Rebel A, Basle M
Ann Pathol. 1981;1(1):21-6.
In spite of the large number of theories advanced to clarify the etiology of Paget's disease, its cause is still being discussed, and no satisfactory conclusion has been reached. The possibility of a viral origin was raised by the discovery of inclusion bodies, detectable by electron microscopy, in the nuclei and cytoplasm of the osteoclasts in the affected bone tissue, in 1974. In fact, the microcylindrical structures described by various authors, and visible only in osteoclasts and only in Paget's disease, if one excepts certain giant-cell bone tumors, have a close analogy, morphologically, with the nucleocapsids of paramyxovirus of the measles group, described in experimental infections or human diseases (subacute sclerosing panencephalitis). Various morphological arguments, drawn from studies of inclusions in richly nucleated giant osteoclasts found in Paget's disease, are in favor of the viral nature of these formations. Immunocytological methods have constituted another approach to the problem raised by the discovery of inclusions. They have demonstrated the existence of an antigenic material in the osteoclasts found in Paget's disease which reacts positively with antiserums containing anti-measles antibodies or with produce a crossed reaction with them. Controlled tests have confirmed these findings. Biological arguments are presently sufficient, therefore, for the possibility of a viral etiology of Paget's disease to be validly accepted from among the pathogenic hypotheses proposed for a disease that was first described a century ago.
尽管为阐明佩吉特病的病因提出了大量理论,但其病因仍在讨论中,尚未得出令人满意的结论。1974年,在受影响骨组织破骨细胞的细胞核和细胞质中发现了可通过电子显微镜检测到的包涵体,这引发了病毒起源的可能性。事实上,不同作者描述的微圆柱形结构,仅在破骨细胞中可见,且仅在佩吉特病中出现(某些巨细胞骨肿瘤除外),在形态上与麻疹组副粘病毒的核衣壳非常相似,在实验感染或人类疾病(亚急性硬化性全脑炎)中有所描述。从对佩吉特病中多核巨破骨细胞包涵体的研究中得出的各种形态学论据,支持了这些结构的病毒性质。免疫细胞学法构成了因发现包涵体而引发问题的另一种研究方法。这些方法证明了在佩吉特病中发现的破骨细胞中存在一种抗原物质,它与含有抗麻疹抗体的抗血清呈阳性反应,或与之产生交叉反应。对照试验证实了这些发现。因此,就一种一个世纪前首次描述的疾病所提出的致病假说而言,目前生物学论据足以使佩吉特病病毒病因的可能性得到有效认可。