CIRI, International Center for Infectiology Research, INSERM U1111, University of Lyon, University Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, France.
Viruses. 2019 Nov 2;11(11):1017. doi: 10.3390/v11111017.
Measles remains a major cause of morbidity and mortality worldwide among vaccine preventable diseases. Recent decline in vaccination coverage resulted in re-emergence of measles outbreaks. Measles virus (MeV) infection causes an acute systemic disease, associated in certain cases with central nervous system (CNS) infection leading to lethal neurological disease. Early following MeV infection some patients develop acute post-infectious measles encephalitis (APME), which is not associated with direct infection of the brain. MeV can also infect the CNS and cause sub-acute sclerosing panencephalitis (SSPE) in immunocompetent people or measles inclusion-body encephalitis (MIBE) in immunocompromised patients. To date, cellular and molecular mechanisms governing CNS invasion are still poorly understood. Moreover, the known MeV entry receptors are not expressed in the CNS and how MeV enters and spreads in the brain is not fully understood. Different antiviral treatments have been tested and validated in vitro, ex vivo and in vivo mainly in small animal models. Most treatments have high efficacy at preventing infection but their effectiveness after CNS manifestations remains to be evaluated. This review describes MeV neural infection and current most advanced therapeutic approaches potentially applicable to treat MeV CNS infection.
麻疹仍然是全球范围内可通过疫苗预防的疾病中导致发病率和死亡率的主要原因。最近疫苗接种覆盖率下降导致麻疹疫情再次出现。麻疹病毒（MeV）感染会导致急性全身性疾病，在某些情况下与中枢神经系统（CNS）感染相关，导致致命的神经疾病。在 MeV 感染后早期，一些患者会发展为急性感染后麻疹脑炎（APME），这与大脑的直接感染无关。MeV 还可以感染中枢神经系统，并在免疫功能正常的人中引起亚急性硬化性全脑炎（SSPE），或在免疫功能低下的患者中引起麻疹包涵体脑炎（MIBE）。迄今为止，控制中枢神经系统入侵的细胞和分子机制仍知之甚少。此外，已知的 MeV 进入受体在中枢神经系统中不表达，MeV 如何进入和在大脑中传播尚不完全清楚。不同的抗病毒治疗方法已在体外、离体和体内（主要在小动物模型中）进行了测试和验证。大多数治疗方法在预防感染方面非常有效，但它们在中枢神经系统表现后的有效性仍有待评估。本文描述了 MeV 的神经感染和目前最先进的治疗方法，这些方法可能适用于治疗 MeV 中枢神经系统感染。
