Md Eram Hosen, Sumaiya Jahan Supti, Paul F Horwood, Subir Sarker
{"title":"Adaptive Evolution of Dengue Virus: Interplay Between Viral Genetics and Host Immunity.","authors":"Md Eram Hosen, Sumaiya Jahan Supti, Paul F Horwood, Subir Sarker","doi":"10.1002/rmv.70082","DOIUrl":"10.1002/rmv.70082","url":null,"abstract":"<p><p>Dengue virus (DENV), a major arboviral pathogen of global concern, evolves rapidly through a combination of intrinsic molecular mechanisms, vector adaptation, and host immune pressures. Despite extensive research, major gap remains in understanding how these forces, collectively generate, shape, and fix adaptive mutations that drive DENV evolution. In this review, we explore the molecular mechanisms underlying DENV evolution, with emphasising the error-prone RNA-dependent RNA polymerase, template switching, recombination, and the modulatory effects of viral RNA secondary structures. We also highlight the replicase complex's intrinsic tolerance to mutations as a driver of evolutionary plasticity. At the protein level, we summarise adaptive mutation in capsid, envelop, NS1 and NS5 protein that influence virulence, transmission efficiency, and immune escape. Additionally, we also address the role of vector adaptation, whereby DENV overcomes midgut and salivary gland infection barriers in Aedes mosquitoes, often through bottleneck-driven selection and compensatory mutations, consequently enhancing transmission potential. Finally, we discuss host immune-driven selection including T cell-mediated immune responses, and the regulation of IFN, NF-κB, and PI3K/Akt/mTOR signalling pathways shapes the evolution of DENV. Together, these insights highlight the dynamic interplay between viral genetics, mosquito vectors, and host immunity in shaping the evolutionary trajectory of DENV.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70082"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rania Hamdy, Amal Z Barakat, Eman J Abuzaid, Tasneem M Elsayed, Mohamed I Husseiny
{"title":"COVID-19 in Diabetic Patients: Mechanisms, Risks, and Therapeutic Considerations.","authors":"Rania Hamdy, Amal Z Barakat, Eman J Abuzaid, Tasneem M Elsayed, Mohamed I Husseiny","doi":"10.1002/rmv.70085","DOIUrl":"10.1002/rmv.70085","url":null,"abstract":"<p><p>The COVID-19 pandemic, caused by SARS-CoV-2, has had a profound global impact. Diabetes mellitus is a major comorbidity associated with higher infection risk, severe disease, and mortality in COVID-19 patients. This review examines the bidirectional relationship between COVID-19 and diabetes, focussing on immunometabolic mechanisms, post-COVID metabolic effects, and therapeutic implications. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science for articles published until May 2025 using the terms \"COVID-19,\" \"SARS-CoV-2,\" \"diabetes,\" and \"immunometabolism.\" Peer-reviewed studies addressing clinical, molecular, or therapeutic interactions between the two diseases were included. Evidence shows that SARS-CoV-2 infection aggravates metabolic dysfunction through immune dysregulation, cytokine-mediated inflammation, and β-cell injury. Hyperglycemia promotes viral replication and inflammatory damage, creating a vicious cycle that worsens outcomes. Reports also indicate an increased risk of new-onset and post-COVID diabetes. Certain antidiabetic agents, such as metformin and GLP-1 receptor agonists, may improve prognosis via anti-inflammatory and metabolic effects. Diabetes significantly amplifies the severity of COVID-19 through intertwined metabolic and immune mechanisms. Understanding these interactions provides new insights into disease management and supports the development of targeted immunometabolic therapies for improving outcomes in diabetic patients affected by COVID-19.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70085"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Discovery, Diversity and Evolution of Emerging Jingmenviruses.","authors":"Jing-Jing Guo, Ru-Yi Chen, Zu-Xin Wang, Cheng-Feng Qin","doi":"10.1002/rmv.70084","DOIUrl":"10.1002/rmv.70084","url":null,"abstract":"<p><p>Jingmenviruses are a group of emerging arboviruses. In the past decade, a variety of jingmenviruses were identified from arthropods, mammals and even humans, which expands knowledge of their biodiversity. These viruses contain four or five segments of genomic RNA and the manner of packaging is very flexible. Surprisingly, two segments of jingmenviruses are derived from unsegmented orthoflaviviruses. Jingmenviruses form a monophyletic group within the Flaviviridae family and further can be divided into two groups: tick- and vertebrate-associated jingmenvirus and insect-associated jingmenvirus. Additionally, a few tick- and vertebrate-associated jingmenviruses have been linked to human diseases, highlighting the urgent need for extensive surveillance and further etiological investigation. The present review summarizes the discovery, diversity and evolution of emerging jingmenviruses, and highlights the potential risk of further human transmission.