Herpesviruses and biomarkers in disseminated encephalomyelitis and multiple sclerosis in children

Skripchenko, E.Yu.; Железникова, Г Ф; Алексеева, Л. А.; Скрипченко, Н. В.; Astapova, A.V.; Gorelik, Е.Yu.; Вильниц, А. А.

doi:10.17116/jnevro2021121031138

Cited by 3 publications

(1 citation statement)

References 50 publications

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“…Было выявлено, что в группе больных РС c частой реактивацией герпетической инфекции, при одинаковом возрасте и длительности заболевания, наблюдалось более неблагоприятное течение демиелинизирующего процесса. Сходные данные были получены и в других работах последних лет [10,16,17], поэтому наличие реактивации ПГВИ следует рассматривать как прогностически неблагоприятный фактор течения основного заболевания.…”

Section: The Ratio Of Different Variants Of Mixed Infectionin Ms Patients and In The Control Group N (%)unclassified

Clinical presentation and course of multiple sclerosis in patients with herpesvirus infection

Gris

Baranova

Спирин

et al. 2021

RJTAO

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To date, the features of clinical presentation, course, and the effectiveness of therapy for multiple sclerosis (MS) in the presence of persistent herpesvirus infection (PHVI) remain poorly understood.Objective: to evaluate the features of clinical presentation and course of MS in patients with PHVI to optimize patient management.Patients and methods. We examined 122 patients with a clinically definite diagnosis of MS according to McDonald criteria (2010) (82 women and 40 men, age: 18–50 years, mean age – 37.74±11.04 years). MS duration at the time of examination was from 6 months to 20 years (mean – 8.53±7.47 years), mean Expanded Disability Status Scale (EDSS) score – 2.91±1.67. 86% of patients had relapsing-remitting MS; 14% – secondary progressive MS. 98 (80%) patients received disease modifying therapies (DMTs). All patients underwent a comprehensive clinical and neurological examination, magnetic resonance imaging (MRI). 30 healthy donors (20 women and 10 men, age: 19–62 years, mean age: 39.1±12.1 years) were included in the control group. Serum levels of type-specific IgM and IgG antibodies to herpes simplex virus (HSV) 1, 2, 6, Varicella zoster virus (VVZ), Epstein–Barr virus (EBV), cytomegalovirus (CMV) were detected, in some patients – blood and cerebrospinal fluid (CSF) polymerase chain reaction, serum and CSF oligoclonal IgG.Results and discussion. We identified two sub-groups of MS patients: with PHVI reactivation (main group, n=29) and without it (comparison group, n=93). There were a significantly higher VZV (72%) and EBV infection rate (100%) in MS patients compared to the control group (50% and 83%, respectively). Mixed herpesvirus infection prevailed over mono-infection in MS patients. In contrast to controls, the most common viral pattern in MS group was a combination of 4 herpes viruses: HSV 1, 2 + VZV + EBV + CMV (χ2=3.9; p<0.05). Patients in the main group had an unfavorable disease course: earlier MS onset, predominantly polysymptomatic onset, significantly higher relapse rate, faster disease progression, and higher EDSS and Functional Systems Scale (FSS) scores (p <0.05). MRI activity was also associated with EBV infection: new T1Gd+ and T2 foci were associated with an increase in VCA-IgM to EBV level. We also observed decreased DMTs effectiveness (χ2=4,6; p=0,033) and worse DMTs tolerability (χ2=5,3; p=0,022) in the main group.Conclusion. MS patients with PHVI reactivation, have a more unfavorable course of the demyelinating process and, therefore, a greater degree of disability, compared with age-adjusted patients without a viral infection and the same disease duration.

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Section: The Ratio Of Different Variants Of Mixed Infectionin Ms Patients and In The Control Group N (%)unclassified

Clinical presentation and course of multiple sclerosis in patients with herpesvirus infection

Gris

Baranova

Спирин

et al. 2021

RJTAO

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The infectious status of patients with optic neuritis of inflammatory and demyelinating etiologies

Neroev,

Eliseeva,

Krichevskaya

et al. 2023

Rossijskij oftalʹmologičeskij žurnal

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Purpose: to study the prevalence of various chronic infections, the frequency of their reactivation and characteristic associations of microorganisms in patients with optic neuritis of various etiologies.Material and methods. 13 patients with optic neuritis (ON) and 12 patients with ON and multiple sclerosis were tested for a broad range of infectious agents in their blood serum.Results. All patients were shown to have mixed infections; 64 % of them had an association of 4 or more infectious agents. The patients of both groups were infected with Epstein-Barr virus (100 %), Cytomegalovirus (92 %) and Herpex simplex viruses (92 %) types 1 and/or 2 with serological signs of their reactivation. The combination of Herpes virus reactivation, Toxoplasma and urogenital infection was more often detected in patients with demyelinating ON. In patients with multiple sclerosis, a mutual correlation was detected: the higher the degree of infection (combination of 5 or more pathogens), the lower the visual acuity at the onset of the disease (p < 0.05) and the less favourable the vision prognosis.Conclusion. Possibly, mixed infection may play an important role in the pathogenesis of ON, including that of demyelinating etiology, as a trigger or an aggravating factor.

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Infectious hypothesis of neurodegenerative diseases. What waits us after the COVID-19 pandemic?

Litvinenko

Lobzin

Pushkarev

et al. 2022

РНЖ

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Since the description of the first clinical cases of the most common neurodegenerative diseases, numerous hypotheses have been proposed for their development. At the same time, the failure of therapeutic strategies in various directions of clinical research indicates the fallacy of most theories. In this regard, in recent years, various infectious agents are increasingly considered as a trigger of neuronal inflammation and a factor inducing the onset of the neurodegenerative process. Infectious agents differ in their mechanisms of invasion into the central nervous system and can even enter the brain perineurally. Reactivation of latent viral infection induces the production of viral proteins and the accumulation of abnormal proteins that are markers of Alzheimer’s disease and Parkinson’s disease. Both bacterial (chlamydia, causative agents of chronic periodontitis, E. coli) and viral (herpes viruses, noroviruses) infectious agents are considered. However, for the development of neurodegeneration, it is not enough just a simple invasion and reactivation of the infectious process: the genetic characteristics of the main histocompatibility complex also play a huge role. Currently, several studies have been initiated on the possible efficacy of antibacterial and antiviral drugs in Alzheimer’s disease. Data obtained over the past year suggests that the brain may act as a target for SARS-CoV-2. Neurological manifestations of COVID-19 can occur as a result of both the direct cytopathic action of the pathogen and the activation of neuroinflammation, accompanied by a violation of the integrity of the blood-brain barrier. Further study of the molecular and cellular mechanisms of neuroinflammation and neurodegeneration in COVID-19 will form the basis for the development of treatments for neurological complications.

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Herpesviruses and biomarkers in disseminated encephalomyelitis and multiple sclerosis in children

Cited by 3 publications

References 50 publications

Clinical presentation and course of multiple sclerosis in patients with herpesvirus infection

Clinical presentation and course of multiple sclerosis in patients with herpesvirus infection

The infectious status of patients with optic neuritis of inflammatory and demyelinating etiologies

Infectious hypothesis of neurodegenerative diseases. What waits us after the COVID-19 pandemic?

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