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病毒性脑炎的病因及长期后果

The Causes and Long-Term Consequences of Viral Encephalitis.

作者信息

Bohmwald Karen, Andrade Catalina A, Gálvez Nicolás M S, Mora Valentina P, Muñoz José T, Kalergis Alexis M

机构信息

Millennium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.

Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Front Cell Neurosci. 2021 Nov 30;15:755875. doi: 10.3389/fncel.2021.755875. eCollection 2021.

Abstract

Reports regarding brain inflammation, known as encephalitis, have shown an increasing frequency during the past years. Encephalitis is a relevant concern to public health due to its high morbidity and mortality. Infectious or autoimmune diseases are the most common cause of encephalitis. The clinical symptoms of this pathology can vary depending on the brain zone affected, with mild ones such as fever, headache, confusion, and stiff neck, or severe ones, such as seizures, weakness, hallucinations, and coma, among others. Encephalitis can affect individuals of all ages, but it is frequently observed in pediatric and elderly populations, and the most common causes are viral infections. Several viral agents have been described to induce encephalitis, such as arboviruses, rhabdoviruses, enteroviruses, herpesviruses, retroviruses, orthomyxoviruses, orthopneumovirus, and coronaviruses, among others. Once a neurotropic virus reaches the brain parenchyma, the resident cells such as neurons, astrocytes, and microglia, can be infected, promoting the secretion of pro-inflammatory molecules and the subsequent immune cell infiltration that leads to brain damage. After resolving the viral infection, the local immune response can remain active, contributing to long-term neuropsychiatric disorders, neurocognitive impairment, and degenerative diseases. In this article, we will discuss how viruses can reach the brain, the impact of viral encephalitis on brain function, and we will focus especially on the neurocognitive sequelae reported even after viral clearance.

摘要

关于脑部炎症(即脑炎)的报告显示,在过去几年中其发病频率呈上升趋势。由于脑炎的高发病率和高死亡率,它成为公共卫生领域的一个重要关注点。感染性或自身免疫性疾病是脑炎最常见的病因。这种病理状况的临床症状会因受影响的脑区不同而有所差异,轻症包括发热、头痛、意识模糊和颈部僵硬,重症则有癫痫发作、虚弱、幻觉和昏迷等。脑炎可影响所有年龄段的人群,但在儿童和老年人群体中更为常见,最常见的病因是病毒感染。已有多种病毒被描述可引发脑炎,如虫媒病毒、弹状病毒、肠道病毒、疱疹病毒、逆转录病毒、正粘病毒、正肺病毒和冠状病毒等。一旦嗜神经病毒抵达脑实质,诸如神经元、星形胶质细胞和小胶质细胞等驻留细胞就可能被感染,促使促炎分子分泌以及随后免疫细胞浸润,进而导致脑损伤。在病毒感染消退后,局部免疫反应可能仍保持活跃,这会导致长期的神经精神障碍、神经认知损害和退行性疾病。在本文中,我们将探讨病毒如何抵达脑部、病毒性脑炎对脑功能的影响,并且我们将特别关注即使在病毒清除后仍有报道的神经认知后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba5/8668867/b13643d7c494/fncel-15-755875-g001.jpg

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