Barnett E M, Jacobsen G, Evans G, Cassell M, Perlman S
Neuroscience Program, College of Dentistry, University of Iowa, Iowa City.
J Infect Dis. 1994 Apr;169(4):782-6. doi: 10.1093/infdis/169.4.782.
Herpes simplex virus type 1 causes an encephalitis in humans that is primarily restricted to the temporal lobe and limbic system. The distribution of lesions suggests that virus enters the brain from a single site and then spreads transneuronally to infect connected structures. Two obvious sites of potential viral entry are the olfactory and trigeminal nerves. Trigeminal nerve entry is more likely because it innervates the oral cavity, a common site of initial infection, and the trigeminal ganglion is the most common site of viral latency. In previous reports, however, experimental trigeminal nerve infection has never led to the pattern of disease observed in humans. By directly inoculating virus into the murine tooth pulp, the mandibular division of the trigeminal nerve was selectively infected. This division, which innervates the oral cavity, is the one most commonly infected in humans. Intrapulp inoculation led to an encephalitis primarily affecting the temporal cortex and limbic system. Thus, spread via the trigeminal nerve provides an explanation for the distribution of herpes simplex virus observed in the human encephalitis.
1型单纯疱疹病毒可引发人类脑炎，主要局限于颞叶和边缘系统。病变分布表明病毒从单一部位进入大脑，然后经神经元传播感染相连结构。两个明显的潜在病毒进入部位是嗅神经和三叉神经。三叉神经进入更有可能，因为它支配口腔，而口腔是初始感染的常见部位，且三叉神经节是病毒潜伏的最常见部位。然而，在之前的报道中，实验性三叉神经感染从未导致在人类中观察到的疾病模式。通过将病毒直接接种到小鼠牙髓中，三叉神经的下颌分支被选择性感染。该分支支配口腔，是人类中最常被感染的分支。牙髓内接种导致了主要影响颞叶皮质和边缘系统的脑炎。因此，通过三叉神经传播为人类脑炎中观察到的单纯疱疹病毒分布提供了解释。