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70084"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long Covid Syndrome and Role of Autonomic Nervous System.","authors":"A Vitiello","doi":"10.1002/rmv.70101","DOIUrl":"https://doi.org/10.1002/rmv.70101","url":null,"abstract":"","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70101"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145864914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of the COVID-19 Pandemic on HPV Vaccination Coverage Among Adolescents From High-Income Countries and Challenges: A Scoping Review.","authors":"Sasidharanpillai Sabeena, Caryl Beynon","doi":"10.1002/rmv.70102","DOIUrl":"10.1002/rmv.70102","url":null,"abstract":"<p><p>Persistent high-risk Human Papillomavirus (HPV) infection causes anogenital and oropharyngeal cancers across all genders. The primary cancer associated with HPV is cervical cancer and the HPV vaccination before sexual exposure is recommended for cervical cancer elimination globally. This scoping review aims to map the preliminary evidence regarding the determinants of adolescent HPV vaccine acceptance and hesitancy during the COVID-19 pandemic in high income countries. A scoping review was conducted as per the updated Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Using the PCC (Population, Concept, and Context) framework, search keywords and search strategies were developed. Electronic databases were searched using specific search terms and the last search date noted as February 8, 2025. A thematic content analysis was carried out to identify the themes and subthemes by a deductive approach. Fourteen studies were included as the potential sources of evidence in this review. The study population included 493,819 adolescents from Australia, Hong Kong, Italy, Poland, Saudi Arabia, and the USA. The themes identified were inequity, attitude and behaviour, knowledge and communication, and engagement and influence. The COVID-19 pandemic generated a negative parental attitude towards HPV vaccines for a brief period. The adolescent HPV vaccine acceptance mainly depended on strong parental support and appropriate access to healthcare professionals and vaccination services. Travel restrictions, lockdowns, school closures, and social distancing contributed to significant HPV vaccine hesitancy in high income countries.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70102"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-Vaccination Syndromes: The Evidence and a Roadmap for Rigorous Research.","authors":"DuJiang Yang, GuoYou Wang","doi":"10.1002/rmv.70100","DOIUrl":"10.1002/rmv.70100","url":null,"abstract":"<p><p>The recent review by Yong et al. (Rev Med Virol. 2025; 35:e70070) proposes the entity of \"Long Vax Syndrome\" or Post-COVID-19 Vaccination Syndrome (PCVS). While this synthesis of anecdotal and early observational reports is a timely contribution, it necessitates a critical evaluation of the underlying evidence. This letter highlights substantial methodological limitations, including a reliance on data susceptible to significant ascertainment bias and the conflation of correlation with causation, given the non-negligible background prevalence of conditions like POTS and chronic fatigue. We argue that the pathophysiological narrative, while plausible, remains highly speculative due to a lack of direct mechanistic validation in human subjects. Furthermore, the proposed therapeutic strategies, borrowed from analogous disorders, are empiric and untested in this specific context, posing potential risks if adopted without evidence. The review by Yong et al. should thus serve not as a definitive guide, but as a critical catalyst for a disciplined research agenda. We outline essential next steps, including the urgent need for large, prospective controlled cohort studies to establish true incidence, deep phenotyping to identify distinct endotypes, and the development of standardised diagnostic criteria before randomised controlled trials can ethically evaluate interventions. Only through such rigorous inquiry can we ensure both compassionate care for affected individuals and the preservation of public confidence in vaccines.