PRESENCE, DISTRIBUTION AND SPREAD OF PRODUCTIVE VARICELLA ZOSTER VIRUS-INFECTION IN NERVOUS TISSUES
PRESENCE, DISTRIBUTION AND SPREAD OF PRODUCTIVE VARICELLA ZOSTER VIRUS-INFECTION IN NERVOUS TISSUES
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DOI：
10.1093/brain/115.2.383
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发表时间：
1992-04-01
期刊：
影响因子：
14.5
通讯作者：
HONDO, R
中科院分区：
文献类型：
--
作者：
SCHMIDBAUER, M;BUDKA, H;HONDO, R
回顾性研究33例尸检患者的神经组织病变，检测产性水痘带状疱疹病毒（VZV）感染，其中带状疱疹19例（三叉神经10例，脊髓9例），无带状疱疹的结节性脑干脑炎14例。用免疫细胞化学方法检测VZV抗原，并用生物素化VZV DNA探针对甲醛固定石蜡切片进行原位杂交。连续切片观察外周和中枢神经系统、皮肤和横纹肌；然而，可用的组织块因病例而异。在HZ病例中发现神经组织中产生水痘带状疱疹病毒（抗原和DNA），但仅在皮疹长达7周后短暂存活（12例患者中有8例）。水痘带状疱疹病毒在神经细胞、神经胶质细胞、雪旺细胞和血管中可见。在中枢神经系统（CNS），在三叉神经核（1 / 10脑）或弥散性结节性脑干病变（1 / 10脑），室管膜下微血管（1 / 10脑）或血管血管动脉（2 / 19脑或脊髓）中检测到VZV。在周围神经系统（PNS）中，在感觉神经节的神经元和卫星细胞中发现了VZV （DNA和抗原）（7例神经节取样中有4例），在受损的神经纤维中发现了VZV （DNA和抗原），其中包括一例肌肉神经；后者为肌炎伴VZV感染肌纤维。结节性脑干脑炎1例，结节性病变内含有VZV。结论：(1)在神经节、神经纤维和中枢神经系统靶核可检测到病毒，提示VZV神经传播；（ii）在中枢神经微血管和播散性脑干脑炎中检测到病毒，提示VZV有血液传播；（iii）带状肌瘤可发生VZV肌炎；（iv） VZV可能是结节性脑干脑炎的病原体。
Nervous tissue lesions were retrospectively studied for detection of productive varicella zoster virus (VZV) infection in 33 autopsied cases, including 19 herpes zoster (HZ) (10 trigeminal, nine spinal) and 14 cases of nodular brainstem encephalitis without HZ. Immunocytochemistry for VZV antigens and in situ hybridization with a biotinylated VZV DNA probe were used on formol-fixed paraffin sections. Peripheral and central nervous system, skin and striated muscle were investigated in serial sections; available tissue blocks, however, varied between cases.Varicella zoster virus production (both antigen and DNA) in nervous tissue was found in HZ cases but only of short survival after a rash of up to 7 wks (eight out of 12 patients). Varicella zoster virus was visualized in nerve cells, glial cells, Schwann cells and blood vessels. In the central nervous system (CNS), VZV was detected in trigeminal nuclei (one out of 10 brains) or disseminated nodular brainstem lesions (one out of 10 brains), in subependymal microvessels (one out of 10 brains) or vasculitic arteries (two out of 19 brains or spinal cords). In the peripheral nervous system (PNS), VZV (DNA and antigen) was found in neurons and satellite cells of sensory ganglia (four out of seven cases with sampling of ganglia), and in damaged nerve fibres including a muscle nerve in one case; myositis with VZV in affected muscle fibres was found in the latter case. In nodular brainstem encephalitis, one case contained VZV within nodular lesions.We conclude that (i) VZV neural spread is suggested by detectable virus in ganglia, nerve fibres and CNS target nuclei; (ii) haematogenous spread of VZV is suggested by detection of virus in CNS microvessels and in disseminated brainstem encephalitis; (iii) VZV myositis may occur in zosteric myotomes; and (iv) VZV is a possible agent in nodular brainstem encephalitis.