Evidence of presence of poliovirus genomic sequences in cerebrospinal fluid from patients with postpolio syndrome

Abstract

The postpolio syndrome (PPS) is characterized by new neuromuscular symptoms occurring 30 to 40 years after the acute episode of poliomyelitis paralysis. The presence of the poliovirus RNA genome in the cerebrospinal fluid from 10 patients with PPS and from 23 control patients was sought by using reverse transcription and a PCR specific for polioviruses and/or other enteroviruses. Poliovirus-specific genomic sequences in the 5 untranslated region and in the capsid region (VP1) were detected by reverse transcription PCR in 5 of 10 patients with PPS but in none of the control patients. Sequencing confirmed the presence of mutated poliovirus sequences. This finding suggests persistent viral infection in the central nervous system related to the presence of poliovirus genomes.

Postpolio syndrome and the late effects of poliomyelitis. Part 1. pathogenesis, biomechanical considerations, diagnosis, and investigations

“…52 Subsequent studies demonstrated the presence of the poliovirus RNA genome in the CSF in a number of patients with PPS. 14,[53][54][55][56][57] However, several other studies that included evaluation of CSF, skeletal muscle biopsy, and postmortem CNS tissue either did not demonstrate any evidence of poliovirus RNA or a poliovirus-specific immunoglobulin (Ig) M antibody response in patients with strictly defined PPS or demonstrated no association with the laboratory findings and the late functional decline in postpolio patients. [58][59][60][61] Thus, because of the lack of consistent results reported in the research literature, the role of potential poliovirus persistence or reactivation in the pathogenesis of PPS is currently unclear, and, at this point, it does not appear to be the singular cause of this condition.…”

Human Astrocytic Cells Support Persistent Coxsackievirus B3 Infection

“…EV infections can also persist long after the initial infection in vivo as well as in vitro. Emerging evidence suggests that EV persistence is associated with a variety of chronic diseases, such as myalgic encephalomyelitis/chronic fatigue syndrome (10), dilated cardiomyopathy (11,12), and postpolio syndrome (PPS) (13,14), in clinical settings. Although a number of cell models of EV persistence, including human thymic epithelial cells (15,16), microvascular endothelial cells (17), myocardial fibroblasts (18)(19)(20), glomerular and tubular kidney cells (21), as well as murine cardiac cells (22), have been described, the mechanisms responsible for EV persistence remain to be fully addressed.…”

“…Virological evidence indicates that EVs may also persist in the human CNS. For instance, the detection of persistent viral RNA in brain tissue or cerebrospinal fluid implicates a close association of EVs with the late onset of neurological deterioration, exemplified by the development of PPS and amyotrophic lateral sclerosis (ALS) (14,31,32).…”

Enteroviruses and the risk of MS in the Finnish Twin Cohort

“…Recently, latent EV RNA has been reported to be present in patients with varying autoimmune disorders such as diabetes mellitus (Hyo¨ty et al, 1995), chronic fatigue syndrome (Clements et al, 1995), chronic myocarditis (Heim et al, 1997) and post-polio syndrome (Leparc-Goffart et al, 1996). Thus, these observations suggest a connection between EV infection and autoimmunity.…”

“…According to the current hypothesis viral infections during early life in genetically susceptible individuals can distort immune homeostatis towards development of autoreactive T cells, which can lead to the clinical MS over time (Hunter and Hafler, 2000). Recent studies have suggested the role of enteroviruses in various autoimmune diseases (Clements et al, 1995;Hyo¨ty et al, 1995;Leparc-Goffart et al, 1996;Heim et al, 1997) and also amyotrophic lateral sclerosis (ALS) (Berger et al, 2000;Giraud et al, 2001).…”