Martyn C N
MRC Environmental Epidemiology Unit, Southampton General Hospital, UK.
Br Med Bull. 1997 Jan;53(1):24-39. doi: 10.1093/oxfordjournals.bmb.a011603.
Other chapters in this issue discuss the evidence that implicates infection during infancy and childhood in the etiology of respiratory disease. Here I argue that experience of infection in early life may also be involved in the aetiology of some diseases of the adult nervous system. The descriptive epidemiology of three neurological diseases is compatible with the hypothesis that they are delayed consequences of childhood infection. It is not difficult to imagine that the effects of an infection which results in loss of cells from an organ system, like the central nervous system, whose cell populations have lost the capacity to replace themselves by mitotic division could remain hidden until unmasked by ageing. Such a mechanism may be important in the aetiology of motor neuron disease and Parkinson's disease. Age-related differences in host response, which may be partly related to a maturing immune system, are known to influence both short- and long-term outcome for several infections. Perhaps the immune response to infection with Epstein-Barr virus, or another common micro-organism with similar epidemiology, in adolescence or early adult life is sometimes directed at antigens that are also present in the central nervous system. At present, the evidence that supports these hypotheses is largely circumstantial. But it may be possible to devise ways of testing them both epidemiologically and in the laboratory.
本期的其他章节讨论了婴幼儿期感染与呼吸道疾病病因学之间存在关联的证据。在此，我认为早年的感染经历也可能与某些成人神经系统疾病的病因有关。三种神经系统疾病的描述性流行病学与它们是儿童期感染的延迟后果这一假说相符。不难想象，一种导致器官系统（如中枢神经系统，其细胞群体已丧失通过有丝分裂进行自我更新的能力）细胞丢失的感染，其影响可能一直隐藏着，直到因衰老而显现出来。这样一种机制在运动神经元病和帕金森病的病因学中可能很重要。已知宿主反应的年龄相关差异（这可能部分与免疫系统成熟有关）会影响多种感染的短期和长期结果。也许青春期或成年早期对爱泼斯坦 - 巴尔病毒或另一种具有相似流行病学特征的常见微生物感染的免疫反应，有时会针对中枢神经系统中也存在的抗原。目前，支持这些假说的证据大多是间接的。但或许有可能设计出从流行病学和实验室两方面对其进行检验的方法。
