Key result
Enterovirus 71 antigens in neural pathways link peripheral nerves to viral CNS invasion.
Why the study?
Enterovirus 71 is a major pathogen causing hand, foot, and mouth disease with fatal encephalomyelitis in children, but its pathogenesis remains elusive.
How does Enterovirus 71 enter the central nervous system in fatal encephalomyelitis in children?
Observational (n=6)
How does Enterovirus 71 enter the central nervous system in fatal encephalomyelitis in children?
EV71 can enter the central nervous system through peripheral sensory and autonomic pathways via retrograde axonal transport, in addition to the major motor pathway.
Answers are grounded in this paper and cite their sources.
Autopsy data on EV71 encephalomyelitis may aid recognition of severe neurologic disease; leaves open precise cellular tropism and therapeutic targets.
OBJECTIVES: Enterovirus 71 (EV71) is the major pathogen of hand, foot, and mouth disease and can cause death; however, its pathogenesis remains elusive. METHODS: We performed a detailed systematic histopathologic examination and molecular studies on six autopsy cases of EV71 infection using H&E, immunohistochemistry, double immunofluorescence staining, and nested reverse transcription polymerase chain reaction. RESULTS: Characteristic features of acute encephalomyelitis were observed. Viral antigens were mainly detected in neuronal cytoplasm and processes in the different brainstem nuclei and spinal cord, including the anterior and posterior horn cells. Viral antigens were also positive in the nerve roots of spinal cord and autonomic ganglia of intestines. CONCLUSIONS: Our study revealed direct pathologic evidence supporting viral entry into the central nervous system (CNS) through peripheral nerves. In addition to the major motor pathway, EV71 can also enter the CNS via peripheral sensory and autonomic pathways in retrograde axonal transport.
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Xing et al. (2016) conducted an observational in Fatal encephalomyelitis caused by Enterovirus 71 (EV71) infection (n=6). Enterovirus 71 (EV71) infection was evaluated on Histopathologic features and viral antigen localization. Enterovirus 71 antigens were detected in brainstem nuclei, spinal cord, nerve roots, and autonomic ganglia, supporting viral entry into the CNS via peripheral sensory, autonomic, and motor pathways.
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