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70100"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding Monkeypox Virus Evolution, Host-Pathogen Interactions, and Therapeutic Advances.","authors":"Anjali Prajapati, Rithika Jella, Meghana Reddy Dendi, Sumithra Salla, Suprabhat Mukherjee, Jagadeesh Bayry, Rajitha Rajeshwar Tatikonda, Haitao Hu, Srinivasa Reddy Bonam","doi":"10.1002/rmv.70103","DOIUrl":"10.1002/rmv.70103","url":null,"abstract":"<p><p>The recent outbreak of the Monkeypox (Mpox) virus has raised significant concerns. First identified in 1958, Monkeypox virus (MPXV) belongs to the Orthopoxvirus genus, sharing similarities with the Smallpox virus. It is a zoonotic disease mainly harboured by rodents and transmitted through direct interaction with infected animals, respiratory droplets, contaminated materials, or body fluids and from mother to child during pregnancy. The MPXV has a brick-shaped lipoprotein envelope, usually containing conserved genes essential for viral replication and variable genes that influence pathogenicity. The virus exists in two genetic clades: West African (Clade II) with lower mortality (∼1%) and Central African (Clade I) with higher mortality (∼10%). The spread of Mpox was primarily limited to Congo Basin (West Africa), which eventually increased globally. In the year 2022, World Health Organisation (WHO) declared Mpox an 'International Public Health Emergency Concern', indicating vital need to develop robust strategies to combat Mpox. As per 2022 outbreak, 40% patients required medical treatment (antiviral, antibacterials, and pain killer), 1%-13% patients required hospitalisation and 0.1% cases ended in fatality. The contemporary pre- and post-prophylactic therapies, include non-replicating modified vaccinia Ankara vaccination, are not yet available in endemic countries in Africa. Moreover, since January 1, 2024, there have been 812 deaths reported linked to the clade Ib Mpox outbreak in Central Africa, mostly in the Democratic Republic of the Congo. This corresponds to a case-fatality rate of about 3% among the nearly 29,000 assumed cases by September 2024. Hence, this review outlines routes of Mpox transmission and early and chronic symptoms of infection. The mechanisms employed by the virus for immune evasion or immune suppression to promote viral survival inside the host are discussed in detail. The review illustrates Mpox therapeutics and medications, including anti-viral drugs that help to treat symptoms, prevent complications, and support recovery, particularly in the immunocompromised patients. In addition, we discuss recent advancements in the development of prophylactic vaccine for Mpox, including ACAM2000, LC16m8, JYNNEOS (MVA), and others. Future research directions include exploiting the conserved Mpox antigens to develop safer and more broadly protective vaccines. There is also an urgent need for international collaborations in surveillance, rapid response systems and comprehensive OMICS studies for understanding the viral evolution and mutations, which will greatly aid vaccine design and therapeutic strategies to combat Mpox.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70103"},"PeriodicalIF":5.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145945747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dengue Fever: Viral, Environmental, and Human Factors Driving Expansion and Pandemic Risk.","authors":"Mohsen Nakhaie, Amirhossein Shahpar, Mohammad Rezaei Zadeh Rukerd, Niloofar Farsiu, Javad Charostad, Davood Bashash, Nazanin Zeinali Nezhad, Mohammad Pardeshenas, Azadeh Haghi Navand, Hanieh Mirkamali, Keivan Zandi, Sazaly AbuBakar","doi":"10.1002/rmv.70088","DOIUrl":"10.1002/rmv.70088","url":null,"abstract":"<p><p>Dengue fever (DF), caused by the dengue virus (DENV), is the fastest-spreading mosquito-borne viral disease globally and presents significant public health challenges. This comprehensive review explores the multifaceted factors influencing DENV expansion and control. We examine viral factors, including serotypes, sub-genotypes, genetic mutations, recombination, and immune evasion mechanisms, and their role in enhancing dengue's adaptability and virulence. The influence of environmental factors, such as climate change, global warming, and unplanned urbanization on mosquito vector distribution, and the impact of natural disasters and human conflicts on population dynamics and transmission risks are discussed. Human factors, including global travel, migration, inadequate public health infrastructure, and the role of herd immunity from previous infections and cyclical outbreaks, are critically assessed. Additionally, emerging challenges like co-infections, drug resistance, and the potential for pandemic outbreaks are considered. By synthesizing current knowledge across these dimensions, this review provides insights into dengue transmission complexities and identifies key intervention areas, aiming to enhance strategies for prevention, control, and preparedness in the face of evolving global health threats.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70088"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed M Basri, Mona M Almramhi, Wajnat A Tounsi, Ammar A Basabrain, Amany I Almars
