Ordoñez Graciela, Martinez-Palomo Adolfo, Corona Teresa, Pineda Benjamin, Flores-Rivera Jose, Gonzalez Alberto, Chavez-Munguia Bibiana, Sotelo Julio
Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico, Mexico.
Clin Neurol Neurosurg. 2010 Oct;112(8):653-7. doi: 10.1016/j.clineuro.2010.04.018. Epub 2010 May 18.
The apparent association between varicella zoster virus (VZV) and multiple sclerosis (MS) has been described. In patients with relapse/remission (R/R) MS we have found high loads of VZV DNA in lymphocytes and in cerebrospinal fluid (CSF), as well as abundant viral particles in CSF visualized by electron microscopy at the time of relapse. Both, the molecular and the ultrastructural evidence of VZV became negative in the same patients at the time of remission.
In the present study we analyzed the presence of VZV in patients with progressive forms of MS; DNA from VZV was searched by real-time PCR in blood lymphocytes and in CSF of 20 patients with progressive MS. Ultrastructural study searching for viral particles in CSF was made with transmission electron microscopy.
VZV DNA was found in the CSF from 65% of cases with progressive MS- and VZV-like viral particles were found in 30% of these patients. Nonetheless, the amount of DNA and the number of viral particles were lower than those that have been found in MS patients with R/R at the time of relapse, but higher than those found during remission.
Similar to findings in patients with R/R MS, VZV might be associated to progressive MS, but in minor quantity. In these cases, the virus may produce a chronic, relentless infection or trigger a process of immune-mediated demyelination.
水痘带状疱疹病毒（VZV）与多发性硬化症（MS）之间的明显关联已被描述。在复发/缓解型（R/R）MS患者中，我们发现淋巴细胞和脑脊液（CSF）中VZV DNA含量很高，并且在复发时通过电子显微镜观察到CSF中有大量病毒颗粒。在缓解期，同一患者的VZV分子和超微结构证据均变为阴性。
在本研究中，我们分析了进展型MS患者中VZV的存在情况；通过实时PCR在20例进展型MS患者的血液淋巴细胞和CSF中搜索VZV的DNA。用透射电子显微镜对CSF中的病毒颗粒进行超微结构研究。
在65%的进展型MS病例的CSF中发现了VZV DNA，在这些患者中有30%发现了VZV样病毒颗粒。尽管如此，DNA量和病毒颗粒数量低于复发时R/R型MS患者中发现的量，但高于缓解期发现的量。
与R/R型MS患者的发现相似，VZV可能与进展型MS有关，但数量较少。在这些病例中，病毒可能产生慢性、持续性感染或引发免疫介导的脱髓鞘过程。
