Projection neurons are preferentially affected in West Nile viral encephalitis: Case series and review of mechanisms of neuroinvasion and toxicity in a setting of solid organ transplant.

West Nile virus (WNV) is an emerging human pathogen responsible for a systemic disease with generally indolent clinical course in immunocompetent hosts. Solid organ transplant recipients are vulnerable to WNV-induced encephalitis (WNVE) with no effective treatment and high mortality. We systematically assess various nuclei of the central nervous system in two human autopsy cases of WMVE using in situ hybridization (ISH) in combination with immunohistochemistry (IHC). We identify several types of projection neurons as exclusively affected in WNVE. Cellular and molecular mechanisms of anti-viral innate immunity are reviewed in respect to immunosuppression in solid organ transplant setting.