Johnson K P, Byington D P, Gaddis L
Neurol Neurocir Psiquiatr. 1977;18(2-3 Suppl):495-507.
Subacute sclerosing panencephalitis (SSPE) is a progressive, fatal inclusion cell encephalitis of children and adolescents caused by persistent measles virus within the central nervous system (CNS). Because studies in man have failed to elucidate the pathogenesis of this condition, animal studies are necessary. Persistent infection of the hamster CNS can be achieved with a hamster adapted SSPE agent. Animals inoculated intracerebrally with this virus raise antibodies to all known antigens of measles virus and some display clinical signs and pathological changes similar to those noted in human SSPE. Persistent CNS infection occurs only if the hamster is inoculated at a critical age (18 to 25 days of life) or if adults are given transient immunosuppression during acute infection. The biological behavior of the virus isolated from hamster CNS appears to change from a complete to a defective state coincidents with the appearance of serum antibodies to measles virus. Adult hamsters from whom the thymus was removed in the newborn period develop a subacute, uniformly fatal infection when exposed to the SSPE agent. These studies suggest that SSPE may develop in man when measles virus invades the immature CNS at a critical age or when the immune system is uncompletely developed or is inhibited. The finding that transient immunosuppression allows development of persistent CNS infection in adults suggest that immunological malfunction is the significant factor. Of interest, antibody appears to alter viral behavior to a defective, intracellular state thus enhancing viral survival in the host. Once a defective, CNS infection is achieved, lack of, or inhibition of the host cellular immunes response allows it to persist. Methods of therapy in light of these findings will be discussed.
亚急性硬化性全脑炎(SSPE)是一种由中枢神经系统(CNS)内持续存在的麻疹病毒引起的儿童和青少年进行性致命性包涵体细胞脑炎。由于对人类的研究未能阐明这种疾病的发病机制,因此有必要进行动物研究。用适应仓鼠的SSPE病原体可实现仓鼠CNS的持续感染。脑内接种该病毒的动物会产生针对麻疹病毒所有已知抗原的抗体,一些动物还会出现与人类SSPE中所观察到的相似的临床症状和病理变化。仅当仓鼠在关键年龄(出生后18至25天)接种,或成年动物在急性感染期间接受短暂免疫抑制时,才会发生CNS持续感染。从仓鼠CNS分离出的病毒的生物学行为似乎会从完整状态转变为缺陷状态,这与血清中麻疹病毒抗体的出现相一致。在新生期切除胸腺的成年仓鼠在接触SSPE病原体时会发生亚急性、一致致命的感染。这些研究表明,当麻疹病毒在关键年龄侵入未成熟的CNS时,或当免疫系统未完全发育或受到抑制时,人类可能会发生SSPE。短暂免疫抑制可使成年动物发生CNS持续感染这一发现表明,免疫功能失调是一个重要因素。有趣的是,抗体似乎会将病毒行为改变为缺陷性的细胞内状态,从而提高病毒在宿主体内的存活率。一旦实现了缺陷性的CNS感染,宿主细胞免疫反应的缺乏或抑制会使其持续存在。将根据这些发现讨论治疗方法。