ABSTRACT
OBJECTIVE: Intrathecal measles(M)- rubella(R)- and varicella zoster(Z)-antibody synthesis in German and Cuban multiple sclerosis (MS) patients are compared considering the different rubella epidemiology in the tropics. PATIENTS AND METHODS: Twenty-three Cuban MS patients with a representative age distribution and gender ratio like the group of 177 German MS patients were analysed for albumin, IgG, IgA IgM, oligoclonal IgG and MRZ- antibodies in cerebrospinal fluid (CSF) and serum. RESULTS: Cuban MS patients show similar CSF data patterns like German patients and high frequencies of intrathecal measles- (78/78%) and varicella zoster- (59/55%) antibody synthesis correspondingly. A lower frequency of intrathecal rubella antibody synthesis (rubella-AI >or= 1.5) in Cuban patients (30%, gender ratio of increased rubella - AI m:f = 1:6) compared with German patients (60%, m:f = 1:1.8) is explained by low incidence of rubella infections in Cuba. Only about 10% of the male population (not immunized before 1986, in contrast to females) had rubella antibodies compared to at least 60% in a European male population, representing the relation of increased rubella-AI in male MS patients. CONCLUSION: In MS the frequency of intrathecal antibody synthesis is limited by the fraction of seropositives in the population. Natural infection or vaccination are a necessary and equivalent precondition contributing to the arguments against microorganisms as a cause of MS.
Subject(s)
Antibodies, Viral/cerebrospinal fluid , Immunization/statistics & numerical data , Measles virus/immunology , Measles/immunology , Multiple Sclerosis , Adult , Age Distribution , Antibodies, Viral/blood , Cuba/ethnology , Encephalitis, Varicella Zoster/immunology , Female , Germany/epidemiology , Herpesvirus 3, Human/immunology , Humans , Immunoglobulin A/blood , Immunoglobulin A/cerebrospinal fluid , Immunoglobulin G/blood , Immunoglobulin G/cerebrospinal fluid , Immunoglobulin M/blood , Immunoglobulin M/cerebrospinal fluid , Male , Middle Aged , Multiple Sclerosis/epidemiology , Multiple Sclerosis/immunology , Multiple Sclerosis/virology , Rubella/immunology , Rubella virus/immunology , Seroepidemiologic Studies , Sex DistributionABSTRACT
A 2-year-old girl with recurrent severe varicella infections had a fatal outcome. Studies of cellular and humoral immunity were normal. No natural killer (NK) cells were detected, and NK activity was markedly decreased. The interleukin (IL)15/IL15R signaling pathway was intact. This case emphasizes the role of NK cells in controlling herpes viral infection.
Subject(s)
Chickenpox/immunology , Encephalitis, Varicella Zoster/immunology , Killer Cells, Natural/immunology , Fatal Outcome , Female , Herpesvirus 3, Human , Humans , Infant , Killer Cells, Natural/physiology , RecurrenceABSTRACT
Varicella-zoster virus (VZV) reactivation in the brain caused encephalitis in a 2-year-old immunocompetent child who had chickenpox 20 months before. Radiologic findings were consistent with large to medium-vessel-vasculitis. VZV-DNA was detected in cerebrospinal fluid. Early acquisition of VZV may predispose to major neurologic complications that can occur years after the primary infection.