Parvovirus B19 Infection in Children With Arterial Ischemic Stroke.
Parvovirus B19 Infection in Children With Arterial Ischemic Stroke.
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DOI：
10.1161/strokeaha.117.018272
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发表时间：
2017-10
期刊：
影响因子：
8.3
通讯作者：
VIPS Investigators*
中科院分区：
文献类型：
--
作者：
Fullerton HJ;Luna JM;Wintermark M;Hills NK;Tokarz R;Li Y;Glaser C;DeVeber GA;Lipkin WI;Elkind MSV;VIPS Investigators*
病例对照研究表明，急性感染会短暂增加儿童动脉缺血性卒中（AIS）的风险。我们假设，一个公正的病原体发现方法，利用MassTag聚合酶链反应（PCR）将确定病原体在儿童AIS病例的血液。多中心国际“儿科卒中感染的血管效应”研究招募了年龄为29天至18岁的AIS病例和无卒中对照。父母访谈包括关于最近感染的问题。在这项初步研究中，我们使用MassTag-PCR检测了前161例病例和34例对照的血浆，这些病例和对照被纳入了一组28种常见的细菌和病毒病原体。14例（8.7%）病例中检出病原体DNA：细小病毒B19（n=10）、疱疹病毒6（n=2）、腺病毒（n=1）和鼻病毒6C（n=1）。细小病毒B19感染证实血清学在所有十个;感染是亚临床的八个。4例细小病毒B19有潜在的先天性心脏病，而另外5例有明显的动脉病变，涉及颈内动脉远端和大脑中动脉近端的长段狭窄。使用MassTag-PCR，我们检测到细小病毒B19，一种已知感染红细胞和内皮细胞的病毒，在一些儿童AIS病例中。这种方法可以产生新的，可验证的假说，儿童中风的发病机制。
Case-control studies suggest that acute infection transiently increases the risk of childhood arterial ischemic stroke (AIS). We hypothesized that an unbiased pathogen discovery approach utilizing MassTag polymerase chain reaction (PCR) would identify pathogens in the blood of childhood AIS cases. The multi-center international “Vascular effects of Infection in Pediatric Stroke” study enrolled AIS cases, and stroke-free controls, aged 29 days through 18 years. Parental interview included questions on recent infections. In this pilot study, we used MassTag-PCR to test the plasma of the first 161 cases and 34 controls enrolled for a panel of 28 common bacterial and viral pathogens. Pathogen DNA was detected in no controls and 14 cases (8.7%): parvovirus B19 (n=10), herpesvirus 6 (n=2), adenovirus (n=1), and rhinovirus 6C (n=1). Parvovirus B19 infection was confirmed by serologies in all ten; infection was subclinical in eight. Four cases with parvovirus B19 had underlying congenital heart disease, while another five had a distinct arteriopathy involving a long-segment stenosis of the distal internal carotid and proximal middle cerebral arteries. Using MassTag-PCR, we detected Parvovirus B19, a virus known to infect erythrocytes and endothelial cells, in some cases of childhood AIS. This approach can generate new, testable hypotheses about childhood stroke pathogenesis.