Research on the pathogenesis, clinical features, diagnostic methods and treatment of acute encephalitis/encephalopathy.

在15岁以下儿童中，急性脑炎/脑病的年发病率约为1,000例，其中25%是流感相关脑病，其次是由HHV-6或7引起的脑病/脑炎（12%），腮腺炎和轮状病毒中枢脑炎/脑病（4-5%）。虽然流感相关脑病的发病机制尚不清楚，但一些报道表明，发病机制涉及细胞因子，如可溶性肿瘤坏死因子（sTNF）受体1、白细胞介素-1β (IL-1β)、IL-6、TNF-a、IL-8和IL-10。有研究表明，在流感相关脑病中，由于高细胞分裂血症，神经元和肝细胞被诱导进行凋亡。相比之下，其他病毒性脑炎/脑病的发病机制尚不清楚。在轮状病毒脑病中，在大脑中无法发现病毒复制，而严重的脑和肺水肿与高细胞分裂血症有关。因此，不仅在流感中，而且在其他病毒感染中，由于高细胞分裂血症而没有病毒复制，可能会发生脑损伤。这些发现可能对疾病的管理很重要。此外，我们还可以建立多重PCR系统，用于早期诊断HSV脑炎、HHV-6脑病和EBV CNS感染。

The annual incidence of acute encephalitis/encephalopathy among children younger than 15 years old is approximately 1,000 cases and 25% of them are influenza-associated encephalopathy, followed by encephalopathy/encephalitis caused by HHV-6 or 7 (12%), mumps and rotavirus CNS encephalitis/encephalopathy (4-5%). Although the pathogenesis of influenza-associated encephalopathy is still unclear, several reports have suggested that the pathogenesis involves cytokines such as soluble tumor necrosis factor (sTNF) receptor-1, interleukin-1β (IL-1β), IL-6, TNF-a, IL-8, and IL-10. It has been suggested that neurons and hepatocytes are induced to undergo apoptosis in influenza-associated encephalopathy as a consequence of hypercytokinemia. In contrast, the pathogenesis of other viral encephalitis/encephalopathy is still unclear. In rotavirus encephalopathy, the virus replication could not be found in the brain, while severe brain and lung edema was found associated with hyper cytokinemia. Therefore, not only in influenza but in other virus infections, brain damage may occur due to hyper cytokinemia without virus replication. These findings might be important for the management of the illness. In addition, we could develop multiplex PCR system for the early diagnosis of HSV encephalitis, HHV-6 encephalopathy and EBV CNS infections.