Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence
Acute enterovirus infection followed by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and viral persistence
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DOI：
10.1136/jcp.2009.070466
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发表时间：
2010-02-01
影响因子：
3.4
通讯作者：
Chang, R.
中科院分区：
文献类型：
--
作者：
Chia, J.;Chia, A.;Chang, R.
目的肠道病毒是引起急性呼吸道和/或胃肠道感染以及非特异性流感样疾病的常见病原。虽然肠病毒蛋白、RNA和非致细胞病变病毒已在肌痛脑脊髓炎/慢性疲劳综合征（ME/CFS）患者的胃活检中得到证实，但在没有充分记录的急性肠病毒感染病例的情况下，难以确定慢性疾病的因果关系。本研究的目的是链接急性肠道病毒感染的病毒持续存在的ME/CFS.Method患者入院急性发热性疾病的肠道病毒感染进行筛选。急性感染的患者进行了纵向随访，和那些谁开发的ME/CFS的症状进行食管胃镜检查和活检的胃窦病毒持久性的免疫过氧化物酶染色的病毒蛋白和病毒RNA assay.Results三个代表性的急性肠道病毒感染的不同表现的患者进展到有慢性症状的ME/CFS。结论急性感染后肠道病毒可在患者体内持续存在，导致ME/CFS的临床表现。免疫活性宿主中的慢性肠道病毒感染可能是减毒细胞内病毒和无效免疫应答之间的僵局的一个实例。
Aims Enteroviruses are well-known causes of acute respiratory and/or gastrointestinal infections and nonspecific flu-like illness. Although enterovirus protein, RNA and non-cytopathic viruses have been demonstrated in the stomach biopsies of patients with myalgia encephalomyelitis/chronic fatigue syndrome (ME/CFS), causality for chronic diseases is difficult to establish without having well-documented cases of acute enterovirus infections. The aim of this study was to link acute enteroviral infection to viral persistence in patients with ME/CFS.Method Patients admitted to the hospital with acute febrile illnesses were screened for enteroviral infections. Acutely infected patients were followed longitudinally, and those who developed symptoms of ME/CFS underwent oesophagogastroduodenoscopy and biopsies of the antrum to document viral persistence by immunoperoxidase staining for viral protein and viral RNA assay.Results Three representative patients with different manifestations of acute enterovirus infections progressed to have chronic symptoms of ME/CFS. Persistent viral infection was demonstrated in the antrum years later.Conclusion After acute infections, enteroviruses can persist in patients resulting in manifestation of ME/CFS. Chronic enterovirus infection in an immunocompetent host may be an example of a stalemate between attenuated, intracellular viruses and an ineffective immune response.