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中枢神经系统的慢性病毒感染:多发性硬化症的特定方面

Chronic viral infections of the central nervous system: Aspects specific to multiple sclerosis.

作者信息

Giraudon P, Bernard A

机构信息

Inserm U, Lyon, France.

出版信息

Rev Neurol (Paris). 2009 Oct;165(10):789-95. doi: 10.1016/j.neurol.2009.07.004. Epub 2009 Aug 4.

Abstract

The involvement of a viral infection in the physiopathology of multiple sclerosis has been said to cause certain viruses to target the central nervous system and induce neuroinflammation leading to cell dysfunction, as seen, for example, by demyelination or neuronal death. The most recent results of the literature have focused on the Herpes family viruses (HHV-6 and HHV-4/Epstein-Barr virus) and their possible role in the development of multiple sclerosis. Even if no virus has been identified so far as the multiple sclerosis etiological agent, our aim here is to show that some viruses may be responsible for triggering or sustaining neurological diseases. This is particularly the case for Paramyxoviruses, in the late appearance of functional alterations, Picornaviruses, in inducing a breakdown of immune tolerance, epitope spreading and demyelination, and Herpes viruses in inducing T and B lymphocyte activation, T lymphocytes dysregulation and autoimmunity after their reactivation. Therefore, "common" viruses can play a role as potential modulators of the immune and nervous systems which, in the specific context of dysimmunity and genetic susceptibility, stimulate a favorable background to the development of multiple sclerosis. Tracing and studying viruses in multiple sclerosis patients may improve our understanding of their actual involvement in multiple sclerosis physiopathology.

摘要

据说病毒感染参与多发性硬化症的病理生理过程,会导致某些病毒靶向中枢神经系统并引发神经炎症,进而导致细胞功能障碍,例如脱髓鞘或神经元死亡。文献的最新研究结果聚焦于疱疹病毒家族(HHV-6和HHV-4/爱泼斯坦-巴尔病毒)及其在多发性硬化症发展中的可能作用。尽管目前尚未确定哪种病毒是多发性硬化症的病原体,但我们在此的目的是表明某些病毒可能是引发或维持神经疾病的原因。副粘病毒在功能改变的后期出现这种情况,小核糖核酸病毒在诱导免疫耐受破坏、表位扩展和脱髓鞘方面是如此,疱疹病毒在其重新激活后诱导T和B淋巴细胞活化、T淋巴细胞失调和自身免疫也是如此。因此,“常见”病毒可作为免疫和神经系统的潜在调节因子,在免疫失调和遗传易感性的特定背景下,为多发性硬化症的发展营造有利环境。追踪和研究多发性硬化症患者体内的病毒,可能会增进我们对它们在多发性硬化症病理生理过程中实际作用的理解。

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