Introduction: The research of biological properties of enteroviruses associated with ischemic stroke (IS) allows us to identify their intratypic differences. The aim: to identify genetic markers of strains of enteroviruses associated with IS. Materials and methods: 11 strains of enteroviruses isolated from the serum of patients with IS were identified in the virus neutralization test. Genetic markers of isolated strains (Abent, marker S, marker rct40) were determined. Results: Eleven strains of enteroviruses were isolated from the serum of patients with IS. Eight viruses: Coxsackie B viruses (serotypes 2, 3, 4) and ECHO viruses (serotypes 6, 9, 27 (two strains), 29) were identified in these strains. Other three strains of enteroviruses were unidentified. Different combinations of genetic markers were found. Seven strains of enteroviruses (Coxsackie B2, B3, ECHO 6, ECHO 9, ECHO 27 (two strains) and one unidentified virus) had virulence markers: Abent–, rct40+ and S−. Three strains (Coxsackie B4, ECHO 29, one unidentified virus) had markers: Abent–, rct40+, S+. Another one unidentified virus had markers: Abent+, rct40+, S –. Conclusions: All 11 isolates of enteroviruses associated with IS had rct40+ marker, 10 of the 11 isolates had marker Abent– and 8 of 11 isolates had marker S–. The research of genetic markers allows to perform typic and intratypic differentiation of strains of enteroviruses associated with the IS.
Relevance. Numerous virological studies prove the importance of enteroviruses in human somatic pathology. However, the etiopathogenetic role of enterovirus infection in patients with acute cerebrovascular disorder (GVMK) is not sufficiently highlighted. Objective: to establish the value of enterovirus infection as a trigger factor in the pathogenesis of acute stroke. Materials and methods. The pear blood serum of 72 patients with acute stroke (main group) and 35 patients with neurological pathology without vascular pathology (group of comparison) were screened for presence of enteroviruses using the virological method, detection of enterovirus genomes using a polymerase chain reaction and the presence of specific Ig M and Ig G to enteroviruses in the enzyme-linked immunosorbent assay (ELISA). Results. The enterovirus genomes were isolated from blood serum in 23,6±5,9 % of patients with acute stroke, that is significantly higher than in patients of the comparison group – 2,9±2,8 % (p <0,05). The enteroviruses were isolated in 11 cases of 17 PCR-positive blood serum samples of the main group. These viruses were identified as Coxsackie B viruses (serotypes 2, 3, 4) and ECHO viruses (serotypes 6, 9, 27 (two strains), 29), three strains of viruses could not be identified. The presence of specific Ig M and Ig G in blood serum of 4 patients with HPMC, as well as enterovirus genomes, has been established. It suggest that they have a recent enterovirus infection, or can indicate a recent enterovirus infection or exacerbation of chronic enterovirus infection. Only specific Ig G in the absence of Ig M were detected in blood serum of 4 PCR positive patients, that can indicate chronic enterovirus infection. Only Ig M in the absence of Ig G was detected in blood serum of 6 PCR-positive patients, that can indicate acute enterovirus infection. No Ig M or Ig G in serum from three PCR-positive patients were detected, possibly due to the presence of latent enterovirus infection. Conclusions. Acute and chronic persistent enterovirus infection plays a possible trigger role in the development of acute stroke. The combination of PCR to detect genomes of enteroviruses, virological for the isolation and identification of viruses, and ELISA for the detection of specific Ig M and Ig G to enteroviruses should be recommended for the diagnosis of persistent enterovirus infection in patients with acute stroke.
The aim: To determine the frequency of HSV1, HSV2, VZV, CMV, EBV, HHV6 and influenza virus detection in patients with ischemic stroke in different seasons. Materials and methods: 144 patients with ischemic stroke were examined: 78 (54.2%) women and 66 (45.8%) men, mean age of 63.1 ± 0.8 years. Detection of the herpesvirus DNA and the influenza virus RNA was performed using PCR monthly in 12 patients. Results: A manifestation of a viral infection was detected in 32 (22.2%) and virus genomes were observed in 29 (90.6%) patients. Viral infection frequency is significantly lower in summer, compared to winter-autumn; p=0.033. HSV1 and HHV6 were the most common (19 (52.8%) and 16 (44.4%)); VZV was the least common (5 (13.9%)). Influenza virus RNA was detected in 10 (27.8%) patients. In winter-autumn the frequency of HSV1, HSV2, HHV6 viruses detection is significantly higher, compared to the spring-summer (p<0.05), and the difference is almost significant for the influenza virus (p=0.060) and the EBV (p=0.060). Association of stroke occurrence with the presence of two or more types of viruses is more common in winter, compared to the summer season: 11 (30.6%) vs. 3 (8.3%), p=0.017. Conclusions: Prevention and treatment of herpesvirus infections exacerbations, in particular HSV1 and HSV2, which significantly increase in winter, compared to summer, is an important direction of stroke prevention measures in risk groups.
The aim: To study the role of enteroviruses (EV) in the development of ischemic stroke and its outcome. Materials and methods: The main group (MG) included 72 patients with acute cerebrovascular disorders were examined using the National Institutes of Health Stroke Scale and Barthel Index. The comparison group (CG) included 35 patients without cerebrovascular disease. Viruses were isolated from patients’ sera and identified in neutralization test. EV genomes were detected in polymerase chain reaction (PCR). Serological diagnosis was performed by enzyme-linked immunosorbent assay. Results: EV genomes were more frequently detected in the patients’ sera in MG than in CG (23.6 ± 5.9% and 2.9 ± 2.8%, p <0.05). The greater level of neurological deficits was in patients with positive PCR test results comparatively with patients with negative PCR test results (11.76 ± 0.31 and 10.97 ± 0, 27, p = 0.040). The regression of neurological deficit during the treatment was a worse in patients with positive PCR test results and presence of specific IgG compared with patients with positive PCR test results and absence of specific IgG (11.2 ± 2.6% and 19.6 ± 2.4%, p = 0.031). Conclusions: The trigger role of EV in the development of IS is established. PCR is recommended for diagnosis of EV in patients with IS.
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