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Viral studies in the cerebrospinal fluid in subacute sclerosing panencephalitis
Banu Anlar1, Ahmet Pinar, F Yaşar Anlar
1Department of Pediatric Neurology, Hacettepe University, Ankara, Turkey. banlar@gen.hun.edu.tr
Objectives:
The pathogenesis of subacute sclerosing panencephalitis (SSPE), and particularly, the cause of measles virus (MV) reactivation following a latent period after primary measles infection is unknown. The hypothesis of other viruses contributing to the pathogenesis of SSPE by affecting the in vivo state of MV was investigated.
Methods:
We examined the cerebrospinal fluid of SSPE patients (n=43) for DNA or RNA and antibodies against HSV type 1 and 2, EBV, CMV, VZV, Hepatitis B, Hepatitis C, JC virus, human herpesvirus (HHV)-6, HHV-7, HHV-8, HTLV-1, and HTLV-2. We compared the findings with those of patients with other neurological disorders (n=39).
Results:
CMV DNA and HSV type 1 IgG were found more frequently in SSPE patients. Other positive results were at similar incidence in SSPE and control groups. The clinical features of SSPE cases with and without positive viral tests did not differ from each other.
Conclusion:
These data do not support a specific role for these agents in SSPE, but imply that the passage of some viruses to the CNS and local antibody synthesis may be facilitated by inflammation. The persistence or reactivation of MV in SSPE may be related to other factors pertaining to the host or environment.
Insights
This study investigated if other viruses contribute to subacute sclerosing panencephalitis (SSPE) by affecting measles virus (MV) reactivation. Findings suggest other viruses do not play a specific role in SSPE pathogenesis.
Area of Science:
- Neurology
- Virology
- Immunology
Background:
- Subacute sclerosing panencephalitis (SSPE) is a rare, fatal neurological complication of measles virus infection.
- The exact mechanism of measles virus (MV) reactivation in SSPE remains unknown.
- This study explores the potential role of other viral infections in SSPE pathogenesis.
Purpose of the Study:
- To investigate the hypothesis that other viruses contribute to SSPE by influencing measles virus (MV) reactivation.
- To identify potential co-infections or contributing viral factors in the central nervous system (CNS) of SSPE patients.
Main Methods:
- Cerebrospinal fluid (CSF) from SSPE patients (n=43) and controls (n=39) was analyzed for DNA/RNA and antibodies against a panel of viruses.
- Viral targets included herpes simplex virus (HSV) types 1 and 2, Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella-zoster virus (VZV), and others.
Main Results:
- Cytomegalovirus (CMV) DNA and HSV type 1 IgG were detected more frequently in SSPE patients compared to controls.
- No significant differences in other viral findings were observed between SSPE and control groups.
- Clinical presentations of SSPE did not vary based on the presence or absence of detected viral markers.
Conclusions:
- The study does not support a specific role for the investigated viruses in the pathogenesis of SSPE.
- Inflammation in the CNS may facilitate the entry and local antibody synthesis of certain viruses.
- The persistence or reactivation of MV in SSPE is likely influenced by host or environmental factors independent of these specific viral co-infections.