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Slow infections of the central nervous system
Abstract:
This review describes the recent advances in slow infections of the nervous system emphasizing the pathogenetic aspects of these diseases. A theoretical model for the pathogenesis of subacute sclerosing panencephalitis (SSPE) is proposed, illustrating the factors that may affect host response to the measles virus and allow it to persist and produce the panencephalitis. The isolation of an oncogenic virus from progressive multifocal leukoencephalopathy (PML) has implications in the consideration of a viral etiology for some brain tumors. The agent responsible for the transmissibility of kuru and Creutzfeldt-Jakob disease (CJD) remains uncharacterized despite recent interest in viroids and abnormalities in replication of cell membranes. The epidemiological data on multiple sclerosis suggests an exposure to an infectious agent at an early age of life modified by the host response. No specific agent has been consistently associated with multiple sclerosis. Amyotrophic lateral sclerosis (ALS), Parkinson's disease, Mollaret's meningitis and Behcet's disease are other examples where a virus is suspect but unproven. The ability of viruses to persist in the host for months to years has linked many chronic neurologic diseases to an infectious agent, enlarging the spectrum of disease caused by viruses.
Insights
This review explores slow nervous system infections, focusing on pathogenesis. Advances in understanding viral roles in diseases like SSPE and PML are highlighted, linking persistent viruses to chronic neurological conditions.
Area of Science:
- Neurology
- Infectious Diseases
- Pathogenesis
Background:
- Slow infections of the nervous system represent a significant challenge in clinical neurology.
- Understanding the pathogenetic mechanisms is crucial for developing effective treatments.
- Viral etiologies are increasingly suspected in various chronic neurological disorders.
Purpose of the Study:
- To review recent advances in the pathogenesis of slow neurological infections.
- To propose a theoretical model for subacute sclerosing panencephalitis (SSPE) pathogenesis.
- To discuss the implications of viral discoveries in diseases like progressive multifocal leukoencephalopathy (PML).
Main Methods:
- Review of current literature on slow neurological infections.
- Analysis of pathogenetic factors influencing host response to viral agents.
- Discussion of epidemiological data and proposed viral links to chronic diseases.
Main Results:
- A theoretical model for SSPE pathogenesis involving measles virus persistence is presented.
- Oncogenic virus isolation from PML suggests a viral role in some brain tumors.
- Uncharacterized agents are implicated in kuru and Creutzfeldt-Jakob disease (CJD).
Conclusions:
- Persistent viruses are increasingly linked to chronic neurological diseases, expanding the spectrum of viral-induced illnesses.
- While viruses are suspected in multiple sclerosis, ALS, Parkinson's disease, and others, definitive agents remain unproven.
- Further research into viral pathogenesis is essential for understanding and managing these complex neurological conditions.