大脑中的疱疹病毒与阿尔茨海默病

Herpesviruses in brain and Alzheimer's disease.

作者信息

Lin Woan-Ru, Wozniak Matthew A, Cooper Robert J, Wilcock Gordon K, Itzhaki Ruth F

机构信息

Department of Optometry and Neuroscience, UMIST, Manchester, UK.

出版信息

J Pathol. 2002 Jul;197(3):395-402. doi: 10.1002/path.1127.

Abstract

It has been established, using polymerase chain reaction (PCR), that herpes simplex virus type 1 (HSV1) is present in a high proportion of brains of elderly normal subjects and Alzheimer's disease (AD) patients. It was subsequently discovered that the virus confers a strong risk of AD when in brain of carriers of the type 4 allele of the apolipoprotein E gene (apoE-epsilon4). This study has now sought, using PCR, the presence of three other herpesviruses in brain: human herpesvirus 6 (HHV6)-types A and B, herpes simplex virus type 2 (HSV2) and cytomegalovirus (CMV). HHV6 is present in a much higher proportion of the AD than of age-matched normal brains (70% vs. 40%, p=0.003) and there is extensive overlap with the presence of HSV1 in AD brains, but HHV6, unlike HSV1, is not directly associated in AD with apoE-epsilon4. In 59% of the AD patients' brains harbouring HHV6, type B is present while 38% harbour both type A and type B, and 3% type A. HSV2 is present at relatively low frequency in brains of both AD patients and normals (13% and 20%), and CMV at rather higher frequencies in the two groups (36% and 35%); in neither case is the difference between the groups statistically significant. It is suggested that the striking difference in the proportion of elderly brains harbouring HSV1 and HSV2 might reflect the lower proportion of people infected with the latter, or the difference in susceptibility of the frontotemporal regions to the two viruses. In the case of HHV6, it is not possible to exclude its presence as an opportunist, but alternatively, it might enhance the damage caused by HSV1 and apoE-epsilon4 in AD; in some viral diseases it is associated with characteristic brain lesions and it also augments the damage caused by certain viruses in cell culture and in animals.

摘要

通过聚合酶链反应(PCR)已证实,单纯疱疹病毒1型(HSV1)在老年正常受试者和阿尔茨海默病(AD)患者的大脑中大量存在。随后发现,当该病毒存在于载脂蛋白E基因(apoE-ε4)4型等位基因携带者的大脑中时,会带来患AD的高风险。本研究现在利用PCR检测大脑中其他三种疱疹病毒的存在情况:人类疱疹病毒6型(HHV6)的A、B亚型、单纯疱疹病毒2型(HSV2)和巨细胞病毒(CMV)。与年龄匹配的正常大脑相比,HHV6在AD大脑中的存在比例要高得多(70%对40%,p = 0.003),并且与AD大脑中HSV1的存在有广泛重叠,但与HSV1不同的是,HHV6在AD中与apoE-ε4没有直接关联。在携带HHV6的AD患者大脑中,59%存在B型,38%同时存在A、B型,3%存在A型。HSV2在AD患者和正常人大脑中的出现频率相对较低(分别为13%和20%),而CMV在两组中的出现频率相对较高(分别为36%和35%);两组之间的差异在两种情况下均无统计学意义。有人认为,携带HSV1和HSV2的老年大脑比例存在显著差异,可能反映了感染后者的人群比例较低,或者额颞叶区域对这两种病毒的易感性差异。对于HHV6,不能排除其作为机会性感染源的存在,但也有可能它会加重HSV1和apoE-ε4在AD中造成的损害;在一些病毒性疾病中,它与特征性脑损伤有关,并且在细胞培养和动物实验中也会加重某些病毒造成的损害。

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