Moench T R, Griffin D E, Obriecht C R, Vaisberg A J, Johnson R T
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
J Infect Dis. 1988 Aug;158(2):433-42. doi: 10.1093/infdis/158.2.433.
Using peroxidase immunohistochemistry and in situ hybridization to localize viral antigen and RNA, we studied autopsy tissues from 20 cases of acute fatal human measles (including seven patients with acute encephalomyelitis) and peripheral blood mononuclear cells from 16 patients with acute, nonfatal measles. In immunologically normal patients, virus was detected in five of nine who died five days or less after the onset of rash but in none of 11 who died later. Virus was localized to epithelial cells of lung, gut, bile duct, bladder, and skin and to lymphoid organs. Neither viral antigen nor RNA was detected in brain sections from 14 patients, including seven with acute encephalomyelitis and four with virus identified in other tissues, a finding supporting an indirect pathogenesis of post-measles encephalomyelitis. These data show that measles virus replicates in cells previously not recognized to be involved (capillary endothelium of lymph node and thymus, Hassall's corpuscles, and hepatic duct epithelium) and that invasion of the brain parenchyma during acute measles is uncommon.
我们运用过氧化物酶免疫组化和原位杂交技术来定位病毒抗原和RNA，研究了20例急性致死性人类麻疹患者的尸检组织（包括7例急性脑脊髓炎患者）以及16例急性非致死性麻疹患者的外周血单个核细胞。在免疫功能正常的患者中，出疹后5天及以内死亡的9例患者中有5例检测到病毒，而出疹后较晚死亡的11例患者中均未检测到病毒。病毒定位于肺、肠道、胆管、膀胱和皮肤的上皮细胞以及淋巴器官。14例患者的脑切片中均未检测到病毒抗原和RNA，其中包括7例急性脑脊髓炎患者和4例在其他组织中鉴定出病毒的患者，这一发现支持麻疹后脑脊髓炎的间接发病机制。这些数据表明，麻疹病毒在先前未被认为参与其中的细胞（淋巴结和胸腺的毛细血管内皮、哈氏小体和肝管上皮）中复制，并且在急性麻疹期间脑实质的侵袭并不常见。
