ISSN:0300-5526    

DOI:10.1159/000150532

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0300-5526    

DOI:10.1159/000150533

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

CNS infections caused by human herpesvirus 1 and human herpesvirus 2 -herpes simplex virus type 1 and herpes simplex virus type 2 – are reviewed. The major diseases associated with these viruses are meningitis and encephalitis. Two forms of encephalitis are known, neonatal encephalitis and encephalitis occurring after the neonatal period. Both diseases are associated with high mortality and morbidity and require prompt diagnosis and aggressive antiviral chemotherapy. Methods for the specific diagnosis of these infections are reviewed and the value of intrathecal antibody assay and nucleic acid amplification techniques are emphasise

ISSN:0300-5526    

DOI:10.1159/000150534

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Varicella-zoster virus (VZV) is a cause of neurologic disease among humans. Both primary infection and recurrence may lead to neurologic infection and disease. Neurologic syndromes associated with acute VZV infection are caused by abnormal immune responses, the most frequent manifestation being cerebellar ataxia. Those associated with recurrences are often due to the direct effect of viral replication in the nervous tissue. VZV reaches the nervous system either through the bloodstream or by direct spread from sensory ganglia where it remains latent. Postherpetic neuralgia, acute encephalitis, aseptic meningitis and myelitis are the most frequent diseases and have been recorded both in association with herpes zoster and in the absence of a cutaneous rash. Early diagnosis may be established by detecting virus-specific DNA sequences in the cerebrospinal fluid (CSF) after amplification by the polymerase chain reaction and then confirmed by detection of intrathecally produced, specific IgG antibody. Virus isolation from CSF and antibody testing in serum are unsuitable for diagnosis. Early acyclovir therapy is recommended in immuno-compromised patients and those with serious disease.

ISSN:0300-5526    

DOI:10.1159/000150535

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Experimental evidence and pathological observation indicate that human cytomegalovirus (HCMV) has a tropism for cells of the nervous system, including both neuronal and glial cells. As demonstrated in animal models, after a viremic phase, the virus may reach the brain, where it may cause mild infection or severe encephalitis. The nervous system is one of the principal target organs in congenital HCMV infections and in HCMV-infected AIDS patients. In the former case, mortality is high and neurological sequelae, such as mental retardation, are frequent; in the latter it may lead to a progressively wasting encephalopathy and death within a few weeks. The diagnosis of the nervous system manifestations due to HCMV can now rely upon the detection of HCMV DNA in cerebrospinal fluid by means of polymerase chain reaction. However, the current antiviral treatments of these complications are of limited effect.

ISSN:0300-5526    

DOI:10.1159/000150536

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The human polyomaviruses JC virus (JCV) and BK virus (BKV) have long been known as onco- and neurooncogenic. Interest in their oncogenic potential has reemerged with the discovery of simian virus 40 DNA in human brain tumors including the pituitary as well as in bone tumors and mesotheliomas. The only human disease caused by an infection with the human polyomavirus JCV is progressive multifocal leukoencephalopathy (PML) characterized by a lytic infection of oligodendrocytes with consecutive demyelination. Malignant transformation of cell lines appears to be caused by a complex interaction of the viral large T (tumor) antigen with several transcription factors and tumor suppressor proteins such as p53 and the retinoblastoma protein. PML, once an extremely rare disease, has become much more frequent in the western world owing to the AIDS pandemic. An exceedingly complicated, cell-, tissue- and species-specific pattern of protein-DNA interaction and negative as well as positive feedback regulation by at least a dozen proteins and possibly mutations in the JC viral promoter-enhancer region govern host range and development of PML. The intricate molecular and immunological prerequisites ultimately leading to PML in humans have not yet been completely elucidated.

ISSN:0300-5526    

DOI:10.1159/000150537

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Due to the worldwide AIDS pandemic, HIV-1 has become the major factor for central nervous system (CNS) diseases. Two major disorders of the CNS caused by HIV-1 have been described, a meningoencephalitis which occurs in 30-50% of patients early after infection and the AIDS dementia complex (ADC, also known as HIV-associated dementia) which is characterized by a predominantly subcortical dementia. The pathophysiology of these clinical syndroms still remains an enigma. However, since monocytes/macrophages may represent the major place of virus replication in the CNS, a hematogenous invasion of HIV-1 into the brain may be crucial to the neuropathogenesis of ADC. One of the most valuable animal models for the study of neuro-AIDS is the infection of macaque monkeys with the simian immunodeficiency virus (SIV). In about 50% of infected rhesus monkeys with an AlDS-like disease, neuropathological lesions similar to ADC in men have been observed. This animal model contributes to our understanding of the mechanisms of viral neuroinvasion early after infection and in the development of neurological disease. In this review we will summarize the state of the art and will focus on further questions concerning the neuropathogenesis of HI V/SIV.

ISSN:0300-5526    

DOI:10.1159/000150538

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Infection with the human immunodeficiency virus frequently results in a dementing illness which manifests predominantly as a subcortical dementia. Parkinsonian features may be prominent in these patients and may on occasion be the presenting manifestation. These patients are exquisitely sensitive to dopaminergic blocking agents. Radiological studies, metabolic uptake studies and pathological examination of the brain suggest that the basal ganglia are the major target of this infection. Although further studies are necessary to determine appropriate treatment for this condition and to develop an understanding of the underlying pathophysiological mechanisms, available evidence suggests that the response to dopamine agonists may be variable and that viral strains and viral products may specifically target cells within the basal ganglia.

ISSN:0300-5526    

DOI:10.1159/000150539

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In less than 1 % of persistently infected individuals, human T cell lymphotropic virus type I (HTLV-I) causes a chronic inflammatory disease of the central nervous system (CNS), called HTLV-I-associated myelopathy/tropical spastic paraparesis. Important prerequisites for disease induction are oligoclonal expansion of HTLV-I-infected CD4+ T lymphocytes, their trafficking across the blood-brain barrier, expression of viral proteins in the CNS, and an increased immune response within the CNS. The HTLV-I Taxi protein has unique abilities to transactivate viral and cellular genes in T lymphocytes, but possibly also in cells of the CNS. Thus Taxi supports the persistence of HTLV-I, the ongoing immune responses within the CNS and the destruction of myelin and axons, most pronounced in the thoracic spinal cord.

ISSN:0300-5526    

DOI:10.1159/000150540

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

After an acute phase of virus growth in neurons (e.g. anterior horn cells), Theiler’s murine encephalomyelitis virus (TMEV) persists as a chronic productive infection, largely in macrophages in the CNS white matter. TMEV replication in macrophages is highly restricted, probably as the result of host cell factors. The preponderance of evidence indicates that TMEV persistence leads to immunopathologic damage of myelin, mediated by major histocompatibility class Π-restricted Thl lymphocytes directed at a virus epitope(s) rather than host neuroantigens at least early in the infection. Analysis of TMEV recombinant and mutant viruses suggests that persistence requires a specific capsid conformation involving the VP2 puff and VP 1 loops, which may influence persistence through virion receptor binding or attachment to host cells, e.g. macrophag

ISSN:0300-5526    

DOI:10.1159/000150541

出版商:S. Karger AG    

年代:1997

数据来源: Karger