肠道病毒或与急性弛缓性脊髓炎有关
2019-10-22 15:18
美国加州大学旧金山分校Michael R. Wilson课题组发现，泛病毒血清学提示肠道病毒（EV）与急性弛缓性脊髓炎（AFM）发病有关。相关论文2019年10月21日在线发表于《自然—医学》杂志。
使用表达从所有已知脊椎动物和虫媒病毒来源的481966重叠肽的噬菌体展示文库，研究人员对患有AFM（n=42）和其他小儿神经疾病对照（n=58）儿童的脑脊液（CSF）进行鞘内抗病毒抗体的研究。研究人员还进行了AFM CSF RNA的元基因组下一代测序（mNGS，无偏倚靶向EV的测序，n=20例）。使用VirScan，相对于对照，AFM病例的CSF显着富集的病毒家族是Picornaviridae，其中最富集的Picornaviridae肽属于肠病毒属（n=29/42例，而4/58例）。EV VP1 ELISA测试证实了这一发现（n=22/26例，而对照组为7/50）。mNGS未检测到其他EV RNA。尽管很少检测到EV RNA，但与对照组相比，泛病毒血清学经常在AFM中鉴定出高水平的CSF EV特异性抗体，这为非脊髓灰质炎EV在AFM中的因果作用提供了进一步的证据。
研究人员介绍，自2012年以来，美国小儿AFM出现了两年一度的飙升。流行病学证据表明，非脊髓灰质炎性EV是一种潜在病因，但在CSF中很少检测到EV RNA。
附：英文原文
Title:Pan-viral serology implicates enteroviruses in acute flaccid myelitis
Author:Ryan D. Schubert, Isobel A. Hawes, Prashanth S. Ramachandran, Akshaya Ramesh, Emily D. Crawford, John E. Pak, Wesley Wu, Carly K. Cheung, Brian D. O’Donovan, Cristina M. Tato, Amy Lyden, Michelle Tan, Rene Sit, Gavin A. Sowa, Hannah A. Sample, Kelsey C. Zorn, Debarko Banerji, Lillian M. Khan, Riley Bove, Stephen L. Hauser, Amy A. Gelfand, Bethany L. Johnson-Kerner, Kendall Nash, Kalpathy S. Krishnamoorthy, Tanuja Chitnis, Joy Z. Ding, Hugh J. McMillan, Charles Y. Chiu, Benjamin Briggs, Carol A. Glaser, Cynthia Yen, Victoria Chu, Debra A. Wadford, Samuel R. Dominguez, Terry Fei Fan Ng, Rachel L. Marine, Adriana S. Lopez, W. Allan Nix, Ariane Soldatos, Mark P. Gorman, Leslie Benson, Kevin Messacar, Jennifer L. Konopka-Anstadt, M. Steven Oberste, Joseph L. DeRisi & Michael R. Wilson
Issue&Volume:21 October 2019
Abstract:
Since 2012, the United States of America has experienced a biennial spike in pediatric acute flaccid myelitis (AFM)1,2,3,4,5,6. Epidemiologic evidence suggests non-polio enteroviruses (EVs) are a potential etiology, yet EV RNA is rarely detected in cerebrospinal fluid (CSF)2. CSF from children with AFM (n = 42) and other pediatric neurologic disease controls (n = 58) were investigated for intrathecal antiviral antibodies, using a phage display library expressing 481,966 overlapping peptides derived from all known vertebrate and arboviruses (VirScan). Metagenomic next-generation sequencing (mNGS) of AFM CSF RNA (n = 20 cases) was also performed, both unbiased sequencing and with targeted enrichment for EVs. Using VirScan, the viral family significantly enriched by the CSF of AFM cases relative to controls was Picornaviridae, with the most enriched Picornaviridae peptides belonging to the genus Enterovirus (n = 29/42 cases versus 4/58 controls). EV VP1 ELISA confirmed this finding (n = 22/26 cases versus 7/50 controls). mNGS did not detect additional EV RNA. Despite rare detection of EV RNA, pan-viral serology frequently identified high levels of CSF EV-specific antibodies in AFM compared with controls, providing further evidence for a causal role of non-polio EVs in AFM.
DOI:10.1038/s41591-019-0613-1
Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：87.241
官方网址：https://www.nature.com/nm/
投稿链接：https://mts-nmed.nature.com/cgi-bin/main.plex
本期文章：《自然—医学》：Online/在线发表
