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先天性人类巨细胞病毒感染与新生儿神经系统疾病。

Congenital human cytomegalovirus infection and neurologic diseases in newborns.

机构信息

Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.

出版信息

Chin Med J (Engl). 2019 Sep 5;132(17):2109-2118. doi: 10.1097/CM9.0000000000000404.

Abstract

OBJECTIVE

This review aimed to summarize research progress regarding congenital cytomegalovirus (cCMV) infection-related nervous system diseases and their mechanisms.

DATA SOURCES

All literature quoted in this review was retrieved from PubMed and Web of Science using the keywords "Cytomegalovirus" and "Neurologic disease" in English. To identify more important information, we did not set time limits.

STUDY SELECTION

Relevant articles were selected by carefully reading the titles and abstracts. Then, different diagnosis and clinical treatment methods for human CMV infection-related neurologic diseases were compared, and the main mechanism and pathogenesis of neurologic damage caused by CMV were summarized from the selected published articles.

RESULTS

cCMV infection is a major cause of neonatal malformation. cCMV can infect the fetal encephalon during early gestation and compromise neurodevelopment, resulting in varying degrees of neurologic damage, mainly including hearing impairment, central nervous system (CNS) infection, neurodevelopmental disorders, ophthalmic complications, cerebral neoplasms, infantile autism, epilepsy, and other neurologic abnormalities.

CONCLUSIONS

cCMV infection-induced neurodevelopmental abnormalities, which were directly caused by fetal encephalon infection, thus inducing neuroimmune responses to damage nerve cells. Such abnormalities were also caused by suppression of the proliferation and differentiation of neural progenitor cells by CMV's gene products. cCMV infection in the fetal encephalon can also inhibit neuronal migration and synapse formation and indirectly trigger placental inflammation and thus disrupt the oxygen supply to the fetus.

摘要

目的

本综述旨在总结先天性巨细胞病毒(cCMV)感染相关神经系统疾病及其机制的研究进展。

资料来源

本综述中引用的所有文献均通过在 PubMed 和 Web of Science 上使用英文关键词“Cytomegalovirus”和“Neurologic disease”进行检索。为了识别更重要的信息,我们没有设置时间限制。

研究选择

通过仔细阅读标题和摘要选择相关文章。然后,比较了人类 CMV 感染相关神经系统疾病的不同诊断和临床治疗方法,并从选定的已发表文章中总结了 CMV 引起神经损伤的主要机制和发病机制。

结果

cCMV 感染是新生儿畸形的主要原因。cCMV 可在妊娠早期感染胎儿大脑,损害神经发育,导致不同程度的神经损伤,主要包括听力障碍、中枢神经系统(CNS)感染、神经发育障碍、眼部并发症、脑肿瘤、婴儿自闭症、癫痫和其他神经异常。

结论

cCMV 感染引起的神经发育异常是由胎儿大脑感染直接引起的,从而引发神经免疫反应损伤神经细胞。CMV 的基因产物还通过抑制神经祖细胞的增殖和分化引起这种异常。cCMV 感染胎儿大脑还可以抑制神经元迁移和突触形成,并间接引发胎盘炎症,从而破坏胎儿的氧气供应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5004/6793797/554313b36076/cm9-132-2109-g001.jpg

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