Emerging Infections of CNS: Avian Influenza A Virus, Rift Valley Fever Virus and Human Parechovirus.
Emerging Infections of CNS: Avian Influenza A Virus, Rift Valley Fever Virus and Human Parechovirus.
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DOI：
10.1111/bpa.12281
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Bissel SJ
中科院分区：
文献类型：
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作者：
Wiley CA;Bhardwaj N;Ross TM;Bissel SJ
历史上充斥着导致人类大量死亡的紧急大流行感染。考虑到现在地球上挤满了大量的人类，我们有充分的理由怀疑历史会重演。我们描述了最近在人类群体中出现的三种RNA病毒，它们介导了严重的神经疾病。这些新疾病是感染性病原体的新突变或接触病原体的新途径或两者兼而有之的结果。为了了解它们的发病机制，我们总结了基本的病毒学和对每种病原体的免疫反应。感染是在已知宿主防御的背景下描述的。一旦病毒逃避免疫防御并进入中枢神经系统细胞，它们就会迅速利用宿主的RNA处理达到灾难性的程度。目前尚不清楚为什么大脑对RNA病毒特别敏感；但可能由于大脑的生理功能对RNA处理的高度依赖，经典的宿主防御机制(例如，干扰素破坏病毒复制)已经减弱或不可用。对免疫、免疫和药物治疗的有效性进行了审查，以了解公共卫生挑战的范围。不幸的是，通过非传统途径接触疫苗后，提供对系统性疾病的保护的疫苗并不一定对大脑提供保护。
History is replete with emergent pandemic infections that have decimated the human population. Given the shear mass of humans that now crowd the earth, there is every reason to suspect history will repeat itself. We describe three RNA viruses that have recently emerged in the human population to mediate severe neurological disease. These new diseases are results of new mutations in the infectious agents or new exposure pathways to the agents or both. To appreciate their pathogenesis, we summarize the essential virology and immune response to each agent. Infection is described in the context of known host defenses. Once the viruses evade immune defenses and enter CNS cells, they rapidly co-opt host RNA processing to a cataclysmic extent. It is not clear why the brain is particularly susceptible to RNA viruses; but perhaps because of its tremendous dependence on RNA processing for physiological functioning, classical mechanisms of host defense (e.g. interferon disruption of viral replication) are diminished or not available. Effectiveness of immunity, immunization and pharmacological therapies is reviewed to contextualize the scope of the public health challenge. Unfortunately, vaccines that confer protection from systemic disease do not necessarily confer protection for the brain after exposure through unconventional routes.