de la Monte S M, Linhares A L, da Rosa A P, Pinheiro F P
Trop Geogr Med. 1983 Sep;35(3):235-41.
Accurate diagnosis of fatal Yellow Fever (YF) is important for surveillance and prevention of epidemics in regions where the virus is endemic. Immunoperoxidase (IP) staining for viral antigens offers a means to both document infection and investigate pathogenic mechanisms. We developed an indirect IP staining assay for YF, which was used to detect YF antigen in histologic sections of human liver from patients with fatal natural infections, and suckling mouse brains experimentally inoculated with an unattenuated neurotropic strain of YF virus. In human liver, specific IP staining was present in the cytoplasm of hepatocytes, but in mouse brain, specific IP staining was localized within nuclei of neurons. The distribution of IP staining corresponded to the location of degenerative morphologic changes within cells; however, IP staining was more widespread than expected on the basis of histopathologic lesions. Furthermore, the degree of inflammation was disproportionately mild compared to the extent of infection, i.e. distribution of YF antigen, both in human liver and suckling mouse brain. The results suggest that the pathogenesis of YF in humans and suckling mice is overwhelming viral infection with minimal associated host immunological and/or inflammatory response in tissues.
准确诊断致命性黄热病（YF）对于在该病毒流行地区进行监测和预防疫情至关重要。针对病毒抗原的免疫过氧化物酶（IP）染色为记录感染情况和研究致病机制提供了一种手段。我们开发了一种用于YF的间接IP染色检测方法，该方法用于检测来自自然感染致死患者的人肝组织切片以及用未减毒的嗜神经黄热病毒株实验接种的乳鼠脑中的YF抗原。在人肝中，特异性IP染色出现在肝细胞的细胞质中，但在鼠脑中，特异性IP染色定位于神经元的细胞核内。IP染色的分布与细胞内退行性形态学变化的位置相对应；然而，基于组织病理学病变，IP染色比预期更广泛。此外，与感染程度（即YF抗原的分布）相比，无论是在人肝还是乳鼠脑中，炎症程度都异常轻微。结果表明，人类和乳鼠中黄热病的发病机制是病毒感染压倒性地发生，而组织中相关的宿主免疫和/或炎症反应最小。
