The pathogenesis of, and propagation of the virus in, experimental poliomyelitis
The pathogenesis of, and propagation of the virus in, experimental poliomyelitis
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DOI：
10.1002/path.1700330103
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发表时间：
1930-01-01
期刊：
影响因子：
--
通讯作者：
Hurst, EW
中科院分区：
文献类型：
--
作者：
Fairbrother, RW;Hurst, EW
在猴子的鼻腔和脑内接种后，脊髓灰质炎在组织学上从上到下传播。病变首先出现在同侧视丘脑，然后出现在中脑，潜伏期结束时恰好出现瘫痪，出现在脊髓的多个节段。由于前角细胞，特别是腰部前角细胞的易感性更强，通常会出现瘫痪，然后完全瘫痪，首先出现在腿部。因此，临床结果并不能指导疾病进入的路径或传播和发展的方式。感染传播到脑干和脊髓是通过轴管，这似乎是通常采取的途径到神经系统的其他部分；然而，脑膜传播是可能的，并可能总是在接种部位周围感染的局部传播中起一定作用。脑膜炎并不像通常所说的那样是该病的主要损害，该病始于神经细胞的原发变性，并伴有间质组织的炎症。病毒在神经细胞退化特别严重的区域存在最多，也就是说，在脊髓和脑干。在神经细胞轻微退化的地方，由于对病毒的作用有更大的抵抗力，例如在大脑皮层，尽管存在大量间质炎症灶，但病毒总是不断地被发现。大脑皮层不是病毒存活的有利部位，病毒往往在几天内从接种部位完全消失。当组织学变化开始发展时，病毒同时出现在脐带中，当接种部位没有病毒时，可以在这里检测到完全活跃的病毒。由于病毒主要通过轴柱传播，因此它不会出现在脑脊液中，事实上，除了极少数情况外，也不会在脑脊液中发现它。
After intranasal and intra-cerebral inoculation in monkeys, poliomyelitis spreads histologically from above downwards. Lesions first appear in the optic thalamus of the same side, then in the midbrain, and at the end of the incubation period and coincidently with the appearance of paralysis, at many levels of the spinal cord. Owing to the greater susceptibility of the anterior-horn cells, and particularly those of the lumbar region, paralysis usually appears, and later becomes complete, first in the legs. The clinical findings are thus no guide to the path of entry or manner of spread and development of the disease. Spread of infection to the brain-stem and cord occurs by way of the axis-cylinders and this appears to be the route usually taken to other parts of the nervous system; menin-geal spread is, however, possible and probably always plays some part in the local dissemination of infection around the site of inoculation. Meningitis is not, as is frequently asserted, the primary lesion of the disease, which begins as a primary degeneration of nerve cells accompanied by inflammation in the interstitial tissues. Virus is present in greatest amount in those regions in which nerve-cell degeneration is particularly severe, that is to say, in the spinal-cord and brain-stem. Where nerve-cell degeneration is slight, owing to greater resistance to the action of the virus, as in the cerebral cortex, in spite of the existence of numerous foci of interstitial inflammation, the virus is found inconstantly. The cerebral cortex is not a favorable site for survival of the virus, which tends within a few days to disappear altogether from the site of inoculation. Virus appears in the cord at the same time as histological changes begin to develop, and fully active virus can be detected here at a time when none is present at the site of inoculation. Since the virus travels chiefly by way of the axis-cylinders, its appearance in the cerebro-spinal fluid would not be expected, nor, in fact, is it found there except on rare occasions.