Arpino Carla, Curatolo Paolo, Rezza Giovanni
Child Neurology Unit, Tor Vergata University, Roma, Italy.
Rev Med Virol. 2009 May;19(3):121-9. doi: 10.1002/rmv.606.
Chikungunya virus (CHIKV), an alphavirus transmitted by mosquitoes of the Aedes genus, has recently re-emerged, causing epidemics on Indian Ocean Islands and the Indian subcontinent, and an unexpected outbreak in north-eastern Italy. CHIKV infection was first reported to affect the nervous system in the 1960s; in the early 1970s it was found to be associated with meningoencephalopathy, myelitis, and choroiditis, and animal studies appeared to confirm that CHIKV was neurotropic. Nonetheless, CHIKV has never been considered as a 'true' neurotropic virus. The re-emergence of CHIKV infection in areas with efficient clinical facilities has allowed CHIKV-related neurological disease to be better defined both in adults and children. Encephalopathy appears to represent the most common clinical manifestation among newborns infected through mother-to-child transmission. Although data are still scarce, the ratio between cases with and without CNS involvement for CHIKV appears to be comparable with that for other neurotropic viruses. Unfortunately, the neurotropism of CHIKV has not been completely defined, and different animal studies show inconsistencies with regard to the capacity of the virus to invade and replicate in the brain parenchyma. This merits further investigation in light of the emergence of the virus in previously unaffected areas and of the clinical evidence of CNS involvement in a considerable proportion of symptomatic cases.
基孔肯雅病毒（CHIKV）是一种由伊蚊属蚊子传播的甲病毒，最近再次出现，在印度洋岛屿和印度次大陆引发了疫情，并在意东北部意外爆发。20世纪60年代首次报道CHIKV感染会影响神经系统；20世纪70年代初发现它与脑膜脑炎、脊髓炎和脉络膜炎有关，动物研究似乎证实CHIKV具有嗜神经性。尽管如此，CHIKV从未被视为一种“真正的”嗜神经病毒。在拥有高效临床设施的地区，CHIKV感染的再次出现使得与CHIKV相关的神经系统疾病在成人和儿童中都得到了更好的定义。脑病似乎是通过母婴传播感染的新生儿中最常见的临床表现。尽管数据仍然稀少，但CHIKV有中枢神经系统（CNS）受累和无CNS受累病例的比例似乎与其他嗜神经病毒相当。不幸的是，CHIKV的嗜神经性尚未完全明确，不同的动物研究在病毒侵入脑实质并在其中复制的能力方面存在不一致。鉴于该病毒在以前未受影响的地区出现，以及有相当比例的有症状病例存在CNS受累的临床证据，这值得进一步研究。
