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Immune alterations in subacute sclerosing panencephalitis reflect an incompetent response to eliminate the measles

Sibel P Yentür1, Veysi Demirbilek2, Candan Gurses3

  • 1Department of Physiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

Plos One
|January 7, 2021
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE) shows a diminished immune response, with lower IL-10 and altered T cell cytokine production, hindering measles virus (MeV) clearance. This self-limited immune activity prevents effective viral elimination in SSPE patients.

Area of Science:

  • Immunology
  • Virology
  • Neurology

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a severe neurological complication of measles virus (MeV) infection.
  • The persistence of MeV in SSPE is potentially linked to an altered host immune response.

Purpose of the Study:

  • To evaluate and compare cytokine responses of lymphocytes and monocytes in SSPE patients versus control groups.
  • To investigate the immune cell phenotype and function in relation to MeV persistence in SSPE.

Main Methods:

  • Analysis of peripheral blood mononuclear cells (PBMC) phenotypes using flow cytometry.
  • Measurement of cytokines (IL-2, IL-10, IFN-γ, IL-12p40, IL-12p70, IL-23) via ELISA after various stimulations.
  • Assessment of MeV-specific T cell responses using ELISPOT for IFN-γ secretion.

Main Results:

  • Lower spontaneous and stimulated IL-10 secretion was observed in SSPE patients compared to both inflammatory (ICON) and non-inflammatory (NICON) controls.
  • T cell stimulation in SSPE led to reduced IFN-γ production (vs. ICON) but increased IL-2 production (vs. NICON).
  • Stimulated PBMC in SSPE showed lower IL-12p70 and decreased CD46 expression, with non-prominent IFN-γ responses to MeV peptides.

Conclusions:

  • The immune response in SSPE is characterized by insufficient inflammatory activity to eliminate the measles virus.
  • Diminished IL-10 production suggests a self-limited immune response that is inadequate for controlling the disease.
  • Altered cytokine profiles and reduced CD46 expression indicate impaired immune cell function in SSPE, contributing to MeV persistence.

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