THE VIROLOGY OF DEMYELINATING DISEASES
THE VIROLOGY OF DEMYELINATING DISEASES
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DOI：
10.1002/ana.410360715
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发表时间：
1994-01-01
影响因子：
11.2
通讯作者：
JOHNSON, RT
中科院分区：
文献类型：
--
作者：
JOHNSON, RT
一个多世纪以来，传染性病原体一直被认为是多发性硬化症的病因。一种或多种病毒的可能作用得到以下数据的支持：(1)涉及儿童接触，“病毒”感染可能导致疾病恶化；(2)动物的实验感染和人类的自然感染可导致疾病潜伏期长，病程缓解和复发，以及脱髓鞘；(3)多发性硬化症患者对病毒有异常的免疫反应。讨论了三种已知病毒病因的人类脱髓鞘疾病的发病机制。在进行性多灶性白质脑病中，一种乳头状病毒选择性地感染少突胶质细胞并引起局灶性脱髓鞘。在麻疹后脑脊髓炎中，病毒是淋巴性的，破坏免疫调节，可导致自身免疫性静脉周围脱髓鞘疾病，而没有中枢神经系统感染的证据。在人类免疫缺陷病毒中，脑病和脊髓病病毒存在于巨噬细胞和小胶质细胞中，髓磷脂异常显然是由可溶性因子如病毒蛋白、细胞因子或神经毒素引起的。这些发现可能对如何、何时、何地在多发性硬化症中寻找病毒具有启示意义。
Infectious agents have been postulated as causes of multiple sclerosis for over a century. The possible role of a virus or viruses is supported by data that (1) a childhood exposure is involved and ''viral'' infections may precipitate exacerbations of disease, (2) experimental infections in animals and natural infections in humans can cause diseases with long incubation periods, remitting and relapsing courses, and demyelination, and (3) patients with multiple sclerosis have abnormal immune responses to viruses. The pathogenesis of three human demyelinating diseases of known viral etiology is discussed. In progressive multifocal leukoencephalopathy, a papovavirus selectively infects oligodendrocytes and causes focal areas of demyelination. In postmeasles encephalomyelitis, the virus is lymphotrophic and disrupts immune regulation that can result in an autoimmune perivenular demyelinating illness without evidence of infection of the central nervous system. In human immunodeficiency virus-encephalopathy and myelopathy virus is present in macrophages and microglia and the myelin abnormalities apparently are caused by soluble factors such as viral proteins, cytokines, or neurotoxins. These findings may have implications on how, when, and where to seek viruses in multiple sclerosis.