Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis

mBio

Nischay Mishra¹  James Ng¹  Adam Price¹  Riddhi Thakkar¹  W. Ian Lipkin¹  Thomas Briese¹  Komal Jain¹  Adrian Caciula¹  Joel A. Garcia¹  Rafal Tokarz¹  Jane C. Burns²  Kiran T. Thakur³  Rachel L. Marine⁴  Kimbell L. Hetzler⁴  W. Allan Nix⁴  M. Steven Oberste⁴  Jennifer L. Konopka-Anstadt⁴  Janell A. Routh⁴  Terry Fei Fan Ng⁴ 

[1] Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, USA;Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California, USA;Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia Irving University Medical Center, New York, New York, USA;Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

关键词: VirCapSeq-VERT;    acute flaccid myelitis;    antibodies;    enterovirus;    enterovirus D-68;    peptide array;   

DOI  :  10.1128/mBio.01903-19

来源: DOAJ

【 摘 要 】

ABSTRACT Acute flaccid myelitis (AFM) has caused motor paralysis in >560 children in the United States since 2014. The temporal association of enterovirus (EV) outbreaks with increases in AFM cases and reports of fever, respiratory, or gastrointestinal illness prior to AFM in >90% of cases suggest a role for infectious agents. Cerebrospinal fluid (CSF) from 14 AFM and 5 non-AFM patients with central nervous system (CNS) diseases in 2018 were investigated by viral-capture high-throughput sequencing (VirCapSeq-VERT system). These CSF and serum samples, as well as multiple controls, were tested for antibodies to human EVs using peptide microarrays. EV RNA was confirmed in CSF from only 1 adult AFM case and 1 non-AFM case. In contrast, antibodies to EV peptides were present in CSF of 11 of 14 AFM patients (79%), significantly higher than controls, including non-AFM patients (1/5 [20%]), children with Kawasaki disease (0/10), and adults with non-AFM CNS diseases (2/11 [18%]) (P = 0.023, 0.0001, and 0.0028, respectively). Six of 14 CSF samples (43%) and 8 of 11 sera (73%) from AFM patients were immunoreactive to an EV-D68-specific peptide, whereas the three control groups were not immunoreactive in either CSF (0/5, 0/10, and 0/11; P = 0.008, 0.0003, and 0.035, respectively) or sera (0/2, 0/8, and 0/5; P = 0.139, 0.002, and 0.009, respectively). IMPORTANCE The presence in cerebrospinal fluid of antibodies to EV peptides at higher levels than non-AFM controls supports the plausibility of a link between EV infection and AFM that warrants further investigation and has the potential to lead to strategies for diagnosis and prevention of disease.

【 授权许可】

Unknown