Department of Biochemistry, University of Alberta, Edmonton, Alberta, Canada.
J Infect Dis. 2013 May 1;207(9):1451-6. doi: 10.1093/infdis/jis479. Epub 2012 Aug 21.
Rabies virus (RV) infection is a fatal nervous system disorder. We describe a patient who died of rabies despite a neuroprotective intervention. Neuropathology showed neuronal loss with abundant RV antigen, genome, and Negri bodies, accompanied by intense neuroinflammation, including by CD8(+) T lymphocyte infiltrates. Deep sequencing and real-time reverse-transcription polymerase chain reaction revealed RNA encoding a bat RV strain together with inflammatory gene induction. RV-infected brain demonstrated reduced neuronal metabolites with an anaerobic metabolic profile by nuclear magnetic resonance (NMR) spectroscopy. These multiplatform studies highlight the extent of ongoing viral replication coupled with inflammation in treated rabies, indicative of a neurological immune reconstitution inflammatory syndrome.
狂犬病病毒（RV）感染是一种致命的神经系统疾病。我们描述了一名患者，尽管进行了神经保护干预，但仍死于狂犬病。神经病理学显示神经元丢失，伴有丰富的 RV 抗原、基因组和内格里体，伴有强烈的神经炎症，包括 CD8(+)T 淋巴细胞浸润。深度测序和实时逆转录聚合酶链反应显示 RNA 编码一种蝙蝠 RV 株，同时伴有炎症基因诱导。NMR 光谱显示，狂犬病感染的大脑神经元代谢物减少，表现出厌氧代谢特征。这些多平台研究强调了治疗性狂犬病中持续病毒复制与炎症的程度，表明存在神经免疫重建炎症综合征。
