myelin-basic-protein and Encephalitis--Viral

A previously healthy 19-month-old boy developed acute encephalopathy, thrombocytopenia and hepatic dysfunction. Human herpesvirus-6 (HHV-6) DNA was found in his CSF during the acute stage of the disease by means of the polymerase chain reaction. T2-weighted MRI revealed high signal intensity in the left thalamus and left parieto-occipital deep white matter. The myelin basic protein concentration in the CSF was elevated suggesting acute demyelination. The patient is now 2.5 years old and has no sequelae.. Since clinical course and neuroimaging after HHV-6 infection are similar to those in acute disseminated encephalomyelitis, clinicians must pay attention to primary HHV-6 infection in patients under 2 years old with white matter lesions.

Topics: Acute Disease; Brain; Brain Diseases; Child, Preschool; Demyelinating Diseases; DNA, Viral; Dominance, Cerebral; Encephalitis, Viral; Follow-Up Studies; Herpesviridae Infections; Herpesvirus 6, Human; Humans; Infant; Liver Function Tests; Magnetic Resonance Imaging; Male; Myelin Basic Protein

Despite the effective suppression of viremia with antiretroviral therapy, HIV can still replicate in the central nervous system (CNS). This was a longitudinal study of the cerebrospinal fluid (CSF) and serum dynamics of several biomarkers related to inflammation, the blood-brain barrier, neuronal injury, and IgG intrathecal synthesis in serial samples of CSF and serum from a patient infected with HIV-1 subtype C with CNS compartmentalization.The phylogenetic analyses of plasma and CSF samples in an acute phase using next-generation sequencing and F-statistics analysis of C2-V3 haplotypes revealed distinct compartmentalized CSF viruses in paired CSF and peripheral blood mononuclear cell samples. The CSF biomarker analysis in this patient showed that symptomatic CSF escape is accompanied by CNS inflammation, high levels of cell and humoral immune biomarkers, CNS barrier dysfunction, and an increase in neuronal injury biomarkers with demyelization. Independent and isolated HIV replication can occur in the CNS, even in HIV-1 subtype C, leading to compartmentalization and development of quasispecies distinct from the peripheral plasma. These immunological aspects of the HIV CNS escape have not been described previously. To our knowledge, this is the first report of CNS HIV escape and compartmentalization in HIV-1 subtype C.

Topics: Adult; Anti-HIV Agents; Biomarkers; Blood-Brain Barrier; Central Nervous System; Chemokine CCL5; Encephalitis, Viral; HIV Antibodies; HIV Infections; HIV-1; Humans; Immune Evasion; Immunoglobulin G; Leukocytes, Mononuclear; Lipopolysaccharide Receptors; Longitudinal Studies; Male; Myelin Basic Protein; Neurofilament Proteins; Phylogeny; RNA, Viral; Virus Replication

Myelin oligodendrocyte glycoprotein (MOG) may be implicated in the immunopathogenesis of multiple sclerosis (MS) inducing demyelination in the animal model of MS. In adults reported anti-MOG antibody frequencies have been variable across a number of studies and can also be detected in controls.. To measure antibodies against MOG in paediatric patients with demyelinating disorders of the central nervous system and in controls.. Serum antibodies against MOG and myelin basic protein were measured by ELISA, flow cytometry (FACS) and in the liquid phase in 11 children with acute disseminated encephalomyelitis (ADEM), 22 children with MS, seven children with acute viral encephalitis and 13 healthy controls. The serostatus of Epstein-Barr virus (EBV) infections were assessed.. Anti-MOG antibodies, measured either by ELISA or FACS were exclusively detected in children with demyelination. In ADEM these antibodies were highly reactive. Anti-MBP reactivity was detectable equally in all groups. The presence of either autoantibodies did not associate with EBV serostatus, age, gender or disease course.. This study independently corroborates recently published results of seroprevalence and specificity of the assay. Due to their low sensitivity anti-MOG antibodies will not serve as disease-specific biomarkers, but could help to support the diagnosis of ADEM in difficult cases.

Topics: Adolescent; Autoantibodies; Biomarkers; Chi-Square Distribution; Child; Child, Preschool; Demyelinating Diseases; Diagnosis, Differential; Encephalitis, Viral; Encephalomyelitis, Acute Disseminated; Enzyme-Linked Immunosorbent Assay; Epstein-Barr Virus Infections; Female; Flow Cytometry; France; Germany; Humans; Immunity, Humoral; Male; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Nerve Tissue Proteins; Predictive Value of Tests; Retrospective Studies; Transcription Factors

The development of severe CNS damages including encephalitis is highly probable in some respiratory and exanthemata viral infections (measles, rubella, parotitis). A high level of IgG antibodies to the myelin basic protein was found in patients with parotitis meningitis and rubella encephalitis but it was not high in 80% of patients with encephalitis of the unclear etiology and in 25% of cases with rubella encephalitis. More accurate analysis of clinical, neurovisual and immunologic data revealed a link of appearance of such complications with both the presence of more pronounced demyelinization and prolongation of the disease.

Topics: Acute Disease; Adolescent; Antibodies, Bacterial; Child; Child, Preschool; Encephalitis, Viral; Female; Humans; Immunoglobulin E; Immunoglobulin G; Male; Meningitis, Bacterial; Myelin Basic Protein; Prognosis

Five cases of apparent relapse of herpes encephalitis were investigated. All patients recovered after antiviral and corticosteroid therapy. Samples of CSF taken from the patients at intervals through the initial and subsequent encephalitic episode were examined. PCR amplification of a 351 bp sequence from the Herpesvirus simplex (HSV) thymidine kinase gene demonstrated the presence of HSV DNA in CSF taken during the initial encephalitic illness but not during the second encephalitic episode. Intrathecal synthesis of HSV antibody (HSV antibody index > 1.9) was observed in all cases following the first episode, and there appeared to be no significant increase in intrathecal antibody synthesis in the second episode. High levels of CSF myelin basic protein were found during the acute phases of both the initial and the subsequent encephalitic illnesses. These data suggest that at least in our series of five patients, relapse following HSE may not be due to active viral replication.

Topics: Adolescent; Adult; Aged; DNA, Viral; Encephalitis, Viral; Female; Herpes Simplex; Herpesvirus 1, Human; Humans; Male; Middle Aged; Myelin Basic Protein; Polymerase Chain Reaction; Recurrence