Research Center for Immunodeficiencies, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Network of Immunology in Infections, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
J Clin Immunol. 2018 Jul;38(5):610-616. doi: 10.1007/s10875-018-0521-z. Epub 2018 Jun 14.
The use of oral poliovirus vaccine in a worldwide scale has led to a 99.9% decrease in annual incidence of wild-type poliomyelitis and the eradication of serotype 2 poliovirus. However, the emergence of vaccine-derived polioviruses (VDPVs) is endangering the eradication program. Patients with combined immunodeficiencies are at increased risk of both vaccine-associated poliomyelitis and prolonged asymptomatic infection with immunodeficiency-associated VDPVs (iVDPVs). Herein, we present a severe combined immunodeficiency patient with prolonged and asymptomatic iVDPV infection. He continued to shed poliovirus during immunoglobulin replacement therapy and cleared the infection following successful hematopoietic stem cell transplantation (HSCT). To explain the efficiency of HSCT in clearing the infection, we reviewed the literature for all reports of HSCT in iVDPV-excreting patients and discussed novel ideas about the role of different immune mechanisms, including cell-mediated interactions, in mounting immune responses against poliovirus infections. This study could provide further insights into the immune mechanisms contributing to the clearance of enteroviral infections.
在全球范围内使用口服脊髓灰质炎疫苗使得野生型脊髓灰质炎的年发病率降低了 99.9%，并消灭了血清型 2 脊髓灰质炎病毒。然而，疫苗衍生脊髓灰质炎病毒（VDPV）的出现正在危及消灭脊髓灰质炎计划。合并免疫缺陷的患者罹患疫苗相关脊髓灰质炎和免疫缺陷相关 VDPV（iVDPV）的无症状长期感染的风险增加。在此，我们报告了一例严重联合免疫缺陷患者，他存在 iVDPV 的无症状长期感染。在接受免疫球蛋白替代治疗期间，他持续排出脊髓灰质炎病毒，并在成功进行造血干细胞移植（HSCT）后清除了感染。为了解释 HSCT 清除感染的效率，我们回顾了所有报告 HSCT 治疗 iVDPV 排出患者的文献，并讨论了不同免疫机制（包括细胞介导的相互作用）在引发针对脊髓灰质炎病毒感染的免疫反应中的作用的新观点。这项研究可以进一步深入了解有助于清除肠道病毒感染的免疫机制。
