Systemic distribution of West Nile virus infection: Postmortem immunohistochemical study of six cases
Systemic distribution of West Nile virus infection: Postmortem immunohistochemical study of six cases
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DOI：
10.1111/j.1750-3639.2007.00080.x
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发表时间：
2007-10-01
期刊：
影响因子：
6.4
通讯作者：
Wiley, Clayton A.
中科院分区：
文献类型：
--
作者：
Armah, Henry B.;Wang, Guoji;Wiley, Clayton A.
已有罕见的中枢神经系统（CNS）外与西尼罗河病毒（WNV）相关的炎症病例报道。我们使用免疫组织化学方法评估了 6 名脑炎患者死后组织中 WNV 的全身分布。中枢神经系统神经元（全部6例）、肾脏（4例）、肺（2例）、胰腺（2例）、甲状腺（2例）、肠（2例）、胃（1例）、食管（1例）、胆管（1例）、皮肤（1例）、前列腺（1例）和睾丸（1例）中检测到WNV抗原。全身器官的上皮细胞被感染。在这六例病例中，肝细胞、心脏、肾上腺、神经、骨骼肌、骨骼、血管和脂肪中均未检测到病毒抗原。除中枢神经系统外，所有在全身器官中发现病毒抗原的病例都是免疫功能严重受损的移植受者。除睾丸和大脑外，大多数感染灶与炎症无关。虽然没有炎症可能部分是由于患者免疫抑制或任何宿主反应可能短暂的性质，但病毒抗原在上皮细胞腔区域的区室化可能会隔离西尼罗河病毒免遭免疫识别。我们的研究结果与之前的报告进行比较表明，西尼罗河病毒脑炎患者可能存在广泛的全身感染。
Rare cases of West Nile virus (WNV)-associated inflammation outside the central nervous system (CNS) have been reported. We evaluated the systemic distribution of WNV in postmortem tissues during encephalitis in six patients using immunohistochemistry. WNV antigens were detected in neurons of CNS (all 6 cases), kidney (4 cases), lungs (2 cases), pancreas (2 cases), thyroid (2 cases), intestine (2 cases), stomach (1 case), esophagus (1 case), bile duct (1 case), skin (1 case), prostate (1 case) and testis (1 case). In systemic organs epithelial cells were infected. In none of the six cases were viral antigens identified in hepatocytes, heart, adrenal gland, nerves, skeletal muscles, bone, vessels and fat. All cases in which viral antigens were identified in systemic organs in addition to CNS were severely immunocompromised transplant recipients. With the exception of testis and brain, most foci of infection were not associated with inflammation. While the absence of inflammation may in part be due to patient immunosuppression or to possible transient nature of any host response, compartmentalization of viral antigen to the luminal region of epithelial cells may sequester WNV from immune recognition. Comparison of our findings with previous reports suggests that patients with WNV encephalitis can have widespread systemic infection.