{"title":"Immune Evasion Mechanisms of Neurotropic Dengue Virus.","authors":"Ahmed M Basri, Mona M Almramhi, Wajnat A Tounsi, Ammar A Basabrain, Amany I Almars","doi":"10.1002/rmv.70083","DOIUrl":"10.1002/rmv.70083","url":null,"abstract":"<p><p>Dengue virus (DENV) is an important human pathogen that infects millions of people each year and can cause diseases such as dengue haemorrhagic fever and dengue shock syndrome. Despite the efforts of the immune system to control the innate and adaptive immune responses to the virus, DENV escapes from immune responses using complex and multiple mechanisms. In certain cases, these immune evasion strategies may also contribute to the neurotropic potential of DENV, facilitating its ability to invade or affect CNS. This narrative review summarises the current knowledge by focusing on major immune evasion pathways of dengue virus at three levels of innate, adaptive and effector mechanisms, including inhibition of interferon production, disruption of immunological signalling pathways, regulation of proliferation proteins and inhibition of effector cells. The aim of this review is to collect, compare and describe all the ways in which this virus evades immunity, which will help identify knowledge gaps for future research and subsequently guide the development of effective vaccines and therapeutics.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70083"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Varicella Zoster Virus in Giant Cell Arteritis: Evidence From a Systematic Review and Meta-Analytic Synthesis.","authors":"Golbarg Mehrpoor, Omid Kohandel Gargari, Saleheh Khorasani, Sheida Mobader Sani","doi":"10.1002/rmv.70091","DOIUrl":"10.1002/rmv.70091","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) is a systemic vasculitis of older adults with potential for severe ischaemic complications. Although its aetiology remains unclear, varicella zoster virus (VZV) has been proposed as a potential trigger due to its neurotropism and ability to induce granulomatous vasculitis. However, conflicting evidence has clouded this association. To systematically assess and synthesise the available evidence on the presence of VZV in arterial tissues of patients with GCA, and to evaluate the strength and consistency of this association. We conducted a systematic review and meta-analysis according to PRISMA guidelines. We searched Web of Science, PubMed, and Scopus (up to April 2025) for studies examining VZV detection in arterial tissues of GCA-positive and GCA-negative patients. Eligible studies reported original data using immunohistochemistry, PCR, or molecular methods. Pooled log odds ratios (LogORs) were calculated using a random-effects model. Heterogeneity, publication bias, subgroup effects (by geography), and study quality (NOS scores) were assessed. Eighteen studies met inclusion criteria, encompassing 606 GCA cases and 589 controls. Meta-analysis revealed a significant association between VZV presence and GCA (pooled LogOR: 1.03; 95% CI: 0.35-1.71; p = 0.003). Heterogeneity was moderate (I<sup>2</sup> = 38.7%). Sensitivity analyses confirmed robustness of the association. Subgroup analysis demonstrated a significant association in U.S.-based studies (LogOR: 1.86; 95% CI: 0.70-3.01), but not in European cohorts (LogOR: 0.09; 95% CI: -0.62-0.79; p for difference = 0.011). Egger's test suggested potential publication bias (p = 0.027). Meta-regression showed no significant relationship between study quality and effect size. Our findings indicate a statistically significant but heterogenous association between VZV and GCA. The signal appears geographically and methodologically dependent, with conflicting high-quality studies reporting both positive and null findings. While the data support further investigation into a potential viral role in GCA pathogenesis, current evidence does not justify routine antiviral treatment or changes in clinical practice. Future research should employ standardized, blinded, and multicenter approaches to clarify this potential link.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70091"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}