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

15岁以下儿童急性脑炎/脑病的年发病率约为1，000例，其中25%为流感相关脑病，其次是HHV-6或7引起的脑病/脑炎（12%），腮腺炎和轮状病毒引起的CNS脑炎/脑病（4-5%）。尽管流感相关脑病的发病机制仍不清楚，但一些报道已经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-1 β（IL-1β）、IL-6、TNF-α、IL-8和IL-10。已经表明，在流感相关脑病中，高细胞因子血症导致神经元和肝细胞被诱导进行细胞凋亡。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，在脑中不能发现病毒复制，而发现与高细胞因子血症相关的严重脑和肺水肿。因此，不仅在流感中，而且在其他病毒感染中，由于没有病毒复制的高细胞因子血症可能发生脑损伤。这些发现可能对疾病的管理很重要。此外，本研究还为HSV脑炎、HHV-6脑病和EBV CNS感染的早期诊断提供了一种新的方法。

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.