under the same list indicated for cases by the competent entity. In turn, the controls were individuals matched for age, sex, neighborhood of residence and date of presentation of symptoms compatible with vZIKA infection (± 1 month). Demographic and clinical characteristics relevant to the study were recorded. It is worth emphasizing that the ¿fieldwork¿ (inclusion of patients - cases and controls ¿ and collection of biological samples) for the present study has already been performed. The samples obtained will be used for environmental exposure, immunological and genetic studies. The analysis of the data obtained will be carried out using case-control matching techniques, univariate and bivariate descriptive statistics techniques, multiple comparisons methods, data mining techniques to analyze the large volume of information, as well as a conditional logistic regression model, among other techniques. For the genetic study, genetic epidemiology tools, routinely used in CREA, will be used, including an adjustment for ancestry. Likewise, bioinformatics tools will be used to predict epitopes and eventual new autoantibodies. The results of this research will allow a better understanding of the environmental, infectious, immunological and genetic factors or cofactors that cause an individual to develop GBS after presenting vZIKA infection. These results will be novel for the national and international scientific community. Our results could be useful in the design of public policies for the development of strategies for the prevention and prediction of pathologies associated with vZIKA.