Laboratory of Clinical Microbiology, University of Insubria Medical School, Viale Borri 57, 21100 Varese, Italy.
Post-Polio Health International, Saint Louis, Missouri, USA.
Int J Infect Dis. 2015 Jun;35:107-16. doi: 10.1016/j.ijid.2015.04.018. Epub 2015 May 1.
This review summarizes current concepts on post-polio syndrome (PPS), a condition that may arise in polio survivors after partial or complete functional recovery followed by a prolonged interval of stable neurological function. PPS affects 15-20 million people worldwide. Epidemiological data are reported, together with the pathogenic pathways that possibly lead to the progressive degeneration and loss of neuromuscular motor units. As a consequence of PPS, polio survivors experience new weakness, generalized fatigue, atrophy of previously unaffected muscles, and a physical decline that may culminate in the loss of independent life. Emphasis is given to the possible pathogenic role of persistent poliovirus infection and chronic inflammation. These factors could contribute to the neurological and physical decline in polio survivors. A perspective is then given on novel anti-poliovirus compounds and monoclonal antibodies that have been developed to contribute to the final phases of polio eradication. These agents could also be useful for the treatment or prevention of PPS. Some of these compounds/antibodies are in early clinical development. Finally, current clinical trials for PPS are reported. In this area, the intravenous infusion of normal human immunoglobulins appears both feasible and promising.
这篇综述总结了目前关于后灰质炎综合征（PPS）的概念，这是一种可能发生在部分或完全功能恢复后，经过长时间稳定神经功能期的脊髓灰质炎幸存者身上的疾病。PPS 影响全球 1500 万至 2000 万人。本文报告了流行病学数据，以及可能导致神经肌肉运动单位进行性退化和丧失的发病途径。由于 PPS，脊髓灰质炎幸存者会出现新的无力、全身疲劳、以前未受影响的肌肉萎缩以及身体衰退，最终可能导致丧失独立生活能力。本文强调了持续的脊髓灰质炎病毒感染和慢性炎症的可能致病作用。这些因素可能导致脊髓灰质炎幸存者的神经和身体衰退。然后，本文对新开发的抗脊髓灰质炎病毒化合物和单克隆抗体进行了展望，这些化合物和单克隆抗体有助于脊髓灰质炎的最终消除阶段。这些药物也可用于治疗或预防 PPS。其中一些化合物/抗体处于早期临床开发阶段。最后，本文报告了目前针对 PPS 的临床试验。在这一领域，静脉输注正常人免疫球蛋白似乎既可行又有前途。
