Ordoñez Graciela, Pineda Benjamin, Garcia-Navarrete Roberto, Sotelo Julio
Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico, Mexico City.
Arch Neurol. 2004 Apr;61(4):529-32. doi: 10.1001/archneur.61.4.529.
A possible viral cause for multiple sclerosis (MS) has long been suspected. A progressive increase in MS has been reported in Mexico during the past 20 years; a conspicuous antecedent of varicella infection during childhood has been the most relevant finding in the medical history of patients with MS.
To investigate the possible participation of varicella-zoster virus (VZV) in the etiopathogenesis of MS.
DESIGN, SETTING, AND PATIENTS: We searched, by polymerase chain reaction (PCR), for VZV DNA in peripheral mononuclear cells of 82 patients with relapsing-remitting MS. Additionally, genes gD from herpes simplex viruses 1 and 2 were sought by PCR, as well as IgG and IgM serum antibodies to VZV.
Viral DNA from the genes open reading frame (ORF)31, ORF62, ORF63, and ORF67 of VZV was found in mononuclear cells from 13 (87%) of 15 patients with MS who were tested during acute relapse. All patients who were tested during remission (n = 67) were negative for the DNA, including patients who were initially positive and were tested again after 2 months of remission. All control patients with a comprehensive variety of neurologic diseases (n = 100) and healthy controls (n = 20) also tested negative. All subjects were negative for herpes simplex viruses 1 and 2 DNA, and no differences were found in serum antibodies to VZV.
The finding of genes of VZV in peripheral mononuclear cells, restricted to a brief period during clinical relapse of MS, suggests either its participation in the etiopathogenesis of MS or an epiphenomenon of viral activation simultaneous with the relapse of MS.
长期以来人们一直怀疑多发性硬化症(MS)可能由病毒引起。据报道,在过去20年中墨西哥的MS发病率呈逐渐上升趋势;儿童期水痘感染这一显著病史是MS患者病史中最相关的发现。
研究水痘带状疱疹病毒(VZV)在MS发病机制中的可能作用。
设计、场所和患者:我们通过聚合酶链反应(PCR)在82例复发缓解型MS患者的外周单个核细胞中寻找VZV DNA。此外,通过PCR寻找单纯疱疹病毒1型和2型的gD基因,以及针对VZV的血清IgG和IgM抗体。
在15例急性复发期接受检测的MS患者中,有13例(87%)的单个核细胞中发现了VZV基因开放阅读框(ORF)31、ORF62、ORF63和ORF67的病毒DNA。所有缓解期接受检测的患者(n = 67)DNA均为阴性,包括最初呈阳性且在缓解2个月后再次检测的患者。所有患有各种神经系统疾病的对照患者(n = 100)和健康对照者(n = 20)检测结果也均为阴性。所有受试者的单纯疱疹病毒1型和2型DNA均为阴性,VZV血清抗体未发现差异。
在MS临床复发的短暂期间外周单个核细胞中发现VZV基因,提示其要么参与了MS的发病机制,要么是与MS复发同时发生的病毒激活的一种附带现象。