Chapter 28 : Viral Pathogens of the Intestine

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Rotaviruses and caliciviruses are currently recognized as the etiologic agents of greatest medical and epidemiologic importance for humans, and this chapter summarizes current information on the epidemiology and consequences of infection with these viruses. Much of the chapter focuses on information about the pathophysiology of rotavirus-induced disease because this disease is the best understood at present. Pathologic changes induced by rotavirus infections are almost exclusively limited to enterocytes in the small intestine. In pigs and lambs, the most pronounced lesions are seen in the distal intestine (jejunum, ileum), while the proximal intestine (duodenum, jejunum) is infected in calves, with changes being seen throughout the length of the small intestine. In mice, the most pronounced changes are in the proximal to middle small intestine, and lesions in rabbits are seen throughout the small intestine. A number of studies have shown that rotavirus infection can lead to malabsorption due to destruction of enterocytes. This mechanism is based on the observation that histopathologic changes are seen in the intestines of rotavirus-infected animals and loss of enterocytes is associated with depressed levels of mucosal disaccharidases. The site of primary replication is assumed to be in the upper small intestine, because biopsies of the jejunum of volunteers who developed illness following oral administration of the Norwalk or Hawaii virus exhibit histopathologic lesions.

Citation: Estes M, Atmar R. 2003. Viral Pathogens of the Intestine, p 525-545. In Hecht G (ed), Microbial Pathogenesis and the Intestinal Epithelial Cell. ASM Press, Washington, DC. doi: 10.1128/9781555817848.ch28

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Segmented Double-Stranded RNA
Interferon Regulatory Factors
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Image of FIGURE 1

Schematic of the small intestinal epithelium and sites of virus infection. The left panel shows the locations of cells infected by specific GI viruses. The right panel shows the release of the viral enterotoxin from infected cells that can affect neighboring uninfected epithelial cells, and outlines the effects of rotavirus infection of mature enterocytes.

Citation: Estes M, Atmar R. 2003. Viral Pathogens of the Intestine, p 525-545. In Hecht G (ed), Microbial Pathogenesis and the Intestinal Epithelial Cell. ASM Press, Washington, DC. doi: 10.1128/9781555817848.ch28
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Image of FIGURE 2

Norwalk virus genome organization. The top line illustrates this nonenveloped virus's singlestranded RNA genome of ∼7.7 kb. The lower boxes depict the three predicted ORFs encoded in the genome. ORF1 produces the nonstructural proteins, ORF2 is the major capsid protein, and ORF3 is a basic protein present as a few copies in virus particles. Expression of the 3′end of the genome using recombinant baculoviruses results in the self-assembly of VLPs.

Citation: Estes M, Atmar R. 2003. Viral Pathogens of the Intestine, p 525-545. In Hecht G (ed), Microbial Pathogenesis and the Intestinal Epithelial Cell. ASM Press, Washington, DC. doi: 10.1128/9781555817848.ch28
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Viral gastroenteritis in humans

Citation: Estes M, Atmar R. 2003. Viral Pathogens of the Intestine, p 525-545. In Hecht G (ed), Microbial Pathogenesis and the Intestinal Epithelial Cell. ASM Press, Washington, DC. doi: 10.1128/9781555817848.ch28

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